[Senate Hearing 117-234]
[From the U.S. Government Publishing Office]


                                                       S. Hrg. 117-234

                      NOMINATION OF XAVIER BECERRA

=======================================================================

                                HEARING

                               BEFORE THE

                          COMMITTEE ON FINANCE
                          UNITED STATES SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             FIRST SESSION

                                 ON THE

                             NOMINATION OF

                    XAVIER BECERRA, TO BE SECRETARY,
                DEPARTMENT OF HEALTH AND HUMAN SERVICES

                               __________

                           FEBRUARY 24, 2021

                               __________

                                     
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]                                     

            Printed for the use of the Committee on Finance

                              __________

                    U.S. GOVERNMENT PUBLISHING OFFICE                    
47-302 PDF                 WASHINGTON : 2022                     
          
-----------------------------------------------------------------------------------   

                          COMMITTEE ON FINANCE

                      RON WYDEN, Oregon, Chairman

DEBBIE STABENOW, Michigan            MIKE CRAPO, Idaho
MARIA CANTWELL, Washington           CHUCK GRASSLEY, Iowa
ROBERT MENENDEZ, New Jersey          JOHN CORNYN, Texas
THOMAS R. CARPER, Delaware           JOHN THUNE, South Dakota
BENJAMIN L. CARDIN, Maryland         RICHARD BURR, North Carolina
SHERROD BROWN, Ohio                  ROB PORTMAN, Ohio
MICHAEL F. BENNET, Colorado          PATRICK J. TOOMEY, Pennsylvania
ROBERT P. CASEY, Jr., Pennsylvania   TIM SCOTT, South Carolina
MARK R. WARNER, Virginia             BILL CASSIDY, Louisiana
SHELDON WHITEHOUSE, Rhode Island     JAMES LANKFORD, Oklahoma
MAGGIE HASSAN, New Hampshire         STEVE DAINES, Montana
CATHERINE CORTEZ MASTO, Nevada       TODD YOUNG, Indiana
ELIZABETH WARREN, Massachusetts      BEN SASSE, Nebraska
                                     JOHN BARRASSO, Wyoming

                    Joshua Sheinkman, Staff Director

                Gregg Richard, Republican Staff Director

                                  (ii)


                            C O N T E N T S

                              ----------                              

                           OPENING STATEMENTS

                                                                   Page
Wyden, Hon. Ron, a U.S. Senator from Oregon, chairman, Committee 
  on Finance.....................................................     1
Crapo, Hon. Mike, a U.S. Senator from Idaho......................     3

                        CONGRESSIONAL WITNESSES

Feinstein, Hon. Dianne, a U.S. Senator from California...........     5
Padilla, Hon. Alex, a U.S. Senator from California...............     6

                         ADMINISTRATION NOMINEE

Becerra, Hon. Xavier, nominated to be Secretary, Department of 
  Health and Human Services, Washington, DC......................     8

               ALPHABETICAL LISTING AND APPENDIX MATERIAL

Becerra, Hon. Xavier:
    Testimony....................................................     8
    Prepared statement...........................................    55
    Biographical information.....................................    56
    Responses to questions from committee members................    77
Crapo, Hon. Mike:
    Opening statement............................................     3
    Prepared statement with attachment...........................   137
Feinstein, Hon. Dianne:
    Testimony....................................................     5
Lankford, Hon. James:
    Submissions for the record...................................   142
Padilla, Hon. Alex:
    Testimony....................................................     6
Wyden, Hon. Ron:
    Opening statement............................................     1
    Prepared statement with attachments..........................   146
Young, Hon. Todd:
    Submissions for the record...................................   226

                             Communications

Alcala, Cassandra................................................   229
California Hospital Association..................................   235
Evans, Patrick J.................................................   235
Hispanas Organized for Political Equality........................   239
National Hispanic Medical Association............................   240
National Human Services Assembly.................................   241
Taffe, Anne C....................................................   242

                                 (iii)

 
                     NOMINATION OF XAVIER BECERRA,
                     TO BE SECRETARY, DEPARTMENT OF
                       HEALTH AND HUMAN SERVICES

                              ----------                              


                      WEDNESDAY, FEBRUARY 24, 2021

                                       U.S. Senate,
                                      Committee on Finance,
                                                    Washington, DC.
    The WebEx hearing was convened, pursuant to notice, at 2:08 
p.m., Dirksen Senate Office Building, Hon. Ron Wyden (chairman 
of the committee) presiding.
    Present: Senators Stabenow, Cantwell, Menendez, Carper, 
Cardin, Brown, Bennet, Casey, Whitehouse, Cortez Masto, Warren, 
Crapo, Grassley, Thune, Toomey, Cassidy, Lankford, Daines, 
Young, Sasse, and Barrasso.
    Also present: Democratic staff: Ian Nicholson, Investigator 
and Nominations Advisor; and Joshua Sheinkman, Staff Director. 
Republican staff: Kellie McConnell, Health Policy Director; 
Gregg Richard, Staff Director; Jeffrey Wrase, Deputy Staff 
Director and Chief Economist; and Nicholas Wyatt, Tax, 
Infrastructure, and Nominations Policy Advisor.

   OPENING STATEMENT OF HON. RON WYDEN, A U.S. SENATOR FROM 
             OREGON, CHAIRMAN, COMMITTEE ON FINANCE

    The Chairman. The meeting will come to order.
    Colleagues, this is nominations week here in the Senate 
Finance Committee. This is the second of three nominations 
hearings, and we are very pleased to be able to welcome 
Attorney General Xavier Becerra, President Biden's nominee to 
lead the Department of Health and Human Services.
    With the pandemic raging, so many Americans are struggling 
to get by, and our health-care system is strained to the max. 
There may not be a higher-stakes job in the executive branch 
outside the President.
    Attorney General Becerra brings more than 2 decades of 
experience in the Congress. He was a senior member of the House 
Ways and Means Committee, which overlaps this committee on many 
important health issues. He was closely involved in major 
accomplishments on health care, including the Affordable Care 
Act. For 4 years, he has led the second largest department of 
justice in America, overseeing thousands of employees and a 
billion-dollar budget. Anybody who discounts the experience of 
leading a California agency that large and influential to the 
fifth largest economy in the world is straining awfully hard to 
find something to critique.
    The Attorney General defended the Affordable Care Act from 
absurd and dangerous far-right attacks. When the pandemic hit, 
he went to bat for Californians by increasing access and 
affordability for COVID treatments, protecting workers from 
exposure, and securing key safeguards for front-line health-
care workers.
    Having started my career in legal aid for senior citizens, 
as a co-founder of the Oregon Gray Panthers, I appreciate the 
Attorney General got his start in legal aid for the less 
fortunate. This is a nominee with the right policy experience, 
the right leadership experience, and the right experience 
fighting for people without power. That is exactly what is 
needed at the Department of Health and Human Services, after 4 
years of management that took America in the wrong direction.
    Now in this committee, a special focus of our work is going 
to be tackling inequality in every form. In America, inequality 
is a killer. If you did not believe it before the pandemic, 
there can be no questioning it today. People of modest means, 
people targeted by discrimination, people marginalized in 
society, they are the Americans who have suffered 
disproportionately in the pandemic. That is because they were 
vulnerable before the pandemic, and Federal policy did not do 
enough to protect them.
    I will pick through a few examples. First, Americans are 
getting clobbered every time they walk up to the pharmacy 
window to pick up their prescription drugs. In a country as 
wealthy as ours, it is shameful that you still hear about 
people rationing their own medicine and suffering terrible 
consequences because they cannot afford their medicine.
    Second, the pandemic has proven there needs to be a new 
focus on mental health in America. With so many lives lost and 
so many people out of work, it should not be a surprise that 
people in Oregon and across the country are struggling when it 
comes to mental health care. Compared to physical health 
issues, mental health has gotten short shrift for far too long. 
Now the laws say they are equally important, but I will tell 
you, that is often not the way it is handled in the real world. 
That needs to be changed. We are going to talk some more about 
it this afternoon.
    Third, the pandemic has shined a spotlight on many long-
running disparities in health care in the country, many of them 
that stretch back generations. One of them is maternal health 
care. The American people want this to be a pro-family Nation. 
It is totally unacceptable that pregnancy and childbirth in the 
postpartum period are so dangerous to American women, 
particularly when you compare our country to wealthy nations. 
This is especially serious for black and Native American women, 
and it is getting worse as the years go by. In fact, here is a 
shocking statistic. Women today are more likely to die in 
childbirth than their mothers were a generation ago. Addressing 
the crisis goes hand-in-hand with the need to expand and 
improve women's health care overall, since the last 4 years 
have been a women's health nightmare.
    I am looking forward to working with the Attorney General 
in the Biden administration on these issues, and more. It has 
been a difficult 4 years for too many vulnerable Americans who 
struggle to pay for medicine and secure health care. If AG 
Becerra and his team start every day actually focusing on 
expanding health care and improving health services instead of 
limiting them, they will already be doing better than the last 
administration.
    This is a nominee who is highly qualified. He has had a 
valuable range of experience that will help him succeed in this 
job, and this is a historic nomination because the Attorney 
General would be the first Latino Secretary of Health and Human 
Services.
    Finally, I want to congratulate him on a late-breaking 
development. Today, he won in Federal court, defending 
California's net-neutrality law. And I see the chair of the 
Commerce Committee, who has done so much on that issue, and we 
are looking forward to seeing the Attorney General score more 
wins for the American people.
    With that, let me recognize our friend, Ranking Member 
Senator Crapo, for his opening statement.
    [The prepared statement of Chairman Wyden appears in the 
appendix.]

             OPENING STATEMENT OF HON. MIKE CRAPO, 
                   A U.S. SENATOR FROM IDAHO

    Senator Crapo. Thank you very much, Senator Wyden. Welcome, 
Attorney General Becerra.
    The Department of Health and Human Services is a sprawling 
department, with over 80,000 employees and responsibility for 
over $1 trillion in annual spending. HHS and its agencies 
directly affect everyday life, including running programs that 
provide health-care coverage to nearly 150 million people. The 
HHS Secretary will shape Medicare and Medicaid, Obamacare, and 
many other important programs in the Finance Committee's 
jurisdiction. These responsibilities are formidable in normal 
times, but the COVID-19 pandemic has made the HHS mission even 
more critical, as these programs will play a key role in the 
pandemic response.
    This hearing is important for us to understand how Attorney 
General Becerra would carry out these monumental 
responsibilities. A few weeks ago, I outlined several issues in 
the health-care space where I intend to focus my efforts as 
ranking member, including fostering innovation to improve 
patient care and making our health-care system more efficient. 
The COVID-19 pandemic has threatened Americans' physical and 
economic health, but it has also reinforced the value of 
innovation and provided an opportunity to test changes that 
foster it.
    HHS has used its authority under the public health 
emergency to waive numerous requirements to ensure Medicare 
beneficiaries and other patients receive care during the 
pandemic. Patients have benefited from expanded access to 
telehealth and expedited approval of COVID-19 vaccines, 
diagnostics, and treatment. Going forward, Medicare and 
Medicaid patients should have the same access to those 
innovative items and services as those with commercial 
insurance.
    We must carefully evaluate our response to the pandemic and 
implement appropriate reforms based on the lessons we have 
learned. HHS should partner with this committee in that effort.
    Another long-term priority for many on this committee is to 
finally address Medicare's looming financial problems. 
Medicare's financial stability was a key issue discussed by the 
bipartisan Bowles-Simpson Commission, on which I served with 
Attorney General Becerra a decade ago.
    Although the Commission's proposal did not reach the 
required super-majority of 14 out of 18 votes for adoption, it 
did produce a constructive bipartisan blueprint to reform and 
secure our entitlement programs. Medicare's finances remain 
unsettled, with the Medicare trustees currently projecting that 
the hospital insurance trust fund will go broke in 2026. And 
unforeseen circumstances could move the insolvency date even 
closer.
    The new administration should work with Congress in a 
bipartisan way to ensure that Medicare is able to serve current 
and future beneficiaries. In yesterday's hearing before the 
HELP Committee, many of my colleagues raised concerns about the 
enforcement of California's restrictive actions related to 
COVID-19, including the ban on indoor religious services that 
was rejected by the Supreme Court.
    They also raised questions about challenges to HHS's 
authority to provide a conscience exemption from the Obamacare 
contraception coverage mandate. A coalition of pro-life 
Americans sent a letter to all Senators in opposition to the 
nomination of Xavier Becerra to be Secretary of Health and 
Human Services.
    And, Mr. Chairman, I ask that that letter be included as a 
part of the record.
    The Chairman. Without objection, so ordered.
    [The letter appears in the appendix on p. 138.]
    Senator Crapo. Nearly a year ago, the committee worked 
together to expand unemployment compensation in response to the 
economic devastation caused to workers by shutdowns. As time 
has passed, there has been substantial reporting of fraud 
perpetrated against California's unemployment insurance 
program. Fraudsters, including international criminal 
organizations, have siphoned off perhaps more than $11 billion. 
That raises questions regarding what specific steps were taken 
to combat unemployment fraud, and when those steps were taken.
    Finally, Attorney General Becerra, you have long been an 
advocate for moving all Americans to a government-run Medicare-
for-All plan, raising concerns with me that your policy 
preferences could undermine the Medicare programs that rely on 
private insurance. You and I have talked about this privately, 
and I will discuss it further with you during the question 
period. I strongly support private insurance so patients can 
choose the coverage option that best meets their need.
    The popular Medicare Advantage program that covers 24 
million beneficiaries must be allowed to continue to thrive. 
And the successful Medicare Part B program must continue to 
serve its 47 million enrollees without government interference. 
The number of issues I have raised indicate the scope and 
importance of this position, and I look forward to hearing your 
testimony and your responses to questions. Thank you.
    [The prepared statement of Senator Crapo appears in the 
appendix.]
    The Chairman. I thank my colleague. We are going to have a 
big debate on that, on how the Department of Labor handles 
unemployment, and we are going to talk through all of these 
issues, I am sure.
    Now we have the senior Senator from California, Senator 
Feinstein, who is here for an introduction of the nominee, and 
we welcome her for her comments.

              STATEMENT OF HON. DIANNE FEINSTEIN, 
                 A U.S. SENATOR FROM CALIFORNIA

    Senator Feinstein. Thank you very much, Mr. Chairman and 
Ranking Member Crapo. Thank you for the opportunity to appear 
before the committee to introduce California's Attorney General 
Xavier Becerra as President Biden's nominee to be Secretary of 
Health and Human Services.
    I am so proud to have known this man as both a friend and a 
colleague. He spent decades serving our State, currently as the 
State's Attorney General, and previously as a 12-term 
Congressman from Los Angeles.
    Mr. Becerra was the first in his family to receive a 4-year 
college degree, earning his bachelor of arts in economics from 
the University we share, which is Stanford, and later his J.D. 
from Stanford Law School.
    As a member of the House of Representatives, he was a 
strong advocate for the health care of his constituents, and he 
fought to make the Affordable Care Act law. As California's 
Attorney General, he has been a staunch defender of the 
Affordable Care Act, leading 20 States and the District of 
Columbia in defense of the Act before the Supreme Court.
    As part of his focus on protecting the health of Americans, 
Mr. Becerra worked with Nebraska Attorney General Doug 
Peterson, a Republican, to lead a bipartisan coalition of 43 
Attorneys General to reduce youth exposure to tobacco products 
like e-cigarettes, which we have all become very concerned 
about, and which continue to pose significant health risks to 
children.
    He has also worked on a bipartisan basis with multi-State 
coalitions of Attorneys General on health priorities that align 
with the work of this committee, which includes increasing 
access to COVID-19 treatments, as well as addressing the opioid 
epidemic and the considerable harm it has caused to families.
    As our State's Attorney General, AG Becerra led the 
Nation's second-largest Department of Justice, behind only the 
U.S. Department of Justice. So he is skilled, and just 
extraordinarily good. As Secretary, he will lead the Nation's 
top health agency charged with enhancing the health and well-
being of all Americans.
    In this global pandemic, he will hopefully play a lead role 
in overseeing the implementation of President Biden's national 
strategy for COVID-19 response, which is integral to defeating 
the virus that has plagued our country for far too long.
    His history-making nomination as the first Latino to manage 
this department comes at a time when this pandemic is effecting 
communities of color at much higher rates than white Americans. 
And those of us who know him personally know the level of his 
concern, and the strength of his dedication to protecting the 
health and safety of all hardworking Americans and their 
families.
    I deeply believe--and I have had the privilege of making 
this statement to another committee as well--that Xavier 
Becerra is the right candidate to lead the Department of Health 
and Human Services at this time, and I would give my strongest 
recommendation to this committee to approve his nomination.
    And, Mr. Chairman, it is good to see you again after this 
morning's hearing, and I am grateful to be here. Thank you so 
much.
    The Chairman. Thank you very much, Senator Feinstein. We 
are very pleased to have you here. And I would also like to 
note that California now has 100 percent of their United States 
Senators here for the launch of the nomination of the AG. And 
we welcome our new colleague, Senator Padilla.

                STATEMENT OF HON. ALEX PADILLA, 
                 A U.S. SENATOR FROM CALIFORNIA

    Senator Padilla. Thank you, Chairman Wyden, Ranking Member 
Crapo, for inviting me to address this committee today to 
introduce my friend, California Attorney General Xavier 
Becerra.
    As we recognized in yesterday's HELP Committee hearing, our 
Nation is going through one of the toughest times we have faced 
in recent memory. The COVID-19 pandemic has taken an incredible 
toll on our lives and our communities across the United States.
    COVID-19 deaths in the United States just surpassed 
500,000, a grim milestone for our country. As has been 
referenced, the devastation has disproportionately impacted 
working-class families and communities of color, very similar 
to the communities that both Attorney General Becerra and I 
grew up in.
    These communities are hurting and dying at alarming rates, 
and they desperately need someone who knows these communities 
at their core. The Los Angeles Times published an article this 
past Saturday documenting the disparity in vaccination rates 
across, in this particular case, Los Angeles County, where 
wealthy neighborhoods like Beverly Hills are receiving vaccines 
at five times the rate of predominantly minority communities 
such as south Los Angeles. And that is why I am honored to 
introduce Attorney General Becerra today as the nominee for 
Secretary of the Department of Health and Human Services.
    If confirmed, Attorney General Becerra will be the first 
Latino Secretary of Health and Human Services, an honor I know 
that he will not take lightly. Throughout his upbringing and 
time as a public servant, Xavier has shown his passion for 
people and his commitment to improving the lives of those he 
represents.
    His parents immigrated from Mexico, just like my parents 
did, with the dream of building a better life for themselves 
and their family. As has been noted, Xavier received his 
undergraduate and law degrees from Stanford University. And 
while at Stanford, he met his wife, Dr. Carolina Reyes, a 
widely respected obstetrician who helps care for women with 
high-risk pregnancies in under-served communities.
    Xavier's first job out of law school was working with 
individuals with mental health disorders, a health issue that 
is too often overlooked, especially in communities of color. He 
was elected to Congress in 1992, where he quickly gained and 
maintained a reputation for being a strong supporter of 
reproductive health, protections for seniors, mental health 
parity, and the Children's Health Insurance Program, also known 
as CHIP.
    Xavier was instrumental in both the drafting and the 
passing of the Affordable Care Act, which has helped provide 
access to quality health care for millions of previously 
uninsured Americans, and his work did not stop there.
    As Attorney General of California, he has made it his 
mission to tackle structural inequalities within our health-
care system. He has been the leading force behind a lawsuit to 
protect the Affordable Care Act, and to maintain the 
protections for people with preexisting conditions and for 
those suffering from a mental illness.
    Over the past year, Attorney General Becerra fought to 
protect front-line health-care workers from further exposure to 
COVID-19, and he stood up for homeowners struggling to meet 
their mortgage payments.
    Now, while I understand the politics of the moment may 
compel some to try and paint a distorted picture of Attorney 
General Becerra, let me point out that many of you have worked 
with him for decades here in Congress. Republicans and 
Democrats know Xavier Becerra to be a thoughtful, open-minded 
leader, and always willing to listen to both sides.
    It appears to me, as it appears to many, that he is being 
held to a much different standard than some of the nominees 
that this Senate has supported and confirmed over the last 4 
years.
    Let me say this: both Attorney General Becerra and I, 
throughout our careers, have too often been the only Latino in 
the room. Sadly, Xavier and I are not unfamiliar with being 
held to different standards. But, members of the committee, 
Xavier Becerra is a proven leader who is uniquely qualified to 
take on the challenges of this moment, and I urge the committee 
to support his nomination. Thank you.
    The Chairman. Senator, thank you very much. And we are very 
glad that you are here today. And I would say to you and 
Senator Feinstein, thank you both for your statements. We know 
you have very busy schedules, and feel free to depart should 
you wish to.
    Senator Feinstein. Thank you.
    The Chairman. Thank you both.
    Let me also--one other item of business before we turn to 
the nominee for his opening statement. I am going to take a 
quick moment to enter a number of letters of support into the 
hearing record for Secretary-Designate Becerra. As of this 
morning, the Finance Committee has received 77 letters of 
support for Mr. Becerra from a wide range of groups and 
stakeholders representing patients and nurses and doctors and 
public health advocates, civil rights groups, and many more. 
Without objection, I would like to make those materials part of 
today's hearing record.
    [The letters appear in the appendix beginning on p. 147.]
    The Chairman. And with that, Attorney General Becerra, we 
welcome you, and we look forward to your opening statement.

 STATEMENT OF HON. XAVIER BECERRA, NOMINATED TO BE SECRETARY, 
    DEPARTMENT OF HEALTH AND HUMAN SERVICES, WASHINGTON, DC

    Mr. Becerra. Mr. Chairman, and to Ranking Member Crapo and 
members of the committee, thank you for this opportunity to 
speak to you. To my good friends Senator Feinstein and Senator 
Padilla, I thank them as well for their gracious introductions.
    I want to thank my family, if I may begin by doing that. 
Dr. Carolina Reyes, who has been my long-term partner--I call 
her my north star--she is here with me, and our three 
daughters, Natalia, Olivia, and Clarisa, and Clarisa's husband 
Ivan. Everything I do, including this, is a family affair. And 
I know I am here because my parents, Manuel and Maria, who had 
only their health and their hope when they settled in 
Sacramento, CA, taught me to earn the American Dream.
    A construction worker with a sixth grade education and a 
clerical worker who arrived from Guadalajara, Jalisco, Mexico, 
they never saw the inside of a college classroom, but they sent 
all their kids to one, or to the military. We lost my Dad last 
year, on New Year's Day, and when the end came, my Dad knew we 
were there with him at his side in our home. Sadly, hundreds of 
thousands of Americans have not had closure this past year.
    That, Senators, is why I am here today. The COVID pandemic 
has killed more than 500,000 Americans, many of them alone 
without their families. Millions more have lost their jobs and 
their health care. That is not the America my parents would 
believe possible.
    To meet this moment, we need strong Federal leadership. 
That is what President Biden is demonstrating, and if I am 
fortunate to be confirmed, I look forward to joining the 
President in his critical mission. I understand the enormous 
challenges before us and our solemn responsibility to be 
faithful stewards of an agency that touches almost every aspect 
of our lives. I am humbled by the task, and I ready for it.
    The mission of HHS to enhance the health and well-being of 
all Americans is core to who I am. When I was a child, my mom 
had a health scare. She was rushed to the hospital after 
hemorrhaging at home. The image is seared in my memory. We were 
lucky. My mom is now 87 years young. Better put, we were 
blessed. My Dad, the laborer, he had insurance through his 
union, Laborers' Local 185.
    We did not have much, but we did not have to face the 
threat of unpaid medical bills, or even bankruptcy. Over 2 
decades in Congress, I worked to ensure every family had the 
same insurance that my family had. I helped expand the 
Children's Health Insurance Program. I helped write and pass 
the Affordable Care Act.
    From the Ways and Means Committee, I fought to strengthen 
and modernize Medicare and how we finance it. As Attorney 
General, I created a health-care rights and access task force. 
We cracked down on Medicare and Medicaid fraud. I have worked 
to hold opioid manufacturers accountable for the addiction 
crisis. I have taken on hospitals and drug makers who unfairly 
jack up prices on patients. And I have protected patients' 
rights of privacy.
    If confirmed, I will work with you to continue this type of 
work and to address HHS's biggest challenges. And that of 
course starts with COVID. The President has ambitious goals: 
100 million vaccine shots in arms in his first 100 days, 
increasing access to testing, sequencing the virus to prepare 
for the variants, and reopening schools and businesses. HHS has 
a central role in meeting these goals safely and equitably.
    As Attorney General, I saw the importance of this on the 
front lines. I worked with colleagues in other States, both 
Republicans and Democrats, to make COVID treatments more 
readily available. I am ready to work with you, with our State 
and local partners, our tribal partners, our territorial 
partners, and across government, to get this right.
    Next, we must ensure that people have access to quality and 
affordable health care. If confirmed, I will work with you to 
strengthen our Medicare and Medicaid lifelines, to reduce the 
cost of health care and prescription drugs, and ensure we are 
accountable, spending resources wisely and effectively.
    And I will not forget the other ``H'' in HHS: Human 
Services. I want to work with you supporting our vulnerable 
children, those in foster care, strengthening Head Start, and 
expanding access to child care.
    Finally, we must restore faith in our public health 
institutions. That starts with putting science and the facts 
first and showing respect for a career workforce. No one 
understands your State and your communities better than you. We 
may not always agree, but if I am fortunate enough to be 
confirmed, I will always listen to you and keep an open mind. I 
will look for common cause, and I will work with you to improve 
the health and dignity of the American people.
    Thank you, Mr. Chairman, Ranking Member Crapo, and members, 
for this opportunity to share my vision.
    [The prepared statement of Mr. Becerra appears in the 
appendix.]
    The Chairman. Mr. Attorney General, thank you. And there 
are some obligatory questions that we ask nominees before we 
get into member questions.
    First, is there anything you are aware of in your 
background that might present a conflict of interest with the 
duties of the office to which you have been nominated?
    Mr. Becerra. No, Mr. Chairman.
    The Chairman. Second, do you know of any reason, personal 
or otherwise, that would in any way prevent you from fully and 
honorably discharging the responsibilities of the office to 
which you have been nominated?
    Mr. Becerra. No, Mr. Chairman.
    The Chairman. Do you agree, without reservation, to respond 
to any reasonable summons to appear and testify before any duly 
constituted committee of the Congress, if you are confirmed?
    Mr. Becerra. Yes, Mr. Chairman.
    The Chairman. Finally, do you commit to provide a prompt 
response in writing to any questions addressed to you by any 
Senator of this committee?
    Mr. Becerra. Certainly, Mr. Chairman.
    The Chairman. Okay, we will now begin, Mr. Attorney 
General, with 5-minute rounds of Senators. I will begin, and 
then Senator Crapo.
    I think we all understand that the COVID-19 pandemic has 
compounded the country's longstanding health disparities. The 
fact is, America really has two health-care systems. In the 
suburbs, often affluent white families have all kinds of 
incredible health care. That is a stark difference to areas 
where many more black or Latino families live. They really 
face, in many instances, a health-care desert. For those 
communities, long drives, long wait times, or a lack of health 
providers are enormous constraints.
    This is especially true when it comes to mental health. The 
United States has the worst record among similar countries. 
There is a statistic to remember. Women today are more likely 
to die in childbirth than their mothers. Women of color have 
borne the brunt of this tragedy. Black, American Indian, and 
Alaskan Native women are three times more likely to die of 
pregnancy-related complications than their white counterparts.
    So our first question is, do you agree that expanding 
Medicaid coverage from just 60 days to 12 months postpartum, as 
the House COVID-19 relief bill provides, is a necessary step to 
reverse this rising maternal mortality crisis?
    Mr. Becerra. Mr. Chairman, absolutely. And if my wife were 
allowed to say a few words, she would probably say, ``Keep 
going. Do not stop.''
    The Chairman. Good. If you are confirmed, Mr. Attorney 
General, what else would you do right out of the gate to 
address the significant racial, ethnic, and geographic 
disparities in maternal health?
    Mr. Becerra. Mr. Chairman, I have worked on this for many 
years. We need better data. We have to be collecting 
information that lets us know where to go. If we collect bad 
data, we are going to have bad results. So one of the first 
things we have to do is make sure that we are collecting good 
data. And that is a responsibility that HHS has in many 
respects.
    We also have to reach out to the communities that know the 
people that we are missing. Go to the civic and religious 
leaders back home where we know we are missing families. They 
are respected. They are trusted. They can help us reach out to 
those folks.
    We have to train a better workforce, a bigger workforce, 
and we have to make sure they are competent in the cultural, 
linguistic differences that oftentimes we see. And of course we 
have to tackle the social determinants of health that I think--
I am proud to say, now as I watch what Congress is doing, it is 
great to see how much it is a bipartisan effort now.
    The Chairman. Mr. Attorney General, let's return to the 
issue of mental health for a moment. And I think it would be 
fair to say, from sea to shining sea, communities are reporting 
that demand for mental health services has just soared into the 
stratosphere. And it is for virtually every group: for seniors, 
even schools--youngsters who have had challenges of learning 
are reporting being in need of mental health services. And I 
want to say, I think this mental health challenge right now is 
the public health equivalent of a four-alarm fire. It is just 
that serious, with the situation of care being too expensive or 
unavailable, and it is something I take very personally because 
my brother was a schizophrenic, and for years there were nights 
in our household where he would be out on the streets, and we 
were convinced he was going to hurt himself or someone else.
    So the question then is, what do we do about it? And one of 
the solutions comes from my home State, and it deals with some 
of the challenges that we are facing on the streets. I have 
talked to several of my colleagues here, and Senator Crapo and 
I have had discussions about it. On the streets, very often the 
question is, do you look to a mental health counselor? Or do 
you look to law enforcement to try to respond in the 
appropriate way?
    And we have come up with a program in my home State called 
CAHOOTS, which is supported by both mental health counselors 
and law enforcement. Senator Cortez Masto is our lead sponsor. 
A number of other colleagues are for it as well. And our 
approach deploys Medicaid, which would be under your 
jurisdiction, to set up mobile crisis response teams that can 
be dispatched when a person is experiencing a mental health or 
substance use disorder that would be appropriately handled from 
the mental health side rather than the law enforcement side.
    So my question is--and time is short, and I apologize for 
that--if you are confirmed, would you be supportive of efforts 
like the CAHOOTS program so we can expand it in my home State 
of Oregon, but also implement it across the land?
    Mr. Becerra. Senator, count me in. I know law enforcement 
back home would say the same thing. It is not a good use of our 
resources as we watch as a 911 call comes in, and we are now 
seeing a person who is in distress, usually mental distress, on 
the streets. It is our officers who are asked to respond, and 
they will tell you they are not trained professionals on mental 
health care or social services. They are trained to do public 
safety protection. And they would love to have people working 
with them so we can make sure the right professional is the 
first responder to these cases.
    The Chairman. Okay. Very good. Thank you very much, Mr. 
Attorney General.
    Senator Crapo?
    Senator Crapo. Thank you very much, Senator Wyden.
    Attorney General Becerra, as we discussed, you know I 
strongly support private insurance to allow consumers to choose 
the health-care coverage that best meets their needs. But your 
longstanding support for single-payer government-run health 
care seems hostile to our current system, from my perspective.
    What assurances can you give to Americans who currently 
have private insurance, including through Medicare Advantage, 
and are satisfied with their insurance provider, that they will 
not lose their coverage in the future to some sort of Medicare-
for-All approach or other Federal takeover of health care?
    Mr. Becerra. Senator Crapo, first, thank you for the chance 
to respond to the question and also the time you gave me to sit 
and chat.
    I will tell you that we will both agree that the most 
important thing is to give everyone in this country coverage, 
good coverage. And what I will tell you is, I am here at the 
pleasure of the President of the United States. He has made it 
very clear where he is. He wants to build on the Affordable 
Care Act. That will be my mission, to achieve the goals that 
President Biden put forward to build on the Affordable Care 
Act.
    Senator Crapo. I appreciate hearing that. And could you 
just go a little bit further? I would like to know what your 
feelings are about the Medicare Advantage program. That is, I 
think, one of the most successful parts of our Medicare system, 
and one in which the people who choose it, who are increasing 
dramatically around the country, are showing by their votes in 
support of it that they think it is a program that is meeting 
their needs and helping them significantly. But what is your 
perspective of the Medicare Advantage program?
    Mr. Becerra. Senator, millions of Americans have been on 
Medicare Advantage, of our seniors. We see that Medicare 
Advantage gives us an easier chance to do what are called 
``wrap-around programs,'' to reach out to more people with more 
services. And I think we have to take every approach we can. 
Because at the end of the day, as I said at the beginning, it 
is about getting more health care to people at an affordable 
price and with good quality.
    And so, whether it is in rural America or urban America, 
what we have to do is see how we can make Medicare for our 
seniors work better.
    Senator Crapo. Thank you. And I want to move to the HI 
trust fund. I know that you are aware that the trust fund is in 
dire straits. The most recent Medicare trustees report 
projected that the HI trust fund would be officially bankrupt 
in 2026, at which time it would no longer be able to pay full 
benefits for our Nation's seniors and the disabled.
    That report failed to include any analysis showing the 
fiscal impact of the COVID-19 pandemic on the trust fund. 
Earlier this month, the Congressional Budget Office released 
its updated winter baseline, and the new baseline takes into 
account the increased tax revenue due to stronger economic 
forecasts. But while CBO now also predicts that the HI trust 
fund will be insolvent in 2026, there is substantial 
uncertainty behind their projections.
    Given the recent Medicare spending trends, it seems 
unlikely that the trust fund could remain solvent through 2025. 
Will you commit to me today that, if you are confirmed, you 
will immediately direct the Centers for Medicare and Medicaid 
Services, the Chief Actuary, to provide an update to me in 
writing that shows the current status of the Medicare HI 
insolvency date, taking into account the fiscal impact of the 
COVID-19 pandemic?
    Mr. Becerra. Senator, I can commit to that. We will 
absolutely look forward to working with you to give this 
committee, you and this committee, the information we need to 
make the right decisions when it comes to Medicare moving 
forward.
    Senator Crapo. Well, thank you. I appreciate that. You 
know, Congress has historically looked to reform and adjust 
Medicare payments to providers in order to extend the life of 
the HI trust fund. However, the last time Congress enacted 
significant Medicare savings, the money was used to finance 
further spending.
    Now here we are, a decade later, and those savings are no 
longer available to protect Medicare. What policies do you now 
think Congress should consider to extend the life of the HI 
trust fund?
    Mr. Becerra. Senator, I remember well our experiences on 
the Bowles-Simpson Commission, which I thought was a tremendous 
experience, because it really brought some thoughtful minds 
together.
    Here is what I think I can tell you right off the bat. I 
believe you and I, in fact everyone here, can agree that our 
seniors who paid into Medicare should not be harmed by our need 
to come up with policy recommendations and solutions. And so 
first and foremost, our beneficiaries must come first in any 
discussion about this.
    Secondly, as you know, and as we worked on in Bowles-
Simpson, and I know you have done since, there are short-term 
solutions, and then there are the longer-term solutions. And 
none are easy. Otherwise, we would have done them already. But 
here is what I would suggest to you.
    President Biden is prepared to tackle this, because our 
seniors depend on it. And we have seen what Medicare has done 
in pulling so many seniors out of poverty from the 1960s, 
before it was enacted, to today. And so what I will tell you, 
the team at HHS, should I be fortunate to be confirmed, will be 
ready to sit down with you to discuss this and more on 
Medicare's future.
    Senator Crapo. All right; thank you very much. I am out of 
time. I would have asked you, and I will probably ask you to 
just respond to this in writing afterward, that I would like to 
know how soon we can expect that opportunity to develop a 
comprehensive legislative proposal from HHS that will extend 
the life of the trust fund.
    Thank you.
    The Chairman. Thank you, Senator Crapo.
    Senator Stabenow?
    Senator Stabenow. Well, thank you very much, Mr. Chairman 
and Ranking Member Crapo. It is wonderful to have you in front 
of us, Attorney General Becerra. And it was wonderful to serve 
with you in the House of Representatives and work on so many 
issues that related to health care and behavioral health. And 
as I told you, I think when I called right after you were 
nominated, I was very excited to see that someone of your 
values and experience and competency would be nominated by 
President Biden to lead this incredibly important agency.
    And I do say, I know some have said that they are concerned 
that you are not a doctor. Well, our former HHS Secretary was a 
drug company executive, a CEO, and you were on the other side 
as an Attorney General and Congressman fighting high drug 
prices. So that is the side I am glad to have an HHS Secretary 
on. So it is wonderful to have you here.
    And I have to say, I am so pleased this morning that there 
has been so much focus on mental health. I want to ask, and 
thank Mr. Chairman, about all of these issues. Because I know 
you, as well, have experience in behavioral health, and as has 
been stated, your career started as a Legal Aid attorney 
supporting clients with mental health issues, among others. And 
you have worked to enforce the Mental Health Parity Act in 
California, made reforms to decriminalize mental illness, and 
more.
    So I want to just add my voice today, as you and I have 
talked about privately, because more than half of the adults in 
the U.S. right now report mental health as being negatively 
impacted for them due to stress over the coronavirus, which 
certainly is not a surprise, given what has happened to people.
    But as of August 2020, one in four young adults between the 
ages of 18 and 24 say they have considered suicide in the past 
month because of the pandemic, which is incredibly concerning. 
Drug overdoses are accelerating, with CDC reporting the most 
overdose deaths ever--ever--over the last 12-month period.
    So we want to make sure you are hearing it today, that 
people with mental illness or substance abuse disorders are not 
left behind in what is happening. And the good news is that we 
are seeing some great progress through the creation and 
expansion of new certified community behavioral health centers. 
And I know Oregon is benefiting from this, which has allowed 
funding to be able to do some creative things.
    We are seeing a difference. In fact, the most recent HHS 
budget found that these services led to a 63-percent decrease 
in emergency room visits for behavioral health and a 60-percent 
decrease in time spent in jails--which is why these 
comprehensive community services are so widely supported by law 
enforcement--and a 41-percent decrease in homelessness.
    And so let me just ask. We have now comprehensive community 
centers--actually 340 of them across 41 states. But communities 
across the country, every State wants to be able to do this 
like we have Federally Qualified Health Centers with 
comprehensive funding. We now have this model for behavioral 
health. And it really needs to be permanent and comprehensive.
    So I wondered if you would talk about some of your goals, 
again about ensuring coverage, paying for behavioral health, 
and can I count on you to work with us to move forward to make 
this very effective, proven program now permanent as a 
nationwide expansion of the Certified Community Behavioral 
Health Clinic program?
    Mr. Becerra. Senator, thank you for the question. I have to 
first say, thank you for the work that you have done. If there 
is someone who has been the patron saint for this issue, I 
think you are--you get to qualify for that title, because it is 
so important. Many of these folks, as you know, feel like no 
one really cares. And their esteem goes up when someone talks 
about their issues, the respect that they deserve increases, 
and so I will say this.
    The money that you all made available to help us expand 
some of these centers, most of it, I think $500 of the $600 
million is already on the streets, on the ground trying to 
help. The more we coordinate directly with our local partners, 
we will be more effective. We have to also reach out more 
effectively with our Indian Health Service folks. And I think 
what we can do is elevate this issue, because the law, as the 
chairman said, the law is already there. We are supposed to 
treat mental health services with parity.
    We are supposed to provide the behavioral health service. 
What we are learning is that these centers completely help us 
do it better.
    Senator Stabenow. Well, thank you so much. I know my time 
is up, Mr. Chairman, and so I will just ask, for the record, 
questions related to expanding access to home health services 
and Alzheimer's, maternal/infant health, cost of prescription 
drugs. There is a lot that we need to do together that will 
make a real difference in the lives of Americans across the 
country. So thank you, Mr. Chairman.
    [The question appears in the appendix.]
    The Chairman. Thank you, Senator Stabenow.
    Senator Grassley?
    Senator Grassley. I will bet you are just waiting to talk 
about abortion [laughing], and I am going to start with 
something that is a fact. During the second trimester of fetal 
surgery--fetal surgery--doctors may administer anesthesia to 
reduce pain experienced by the unborn.
    So, a question: do you believe it should be routine to also 
give anesthesia to unborn children during late-term abortion to 
minimize the pain that they are capable of experiencing?
    Mr. Becerra. Senator, you are asking, I know, an important 
question, but a very technical question. And you are moving 
into an area which I know carries with it very deeply held 
beliefs, where folks sometimes have differences, and I respect 
that. I also want to make it clear that I respect the law and 
the science.
    And what I can tell you is that, in my career of having 
worked to protect the health of all Americans--men, women, 
young, old--what I would do as Secretary is what I have done as 
the Attorney General of our State. And that is, I would follow 
the law and expect others to follow the law.
    And while we may not always see it the same way in terms of 
how we get there on a particular issue, I will tell you that, 
on health care, these are challenges we have to confront for 
the American people. So I would look forward to trying to reach 
that common ground with you and others.
    Senator Grassley. Well, I appreciate that. And I think you 
made my question more complicated than I meant it to be. I was 
not asking if you were for late-term abortions or not. I was 
asking about, during that process, whether or not you thought 
that the baby ought to have a pain killer in the process of 
that abortion, like we have as a requirement for fetal surgery.
    So maybe you cannot answer that question, but I did not 
mean to get into whether or not you support late-term abortions 
or not.
    Mr. Becerra. And, Senator, let me try to address that, if I 
can, more directly. It still might not be enough for you, but I 
tried to make clear that I would rely on the science and the 
experts, as the Secretary of HHS, to help us make decisions to 
the degree that the agency has any role in making some 
decisions related to that. I would rely on the science and the 
experts.
    Senator Grassley. Okay. Thank you.
    Now I want to go to something that the chairman, Senator 
Wyden, and I worked together on, and worked in good faith and 
arrived at quite a compromise. And it deals with the subject of 
prescription drugs.
    I believe Congress must pass something like what he and I 
worked out last year in a bipartisan way, because we have this 
60-vote requirement, and I think it might be very difficult to 
get something through that would take 60 votes, that some 
people in your political party are thinking about doing. And 
most of that deals with whether or not we are just going to put 
a cap on increases in drug prices as the best way to get to 
solving the high cost of prescription drugs, or whether we are 
going to have the government negotiate prices, where basically 
the government dictates prices. And also we have some letters 
from CBO over a long period of time that say that it really did 
not save money, where the Wyden-
Grassley bill saves about $95 billion.
    So this is my question: do you know if the Biden 
administration would be interested in enacting a bipartisan 
prescription drug pricing reform bill like, for instance, along 
the lines of what Senator Wyden and I worked out, that actually 
saves the taxpayer dollars and can get 60 votes in the United 
States Senate? And it will be a lot easier to get it up under a 
Schumer majority leader position than it was under a McConnell 
leadership position. Or do you think they want the alternative 
of trying to get something a lot stronger from the Democrat 
point of view along the lines of what I suggested?
    Mr. Becerra. Senator, you have asked a great question, 
which probably would be easier for me to answer if I were still 
a House member or a Senate member, because those negotiations 
really are up to you all.
    But I will tell you this: there is no doubt that President 
Biden wants to see us lower the price of prescription medicine. 
And he and his team--and if I am fortunate to be part of that 
team--will be working with you on a bipartisan fashion to reach 
a solution. And I want to congratulate you and Chairman Wyden 
for the work that you have done in the past to try to bring 
members together.
    Senator Grassley. One second left. We passed a bill that I 
have been working on for 6 years, and you will be in a position 
to get the regulations and get it underway. It sets up an 
alternative program for rural hospitals. It is called the Rural 
Emergency Hospital program. And it would work this way: a 
critical access hospital would have the alternative--they would 
not be forced to do this; this would be an alternative--that if 
they want to give up their residential beds and preserve the 
other things that hospitals would do, then they could do that.
    And it is my way of keeping--when there is only 4-percent 
occupancy in most of these critical access hospitals and it is 
a very expensive thing for them to operate, this will maintain 
rural health services, short of residence beds.
    So I do not know whether you know enough about the bill 
that we passed, but I think it is very critical. The American 
Hospital Association worked with us, the Iowa Hospital 
Association. And I would like to get that thing up and running 
as fast as we could.
    Mr. Becerra. Senator, I know the time has expired, but let 
me just say--and we can follow up with this question--that I am 
absolutely looking forward to working with you on this. People 
often forget that California, as big as it is, has some very 
large rural areas.
    And I was approached by many of our State legislators when 
I was trying to tackle the whole issue of hospital over-
consolidation--you know, hospitals gobbling each other up. And 
I said you have to make sure you are very careful, because in 
some of our rural communities, there may be only one facility. 
And they may not have any choice, if they are going to survive, 
but to have a major player come in and take them over. And so, 
please make sure that you do not think that a rural facility, 
which is standing out there by itself, is just like all these 
other places in urban America.
    The Chairman. Colleagues, we are just going to have to move 
on. And----
    Mr. Becerra. I will follow up. But, Senator, I look forward 
to working with you.
    Senator Grassley. Thank you.
    The Chairman. I thank the Senator from Iowa.
    Senator Cantwell, and then Senator Thune.
    Senator Cantwell. Thank you, Mr. Chairman.
    Attorney General Becerra, I am so excited and proud of your 
nomination because of the diversity and breadth of experience, 
and basically just following many of the decisions you have 
made over your career. So I very much appreciate seeing you 
here today as President Biden's nominee.
    Following up on Senator Grassley's drug questions, because 
it is topical at the moment, we had a chance to discuss drug 
shortage issues, the fact that the price of insulin is just too 
darned high, and other issues. Do you think there is more that 
the FDA and the FTC should do in this area?
    Mr. Becerra. Absolutely. We cannot afford to see drug 
shortages continue. We have to plan ahead. We have to work on 
the supply chain. We have to make sure that we do not encounter 
a situation where Americans in one part of the country have the 
medications they need, but in other parts they do not.
    Senator Cantwell. Well, there is no reason to see the 
spikes that we have seen in insulin. Is that correct, and that 
there are policies that we can be putting in place?
    Mr. Becerra. Well, and in some cases what we are finding is 
that these are artificially created. Yes.
    Senator Cantwell. Thank you for saying that. I hope--
Senator Grassley just left the room, but he and I have done 
some work on this in his role on Judiciary. But I plan to do a 
lot on this issue as it relates to the Federal Trade Commission 
and its oversight.
    Turning to the broader issue of affordability of health 
care, we also had a chance to talk about the basic health plan, 
something that was part of the Affordable Care Act to take care 
of people above the Medicaid rate, but at a very cost-effective 
way to bundle people who do not have access to insurance and 
make it a more interesting market, but still leave States in 
control of helping to negotiate on those programs.
    So the end result of that has been 800,000 people in the 
State of New York buying insurance at basically $500 in annual 
premiums and saving more than $1,000 for what we would save 
from those individuals on the Silver Plan.
    So is this something, this concept, something that we 
should continue to look at as a way to both leverage and bundle 
up people who are not quite as interesting to the market right 
above that Medicaid rate?
    Mr. Becerra. Certainly, Senator. I think Minnesota as well 
has also done this. And it is another innovation. It is another 
way, especially for States that are willing to put skin in the 
game, to make this happen, to try to get to the point where we 
are providing more coverage, better coverage, at lower cost.
    Senator Cantwell. Well, I think my colleagues who have 
talked about already that we do not want this, we do not want 
that--we have combined the best in the context of allowing a 
State to still be in charge of that end product, but to allow 
people to propose from the private provider some sort of 
discounted rate, and I definitely think that we need to be 
getting more out of the providers on discount. That is not to 
say that you cannot have other public options, but I just think 
this one has been working and successful on that front.
    Also, the issue of N95 masks and frauds has come up in the 
State of Washington. I want to know that you will do everything 
you can. I personally believe that we need a task force at this 
point in time between the FDA and Border and Customs and DOJ, 
and others, to look at this issue. Again, the FTC was given--we 
have given the FTC broad authority now to fine immediately 
anybody who takes advantage of the COVID pandemic to manipulate 
or to over-charge.
    We have health-care workers whom we are asking to go into 
these situations, and then they are finding out big vast 
amounts of supply of these masks do not meet the standards.
    So we need to be aggressive here with the FDA on a task 
force to make sure that we are looking at this.
    Mr. Becerra. I could not agree more, Senator. I think HHS 
would be more than willing to work--as you know, our 
jurisdiction comes more on the side of certifying what it takes 
to have a mask that works. We will work with our partners to--
by the way, State and local and tribal and territorial partners 
are important too, because they are the ones that are on the 
ground. As the AG in California, I have worked to go after some 
of the fraud, the gouging that has gone on with some of these 
products during pandemics and disasters.
    And so, we are willing to work with you. I have had that 
experience as a prosecutor doing this. And now, if I am 
fortunate to be confirmed as Secretary of HHS, we will partner 
with all those different agencies that you have mentioned to 
try to get to this.
    Senator Cantwell. Thank you. Thank you, Mr. Chairman.
    The Chairman. I thank my colleague. And just very quickly 
before we get to Senator Thune, we have a bipartisan effort on 
insulin prices out of this committee; a report that we did. 
Prices have gone up 12-fold in recent years, and the drug is 
not 12 times better. It is essentially a product of price-
gouging. And Senator Grassley and I put together this report.
    We are going to put it into the record, without objection, 
after Senator Cantwell's good statement.
    [The report appears on the committee's website: https://
www.
finance.senate.gov/imo/media/doc/Insulin%20Committee%20Print.
pdf.]
    Senator Thune. Thank you, Mr. Chairman.
    Mr. Becerra, welcome to the committee. You have heard a 
number of my colleagues, starting with the chairman, talking 
about a big range of public health issues that we have to deal 
with, starting with the pandemic.
    Senator Crapo talked about Medicare and Medicaid, and 
Senator Grassley talked about rural health. I would like to 
bring up IHS here in just a minute. But in examining your 
record--and I want to come back to this for just a minute 
because it does seem like, as Attorney General, you spent an 
inordinate amount of time and effort suing prolife 
organizations like Little Sisters of the Poor, or trying to 
ease restrictions or expand abortion.
    You are going to have a big job as Secretary of Health and 
Human Services, if confirmed. So how do you assure us that--
because I think the majority of the American people would not 
want their Secretary of Health and Human Services focused, or 
fixated on expanding abortion when we have all these public 
health issues to deal with.
    So how do you assure us that that is not going to be 
something that continues over from your time as Attorney 
General?
    Mr. Becerra. Senator, thank you very much for giving me a 
chance to answer the question. And here, I think I tried to say 
to Senator Grassley, I understand that Americans have 
different, deeply held beliefs on this particular issue. And I 
absolutely respect that.
    By the way, I have never sued the nuns, any nuns. I have 
taken on the Federal Government, but I have never sued any 
affiliation of nuns. And my actions have always been directed 
at the Federal agencies, because they have been trying to do 
things that are contrary to the law in California. It is my job 
to defend the rights of my State and uphold the law.
    What I will say to you is this: as I try to uphold the law, 
I recognize that people will look at these things a little bit 
differently. And here is where I think there is an 
opportunity--and now as Secretary of HHS, if I am fortunate to 
be confirmed--for working with all of you to try to see if we 
can find that common cause on how we move forward on this very, 
very difficult issue, but very important for so many Americans.
    Senator Thune. Let me shift to, as I mentioned, the Indian 
Health Service. I know there is a significant tribal population 
in California. I want to draw your attention to specific issues 
that we faced with Indian Health Service in the Great Plains 
region.
    IHS-run facilities in South Dakota have lost accreditation 
on more than one occasion for failure to comply with safety and 
quality measures, and multiple health-care providers have been 
exposed for abusing patients.
    We have to talk about the leadership and management 
failures that have led to this situation. It cannot be blamed 
all on funding. HHS has got to be involved and active in 
driving improvements at IHS, and demanding excellence from its 
leadership.
    If confirmed, what specific actions would you take to hold 
IHS accountable to the patients it serves, as well as to the 
Congress, which often faces obstacles in getting answers to 
important oversight questions?
    Mr. Becerra. I know this one is important to you, Senator, 
and so many who have a number of our tribal communities in 
their State. Transparency--we must work much better at 
providing you and others, and those in these tribal 
communities, with the information they need, better data. But 
mostly it is accountability, and that I commit to you.
    And I say that as someone who has represented more than 100 
tribes in the State of California for many, many years; we owe 
it to our tribal governments, our native communities, to be 
there. We owe it to them because they have sovereign rights.
    We have a trust responsibility. And so what I can tell you 
is, we will work with you. I will say one thing. IHS has done 
something right working with tribal communities, because they 
have had more success than many States in actually putting 
vaccines in arms recently. And we do need to applaud them when 
they have done something well.
    Senator Thune. I have a bill with Senator Barrasso that 
would improve management hiring practices at IHS, and I would 
like, if you end up getting confirmed, to work with you on 
that.
    Mr. Becerra. I look forward to working with you.
    Senator Thune. I know you heard about 340B a few times 
yesterday, so I will try to keep this quick. But to me, the key 
to 340B is that it enables hospitals and covered entities to 
provide community benefits that otherwise may not be available.
    If confirmed, will you commit to ensuring the strength of 
the 340B program and the community that it supports?
    Mr. Becerra. Absolutely. Not just in your rural 
communities, but I have inner city communities that I have had 
to represent who depend on 340B.
    Senator Thune. Good. All right, one last quick question. 
And I would say that probably the one bright spot of the 
pandemic has been telehealth. That is something that I have 
been working with this committee on for a long time.
    As we continue to look at options for expanding telehealth, 
what will your approach be to taking administrative action at 
HHS and CMS, and what legislative approaches from the Congress 
would you support?
    Mr. Becerra. Well, we have learned a lot, Senator, from 
COVID. And we have seen how important it is to have broadband 
reach all our communities. We have seen how we have to have 
some flexibility. But mostly what we can do is talk to the 
communities that are actually now benefiting from it in our 
rural parts of America, in other parts that did not have 
broadband before, to find out what it is that we can do to do 
it better. But I do not think we are going back to the old days 
when it comes to telehealth.
    Senator Thune. Thank you, Mr. Chairman.
    The Chairman. Senator Menendez?
    Senator Menendez. Thank you, Mr. Chairman. Mr. Becerra, 
welcome. It is good to see you again. A few quick questions 
that hopefully you can help glide through with me so that I can 
get to some other things.
    You were a member of the Ways and Means Committee of the 
House of Representatives, which is almost the equivalent of the 
Finance Committee. I say ``almost'' because we have pride here 
in the Finance Committee. [Laughter.]
    Is that not correct?
    Mr. Becerra. That is correct.
    Senator Menendez. And as such, were you there during the 
period of time in which the Affordable Care Act was being 
legislated?
    Mr. Becerra. That is correct.
    Senator Menendez. Were you instrumental in various parts of 
the Affordable Care Act?
    Mr. Becerra. I was in those rooms.
    Senator Menendez. And as part of that, you became familiar 
that the Affordable Care Act created the opportunity for 
millions to get health-care coverage who did not have it 
before. Correct?
    Mr. Becerra. I was very active on those provisions.
    Senator Menendez. And to create affordability for millions 
who found it less affordable; who created Medicaid expansion. 
Is that fair to say?
    Mr. Becerra. That is correct.
    Senator Menendez. And who also closed the doughnut hole for 
prescription drugs for seniors. Is that fair to say?
    Mr. Becerra. That is fair to say.
    Senator Menendez. You had all of the experience during that 
whole period of time. It also created a special provision for 
women's health. Is that fair to say?
    Mr. Becerra. Yes, it is.
    Senator Menendez. Now as Attorney General of California--
California is the fifth largest economy in the world, is it 
not, if it were an independent country?
    Mr. Becerra. That is correct.
    Senator Menendez. As Attorney General, what was the size of 
the office of the Attorney General?
    Mr. Becerra. We were several thousand, over a billion-
dollar budget.
    Senator Menendez. So several thousand, over a billion-
dollar budget. Now let me ask you this. When you were chosen to 
be the Attorney General of the State of California, you took an 
oath, did you not?
    Mr. Becerra. I did.
    Senator Menendez. And in that oath, I believe that part of 
that oath was to preserve, protect, and defend not only the 
Constitution of the United States, but the Constitution of the 
State of California and the laws of California?
    Mr. Becerra. That is correct.
    Senator Menendez. You do not pass the laws; you defend 
them?
    Mr. Becerra. That is correct.
    Senator Menendez. Now let me ask you this. If you are 
successful--and I believe you will be--at being confirmed by 
the Senate, and you take that oath, then you are going to 
defend the laws of the United States as they exist at the time?
    Mr. Becerra. That is correct.
    Senator Menendez. I find it interesting that many of my 
colleagues have raised issues about you being a lawyer without 
sufficient experience. The reality is that thousands of 
employees under your direction experienced it first-hand in 
creating the most significant landmark legislation on health 
care and dealing with issues of Medicare and Medicaid within 
the Committee on Ways and Means' jurisdiction. Somehow that 
seems to be a problem. But the previous Secretary of HHS was 
also a lawyer. The only thing is that he was a lawyer at a drug 
company that ultimately did a pretty good job in fleecing 
insulin patients. So I hope--I do not think we would see that 
from you.
    Let me ask you a few specific policy questions. You and I 
had an opportunity to talk. Will you work with us on improving 
diversity in clinical trials? Because this is an area that we 
think lacks diversity. And I have written to all of the 
companies that are engaged in clinical trials. Most of them 
have been pretty responsive. But it is something I think we 
need to do in order to make sure that all of America is 
represented in these trials.
    Mr. Becerra. Senator, absolutely. As I always say, if you 
have bad inputs going in, you are going to produce bad outputs. 
And if we are going to start having studies reflect the 
American people, we have to have good inputs.
    Senator Menendez. Would you work with me and others to 
improve diagnoses of black and Latino dementia patients, as we 
begin to address Alzheimer's disparities in communities of 
color?
    Mr. Becerra. Absolutely.
    Senator Menendez. One of the things with the pandemic is 
that it has magnified the incredible disparities that exist in 
our society, particularly in terms of the health care of 
minority communities. Will you commit to working with me on 
ways to reduce the disparity for communities of color in the 
delivery of our health-care system?
    Mr. Becerra. Yes, sir.
    Senator Menendez. Let me ask you a question. We have had a 
bipartisan support here for a program called MIECHV, Maternal 
Infant Early Childhood Home Visiting Program. I used to work 
with Senator Enzi on it when he was on the committee, and I 
look forward to working with others.
    Do you support an expansion of this valuable program?
    Mr. Becerra. Senator, as you know, my wife is a maternal-
fetal medicine specialist----
    Senator Menendez. So I have an in-house lobbyist----
    Mr. Becerra. You have me squeezed between you and her, and 
the response is, I am absolutely looking forward to working 
with you.
    Senator Menendez. And finally, we were able--part of my 
work here was to ensure that we could include a thousand new 
GME slots that Congress provided. I would like to get you to 
work with us to ensure that we quickly and efficiently 
implement that provision of the law.
    Mr. Becerra. Done.
    Senator Menendez. Thank you. Thank you very much. Thank 
you, Mr. Chairman.
    The Chairman. I thank my colleague. We are just going to 
move through this list of members. I think next is Senator 
Carper, who is available on the web. Is that actually current?
    [No response.]
    The Chairman. Senator Carper?
    [Pause.]
    The Chairman. There you are.
    Senator Carper. Pardon?
    The Chairman. Senator Carper, are you there?
    Senator Carper. Hello? Hey there----
    The Chairman. We are waiting for you, Senator Carper.
    Senator Carper. Oh, good. Good, good, good.
    First of all, General, how are you today?
    Mr. Becerra. Senator, I am well.
    Senator Carper. Have any of our Republican friends 
questioned whether or not you have the ability to, I would say, 
the strengths for leading a large organization?
    Mr. Becerra. We have had some good discussions.
    Senator Carper. What I am asking is, has anybody raised the 
question of how could you lead an organization as big as HHS; 
what have you ever done that would suggest that you could do 
that? How would you respond to that?
    Mr. Becerra. How I would--I'm sorry? Say that question 
again. How I would respond to----
    Senator Carper. If someone raised the question about your 
ability to lead an organization as big as HHS--it is huge, as 
you know. What have you done in your life that would suggest, 
well, maybe I am up to that task?
    Mr. Becerra. Senator, for 30 years I have been working on 
health care. My first job----
    Senator Carper. I am thinking more of the administrative 
side, running a huge organization. My recollection is, talking 
to Kamala Harris, that the job you have right now is not a 
small job.
    Mr. Becerra. It is the second largest department of justice 
in the land. And I would say, over the 4 years that I was 
there, we outdid the largest department of justice in the land 
every time we were in court.
    We have continued to protect the largest State in the 
Nation, and we are an operation that I think most people would 
love to see--the size of their operation, well over a billion 
dollars, and several thousand personnel--and we do a really 
good job of protecting the rights and opportunities for 
Californians.
    Senator Carper. That is a pretty good answer. Thank you.
    We talked a little bit about the role of federally 
qualified community health centers in vaccination efforts that 
are going on. Could you talk to us about why that is important, 
particularly why that is important with people of color?
    Mr. Becerra. Senator, as you know, too many people are 
missed. They fall through the cracks. And community health 
clinics have been a godsend for many of these communities, 
because oftentimes they are the only facility, the only 
available source for good health care. And with community 
clinics able to help provide the vaccines, it makes it more 
possible for many of our families who have often been left 
behind to actually get the care and the protection that they 
need.
    And so, they have been indispensable. Thank you for the 
work that you and others have done to recognize how important 
they are, and especially now during COVID.
    Senator Carper. I understand there was a hearing, I think 
it was yesterday in the House, that focused on development of 
additional vaccines beyond Pfizer, beyond Moderna, and they 
included--I think there was some discussion at the hearing with 
respect to AstraZeneca, and with respect to Johnson & Johnson.
    Have you had a chance to come up to speed on what was 
covered at that hearing?
    Mr. Becerra. I have not heard much about what happened in 
that hearing. I was in my hearing as well, in the HELP 
Committee. But I do know something about what is going on. It 
has been brought to my attention. Certainly HHS will be on top 
of whatever happens with any future vaccine, because it has to 
run--those vaccines and those trials would run through our 
different agencies.
    Senator Carper. Would you just take a minute and just kind 
of describe, just very briefly, at the 30,000-foot level, the 
process, the next steps in approving--getting emergency 
approval for both AstraZeneca and the Johnson & Johnson.
    Mr. Becerra. The FDA plays a very crucial role, along with 
CDC. And there are several other subagencies within HHS that 
will have roles that are critical, as we try to continue to 
deal with the pandemic. And HHS, I can guarantee you, if I am 
fortunate to be confirmed, will make sure it is working with 
due speed to make sure that whatever is within our bailiwick to 
handle, we will do it quickly, because we know how important it 
will be that Americans have a vaccine available. And while we 
have seen success, especially under President Biden's tenure, 
in reaching more and more Americans--and President Biden has 
announced that we have secured up to 600 million shots of the 
vaccine for Americans--we will continue to work to make sure 
that we are on top of it and ahead of the game when it comes to 
making sure we are protecting all Americans.
    Senator Carper. How long did you serve in the House?
    Mr. Becerra. I was there for 24 years, sir.
    Senator Carper. Did you ever meet a guy named John Carney?
    Mr. Becerra. Of course. Your colleague, and now your 
Governor.
    Senator Carper. Yes. He used to be a member of my Cabinet, 
and I am enormously proud of him. Usually our congressional 
delegation has a chance to catch up with him every couple of 
weeks. And one of the comments we continue to hear is 
``adequate supply of vaccine delivered in a timely way.'' And 
in accordance with expectation, consistent with expectations.
    Do you have any thoughts on that for us?
    Mr. Becerra. And my response is going to be based as a 
leader in my State. And absolutely our States, our local 
partners, our tribal communities, our territories, they all 
want to know the same thing: that we are going to be working in 
partnership with them, that we will coordinate with them, that 
we are not going to blind-side them, because they have to 
prepare.
    They are the ones that are doing most of this on the 
ground. They want to know that there is a real partnership so 
that we are not doing this as if we are the Federal Government 
and we know everything.
    And so I would expect that Governor Carney--who is a 
champion for the people and the State, and is a real fighter--
would make sure that he is on top of it, because he is working 
closely with the Federal Government. And I would look forward, 
if I am fortunate to be confirmed, to work with my former 
colleague.
    Senator Carper. I understand that in a hearing yesterday, 
Johnson & Johnson reported that they were close to being--
getting the emergency approval, if you will, the emergency 
distribution approval from the FDA.
    And I understand that there was also, I believe, testimony 
that suggested that AstraZeneca could receive the emergency 
approval about a month later, at the beginning of April. Folks 
at AstraZeneca have the ability to produce a lot of their 
vaccine, I am told. And I hope the same is true of Johnson & 
Johnson.
    We have been really starved for a vaccine for the last 
several months, and I think we could be in a position all of a 
sudden to get actually more vaccine than we know what to do 
with. And that would be a good problem.
    But I would just ask that you be thinking about that, 
because it is possible that we could just be flooded with this 
stuff in about a month--and to make sure that when it comes and 
flows in great quantities, that we are ready to do something 
with it.
    The Chairman. Senator Carper is asking about an especially 
important issue. Mr. Attorney General, would you like to give a 
brief answer, because I have a lot of members waiting? But it 
is such an important question, would you like to give a brief 
answer, or can we move on?
    Mr. Becerra. Senator, I will just say to Senator Carper, I 
look forward to working with him. We want to be prepared. We 
would rather have more than less, to make sure we are saving 
lives.
    The Chairman. Very good.
    Senator Carper. Thank you, Mr. Chairman.
    The Chairman. It is a very, very important area.
    Senator Cardin and Senator Lankford are next. And, 
colleagues, it is our intention, after consultation with the 
minority and with Senator Crapo, we will see if we can complete 
the business of the hearing by 4 o'clock when we have the vote. 
My sense is we cannot, and it would then be our intention to 
recess briefly between 4 o'clock and 4:15. And that is what we 
have talked about.
    Now we are at Senator Cardin, and then Senator Lankford.
    Senator Cardin. Mr. Chairman, thank you very much. And to 
my good friend, Xavier Becerra, it is good to see you again. 
There has been a lot of talk about your career. I enjoyed our 
service together on the Ways and Means Committee, and I very 
much remember the days of the Affordable Care Act and the work 
that you did on that. So thank you for your willingness to 
continue to serve our country.
    I want to talk about one of the provisions that was 
included in the Affordable Care Act which set up the Offices 
for Minority Health throughout HHS and also established the 
National Institute for Minority Health and Health Disparities 
at the National Institutes of Health.
    Chairman Wyden talked about meeting the needs of the under-
served communities. You have talked about it. I have no 
question about your commitment to provide services to those who 
have been left behind in health care in America. But my 
question to you is, what strategy do you have to reinforce 
these offices that currently exist so that a legacy of dealing 
with health disparities will be institutionalized within the 
Department of Health and the National Institutes of Health so 
that we will have an ongoing commitment to deal with the 
disparities in this country?
    Mr. Becerra. Senator, thank you for the question. And it is 
great to see you again. It brings back great memories of our 
work together.
    The Office of Minority Health is a critical operation 
within HHS. I intend to make it an even more important office 
than perhaps its stature was in the past, simply because COVID 
has exposed what many of us already knew, and that is, that we 
have failings when it comes to approaching all of our 
communities in America and giving them the same access.
    And so the Office of Minority Health will prove 
indispensable if we want to really tackle this beyond COVID. 
And so I look forward to working with you and others who are 
interested in this, because there are several offices within 
HHS that deal with minority health. And certainly the principal 
office, I will want to make sure I empower them.
    So I look forward to working with you. I am glad you asked 
the question. If I am fortunate to be confirmed, I think 
everyone in HHS has just heard this, that the Office of 
Minority Health will have real prominence under my tenure, if I 
am fortunate to be confirmed.
    Senator Cardin. Thank you very much.
    One of the impacts of COVID-19 that has been a positive 
impact is that we have recognized the importance of telehealth. 
We have made it easier for providers to provide telehealth 
services.
    Some of these changes are not permanent in nature. What is 
your strategy to try to expand the access to health care 
through telehealth, which can easily make health care more 
accessible to communities today that are challenged with 
accessibility?
    Mr. Becerra. Senator, as I mentioned previously in response 
to some other questions, we cannot go back to the old days. We 
have learned so much from COVID and how indispensable 
telehealth has been, especially to our rural communities, but 
also to some of our inner city communities. And here it has 
become very obvious that if you do not have broadband 
accessibility, you are in real trouble. And so we have to do a 
much better job.
    We are now into the year 2021, and there are still parts of 
America that do not have good access to broadband. And now 
COVID has explained why it was so essential that we have worked 
so hard in the past. So broadband access is critical.
    The flexibility that has been necessary to make telehealth 
work for everyone--we are not going to go back to the old way 
of doing business. And so there are things that we are going to 
learn that help us.
    I look forward to working with you and members on this 
committee and beyond to try to see how we can make telehealth 
accessible to everyone.
    Senator Cardin. Thank you. On oral health, we have made 
progress with pediatric dental care, which is included under 
the Affordable Care Act as an essential service. But still our 
seniors lack access to certain dental care. Private insurance 
does not necessarily provide dental care for routine dental 
work.
    So we still have a gap. Do you have a strategy to try to 
expand access to dental care? As you know, good oral health 
care is essential to good general health.
    Mr. Becerra. Senator, who can forget Deamonte Driver, who--
--
    Senator Cardin. Thank you.
    Mr. Becerra [continuing]. Was a young resident in your 
State who died because his parents did not really have the kind 
of access to health care, in this case dental care, that they 
needed. And what was an infection turned into an abscess, and 
that turned into a lost life.
    And I will tell you that dental health can be critical. You 
and I know this. And so I would look forward to working with 
you to try to see us expand access to dental health, vision 
care, the types of things that sometimes we take for granted 
until we are in our later stages of life. But it is so 
critical, and the family of Deamonte Driver could tell you 
that.
    Senator Cardin. And I would ask that you consider 
appointing the Chief Dental Officer, which has laid vacant from 
the previous administration.
    The last point I just want to raise is, you have been 
talking about prescription drug costs, and that is certainly an 
issue you have to deal with. But in America we have drug 
shortages of drugs that are relatively inexpensive but are not 
being manufactured by drug manufacturers because they are not 
making enough money on them, which is really causing a health-
care issue.
    I would just urge you to make it a priority issue, that 
there should not be a shortage of drugs in America that are 
necessary for health care because the private pharmaceutical 
network does not feel it is profitable enough to make those 
drugs.
    Mr. Becerra. Senator, I agree completely. Profits should 
not be the reason we are trying to come up with life-saving 
medication.
    Senator Cardin. Thank you, Mr. Chairman.
    The Chairman. I thank my colleague.
    Senator Lankford?
    Senator Lankford. Mr. Chairman, thank you. Mr. Becerra, it 
is good to see you. I know this is a tough process to go 
through, and you have walked through this. You have been on the 
other side of this in the House of Representatives. You have 
walked through a lot of these issues.
    I do need to get some clarity on a couple of things that we 
have not talked about so far. As the California Attorney 
General, you have sued the Federal Government over 100 times, 
including multiple times dealing with issues about conscience 
protection that you would specifically have to now enforce on 
the other side of it.
    And so I am trying to get some clarity on this. There is a 
Conscience and Religious Freedom Division at HHS. They have 
compiled the 25 different conscience laws that already exist in 
statute that are law and to say that HHS in the past was not 
always consistent in enforcing those laws, but they were going 
to actually be consistent, because they were laws on the books.
    So my question for you is, will you continue to enforce 
existing Federal law on conscience issues when you get to HHS? 
And what will you do with the Conscience and Religious Freedom 
Division?
    Mr. Becerra. Senator, you--by the way, thank you for the 
chance to respond to the question. It is a critical and 
important question. And I believe deeply in religious freedom. 
And I will make sure that, as Secretary of HHS, you will know 
that I will not only respect the law when it comes to these 
issues of religious freedom, but I will enforce them as 
Secretary of HHS within my department.
    Senator Lankford. So the challenge that I have in just 
processing through this is some of the history there. Obviously 
when you were Attorney General, you had suits that went all the 
way to the Supreme Court, that the Supreme Court overturned, 
some of your decisions--specifically on conscience issues.
    For instance, the issue of the FACT Act that came out of 
California requiring pro-life facilities to post in their 
facility ``here's a way to get an abortion instead of having 
your child up for adoption,'' which feels very much like 
promoting abortion, not just providing abortion. It is a very 
different issue on that.
    You argued that case all the way to the Supreme Court and 
ultimately lost because the Supreme Court said what is obvious 
to everyone. You cannot require someone to say something they 
disagree with. That is a conscience issue.
    Another conscience issue was the Little Sisters of the Poor 
and other groups like that that said, hey, we do not want to 
participate in abortion-related health care, and about 28,000 
Californians lost their health care that fit in with their 
conscience, based on how you were combating with those folks.
    So help me understand the disparity between those two?
    Mr. Becerra. So, Senator, again it is important to provide 
clarity there. As you mentioned, I was in these cases. My job 
as the Attorney General was to defend the laws of our State.
    In the first case, you referenced a law in our State, which 
by the way had been upheld in court. It was ultimately 
overturned by the Supreme Court, but as you said it was 
overturned, which means up until the Supreme Court, I had been 
defending the law of our State.
    In the second case, the actions we took were against the 
Federal Government. And once again, we were defending our 
State's laws and its rights under the law. Some cases we have 
lost, some cases we have won. Where we have lost, I can assure 
you that right now California is following the rules that were 
provided to us by the Supreme Court.
    And so we will always abide by the law. But it is my 
obligation to also defend the law.
    Senator Lankford. So you are going to be in this unique 
situation where you were a litigant against HHS in these areas, 
and now you are going to have to flip and actually try to 
defend those areas. So I am trying to figure out how that is 
going to fit for you, and if there is a conflict of interest in 
that.
    Mr. Becerra. So to clarify--and that is a great point, and 
I say this for everyone to hear--I will have to abide by ethics 
rules. I will be signing an ethics agreement. There are certain 
cases, because I handled them as the Attorney General within 
California, where I will have to recuse myself from certain 
cases where I was involved at the State level.
    And certainly because of the ethics agreement that I will 
have, there will be always a check on what I am doing to make 
sure that it does not somehow conflict with what I have done 
previously as the Attorney General.
    Senator Lankford. Yes, this conscience issue is really 
important. For a health-care provider who believes that a child 
is a child, whether they are in the womb or whether they are 
outside the womb, that is a child that God created and it has 
value and worth.
    It is exceptionally important to be able to honor the 
conscience rights of that individual, and that they not be 
compelled to be able to perform an abortion, or to participate 
in an assisted suicide, or something where they have a 
conscience issue with that. And this is going to be a very 
significant issue that you are going to face, that in previous 
times administrations just ignored and did not enforce.
    Mr. Becerra. Senator, I hear you very clearly. And as I 
said, I will respect the law as HHS Secretary.
    Senator Lankford. There are multiple grants-in-aid that are 
out there that there will have to be decisions made over where 
the faith-based entities can get grants or aid at the same 
level as nonfaith-based entities.
    Here is the challenge. In some previous administrations, if 
you were a faith-based entity, you were not allowed to 
participate strictly because of your faith and the structure of 
that. The Supreme Court has now stepped in with pretty clear 
decisions over the past several years to make it clear you 
cannot discriminate against someone on the basis of their 
faith.
    Will you make sure that grants in the aid proposals from 
HHS are equal for faith-based entities and nonfaith-based 
entities for the same issues?
    Mr. Becerra. Again, you raised the issue of, regardless of 
what your perspective is, right, wherever we all may fall on 
these issues, at the end of the day we have to make sure--at 
least I do, if I am fortunate to be the Secretary of HHS--I 
have to follow the law. And there I will tell you that we will 
make sure that we are following the law.
    Senator Lankford. Thank you.
    Mr. Chairman, I would like to ask for different letters to 
be entered into the record that folks have sent to me and to 
other members of this committee.
    The Chairman. Without objection, it is so ordered.
    [The letters appear in the appendix beginning on p. 142.]
    The Chairman. All right; our next colleague is Senator 
Brown on the web. And I see Senator Daines here. So Senator 
Daines would follow Senator Brown.
    Senator Brown?
    Senator Brown. Thank you, Mr. Chairman. General Becerra, it 
is good to see you. Thanks for your willingness to serve as 
Secretary of HHS. Thanks for your commitment through your whole 
career--because I have known you a long time--to reducing 
health disparities and prioritizing policies to address the 
social determinants of health.
    A number of communities in my State have passed resolutions 
declaring racism a public health crisis. I think it is 
important that we know that the history of institutional racism 
continues to impact health outcomes for communities, and it is 
particularly important that you understand the urgent need to 
be intentional about your work. And I know you will be. So 
thank you for that.
    Cincinnati is home to two CDC NIOSH facilities--National 
Institute for Occupational Safety and Health. They are unlike 
any facilities in the country, maybe in the world. Their focus 
is occupational injury, repetitive injury, occupational health 
generally, toxins in the workplace, all of that.
    In 2015, Secretary Burwell announced that HHS would be 
dedicating $110 million to consolidate and upgrade the current 
Cincinnati NIOSH facilities. They are in various degrees of 
disrepair, the way CDC was half a generation ago.
    CDC and GAO are currently undergoing site acquisition 
activities. I understand both the site purchase and a design-
build contract will be finalized this spring. It has moved 
entirely too slowly. There was indifference, or worse, from the 
previous administration. My request is simple: to ask if you 
would work with Senator Portman and me to ensure this project 
continues to get the attention it deserves from HHS, including 
the funding necessary to stay on track.
    Mr. Becerra. You have my commitment to that.
    Senator Brown. Thank you. Thank you, General.
    In recent years, Congress and HHS have expanded the scope 
of benefits available to those enrolled in Medicare Advantage 
plans without doing the same thing for those individuals who 
choose to remain in traditional Medicare.
    We have added benefits: vision, dental. We removed barriers 
to care, like the 3-day stay for skilled nursing facility care 
for Medicare Advantage beneficiaries--that is the more 
privatized Medicare, if you will--but failed to extend those 
same advantages to those seniors who stay in traditional 
Medicare plans. And those seniors typically are a little older 
and a little sicker and a little poorer, generally.
    The growing imbalance between the programs concerns me 
greatly, especially when the Medicare program has been spending 
more money per Medicare Advantage plan enrollee than on people 
who choose traditional Medicare, a relatively recent but 
inexorable move in that direction.
    My question, General Becerra: will you commit to using your 
authority hold private insurers accountable in reining in those 
Medicare Advantage over-payments to ensure taxpayers and all 
Medicare beneficiaries are getting their money's worth?
    Mr. Becerra. Senator, you have my commitment. Now in terms 
of dealing with Medicare, you are right. We do not have the 
dollars to spare and to waste. And so in this process of trying 
to strengthen and improve Medicare, we have to make sure we are 
doing oversight and keeping everyone accountable.
    And so I absolutely agree that that is going to be one of 
the principal responsibilities we have. We have to be good 
stewards of the Medicare program, taxpayer dollars. And as you 
mentioned, with this 3-day rule for post-acute care, there are 
ways that we have to make sure that we are keeping everyone 
honest. And I will make sure that there is a level playing 
field.
    Senator Brown. A level playing field here is so important.
    In closing, one last one, General Becerra, I would like 
to--I want to bring forward to you the issue of the priority of 
bringing down the high cost of prescription drugs.
    Let me share a story quickly with you from a constituent in 
the Columbus area community called Pickerington, from a young 
man, someone named Colton. He was diagnosed with ulcerative 
colitis in 2014. But his insurance coverage changed 2 years 
later and he was forced to pay $1,200 every 4 weeks for the 
infusions that kept his disease in remission. I just want to 
read you his comments, briefly.
    ``At the time of this cost increase, I was in college. I 
was already feeling the financial burden of student debt. 
Budgets for students are already tight enough, but the immense 
increase in cost for my infusions left me in a very difficult 
position.
    ``Unfortunately, with the added financial burden for my 
infusions, I have had to choose between affording the cost of 
my infusions or school. This decision was not a decision at 
all, since I needed the infusions to stay alive. Yet the 
unreasonable price of my prescriptions forced me to leave 
college.
    ``My life path,'' he writes, ``has been completely altered 
by expensive prescription drugs and drug company greed. I often 
feel like I am behind all of the people my age, even people 
younger than I, because I have had to focus my time and my 
money on staying alive. We should not have to give up pursuing 
a college education because of crippling medical debt. We 
should not have to make every financial decision with the cost 
of prescriptions and medical debt in the back of our minds. 
Things can be better if our leaders rein in drug company greed 
and make the needs of patients like me the priority.''
    That is the end of this letter. Now is the time, General, 
for meaningful reforms to bring down drug prices. My question 
is simple: if confirmed, will you commit to working with me and 
other members of this committee--especially Chair Wyden, who 
has been so involved in this--to deliver real change that will 
make American prescription drugs more affordable?
    Mr. Becerra. You have that commitment.
    Senator Brown. Thank you, General. Thank you, Chairman 
Wyden.
    The Chairman. Thank you, Senator Brown. We will be working 
on that.
    Senator Daines?
    Senator Daines. Thank you, Chairman Wyden.
    Attorney General Becerra, I just want to be up-front and 
tell you I have serious concerns with the radical views that 
you have taken in the past on abortion, as well as one of our 
very important constitutional protections--that is, religious 
liberty. Frankly, it is a record that shows a disregard for 
that.
    Our present challenges demand an HHS Secretary who is 
prepared to combat the COVID-19 pandemic and command a position 
of public trust. Many Montanans and pro-life groups across the 
country have written to say that you have taken the most 
radical positions on this very important issue of life and 
abortion.
    If you want to push back on that impression, I think you 
have an opportunity here to try to gain some public trust, and 
to take a look at the record you have had in California and how 
you might govern if you are approved here in Washington, DC.
    Could you name one abortion restriction that you might 
support?
    Mr. Becerra. Senator, let me try to respond this way. I 
have tried to make sure on this important issue for so many 
people where oftentimes--and again, we have different views, 
deeply held views--I have tried to make sure that I am abiding 
by the law. Because whether it is a particular restriction, or 
whether it is the whole idea of abortion, whether we agree or 
not, we have to come to some conclusion. And that is where the 
law gives----
    Senator Daines. But to be clear, is there any line you 
would draw? Is there just one, just one restriction that 
relates to abortion that you might support?
    Mr. Becerra. Senator, you are talking to the spouse of an 
OB-GYN who for decades has practiced saving lives of women and 
babies. And I can tell you that, from the stories I have heard 
from Carolina, my wife, I know how hard many women struggle 
just to save the life of their baby.
    And so what I would say to you--and I know that, right now 
as I speak, my mother has blessed me this morning as I got 
ready to come here, and last night I know when she prayed the 
rosary, as she does every day, every evening with my aunt, that 
she said a prayer and included me in that prayer----
    Senator Daines. Well, you know, part of it is the battle 
for those who do not have a voice, which are the little babies. 
You did not answer the question, but even one, even one 
restriction on abortion? I did not get an answer.
    Let me just throw one out there. How about a ban on the 
legal discrimination in babies who are diagnosed with Down 
syndrome?
    Mr. Becerra. So, Senator, once again if I can simply say to 
you that I respect the different views that are out there, but 
what is important is that it makes sure that it is according to 
the law.
    Senator Daines. You have been a--if confirmed, you are 
going to be the head of HHS. That is a huge organization that 
has profound impact on our society. How about a ban on sex-
selective abortions? Whether the little baby is a male or a 
female, would you say you cannot have a sex-selective abortion?
    Mr. Becerra. And I respect those who take a particular 
view. My job will be to make sure that I am following the law.
    Senator Daines. There is a ban on partial-birth abortion. I 
know that question came up yesterday. Is that yes or no? Would 
you support a ban on partial-birth abortion?
    Mr. Becerra. Again, Senator, you are asking questions which 
will touch on aspects that I know have differing views, and 
what I can say is that I will make sure that I am respecting 
the law on those issues.
    Senator Daines. You have repeatedly intervened in court to 
revoke an important religious exemption to Obamacare's 
contraception mandates from people like The Little Sisters of 
the Poor, an order of Catholic nuns that serves the poor and 
the most vulnerable. And they have won at the Supreme Court.
    As HHS Secretary, would you commit to defending the 
existing regulatory exemption to the contraceptive mandate? Or 
would you seek to eliminate the exemption, protecting The 
Little Sisters of the Poor from crippling government fines?
    Mr. Becerra. Well, as you mentioned, the Supreme Court 
issued a ruling. We will make sure, if I am fortunate to become 
Secretary of HHS, that we will abide by the law as it stands. 
And now with this ruling from the----
    Senator Daines. You would defend the existing mandate, 
then, per the Court?
    Mr. Becerra. I will defend the law and support the law that 
is in place.
    Senator Daines. According to CDC data--they have been 
comparing States and territories--Montana is ranked near the 
top for administration of vaccine, but we fall near the bottom 
for first doses allocated by the Federal Government. That is 
why our congressional delegation wrote to President Biden 
expressing frustration that Montana is not getting its fair 
share of vaccines.
    I am concerned that HHS is neglecting to reward States like 
Montana that could administer at least three times the number 
of doses being delivered currently. Do you believe HHS should 
provide additional vaccines to States like Montanas that have 
been able to quickly and efficiently get vaccines in the arms 
of people who want them?
    Mr. Becerra. Senator, we applaud States that are moving 
forward and being diligent in getting their people protected. 
And I know that President Biden has made the commitment to have 
all the vaccines that we will need throughout the country. And 
what I can commit to you is to make sure we are working with 
you and the folks in Montana to make sure that the vaccines are 
there for the people of your State when they need them, and 
doing that the same way for all the people in this country.
    We want to make sure we are not missing anyone, and that is 
where this issue of pockets of population----
    Senator Daines. Thank you for that. I appreciate that 
answer.
    Last question: you are on record for pushing for allowing 
illegal immigrants to receive taxpayer-funded health care, and 
for decriminalizing illegal entry into the United States.
    This, coupled with President Biden's radical plan for 
granting citizenship to those who are here illegally would 
potentially lead to hundreds of thousands, if not potentially 
millions more people flooding into our country.
    As you know, in 2016 California passed a law requiring 
covered Californians to apply for a section 1332 waiver to 
allow illegal immigrants to purchase health insurance through 
the marketplace. This waiver was withdrawn after President 
Trump's election.
    My question is this: will you attempt to use the waiver 
authority contained in the Affordable Care Act to grant health-
care benefits to illegal immigrants?
    Mr. Becerra. Senator, what I can tell you is that where the 
law stands now, as I see it, it does not allow those who are 
unauthorized in this country to receive taxpayer-paid benefits 
except in very rare circumstances. And it will be my job to 
make sure that we are following and enforcing the law. And I 
can commit to you that that is what we will do.
    Senator Daines. Thank you.
    The Chairman. Senator Bennet?
    Senator Bennet. Thank you, Mr. Chairman.
    Let me turn to another--it is very nice to see you, Mr. 
Attorney General. Welcome back to Washington. And I want to 
turn to what was also called a radical point. And that was the 
Affordable Care Act, which has made massive strides in 
providing health care to 20 million Americans, protecting 
people with preexisting conditions from discrimination, and a 
lot of other things that have become the norm in this country, 
like staying on your parent's health insurance until you are 
26, something you could not do before the Affordable Care Act 
was passed.
    I think we need to build on the Affordable Care Act and use 
the Medicare system to provide a true public option. And it is 
something that the President has also talked about on his 
campaign.
    I believed in it when we passed the ACA to begin with. The 
votes were not there to do it. I think it has become very clear 
during the course of the pandemic that nobody is served by 
having people who do not have access to primary health care. 
Because you can see in the numbers in the pandemic what has 
happened to this country versus some other places.
    Last August, the President, then candidate Biden, was 
speaking to one of my constituents from Colorado, Laura 
Packard, who told the Vice President at the time that she was 
literally receiving chemotherapy on the day that there were 
some folks here trying to repeal the Affordable Care Act.
    And she asked what he was going to do for people like her, 
and for people in America. And he told her, quote, ``We're 
going to provide a Medicare-like option as a public option.'' 
He went on, ``I'm going to protect you like I try and protect 
my own family, and I promise you that.''
    That was a powerful moment for all of us who were watching. 
And yesterday Senator Tim Kaine and I and some of my colleagues 
on this committee reintroduced the Medicare-X Choice Act to 
create a true public option, increasing choice for consumers, 
starting in rural areas, reducing health-care costs, and 
increasing affordability and quality of health insurance.
    We worked to ensure that our updated legislation aligns 
with President Biden's plan, including plans offering primary 
care services without cost-sharing, fixing the family glitch to 
increase access to premium support, and ensuring that the cap 
on premiums for everyone above 400 percent of the Federal 
poverty level is 8.5 percent of their income.
    Medicare-X both finishes the work of the ACA and aligns 
with the President's objectives. You are uniquely situated, 
having been both a lawmaker and the California Attorney 
General, to help us get this across the finish line. And I just 
want to ask what your thoughts are on the commitments the 
President made on a public option during the campaign, and how 
we can get it across the finish line so we can finally fulfill 
the promise that every single American has access to health 
care in this country.
    Mr. Becerra. Senator, you pointed out where now-President 
Biden stood as candidate Biden, and he was very strong about 
this. He made it very clear that the Affordable Care Act is a 
strong foundation from which we can build.
    You have mentioned the public option. He made it very clear 
he is a supporter of moving forward on a public option. My job 
will be to try to implement the President's agenda on health 
care. And so I will look forward to working with you and all of 
your colleagues to try to make sure we can continue to see more 
Americans access health care, whether through their employer, 
or whether through Medicaid, or whether through the Affordable 
Care Act's marketplaces.
    We need to have those options, including the public option, 
available. If States want to move in that direction, we will 
try to be--we will work with them as best we can. But as you 
have said, the goal here has to be to make things even better, 
more affordable for Americans.
    Senator Bennet. You know, Mr. Chairman, I came up with the 
idea for this legislation after I was in a meeting in Jackson 
County, CO. And to give you a sense of Jackson County--I just 
saw my friend from Indiana--I had to start the meeting by 
apologizing for how badly I had done in the election the last 
time, because, you know, there are very few Democrats there. 
And somebody actually said, ``Oh, you actually won a few more 
Democrats than there actually are.'' But it was grim.
    But I was there, and somebody said to me, ``You know, 
Michael, I moved back to this town.'' It is a county with, I 
think fewer than a thousand people in it. It is a huge space. 
``I moved back to this town to take over the bowling alley that 
I loved to go to as a kid. And I am working 50 hours a week. My 
wife is working 50 hours a week. Neither of us has health 
insurance.'' He said, ``I've got people I would want to hire, 
but I can't hire people because they have to give up their 
welfare to come work for me.''
    I said, ``What do you mean `their welfare'?'' And he said, 
``Their Medicaid.'' In other words, their health care. So here 
in America--this is after the Affordable Care Act--here we have 
a situation where a small business owner and his wife are 
working 50 hours a week and they cannot afford health 
insurance.
    Folks who would want to come work, cannot come work because 
they have to give up their insurance. How can we defend a 
system like that? And we do not need to. And I think--I hope we 
look back at the history of all of that and find a way to put 
the partisanship aside and actually provide the American people 
with just what this is, an option. They can choose. They can 
choose all over rural and urban Colorado; it would be a choice. 
If you want to stay with your private insurance, stay with it. 
If you want a public option administered by Medicare, you can 
have that too.
    And I think that is going to be a powerful argument for the 
American people who, coming out of this pandemic, want more 
choices, not fewer.
    So I am very glad you have been nominated, and I look 
forward to supporting your nomination and working with you to 
deliver this for the American people.
    Thank you, Mr. Chairman.
    The Chairman. Thank you, Senator Bennet.
    Senator Young?
    Senator Young. Mr. Becerra, there are all sorts of concerns 
by my constituents--and I think every American--about getting 
shots in the arms as quickly as possible. That is my foremost 
objective in trying to support the administration in 
furtherance of that goal.
    The Biden administration just announced the launch of two 
new Federal programs, the Federal Retail Pharmacy Program and 
the Community Health Center vaccination program. This was an 
effort to speed up vaccinations across the country. These 
programs are in addition to an existing program, which is the 
Pharmacy Partnership for Long-Term Care Program. Unfortunately, 
these various programs are causing some confusion for the 
States, as the States are not able to oversee and coordinate 
distribution of our already limited supply of vaccine with 
these various entities--long-term care facilities, community 
health centers, retail pharmacies. And individual Hoosiers are 
confused as well, because now they have to sign up in multiple 
places in order to become vaccinated.
    In fact, the National Governors Association recently wrote 
to the administration highlighting this issue, indicating, 
quote, ``if the Federal Government distributes independently of 
the States to these same entities without State coordination 
and consultation, redundancy and inefficiency may very well 
follow,'' unquote.
    I would like to submit two letters for the record, one from 
the NGA and one from my home State of Indiana, further 
detailing these concerns.
    The Chairman. Without objection, so ordered.
    [The letters appear in the appendix beginning on p. 226.]
    Senator Young. So I bring this to your attention because, 
until adequate supply is available, Mr. Becerra, the 
administration should be working with States on vaccine 
distribution, especially since retail pharmacies and Federally 
Qualified Health Centers are already part of many States' 
vaccine plans.
    The State of Indiana has been making great strides with the 
available vaccine to get it in the arms of Hoosiers. So do you 
commit to working with the States before announcing major 
program roll-outs, like the two I mentioned, in the future?
    Mr. Becerra. And, Senator, you will understand why this is 
close to my gut more than my heart, because I am a State 
official right now. And we have had to administer a lot of 
these programs. I have had to defend many of these programs at 
our State level in court.
    And what I will say to you is that, if we are not doing a 
good job of coordinating with our State and local and tribal 
and territorial partners, then we are not doing it as well as 
we can. And so I am committed to working with you to make sure 
that, as we get the product out--and, fortunately, President 
Biden has made an aggressive effort to make sure we have enough 
vaccines for everyone--that we are working with all those who 
have to make sure that shot actually gets into the arm.
    Senator Young. So that is an encouraging response. Let me 
go further.
    Mr. Becerra. Sure.
    Senator Young. Would you allow States like Indiana that may 
well find these programs counterproductive--as shared goals of 
getting vaccine into arms--to opt out of these Federal programs 
until a time where there is adequate supply available?
    Mr. Becerra. So let me--I am not yet there, and I hope to 
be confirmed, but it would be tough, Senator, to be honest with 
you, to----
    Senator Young. Would you consider it?
    Mr. Becerra. Absolutely. We will sit down with you and 
talk. The moment I am in that seat, I will make sure that we 
are sitting together. We will go to your office, and we will 
talk about this.
    Senator Young. Can you conceive of a reason why you would 
not allow a State like Indiana to opt out of these programs?
    Mr. Becerra. I will tell you that the President's goals are 
ambitious. We want to move quickly. I cannot understand why we 
would not want to always coordinate, but I also want to make 
sure it is clear that the President has been very transparent 
in saying that we want to make sure we are reaching everyone, 
we are doing it in a fair way, and we are doing it, you know, 
so it makes sense.
    Senator Young. I am going to cut you off, because you know 
how this goes. I have limited time.
    Mr. Becerra. Yes.
    Senator Young. But I would hope you would allow States like 
Indiana to opt out if that will help us get more vaccine in the 
arms of Hoosiers.
    So 33 Americans die every day waiting for a life-saving 
organ transplant. We have an organ shortage in this country, 
and it results from a severe lack of oversight and 
accountability among government monopoly contracts that run our 
organ donation system.
    These are known as ``organ procurement organizations,'' or 
OPOs. The Senate Finance Committee recently noted that our 
organ donation system has been severely under-performing for 
decades. The Department of Health and Human Services finalized 
a rule last November that will allow HHS to hold OPOs 
accountable for their performance for the first time in their 
40-year history.
    This rule is projected to save more than 7,000 additional 
lives every year, and it is going to save money too: over a 
billion dollars annually to Medicare. But because this rule was 
finalized in the last 60 days of the previous administration--
you know where I am headed with this--it is currently being 
subjected to the Biden administration's freeze on midnight 
regulations.
    So as HHS Secretary, will you commit to implementing and 
enforcing the November 2020 OPO Final Rule swiftly and 
forcefully as soon as the review period ends?
    Mr. Becerra. Well, first I have to say ``thank you'' for 
the role you played on organ donation. It is critical. It is 
not a subject everyone wants to take on.
    Secondly, there is--the pause the President put on a number 
of these rules is something that most administrations do, but I 
can guarantee you that the administration, if I am fortunate to 
be confirmed to HHS, will work quickly to try to get back up to 
speed on some of these different rules.
    What I can commit to you is this. We all know we need to 
increase the supply. We know we have to be fair. We have to 
make sure we are doing this in a way that makes sense. And we 
have to do the oversight.
    And so I can commit to you to work with you to make sure 
that, once I get in the chair, if I am fortunate to be 
confirmed, that we will talk to you about how we move forward 
with that rule, and of course your legislation as well.
    The Chairman. Thank you, Mr. Attorney General. Let me also 
say to my colleague, and to those following this, I think these 
are very important issues. And we have had a bipartisan inquiry 
going on in this committee where our colleague has been very 
actively involved. We will be continuing that. It is a really 
high-priority matter, and my colleague has laid out some of the 
problems, and we are going to want to get into the details, I 
believe, when the Attorney General is confirmed. And I was 
appreciative of the positive answer, so I thank you.
    Let us do this. If there are any Senators waiting in the 
queue on the web, we will take one more before we go and vote. 
And then otherwise, per an agreement with both sides, we will 
take a 15-minute recess, Mr. Attorney General. Are any of my 
colleagues waiting on the web to ask questions?
    [No response.]
    The Chairman. All right, I gather not. So we will take 15 
minutes. We will have a recess, and we will be back at that 
point.
    Oh, Senator Casey? Okay. Senator Casey, you are out there 
in cyberspace somewhere?
    Senator Casey. I did not think I would have a chance.
    The Chairman. Terrific, terrific. Okay, then we will revise 
the state of play here, and we will hear from Senator Casey. 
And after he has completed his questions, then we will take a 
15-minute break, and that is in accord with the wishes of both 
the majority and the minority.
    Senator Casey?
    Senator Casey. Thank you, Mr. Chairman. I think I may have 
jumped ahead, so I just want the Attorney General to know this 
has never happened before. [Laughter.]
    So let me use my time wisely. Mr. Attorney General, thank 
you again for your public service and your willingness to 
continue public service on behalf of the Nation by running a 
major agency of our government that is so important these days, 
and that is the Department of Health and Human Services.
    I also want to thank you for the commitment of your family, 
which I know is a major commitment by any family when you are 
in public service like you have been all these years. And yours 
is a great American story.
    I wanted to start with the issue of home- and community-
based services. We know that one of the real tragedies within 
the larger tragedy of the pandemic, now that we have reached 
that awful, awful number of 500,000 deaths, is a high 
percentage of those deaths--at last count, more than 170,000--
were residents and workers dying of the virus who were in 
nursing homes, living or working in nursing homes or other 
long-term care settings.
    One way to protect these populations is with a responsive 
and robust support system that provides quality home- and 
community-based services.
    We know that those who do this work in the home or home- or 
community-based services, as well as in the long-term care 
setting, are front-line workers. They are heroic. And the folks 
who do this work support older adults in our communities, and 
they also support and provide care for folks with disabilities 
who need that help.
    They are often paid about $12 an hour for this essential 
work. Most of them, a high percentage of them, are women of 
color. And because these home- and community-based services are 
not required under Medicaid under current law, there are over 
800,000 people on waiting lists for these services, 16,000 of 
those in Pennsylvania.
    So we need to invest in this option that we have not really 
made part of Medicaid in a substantial way other than the 
waiver program. We need to invest now. The House legislation, 
their COVID-19 bill, has over $9 billion. This is but a foot in 
the door, but a very important, unprecedented foot in the door.
    So I have two questions for you. First, upon the passage--
and I am being optimistic here, but I think it will happen--of 
this emergency funding legislation, COVID-19 legislation, as 
well as the funding for home- and community-based services, 
will you work to distribute it to the States as quickly as 
possible?
    Mr. Becerra. You have my commitment, Senator.
    Senator Casey. Thank you. And then secondly, as you know, 
the next matter for President Biden and Vice President Harris 
is to work on the Build Back Better plan. And that is another 
opportunity I think for us to really focus on this issue, but 
provide an even more substantial investment in home- and 
community-based services. And I hope you would work with us to 
secure that funding.
    Mr. Becerra. You have my commitment, again, to work with 
you on that.
    Senator Casey. The last issue, in my remaining time, is 
Medicaid. I do not have to tell you, because you have been a 
strong supporter and a fighter to preserve Medicaid funding, 
Medicaid, in so many ways, is not ``some program.'' It tells us 
who we are. It tells us who we are, and it tells us whom we 
value, whether it is kids or seniors or people with 
disabilities. So many millions of Americans, 70 million-plus at 
last count, have the benefit of Medicaid.
    You were familiar, when we sat down most recently and in 
our last hearing in the HELP Committee, with my agenda for 
children, and the Five Freedoms for America's Children.
    I believe every child at birth, if they do not have health-
care coverage, should be covered by Medicaid. And I just wanted 
to ask you, how will you use your authority as HHS Secretary to 
utilize waiver authority and other tools to strengthen Medicaid 
and to help expand coverage to uninsured or under-insured 
Americans?
    Mr. Becerra. Senator, I know you know this, so I am just 
repeating what you have already worked on so much, and that is: 
Medicaid is the lifeline. It is what has kept so many American 
families from losing all hope, and in many cases losing 
respect.
    And so I am absolutely prepared to work with you and many 
of your colleagues to try to do what we can to strengthen 
Medicaid for so many, including seniors who have Medicare who 
oftentimes rely on Medicaid as well. We have to make sure that 
we do not lose sight of how important Medicaid has become to 
the entire population. And with the President's commitment to 
continue to build on the Affordable Care Act, Medicaid, as you 
know, is indispensable.
    So we are ready to work with you on any issues, especially 
for children. And I know my wife is applauding everything you 
have just said to try to make sure our children have 
opportunities from the get-go.
    Senator Casey. Thanks so much. We look forward to your 
confirmation.
    The Chairman. Thank you, Senator Casey.
    We are calling some audibles here and, with the consent of 
both sides, we will have Senator Whitehouse, and then all other 
Senators should know we are going to take a 15-minute break, 
and then we will finish.
    Senator Whitehouse?
    Senator Whitehouse. Welcome, Attorney General. It is great 
to see you, and I wish you every success in the remaining days 
of your confirmation process.
    I want to mention two things to you that I have put a lot 
of work into over time. One is delivery system reform in our 
health-care system. Macro, we hit the Medicare trust fund in 
2024, and so we are going to have to deal with that issue 
between now and then. Micro, Rhode Island has two of the best 
Accountable Care Organizations in the country. These are 
primary care provider groups, doctors' practices that have 
gotten together early, signed up as ACOs under the Affordable 
Care Act, and have changed the way they practice. And as a 
result, their cost per patient is coming down. Their patient 
satisfaction is through the roof. Their outcomes are improving, 
and they are sending checks back to the Federal Government out 
of the shared savings that they have been able to obtain.
    My staff person will hand you a little graph that I have a 
big copy of right here, which is something that I have worked 
on for a while, as time has gone by. In the far left here 
[indicating], time begins around the time we passed Obamacare. 
At that point, CBO projected what Federal health-care spending 
was going to look like. And their projection then is that top 
line [indicating]. But in fact, with the Obamacare law, we did 
not follow that trajectory. Costs were actually lower.
    And as we have gone forward, we have experienced actual 
costs that are that bottom line [indicating]. And the current 
projection, matching that original one from 12 years ago I 
guess now, pushes that from where we are now out 10 years. But 
if you took that same projection and put it onto where we were 
before, here is this gap between what was predicted and what we 
have achieved.
    And in the next 10 years, that gap is $6 trillion. 
Something changed from what was anticipated at the time we 
passed Obamacare. And the savings in the next decade are going 
to be $6 trillion from whatever that thing was that changed.
    I think that what changed was getting away from fee-for-
service, getting providers engaged in Accountable Care 
Organizations and the emphasis on quality and reducing medical 
errors, and dealing with patients better.
    So I have had my rows with the Obama administration over 
how they were doing ACOs, and I have had my rows with the Trump 
administration. And I want to work with you to make sure that 
these organizations that are basically breaking trails for the 
rest of the health-care system, these leadership ACOs, are 
getting the support and the encouragement that they need. 
Because when they win, we win.
    And with the Medicare trust fund starting to hit its limit 
looming, we have to get serious about that. I do not need a 
long response from you now, but I want to make sure you are 
aware of the opportunities for delivery system reform. And I 
know you have some very good ACOs in California as well.
    Mr. Becerra. Yes. And, Senator, the response there is: I 
look forward to working with you on it.
    Senator Whitehouse. We will, because we have work to do. It 
is also very likely a big political win/win. I do not know 
anybody on any side of any aisle in Washington who does not 
want better care, producing lower costs, with happier patients.
    Last point; this is a bit of a personal thing. I have been 
working for a long time on having us treat people at the end of 
their lives better than we do, making sure that their choices 
are respected, making sure that their capability to be at home 
at that time is respected, making sure that they are pulled out 
of the hospital treadmill and they are not dying in intensive 
care units that they do not want to be in, and should not be 
in.
    We have worked with CMMI a lot on that, and I am hoping 
that we can close out, under your leadership through the Center 
for Medicare and Medicaid Innovation, a pilot program that will 
show that when you treat people at the end of their lives with 
more humanity, everybody is happier and it saves money. Will 
you work with me on that?
    Mr. Becerra. As someone who had his father live with him in 
the last few years of his life, so that when he passed, he 
passed in his bed in my home, I absolutely look forward to 
working with you on that.
    Senator Whitehouse. Thank you, sir. And Godspeed in your 
confirmation.
    Mr. Becerra. Thank you, Senator.
    The Chairman. I thank my colleague.
    Mr. Attorney General, we will take a 15-minute break.
    Mr. Becerra. Thank you.
    [Whereupon, at 4:15 p.m., the committee recessed, 
reconvening at 4:30 p.m.]
    The Chairman. The committee will come to order. The 
tentative order of Senators will be: Senator Cortez Masto on 
the web and Senator Warren in person. So that may be subject to 
a change if someone who was here earlier did not come, but I 
believe that is the case.
    Senator Cortez Masto?
    [No response.]
    The Chairman. Are you out there in cyberspace?
    [No response.]
    The Chairman. Okay, we will go to Senator Warren, and then 
we will go----
    Senator Warren. Are you ready for me, Mr. Chairman?
    The Chairman. Yes. Let me just--yes. Why don't you go, and 
then we will sort out where we are after that.
    Senator Warren?
    Senator Warren. Thank you. Thank you, Mr. Chairman.
    So, early in the pandemic, Representative Ayanna Pressley 
and I, along with many of our colleagues, pushed the Trump 
administration to collect and to publicly release demographic 
information on who was getting tested for COVID-19, and who was 
getting infected. Without this information, there would be no 
way to know if black, brown, and indigenous communities had the 
same access to tests as white communities. And it would be 
impossible for the Federal Government to allocate resources 
equitably.
    Put plainly, you cannot fix what you cannot see.
    Now, we kept pushing and mandated this data collection in 
one of the COVID relief packages. And now we have begun to get 
a fuller picture. We know that black, Latino, and indigenous 
people are nearly two times as likely to contract COVID-19, 
roughly four times more likely to be hospitalized when they get 
sick, and more than twice as likely to die.
    Those data are critical to setting policies to combat 
racial inequality, but today, almost a year into the pandemic, 
nearly half of all testing data collected by the CDC still does 
not have associated race or ethnicity information.
    As HHS Secretary, will you commit to prioritizing 
collecting and reporting these critical data so that we get a 
fuller picture of how the virus is affecting all Americans?
    Mr. Becerra. Senator, first, thank you for making that 
effort to secure that information. I can make this commitment 
to you now that I will work with you to make sure we have all 
of that type of information. We need that information to do a 
good job.
    Senator Warren. Good. I am glad to hear you say that.
    Now on the vaccine front, we have administered over 64 
million doses of the COVID-19 vaccine, but the CDC has race and 
ethnicity information for just over half of those vaccines. So, 
if confirmed, will you also commit to improving the collection 
and publishing of the data on vaccines?
    Mr. Becerra. I commit to work with you to make that happen.
    Senator Warren. That is terrific. You know, there is more, 
though. Racial equity should be a part of every public health 
issue that you approach as HHS Secretary: chronic conditions, 
infant mortality, addiction, police brutality. Racial health 
disparities are not coincidences or aberrations in the data. 
They result from structural racism, and it is time to start 
treating structural racism like any other public health 
problem: investing in research into its symptoms and its causes 
and finding ways to mitigate its effects.
    So let me ask you the third in this series. Will you commit 
to collecting the data we need to see the racial disparities in 
our health-care system, and to attacking those disparities 
head-on?
    Mr. Becerra. Senator, I am looking forward to working on 
that with you, because it is time.
    Senator Warren. Thank you very much. I am looking forward 
to working with you, and I am going to support this nomination 
all the way. Thank you.
    Mr. Becerra. Thank you.
    Senator Warren. Thank you, Mr. Chairman.
    The Chairman. I thank our colleague.
    Senator Cortez Masto, I believe, is next.
    Senator Cortez Masto. Thank you. I am here.
    Attorney General Becerra, congratulations on your 
nomination. I am very excited for you and your family.
    Let me start with an issue that I have been focused on for 
the State of Nevada and that many of us really have been 
talking about and putting in the most recent package. First, I 
want to thank the administration for the work that went into 
President Biden's American Rescue Plan to provide COVID-19 
relief to millions of families across the country. There is 
still a need for it out there, including in Nevada that has 
been so hard-hit. So many of the provisions in the plan are 
critical to getting Americans back on their feet.
    But I would like to focus on the COBRA subsidies that will 
be a lifeline to out-of-work Nevadans. Nevada's tourism-driven 
economy was devastated by the coronavirus. The losses suffered 
by our gaming and hospitality sectors have taken a toll on 
hardworking families across the Silver State, as families have 
experienced layoffs or seen their hours cut. They have lost 
steady wages. They have experienced food and housing 
insecurity. And they have lost their health care.
    The Rescue Plan includes measures to address each one of 
these issues, but COBRA subsidies are especially critical 
because they are key to preserving the benefit that union 
workers have fought for. They are central to protecting the 
coverage of whole families and ensuring access to their doctors 
and specialists.
    So, Attorney General Becerra, I know you understand how 
essential these benefits are to working families. Can we count 
on you to help us protect these hard-fought benefits that will 
help Nevada families and all families stay afloat through this 
crisis and beyond?
    Mr. Becerra. Senator, you have my commitment, because you 
are talking about having a continuity of coverage for people 
who were working, oftentimes had their coverage because of 
their work, or through their union. Through no fault of their 
own, now they find themselves in these conditions. And so 
absolutely, you have my commitment to work with you on this.
    Senator Cortez Masto. Thank you. And I want to touch on 
another subject that my colleagues, Senators Wyden and 
Stabenow, have talked about, which is mental health.
    As we have seen, the pandemic has shone a new bright light 
on the mental health needs of American families, from seniors 
struggling with loneliness, to young students navigating an 
online learning environment; from those with a history of 
substance abuse or serious mental illness who have been thrown 
off track by the radical change in our daily life, to families 
facing the trauma of job loss and poverty--everyone is hurting.
    We have had and made a huge effort last year to incorporate 
funding for mental health support in the various coronavirus 
relief packages. But let me just say this: block grants and 
patchwork funding are no way to sustain the mental health 
infrastructure that the Nation needs over the long term.
    We should see the pandemic as an opportunity to build an 
even stronger support system for American families. And that is 
why I have been working on legislation that builds on Senator 
Wyden's CAHOOTS Act to bolster behavioral health crisis 
response services across the country. It integrates Senator 
Stabenow's Certified Community Behavioral Health Services. And 
so I look forward to working with you on this legislation that 
will build on SAMHSA's guidelines to create a framework for 
providing emergency mental health services to individuals in 
crisis.
    You know better than anyone, with your broad experience, 
particularly as the most recent Attorney General of California, 
that there is a need for this. We just have to get it right 
moving forward.
    So can I count on your support in working with us to 
address metal health and behavioral health services in States 
across the country?
    Mr. Becerra. Senator, for the reasons you have just 
articulated, I started a disability rights unit in the 
Department of Justice in California, and I am absolutely 
looking forward to working with you on these issues.
    Senator Cortez Masto. Wonderful.
    And then lastly, let me just put this on your radar. I 
would like to underscore the imperative that HHS focus on 
improvements to the Indian Health Service. We are in bipartisan 
agreement here in Congress that the Service is in dire need of 
additional, stable funding in order to meet the basic needs of 
Indian country.
    Many of us also sit on Senate Indian Affairs, and this is 
crucial and critical that we have your support. You know, the 
crisis at IHS was years in the making. And so, can I get a 
commitment from you that we can work with you, that you are 
willing even to come to the committee, Senate Indian Affairs, 
and talk with us about how we address and improve upon the 
Indian Health Service in this country?
    Mr. Becerra. Absolutely; you have that commitment.
    Senator Cortez Masto. Thank you. Congratulations, again.
    Mr. Becerra. Thank you.
    The Chairman. Thank you, Senator Cortez Masto.
    Senator Cassidy is next.
    Senator Cassidy. Hello, General Becerra. Again, it is good 
to see you.
    General Becerra, if I had to guess, if I was a betting man, 
I would bet that you have the votes to be approved. As I 
mentioned in the HELP Committee, my concern is that you will be 
in charge of the largest domestic agency and you do not have 
the background.
    Now your answers have been typically general, and I have no 
doubt that you will have good advisors. But as I said 
yesterday, I am a physician. Should I be the Attorney General 
of the United States? Obviously the answer is ``no.''
    So--but, you know, there are three major buckets of HHS. 
One bucket is the TANF or the social services; the other is the 
finance in the Medicare and Medicaid; and the third is what we 
discussed at HELP, those kind of FDA, NIH, and other buckets, 
if you will. And those are the three big ones. And everything 
else is far less.
    So just to kind of explore, because, as Senator Burr said 
yesterday, this is kind of your opportunity to introduce 
yourself to the American people and to say, ``Nope, I've got 
it. I'm ready. I don't know everything, but I know enough, and 
you do not have somebody coming in who is unfamiliar with what 
might be happening.''
    So let me just ask you a couple of things. TANF is a 
program that will be under your administration. And can you 
just talk--and you have spoken about enforcing existing laws. 
So knowing the goals of the TANF program, what could we do to 
more specifically address those specific goals as laid out in 
statute for TANF?
    Mr. Becerra. So, Senator, thanks very much for the chance 
to answer the question. And by the way, thank you very much for 
the time you gave me to sit down and talk about a number of 
issues.
    What I can tell you is, if we are talking about children 
and families, HHS can do a whole lot to make sure that, whether 
it is nutritional goals, whether it is the health status, or 
whether it is making sure that we are talking about wellness, 
not just about remedying conditions, that we are working with 
all of our sister agencies, and with our State and local 
partners to make sure that we are trying to improve the 
condition of life for these families--especially families----
    Senator Cassidy. Let me, if I may, because I have limited 
time. The statute says specifically that, among its four goals 
are to reduce out-of-wedlock pregnancies; to promote the 
formation and maintenance of two-parent families; to end the 
dependence on government benefits through work, job 
preparation, and marriage; and then to provide assistance to 
needy families with children so they can live in their own 
homes, or the homes of relatives.
    So what specifically about those goals--because this is 
part of one of those big three buckets that you will be 
administering--would you bring to the table as sort of a policy 
solution?
    Mr. Becerra. Well, having been someone who had the benefit 
of having two loving parents and who had a chance to be raised 
by people who always worked hard and gave me the best example, 
I certainly believe that one of the things that we can do is 
continue to strive to give all of our children the opportunity 
to be raised in a loving home, and with an opportunity to----
    Senator Cassidy. So, General, that is the goal of the 
program. That is the statute. I guess the question is, what 
experience, or what specific programs, or what critique of 
existing programs would you offer in order to better meet that 
goal? Again, something that the HHS Secretary will be 
responsible for.
    Mr. Becerra. Well, certainly I think there is always a need 
to try to improve on the different programs. We always learn 
every year how we can make them better. We learn of 
inefficiencies of bureaucracies that sometimes get in the way.
    If I am fortunate to be confirmed, I certainly will take a 
close look and, with your help and the oversight that you all 
do, I hope what we can do is improve these programs and have in 
place the road maps, whether it is through statute or through 
regulation, that let us advance the interests of these 
families.
    Senator Cassidy. So then the second question is financing, 
which is the Medicaid and Medicare programs. And we have talked 
about a lot of things on this committee. You have been on Ways 
and Means and were involved in the Medicare modernization, so 
this might be more in your wheelhouse.
    But one issue that we have discussed is, Medicare 
beneficiaries and an increasing share of commercial enrollees 
pay co-insurance based upon the list price of a drug. So if the 
pharmaceutical company drives up the list price to give a 
bigger rebate to a pharmacy benefit manager, the net price may 
be lower for the PBM, but the patient is paying based on the 
list price.
    What steps could HHS take to protect the patient in this 
situation?
    Mr. Becerra. Well, here we have to look at this from the 
perspective of the patient. And I know that there are a number 
of things going on right now with the rebate program. And 
rather than let patients, Medicare beneficiaries, get embroiled 
in the food fight between PBMs and drug makers, we have to make 
sure that we agree, all of us agree that whatever we are going 
to do, whether it is on rebates or anything having to do with 
prescription drugs, we are letting our seniors on Medicare know 
that we are going to fight to lower the price.
    And so without getting into the specifics of the different 
fights that are going on between the different providers and 
those that are involved as stakeholders, what I can tell you is 
that we will do the oversight.
    There are in some cases existing regulations that tell us 
how to proceed with regard to the rebates. There is existing 
authority. And what we can do is make sure that no one is 
trying to game the system; that at the end of the day we are 
looking for lower prices on the prescription drugs that our 
seniors count on.
    Senator Cassidy. Okay; thank you very much.
    The Chairman. I thank my colleague, and I look forward to 
working with him. The three remaining Senators that we have are 
Senator Sasse, Senator Hassan, and Senator Portman.
    Senator Sasse?
    Senator Sasse. Thank you, Mr. Chairman.
    Mr. Becerra, you said a little while ago that you never 
sued the nuns, which is a pretty interesting way of reframing 
your bullying. You actually sued the Federal Government who had 
given an exemption to the nuns. Can you explain to us what The 
Little Sisters of the Poor were doing wrong?
    Mr. Becerra. So, Senator, as I tried to explain, my actions 
were against the Federal Government. The Little Sisters of the 
Poor, we never alleged that The Little Sisters of the Poor did 
anything wrong. Our problem was that the Federal Government was 
not abiding by the law as we saw it, and what we did is, we 
took action against the Federal Government so California could 
administer its programs to make sure that the Affordable Care 
Act continued to work.
    Senator Sasse. What were the nuns doing that made it 
impossible for California to administer their program? That was 
just a complete nonsense answer. What were the nuns doing that 
would have made it difficult for California to administer your 
program?
    Mr. Becerra. Well, as I said, Senator, our action was 
against the Federal Government----
    Senator Sasse. No, no; you continued and you said ``so that 
California could administer'' your program. What did the nuns 
do that made it difficult for California to administer their 
program?
    Mr. Becerra. And, Senator, what I am trying to explain to 
you is that we were not looking at the actions of The Little 
Sisters or any other program. Our actions were against the 
Federal Government in the way it was applying the law as it 
existed to California.
    Senator Sasse. But what did the Federal Government do? It 
was about the nuns. This is nonsense. Like what you are saying 
is not true. You say you did not sue the nuns, you sued the 
Federal Government that was keeping you from making sure that 
the nuns had to buy contraceptive insurance. Were the nuns 
going to get pregnant?
    Mr. Becerra. Senator, the actions of the State of 
California--and I was defending the actions of our State and 
the laws that were in place--the Federal Government took 
actions, changed the way that we would administer the programs 
that we had under the Affordable Care Act. Our actions related 
to how providers are providing services to the people of 
California.
    When the Federal Government took action that we thought was 
unlawful, we took action to protect the people of California.
    Senator Sasse. So again, a whole bunch of words. But you 
know well--you are an incredibly smart man--you know well that 
what the Federal Government did was to make sure that you could 
not target the nuns.
    So you sued the Federal Government because the Federal 
Government said the nuns did not have to buy contraceptive 
insurance. You can put 17 layers of you were following the law 
to go after the Federal Government for administering the 
program, or doing X, or doing Y that made it difficult for 
California to administer the program, but it was just about 
nuns buying contraceptive coverage.
    Was there something else the Federal Government did that 
you were suing them for in the case called California versus 
Little Sisters of the Poor?
    Mr. Becerra. Senator, the case was not, again--that was not 
the name of the case. And what I will tell you is that our 
actions were based on trying to follow the law. When the 
Federal Government took action, which we believe did not 
comport with the law, at that point we took action. And our 
action was based on the law.
    And so as I have said, we may disagree on how we see this, 
and I respect the differences that we may have, but my action 
was to follow the law.
    Senator Sasse. What about the law--as the Federal 
Government's conscience exemptions applied in the case where 
you sued the Federal Government--what about the law applied to 
anybody except the nuns and other similarly situated religious 
institutions?
    You were targeting religious liberty.
    Mr. Becerra. Senator, let me see if I can try to answer it. 
The Affordable Care Act tried to make sure that we are 
providing health care to all Americans. And we have to make 
sure that we provide the services that Americans are entitled 
to receive.
    We tried to make sure that in California, under the 
Affordable Care Act, every Californian received the benefit 
they are entitled to under that Act. And so when we saw that 
the Federal Government was taking actions which might abridge 
those rights----
    Senator Sasse. And I am going to ask the question again. 
You said the Federal Government taking actions--this is the 
third time you have not answered. Were any of those actions 
about anything except nuns and religious liberty? Was the 
Federal Government taking other actions that you were suing 
about in that case? Or was it just because you wanted to target 
the nuns and religious liberty?
    Mr. Becerra. Senator, again I respect the way you view it, 
but----
    Senator Sasse. Because it is actually what happened.
    Mr. Becerra. Senator, again I understand that we may view 
it differently, but I was trying to protect access to care----
    Senator Sasse. I am giving you the chance to explain what 
you think it was about, if it was not this. And you have not 
yet explained any part except ``the law as administered by the 
Federal Government.'' But it was about the nuns.
    Mr. Becerra. Senator, I will try once again to explain. 
Californians are entitled under the Affordable Care Act to 
access care.
    Senator Sasse. And the nuns were keeping them from getting 
care how?
    Mr. Becerra. The Federal Government was changing the----
    Senator Sasse. To make sure that the religious liberty 
rights of the nuns were protected. Was there anything else the 
Federal Government was doing, except making sure the nuns had 
religious liberty?
    Mr. Becerra. Senator, I respect the differences in the way 
you pursue this----
    Senator Sasse. For the fifth time, you have not answered 
the question. I have asked you for any party, besides the nuns, 
and you have just said you respect the diversity of opinion.
    I will move on to another question. Former abortion 
industry employees from your State have claimed on camera that 
babies who survived abortions were left to die by Planned 
Parenthood staff in your State, in clear violation of both 
State and Federal law.
    Instead of investigating these claims, you raided the 
houses of the film makers who brought these atrocities to 
light. Why did you do that?
    Mr. Becerra. Senator, again I respect the way you framed 
it. I would say to you that it is clear that we look at it 
differently. California has privacy laws. We enforce privacy 
laws. When we take action based on a violation of privacy laws, 
it is because we have evidence that the rights of Californians 
to their privacy have been violated.
    You have described it differently, but what I will say to 
you is, my job is to follow the law and make sure others do as 
well.
    Senator Sasse. I think what you are saying is, the baby 
body parts were not interesting, but the filming of it was? But 
in 2014 and 2015, at a California----
    The Chairman. The Senator from Nebraska is over his time, 
and his colleague, Senator Barrasso, is next, and two other----
    Senator Sasse. Can I ask my colleague if he minds if I go 
for 45 seconds?
    The Chairman. Sure. Forty-five seconds, and that is it.
    Senator Sasse. Thank you, Mr. Chairman. In 2014 and 2015, 
California poultry farms were recorded secretly showing 
inhumane treatment of animals in California. Did you 
investigate the film makers of the poultry farm filmings?
    Mr. Becerra. In what years?
    Senator Sasse. 2014 and 2015.
    Mr. Becerra. Senator, I was not the Attorney General at 
that time.
    The Chairman. The time of the gentleman has expired.
    The Senator from Wyoming.
    Senator Barrasso. Thank you, Mr. Chairman. Thank you for 
taking time to visit by phone, and we all value your 
willingness to serve our country.
    You started the testimony referring to the painful impact 
of coronavirus on all of us. Rural communities, as we talked 
about, are facing significant challenges, especially as a 
result of the pandemic. We talked about rural health needs and 
getting physicians in training into rural communities. As a 
doctor who practiced in Wyoming for over 2 decades, I am very 
interested and focused on protecting and improving health care 
in rural America.
    The one aspect of health care that is often overlooked is 
the many factors outside of direct patient care that impact the 
health of individuals. According to the Centers for Disease 
Control and Prevention, social determinants of health have a 
major impact on people's health, well-being, and quality of 
life. And when you were in the House of Representatives, you 
actually helped draft legislation requiring the Secretary of 
Health and Human Services, which you are now nominated to 
serve, to conduct research on social determinants of health in 
Medicare's value-based programs.
    So then you agree that social determinants of health such 
as employment, educational opportunity, all strongly impact the 
health of individuals, that chronic unemployment is harmful at 
a high rate. And that is why I am so bothered that one of the 
first actions taken by the Biden administration was a ban on 
oil and gas leasing. And the impact of that on jobs in my State 
is just devastating.
    It is killing jobs. It is killing hope in communities. 
People are worried about rising unemployment rates and all of 
the issues that come along with that. These industries create 
thousands of jobs and contribute hundreds of millions of 
dollars to States. And in the States, the money is used for 
education, for schools, for students, and to help hospitals 
stay open and stay viable in these communities.
    The Biden administration's decisions are clearly going to 
have a terrible impact, I believe, on the health and well-being 
of communities in Wyoming and across rural America. And it is a 
decision made by executive order, Day One.
    Do you agree that cutting hundreds of millions of dollars 
from hospitals and schools is going to have an impact on health 
in rural communities?
    Mr. Becerra. Well, Senator, first, thank you for the 
question, and thank you for the chance to chat by phone. Any 
time a community is impacted where it loses jobs, it loses 
access to care and good schools, you are going to see impacts. 
And so I think we all want to make sure that we are doing 
everything possible to make sure that every family, wherever 
they locate, has the opportunities that we expect in America.
    Senator Barrasso. I want to talk about what is happening 
also with the pandemic, especially how it has impacted seniors 
and other vulnerable people living in nursing facilities. In 
terms of my home State of Wyoming, a large proportion of people 
who have lost their lives to coronavirus have been patients in 
nursing homes. That is where it struck first within the State, 
and continues.
    From a public health perspective, I think it is important 
for States and local governments to accurately report 
information regarding the impact of coronavirus. And you know, 
unfortunately it is clear now that the State of New York not 
only failed to report accurate data regarding nursing home 
deaths, but likely deliberately misled the public.
    According to the Attorney General of New York--and I do not 
know if that is someone you have worked with, because you are 
still Attorney General of California--the Attorney General of 
New York says the State under-counted deaths from coronavirus 
in nursing homes by up to 50 percent.
    Do you believe it is important for States to accurately 
report public health data--especially deaths--from coronavirus?
    Mr. Becerra. Senator, I think it is important that all of 
us do the work to make sure that our data reflects the facts, 
and that the data is used in appropriate ways so we can make 
decisions on how to move forward.
    Senator Barrasso. So, given this glaring evidence that is 
presented by the New York Attorney General, as Secretary will 
you advocate that the Biden administration fully investigate 
what occurred in this situation?
    Mr. Becerra. Senator, I know the Attorney General of New 
York very, very well. AG James is a tremendous advocate for her 
State. But I do not know the facts in that particular case, and 
it would be difficult for me to comment.
    Senator Barrasso. The other issue that you and I talked 
about is graduate medical education, and you and I have similar 
situations. You in California know that the majority of the 
money goes to the big cities. Doctors train there. And we 
talked about your wife, who is a physician. Most people 
practice medicine within 50 miles of where they do their 
training.
    And so little of the money goes to the 26 States that have 
the greatest needs in terms of under-served communities. I do 
not know if you have had a chance to give additional thought to 
that, but it is critical that we get a redistribution of the 
money, if we are going to get a redistribution of where 
physicians practice in America, because they tend to stay 
pretty close to the area where they train.
    Mr. Becerra. Senator, you brought up a very good point, 
because I think the data will bear out what you said that 
oftentimes, once you find yourself in a residency program, you 
end up sticking around pretty close. You start to meet people. 
Sometimes you meet your spouse and establish a family.
    And so I think it is important that we make sure that no 
community in the country is not considered when it comes to the 
opportunity to have these tremendously important professionals 
like you, like my wife, provide care to our families.
    And so I am more than willing to work closely with you on 
that, because I think it would be a mistake if we allow the 
real professionals who have been champions in this COVID 
pandemic to not be spread throughout the country.
    Senator Barrasso. Thank you, Mr. Chairman.
    The Chairman. I thank my colleague.
    Senator Toomey is on the web. And then we will have Senator 
Hassan and Portman, and that will be it. It has been a long 
afternoon.
    Senator Toomey. Thank you, Mr. Chairman. Can you hear me 
okay?
    The Chairman. Yes.
    Senator Toomey. Thank you, Mr. Chairman.
    Attorney General Becerra, welcome and thanks for your 
willingness to serve.
    I wanted to zero in on one particular health-care policy 
that you have advocated for, and which I find very, very 
disturbing. Specifically, I am referring to the use of the so-
called march-in rights by the Federal Government, to basically 
confiscate the intellectual property of a private company. You 
sent a letter to Dr. Francis Collins, the Director of the NIH, 
and former Commissioner of the FDA Stephen Hahn, demanding that 
the government use these so-called march-in rights to steal the 
legal right to Gilead's product, in this case it was 
remdesivir, and give it to a third party to manufacture.
    The letter was sent just last August 4, 2020, so just a few 
months ago. We are in the midst of a global pandemic, and just 
a few months after this perhaps life-saving treatment was 
approved by the FDA for emergency use in hospitalized patients 
with COVID-19. And it was almost an entire month before the FDA 
expanded the authorized use, no longer limiting it to nations 
with severe disease. And the reason that you cited in the 
letter was you did not think that the product was being 
manufactured fast enough, and you did not like the price.
    Well, I am not convinced that that comports with reality 
here. Consumers were not being charged the full cost of the 
drug, and separate co-pays are not paid on inpatient drugs. 
Congress had already acted to protect uninsured patients from 
any cost related to COVID-19 treatments. In fact, Congress went 
a step further, increasing payments to hospitals that cared for 
COVID-19 patients.
    But this policy that you are recommending also seems to me 
to betray a lack of understanding of the basic incentives, and 
the science, and how drugs are made. Gilead was in the process 
of finding other manufacturers at the time who could help them 
expand the production, had there been a significant increase in 
demand.
    Also, you disregarded the opinions of legal and scientific 
experts about this. Dr. Collins himself previously testified 
that NIH legal experts do not believe that the law allows the 
agency to intervene based on a drug's price, which was one of 
the reasons you cited.
    Here is what Dr. Collins said, and I quote: ``If you look 
at the language of the bill, it really intends to cover a 
circumstance where a drug is simply not available to the public 
under any circumstances, and then NIH is entitled to step in. 
This is a little different when it is available, but at a high 
cost. Our legal experts do not feel that the law actually puts 
us in a position to step in,'' end quote.
    So, Mr. Becerra, I am not convinced that you fully 
appreciate the downstream effects of socialist-type policies 
such as those that you have advocated. So let me just ask this: 
do you acknowledge that the administration does not actually 
have the legal authority to use march-in rights as a mechanism 
to try to lower drug prices?
    Mr. Becerra. Senator, first, thank you for the question. It 
is great to have an opportunity to have a dialogue with you 
again after years of serving together, including on the Super 
Committee.
    What I will tell you is this: you have already raised the 
subject of march-in rights. The letter that I was a part of was 
a bipartisan letter. Attorney General Jeffrey Landry from 
Louisiana and I put together that letter. And we had many, many 
Attorneys General from both sides of the aisle who were part of 
that. And if you remember, the date that you mentioned the 
letter was issued, that was at the time, if you recall, when we 
started to see the rapid increase in cases of COVID.
    And what we know now is far more than what we knew then. 
What we knew then was that many Americans were dying. And what 
we knew then was that remdesivir was a drug that was keeping 
people alive. And what we also knew then--and this was 
bipartisan--at least back at the State level, maybe folks here 
at the Federal level had more information, but at the State 
level we were seeing our folks die. And we knew that there was 
a drug that----
    Senator Toomey. I am about to run out of time, and I just 
have to say, we have very different understandings of this 
history. There was not a shortage of remdesivir. There was not 
a problem with people who could not afford it, because of other 
steps that Congress had taken. But there is a big problem when 
the government comes in and confiscates the intellectual 
property that has led to a successful product. It creates a 
chilling effect and seriously discourages future investment.
    So I would--I am running out of time here--but I would 
appreciate it and suggest you might want to reconsider whether 
the Bayh Dole Act ever intended to act as a mechanism that 
would undermine the incentive for the private sector to deliver 
needed products.
    The Chairman. I thank my colleagues. We have two Senators 
who may join us momentarily, Mr. Attorney General, and what we 
are going to do is just go through a couple of the formalities 
and see if they are going to arrive, and we should be able to 
wrap up.
    First with respect to members, I would like to thank all 
members for their participation. I would like to thank Attorney 
General Becerra for a very long afternoon.
    Regarding questions for the record, the deadline for 
members to submit questions will be Friday, February 26th, at 5 
p.m. That 5 p.m. deadline is firm. We want to thank everyone 
for their cooperation.
    I have a couple of other matters. Senator Crapo, is there 
anything that you need to ask? Okay, then moving very quickly, 
Mr. Attorney General, we wrote a law, a bipartisan law in this 
committee--I think I mentioned this to you briefly in our 
conversation--and it went into effect in 2018 to reflect the 
transformation in the Medicare program. The Medicare program, 
when I began the Gray Panthers in Oregon, we acknowledged that 
it was an acute care program. Part A, Part B--if you broke your 
ankle, you went to the hospital; if you had a bad case of the 
flu, you went to the doctor. But it was acute care. That is not 
Medicare today. Today Medicare is mostly chronic care--cancer 
and diabetes and heart disease and strokes and the like.
    This committee wrote a bipartisan law. I consider it one of 
the most transformative health initiatives in many years, and 
the Trump people basically said it was a wonderful idea and 
never did anything about it in terms of moving it forward.
    My question to you is, when you are confirmed--and I will 
use that, ``when'' you are confirmed--will you assign several 
people of your staff to work with the bipartisan leadership on 
this committee? Senator Crapo and I have talked about these 
issues before with Senator Hatch and others, and we would like 
to have a chance to work with you after the Senate votes on 
your confirmation.
    Mr. Becerra. Senator, I look forward to that, and I can 
certainly confirm that.
    The Chairman. Very good. One last point. And that is, at 
today's hearing it was clear there were stark differences of 
opinion when it comes to women's health care. And, Mr. Attorney 
General, you have made it clear that you respect those 
differences.
    And I want to emphasize this point now. If confirmed, you 
will follow the law on women's health and all other issues that 
you will be responsible for as Health and Human Services 
Secretary.
    So, given those commitments that you have made, Mr. 
Attorney General, today, in my view the differences of opinion 
should not be used as a rationale to prevent confirmation of a 
person like yourself who is qualified. And I just wanted to set 
that out for the record.
    I want to make sure that Senator Hassan and Senator Portman 
are not waiting. I see no evidence that they are.
    And with that, the Finance Committee is adjourned.
    [Whereupon, at 5:14 p.m., the hearing was concluded.]

                            A P P E N D I X

              Additional Material Submitted for the Record

                              ----------                              


      Prepared Statement of Hon. Xavier Becerra, Nominated to be 
           Secretary, Department of Health and Human Services
    Thank you, Mr. Chairman, Ranking Member Crapo, members of the 
committee. I'm grateful for the opportunity to speak with you. And a 
sincere ``thank you'' to Senators Feinstein and Padilla for their kind 
introduction.

    I also want to thank my family: my wife, Dr. Carolina Reyes, who is 
here with me, and my daughters Clarisa--along with her husband Ivan--
Olivia, and Natalia, for their constant love and support.

    I am here because my parents Manuel and Maria Teresa--who had only 
their health and hope when they settled in Sacramento--were tireless 
believers in earning the American Dream. A construction worker with a 
sixth-grade education and a clerical worker who arrived in her teens 
from Guadalajara, Jalisco, Mexico, they never saw the inside of a 
college classroom, but they sent all their kids to one, or to the 
military.

    We lost my dad last year on New Year's Day. When the end came, my 
dad knew we were there with him--at his side, in our home. Sadly, 
hundreds of thousands of Americans haven't had that closure this past 
year. That, Senators, is why I'm here today.

    The COVID pandemic has killed 500,000 Americans, many of them alone 
without their families. Millions more have lost their jobs and health 
care. That is not the America my parents would believe possible.

    To meet this moment, we need strong Federal leadership. That's what 
President Biden is demonstrating. If I'm fortunate to be confirmed, I 
look forward to joining the President in this critical mission.

    I understand the enormous challenges before us and our solemn 
responsibility to be faithful stewards of an agency that touches almost 
every aspect of our lives. I'm humbled by the task. And I'm ready for 
it.

    The mission of HHS--to enhance the health and well-being of all 
Americans--is core to who I am. When I was a child, my mom had a health 
scare: she was rushed to the hospital after hemorrhaging at home. The 
image is seared in my memory.

    We were lucky. My mom is now 87 years old. Better put, we were 
blessed: my dad had insurance--through his union, Laborers' Local 185. 
We didn't have much, but we didn't have to face the threat of unpaid 
medical bills or even bankruptcy.

    Over 2 decades in Congress, I worked to ensure every family had the 
assurance of care that mine had. I helped expand the Children's Health 
Insurance Program. I helped write the Affordable Care Act. From the 
Ways and Means Committee, I fought to strengthen and modernize Medicare 
and how we finance it.

    As California's Attorney General, I created a health-care rights 
and access unit and cracked down on Medicare and Medicaid fraud. I 
worked to protect people's health--holding opioid manufacturers 
accountable for the addiction crisis and successfully taking on 
hospitals and drugmakers who unfairly jacked up prices on patients. I 
protected patients' privacy. If confirmed, I'll work with you to 
continue this type of work, and to address HHS's biggest challenges.

    First, COVID. The President has ambitious goals: 100 million 
vaccine shots in arms in his first 100 days, increasing access to 
testing, sequencing the virus so we're prepared for the variants, and 
reopening schools and businesses. HHS has a central role in meeting 
these goals--safely and equitably.

    As Attorney General, I saw the importance of this on the front 
lines. I worked with colleagues in other States--both Republicans and 
Democrats--to make COVID treatments more readily available. I am ready 
to work with you, our State and local partners, and across government, 
to get this right.

    Second, we must ensure people have access to quality, affordable 
health care. If confirmed, I will work with you to strengthen our 
Medicare and Medicaid lifelines; reduce the cost of health care and 
prescription drugs; and ensure we are accountable, spending resources 
wisely and effectively.

    I won't forget the other ``H'' in HHS: human services. I want to 
work with you supporting our vulnerable kids, those in foster care, 
strengthening Head Start, and expanding access to child care.

    Third, we must restore faith in our public health institutions. 
That starts with putting science and facts first and showing respect 
for our career workforce.

    No one understands your States and communities better than you. We 
may not always agree, but if I'm fortunate enough to be confirmed, I 
will always listen to you and keep an open mind, find common cause, and 
work with you to improve the health and dignity of the American people.

    Thank you for the opportunity to share my vision.

                                 ______
                                 

                        SENATE FINANCE COMMITTEE

                  STATEMENT OF INFORMATION REQUESTED 
                               OF NOMINEE

                      A. BIOGRAPHICAL INFORMATION

 1.  Name (include any former names used): Xavier Becerra.

 2.  Position to which nominated: Secretary of Health and Human 
Services.

 3.  Date of nomination: The President-elect announced his intent to 
nominate me on December 7, 2020.

 4.  Address (list current residence, office, and mailing addresses):

 5.  Date and place of birth: January 26, 1958; Sacramento, CA.

 6.  Marital status (include maiden name of wife or husband's name):

 7.  Names and ages of children:

 8.  Education (list all secondary and higher education institutions, 
dates attended, degree received, and date degree granted):

        Stanford Law School.
        Dates attended: September, 1981-June, 1984.
        Degree received: JD.
        Degree granted: June, 1984.

        Stanford University.
        Dates attended: September, 1976-June, 1980.
        Degree received: Bachelor's Degree.
        Degree granted: June, 1980.

        C.K. McClatchy High School.
        Dates attended: September, 1973-June 1976.
        Degree received: High School Diploma.
        Degree granted: June, 1976.

 9.  Employment record (list all jobs held since college, including the 
title or description of job, name of employer, location of work, and 
dates of employment for each job):

        Attorney General (January 2017 to present).
        State of California.
        Sacramento, CA.

        Member of Congress (January 1993-January 2017).
        U.S. House of Representatives.
        Washington, DC.

        Assemblymember (December 1990-November 1992).
        Assembly, State of California.
        Sacramento, CA.

        Deputy Attorney General (January 1987-November 1990).
        State of California.
        Los Angeles, CA.

        Acting District Director (January 1986-December 1986).
        State Senator Art Torres, Senate, State of California.
        Los Angeles, CA.

        Reginald Heber Smith Community Lawyer Fellowship/``Reggie 
        Fellow'': (September 1984-September 1985).
        Legal Services Corporation of Central Massachusetts.
        Worchester, MA.

        Summer Law Clerk (June 1983-August 1983).
        Mexican American Legal Defense and Education Fund (MALDEF).
        San Francisco, CA.

        Summer Law Clerk (June 1982-September 1982).
        Legal Aid Foundation of Los Angeles.
        Los Angeles, CA.

        California State Legislature Fellow (September 1980-September 
        1981).
        State Senate and Assemblymember Art Torres, State of 
        California.
        Sacramento, CA.

10.  Government experience (list any current and former advisory, 
consultative, honorary, or other part-time service or position with 
Federal, State, or local governments held since college, including 
dates, other than those listed above):

        Hispanic Employee Advisory Committee to the State Attorney 
        General, Chair, 1989.

        National Commission on Fiscal Responsibility and Reform 
        (Simpson-Bowles), Commission Member, 2010.

11.  Business relationships (list all current and former positions held 
as an officer, director, trustee, partner (e.g., limited partner, non-
voting, etc.), proprietor, agent, representative, or consultant of any 
corporation, company, firm, partnership, other business enterprise, or 
educational or other institution):

        The following are all former positions: Smithsonian 
        Institution, Board of Regents; National Museum of African 
        American History and Culture, Council; Smithsonian National 
        Latino Board; Pitzer College, Board of Trustees; Congressional 
        Hispanic Caucus Institute, Board (and Advisory Council); Center 
        for the Advancement of Hispanics in Science and Engineering 
        Education, Board; Close up Foundation--Board of Advisors; 
        National Association of Latino Elected and Appointed Officials, 
        Board; and the Los Angeles Annenberg Metropolitical Project 
        (LAAMP)/Families in Schools, Board.

12.  Memberships (list all current and former memberships, as well as 
any current and former offices held in professional, fraternal, 
scholarly, civic, business, charitable, and other organizations dating 
back to college, including dates for these memberships and offices):

        To the best of my knowledge, I've included a list of my current 
        and former memberships.
        Memberships and Boards


                     Courts and Legal Organizations
------------------------------------------------------------------------
       Year                    Organization                   Role
------------------------------------------------------------------------
2020-Present       U.S. Supreme Court Bar               Member
------------------------------------------------------------------------
2017-Present       Ninth Circuit Court of Appeals Bar   Member
------------------------------------------------------------------------
2017-Present       U.S. District Court, Eastern         Member
                    District of California Bar
------------------------------------------------------------------------
2017-Present       U.S. District Court, Northern        Member
                    District of California Bar
------------------------------------------------------------------------
2017-Present       U.S. District Court, Southern        Member
                    District of California Bar
------------------------------------------------------------------------
1987-Present       U.S. District Court, Central         Member
                    District of California Bar
------------------------------------------------------------------------
1987-1990          Mexican American Bar Association of  Member
 (Estimate)         Los Angeles County
------------------------------------------------------------------------
1985-present       State Bar of California              Member
------------------------------------------------------------------------



                      Attorney General Memberships
------------------------------------------------------------------------
       Year                    Organization                   Role
------------------------------------------------------------------------
2017-Present       National Association of Attorneys    Member
                    General
------------------------------------------------------------------------
2017-Present       Democratic Attorneys General         Member
                    Association
------------------------------------------------------------------------
2017-Present       Conference of Western Attorneys      Member
                    General
------------------------------------------------------------------------


                        Congressional Memberships
------------------------------------------------------------------------
       Year                    Organization                   Role
------------------------------------------------------------------------
1993-2016          United States-Korea Inter-           Vice Chair
 (Estimate)         Parliamentary Exchange
------------------------------------------------------------------------
1993-2016          Congressional Progressive Caucus     Member
------------------------------------------------------------------------
2013-2016          Democratic Caucus                    Chair
------------------------------------------------------------------------
2011-2012          Joint Select Committee on Deficit    Member
                    Reduction
------------------------------------------------------------------------
2009-2010          National Commission on Fiscal        Member
                    Responsibility and Reform
------------------------------------------------------------------------
2009-2013          Democratic Caucus                    Vice Chair
------------------------------------------------------------------------
2008 (Estimate)    Congressional Friends of Spain       Co-Chair
------------------------------------------------------------------------
1994-2016          Congressional Asian Pacific          Executive
                    American Caucus (CAPAC)              Committee
                                                         Member, Member
------------------------------------------------------------------------
1993-2016          Congressional Hispanic Caucus        Board Member,
                                                        Advisory Council
                                                         Member,
                                                        Chair 1997-1998
------------------------------------------------------------------------


                              Organizations
------------------------------------------------------------------------
       Year                    Organization                   Role
------------------------------------------------------------------------
1993-2016 **       Inter-American Dialogue              Member
------------------------------------------------------------------------
2011-2016          National Museum of African American  Museum Council
                    History                              Member
------------------------------------------------------------------------
1994-2015          Close up Foundation                  Board of
 (Estimate)                                              Advisors
------------------------------------------------------------------------
2008-2016          Smithsonian Institution              Regent
------------------------------------------------------------------------
2008-2016          Smithsonian Institution National     Board Member
                    Latino Board
------------------------------------------------------------------------
2008-2015          Center for the Advancement of        Board Member
 (Estimate)         Hispanics in Science and
                    Engineering Education
------------------------------------------------------------------------
1993-1996          National Student Leadership          Honorary Board
 (Estimate)         Conference                           of Advisors
------------------------------------------------------------------------
1993-1996          Hispanic Outreach Advisory Board,    Member
 (Estimate)         National Parent Teacher
                    Association
------------------------------------------------------------------------
2001-2016          BOLD PAC                             Member, Chair
                                                         2007-2008
------------------------------------------------------------------------
2001-2007          Families in Schools                  Founding Board
                                                         Member
------------------------------------------------------------------------
1995-2003          Pitzer College                       Board of
                                                         Trustees Member
------------------------------------------------------------------------
1995-2001          Los Angeles Annenberg Metropolitan
                    Project (LAMP)
                                                        Board Member
------------------------------------------------------------------------
****               Mexican American State Legislators   Member
                    Policy Institute
------------------------------------------------------------------------
****               Greater Eastside Voter Registration  Member
                    Project
------------------------------------------------------------------------
1993-2016          Congressional Hispanic Caucus        Chair 1997-1998,
                    Institute                           Board of
                                                         Directors,
                                                        Advisory Council
                                                         Member, Member
------------------------------------------------------------------------
1991-2005          National Association of Latino       Board Member
 (Estimate)         Elected and Appointed Officials
                    (NALEO)
------------------------------------------------------------------------
1987-1990          Association of California State      Member
                    Attorneys and Administrative Law
                    Judges
------------------------------------------------------------------------
1977-1978          Northern CA District Council of      Member
                    Laborers, Laborers' Local 185
------------------------------------------------------------------------
1976-1980          MEChA (Stanford University)          Member
------------------------------------------------------------------------
** When I became Attorney General, my office requested that all outside
  organizations in which I had an affiliation end any role I might have
  and remove my name from their materials. However, during this process,
  it came to our attention that I was still listed on this
  organization's website as a member. We have asked that my name be
  removed.
 
**** This organization was listed in a previous biography. However, we
  have not been able to determine the dates of participation.


13.  Political affiliations and activities:

        a.  List all public offices for which you have been a candidate 
        dating back to the age of 18.

       California State Assembly: 1990.

       U.S. House of Representatives: 1992-2016 elections.

       Los Angeles Mayor: 2001.

       Attorney General of California: 2018 (appointed first in 2017)

        b.  List all memberships and offices held in and services 
        rendered to all political parties or election committees, 
        currently and during the last 10 years prior to the date of 
        your nomination.

       During the last 10 years, I've had the following campaign 
committees: Becerra for Congress and Becerra for Attorney General. I 
also had a Leadership PAC, Leadership for Today and Tomorrow, which has 
been terminated.

        c.  Itemize all political contributions to any individual, 
        campaign organization, political party, political action 
        committee, or similar entity of $50 or more for the past 10 
        years prior to the date of your nomination.

       To the best of my knowledge, I have not made any personal 
contributions of more than $50 during the past 10 years, other than a 
$60 contribution to ActBlue in 2015. However, as with many members of 
Congress, my Leadership PAC and campaign committees did make political 
donations.

14.  Honors and awards (list all scholarships, fellowships, honorary 
degrees, honorary society memberships, military medals, and any other 
special recognitions for outstanding service or achievement received 
since the age of 18):

        California Legislature Fellowship: 1980-1981.

        Reginald Heber Smith Community Lawyer Fellowship (``Reggie 
        Fellow''): 1984-1985.

        During my 30 years in public service, I have received numerous 
        awards and other special recognitions--and those that I could 
        locate, I have listed below by year.


                 Awards Received by the Attorney General
------------------------------------------------------------------------
      Year               Organization                    Award
------------------------------------------------------------------------
2020             National Health Law Program  Henry Waxman Award for
                                               Health Care Advocacy
------------------------------------------------------------------------
2020             Lawyers' Committee for       LCCR's Living the Dream
                  Civil Rights of the San      Award
                  Francisco Bay Area
------------------------------------------------------------------------
2020             UnidosUS                     Public Service Award
------------------------------------------------------------------------
2020             Consumer Federation of       Lifetime Achievement Award
                  America
------------------------------------------------------------------------
2020             Friends of the River         Mark Dubois Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2019             Mexican American Bar         Precursor de Justicia/
                  Foundation                   Pioneer of Justice Award
------------------------------------------------------------------------
2019             California Rural Legal       Cruz Reynoso-Ralph Abascal
                  Assistance, Inc.             Don Quixote Award
------------------------------------------------------------------------
2019             California ChangeLawyers     ChangeLawyer Leadership
                                               Award
------------------------------------------------------------------------
2019             Coalition for Clean Air      Air Quality Award for
                                               Leadership in Government
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2018             United Nations Association   Eleanor Roosevelt Human
                  of San Diego                 Rights Award
------------------------------------------------------------------------
2018             California Reinvestment      Community Hero Award
                  Coalition
------------------------------------------------------------------------
2018             Adventist Health--White      Man of the Year Award
                  Memorial Charitable
                  Foundation
------------------------------------------------------------------------
2018             American Public Health       Paul Wellstone Award
                  Association
------------------------------------------------------------------------
2018             Equality California          Nancy McFadden Ally
                                               Leadership Award
------------------------------------------------------------------------
2018             Mexican Bar Association of   Benito Juarez Attorney of
                  Los Angeles County           the Year Award
------------------------------------------------------------------------
2018             Instituto Laboral de La      California Visionary Award
                  Raza
------------------------------------------------------------------------
2018             Breathe California of Los    Civic Leader Award
                  Angeles County
------------------------------------------------------------------------
2018             TELACU                       Creo Award
------------------------------------------------------------------------
2018             Metro Los Angeles--Metro     Visionary Award
                  Latino Association
------------------------------------------------------------------------
2018             NAACP--San Diego Chapter     Honoree for Community
                                               Service
------------------------------------------------------------------------
2018             Essential Access Health      Family Planning Champion
                                               Award
------------------------------------------------------------------------
2018             The Campaign for College     Change Maker Award
                  Opportunity
------------------------------------------------------------------------
2018             Coalition for Humane         Honored for Leadership of
                  Immigrant Rights of Los      the Immigrant Rights
                  Angeles                      Movement
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2017             Cesar Chavez Foundation      Cesar Chavez Legacy Award
------------------------------------------------------------------------
2017             The Women's Foundation of    Visionary Award
                  California--Women's Policy
                  Institute
------------------------------------------------------------------------
2017             Black Prosecutors            Black Prosecutors
                  Association of Los Angeles   Association of Los
                                               Angeles Champion of
                                               Justice Award
------------------------------------------------------------------------
2017             Conference of California     John Van de Kamp Justice
                  Bar Association              Through Laws Award
------------------------------------------------------------------------
2017             Cruz Reynoso Bar             Community Service Award
                  Association
------------------------------------------------------------------------
2017             California Hispanic          Hispanic Appointee of the
                  Chambers of Commerce         Year
------------------------------------------------------------------------
2017             Equality California          Vanguard Leadership Award
------------------------------------------------------------------------



                          Congressional Awards
------------------------------------------------------------------------
      Year               Organization                    Award
------------------------------------------------------------------------
2016             League of United Latin       Recognition
                  American Citizens (LULAC)
------------------------------------------------------------------------
2016             Asian Pacific American       Lifetime Achievement Award
                  Institute for
                  Congressional Studies
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2015             Health Access                Health Care Champion Award
------------------------------------------------------------------------
2015             California Retired Teachers  Friend of CalRTA Award
                  Association
------------------------------------------------------------------------
2015             The National Association of  Edward R. Roybal Award for
                  Latino Elected and           Public Service
                  Appointed Officials
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2014             National Association of      Leadership Award
                  Community Health Centers
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2013             National Association of      Founders Award
                  Hispanic Real Estate
                  Professionals
------------------------------------------------------------------------
2013             Clinica Romero               Spirit Award
------------------------------------------------------------------------
2013             Los Angeles United           Outstanding Achievement
                  Methodist Museum of Social
                  Justice
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2012             California Alliance of       Retiree Hero Award
                  Retired Americans
------------------------------------------------------------------------
2012             A Community of Friends       Leadership Award
------------------------------------------------------------------------
2012             Alta Med                     Thank You For Outstanding
                                               Support
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2011             Enterprise Foundation        Visionary of the Year
------------------------------------------------------------------------
2011             California Council for       Appreciation Certificate
                  Adult Education
------------------------------------------------------------------------
2011             Arroyo Vista Family Health   Recognition
                  Center
------------------------------------------------------------------------
2011             Hollywood Freeway Central    A Real Star of Hollywood
                  Park
------------------------------------------------------------------------
2011             South Central Family Health  Appreciation of Public
                  Center                       Service
------------------------------------------------------------------------
2011             CARA                         Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2010             The Muniz Family Foundation  Distinguished Community
                                               Leadership Award
------------------------------------------------------------------------
2010             Los Angeles Community        Visionary Leadership Award
                  College Foundation
------------------------------------------------------------------------
2010             The American Physical        Public Service Award
                  Therapy Association
------------------------------------------------------------------------
2010             California Hospital          Health Care Champion Award
                  Association
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2009             American Society of          Legislative Advocacy Award
                  Radiologic Technologists
------------------------------------------------------------------------
2009             City of El Paso              Key to the City
------------------------------------------------------------------------
2009             FASGI                        Leader of the Year Award
------------------------------------------------------------------------
2009             Esperanza Community Housing  20th Anniversary Builder
                  Corporation                  of Hope Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2008             AARP                         Legislative Achievement
                                               Award
------------------------------------------------------------------------
2008             ACLU                         Legislator of the Year
                                               Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2007             Armenian Assembly            2007 Honor
------------------------------------------------------------------------
2007             Hispanic Heritage            Education Award
                  Foundation
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2006             Congressional Management     Gold Mouse Award
                  Foundation
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2005             The Word--Pastor Castro      Recognition
------------------------------------------------------------------------
2005             Normandie Residents          Recognition
------------------------------------------------------------------------
2005             Career Opportunities for     Recognition
                  Youth
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2004             Mobility 21--Los Angeles     Julian Dixon Award
                  County Moving Together
------------------------------------------------------------------------
2004             Los Angeles City College     Outstanding Support
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2003             Eastside Democratic Club     Legislator of the Year
------------------------------------------------------------------------
2003             Santa Monica College         Appreciation Award
------------------------------------------------------------------------
2003             Baptist Church               Partners in Progress Award
------------------------------------------------------------------------
2003             Arroyo Vista Family Health   Recognition
                  Center
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2002             National Hispanic Medical    Recognition
                  Association
------------------------------------------------------------------------
2002             San Francisco Board of       Recognition
                  Supervisors
------------------------------------------------------------------------
2002             Indo American Award          Recognition
------------------------------------------------------------------------
2002             Urban Issues Breakfast       Recognition
                  Forum
------------------------------------------------------------------------
2002             UPS                          Plaque for Years of
                                               Service
------------------------------------------------------------------------
2002             Barrio Planners              Appreciation Award
------------------------------------------------------------------------
2002             Farmers Insurance            Star Award--Support of
                                               Bronze Screen
------------------------------------------------------------------------
2002             City of Pontiac, Michigan    Key to the City
------------------------------------------------------------------------
2002             Korean American Democratic   Appreciation Award
                  Committee
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2001             LAUSD--District F            Appreciation Award
------------------------------------------------------------------------
2001             HACU                         Appreciation Award
------------------------------------------------------------------------
2001             ICT College                  Appreciation Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2000             NCLR                         Graciela Olivarez La Raza
                                               Award
------------------------------------------------------------------------
2000             Filipino American Senior     Appreciation Award
                  Citizens Association
------------------------------------------------------------------------
2000             The New Leaders              Appreciation Award
------------------------------------------------------------------------
2000             Parents of BBAC              Appreciation Award
------------------------------------------------------------------------
2000             Cal State La Raza            Appreciation Award
                  Graduation
------------------------------------------------------------------------
2000             KAC                          Award of Appreciation
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1999             Los Angeles Unified School   Recognition
                  District
------------------------------------------------------------------------
1999             USC Cuahtemoc Award          Recognition
------------------------------------------------------------------------
1999             Filipino American Service    Recognition
                  Group, Inc. FASGI
------------------------------------------------------------------------
1999             Hollywood Chamber of         Appreciation Award
                  Commerce
------------------------------------------------------------------------
1999             Korean American Coalition    Appreciation Award
                  (KAC)
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1997             NABE                         Recognition
------------------------------------------------------------------------
1997             Koreatown Youth and          Recognition
                  Community Center
------------------------------------------------------------------------
1997             Northeast Trees              Recognition
------------------------------------------------------------------------
1997             Pakistan Golden Jubilee      Appreciation Award
                  Celebration
------------------------------------------------------------------------
1997             Asian Pacific American       Appreciation Award
                  Legal Center
------------------------------------------------------------------------
1997             Franciscans of California    Appreciation Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1996             CA Hispanic American         Recognition
                  Medical Association
------------------------------------------------------------------------
1996             Latino Coalition Healthy CA  Appreciation Award
------------------------------------------------------------------------
1996             Alta Med                     Appreciation Award
------------------------------------------------------------------------
1996             Covenant House California    Appreciation Award
------------------------------------------------------------------------
1996             AARP                         Recognition
------------------------------------------------------------------------
1996             St. John's Well Child &      Advocate Award
                  Family Center
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1995             Korean American Coalition    Recognition
------------------------------------------------------------------------
1995             National Compadres Network   Recognition
------------------------------------------------------------------------
1995             California Association of    Appreciation Award
                  Bilingual Education
------------------------------------------------------------------------
1995             Society of Hispanic          Appreciation Award
                  Professional Engineers
------------------------------------------------------------------------
1995             Bilingual Foundation of the  El Angel Community Award
                  Arts
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1994             Association of Community     Recognition Award
                  Health Agencies
------------------------------------------------------------------------
1994             City Terrace Community       Public Service Award
                  Council
------------------------------------------------------------------------
1994             State of California Migrant  Appreciation
                  Education
------------------------------------------------------------------------
1994             Career Opportunities for     Award of Appreciation
                  Youth, Inc.
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1993             Gay and Lesbian Latinos      Community Member Award
                  Unidos
------------------------------------------------------------------------
1993             DWP Latin American           Appreciation Award
                  Employees Association
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1992             Chicano/Latino Medical       Leadership Award
                  Association
------------------------------------------------------------------------


15.  Published writings (list the titles, publishers, dates, and 
hyperlinks (as applicable) of all books, articles, reports, blog posts, 
or other published materials you have written):

        OP-EDS AND LETTERS TO THE EDITOR

        September 19, 2018: USA Today: California Focuses on Taking 
        Guns From Criminals, https://www.usatoday.com/story/opinion/
        2018/09/19/california-attorney-general-we-take-guns-criminals-
        editorials-debates/1362407002/.

        March 26, 2018: San Francisco Chronicle: Citizenship Question 
        on 2020 Census May Result in Undercount, https://
        www.sfchronicle.com/opinion/openforum/article/Citizenship-
        question-on-2020-census-may-result-in-12783055.php.

        March 14, 2018: Washington Post: Message to Trump: California 
        Isn't in the Deportation Business, https://
        www.washingtonpost.com/opinions/message-to-trump-california-
        isnt-in-the-deportation-business/2018/03/14/0a48d250-2701-11e8-
        bc72-077aa4dab9ef_story.html.

        February 22, 2018: San Diego Union Tribune: Why Supreme Court 
        Case Critical to Future Health of California, https://
        www.sandiegouniontribune.com/opinion/commentary/sd-oe-unions-
        california-janus-workers-20180222-story.ht
        ml.

        February 18, 2018: San Jose Mercury News: Letter: State AG 
        Becerra Vows to Protect Patient Drug Data, https://
        www.mercurynews.com/2018/02/18/letter-state-ag-becerra-vows-to-
        protect-patient-drug-data/.

        January 16, 2018: New York Times: Florida Isn't the Only State 
        That Will Be Hurt By Offshore Drilling, https://
        www.nytimes.com/2018/01/16/opinion/florida-offshore-
        drilling.html.

        September 1, 2017: HuffPost: DACA Is Lawful and Making America 
        Stronger, https://www.huffpost.com/entry/daca-is-lawful-and-
        making-america-stronger_b_59a9c6a4e4b0b5e530febdb9.

        December 16, 2013: USA Today: Honor Our Heritage and Our 
        Values, https://www.usatoday.com/story/opinion/2013/12/15/
        immigration-reform-citizenship-editorials-debates/4034153/.

        February 25, 2012: Arizona Republic: Fixing Middle Class, 
        https://drive.
        google.com/file/d/1Ssxb32rKyKFnwZCq8QXzVVjXvtMXDv3r/view.

        September 7, 2010: Let's Make It in America Again, https://
        www.politico.com/story/2010/09/lets-make-it-in-america-again-
        041842.

        June 1, 2010: Becerra Responds, https://www.politico.com/story/
        2010/06/letter-to-the-editor-becerra-responds-037979.

        November 3, 2008: Wall Street Journal: Real Charities Deserve 
        Deductions, https://www.wsj.com/articles/SB122568104723692401.

        February 24, 2007: Myrtle Beach Sun: Amends Still Needed for 
        WWII Detentions, https://drive.google.com/file/d/
        1UVvhnr4y1QW1p5y1b-T61xmSo9HXnC5
        M/view.

        August 9, 1998: New York Times: Letter to the Editor: 
        Prosecutor Is Qualified, https://www.nytimes.com/1998/08/09/
        opinion/l-prosecutor-is-qualified-2697
        51.html.

        BLOG POSTS

        October 15, 2019: Medium: Liberty and Justice Under Law--A Look 
        at Legislation Sponsored by the California Department of 
        Justice, https://medium.com/@AGBecerra/liberty-and-justice-
        under-law-d85c3762d7c.

        June 30, 2019: Medium: Reasons to Smile: Immigrant Heritage 
        Month, https://medium.com/@AGBecerra/reasons-to-smile-
        immigrant-heritage-month-289f8928
        f747.

        June 20, 2019: Medium: Protecting California's Oceans During 
        World Oceans Month, https://medium.com/@AGBecerra/protecting-
        californias-oceans-during-world-oceans-month-f345c4e46f2f.

        October 26, 2018: Medium: Saving the Clean Car Standards and 
        the Clean Power Plan, https://medium.com/@AGBecerra/saving-the-
        clean-car-standards-and-clean-power-plan-5fa4a1532aa8.

        September 13, 2018: Medium: California's Roadmap to Building a 
        More Just World Through Climate Action, https://medium.com/
        @AGBecerra/californias-roadmap-to-building-a-more-just-world-
        through-climate-action-6e61ee867b4c.

        January 16, 2018: HuffPost: DACA Is Lawful and Making America 
        Stronger, https://www.huffpost.com/entry/daca-is-lawful-and-
        making-america-stronger_
        b_59a9c6a4e4b0b5e530febdb9.

        January 9, 2018: Medium: In His Own Words: Why EPA 
        Administrator Pruitt Should Have Nothing To Do With the Clean 
        Power Plan, https://medium.com/@AGBecerra/in-his-own-words-why-
        epa-administrator-pruitt-should-have-nothing-to-do-with-the-
        clean-power-plan-9f7be3fbb44d.

        December 22, 2017: SCOTUS Blog: Symposium: Agency Fees Benefit 
        the Workplace--Just Ask the States, https://www.scotusblog.com/
        2017/12/symposium-agency-fees-benefit-workplace-just-ask-
        states/.

        June 8, 2017: Medium: Trump Administration Threatens 
        Protections for California's Cherished National Monuments, 
        https://medium.com/@AGBecerra/trump-administration-threatens-
        protections-for-californias-cherished-national-monuments-
        22dcf519975e.

        May 31, 2017: Medium: Clean Air Month: Breathing Easier in 
        California, https://medium.com/@AGBecerra/clean-air-month-
        breathing-easier-in-califor
        nia-490fcae03834.

        March 26, 2016: HuffPost: 20 Pictures of Cuba Through My Lens, 
        https://www.huffpost.com/entry/20-pictures-of-cuba-
        throu_b_9550660.

        November 3, 2016: Daily Kos: GOP Incumbent in CO-06, Who Tries 
        to Run and Hide From Trump, Supports Deportation Force 
        Policies, https://www.
        dailykos.com/stories/2016/11/3/1590541/-CO-06-Republican-
        Incumbent-Who-Tries-to-Run-Hide-From-Trump-Supports-
        Deportation-Force-Policies.

        October 27, 2016: Daily Kos: Republicans Are Down on America as 
        Democrats Build It Up, https://www.dailykos.com/stories/2015/
        10/27/1441533/-Republicans-Are-Down-On-America-As-Democrats-
        Build-It-Up.

        October 27, 2016: Daily Kos: Grassroots Momentum for Zephyr 
        Teachout's Congressional Bid Grows in NY-19, https://
        www.dailykos.com/stories/2016/10/27/1587741/-Grassroots-
        Momentum-for-Zephyr-Teachout-s-Campaign-for-Congress-Grows-in-
        NY-10.

        October 26, 2016: Only One Candidate Knows How to Protect 
        Social Security and Medicare in NJ-05, https://
        www.dailykos.com/stories/2016/10/26/1461678/-Only-One-
        Congressional-Candidate-Knows-How-to-Protect-Social-Security-
        and-Medicare-in-NJ-05.

        October 26, 2016: Why Many Texans Aren't Enamored By Trump's 
        Border Wall, https://www.dailykos.com/stories/2016/10/26/
        1587021/-Why-Many-Texans-Aren-t-Enamored-By-Trump-s-Border-
        Wall.

        October 21 2016: In NV-4, House Race Polls, Premised on Likely 
        Voters, Fail to Account for Many Latinos Who Will Vote, https:/
        /www.dailykos.com/stories/2016/10/21/1585068/-In-NV-4-House-
        Race-Polls-Premised-on-Likely-Voters-Fail-to-Account-For-Many-
        Latinos-Who-Will-Vote.

        December 18, 2015: Daily Kos: Congress Is Broken and It's Not 
        Working for Working Families, https://www.dailykos.com/stories/
        2015/12/18/1461680/-Congress-is-Broken-and-It-s-Not-Working-
        for-Working-Families.

        October 15, 2007: Daily Kos: Three Weeks of War or One Week of 
        Health Coverage for Kids?, https://www.dailykos.com/stories/
        2007/10/15/398228/-Three-Weeks-of-War-or-One-Year-of-Health-
        Coverage-for-Kids.

        February 20, 2007: Daily Kos: The Forgotten Internees, https://
        www.daily
        kos.com/stories/2007/2/20/303962/-.

        January 27, 2007: Daily Kos: Justice for Japan Latin American 
        Internees, https://www.dailykos.com/stories/2007/1/26/295189/-
        Justice-for-Japanese-Latin-American-Internees.

        September 21, 2006: Daily Kos: H.R. 4844: A 21st Century Poll 
        Tax, https://www.dailykos.com/stories/2006/9/21/248521/-H-R-
        4844-A-21st-Century-Poll-Tax.

        September 19, 2006: Daily Kos: Voters Need to Feel Confident, 
        https://www.dailykos.com/stories/2006/9/19/247832/-.

        LAW REVIEWS

        1994: ``Reinventing Asylum: A Challenge to America.'' American 
        University International Law Review 9, no. 4 (1994): 39-42, 
        https://digitalcommons.wcl.
        american.edu/cgi/viewcontent.cgi?article=1482&context=auilr.

        BOOK CHAPTERS

        2004: ``Policymaking in a Diverse America'' (pages 29-39), as 
        part of the book: Strengthening Community: Social Insurance in 
        a Diverse America, by Kathleen Buto, https://www.jstor.org/
        stable/10.7864/j.ctt1gpccpf.

        1995: ``Beyond Ideology: Educating Language-Minority Children 
        Through the ESEA,'' as part of the book: National Issues in 
        Education: Elementary and Secondary Education Act, by John F. 
        Jennings, https://eric.ed.gov/?id=ED386803.

        Supplemental information: As Attorney General, my name and/or 
        office also appear on a large number of reports.

16.  Speeches (list all formal speeches and presentations (e.g., 
PowerPoint) you have delivered during the past 5 years which are on 
topics relevant to the position for which you have been nominated, 
including dates):

        October 15, 2020--Remarks at Health Access California Forum: 
        ``Still Fighting for Our Health!'', https://drive.google.com/
        file/d/11xzQLtDejajiI5CKCGZWpeye
        KvANlWAK/view.

        August 17, 2020--Remarks at Protect Our Care's Town Hall During 
        Democratic National Convention Week, https://drive.google.com/
        file/d/1MSnHDne_mlkt
        GSVenYIJPSF2ld8Vq8Ij/view.

        May 7, 2020--Remarks at Annual Consumer Federation of America 
        Conference: ``Stepping in and Protecting the Health, Safety and 
        Welfare of Consumers and the Environment When the Federal 
        Government Fails to,'' https://vimeo.com/417955875.

        January 28, 2020--Remarks at the National Health Law Program's 
        50th Anniversary Celebration (remarks as prepared), https://
        drive.google.com/file/d/15ffRTL44zBm5I2DVJyFuudpzOSAxijul/view.

        March 5, 2020--Remarks on the 25-Year Anniversary of The 
        Children's Partnership: ``State of the Child 2020,'' https://
        drive.google.com/file/d/1EzXCk
        7chcLPc7hyfml39rr3rtg0Sgv8M/view.

        January 21, 2020--Keynoting the Annual Families USA Conference: 
        ``Health Action 2020,'' https://drive.google.com/file/d/
        1oDDu2MWiuXkWVUSQuAbQM
        MJzRvMBYz0n/view.

        December 4, 2019--Remarks at Essential Access Health's Title X 
        Business Meeting and Awards Luncheon (remarks as prepared), 
        https://drive.
        google.com/file/d/19g3nZ6AJRDGL6sz4LrgeXZ1-ktyleIz8/view.

        September 26, 2019--Keynoting the USC Schaeffer Center ``Moving 
        Towards Universal Coverage'' Conference, https://
        drive.google.com/file/d/1BGn5F
        FrMI34X0--2ZfTnTfjAKyI6ySpob/view.

        February 5, 2019--Remarks at the Annual Insure the Uninsured 
        Project Conference: ``Mapping the Future of Health Reform'' 
        (remarks as prepared), https://drive.google.com/file/d/
        1YKmJNB_4XxPdQIWgu2rG6ahvnNf335MZ/view.

        November 11, 2018--Remarks at the American Public Health 
        Association's Annual Health Advocate Dinner (remarks as 
        prepared), https://drive.google.com/file/d/
        1ZXBSM3HlC5kgfD6Jv7PBRd9Qi91wBFDZ/view.

        September 27, 2018--Keynoting the Community Health 
        Association's Inland Southern Region Biennial Symposium 
        (remarks as prepared), https://drive.google.com/file/d/
        1RgS5Uq_Q_NhOAMnyhLS41smwuvg6SSNI/view.

        February 15, 2018--Remarks at Regional Planned Parenthood 
        Inaugural Leadership Council Symposium (remarks as prepared), 
        https://drive.google.com/file/d/15J9kI7S7A5_n6vRMX_SVFALRv-
        s70k84/view.

        January 12, 2018--Keynoting My Sister's House Conference: ``A 
        Trauma-
        Informed Response to Human Trafficking Victims'' (remarks as 
        prepared), https://drive.google.com/file/d/
        1_zC9sNuMyj0aAlkEh0I0CraWV6nz6TA2/view.

        June 19, 2017--Remarks at the Public Law Center Volunteers for 
        Justice Dinner (remarks as prepared), https://drive.google.com/
        file/d/17LFQ-5FWfBO--Vnx6BV3EdT33DbDUY4ZE/view.

        March 23, 2016--Marking the Six-Year ACA Anniversary on Capitol 
        Hill, https://www.c-span.org/video/?c4938115/user-clip-xavier-
        becerra-remarks-acas
        -6th-year-anniversary.

17.  Qualifications (state what, in your opinion, qualifies you to 
serve in the position to which you have been nominated):

        The mission of the Department of Health and Human Services--to 
        protect people's health and dignity--has been central to my 
        life's work. I worked early on as a legal aid lawyer helping 
        people struggling with mental health challenges. Since then, 
        during more than 30 years in public service, I have focused on 
        getting people the best health care at the best possible price, 
        from my decades on the House Ways and Means Committee to the 
        last 4 years serving as Attorney General of the largest State 
        Department of Justice in the country.

        As a 12-term member of Congress, I fought to give people access 
        to quality, affordable health care. I served on the Ways and 
        Means Committee for 2 decades, where I focused on protecting 
        and strengthening Medicare, Medicaid, and health-care payments 
        and program financing, and where, in 2015, I led efforts to 
        successfully stave off roughly 20-percent cuts in Social 
        Security Disability Insurance.

        I helped write and pass the Affordable Care Act, including the 
        provision addressing Medicare benefits and reimbursements. I 
        helped expand the Children's Health Insurance Program and 
        introduced legislation--the Medicare Savings Programs 
        Improvement Act of 2007--that passed to expand cost-sharing 
        subsidies for low-income seniors who receive both Medicare and 
        Medicaid benefits by increasing the amount of resources they 
        could receive. Several of these provisions were included in the 
        Medicare Improvements for Patients and Providers Act of 2008 
        and the Medicare Access and CHIP Reauthorization Act of 2015.

        I also championed provisions of the Medicare Improvements for 
        Patients and Providers Act of 2008 that required physicians who 
        perform imaging to be accredited and trained to ensure patient 
        safety. I introduced legislation in 2007 to raise the cap on 
        the benefits of patients receiving Medicare physical therapy, 
        as well as the E-Centives Act of 2009, which provided 
        incentives for Medicaid providers to implement electronic 
        health records. A version of this legislation was included in 
        the American Recovery and Reinvestment Act of 2009. I 
        introduced the Medical Anesthesiology Teaching Funding 
        Restoration Act of 2007 to improve anesthesiologists' teaching 
        payments, and it passed in 2008.

        I helped draft the Improving Medicare Post-Acute Care 
        Transformation (IMPACT) Act of 2014, requiring the HHS 
        Secretary to conduct research on the social determinants of 
        health in Medicare's value-based programs, so we could use good 
        data to improve outcomes and save costs. In 2016, I helped 
        launch a House Affordable Drug Pricing Task Force to tackle 
        rising prescription drug costs.

        As Attorney General, I have taken on powerful interests to make 
        sure Americans have the best and most affordable health care, 
        managing a large, complex agency to get results for 
        Californians. I created a special Health Care Rights and Access 
        Unit, with 55 attorneys uniquely focused on health-care 
        antitrust and consumer protection. Our team has cracked down on 
        Medicare and Medicaid fraud to protect these lifelines, 
        recovering almost $1 billion in just the last 3 years from 
        defendants that defrauded California's State Medicaid program 
        with false claims for payment. I also launched a Disability 
        Rights Unit to investigate discrimination against people with 
        disabilities. This unit has successfully investigated and 
        negotiated agreements with several school districts to ensure 
        that students with disabilities have received their legally 
        entitled quality education.

        I have overseen the maintenance and regulation of our State 
        prescription drug monitoring program called the Controlled 
        Substance Utilization Review and Evaluation System (CURES)--a 
        required database for prescribers, devised to stop people from 
        ``doctor shopping'' and receiving multiple opioids 
        prescriptions. I have worked with a bipartisan group of 
        Attorneys General to prevent youth and children from using 
        tobacco products and taken on the opioid epidemic, working to 
        hold drug makers and distributors, including Purdue Pharma, 
        responsible for the addiction crisis. I have used my authority 
        as Attorney General to tackle skyrocketing prescription drug 
        prices by helping pass State laws to deter ``pay for delay'' 
        deals and ensure transparency in prescription drug pricing. 
        Moreover, my office settled a $69-million lawsuit against Teva 
        Pharmaceutical Industries for its illegal pay for delay 
        activities.

        We have prioritized protecting patients' privacy--securing 
        settlements against Cottage Health System for failing to 
        protect patient medical records, Aetna over exposing HIV 
        patient statuses in mailers, Anthem for its violation of 
        privacy laws resulting from a 2014 data breach, Glow, Inc. for 
        their privacy and security failures that put women's sensitive 
        personal information at risk, and Premera Blue Cross over their 
        breaches of patient privacy.

        I worked with the Republican Attorney General of Louisiana to 
        lead a bipartisan, multistate coalition urging HHS, NIH, and 
        FDA to use their legal authority to increase the availability 
        and affordability of Remdesivir. In California, I used my 
        authority to protect workers from exposure to COVID-19, take on 
        fraudsters trying to take advantage of people during the 
        pandemic, and press the Federal Government to do more to 
        produce PPE and boost reporting by nursing homes.

        With the responsibility for reviewing non-profit health-care 
        mergers in the State, I have fought to ensure that hospitals 
        benefiting from nonprofit status give back appropriately to the 
        communities they serve. For example, in 2018, my office 
        approved the biggest merger in our State history, the Dignity-
        Catholic Health Initiative Merger, and along with it, secured a 
        grant program between the hospital system and local governments 
        to better support the delivery of treatment and services to 
        hospitalized individuals experiencing homelessness. I also 
        secured a half-billion-dollar settlement from Sutter Health, 
        one of our country's largest hospital systems, for unfairly 
        sucking up hospitals and doctors and using their market power 
        to jack up costs for patients.

        As part of our efforts to ensure integrity among health-care 
        providers and vigorously protect patients, the California DoJ 
        won a $344-million verdict against Johnson & Johnson for its 
        deceptive marketing arising from sale of pelvic mesh. The 
        pelvic mesh implants, which were advertised to treat a 
        condition called organ prolapse, caused severe bleeding and 
        searing pain in these female patients. The award was more than 
        twice the size of the $117-million settlement J&J reached to 
        resolve claims by 41 States and the District of Columbia for 
        similar deceptive marketing accusations arising from the sale 
        of pelvic mesh products.

        Finally, over 3 years, I led the national defense of the 
        Affordable Care Act in court, going all the way to the Supreme 
        Court to ensure that the American people don't lose their 
        health care or see their coverage denied just because they have 
        a pre-existing condition, which is especially critical as we 
        address the twin public health and economic crises caused by 
        the pandemic.

        The mission of the Department of Health and Human Services has 
        never been more important than right now. I believe my 
        experiences and background qualify me for this role, and I am 
        humbled by and ready for this responsibility of leading HHS 
        during this consequential time for the agency--and for our 
        country.

                   B. FUTURE EMPLOYMENT RELATIONSHIPS

 1.  Will you sever all connections (including participation in future 
benefit arrangements) with your present employers, business firms, 
associations, or organizations if you are confirmed by the Senate? If 
not, provide details.

        Upon consultation with and approval by my agency ethics 
        officials, I will continue to participate in the State of 
        California's 401(k) and 457(b) retirement plans and the CalPERS 
        pension plan. The State of California will not make any 
        contributions after my resignation.

 2.  Do you have any plans, commitments, or agreements to pursue 
outside employment, with or without compensation, during your service 
with the government? If so, provide details.

        No.

 3.  Has any person or entity made a commitment or agreement to employ 
your services in any capacity after you leave government service? If 
so, provide details.

        No.

 4.  If you are confirmed by the Senate, do you expect to serve out 
your full term or until the next presidential election, whichever is 
applicable? If not, explain.

        Yes.

                   C. POTENTIAL CONFLICTS OF INTEREST

 1.  Indicate any current and former investments, obligations, 
liabilities, or other personal relationships, including spousal or 
family employment, which could involve potential conflicts of interest 
in the position to which you have been nominated.

        I have consulted with agency ethics officials to determine 
        what, if any, steps I must take to avoid conflicts of interest 
        and appearance issues in carrying out my duties as the 
        Secretary of Health and Human Services. My wife is a practicing 
        physician. In connection with her work, I will comply with all 
        applicable ethics laws and regulations and with the provisions 
        of my ethics agreement, which spells out my recusal obligations 
        with respect to her employment.

        My financial holdings consist largely of diversified mutual 
        funds, real property, cash and cash equivalents, which do not 
        present significant potential for conflicts of interest in 
        carrying out my anticipated official duties.

 2.  Describe any business relationship, dealing, or financial 
transaction which you have had during the last 10 years (prior to the 
date of your nomination), whether for yourself, on behalf of a client, 
or acting as an agent, that could in any way constitute or result in a 
possible conflict of interest in the position to which you have been 
nominated.

        None. My financial interests consist largely of diversified 
        mutual funds, real property, and cash or cash equivalents, 
        which do not present a conflict of interest with my anticipated 
        official duties. However, I will consult with agency ethics 
        officials and comply with the ethics laws and regulations.

 3.  Describe any activity during the past 10 years (prior to the date 
of your nomination) in which you have engaged for the purpose of 
directly or indirectly influencing the passage, defeat, or modification 
of any legislation or affecting the administration and execution of law 
or public policy. Activities performed as an employee of the Federal 
government need not be listed.

        Since becoming Attorney General, I have testified twice before 
        Congress.

        On September 19, 2017, I testified before the Senate Commerce 
        Committee regarding sex trafficking. The title of the hearing 
        was ``S. 1693, The Stop Enabling Sex Traffickers Act of 2017.'' 
        The press release below includes my testimony submitted to the 
        committee.

        https://oag.ca.gov/news/press-releases/attorney-general-
        becerra-testifies-us-senate-support-protecting-children-sex

        On September 23, 2020, I testified before the Senate Commerce 
        Committee regarding California's privacy laws. The title of the 
        hearing was ``Revisiting the Need for Data Privacy 
        Legislation.'' The press release below includes my testimony 
        submitted to the committee.

        https://oag.ca.gov/news/press-releases/attorney-general-
        becerra-testifies-us-senate-cormnittee-commerce-science-and

        As Attorney General, I have also written to Congress on a 
        variety of issues. Most of these letters have been sent with 
        other Attorneys General. To the best of my knowledge, the 
        topics and dates of all such letters sent are listed below:


------------------------------------------------------------------------
          Legislation                   Date               Comments
------------------------------------------------------------------------
S. 168, The Commercial Vessel    February 15, 2017   Multistate
 Incidental Discharge Act.                            Opposition Letter
                                                      from AG Becerra
                                                      and nine AGs to
                                                      Majority Leader
                                                      McConnell and
                                                      Minority Leader
                                                      Schumer.
------------------------------------------------------------------------
S. 118, Reinforcing American-    March 15, 2017      Opposition Letter
 Made Products Act of 2017.                           from AG Becerra to
                                                      Senate Commerce
                                                      Chairman Thune and
                                                      Ranking Member
                                                      Nelson.
------------------------------------------------------------------------
S.J. Res. 19, H.J. Res. 62, and  April 5, 2017       Multistate
 H.J. Res. 73 (bills that would                       Opposition Letter
 eradicate protections for                            from AG Becerra
 consumers who use prepaid                            and 18 AGs to
 cards to receive wages or make                       Majority Leader
 purchases).                                          McConnell,
                                                      Minority Leader
                                                      Schumer, Speaker
                                                      Ryan, House
                                                      Majority Leader
                                                      McCarthy, and
                                                      House Minority
                                                      Leader Pelosi.
------------------------------------------------------------------------
Federal funding for the Legal    May 22, 2017        Bipartisan
 Services Corporation.                                Multistate
                                                      Opposition Letter
                                                      opposing reduction
                                                      in funds to Legal
                                                      Services
                                                      Corporation from
                                                      AG Becerra and 31
                                                      AGs to House
                                                      Appropriations
                                                      Chairman
                                                      Frelinghuysen,
                                                      House
                                                      Appropriations
                                                      Ranking Member
                                                      Lowey, House
                                                      Appropriations
                                                      Subcommittee
                                                      Chairman
                                                      Culberson, and
                                                      House
                                                      Appropriations
                                                      Subcommittee
                                                      Ranking Member
                                                      Serrano.
------------------------------------------------------------------------
The Financial CHOICE Act of      June 7, 2017        Multistate
 2017 (H.R. 10) (bill would                           Opposition Letter
 eliminate consumer protections                       from AG Becerra
 from Dodd-Frank Wall Street                          and 20 AGs to
 Reform and Consumer Protection                       Speaker Ryan,
 Act).                                                Majority Leader
                                                      McCarthy, Minority
                                                      Leader Pelosi, and
                                                      Minority Whip
                                                      Hoyer.
------------------------------------------------------------------------
H.R. 23 (bill would exempt       July 11, 2017       Opposition Letter
 California from longstanding                         from AG Becerra to
 principle that Congress should                       Speaker Ryan and
 defer to States in managing                          Minority Leader
 water resources).                                    Pelosi.
------------------------------------------------------------------------
S. 1693, Stop Enabling Sex       2017                AG Becerra's
 Traffickers Act of 2017.                             Responses to
                                                      Questions for the
                                                      Record from
                                                      Senator Cortez
                                                      Masto from
                                                      September 2017
                                                      Senate Commerce
                                                      Committee Hearing.
------------------------------------------------------------------------
Safe Banking Act (legislation    January 16, 2018    Bipartisan
 to provide a safe harbor for                         Multistate Support
 depository institutions that                         Letter for the
 service marijuana-related                            Safe Harbor
 business).                                           Legislation from
                                                      AG Becerra and 19
                                                      AGs to Senate and
                                                      House Leadership.
------------------------------------------------------------------------
Legislation to protect the       February 12, 2018   Bipartisan
 victims of sexual harassment                         Multistate Support
 in the workplace.                                    Letter from AG
                                                      Becerra and 55 AGs
                                                      to Leaders of
                                                      Congress.
------------------------------------------------------------------------
S. 2152, Amy and Vicky Child     March 6, 2018       Bipartisan
 Pornography Victim Assistance                        Multistate Support
 Act of 2017.                                         Letter from AG
                                                      Becerra and 54 AGs
                                                      to Speaker Ryan,
                                                      Minority Leader
                                                      Pelosi, Judiciary
                                                      Committee Chairman
                                                      Goodlatte, and
                                                      Judiciary
                                                      Committee Ranking
                                                      Member Nadler.
------------------------------------------------------------------------
Protection for Eligible          March 13, 2018      Multistate Support
 Refugees with Established                            Letter from AG
 Residency Act of 2017 (ESPERER                       Becerra and 18 AGs
 Act of 2017), H.R. 4184, and                         to Majority Leader
 the Safe Environment from                            McConnell,
 Countries Under Repression and                       Minority Leader
 Emergency Act (SECURE Act), S.                       Schumer, Speaker
 2144.                                                Ryan, Majority
                                                      Leader McCarthy,
                                                      and Minority
                                                      Leader Pelosi.
------------------------------------------------------------------------
Legislation to safeguard the     March 15, 2018      Bipartisan
 rights of States to protect                          Multistate Support
 their residents from student                         Letter from AG
 loan-related abuses.                                 Becerra and 32 AGs
                                                      to Speaker Ryan,
                                                      Senate Majority
                                                      Leader McConnell,
                                                      House Minority
                                                      Leader Pelosi,
                                                      Senate Minority
                                                      Leader Schumer,
                                                      House Education
                                                      Committee
                                                      Chairwoman Foxx,
                                                      Ranking Member
                                                      Scott, Senate HELP
                                                      Committee Chairman
                                                      Alexander, and
                                                      Ranking Member
                                                      Murray.
------------------------------------------------------------------------
Data Acquisition and Technology  March 19, 2018      Bipartisan
 Accountability and Security                          Multistate
 Act.                                                 Opposition Letter
                                                      from AG Becerra
                                                      and 31 AGs to the
                                                      House Committee on
                                                      Financial
                                                      Services.
------------------------------------------------------------------------
H.R. 3891 (bill would expand     March 28,2018       Bipartisan
 the authority of Medicaid                            Multistate Support
 Fraud Control Units to                               Letter from AG
 prosecute Medicaid patient                           Becerra and 48 AGs
 abuse).                                              to Representatives
                                                      Walberg and Welch.
------------------------------------------------------------------------
H.R. 3299 (Protecting            June 27, 2018       Bipartisan
 Consumers' Access to Credit                          Multistate
 Act of 2017) and H.R. 4439                           Opposition Letter
 (Modernizing Credit                                  from AG Becerra
 Opportunities Act). Bills                            and 20 AGs to
 would allow non-bank lenders                         Majority Leader
 to sidestep State usury laws                         McConnell,
 and charge excessive interest                        Minority Leader
 rates..                                              Schumer, Senate
                                                      Banking Chairman
                                                      Crapo, and Ranking
                                                      Member Brown.
------------------------------------------------------------------------
Legislation to improve           July 27, 2018       Multistate Support
 corporate transparency by                            Letter from AG
 requiring companies to                               Becerra and 23 AGs
 disclose the identities of                           to House Financial
 individuals who control and                          Services Chairman
 profit from the company at the                       Hensarling, and
 time of its incorporation.                           Ranking Member
                                                      Waters.
------------------------------------------------------------------------
H.R. 6147 (bill that would bar   July 31, 2018       Opposition Letter
 Californians from using State                        from AG Becerra to
 courts to challenge                                  Majority Leader
 construction of State and                            McConnell,
 Federal water projects in                            Minority Leader
 California).                                         Schumer, Speaker
                                                      Ryan, and Minority
                                                      Leader Pelosi.
------------------------------------------------------------------------
Legislation to reauthorize the   September 17, 2018  Bipartisan
 Violence Against Women Act                           Multistate Letter
 (VAWA).                                              from AG Becerra
                                                      and 55 AGs to
                                                      Leaders of
                                                      Congress.
------------------------------------------------------------------------
First Step Act (bill to provide  December 20, 2018   Bipartisan
 tools to the Federal Bureau of                       Multistate Support
 Prisons).                                            Letter from AG
                                                      Becerra and 37 AGs
                                                      to Majority Leader
                                                      McConnell,
                                                      Minority Leader
                                                      Schumer, Speaker
                                                      Ryan, and Minority
                                                      Leader Pelosi.
------------------------------------------------------------------------
Telephone Robocall Abuse         March 5, 2019       Bipartisan
 Criminal Enforcement and                             Multistate Support
 Deterrence (TRACED) Act.                             Letter from AG
                                                      Becerra and 53 AGs
                                                      to Senate
                                                      Committee on
                                                      Commerce, Science,
                                                      and Transportation
                                                      Chairman Wicker
                                                      and Ranking Member
                                                      Cantwell.
------------------------------------------------------------------------
Request funding for the Legal    May 1, 2019         Bipartisan
 Services Corporation (LSC) in                        Multistate Support
 Fiscal Year 2020.                                    Letter from AG
                                                      Becerra and 41 AGs
                                                      to the House
                                                      Committee on
                                                      Appropriations.
------------------------------------------------------------------------
Request funding for the Legal    May 1, 2019         Bipartisan
 Services Corporation (LSC) in                        Multistate Support
 Fiscal Year 2020.                                    Letter from AG
                                                      Becerra and 41 AGs
                                                      to the Senate
                                                      Committee on
                                                      Appropriations.
------------------------------------------------------------------------
Legislation that would allow     May 8, 2019         Bipartisan
 States and territories that                          Multistate Support
 have legalized certain use of                        Letter from AG
 marijuana to bring that                              Becerra and 37 AGs
 commerce into the banking                            to Leaders of
 system.                                              Congress.
------------------------------------------------------------------------
Urge Congress to take action to  June 13, 2019       Support Letter from
 protect the integrity of our                         AG Becerra to the
 election infrastructure.                             Senate Committee
                                                      on Appropriations
                                                      and Senate Rules
                                                      Committee.
------------------------------------------------------------------------
H.R. 1603, the Alan Reinstein    July 12, 2019       Multistate Support
 Ban Asbestos Now Act of 2019.                        Letter from AG
                                                      Becerra and 17 AGs
                                                      to the House
                                                      Committee on
                                                      Energy and
                                                      Commerce.
------------------------------------------------------------------------
H.R. 1705, Jaime's Law (bill     September 23, 2019  Multistate Support
 would require background                             Letter from AG
 checks for ammunition                                Becerra and 20 AGs
 purchases).                                          to Leaders of
                                                      Congress.
------------------------------------------------------------------------
Resolution of Disapproval for    January 14, 2020    Multistate Support
 the U.S. Department of                               Letter for
 Education's ``Borrower                               resolution of
 Defense'' regulation.                                disapproval of the
                                                      Borrower Defense
                                                      Rule from AG
                                                      Becerra and 19 AGs
                                                      to Senator Durbin
                                                      and Representative
                                                      Lee.
------------------------------------------------------------------------
Urge Congress to take action to  February 5, 2020    Support Letter from
 rein in predatory lending                            AG Becerra to
 practices.                                           House Financial
                                                      Services
                                                      Chairwoman Waters
                                                      and Ranking Member
                                                      McHenry.
------------------------------------------------------------------------
H.R. 4421, Bankruptcy Venue      February 20, 2020   Bipartisan
 Reform Act of 2019.                                  Multistate Support
                                                      Letter from AG
                                                      Becerra and 39 AGs
                                                      to House
                                                      Congressional
                                                      Sponsors of H.R.
                                                      4421.
------------------------------------------------------------------------
California Consumer Privacy Act  February 25, 2020   Letter from AG
 and Federal Privacy                                  Becerra providing
 Legislation.                                         support for the
                                                      California
                                                      Consumer Privacy
                                                      Act to Senate
                                                      Commerce Committee
                                                      Chairman Wicker
                                                      and Ranking Member
                                                      Cantwell, and
                                                      House Energy and
                                                      Commerce Chairman
                                                      Pallone and
                                                      Ranking Member
                                                      Walden.
------------------------------------------------------------------------
Concern over the proposed        March 26, 2020      Bipartisan
 allocation of funding for the                        Multistate Letter
 District of Columbia in the                          from AG Becerra
 Coronavirus Relief Fund.                             and 38 AGs to
                                                      President Trump,
                                                      Speaker Pelosi,
                                                      Minority Leader
                                                      McCarthy, Majority
                                                      Leader McConnell,
                                                      and Minority
                                                      Leader Schumer.
------------------------------------------------------------------------
Concerns about the ongoing       May 6, 2020         Multistate Letter
 implementation of the Paycheck                       from AG Becerra
 Protection Program of the                            and 23 AGs to
 CARES Act.                                           Majority Leader
                                                      McConnell,
                                                      Minority Leader
                                                      Schumer, Speaker
                                                      Pelosi, and
                                                      Minority Leader
                                                      McCarthy.
------------------------------------------------------------------------
Legislation to impose remote     May 18, 2020        Opposition Letter
 online notarization on                               from AG Becerra to
 California residents.                                Senate Judiciary
                                                      Chairman Graham
                                                      and Ranking Member
                                                      Feinstein.
------------------------------------------------------------------------
Safe Banking Act (legislation    May 19, 2020        Bipartisan
 to provide a safe harbor for                         Multistate Support
 depository institutions that                         Letter from AG
 service marijuana-related                            Becerra and 33 AGs
 business).                                           to Leaders in
                                                      Congress.
------------------------------------------------------------------------
S. 3607, Safeguarding America's  May 21, 2020        Bipartisan
 First Responders Act of 2020.                        Multistate Support
                                                      Letter from AG
                                                      Becerra and 51 AGs
                                                      to Speaker Pelosi,
                                                      Minority Leader
                                                      McCarthy, Majority
                                                      Leader McConnell,
                                                      Minority Leader
                                                      Schumer, House
                                                      Judiciary
                                                      Committee Chairman
                                                      Nadler, and House
                                                      Judiciary
                                                      Committee Ranking
                                                      Member Jordan.
------------------------------------------------------------------------
Legislation to provide State     June 4, 2020        Multistate Support
 AGs clear authority under                            Letter from AG
 Federal law to investigate                           Becerra and 17 AGs
 unconstitutional policing by                         to Speaker Pelosi,
 local police departments.                            Minority Leader
                                                      McCarthy, Majority
                                                      Leader McConnell,
                                                      and Minority
                                                      Leader Schumer.
------------------------------------------------------------------------
Legislation to provide State     June 5, 2020        Support Letter from
 AGs clear authority under                            AG Becerra to
 Federal law to investigate                           Speaker Pelosi,
 unconstitutional policing by                         Minority Leader
 local police departments.                            McCarthy, Majority
                                                      Leader McConnell,
                                                      and Minority
                                                      Leader Schumer.
------------------------------------------------------------------------
Urge Congress to address the     July 14, 2020       Multistate Letter
 crisis in our childcare                              to Congress from
 systems by providing funding                         AG Becerra and 21
 in the next Federal stimulus                         AGs to Majority
 package.                                             Leader McConnell
                                                      and Minority
                                                      Leader Schumer.
------------------------------------------------------------------------
Driving for Opportunity Act of   August 3, 2020      Bipartisan
 2020 (legislation to end the                         Multistate Support
 practice of license suspension                       Letter from AG
 for unpaid fines and fees).                          Becerra and 23 AGs
                                                      to Senate
                                                      Committee on
                                                      Environment and
                                                      Public Works
                                                      Chairman Barrasso
                                                      and Ranking Member
                                                      Carper.
------------------------------------------------------------------------
Student Loan Fairness Act of     August 5, 2020      Bipartisan
 2020, S. 4237.                                       Multistate Support
                                                      Letter from AG
                                                      Becerra and 29 AGs
                                                      to Senators
                                                      McConnell,
                                                      Schumer,
                                                      Alexander, Murray,
                                                      Durbin, Duckworth,
                                                      Murkowski, and
                                                      Sullivan.
------------------------------------------------------------------------
Questions for the Record         September 23, 2020  Letter from AG
 following AG Becerra's                               Becerra to the
 testimony at Senate Commerce                         U.S. Senate
 Committee Hearing,                                   Committee on
 ``Revisiting the Need for Data                       Commerce, Science,
 Privacy Legislation''.                               and Transportation
                                                      in response to
                                                      Senator Schatz's
                                                      Questions for the
                                                      Record.
------------------------------------------------------------------------
Request that Congress extend     November 30, 2020   Bipartisan
 the spending-related deadline                        Multistate Support
 for relief funding so                                Letter from AG
 Americans can receive the full                       Becerra and 48 AGs
 benefits of the CARES Act.                           to Speaker Pelosi,
                                                      Minority Leader
                                                      McCarthy, Majority
                                                      Leader McConnell,
                                                      Minority Leader
                                                      Schumer, and Ways
                                                      and Means
                                                      Committee Chairman
                                                      Neal and Ranking
                                                      Member Brady.
------------------------------------------------------------------------
Request to allow for free and    December 3, 2020    Multistate Letter
 fast access to a COVID-19                            from AG Becerra
 vaccine to every person.                             and 12 AGs to
                                                      Speaker Pelosi,
                                                      Minority Leader
                                                      McCarthy, Majority
                                                      Leader McConnell,
                                                      Minority Leader
                                                      Schumer
------------------------------------------------------------------------
Supplemental Information: In addition, as the Attorney General of
  California, our department has weighed in on Federal rulemaking and
  legislation in California and across the country.


 4.  Explain how you will resolve any potential conflict of interest, 
including any that are disclosed by your responses to the above items. 
(Provide the committee with two copies of any trust or other 
agreements.)

        I have consulted with agency ethics officials and will sign an 
        ethics agreement that sets forth my ethics obligations. I will 
        receive initial and annual ethics training as required by the 
        Ethics in Government Act. I will comply with my ethics 
        agreement and with all applicable ethics laws and regulations, 
        and I will rely on the advice of my agency ethics officials, 
        whom I will consult regularly.

 5.  Two copies of written opinions should be provided directly to the 
committee by the designated agency ethics officer of the agency to 
which you have been nominated and by the Office of Government Ethics 
concerning potential conflicts of interest or any legal impediments to 
your serving in this position.

                       D. LEGAL AND OTHER MATTERS

 1.  Have you ever been the subject of a complaint or been 
investigated, disciplined, or otherwise cited for a breach of ethics 
for unprofessional conduct before any court, administrative agency 
(e.g., an Inspector General's office), professional association, 
disciplinary committee, or other ethics enforcement entity at any time? 
Have you ever been interviewed regarding your own conduct as part of 
any such inquiry or investigation? If so, provide details, regardless 
of the outcome.

        I have never been disciplined or cited for a breach of ethics 
        or unprofessional conduct.

        In 2011, the Office of Congressional Ethics looked into an 
        allegation that my wife and I had improperly received a 
        homestead exemption for our residence in Maryland, interviewed 
        me, and found that the allegation lacked merit. The Office of 
        Congressional Ethics unanimously recommended to the House 
        Committee on Ethics that the matter be dismissed, which the 
        Committee on Ethics did without any further investigation.

 2.  Have you ever been investigated, arrested, charged, or held by any 
Federal, State, or other law enforcement authority for a violation of 
any Federal, State, county, or municipal law, regulation, or ordinance, 
other than a minor traffic offense? Have you ever been interviewed 
regarding your own conduct as part of any such inquiry or 
investigation? If so, provide details.

        No.

 3.  Have you ever been involved as a party in interest in any 
administrative agency proceeding or civil litigation? If so, provide 
details.

        I have not been involved in any administrative proceedings or 
        civil litigation in my personal capacity.

        Supplemental Information: As Attorney General representing the 
        State of California, I am sometimes named in litigation. In 
        addition, during my 30-year tenure as an elected official, my 
        campaign committees have been the subject of very few 
        complaints. To the best of my knowledge, here is a list of all 
        administrative complaints and civil litigation involving my 
        campaign committees.

        Federal Election Commission

        In 2015, the Foundation for Accountability and Civic Trust 
        filed a complaint against the DNC and every Democratic 
        congressional campaign committee alleging that they had 
        received prohibited in-kind contributions from Catalist and NGP 
        VAN. The FEC rejected those claims by a vote of 6-0 and closed 
        the matter without taking any action.

        In 2001, the company Mattel filed a self-referral complaint 
        with the FEC voluntarily disclosing that a former executive had 
        used corporate funds to make political contributions through 
        Mattel employees to a number of congressional campaign 
        committees, including Becerra for Congress. Becerra for 
        Congress was unaware of any improper contributions, and 
        voluntarily returned the contributions to the U.S. Treasury 
        after the allegations came to light. The FEC voted unanimously 
        that there was no violation of the Act by Becerra for Congress 
        or any other campaign committees, and the matter was closed.

        California Fair Political Practices Commission (FPPC)

        My Democratic opponent in the 2018 primary campaign for 
        Attorney General, Dave Jones, filed a complaint with the State 
        of California Fair Political Practices Commission (FPPC), 
        regarding a television advertisement paid for by my committee, 
        Becerra for Attorney General. The Fair Political Practices 
        Commission found there were no violations and closed the file 
        immediately without any further investigation. Days before the 
        primary election, Dave Jones for Attorney General held a press 
        conference announcing that he had also filed a civil lawsuit 
        against Becerra for Attorney General about the same issue. 
        However, he never served the lawsuit, and dismissed it shortly 
        after the election without taking any further action.

        L.A. City Ethics Commission

        Following a mandatory audit of all the campaign committees 
        involved in the 2001 mayoral election, the Commission found 
        that five of the leading mayoral committees, including the 
        Becerra for Mayor committee, made technical administrative 
        errors during the campaign. Becerra for Mayor agreed to pay 
        $11,089.99 to resolve issues regarding six mailers that weren't 
        filed with the Commission and the receipt of surplus matching 
        funds. The committee also refunded $7,089.99 to the city for 
        the surplus matching funds it received.

        Sacramento County Superior Court

        In 2018, Eric Early, a candidate for Attorney General, filed a 
        Petition for Writ of Mandate and Complaint for Declaratory 
        Relief to remove Xavier Becerra's name from the November 2018 
        statewide general election ballot, alleging that he was 
        ineligible to serve as Attorney General because he was an 
        inactive member of the California State Bar for the 5-year 
        period preceding his appointment or election to office.

        The trial court judge denied the Petition for Writ of Mandate 
        and ruled in favor of Becerra, declaring that the law only 
        required Becerra to be admitted to practice law in the State of 
        California to be eligible to run for the office of Attorney 
        General, not to be an ``active'' member of the State Bar. 
        Following the entry of judgment, the court awarded Becerra his 
        attorneys' fees for defending the lawsuit. Plaintiff appealed 
        the trial court ruling and the Court of Appeal upheld the trial 
        court ruling in favor of Becerra, issuing a published decision 
        (Early v. Becerra (2020) 47 Cal. App. 5th 325.) Plaintiff then 
        filed a separate appeal of the trial court's award of 
        attorneys' fees to Becerra. Oral argument was heard by the 
        court on November 16, 2020, and a decision is pending.

 4.  Have you ever been convicted (including pleas of guilty or nolo 
contendere) of any criminal violation other than a minor traffic 
offense? If so, provide details.

        No.

 5.  Please advise the committee of any additional information, 
favorable or unfavorable, which you feel should be considered in 
connection with your nomination.

        None.

                     E.  TESTIFYING BEFORE CONGRESS

 1.  If you are confirmed by the Senate, are you willing to appear and 
testify before any duly constituted committee of the Congress on such 
occasions as you may be reasonably requested to do so?

        Yes.

 2.  If you are confirmed by the Senate, are you willing to provide 
such information as is requested by such committees?

        Yes.

                                 ______
                                 
       Questions Submitted for the Record to Hon. Xavier Becerra
                 Questions Submitted by Hon. Ron Wyden
                             nursing homes
    Question. The COVID-19 pandemic has taken an outsize toll on our 
Nation's 1.3 million seniors living in nursing homes. As of early 
February, more than 160,000 long-term care workers and residents have 
died. While long-term care residents represent roughly 5 percent of the 
U.S. COVID-19 cases, they represent about one-third of total U.S. 
COVID-19 deaths.

    Throughout the pandemic, nursing homes have faced chronic shortages 
of PPE, staffing, and testing. HHS has allocated roughly $10 billion to 
nursing homes from the Provider Relief Fund, but with essential 
resources like staff and PPE in short supply for much of the last year, 
it is not clear whether those dollars have always translated to an 
improved response on the ground. Nursing homes where black and Latino 
residents make up a higher percentage of their population have faced 
the worst outcomes. The failure to control the spread of the virus in 
communities across the country resulted in nursing homes in majority-
minority communities bearing at disproportionate risk, compared to 
mostly white communities.

    I've worked closely with Senator Casey over the last year to push 
and prod HHS to collect and make public information about COVID-19's 
impact on Medicare and Medicaid certified nursing homes. The weekly 
nursing home data required and posted by CMS has provides families, 
policymakers and heath care experts with timely information about how 
COVID-19 is affecting nursing home residents and workers.

    Broadly speaking, if confirmed as Secretary of HHS, will you 
support efforts to improve transparency relating to COVID-19 in nursing 
homes and address the disproportionate impacts of COVID-19 on nursing 
home residents of color?

    And specifically in regard to vaccinations, will you support 
efforts to provide consumers and Congress facility-level data about the 
rate of COVID-19 vaccinations in nursing homes?

    Answer. Thank you for your leadership on this important issue. If I 
am fortunate enough to be confirmed, it will be a top priority for the 
U.S. Department of Health and Human Services (HHS) to protect our most 
vulnerable Americans by addressing the disproportionate impact of the 
novel coronavirus of 2019 (COVID-19) pandemic on nursing home 
residents, especially people of color. As you and I have discussed, 
making data-driven decisions will be critical to addressing racial and 
ethnic health disparities not just at the Nation's nursing homes but 
across the health-care system. If confirmed, I will make transparency 
and data collection regarding the impacts of COVID-19 and vaccination a 
priority because good data is essential to good policy.
   family separation and treatment of unaccompanied noncitizen minors
    Question. Policies promoting the forced separation of children from 
their families at the border has led to serious trauma for noncitizen 
children and their families.

    If confirmed, how do you plan to support the health and well-being 
of noncitizen children and ensure their safe and timely reunification 
with family members or sponsors?

    Answer. If confirmed, I will ensure HHS is making the safety and 
well being of vulnerable children in the care and custody of the Office 
of Refugee Resettlement (ORR) a priority. Ensuring these children's 
safety and well-being is both our legal duty and our moral obligation--
I take both seriously. Providing such care includes complying with all 
legally mandated services required by the terms of the Flores 
Settlement Agreement, the Homeland Security Act of 2002, and the 
Trafficking Victims Protection Reauthorization Act of 2008. As you 
know, HHS is required to release children to an appropriate sponsor 
without unnecessary delay. When a child enters ORR care, ORR aims to 
put every child safely in contact with their parents, guardians, or 
relatives as soon as possible. We are committed to continued 
improvement in the program's discharge rate.

    Question. Will you commit to providing members of Congress timely 
updates and details on the changes the Office of Refugee and 
Resettlement makes to meet the physical and mental health needs of 
children its care at all placement types?

    Answer. Yes.

    Question. Will you commit to soliciting the input of child welfare 
experts, in addition to comments from the general public before 
implementing significant policy changes?

    Answer. Yes.

    Question. Lastly, will you commit to working with the Secretary of 
the Department of Homeland Security to uphold the Flores Settlement and 
the Trafficking Victims Protection Reauthorization Act?

    Answer. Yes.

                                 ______
                                 
               Question Submitted by Hon. Debbie Stabenow
    Question. I'm a strong supporter of Medicare's home health benefit, 
and it's a really important option, particularly during the pandemic. 
What improvements and modernizations would you like to see made to the 
home health benefit?

    Answer. As you mention, the Medicare home health benefit allows 
beneficiaries to receive care from their home, which is a much needed 
lifeline for our Nation's seniors. I believe the home health benefit is 
necessary to ensuring quality health care. I also understand this issue 
personally. As I discussed briefly in our hearing, I was fortunate 
enough to care for my father at home, prior to his passing. I 
understand that in response to the COVID-19 Public Health Emergency, 
the Centers for Medicare and Medicaid Services provided flexibilities 
to home health agencies, giving them tools to help ensure beneficiaries 
maintain access to care. If confirmed, I will work with you and other 
members of Congress to ensure that our Nation's seniors are able to 
utilize home health care and to continue to improve the benefit.

                                 ______
                                 
               Question Submitted by Hon. Maria Cantwell
                        lymphedema treatment act
    Question. Lymphedema is an incurable but treatable medical 
condition caused by injury, trauma or congenital defects. One of the 
most common causes of Lymphedema is cancer treatments that remove or 
damage lymph nodes and vessels, or cause blockages in the lymphatic 
system. The disease is effectively managed through prescription medical 
compression garments, which are highly specialized compression 
stockings, sleeves, gloves, and other items, all of which must be 
custom-fit by trained providers. In the case of more advanced disease 
or complex cases, these garments must be custom-made.

    Medically necessary supplies such as these should be covered by 
insurance. Moreover, by not treating the condition with compression 
garments, patients are more likely to enter hospitals and doctors' 
offices during the current COVID-19 pandemic, which is not helpful to 
our efforts to combat the spread of the virus.

    Unfortunately, Medicare does not currently provide coverage for 
lymphedema compression supplies, which must be replaced about every six 
months, because the Centers for Medicare and Medicaid Services (CMS) 
claim they do not fit into an existing benefit category.

    I have been leading the effort in Congress to correct this problem 
and have sponsored the Lymphedema Treatment Act (LTA) to direct CMS to 
cover prescribed medical compression garments.

    If confirmed as Secretary, are you willing to endorse this 
legislation and recommend President Biden sign it into law if passed by 
the Congress, unless you are able to fix this administratively?

    Answer. Thank you for your leadership on behalf of Lymphedema 
patients. I agree that we must ensure Medicare beneficiaries have 
access to medically necessary health-care items and services. If 
confirmed, I will work with you to identify solutions to this issue.

                                 ______
                                 
             Question Submitted by Hon. Benjamin L. Cardin
                         medicaid and covid-19
    Question. Last year, at the beginning of the COVID-19 pandemic, the 
country saw a dramatic decline in the utilization of health-care 
services as individuals sought to limit their risk and exposure to 
contracting the coronavirus. Almost a year later, many States have 
lifted restrictions on medical procedures, begun reopening schools, and 
relaxed other restrictions. As a result, utilization of non-urgent care 
has returned to or trended near normal utilization levels, pre-
pandemic.

    Capitated managed care is the dominant way in which States deliver 
services to Medicaid enrollees. States pay Medicaid managed care 
organizations (MCOs) a set per member per month payment for the 
Medicaid services specified in their contracts. During the pandemic, 
States were making payments to plans, but those payments were not 
necessarily flowing to providers where utilization had decreased. As a 
result, many Medicaid providers faced substantial losses in revenue, 
while many health insurers reported record earnings.

    In the waning days of the Trump administration, many States sought 
approval from CMS to implement a risk corridor financing mechanism for 
their respective Medicaid programs. This allowed States to recoup 
monies that were paid to Medicaid MCOs prior to the pandemic and the 
Public Health Emergency Declaration.

    Now that utilization patterns in the Medicaid program are returning 
to normal, when would it be appropriate for CMS to review State risk 
corridor arrangements?

    Answer. The COVID-19 public health emergency (PHE) disrupted all 
aspects of our lives, including our use of routine and urgent health 
services, presenting unique and unanticipated circumstances. Over the 
past year, there have been different patterns in health care 
utilization. If confirmed, I look forward to working with you to 
support State efforts to respond to COVID-19, including regarding 
payment to the managed care plans and providers to ensure Medicaid 
beneficiaries have continued access to care.

                                 ______
                                 
               Questions Submitted by Hon. Sherrod Brown
                         child abuse fatalities
    Question. In my State, there have been a number of tragic child 
abuse-related deaths, which is unacceptable. It is critical that we do 
more to support at risk children and families and ensure States have 
the resources to prevent these tragedies. Right now, the National Child 
Abuse and Neglect Data System (NCANDS) fails to capture the entire 
number of child abuse fatalities. Like almost every other aspect of the 
child welfare system, child abuse deaths disproportionately affect 
black families. The Federal Commission to Eliminate Child Abuse and 
Neglect Fatalities recommended significant reforms, including increased 
funding to child welfare programs and the development of a standard 
definition of ``child maltreatment fatality.''

    Will you commit to working with members of Congress to advocate for 
funding to ensure States and community partners have the resources to 
support families and prevent child abuse-related deaths? Will you 
commit to incorporating the voices and lived experiences of young 
people and families to root out factors that lead to this tragedy 
having a disparate impact on black families? If confirmed, what initial 
steps would you take to strengthen Federal data systems and encourage 
cross agency collaboration to ensure policymakers and practitioners 
have the information necessary to prevent child abuse-related 
fatalities?

    Answer. Federal data systems are critically important to ensuring 
child safety and must be inclusive so that they capture all relevant 
information that States, policymakers, and practitioners need to 
prevent child abuse-related fatalities. Working with Congress to 
support States and community partners will be an important part of our 
broader efforts to reduce child abuse-related fatalities, including by 
strengthening Federal data systems. President Biden has been 
unequivocal that equity issues will be and will remain at the forefront 
of his administration. If confirmed, I will ensure that the experiences 
and perspectives of all children and families will inform my work.
                      family first implementation
    Question. COVID-19 has devastated State budgets, particularly 
systems that were already underfunded, such as the child welfare 
system. As States like Ohio, work to implement provisions from the 
Family First Act, it is critical to ensure they have adequate and clear 
guidance and support to be successful under the new system.

    Will you commit to providing States and child welfare providers 
with the tools, resources, and information necessary to implement 
Family First? Will you commit to working with county-administered child 
welfare systems in States like Ohio to promote equitable access to 
Family First support services across jurisdictions?

    Answer. The Family First Prevention Services Act is an important 
law that seeks to transform child welfare services by increasing 
support for prevention services to strengthen families and keep 
children safely at home and in their communities with their parents, or 
other family members whenever possible. When children must come into 
foster care, the law seeks to limit the use of institutional care and 
encourage family-based placements. If confirmed, I commit to ensuring 
HHS takes every available step to support vulnerable children and 
families, and makes available needed guidance and technical assistance 
so that all States, including those with county-administered child 
welfare systems like Ohio, can effectively implement the law and ensure 
equitable access to needed services.
                     social determinants of health
    Question. As was discussed during Wednesday's hearing, entities 
across the health-care and political spectrum are increasingly focused 
on ways to address the social determinants of health. The Department of 
HHS--as both a payer and a policy driver--has many tools at its 
disposal to improve health and drive value by addressing social 
determinants.

    If confirmed, how will you use Federal payment policy--across 
Medicare and Medicaid and through the Center for Medicare and Medicaid 
Innovation (CMMI)--to address the social determinants of health, ensure 
our Federal programs and models address health-related social needs of 
patients, and support upstream investments in the social determinants 
of health?

    Answer. The COVID-19 pandemic has further exposed the disparities 
that exist in our society. I understand the CMS Innovation Center is 
currently testing the Accountable Health Communities Model, which 
evaluates whether systematically identifying and addressing the health-
related social needs of Medicare and Medicaid beneficiaries through 
screening, referral, and community navigation services will impact 
health-care costs and reduce health-care utilization. In addition, if 
confirmed, I intend to take a department-wide approach to the 
advancement of equity, consistent with President Biden's charge to 
Federal departments and agencies, and this would include examination of 
ways to address the social determinants of health.
                 covid-19 vaccine disparities and data
    Question. A recent Washington Post \1\ article gave examples of 
States that have managed the COVID vaccination process well, while 
others have had a more challenging time navigating the complex process. 
All States, however, have failed to distribute vaccines equitably \2\--
we are failing our communities of color.
---------------------------------------------------------------------------
    \1\ https://www.washingtonpost.com/national/states-vaccine-rollout/
2021/02/03/eae671a0-656f-11eb-886d-5264d4ceb46d_story.html.
    \2\ https://www.kff.org/coronavirus-covid-19/issue-brief/latest-
data-on-covid-19-vaccinations-race-ethnicity/.

    Many States, including Ohio, are working to develop a vaccine 
appointment finder tool to increase resident participation and aid in 
the State's vaccination campaign. Some localities have made use of 
online platforms that help collect data on the root causes of vaccine 
hesitancy, providing public health and community leaders with 
additional information on actions they can take to improve the vaccine 
distribution process, particularly for communities of color and 
---------------------------------------------------------------------------
underserved communities.

    If confirmed, will you commit to getting States the complete set of 
data and information they need to populate their vaccine finder tools, 
and ensure States have the tools to build and leverage their platforms 
to accelerate the vaccine distribution process and reduce disparities 
in access to vaccine?

    Answer. I am acutely aware of the disparities faced by communities 
of color and other underserved communities. If confirmed, I will ensure 
that we are partnering with States on data and vaccine information so 
that Americans, especially communities of color, can more easily access 
vaccination. I will also endeavor to work with States on other options 
for those who may not have access to a computer as well. It is critical 
that Federal and State governments are closely coordinated and sharing 
information to best serve the needs of the American people.
                 direct and indirect remuneration fees
    Question. Community pharmacists are a critical player in our 
Nation's health-care workforce, extending essential services to 
underserved and disproportionately at-risk communities. Especially 
during the COVID-19 pandemic, pharmacists have been critical in our 
efforts to expand access to testing and vaccination services, including 
long-term care residents and other seniors and Part D beneficiaries.

    Unfortunately, the rapid growth of pharmacy direct and indirect 
remuneration (DIR) fees continues to create uncertainty for the 
community pharmacies Ohioans rely on for essential services. The use of 
DIR fees in Medicare Part D has exploded over the past several years, 
threatening the financial viability of pharmacies across Ohio and the 
health of the patients they serve. The Centers for Medicare and 
Medicaid Services (CMS) has estimated that pharmacy DIR fee reform 
could result in saving Medicare beneficiaries between $7.1 and $9.2 
billion in cost-sharing burden over the next decade.

    If confirmed, will you commit to working with Congress on solutions 
to address the explosion of DIR fees and support stability for 
community pharmacies, while ensuring quality and low costs for Medicare 
beneficiaries?

    Answer. I agree that community pharmacists are critical to our 
Nation's health-care system. We must do all we can to ensure that 
Americans can access important health-care services, including from 
local pharmacies in their communities. If confirmed, I look forward to 
working with Congress to ensure that community pharmacists have 
predictability.
           preventive/primary care/screenings during covid-19
    Question. COVID-19 has been a threat to our health in more ways 
than one. Not only has the virus stolen the lives of more than 500,000 
Americans, it has drastically reduced other vital health-care services 
that are essential to keeping Americans healthy. COVID-19 has had a 
significant negative impact on primary care visits, childhood 
vaccination rates, and cancer screening rates.

    The Centers for Disease Control and Prevention (CDC) issued a 
Morbidity and Mortality Weekly Report (MMWR) in September 2020 that 
found that ``because of concerns about COVID-19, an estimated 41 
percent of U.S. adults had delayed or avoided medical care including 
urgent or emergency care (12 percent) and routine care (32 percent). 
Avoidance of urgent or emergency care was more prevalent among unpaid 
caregivers for adults, persons with underlying medical conditions, 
black adults, Hispanic adults, young adults, and persons with 
disabilities.''

    It is essential that we both work to reduce the backlog in 
screenings and vaccinations and other primary health-care services, and 
to better understand factors associated with medical care avoidance 
to--as the CDC MMWR says--``inform targeted care delivery approaches 
and communication efforts encouraging persons to safely seek timely 
routine, urgent, and emergency care.''

    If confirmed, what will you do to ensure that we make up for the 
lost progress (as a result of the pandemic) in our rates of childhood 
vaccinations and cancer screening efforts, as well as in our work to 
reduce the prevalence and severity of other chronic conditions and to 
improve public health outcomes?

    Answer. We know the COVID-19 pandemic caused Americans--adults and 
children--to delay routine care, including important preventive 
measures like vaccinations and cancer screenings. If confirmed, I look 
forward to working across the Department to address lost progress and 
the looming effects of unaddressed chronic conditions.
                 medicare advantage/prior authorization
    Question. Thank you for your commitment to working with me to equal 
the playing field between traditional Medicare and the Medicare 
Advantage program. I look forward to collaborating on this effort.

    One area where we can create some parity lies in the prior 
authorization process. Last Congress, I introduced legislation with 
Senator Thune to establish an electronic prior authorization program in 
Medicare Advantage (MA) to better facilitate the prior authorization 
process in MA and improve the timeliness and efficacy of care delivery 
for beneficiaries and their providers. CMS has issued a notice of 
proposed rulemaking to establish similar programs in Medicaid, the 
Children's Health Insurance Program (CHIP), and insurers operating 
qualified health plans on the federally facilitated exchange under the 
Affordable Care Act (ACA). Beneficiaries and their providers should not 
have to jump through hoops in order to access medically necessary 
services.

    If confirmed, will you work with Senator Thune and me to provide 
additional technical assistance on our legislation so that we can 
advance improved prior authorization processes that put the patient 
back at the center of care and reduce barrier to timely access to 
essential services?

    Answer. I believe that ensuring Americans have timely access to 
health care is critical, and I agree with you that providers and 
individuals should not have to jump through unnecessary hoops for 
access to medically appropriate care. If confirmed, I look forward to 
working with you, Senator Thune, and other members of Congress on these 
important issues.
                              biosimilars
    Question. Thank you for your commitment to lowering the high cost 
of prescription drugs. The robust uptake of biosimilars represents an 
opportunity to increase competition in the prescription drug 
marketplace and reduce costs for patients and taxpayers. I'd like to 
work with you on ways to maximize the uptake of biosimilars as they 
enter the market to ensure competition and reduce patient out of pocket 
cost.

    If confirmed, what additional steps should and will you take to 
build out a robust biosimilars market and ensure all patients who 
require treatment have immediate access to high-quality, affordable 
biosimilar biologic medicines?

    Answer. Competition in the market has helped control the growth in 
spending on prescription drugs. Biosimilars have a role to play in 
containing the cost of innovative yet expensive biologic treatments by 
creating competition. As Attorney General, I helped to promote 
competition by taking on a number of pharmaceutical companies that 
restricted competition through ``pay-for-delay'' schemes, which delayed 
putting a generic product on the market to compete with the brand-name 
product, therefore keeping the price of that brand-name product high. 
In addition, I sponsored a law in California that made it more 
difficult for pharmaceutical companies to enter into anti-competitive 
``pay-for-delay'' agreements. If confirmed, I will continue to work on 
finding ways to lower drug costs and ensuring Americans have access to 
prescription drugs.
                         antibiotic resistance
    Question. From the CDC to the World Health Organization, public 
health experts consider antibiotic resistance to be one of the top 
threats to global health security. The threat posed by superbugs 
demands swift action and a robust response.

    I urge you to commit to building on the National Action Plan for 
Combating 
Antibiotic-Resistance Bacteria (CARB) and follow through on 
coordinated, strategic actions to address antibiotic resistance.

    What actions will you take, amidst and after this pandemic, to 
prioritize our Nation's fight against antibiotic resistance in addition 
to building out our antibiotic stewardship programs and curbing the 
overuse of antibiotics?

    Answer. It is clear that antimicrobial resistance (AMR) must be a 
top public health priority, not only for the United States but around 
the world. Even during this time, AMR remains a top CDC priority, and 
if confirmed, we will continue investing in key prevention strategies 
like early detection and containment, infection prevention, and 
ensuring the appropriate use of antibiotics in the U.S. and around the 
world. I will also support efforts to develop new antibiotics to treat 
infections that are becoming untreatable.

                                 ______
                                 
             Questions Submitted by Hon. Michael F. Bennet
                              rural health
    Question. According to the Brookings Institute, rural communities 
had not yet recovered from the recession when COVID-19 hit. Farm 
workers and packing plant workers have experienced particular hardship 
over the past year. I recently finished a tour of all 64 counties in 
Colorado and I often visited with hospital leaders in the rural parts 
of the State. In the past 10 years, 135 rural hospitals have shut down, 
including 19 in 2020. I heard the same refrains throughout: that 
Medicare reimbursement wasn't adequate, that they needed infrastructure 
support, and that they were afraid that one more thing could shut them 
down. I have worked with my colleagues, Senators Murkowski and Barrasso 
and many others, on legislation to support our rural providers and 
public health, often the bedrock of their communities.

    Will you commit to working with me on rural health? What can you do 
to support rural hospitals and providers to ensure they can recover 
more quickly than they did in the last recession?

    Answer. I believe it is HHS's role to support programs and advance 
policies that promote access to high-quality care in rural and other 
underserved areas. If confirmed, I look forward to working with you and 
other Members of Congress to advance rural health through the work of 
the Health Resources and Services Administration, Centers for Medicare 
and Medicaid Services, and other parts of the Department, and to 
support efforts that put rural hospitals in a better financial position 
to deliver needed care in their communities.
                        surprise medical billing
    Question. In December, Congress passed the No Surprises Act, which 
will end the practice of surprise billing. I think this was a major 
step to protect patients who were often taken advantage of in their 
most vulnerable state. I had been working on that effort for years with 
Senators Cassidy and Hassan and others on the committee, and I am 
grateful it was signed into law. Now you have the responsibility to 
implement the legislation before it goes into effect next year.

    Can you highlight your thoughts on surprise billing and your 
commitment to implement the legislation over the next year should you 
be confirmed?

    Answer. This law is important to so many. I want to thank you and 
your colleagues for the good work that went into getting this 
legislation enacted. If confirmed, I will work to ensure that this 
critical legislation is implemented effectively and in a timely manner. 
I look forward to working with you and other members of Congress on 
this shared goal.
                           public health jobs
    Question. In Colorado, the public health infrastructure has been 
underfunded by up to 40 percent. Our national public health 
infrastructure has been in a similar place. I believe that this 
underinvestment, on top of a total lack of leadership from the previous 
administration, is a huge reason why the response in the United States 
compared to other countries was so poor. The American Rescue Plan has a 
public health jobs program, which looks very similar to the Health 
force proposal that I put together with Senator Gillibrand, and would 
provide 100,000 public health jobs to do everything from contact 
tracing to vaccine administration through and beyond the COVID-19 
pandemic. This proposal would create jobs for people in the communities 
they serve, which I believe can make a massive difference to help 
reduce racial and ethnic disparities, which this pandemic has only 
highlighted.

    Do you agree that public health workers should come from the local 
communities they serve? How can the Public Health Jobs program improve 
case in underserved, black, indigenous, and Latino communities?

    Answer. I am deeply committed to bolstering the Nation's public 
health infrastructure. Like you, I believe that equity must be central 
to all aspects of our COVID-19 response and how we prepare for future 
public health challenges. It is also important that our health 
workforce is representative of the communities they serve. As you know, 
the President's American Rescue Plan calls for 100,000 public health 
workers who will work in their local communities. The President has 
stated that these public health workers will perform critical near-term 
tasks, including vaccine outreach and contact tracing, and ultimately 
transition into long-term roles in low-income and underserved 
communities. If confirmed, I would look forward to the opportunity to 
work with you on this program and other initiatives to promote health 
equity and strengthen the country's public health workforce.

    Question. Will you work to ensure that the formula for the Public 
Health Jobs Program funding includes a percentage of funding that would 
go directly to local public health agencies and not fully through the 
State health agencies?

    Answer. If confirmed, I commit to work with you to ensure that 
support reaches local public health agencies.
                            opo regulations
    Question. Colorado is consistently among the top performing States 
for organ donation in the country: last year, in Colorado, 215 heroic 
organ donors saved a record-setting 622 lives. This marked a 45-percent 
growth in the last 5 years. New organ procurement organization (OPO) 
performance regulations that the Trump administration created were long 
awaited to reform the current organ donation and transplantation 
system. Unfortunately, the age only adjustment for organs transplanted 
metric could unintentionally place the Colorado OPOs in a lower, 
inappropriate tier due to the State's young population.

    As the Centers for Medicare and Medicaid Services may review and 
update the OPO, will you work with me to ensure that such updates take 
into account Colorado's unique situation? For example, will you include 
a medical adjustment in the metric to take into account health 
characteristics that may affect the eligibility for donation, such as 
diabetes or hypertension?

    Answer. I share your desire to ensure OPOs are held to high, fair 
standards using appropriate metrics that account for high-performing 
OPOs. If confirmed, I look forward to working with you to increase the 
organ supply and hold OPOs accountable for their performance.
                       equity in policy decisions
    Question. Many of the efforts surrounding health equity address 
issues among the private sector among the health-care industry, but 
often overlook bias among policy-makers and their staff in both the 
executive and legislative branches. Your nomination as the first Latino 
to lead HHS would be historic and provides you with a unique lens and 
prerogative to create lasting change in the agency.

    Would you work to use all available tools to hire diverse staff 
specifically assigned to reviewing policy and communications (e.g., 
regulations, legislation, technical assistance for legislation, 
guidance, press releases, etc.) and, as appropriate, embed policy and 
feedback that would help reduce disparities among agencies and the 
industries they regulate under your purview?

    Answer. I am committed to a diverse workforce within HHS including, 
but not limited to, policy and communications staff. I agree with 
Office of Personnel Management tenets that workforce diversity benefits 
organizations' ability to effectively serve our increasingly diverse 
Nation and address disparities. A diverse workforce also can ignite 
innovation in policies, programs and processes. If confirmed, I will 
champion diversity, equity, and inclusion across HHS.
                      public health leader safety
    Question. Over the past year, public health leaders at local public 
health agencies (LPHA) in Colorado and across the country have 
experienced a great deal of stress responding to the pandemic, 
including threats to their personal lives and families. This has led to 
a significant amount of turnover, including 21 LPHA directors in 
Colorado alone leaving their posts.

    Should you be confirmed, will you work with the Department of 
Justice to provide guidance to State, local, territorial, and tribal 
governments on how to best support LPHA and other health agency 
leaders, including their physical safety?

    Answer. If confirmed, I commit to working to address the physical 
safety and behavioral health concerns of our Nation's public health 
leaders and consulting with the Department of Justice, as appropriate, 
on these efforts.

                                 ______
                                 
    Question Submitted by Hon. Michael F. Bennet and Hon. Todd Young
                        antimicrobial resistance
    Question. Antibiotic resistance and the broken antibiotic 
marketplace complicate our response to public health emergencies, may 
lead to a public health crisis that is worse than the COVID-19 
pandemic, and threaten the very foundation of modern medicine. It has 
been over 30 years, since the late 80s, since a new class of 
antibiotics has entered the market. Small biotech firms are keeping 
this industry alive, but in the past few years there have been a number 
of casualties and these companies have shuttered. Without better 
preparation and investment in novel antibiotics, some have projected up 
to 10 million deaths globally per year by 2030 if we don't invest now. 
Procedures including cancer chemotherapy, surgery, transplants, 
treatments of wounds and burns, and care of medically complex patients 
all rely upon safe and effective antibiotics.

    We have developed legislation--the PASTEUR Act--to establish a 
subscription model for new, critically needed antibiotics. Under 
PASTEUR, the Federal Government would enter into contracts with 
antibiotic developers to provide set payments for new antibiotics that 
are delinked from the volume of antibiotics used. In exchange, they 
will provide a reliable supply of antibiotics. The PASTEUR Act would 
also provide support for antibiotic stewardship programs in health care 
facilities--which are proven to reduce inappropriate antibiotic use and 
improve patient outcomes.

    Will you commit to working with us on legislation to prepare for 
the threat that resistant infections pose, including the PASTEUR Act, 
which both incents antibiotic development and supports the appropriate 
use of antibiotics?

    Answer. It is clear that antimicrobial resistance (AMR) must be a 
top public health priority, not only for the United States but around 
the world. Even during this time, AMR remains a top CDC priority, and 
if confirmed, we will continue investing in key prevention strategies 
like early detection and containment, infection prevention, and 
ensuring the appropriate use of antibiotics. I agree that it is 
important to encourage the industry to develop innovative therapies 
that improve health outcomes. I also believe it is important to ensure 
access to and appropriate use of crucial therapies such as antibiotics. 
If confirmed, I am committed to working with you to achieve these 
important goals.

                                 ______
                                 
               Questions Submitted by Hon. Mark R. Warner
                  medicare diabetes prevention program
    Question. According to the Centers for Disease Control and 
Prevention (CDC), 88 million Americans--more than 1 in 3--have 
prediabetes while another 34 million--just over 1 in 10--have diabetes. 
Those rates hold true in my home State where over 631,000 Virginians 
suffer from diabetes. Fortunately, there is a proven and innovative 
CDC-recognized lifestyle change program to help prevent or delay type 2 
diabetes, the National Diabetes Prevention Program (DPP).

    In recent years Congress and CMS have recognized the benefits of 
this program for Medicare beneficiaries by ensuring patients have 
access to DPP. However, despite the increased demand and need for 
accessing health care virtually, current CMS rules do not ensure 
comprehensive access to virtual DPP. To address this gap, I introduced 
bipartisan legislation, the PREVENT DIABETES Act, with Senator Tim 
Scott. HHS has temporarily allowed individuals to access the DPP via a 
virtual platform during the COVID-19 pandemic, but this administrative 
change still excludes a number of providers and does not ensure long-
term access to a virtual benefit. Our legislation will improve access 
to the program by ensuring individuals can access the DPP Expanded 
Model via virtual suppliers.

    As Secretary, will you work with CMS and Congress to ensure the DPP 
services can be offered to Medicare beneficiaries via a virtual 
platform?

    Answer. Innovation is important to advancing the administration's 
goals in health care, and the CMS Innovation Center is integral to the 
administration's efforts to promote high-value care and encourage 
health care provider innovation, including virtual and digital health 
innovation. With respect to the Medicare Diabetes Prevention Program 
(MDPP) expanded model, I understand that CMS issued regulatory 
flexibilities in response to the COVID-19 pandemic, including waiving 
the limit on virtual sessions that can be provided by MDPP suppliers. 
If confirmed as Secretary, I commit to working with you on this and 
other models to reduce health disparities and prevent chronic diseases 
such as diabetes.
                      rural health/area wage index
    Question. Over the past decade, well over 100 rural hospitals have 
closed, and over the past year, the COVID-19 pandemic has made this 
rural health-care crisis significantly worse. It is no coincidence that 
the vast majority of these hospital closures have occurred in areas 
with the lowest Medicare Area Wage Index rates. To help solve this 
problem, I have previously introduced the Save Rural Hospitals Act of 
2020 and plan to introduce similar legislation this year.

    This legislation that would establish a reasonable national minimum 
Medicare Area Wage Index of 0.85, and as a result, would increase 
Medicare payments for rural hospitals in 22 States. The previous 
administration took several administrative steps to help solve the 
numerous problems with the Medicare Area Wage System, but much more 
needs to be done.

    If confirmed, would you pledge to work with Congress, and take 
additional administrative steps as needed, to support rural hospitals 
by addressing the problems in the Medicare Area Wage System?

    Answer. The Biden administration believes that all Americans should 
receive quality health care. Rural hospitals provide critical access to 
care in communities that have unique needs and challenges. While many 
requirements for Medicare payment to hospitals are defined in statute, 
I look forward to working with Congress to help rural hospitals serve 
their communities.
                          health data privacy
    Question. I recently worked with Senator Blumenthal, as well as 
with Representatives Eshoo, Schakowsky, and Delbene to introduce the 
Public Health Emergency Privacy Act, which would set strong and 
enforceable privacy and data security rights for health information. 
After decades of data misuse, breaches, and privacy intrusions, 
Americans are reluctant to trust tech firms to protect their sensitive 
health information--according to a recent poll, more than half of 
Americans would not use a contact tracing app and similar tools from 
Google and Apple over privacy concerns.

    Our health privacy laws have not kept pace with what Americans have 
come to expect for their sensitive health data; HIPAA was passed by 
Congress at a time when heath data looked very different than it does 
today. Health data collected by health technology companies, apps, and 
other entities--whether for public health emergency purposes or in 
general--is not protected in the same way as health data collected by 
providers, exposing patients to potential harm.

    The previous administration recently released rules that would 
further reduce privacy protections and lead to an expanded role for 
third party apps and other entities not subject to health privacy laws. 
Strong protections created through the patient authorization process 
have been eroded, and apps are given the same right to access data as 
patients. These rules appear to be moving forward under the new 
administration.

    Will you commit to curtailing data abuses by third parties who seek 
to monetize valuable health data as HHS secretary? How else do you plan 
to address this important issue and protect patient privacy?

    Answer. As California Attorney General, I held several companies 
accountable for legal violations for not protecting patients' health 
information. Patients have a legal, enforceable right to request a copy 
of and access to their health information under the HIPAA Privacy Rule 
and may use a variety of means to do so. As technology has changed, so, 
too, have the ways in which that access can be provided. HHS is aware 
and sensitive to the importance of protecting patient privacy and 
continues to work collaboratively with partner agencies across the 
Executive Branch. If confirmed, I look forward to a collaborative 
relationship with Congress on this evolving issue.

    Question. How will you ensure that companies with documented 
privacy lapses and anti- competitive behavior will not benefit from 
HHS's efforts to enable third-party access to sensitive and valuable 
health data?

    Answer. The issue of data privacy and ensuring the security of 
valuable health data is constantly evolving. If confirmed, I commit to 
working with Congress on this important issue.
                               telehealth
    Question. In recent years, I have worked with a bipartisan group of 
Senators to advance common-sense telehealth reform in the Medicare 
program. Specifically, our previously introduced and soon-to- be 
reintroduced CONNECT for Health Act provides targeted reforms to the 
Social Security Act to ensure access to telehealth for Medicare 
beneficiaries. Telehealth use and popularity--including among the 
Medicare population--has increased significantly during the COVID-19 
Public Health Emergency. However, these services will go away with the 
PHE. Now more than ever, we must work with the administration to 
support policies like those in CONNECT.

    What role do you see telehealth playing post-pandemic?

    Do you think Congress should restrict access to telehealth after 
the end of the PHE based on a patient's geographic or physical 
location?

    How would you, as Secretary, work to ensure patients have the 
choice to access care via telehealth?

    Answer. Telehealth is an important tool to improve health equity 
and improve access to health care. Health care should be accessible, no 
matter where you live. If confirmed, I will look at the telehealth 
flexibilities developed for the current public health emergency and 
determine how we can build on this work to improve health equity and 
improve access to health care.
                        pre-existing conditions
    Question. To date, the COVID-19 pandemic has taken the lives of 
more than half a million Americans and infected millions more across 
our country. Those who have been infected with the diseases have 
suffered with the short-term health implications of the virus, but the 
long-term health impacts are still poorly understood. As a result, more 
Americans than ever will now have a pre-existing condition.

    Junk insurance plans, such as short-term limited-duration plans and 
association health plans, are allowed to discriminate against people 
with pre-existing conditions, charge them more based on their health 
status, and rescind or deny coverage altogether. In the wake of the 
pandemic, it is critically important that the administration move 
quickly and decisively to limit the availability of substandard 
insurance products that undercut the health and well-being of 
Americans.

    Will you commit to taking immediate action to reign in these 
harmful products and if so can you commit to working with me and my 
office on this issue?

    Answer. Making sure that all Americans have access to quality, 
affordable health care is one of the Biden administration's top 
priorities. If confirmed, I will examine rules and other policies, to 
ensure that plans provide Americans access to the care that they need. 
I look forward to working with you and your office on this important 
issue.
                              foster youth
    Question. Almost everyone living in the United States has had to 
make significant adjustments in the wake of the COVID-19 pandemic, but 
it has greatly worsened existing challenges for foster youth across the 
Nation. Even before the public health emergency, only about half of 
youth aging out of the foster care system each year were anticipated to 
have some form of gainful employment by the age of 24. Studies show 
that foster youth have and will continue to feel the brunt of the 
pandemic's economic impact and the growing digital divide. A survey 
conducted by FosterClub found that 65 percent of transition-age foster 
youth who were employed before the pandemic lost their jobs by May 
2020. According to a report conducted by iFoster, only about 5 percent 
of youth in foster care in rural settings and 21 percent of youth in 
foster care in urban settings have regular access to a computer. I am 
concerned that foster youth will continue to be harmed if changes are 
not made to strengthen support and resources. Therefore, I would 
appreciate a response to the following questions.

    In light of the challenges faced by foster youth during the 
pandemic, how would you use your role as HHS Secretary to support 
foster youth and ensure they receive the support and resources 
necessary to enter the workforce and accomplish their personal and 
professional goals?

    What specific steps do you plan to take to ensure stability for 
foster youth, both in the short-term and long-term, during the pandemic 
and its aftermath?

    Answer. I share your concern that young people aging out of the 
foster care system too often lack access to stable housing, income, and 
other resources, and the pandemic has made these challenges even more 
pronounced. The Supporting Youth and Families Through the Pandemic Act, 
passed as part of the Consolidated Appropriations Act of 2021 contained 
critical provisions to prevent youth from aging out of foster care and 
to allow voluntary re-entry into foster care. It also contained 
expanded flexible funding that States may use to provide direct 
financial assistance or housing assistance, or to assist with other 
needs, whether that be purchasing food, cell phones and laptops, or 
gaining Internet access. It is essential that States reach out to and 
listen to the diverse populations of youth with lived experience in the 
foster care system to guide their implementation of these provisions 
and to lay the groundwork for stronger supports for youth moving 
forward. I appreciate your thoughtful leadership on this issue, and, if 
confirmed, look forward to working with you on it.
                      protections for coal workers
    Question. As you well know, the U.S. passed a grim milestone last 
week: more than 500,000 Americans have died after contracting COVID-19. 
Coal miners living with coal workers' pneumoconiosis (black lung 
disease) are particularly at risk for suffering severe consequences of 
the disease. Many miners receive diagnostic, treatment, and 
rehabilitation services at black lung clinics funded through the 
Department of Health and Human Services' (HHS) Health Resources and 
Services Administration (HRSA). Given that these clinics are under your 
authority, I would appreciate your response to the following questions.

    Do you believe that further guidance is needed to ensure that 
miners' treatment is not compromised during the pandemic and their 
needs are best served? If so, what step do you plan to take?

    Moving forward, what specific steps do you plan to take, in 
coordination with the Department of Labor, to ensure that coal miners 
receive the appropriate health screenings, preventive care, and 
treatment necessary for their well-being?

    Answer. It is important to protect the most vulnerable in our 
communities, especially during a global pandemic. If confirmed, I will 
work across the Federal Government to ensure all people with chronic 
conditions are able to access the health care they need, and I will 
support robust oversight of HRSA's black lung clinic program.

                                 ______
                                 
             Questions Submitted by Hon. Sheldon Whitehouse
            substance use and opioid use disorder treatment
    Question. Access to evidence-based substance use disorder treatment 
including medication-assisted treatments (MAT) is limited in the U.S. 
due to restrictive Federal laws and regulations. For example, providers 
are limited in the number of patients they can see and are required to 
obtain an additional ``X waiver'' from the DEA to provide this type of 
treatment. In addition, people incarcerated in U.S. jails and prisons 
often are denied access to these effective treatments and the rate of 
overdose death for individuals who recently have reentered the 
community from incarceration is very high. My legislation the TREATS 
Act would provide providers with flexibility and improve access to MAT.

    Will you work with Congress to eliminate the X waiver and lift the 
patient caps that artificially limit how many patients providers can 
serve?

    Answer. If confirmed, I will work with Congress to expand 
availability of and access to substance use disorder prevention, 
treatment, and recovery services. There are a number of measures that 
HHS can consider implementing. If confirmed, I will work with you 
toward these goals.

    Question. Will you work with SAMHSA and the DEA to make permanent 
the current temporary waivers for methadone and buprenorphine that 
enable more stable patients to take home medications (allowing 14-28 
days to be taken home) and enable buprenorphine induction to happen via 
telehealth?

    Answer. I am committed to reducing barriers to medication-assisted 
treatment and will work with SAMHSA and the DEA to do so.
                          behavioral health it
    Question. I authored a provision in the SUPPORT Act to create a 
CMMI demonstration program that furnishes financial incentives to help 
Community Mental Health Centers, psychiatric hospitals and other 
behavioral health providers obtain Electronic Health Record systems. 
The prior administration did not implement the demonstration, which is 
critical to helping mental health and addiction treatment providers 
communicate with hospitals, primary care doctors and medical 
specialists through Health Information Exchanges (HIEs) and Health 
Information Technology (HIT).

    Will you commit to exploring ways to generate CMMI funding to 
implement this authorized demonstration?

    Answer. Innovation is critically important to advancing goals in 
health care, and the CMS Innovation Center is integral to the 
administration's efforts to improve behavioral health. I know CMS is 
always looking for ways to incorporate payment incentives for improved 
behavioral health into its models, and if confirmed as Secretary, I 
look forward to working with you to find ways to better support our 
Nation's mental health and addiction treatment providers.

                                 ______
                                 
               Questions Submitted by Hon. Maggie Hassan
                     gun purchaser safety education
    Question. The Gun Shop Project was started in New Hampshire as a 
suicide prevention program that encourages gun stores and firing ranges 
to display and distribute suicide prevention materials, as well as 
trains gun dealers on how to look for customers who may be in crisis or 
at risk for suicide.

    Today, more than half of all gun stores in New Hampshire are 
disseminating materials about the risk of suicide, and the program has 
expanded to more than 21 States. The Gun Shop Project is a proven 
example of a successful partnership between gun owner groups and 
suicide prevention advocates.

    The Federal Government can build on the success of the Gun Shop 
Project by providing funding for similar programs. A recent study that 
interviewed leaders from State-level and national-level Gun Shop 
Projects found that funding was the primary challenge to implementing 
these programs.

    Do you support funding and support for public awareness campaigns 
that provide gun purchasers with safety information about the risks 
associated with guns, best practices for responsible gun storage, and 
suicide prevention information?

    Answer. We certainly should be funding innovative and collaborative 
strategies for suicide prevention and reducing gun violence. Providing 
gun purchasers with safety information and information on suicide 
prevention seems like a commonsense way to help protect Americans, and 
if confirmed, I hope to work with you on this issue to keep people 
safe.
       direct distribution of covid-19 vaccines to health centers
    Question. As COVID-19 vaccination continues across the United 
States, the data is showing that people of color, people with low 
incomes or limited English proficiency, and people in rural areas are 
much less likely to get a vaccine. One way to address these disparities 
is to rely on the Nation's system of community health centers.

    To date, many health centers are completely unable to receive 
vaccine allocations. Will you commit to working with States and 
providers to ensure that future vaccine distribution plans incorporate 
the inclusion of community health centers?

    Answer. Yes, if I am confirmed, I will aim to strengthen our 
community health center vaccination program to reduce barriers and 
increase access to the COVID-19 vaccine for people of color, people 
with low incomes or limited English proficiency, and hard-to-reach 
communities in rural areas.
   grant funding to health centers to support vaccine administration
    Question. When health centers have access to COVID-19 vaccines, 
they will need financial support to administer the vaccine. Health 
centers in my State estimate that it costs around $100 per dose to 
administer a vaccine. This reflects the cost of freezers, staff, 
supplies, and scheduling work. If confirmed, how will you work to 
provide health centers with the funding they need so they can be able 
to vaccinate our most vulnerable populations?

    Answer. The Biden administration's program to distribute vaccines 
directly to community health centers is intended to increase access to 
the COVID-19 vaccine. The health centers invited for participation in 
the initial phase of the program serve a significant number of 
vulnerable populations, including those experiencing homelessness, 
migrant/seasonal agricultural workers, residents of public housing, 
seniors, and those with limited English proficiency, and include at 
least one health center in each State or territory. In order to ensure 
that health centers have the support they need to succeed, if 
confirmed, I will work with HRSA to ensure each health center that is 
part of the program has the ability to participate, readiness to 
receive doses, and staff capacity to distribute vaccines.
                        national suicide hotline
    Question. For individuals in a mental health crisis, a law 
enforcement response, rather than a mental health response, can lead to 
negative outcomes, including jail or death. Last year, Congress 
unanimously passed the National Suicide Hotline Designation Act to 
provide a national, easy-to-remember 3-digit number, 988, for 
individuals in crisis to reach trained counselors 24/7. HHS will play a 
vital role in the success of the new, 3-digit dialing code, 988. Should 
you be confirmed, how will you work with the Substance Abuse and Mental 
Health Services Administration to ensure the public is aware of this 
service and improve the outcomes for individuals in crisis?

    Answer. If confirmed, I will work closely with the Assistant 
Secretary for Mental Health and Substance Use and the Substance Abuse 
and Mental Health Services Administration and other Federal partners to 
ensure the American people are aware of the availability of 988 once it 
becomes universally available across the country. We will work to 
improve outcomes for those in a mental health or suicidal crisis, this 
includes pursuing improvements in the crisis response infrastructure in 
order to reduce unnecessary police involvement. HHS will continue to 
work with the FCC, with VA, and with the Office of Emergency Medical 
Services in the Department of Transportation to implement 988.
                      strategic national stockpile
    Question. The COVID-19 pandemic has revealed vulnerabilities and 
shortfalls within our existing Strategic National Stockpile (SNS). 
Since then, the SNS has entered into short-term public-private 
partnership contracts to leverage the capabilities of the distribution 
industry to ensure a continuously replenishing inventory system. As SNS 
continues to reassess and restructure its operations, will you commit 
to working with Congress to improve our Nation's preparedness for 
future shortages caused by pandemics and other national emergencies?

    Answer. Yes, I will work with Congress to improve the SNS in order 
to increase our overall readiness for future public health emergencies.
                            substance misuse
    Question. You were among a bipartisan group of Attorneys General 
that sent a letter to former FDA Commissioner Hahn requesting an update 
on what actions the Food and Drug Administration has taken under the 
SUPPORT Act to address the Nation's devastating opioid epidemic, and 
what actions are proposed for the future. If confirmed, how will you 
work with FDA and SAMHSA to better address the ongoing opioid crisis by 
improving efforts around prevention, including improvements to 
education and awareness campaigns and access to non-opioid therapies, 
and increasing access to medication-assisted treatment?

    Answer. The opioid crisis demands a multifaceted approach to 
include prevention, intervention, treatment, and recovery support 
services. We will continue to fund training, educational resources and 
materials for providers, and technical assistance for professional 
organizations to support these efforts. And we will explore 
opportunities for additional education and awareness activities. 
Moreover, we will work with the FDA in their efforts to approve novel 
therapeutics and devices for the treatment of opioid use disorder.
                         perinatal vaccinations
    Question. Too many women--particularly women of color--in this 
country are dying. Greater attention and efforts are needed to ensure 
that women are receiving necessary preventive care during their 
pregnancies, including recommended immunizations that not only protect 
them but also protect their babies from vaccine preventable illness.

    Senator Cassidy and I have introduced bipartisan legislation to 
help ensure that pregnant women have access to these vital services. If 
confirmed, will you work with us to improve maternal access to care and 
preventive services such as immunizations?

    Answer. Thank you for your leadership on this important issue. If 
confirmed, I look forward to working with you and Senator Cassidy and 
others to improve maternal health in our country, including access to 
preventive services like immunizations and other recommended care.
        access to items and services for vulnerable populations
    Question. HHS and CMS have significant regulatory authority to 
ensure that vulnerable populations have access to items and services. 
This is particularly true during the pandemic, in rural an underserved 
areas where individuals struggle to access care. What steps will you 
take to ensure that seniors and individuals experiencing disabilities 
are able to access health-care services and essential equipment, 
particularly in rural areas?

    Answer. Individuals dually eligible for Medicare and Medicaid, 
including seniors and people experiencing disabilities, are some of the 
most vulnerable Americans. Many of these individuals have complex 
health care needs with multiple chronic conditions. Medicare and 
Medicaid provide indispensable access to care for this vulnerable 
population. These programs have kept many families from losing hope, 
particularly in rural parts of the country. If confirmed,

    I am prepared to work with you and your colleagues in Congress to 
strengthen these valuable programs and ensure vulnerable populations 
have access to the quality, affordable health care that they need.

                                 ______
                                 
              Questions Submitted by Hon. Elizabeth Warren
                            otc hearing aids
    Question. In 2017, President Trump signed into law the Over-the-
Counter Hearing Aid Act, a bill that I introduced with Senator 
Grassley, Senator Hassan, and Senator Isakson. The bill requires the 
FDA to categorize certain hearing aids as over the counter (OTC). Under 
law, the FDA was required to issue regulations regarding OTC hearing 
aid safety and manufacturing by August 18, 2020--but the agency failed 
to issue the rules on time. As HHS Secretary, will you commit to 
ensuring that the FDA releases these statutorily required regulations 
as soon as possible?

    Answer. Thank you for your leadership on this issue. I commit that, 
if confirmed, I will support FDA in its work to ensure availability of 
over-the-counter hearing aids. I recognize this as a public health 
priority as hearing loss can have a negative effect on communication, 
relationships, and other important aspects of life.
                        drug pricing authorities
    Question. The Federal Government has the power to step in and 
rectify the market failures that have allowed drug prices to skyrocket. 
Using its compulsory licensing authority, the Federal Government can 
use patented products without the permission of the patent holder. 
Codified at 28 U.S.C. Sec. 1498, this authority allows the government 
to ``manufacture, import, and use'' products protected by active 
patents, as long as it provides patent holders with ``reasonable and 
entire compensation for such use and manufacture.'' Meanwhile, using 
the march-in rights established under the Bayh-Dole Act, the Federal 
Government can require the re-licensing of certain patents. Bayh-Dole 
gives Federal contractors the right to exclusively manufacture and sell 
products developed with Federal support. However, Bayh-Dole allowed the 
Federal Government to retain ``nonexclusive, nontransferable, 
irrevocable, paid-up'' licenses for products developed with government 
funds. In certain cases, such as when health or safety needs have not 
been reasonably satisfied by the original licensee, the Federal 
Government can ``march-in'' and direct other licensees to produce 
products. As HHS Secretary, will you commit to conducting a review of 
the Department's pre-existing executive authorities to determine how 
they can be used to lower the prices of critical drugs--like insulin 
and naloxone--that millions of Americans rely on?

    Answer. If I am fortunate to be confirmed, we will conduct a 
thorough review to identify and analyze the tools at our disposal to 
reduce the price of drugs and make treatments more affordable for the 
American people. President Biden has been clear that reducing costs is 
a top priority for this administration.
                 nursing homes and private equity firms
    Question. The National Bureau of Economic Research recently 
released a study showing that private equity (PE) ownership of nursing 
homes ``increases the short-term mortality of Medicare patients by 10 
percent, implying 20,150 lives lost due to PE ownership over [a] 12-
year sample period.'' Meanwhile, PE-owned nursing homes also saw 
``declines in other measures of patient well-being, such as lower 
mobility, while taxpayer spending per patient episode increases by 11 
percent.'' As HHS Secretary, will you commit to working with me and my 
colleagues to review, reduce, and mitigate the negative impacts of 
private equity ownership of health-care facilities, including but not 
limited to nursing homes?

    Answer. I agree that we must ensure nursing homes provide high-
quality care to their residents. Nursing homes' first obligation should 
be to their patients, no matter what kind of ownership arrangements 
they have, and nursing homes participating in Medicare and Medicaid 
programs should meet required Federal health and safety standards. If 
confirmed, I am committed to working with you and your colleagues to 
ensure nursing homes provide high-quality care to their residents.
        assisted living facilities and congregate care settings
    Question. Congregate settings like nursing homes, assisted living 
facilities, and prisons and jails have been epicenters of the COVID-19 
pandemic since the virus began to spread. My oversight has revealed the 
extent of these problems, and the gaps that are making outbreaks in 
these facilities so frequent and so severe. Assisted living facilities, 
for example, have high rates of COVID-19 infections, hospitalizations, 
and deaths, but report limited COVID-19 data when compared to more 
heavily regulated nursing homes. Meanwhile, Federal correctional 
facilities and State and local prisons and jails are not required to 
report sufficient demographic data to adequately track the spread of 
COVID-19, and behavioral health facilities have limited resources to 
prevent outbreaks. As HHS Secretary, will you commit to expanding 
COVID-19 demographic data collection at congregate care facilities, 
including but not limited to assisted living facilities, residential 
behavioral health facilities, and correctional facilities? After the 
pandemic subsides, will you commit to examining the regulations that 
currently apply to congregate care facilities to determine if more 
routine data collection and standards could improve patient safety?

    Answer. If confirmed, I am committed to expanding the scope of data 
collection in congregate settings, such as assisted living facilities 
and correctional facilities, in order to better track demographic and 
other relevant trends associated with the spread of COVID-19. If 
confirmed, I will work with various HHS agencies, including the CDC, as 
well as States, tribal, local, and territorial partners on ways to 
improve data collection and the quality of data in such settings.
                              supply chain
    Question. The United States is heavily dependent on foreign sources 
of pharmaceutical products such as active pharmaceutical ingredients 
(API) and their raw materials. Only 28 percent of facilities 
manufacturing APIs used in drugs and 47 percent of facilities 
manufacturing finished dosage forms of drugs for the U.S. market are 
located in the United States. The COVID-19 pandemic revealed the extent 
and the dangers of this overreliance, as materials needed for 
diagnostic testing, PPE, and other pharmaceutical products have been in 
chronically short supply, marring the Nation's response to the 
pandemic. An interruption to the supply of APIs and other 
pharmaceutical products could have severe public health and national 
security implications, and there is an urgent need for the Biden 
administration to take action. As HHS Secretary, what steps will you 
take to address this overreliance?

    How will you work alongside other Federal agencies like the 
Department of Defense, the Food and Drug Administration, and other drug 
procuring agencies to create a unified Federal response to this 
overreliance?

    Answer. The global pandemic has highlighted the vulnerabilities of 
the global supply chain for many products. I am aware that BARDA has 
invested in and is working to expand pharmaceutical manufacturing in 
the United States for use in producing medicines needed during the 
COVID-19 response and future public health emergencies. This work will 
expand domestic manufacturing of raw materials and active 
pharmaceutical ingredients for drugs. If confirmed, I will continue to 
support ongoing efforts in this area, as well as support the 
department's work with the FDA and other Federal agencies to expand 
domestic capacity for supplies needed in the ongoing COVID-19 response.
                          medication abortion
    Answer. Last year, you led 21 Democratic Attorneys General in a 
letter to then-HHS Secretary Alex Azar and FDA Commissioner Stephen 
Hahn, urging them to waive the Risk Evaluation and Mitigation Strategy 
(REMS), or use FDA enforcement discretion, to allow certified 
prescribers to use telehealth for Mifepristone, the prescription drug 
used to provide medication abortion care. As you noted in your letter, 
the REMS requirements on mifepristone create unnecessary delays for 
women who need access to time-sensitive health care and force them to 
travel unnecessarily during the COVID-19 public health emergency. 
Furthermore, your letter noted that mifepristone is extremely safe and 
effective. Mifepristone was approved by the FDA over 20 years ago and 
about 3 million women in the United States have used the drug. On April 
14, 2020, Senators Murray, Baldwin, and I sent a similar letter to 
then-Commissioner Hahn regarding the REMS imposed on mifepristone by 
the FDA and our concerns that FDA is not following the science by 
allowing these restrictions to remain in place. However, we have not 
received a written response or staff briefing from FDA, which we 
requested. Can you commit that the FDA will respond to our request 
within 30 days and will clarify what scientific evidence the FDA is 
currently using to justify that the REMS for mifepristone remains in 
place?

    Answer. Thank you for raising this important issue. I strongly 
believe women should not be put through unnecessary hurdles to receive 
access to health care. Further, I believe FDA should be empowered to 
make regulatory decisions based on the available science. If confirmed, 
it would be a priority to make sure the Congress is provided 
information when requested.
                                title x
    Question. The Title X Family Planning Program (the title X program) 
is the only Federal program dedicated to providing family planning 
services to people with low incomes. In 2016, title X supported nearly 
4,000 health centers providing basic primary and preventive health-care 
services--including contraception, Pap tests, breast exams, and STI and 
HIV testing--to more than 4 million Americans. But in 2019, the Trump 
administration finalized a rule that gutted the title X program, 
causing family planning providers in 34 States to leave the program and 
at least 1.5 million people to lose access to care. On January 28, 
2021, President Biden issued a Presidential Memorandum on Protecting 
Women's Health at Home and Abroad, which directed HHS to ``consider, as 
soon as practicable, whether to suspend, revise or rescind, or publish 
for notice and comment proposed rules, suspending, revising, or 
rescinding those regulations, consistent with applicable law, including 
the Administrative Procedure Act.'' I believe this review will make 
clear the numerous harms patients and community health faced as a 
result of the rule. For example, in Massachusetts, only one title X 
grantee remains in the State. Will you commit to complete the review of 
the title X rule, as directed by President Biden, no later than March 
29, 60 days after the president issued the presidential memorandum?

    Answer. If confirmed, it will be a priority to review the title X 
regulation as quickly as possible.
                         child care assistance
    Question. The COVID-19 pandemic has severely damaged the child care 
sector, with many providers struggling to keep their doors open and 
parents missing work or leaving the workforce altogether because of the 
lack of affordable care. Even before the pandemic, quality, affordable 
child care was much too difficult to find, despite extensive research 
showing that Federal investment in child care and early childhood 
education pays off in increased earnings for families, higher levels of 
parental employment, and improved health development of children. The 
Child Care and Development Fund is the primary source of Federal 
funding dedicated to helping low-income families afford child care. Yet 
national figures show that five out of six children who are eligible 
for help and who need that help aren't receiving a subsidy. According 
to a GAO report, many States manage demand by setting their eligibility 
limits very low, preventing many families from being able to 
participate. In administering the supplemental funds provided under the 
Child Care Development Block Grant (CCDBG) and other child care 
programs for COVID-19 relief, how will you promote the stabilizing the 
child care sector and sharing best practices between States?

    Answer. The COVID-19 pandemic has highlighted the many gaps in 
child care in this country. Important investments have been made, but 
even with these efforts, additional investments are necessary to 
stabilize the child care sector, which is why the Biden administration 
has proposed additional funding for CCDBG as well as new child care 
stabilization grants for child care providers. If confirmed, I look 
forward to working with you on these efforts and appreciate your 
leadership on this important issue.

                                 ______
                                 
                 Questions Submitted by Hon. Mike Crapo
                           covid-19 pandemic
    Question. I appreciate your comments throughout the nomination 
process regarding the importance of good data and following science in 
making decisions. As we approach the first anniversary of the COVID-19 
pandemic lockdowns, many Americans are wondering how long they will 
have to endure the restrictions fighting the pandemic has required.

    How long do you anticipate that the COVID-19 Public Health 
Emergency will last, and what specific criteria would you and the other 
advisors to President Biden use to assess an appropriate public health 
response?

    Answer. Americans' frustrations and exhaustion with this pandemic 
are understandable. We all want to get back to our lives, see our 
friends and families, be able to visit loved ones or go to work or 
school without fear of contracting or spreading the virus. We need to 
approach this crisis with urgency, and if we all do our part, we can 
finally end this pandemic. If confirmed, I would work closely with the 
medical doctors, scientists, and other public health experts at HHS to 
make determinations about the Public Health Emergency and would utilize 
the criteria set forth by experts to ensure that HHS's response to the 
pandemic is driven by the science and relies on the most recent data 
available, such as infection and mortality rates.

    Question. How does the HHS Secretary fit into the larger Biden 
administration COVID-19 response team structure?

    Answer. As the head of the Department tasked with executing so much 
of the Federal Government's public health response to the pandemic, if 
confirmed as the HHS Secretary, I would lead the HHS COVID-19 response 
efforts--everything from ASPR's efforts to expand testing and 
diagnostics, to OASH's deployment of vaccinators and ongoing minority 
outreach efforts, to the development, procurement, and distribution of 
the vaccines--and work in close collaboration with the White House 
COVID-19 Coordinator and the White House COVID-19 Response Team. This 
is a whole-of-government effort, and if confirmed I am committed to 
ensuring HHS is leading the implementation of President Biden's 
national strategy and executing the programs that deliver Americans the 
aid they need.

    Question. What have you learned from your experience with the 
California COVID-19 response, and how would you apply those lessons if 
you are confirmed as HHS Secretary?

    Answer. This has been a dynamic and evolving virus, which has posed 
constant challenges for the American people. In my State, I took action 
as Attorney General early in the pandemic to keep Californians safe. I 
used my authority to protect workers from exposure to COVID-19, secure 
key safeguards for front-line health-care workers' rights, take on 
fraudsters trying to take advantage of people during the pandemic, and 
stand up for homeowners trying to make their mortgage payments during 
the downturn. I also worked with a Republican colleague from Louisiana, 
Attorney General Jeff Landry, to try to make COVID-19 treatments more 
available for the American people. I have seen the importance of 
working together--with urgency--to tackle this crisis, with the 
constant goal of protecting Americans.

    Question. Congressional Democrats are moving swiftly to use budget 
reconciliation to advance President Biden's $1.9 trillion COVID-19 
response plan. The planned increase in spending through reconciliation 
would trigger automatic spending reductions to Medicare and other 
programs.

    Considering that bipartisan support is needed for Congress to waive 
its budget rule to prevent those reductions, would it be more prudent 
for the administration to work with Congress to negotiate another 
bipartisan COVID-19 relief bill?

    Answer. I agree that we must work together to tackle this crisis. 
This pandemic is a threat to us all, and we have to find common ground 
to get the American people the help they need. Urgency is critical: the 
public needs help and they need it now. President Biden has been very 
clear that he agrees and believes bipartisan agreement on this front is 
achievable. If I am confirmed, I will commit to working with you to 
both address this crisis and strengthen our health care lifelines like 
Medicare.

    Question. During the COVID-19 Public Health Emergency, HHS has 
provided flexibility to providers to better furnish care to patients, 
including through telehealth and access to innovative treatments. As we 
begin to consider the end of the pandemic, we must carefully evaluate 
our response to the pandemic, and implement appropriate reforms based 
on the data and lessons learned.

    Which policies do you believe have been most successful for 
patients and providers, and how would you work with Congress to make 
appropriate improvements to our Federal health-care programs?

    Answer. Telehealth is an important tool to improve health equity 
and improve access to health care. Health care should be accessible, no 
matter where you live. If confirmed, I will look at the telehealth 
flexibilities developed for the current public health emergency and 
determine how we can build on this work to improve health equity and 
improve access to health care.

    Question. It was reported on February 14, 2021 that Vice President 
Harris said, with respect to COVID-19 vaccinations and the state of 
preparedness when the Biden administration began, that ``there was no 
stockpile . . . of vaccines; there was not a national strategy or plan 
for vaccinations. We were leaving it to the States and local leaders to 
try and figure it out. And so, in many ways we're starting from scratch 
on something that's been raging for almost an entire year.'' Earlier, 
in a January 21, 2021 White House press briefing, medical adviser Dr. 
Anthony Fauci said during a White House press briefing that, ``We 
certainly are not starting from scratch because there is activity going 
on in the distribution.'' Do you believe that Vice President Harris's 
characterization that in many ways the Biden administration was 
starting from scratch and there was not a national strategy or plan for 
vaccinations, or Dr. Fauci's characterization that the Biden 
administration was certainly not starting from scratch?

    Answer. If I am fortunate to be confirmed, I promise I will work 
with you and your colleagues in the Senate, as well as my colleagues in 
the administration, to ensure our plans for addressing this crisis are 
collaborative and meet the needs of the moment. It is no secret that 
this crisis has carried on for far too long, in no small part because 
of deficiencies in our earlier Federal response efforts, and as HHS 
Secretary, I would work to strengthen our efforts to increase 
vaccinations, expand testing, and ensure that there is a clear, strong, 
and well-executed Federal plan to tackle COVID-19.
                                medicare
Medicare Hospital Insurance Trust Fund Insolvency
    Question. The most recent Medicare trustees report projected that 
the Hospital Insurance (HI) trust fund would be officially bankrupt in 
2026, at which time it would no longer be able to pay full benefits for 
our Nation's seniors and the disabled. That report failed to include 
any analysis showing the fiscal impact of the COVID-19 pandemic on the 
trust fund. Earlier this month, the Congressional Budget Office (CBO) 
released its updated winter baseline. The new baseline takes into 
account increased tax revenue due to a stronger economic forecast. 
While CBO now also predicts that the HI trust fund will be insolvent in 
2026, there is substantial uncertainty behind their projections. Given 
recent Medicare spending trends, it seems unlikely that the trust fund 
could remain solvent through 2025.

    Will you commit, if you are confirmed, to immediately direct the 
Centers for Medicare and Medicaid Services (CMS) Chief Actuary to 
provide an update to me, in writing, that shows the current status of 
the Medicare HI insolvency date that takes into account the fiscal 
impact of the COVID-19 pandemic?

    Answer. If confirmed as Secretary, I can commit to you that we will 
work with you to give you and this committee the information you need 
to make the right decisions with respect to Medicare.

    Question. Congress has historically looked to reform and adjust 
Medicare payments to providers in order to extend the life of the HI 
trust fund. However, the last time Congress enacted significant 
Medicare savings the money was used to finance spending on the 2010 
health-care law.

    As a member of the House, you voted for the law that raided over 
$700 billion from a financially strapped Medicare program and spent it. 
Now, a decade later, those savings are not available to protect 
Medicare. What policies do you now think Congress should consider to 
extend the life of the HI trust fund?

    Answer. If confirmed, my team and I will be ready to sit down with 
you and other members of Congress to discuss both short- and long-term 
solutions to guarantee Medicare's future.

    Question. Medicare is on a near-term path toward bankruptcy. The HI 
trust fund could be insolvent in anywhere from 4 to 5 years. Other than 
during the first few years of the Medicare program's existence, 
Congress has never allowed the HI trust fund to project less than 4 
years of solvency without acting in order to minimize the impact on 
beneficiaries, health-care providers, and taxpayers.

    Given the looming fiscal crisis, how soon would you provide a 
comprehensive legislative proposal that extends the life of the HI 
trust fund?

    Answer. If confirmed, my team and I will be ready to sit down with 
you to discuss short and long-term solutions to guarantee Medicare's 
future.
                           prescription drugs
    Question. Modernizing the successful Medicare Part D program has 
been a feature of numerous recent proposals to address prescription 
drug issues from Republicans and Democrats, including a comprehensive 
bill that I introduced last Congress. The different proposals involve 
many of the same common elements, such as improving incentives to 
increase competition and establishing a cap on patient out-of-pocket 
spending. Making these improvements to a program that serves over 45 
million beneficiaries would be a momentous, bipartisan accomplishment. 
Some, however, have suggested that Part D modernization is insufficient 
and that it should not happen without other major changes. While other 
changes may be worthy of debate, there have been few major reforms that 
have broad bipartisan support. Would you oppose legislating a Part D 
modernization that includes a first-time patient out-of-pocket cap on 
spending as a stand-alone policy?

    Answer. If I am fortunate to be confirmed, we will conduct a 
thorough review to identify and analyze the tools at our disposal to 
reduce the price of drugs and make treatments more affordable for the 
American people. President Biden has been clear that reducing costs is 
a top priority for this administration, and I hope we can work together 
on finding solutions.

    Question. You have consistently advocated for the Federal 
Government to negotiate prescription drug prices in Medicare Part D. If 
confirmed as Secretary, you would be the one in charge of negotiating 
those prices. Barring some type of artificial price ceiling, the 
Congressional Budget Office has consistently maintained that the 
Federal Government would not be able to secure lower prices than those 
established through negotiation between private entities, unless the 
government used a national drug formulary list. Are you prepared to 
determine which prescription drugs over 45 million beneficiaries can 
access, knowing this would inherently involve denying medications that 
physicians prescribe as the best course of treatment for patients?

    Answer. If I am fortunate to be confirmed, we will conduct a 
thorough review to identify and analyze the tools at our disposal to 
reduce the price of drugs and make treatments more affordable and 
accessible for the American people. President Biden has been clear that 
reducing costs is a top priority for this administration, and I hope we 
can work together on finding solution.

    Question. There is broad concern that establishing Medicare (or 
other) prescription drug payment amounts using foreign reference prices 
will harm patient access and stifle innovation. Do you support the use 
of foreign reference prices in Medicare? Do you view the use of a 
foreign reference price to set payment amounts as price setting or a 
form of negotiation?

    Answer. If I am fortunate to be confirmed, we will conduct a 
thorough review to identify and analyze the tools at our disposal to 
reduce the price of drugs and make treatments more affordable and 
accessible for the American people. President Biden has been clear that 
reducing costs is a top priority for this administration, and I hope we 
can work together on finding solution.
                                 other
    Question. You have highlighted the settlement you secured with a 
large California hospital system related to the charge that it acquired 
hospitals and physician practices to unfairly increase market power and 
increase costs for consumers. The Medicare Payment Advisory Commission 
and other experts have determined that Medicare payment systems 
incentivize provider consolidation. Do you believe that some Medicare 
payment policies incent consolidation and increase costs for 
beneficiaries and the program?

    Answer. Thank you for this question. This has been a significant 
focus of my tenure as Attorney General, and if I am confirmed, I will 
continue to focus on preventing consolidation that increases prices on 
consumers and patients. Like President Biden, I believe that all 
Americans should be able to access affordable health care, and part of 
that is identifying solutions to hospital over-consolidation. I hope I 
have the opportunity to work with you to tackle this issue and pursue 
solutions that strengthen our Federal programs and protect patients and 
consumers.

    Question. You have highlighted that you authored Medicare 
provisions included in the Affordable Care Act. Can you describe those 
policies and note those of which you are most proud?

    Answer. As a member of the Ways and Means Committee for 2 decades, 
I have a lot of experience on Medicare legislation. I introduced 
legislation--the Medicare Savings Programs Improvement Act of 2007--
that expanded cost-sharing subsidies for low-income seniors who receive 
both Medicare and Medicaid benefits by increasing the amount of 
resources they could receive. Several of these provisions were included 
in the Medicare Improvements for Patients and Providers Act of 2008 and 
the Medicare Access and CHIP Reauthorization Act of 2015. I also 
championed provisions of the Medicare Improvements for Patients and 
Providers Act of 2008 that required physicians who perform imaging to 
be accredited and trained to ensure patient safety. I introduced 
legislation in 2007 to raise the cap on the benefits of patients 
receiving Medicare physical therapy, as well as the E-Centives Act of 
2009, which provided incentives for Medicaid providers to implement 
electronic health records. A version of this legislation was included 
in the American Recovery and Reinvestment Act of 2009. I introduced the 
Medical Anesthesiology Teaching Funding Restoration Act of 2007 to 
improve anesthesiologists' teaching payments, and it passed in 2008. I 
helped draft the Improving Medicare Post-Acute Care Transformation Act 
(IMPACT) of 2014, requiring the HHS Secretary to conduct research on 
the social determinants of health in Medicare's value-based programs, 
so we could use good data to improve outcomes and save costs. And as 
you mentioned, I worked on the Affordable Care Act which strengthened 
Medicare and lowered costs for seniors. As a member of the Ways and 
Means Committee and House leadership, I led successful discussions on 
the design of the health-care exchanges and Medicare reimbursement 
payments. The ACA added years of solvency to the Medicare Trust Funds, 
closed the prescription drug ``donut hole,'' and provided free 
preventive care to all Medicare beneficiaries. I am proud of all this 
work to protect and strengthen health care for our seniors.

    Question. The Affordable Care Act established the Center for 
Medicare and Medicaid Innovation (CMMI). There is significant 
bipartisan support for testing different ways to pay for services to 
figure out how patients can get better care at a lower cost. However, 
there is concern that Congress ceded too much authority to the 
executive branch by allowing CMMI to override statute, especially in 
Medicare, in the name of a payment change ``test.''

    What are your views on the appropriate use of CMMI authority?

    If confirmed, will you commit to ensuring that CMS would not use 
CMMI to avoid working with Congress?

    Considering that many CMMI tests have run for an extended period of 
time without meeting the criteria for expansion, is there a length of 
time sufficient to determine if a model works?

    With CMMI having a large budget of $10 billion for each decade and 
little accountability to Congress, what metrics would you use to 
determine whether CMMI is successful?

    Answer. Innovation is critically important to advancing goals in 
health care. The CMS Innovation Center is integral to the 
administration's efforts to promote high-value care and encourage 
health care provider innovation. If confirmed as Secretary, I can 
commit to you that we will be wise stewards of CMMI funds and follow 
the evidence generated by Innovation Center models.

    Question. HHS finalized a number of rules toward the end of the 
President Trump's term that the Biden administration is reviewing. 
While this is a routine practice for incoming administrations, have you 
identified which rules you would continue, modify, orwithdraw? Please 
respond specifically on:

    Most Favored Nation (MFN) Model (Interim Final Rule with Comment 
Period); and

    Fraud and Abuse: Removal of Safe Harbor Protection for Rebates 
Involving Prescription Pharmaceuticals and Creation of New Safe Harbor 
Protection for Certain Point-of-Sale Reductions in Price on 
Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager 
Service Fees.

    Answer. If I am fortunate to be confirmed, we will conduct a 
thorough review to identify and analyze the tools at our disposal to 
reduce the price of drugs and make treatments more affordable and 
accessible for the American people. President Biden has been clear that 
reducing costs is a top priority for this administration, and I hope we 
are able to work together on these issues.

    Question. If confirmed, you would be integral to determining what 
goes into President Biden's budget submissions to Congress. Prior 
administrations of both parties have proposed specific policy changes 
that aim to improve Medicare, with many of those policies reducing 
baseline Medicare spending. Democrats characterized Trump 
administration budget policies that would make payment system changes 
that bring efficiencies and reduce Medicare spending as ``cuts'' (even 
when the identical policy had been proposed by the Obama 
administration). Do you view any budget policy proposal that reduces 
Medicare spending as a Medicare ``cut''?

    Answer. I believe that we must protect Medicare beneficiaries, 
being careful stewards of taxpayer dollars and the Medicare Trust 
Funds. I look forward to working with Congress to consider policies 
that would lower costs for seniors, and also enhance our ability to 
reduce waste, fraud, and abuse in these vital programs.

    Question. There are concerns that the inclusion of calcimimetic 
medications in the Medicare End Stage Renal Disease (ESRD) bundled 
payment rate may harm beneficiaries' access to these treatments. There 
are anecdotal reports that some patients have had to change or 
otherwise stop using a medicine that has worked for them in response to 
this payment policy change. How would you ensure that ESRD patients 
have access to calcimimetic treatments and monitor patient outcomes in 
this area?

    Answer. I agree that is it important for Medicare beneficiaries, 
particularly vulnerable groups such as those beneficiaries with ESRD, 
to have access to medically necessary treatments such as calcimimetics. 
If confirmed, I will work to ensure that Medicare beneficiaries 
continue to have access to these treatments and that patient outcomes 
are not compromised.

    Question. Numerous press reports indicate that the Department of 
Justice and the Federal Bureau of Investigation, in conjunction with 
the U.S. Attorney's Office, have opened an investigation into the 
allegations that New York Governor Andrew Cuomo and his administration 
took actions that exacerbated the COVID-19 crisis in nursing home 
facilities, allegedly leading to increased fatalities. Will you commit 
to, if confirmed, fully cooperate with any investigation that examines 
whether the State of New York, Governor Cuomo himself, Governor Cuomo's 
staff, or the Cuomo Coronavirus Task Force obstructed justice or 
violated Federal guidance by pressuring nursing home facilities to 
accept patients who tested positive for COVID-19?

    Answer. I am deeply committed to protecting our most vulnerable 
Americans by addressing the disproportionate impact of COVID-19 on our 
seniors and nursing home residents, but if I am fortunate enough to be 
confirmed, I will not have any role in the Department of Justice or 
Federal Bureau of Investigation decision making with respect to this 
matter. At HHS, we will follow the law and carry out our mission to 
protect people's health care.
                           private insurance
    Question. How would President Biden's proposal to lower the 
Medicare eligibility age affect Medicare's already precarious financial 
situation and would such a plan require raising taxes?

    Answer. President Biden has proposed to allow Americans to enroll 
in Medicare at an earlier age using general revenue, not the Medicare 
trust funds. At the same time, this administration knows the importance 
of lengthening the solvency of the HI trust fund because Medicare's 
current beneficiaries depend on it. I am committed to working with you 
and your colleagues on solutions both to extend the life of the 
Medicare HI trust fund and to expand health-care coverage.

    Question. Idaho has proposed or implemented several reforms in an 
attempt to diversify private insurance options so that consumers can 
choose a plan that best fits their needs and their budget. Several 
years ago, Idaho sought to combine Medicaid and private market 
innovation waivers to better coordinate insurance options and lower 
patient costs. Unfortunately, this approach was rejected because of 
overly stringent statutory and regulatory requirements. Meanwhile, 
Idaho insurers have started offering renewable short-term, limited 
duration plans, which are less expensive than those offered on the 
exchange.

    I strongly support the right of States, as the primary regulators 
of the individual market, to adopt innovative solutions that benefit 
consumers. How do you view HHS's role in the individual market, and 
what reforms would you propose that could impact the types of plans 
offered to consumers?

    Answer. Making sure that all Americans have access to quality, 
affordable health care is one of the Biden administration's top 
priorities. If confirmed as Secretary of HHS, I will work to identify 
opportunities that ensure all Americans can access the care that they 
need and look forward to working with States to help improve health 
care for their residents.

    Question. As States invest in their health systems and public heath 
infrastructure, many could choose to address coverage gaps or 
alternative coverage options through Affordable Care Act section 1332 
waivers. Would you support States using these waivers to increase 
coverage in innovative ways of their own choosing? Are there policies 
that you consider inappropriate for a waiver?

    Answer. I support innovative approaches to make sure that all 
Americans have access to quality, affordable health care, and I believe 
section 1332 waivers can be one tool States can use to achieve such 
results. If confirmed as Secretary, I look forward to working with 
States to help improve health care for their residents.

    Question. Do you support the use of existing enforcement mechanisms 
for Affordable Care Act subsidies? Should the Federal Government claw 
back funds if audits of an individual's income show that the individual 
is not eligible for the subsidy?

    Answer. The Affordable Care Act gives millions of Americans access 
to quality, affordable health coverage. If confirmed, it will be my job 
to ensure that we are following and enforcing applicable laws and 
regulations.
                        waste, fraud, and abuse
    Question. Careful stewardship of public resources is essential, 
both to maintaining our citizens' trust in their government, and to 
ensuring that government programs are effective. HHS is an enormous 
entity and prudent management of its agencies will require close 
scrutiny from its leadership. However, the loss of California's Federal 
pandemic funding to fraudsters over the past year suggests that this 
careful scrutiny has not been a priority to you as Attorney General.

    What initiatives would you undertake to ensure careful stewardship 
of the 
trillion-plus dollars in annual spending that HHS oversees, ensuring 
that each dollar is spent consistently with the law and the intent of 
Congress?

    Answer. At the California Department of Justice, our team has 
cracked down on Medicare and Medicaid fraud to protect these lifelines, 
recovering almost $1 billion in just the last 3 years from defendants 
that defrauded California's State's Medicaid program with false claims 
for payment, and in 2020, we expanded the Bureau of Medi-Cal Fraud and 
Elder Abuse to its own division so we could better investigate and 
prosecute fraud. This has been a priority for me as Attorney General 
because it is critical we are being good stewards of taxpayer dollars 
and making sure our health programs are efficient. If I am confirmed as 
HHS Secretary, I would continue this focus and would like to work with 
you and the Congress to ensure strong oversight of Federal programs and 
continue a bipartisan focus on reducing waste, fraud, and abuse.

    Question. On November 30, 2020, then chairman of the Finance 
Committee Chuck Grassley sent a letter to the Office of the Inspector 
General of the Department of Labor seeking an investigation into 
California's Employment Development Department (EDD), with particular 
attention to fraud and the EDD's practice of mailing documents that 
contain individuals' social security numbers.

    A November 23, 2020 letter to California Governor Gavin Newsom, 
with you as a carbon-copied recipient, from District Attorneys from 
various areas of the State who were on the California District 
Attorney's Statewide EDD Fraud Task Force requested a personal meeting 
and request for State officials to become involved in ``halting what 
appears to be the most significant fraud on taxpayer funds in 
California history.''

    A December 3, 2020 Los Angeles Times article on the ``tsunami'' of 
prison unemployment fraud in California, which the article identified 
was fueling street crime, reported that ``multiple District Attorneys 
interviewed by the Times said they are frustrated that State officials, 
including State Attorney General Xavier Becerra, have not taken 
leadership in what some have described as the biggest taxpayer fraud in 
California history.''

    A January 28, 2021 Los Angeles Times article identified that State 
officials in California have ``confirmed more than $11 billion in 
fraud, and are investigating $19 billion in other, suspicious claims 
for potential fraud.'' The magnitude of fraud in largely federally 
financed unemployment programs in California--upward of $30 billiona of 
fraudulent or suspicious payments and claims--is staggering, the 
largest fraud in California history, and widely reported for quite some 
time.

    Despite all of this, since warning signals were sounded in at least 
late November of last year, a scan of the California Attorney General's 
press releases does not appear to identify any response to multiple 
calls for State officials to get involved in battling fraud. Instead, 
during the period November 23, 2020 through February 25, 2021, there 
were at least 25 press releases directed at political activities by 
your office against the Trump administration.

    Oversight and protection of Federal taxpayer resources is a 
responsibility of Federal Government officials, including the 
Department of Health and Human Services (HHS). Any Secretary of HHS, 
which is responsible for an enormous amount of payments of Federal 
taxpayer resources, must take fraud seriously and devote requisite 
resources to battle fraudsters. Money intended for unemployment 
insurance payments, or payments from HHS, that ends up in pockets of 
fraudsters is money that does not go to those truly in need.

    Given that you were warned about unemployment insurance fraud, and 
asked to respond, at least by the end of November last year, please 
explain:

    When were you first asked to respond to California's massive 
unemployment fraud?

    Why multiple District Attorneys interviewed by The Los Angeles 
Times in late November or early December of last year reportedly 
identified their frustration over lack of action by State officials 
regarding unemployment compensation fraud and their assessment that you 
had ``not taken leadership'' in the face of the biggest taxpayer fraud 
in California's history?

    What actions did you take, and when, to combat unemployment 
compensation fraud in California (and please provide supporting 
documentation)?

    How many full-time equivalent hours of work in the California 
Attorney General's office were devoted to battling unemployment fraud 
relative to hours devoted to activities to battle the Trump 
administration during the period between November 23, 2020 and February 
25, 2021?

    Answer. At the California Department of Justice, we have made 
combating fraud a serious priority. When the Department has been given 
primary authority combating fraud such as in the Medicare and Medicaid 
program, we have cracked down on this fraud to protect these lifelines, 
recovering almost $1 billion in just the last 3 years from defendants 
that defrauded California's State's Medicaid program with false claims 
for payment, and in 2020, we expanded the Bureau of Medi-Cal Fraud and 
Elder Abuse to its own division so we could better investigate and 
prosecute fraud. In regard to other programs, the California Department 
of Justice provides support to investigators in departments like the 
California Employment Development Department investigators when 
requested. In investigations where the California Department of Justice 
has found fraud in any public benefits program, we primarily refer 
those cases to District Attorneys who carry out the vast majority of 
criminal prosecutions in California. If I am confirmed as HHS 
Secretary, I would continue this focus and would like to work with you 
and the Congress to ensure strong oversight of Federal programs and 
continue a bipartisan focus on reducing waste, fraud, and abuse.
                                medicaid
    Question. What would be your top Medicaid priorities?

    Answer. The President has made clear his commitment to protecting 
and strengthening Medicaid so that this critical program can continue 
to provide life-saving access to care for millions of Americans. 
Medicaid will also continue to play an essential role in the Biden 
administration's response to the COVID-19 pandemic. If confirmed, I 
will work to ensure that people have access to quality and affordable 
care, and to ensure that Medicaid makes progress on addressing the 
major health-care challenges facing our country, including maternal 
health.

    Question. Data infrastructure in State Medicaid programs is 
extremely outdated. Historically, State Medicaid programs have 
attributed this to a lack of focus on improving data infrastructure 
among competing priorities. If confirmed, would you prioritize improved 
data systems at the State level to promote the sharing of data--such as 
claims, laboratory results, and eligibility information--between State 
systems and data sharing with the Federal Government?

    Answer. Medicaid data is an important tool for improving health 
equity and access to health care. I believe we need better data because 
good data leads to good policy. If confirmed, I look forward to 
partnering with States to improve Medicaid data.

    Question. You have highlighted the need to stop consolidation in 
California that gives hospitals unfair market power. I am interested in 
how this view may influence your position on the use of restrictive 
networks by insurance companies to drive down cost. For example, if a 
major hospital system chooses not to enter into a contract with any 
Medicaid managed care companies in a State, would you have HHS 
intervene at the Federal level or leave that to the companies and State 
to resolve?

    Answer. As Attorney General in California, I worked to tackle the 
issue of hospital consolidation. If confirmed, I will enforce the laws 
and regulations on the books and work to ensure that individuals have 
adequate access to affordable, quality health care.

    Question. If confirmed, would you rescind Medicaid section 1115 
waivers that were approved in the prior administration? If so, could 
this create considerable disruption and prevent the adoption of 
waivers, given State Medicaid operations could be changed with each new 
administration?

    Answer. Medicaid is an important lifeline for many American 
families. Section 1115 demonstrations can be invaluable in allowing 
States to pursue innovative ideas through Medicaid. If confirmed, I 
will work to ensure that States' Medicaid section 1115 demonstrations 
promote the objectives of the Medicaid program and that these 
demonstrations are approved in accordance and compliance with the 
Medicaid statute.

    Question. The pipeline for new drugs and therapeutics is changing 
rapidly and dramatically. Medicaid remains the primary payer for rare 
disease treatments, yet the Medicaid Drug Rebate Program (MDRP) has not 
evolved to keep up with new technologies, like cell and gene therapies. 
Should the MDRP be updated to ensure patients with rare diseases, 
including cancers and sickle-cell disease, can receive the treatments 
they need? How would you address affordability without causing 
innovators to reduce or eliminate investments in cell and gene 
therapies out of fear of government involvement?

    Answer. Medicaid is a crucial lifeline for ensuring that Americans 
with low incomes, especially those with complex health care needs, have 
adequate access to quality health care, including lifesaving therapies. 
We need to foster innovation in medical technology to encourage the 
development of new therapies. If confirmed, I look forward to working 
with you to ensure that Medicaid beneficiaries have access to those 
therapies.

    Question. If confirmed, will you commit to allowing prescription 
drug value-based arrangements in Medicaid to expand flexibility and 
coverage of lifesaving treatments, especially for cell and gene 
therapies?

    Answer. I believe that people should have timely access to 
lifesaving innovative therapies, including prescription drugs, 
biologics, devices, and other medical products such as cell and gene 
therapies. We need to foster innovation in medical technology to 
develop new lifesaving therapies. If confirmed, I look forward to 
working with you and other members to find solutions to address the 
high cost of new therapies.

    Question. In your role as Attorney General, how have you worked to 
ensure Federal Medicaid funding does not go to non-citizens (a 
requirement under Medicaid) even as California allows non-citizens 
under 26 years old to be covered by its Medicaid program? How do you 
ensure accountability related to the bifurcated Federal and State 
funding streams?

    Answer. The law does not allow people with undocumented status in 
this country to receive Federal Medicaid benefits except in very rare 
circumstances. If confirmed, it will be my job to make sure that the 
Department follows the law.
                             miscellaneous
    Question. The Secretary of Health and Human Services serves as a 
trustee on the Board of Trustees of the Federal Old-Age and Survivors 
trust fund and the Federal Disability Insurance trust fund. As a 
trustee, you would, if confirmed, have a role in helping to develop 
annual ``trustee reports'' on the financial condition of the trust 
funds. In 2017, allegations were made that a single public trustee for 
Social Security somehow forced insertion of assumptions into models 
used to project the future finances of Social Security that led to the 
``playing up the potential future insolvency of the program.'' One 
piece of evidence to support the allegations was that the Chief Actuary 
for Social Security wrote a public statement of actuarial opinion 
containing some sort of public rebuke of questionable elements of the 
2015 Social Security trustee report. The Chief Actuary's Statement of 
Actuarial Opinion from the 2015 report is available on the Social 
Security Chief Actuary's website (on pp. 256-257 of https://
www.ssa.gov/oact/TR/2015/tr2015.pdf). Given that you will assist in 
developing trustee reports if confirmed, it is important to know that 
you have knowledge of and sound judgement regarding Social Security 
trust funds. Do you agree that the Statement of Actuarial Opinion of 
the 2015 trustee report represents a public rebuke of questionable 
elements of the trustee report--elements that represent assumptions 
used to project the future finances of Social Security to play up the 
potential future insolvency of the program?

    Answer. If confirmed as Secretary, I can commit to you that we will 
work with you to give you and this committee the information you need 
to make the right decisions with respect to Medicare.

    Question. In response to a questionnaire sent to you by the Senate 
Committee on Finance, you included the following: ``I served on the 
Ways and Means Committee for 2 decades, where I focused on protecting 
and strengthening Medicare, Medicaid, and health-care payments and 
program financing, and where, in 2015, I led efforts to successfully 
stave off roughly 20-percent cuts in Social Security Disability 
Insurance.'' Republicans on the Finance Committee, led at the time by 
then-Chairman Hatch, worked with Republicans and Democrats in the 
House, and Obama administration officials, to put in place reforms to 
the Disability Insurance program at Social Security to make it better 
for beneficiaries and taxpayers. Unfortunately, Senate Democrats at the 
time took the position that nothing should be changed, aside from 
taking resources from the Old-Age and Survivors (``retirement'') trust 
fund and giving those resources to the Disability Trust Fund--something 
they referred to as a ``clean reallocation.'' The reforms that then-
Chairman Hatch led from the Senate, and a reallocation of resources 
between trust funds, ultimately became law. None of those reforms 
privatized anything or cut benefits for anyone, aside from one change 
that was inserted by the Obama administration to cut benefits for 
certain upper-earners, and the reallocation ensured that Disability 
Insurance benefits did not have to be cut, which otherwise would have 
occurred. However, it is not clear the sense in which you ``led'' 
efforts in the House Ways and Means Committee to arrive at what became 
the reforms. Can you provide evidence of how you led the House efforts, 
such as legislation that you had sponsored that ultimately ended up in 
the Disability Insurance reform package?

    Answer. As chairman of the House Democratic Caucus and ranking 
member of the House Ways and Means Subcommittee on Social Security, I 
was deeply committed in this effort to preventing cuts to Social 
Security, including introducing legislation, as part of this debate.

    Question. During your tenure at the House Ways and Means Social 
Security Subcommittee, you said numerous times that ``Social Security 
has not added 1 penny to our deficit and our debt.'' I don't believe 
that Social Security has contributed a great deal to deficits and debt, 
but to be honest with respect to government accounts of taxpayer 
resources, there have been contributions.

    In his book titled ``Stress Test: Reflections on Financial Crises'' 
(Crown Publishers, New York, 2014), former Treasury Secretary Timothy 
Geithner wrote the following: ``. . . I objected when Dan Pfeiffer 
wanted me to say Social Security didn't contribute to the deficit, but 
it did contribute. Pfeiffer said the line was a `dog whistle' to the 
left, a phrase I had never heard before. He had to explain that the 
phrase was code to the Democratic base, signaling that we intended to 
protect Social Security.''

    Do you agree with Secretary Geithner that Social Security has 
contributed to the deficit?

    When you repeatedly made public statements that ``Social Security 
has not added 1 penny to our deficit and our debt,'' were you being 
truthful, or sounding a ``dog whistle'' to the left as, according to 
Geithner, former Obama administration official Dan Pfeiffer 
characterizes such statements?

    Answer. I am committed to protecting benefits for American seniors, 
and if I am confirmed as HHS Secretary, my commitment will extend to 
efforts to protect Medicare and seniors' benefits, and I hope we can 
find common ground to work together on solutions to strengthen these 
lifelines.

    Question. As Attorney General, you filed 122 lawsuits against the 
Trump administration, with some of these lawsuits related to HHS 
programs. The sheer volume is indicative of how active States can be 
when they are philosophically opposed to the administration in power. 
What impact would the threat of lawsuits or actual lawsuits filed by 
States against HHS have on how you would run the Department?

    Answer. If I am confirmed as HHS Secretary, I will follow the law, 
and we will comply with the law when implementing the President's 
agenda and the laws passed by Congress.

    Question. President Biden announced your nomination for HHS 
Secretary simultaneously with his nomination of Dr. Vivek Murthy as 
Surgeon General. Dr. Murthy has in the past identified gun violence as 
a public health issue. Do you agree with Dr. Murthy's opinion that gun 
violence is a health-care issue, and if so, how would you use your 
position as HHS Secretary to address it?

    Answer. The American Public Health Association lists gun violence 
as a public health issue. If I am confirmed as HHS Secretary, I will 
support ongoing peer-
reviewed research efforts at CDC and NIH, and implement the President's 
agenda.

    Question. The U.S. Supreme Court recently enjoined enforcement of 
California's restrictive rules on gatherings for religious ceremonies. 
Indeed, some in the public health community have said that California's 
extreme restrictions, including on gatherings, may have been 
counterproductive. How, as HHS Secretary, would you balance advocacy 
for public health with respect for constitutionally guaranteed 
liberties, including religious freedom?

    Answer. As a person of faith myself, I believe deeply in religious 
freedom. It is a protection in our Constitution that makes the United 
States so unique and special. This pandemic continues to disrupt our 
daily lives and routines, and we need to be vigilant in mitigating the 
spread and protecting our fellow citizens. If confirmed as HHS 
Secretary, I will follow the law and Constitution in all our efforts to 
implement the President's agenda.

                                 ______
                                 
            Follow-up Questions Submitted by Hon. Mike Crapo
    Question. The response Mr. Becerra provided on the questions of 
unemployment fraud in California did not address the specific questions 
asked in the original question for the record. Please respond directly 
and substantively to the questions that were asked.

    Answer. I have long been concerned about fraud across our State and 
take allegations of fraud seriously. Typically, District Attorneys 
(DAs) prosecute any fraudulent action in their counties, and while we 
can join investigations, DAs are routinely the arbiters. At the 
California Department of Justice (DOJ), it's our policy not to comment 
on any potential or pending investigation--even confirmation or 
denial--to protect the integrity of our work.

    The question concerning the number of hours spent on unemployment 
fraud in relation to our Federal lawsuits seems to presume that we have 
spent substantial time on our Federal lawsuits, perhaps compared to 
other work at DOJ. Yet over the first 3 fiscal years during my tenure 
as Attorney General, our Federal lawsuits amounted to roughly 1 percent 
of our DOJ budget.

    Question. The response Mr. Becerra provided did not address the 
question of whether the nominee agrees that the Statement of Actuarial 
Opinion of the 2015 trustee report represents a public rebuke of 
questionable elements of the trustee report. Given the importance of 
Social Security programs, it is important to know whether the nominee 
agrees or not. Please be directly responsive to the question.

    Answer. The role of the Secretary of Health and Human Services as a 
trustee on the Board of Trustees for the Federal Old-Age and Survivors 
trust fund and the Federal Disability Insurance trust fund is vital. 
While I can't speak to the intentions of the Chief Actuary for Social 
Security in the 2015 Annual Report of the Trustees of the Federal Old-
age and Survivors Insurance and Federal Disability Insurance trust 
funds, I believe that the future of Social Security is of the utmost 
importance. If confirmed as Secretary, I will approach this duty with 
the care and attention it deserves.

    Question. The response Mr. Becerra provided did not answer whether 
he can provide evidence of how he led the House efforts, such as 
sponsored legislation that ended up in the ultimate package. The 
nominee identifies that he had introduced legislation, as part of a 
debate. Please identify the specific legislation, and whether it ended 
up in the Bipartisan Budget Act of 2015.

    Answer. I introduced H.R. 3150, the One Social Security Act, on 
July 22, 2015, which proposed merging two trust funds--the Social 
Security Disability Insurance (SSDI) fund and the Old-Age and 
Survivors' Insurance fund--to cover possible shortfalls. While it did 
not become law, it led to conversations about how to prevent Social 
Security's disability trust fund from running out of money.

    As for preventing the nearly 20-percent cuts to SSDI, I alerted 
House Democratic colleagues to the possible SSDI shortfall and made 
clear that the budget deal of October 2015 must not decrease SSDI 
benefits. Ultimately, I wrangled fellow House Democrats to put their 
feet down and insist on staving off cuts. The deal later passed without 
the cuts.

    Question. The response Mr. Becerra provided regarding deficits, 
debt, and Social Security did not answer the specific questions asked. 
Please answer whether you do or do not agree with Secretary Geithner 
that Social Security has contributed to the deficit; and please answer 
whether your numerously iterated statement that ``Social Security has 
not added 1 penny to our deficit and our debt'' is truthful or, as a 
former Obama administration official reportedly has identified the 
statement, a ``dog whistle'' to the left.

    Answer. I stand by my statement that Social Security has not added 
1 penny to the deficit. As a member of Congress, I have been a champion 
for benefits for seniors including Social Security and Medicare. As HHS 
Secretary, if confirmed, I will continue to work with Congress to 
ensure that seniors have access to critical lifeline programs like 
Medicare.

                                 ______
                                 
               Questions Submitted by Hon. Chuck Grassley
    Question. During the last 2 years as chairman of this committee, 
I've focused some of my oversight on what steps the Department of 
Health and Human Services has taken to detect and deter foreign threats 
to taxpayer-funded research. As part of my oversight, I've also worked 
to ensure that the Department's Office of National Security is given 
full, complete, and consistent access to all Intelligence Community 
information involving threats to the Nation's health care, such as 
COVID-19. That office has gained access to some Intelligence Community 
elements but more must be done.

    Do you agree that China is a significant and consistent bad actor 
when it comes to stealing U.S. taxpayer-funded intellectual property 
and academic research? If so, what will you do to protect American work 
product from the communist Chinese government's theft and espionage 
activities? If not, why not?

    If confirmed, do you intend to work with the Intelligence Community 
to better understand the origins of COVID-19 and China's involvement? 
If not, why not?

    If confirmed, will you commit to briefing this committee on those 
efforts?

    If confirmed, will you commit to updating me on the functions of 
the Office of National Security and how it's interacting within the 
Intelligence Community?

    Answer. If confirmed, I look forward to working with the committee 
to protect research from undue foreign influences. As the president has 
said, China is a serious competitor, and I am deeply concerned about 
China's record of stealing intellectual property and engaging in 
coercive and malign economic practices. If confirmed, I will work with 
my colleagues to protect American work products from these activities. 
and I also am committed to working with the intelligence community and 
other partners to understand the origins of COVID-19, and I will keep 
the committee apprised.

    I recognize the critical role of scientific collaborations based on 
principles of scientific excellence, integrity, responsibility to the 
public, and fair competition in advancing its mission. The National 
Institutes of Health (NIH) has taken a number of steps to address these 
risks, including clarifying expectations around foreign affiliation 
disclosures, financial conflicts of interest, and research support from 
foreign governments. Protecting the integrity of science is a priority 
for me to ensure that U.S. institutions and the American public benefit 
from their investment in biomedical research. If confirmed, I will work 
closely with NIH in their efforts to protect research integrity.

    Question. Congress's ability to acquire information from Federal 
agencies is critical to its constitutional responsibility of conducting 
oversight of the executive branch. If you are confirmed, will you 
commit to providing thorough, complete, and timely responses to 
requests for information from members of this committee, including 
requests from members of the minority?

    Answer. As I committed during Thursday's hearing, I will provide 
prompt responses in writing to requests from any members of this 
committee.

    Question. Science tells us that an unborn child has many of the 
neural connections needed to feel pain, perhaps as early as eight weeks 
and most certainly by 20 weeks fetal age. Providing health care to 
unborn children and their mothers can help reduce infant mortality 
rates in low-income communities, research also suggests. Some States 
already offer prenatal care and other health services to unborn 
children through the Medicaid program. What is your view on whether 
unborn children should be entitled to Medicaid coverage, and do you 
believe that the Federal Government has a role to play in encouraging 
such coverage?

    Answer. Medicaid is an important source of pre- and post-natal 
care, and if I am confirmed, I will work to ensure that pregnant people 
have access to quality health care that improves their own health and 
the health of their babies. I look forward to working with members of 
this committee and Congress to expand access to affordable quality care 
including through the Medicaid program.

    Question. Last year, Senator Wyden and I released a report to 
colleagues exposing the extensive financial ties between manufacturers 
of opioids and opioid-related products and tax-exempt organizations. 
This investigation found that manufacturers made more than $65 million 
in payments to a handful of tax-exempt organizations since 1997 to 
amplify their business interests. Would you agree that the Physician 
Payments Sunshine Act should be expanded to include these types of 
transactions so that the public is aware them?

    Answer. As Attorney General, I have acted to combat the opioid 
crisis, including holding drug makers accountable. As California 
Attorney General, I worked to shine a light on the relationships 
between opioid companies and their consultants. The Open Payments 
Program established by your Physician Payments Sunshine Act promotes 
transparency and accountability by making information about certain 
financial relationships available to the public. If confirmed, I look 
forward to working with you on ways to promote transparency of the 
financial ties of opioid manufacturers.

    Question. In 2020, I cosponsored the Temporary Reauthorization and 
Study of the Emergency Scheduling of Fentanyl Analogues Act and it was 
signed into law. The law extended the Drug Enforcement Administration's 
temporary scheduling order to proactively control deadly fentanyl 
analogues. Fentanyl-related overdose deaths continue to rise and 
sophisticated drug trafficking organizations manipulate dangerous 
substances to skirt the law, so this critical law placed fentanyl 
substances in Schedule I so that they can be better detected and 
criminals can be held accountable for their actions. The law sunsets in 
May of 2021. You as Attorney General of California signed a letter in 
December 2019 joining all 55 other State and territory Attorneys 
General asking Congress to permanently codify a temporary emergency 
scheduling order keeping fentanyl-related substances classified as 
Schedule I drugs. If confirmed, do you support permanently codifying a 
temporary emergency scheduling order keeping fentanyl-related 
substances classified as Schedule I drugs?

    Answer. I recognize that fentanyl and fentanyl analogues pose a 
significant danger, and are responsible for far too many deaths every 
year. I continue to believe that we should place sensible restrictions 
on these substances that pose harm. I am also cognizant of the vital 
role HHS plays in the scheduling process and the need to ensure that 
our actions are not inadvertently stifling the type of research that is 
needed to develop new drugs that can help address the opioid crisis in 
America. I commit that, if confirmed, I will work with you on 
legislation to ensure the appropriate scheduling of the fentanyl and 
fentanyl analogues that pose a danger.

    Question. In 2003, Congress added an outpatient prescription drug 
benefit to the Medicare program called Part D. We did it the right way 
for seniors and taxpayers by allowing the forces of free enterprise and 
competition to drive costs down and drive value up. Key to designing 
this program was ensuring there was competition, not government 
mandates--to drive innovation, curb costs, expand coverage, and improve 
outcomes. This is why we wrote the non-interference clause into the 
law. The non-interference provision expressly prohibits Medicare from: 
negotiating drug prices, setting drug prices, and establishing a one-
size-fits-all list of covered drugs. That language doesn't prohibit 
Medicare from negotiating with drug makers. It prohibits the government 
from interfering in the negotiations that are actually happening. The 
Congressional Budget Office has repeatedly stated that repealing non-
interference wouldn't save money unless there was a restrictive 
formulary, therefore restricting patient access to critical drugs. 
President Biden, then as a candidate for president, said he wanted to 
``allow Medicare to negotiate lower drug prices'' and last Congress the 
U.S. House of Representatives passed legislation that sought to give 
the Department of Health and Human Services (HHS) Secretary ``broad 
power to negotiate lower drug costs now.'' As a member of Congress, you 
cosponsored legislation that would have enabled the Secretary of HHS 
the ability to negotiate with pharmaceutical manufacturers. Does the 
Secretary of HHS have the authority to circumvent the 2003 law to 
negotiate prescription drug prices in Medicare? If confirmed, does the 
Biden administration support changes to Medicare's non-interference 
clause to stifle the free market that includes amending or rescinding 
the non-interference clause provision?

    Answer. Like President Biden, I believe we must do all we can to 
lower the costs of prescription drugs and make them more accessible for 
Americans. If confirmed, I look forward to working with Congress to 
build upon the good work you did in the Finance Committee on this 
important issue and finding ways to achieve these important goals.

    Question. I recently requested the CDC to publicly release its 
weekly formula--including the State-by-State pro-rata share for 
allocating vaccines to States, territories, and tribes. No matter where 
you live, Iowans and all Americans should have fair access to a 
vaccine. Iowans must have confidence we are receiving our fair share of 
vaccines. I appreciate the CDC routinely releasing State-by-State 
vaccine data for allocation, doses delivered, and administration. 
However, it is difficult to determine based on this data whether Iowa 
is receiving its fair share. This publicly reported data can also lag. 
Will the Biden administration commit to the CDC publicly releasing its 
State-by-State weekly pro-rata share of vaccine allocations?

    Answer. If confirmed, I look forward to working with the Department 
to ensure there is transparent and equitable distribution of vaccine 
allocations.

    Question. In Iowa, grandmothered health plans have enabled many 
middle-class Iowans to keep the health plans and doctors they like at a 
reasonable price since the Affordable Care Act was implemented. For 
example, over 56,000 Iowans are covered by grandmothered health plans. 
To put this in context, about 59,000 Iowans signed up for the Federal 
health insurance exchange in 2021. Iowans have chosen health plans that 
meet their individual needs. Currently, grandmothered health plans' 
existence is determined by the Department of Health and Human Services 
(HHS) through the Centers for Medicare and Medicaid Services (CMS) 
annually through non-enforcement extensions. If confirmed, are you 
committed to maintaining these affordable, consumer-chosen health plan 
options for Iowans by extending the non-enforcement authority for 
grandmothered health plans annually? Or do you support actions to 
remove choice for Iowans requiring them to select a one-size-fits-all 
Obamacare plan?

    Answer. Making sure that all Americans have access to quality, 
affordable health care is one of the Biden administration's top 
priorities. If confirmed, I will examine rules and other policies to 
ensure all Americans can access the care that they need.

    Question. I support transparency in the 340B Drug Pricing Program. 
The previous administration finalized a 340B Drug Pricing Program 
Administrative Dispute Resolution regulation that went into effect in 
January 2021. This final rule sets forth the requirements and 
procedures for the 340B Program's administrative dispute resolution 
(ADR) process. The rule establishes a 340B Administrative Dispute 
Resolution Board to review claims. In addition, on December 30, 2020, 
the Department of Health and Human Services' Office of the General 
Counsel released an advisory opinion. If confirmed, are you committed 
to the continued implementation of the 340B Drug Pricing Program 
Administrative Dispute Resolution final rule and Office of General 
Counsel's advisory opinion? If confirmed, what other detailed steps 
will the Biden administration take to ensure transparency in the 340B 
Drug Pricing Program?

    Answer. The 340B Drug Pricing Program is an indispensable program 
for our safety-net providers serving some of our neediest populations. 
If confirmed, I look forward to working with you and other members of 
Congress to uphold the law and ensure this vital program is able to 
support vulnerable communities.

    Question. In 2017, I sponsored the Over the Counter Hearing Aid Act 
with Senator Warren, which was included in the FDA Reauthorization Act 
of 2017. It required the FDA to issue a regulation by August 2020 
establishing the requirements for products in this category. This 
legislation was based on recommendations put forth by the Presidential 
Council of Advisors on Science and Technology and the National 
Academies of Science Engineering and Medicine to increase consumer 
access to hearing aid technology and decrease costs associated with 
hearing aids. The Food and Drug Administration has not completed 
rulemaking on this. If confirmed, will you work to prioritize 
rulemaking so consumers can access affordable help for hearing loss 
that Congress intended?

    Answer. Thank you for your leadership on this issue. I commit that, 
if confirmed, I will support FDA in their work to ensure availability 
of over-the-counter hearing aids. I recognize this as a public health 
priority as hearing loss can have a negative effect on communication, 
relationships, and other important aspects of life.

    Question. A Centers for Disease Control and Prevention (CDC) 
Morbidity and Mortality Weekly Report found the use of telehealth 
increased 154 percent during the last week of March 2020 during the 
emergency of COVID-19 compared to the same period in 2019. We know the 
use of telehealth has continued throughout the COVID-19 pandemic. The 
Centers for Medicare and Medicaid Services (CMS) throughout the public 
health emergency authority has allowed more than 80 services to be 
furnished via telehealth. The data and response from patients and 
providers prove permitting telehealth services is a positive action to 
improve access and care. This last Congress, we provided permanent 
coverage for mental health telehealth visits under Medicare, which is 
helpful during the pandemic and will remain critical for many Americans 
afterwards. If confirmed, are you committed to working with Congress 
and in the executive branch to extend telehealth flexibilities in 
Medicare beyond the pandemic? Additionally, some providers, including 
community health centers, face regulatory barriers based on provider 
type or site of service. If confirmed, do you support removing 
telehealth barriers for certain providers?

    Answer. Telehealth is an important tool to improve health equity 
and improve access to health care. Health care should be accessible, no 
matter where you live. If confirmed, I will look at the telehealth 
flexibilities developed for the current public health emergency and 
determine how we can build on this work to improve health equity and 
improve access to health care, including at community health centers.

    Question. If confirmed, does the Biden administration plan to 
change the State-Federal partnership in response to the COVID-19 
pandemic by placing conditions of participation, including specific 
public health mitigation efforts, on States in order to receive vaccine 
doses?

    Answer. If confirmed, I would work within HHS to determine the best 
way to ensure transparent and equitable distribution of vaccine 
allocations.

    Question. If confirmed, does the Biden administration plan to 
change the State-Federal partnership in response to the COVID-19 
pandemic by placing conditions of participation, including specific 
public health mitigation efforts, on States in order to receive Federal 
funding to respond to COVID-19?

    Answer. If confirmed, I would work within HHS to determine the best 
way to ensure transparent and equitable distribution of COVID-19 relief 
funding.

    Question. I am a proud champion for greater transparency in 
government. This extends to the need for greater transparency in health 
care. I am the author of the Physician Payments Sunshine Act, which 
requires public disclosure of payments between drug companies and 
doctors and have introduced legislation to apply the same disclosure 
rules to nurse practitioners and physician assistants. In 2019, the 
Trump administration issued two major rules requiring price 
transparency for hospitals and health insurance companies. The rules 
took effect in January 2021. This effort shines a light on the health-
care industry that is all too often shrouded in secrecy. While Congress 
can build upon the rules, consumers can finally see sunshine in health-
care pricing. I have cosponsored legislation to codify the two health-
care price transparency rules. This transparency will bring more 
accountability and competition to the health-care industry. If 
confirmed, do you plan to maintain, modify, or rescind these health-
care transparency rules that give consumers the ability to compare 
prices online so they can make an informed choice about what's best for 
them and their families?

    Answer. If I am fortunate enough to be confirmed, I will ensure 
that the Department continues to take steps to improve price 
transparency, so consumers can look behind the curtain to understand 
how providers and insurers are operating.

    Question. As a direct result of the Affordable Care Act's one-size-
fits-all approach, many Iowans have been priced out of health 
insurance. To rectify this, the Trump administration and Iowa Insurance 
Division enabled Iowans more choice and competition in the health-care 
marketplace by enabling and expanding short-term 
limited-duration insurance (STLDI). This gives Iowans access to health 
insurance with consumer protections. If confirmed as Secretary of 
Health and Human Services, will you stifle competition and limit the 
health plan choices for Iowans? Specifically, will you modify or 
rescind the current regulations enabling Americans to purchase STLDIs?

    Answer. Making sure that all Americans have access to quality, 
affordable health care is one of the Biden administration's top 
priorities. If confirmed, I will examine rules and other policies to 
ensure that plans provide Americans access to the care that they need.

    Question. It is important to give people affordable options for 
health insurance. Small business owners, like Iowa farmers, want to be 
able to provide insurance for their employees. Association Health Plans 
are a way for these small businesses to band together to expand access 
to health insurance and drive down costs. I have introduced legislation 
and support efforts to expand the pathway to affordable and accessible 
health care remaining open to employees across America. Association 
Health Plans allow small businesses to join together to obtain 
affordable health insurance as though they were a single large 
employer. The coverage offered to association members is subject to the 
consumer protection requirements that apply to the nearly 160 million 
Americans who receive coverage from large employers. If confirmed, will 
you as Secretary of Health and Human Services modify or rescind current 
regulations enabling employers and employees access to Association 
Health Plans removing the ability to access affordable health 
insurance?

    Answer. Making sure that all Americans have access to quality, 
affordable health care is one of the Biden administration's top 
priorities. If confirmed as Secretary of HHS, I will examine all rules 
and policies to ensure all Americans can access the care that they 
need.

    Question. I support access to affordable health-care coverage for 
all Iowans, regardless of their health status or pre-existing 
conditions. Americans want to be in control of their own health care. 
National, single-payer health systems do not allow that. The Affordable 
Care Act took options away from people and adopting a single-payer 
system will make that worse. A national, single-payer health system 
would eliminate private health insurance for nearly 200 million 
Americans and require middle-class Americans to pay much more in taxes. 
Single-payer health care would also dramatically increase government 
spending substantially, fail to meet patient needs quickly, reduce 
provider payments rates and reduce quality of care, and the government 
would have more control over health care. It also threatens the 
benefits that current seniors on Medicare have paid into the system 
their entire working lives. If confirmed, do you intend to take 
administrative actions to implement the vision of a one-size-fits-all 
government-run health care scheme like single-payer? If so, please 
describe what authority you believe you have to take such actions?

    Answer. President Biden has made it very clear that his goals for 
improving the American health-care system begin with building on the 
successes of the Affordable Care Act, and I am committed to working 
toward that goal.

    Question. If confirmed, will you take actions as Secretary of 
Health and Human Services that stifle innovation and competition in 
health care?

    Answer. Thank you for this question. I believe it is important to 
foster innovation and competition in our health-care system. Americans 
should have access to health-care services and products at an 
affordable price.

    Question. Throughout the pandemic, the Trump administration gave 
States through the Medicaid program more flexibility to continue to 
care for and protect individual Americans and communities at most risk. 
If confirmed, will you work throughout the public health emergency to 
maintain these flexibilities for States?

    Answer. I agree that these emergency flexibilities have played an 
important role in enabling State Medicaid programs to respond 
effectively to the COVID-19 pandemic. If confirmed, I am prepared to 
work closely with State Medicaid programs to ensure that they have the 
flexibility they need to care for Medicaid beneficiaries throughout the 
public health emergency.

                                 ______
                                 
                Questions Submitted by Hon. John Cornyn
                           vaccine allocation
    Question. In order to streamline the distribution of COVID-19 
vaccine from manufacturers to the States, the Trump administration 
created a pro rata formula that the Biden administration has left in 
place. The formula requires Federal administrators to run an automated 
algorithm in a program called Tiberius,\3\ which then calculates the 
division of vaccine doses nationwide based on the size of each State's 
adult population. While Texas has received the second-most vaccine 
doses in the country, an analysis of Centers for Disease Control and 
Prevention data has shown the State ranks near the bottom, 49 out of 
50, when it comes to doses per 100,000.
---------------------------------------------------------------------------
    \3\ https://www.defense.gov/Explore/News/Article/Article/2441698/
pro-rata-vaccine-distribution-is-fair-equitable/.

    The State population numbers used in the algorithm are derived from 
the U.S. Census Bureau's 2018 data. Texas is one of the youngest States 
in the Nation, with 25.5 percent \4\ of the State population under 18 
years old. With that said, Texas media \5\ has noted ``[s]till, even 
when adjusted for adults only, Texas ranks 48th.''
---------------------------------------------------------------------------
    \4\ https://www.census.gov/quickfacts/TX.
    \5\ https://www.houstonchronicle.com/news/investigations/article/
Nobody-is-getting-enough-Texas-near-the-15906851.php.

    What steps would you take as Secretary to ensure Texans receive an 
---------------------------------------------------------------------------
equitable share in future distributions?

    Answer. If confirmed, I commit to working with the Department to 
ensure equitable distribution of vaccinations for States and local 
jurisdictions, including the State of Texas.
                              1115 waivers
    Question. In January, CMS granted Texas a 10-year extension of its 
Medicaid 1115 waiver, providing critical funding and stability for the 
program and Medicaid providers. The extension carries forward many 
policies and programs approved across two different administrations 
that ensure quality outcomes, transparency, and greater access to care. 
A one size fits all approach cannot meet the needs of a State as large 
and diverse as Texas, and the flexibility inherent in the 1115 waiver 
gives the State the authority to employ innovative solutions.

    There are concerns that the Biden administration will seek to 
withdraw approval of waivers that were granted at the end of the Trump 
administration. It is a dangerous precedent for the first action of a 
new administration to undo the final actions of the previous 
administration as States will no longer be able to trust in their 
negotiations with CMS.

    Will you commit to maintaining Texas' waiver extension as approved?

    Will you pledge to work with Texas to ensure the stability of the 
health-care safety net, which is heavily dependent on funding provided 
through the 1115 waiver?

    Answer. Medicaid is an important lifeline for many Texans. Section 
1115 demonstrations can be invaluable in allowing States to pursue 
innovative ideas through Medicaid. If confirmed as HHS Secretary, I 
would work to ensure that States' Medicaid section 1115 demonstrations 
promote the objectives of the Medicaid program and that these 
demonstrations are approved in accordance with and comply with the 
Medicaid statute.
                      foreign threats to research
    Question. In 2019, this committee held a hearing on foreign threats 
to taxpayer-funded research after multiple reports of espionage by the 
People's Republic of China. We have seen attempts by foreign entities 
like North Korea to steal intellectual property related to COVID 
vaccine development and I continue to hear concerns from research 
institutions in Texas.

    Do you believe that NIH and other funders of public research should 
consider cybersecurity protocols that institutions have in place when 
evaluating applications for research grant funds?

    What additional initiatives are you considering to ensure taxpayer 
funded research is protected from foreign threats?

    Answer. If confirmed, I look forward to working with the committee 
to protect research from undue foreign influences. As the president has 
said, China is a serious competitor, and I am deeply concerned about 
China's record of stealing intellectual property and engaging in 
coercive and malign economic practices. If confirmed, I will work with 
my colleagues to protect American work products from these activities. 
I also am committed to working with the intelligence community and 
other partners to understand the origins of COVID-19, and I will keep 
the committee apprised.

    I recognize the critical role of scientific collaborations based on 
principles of scientific excellence, integrity, responsibility to the 
public, and fair competition in advancing its mission. The National 
Institutes of Health (NIH) has taken a number of steps to address these 
risks, including clarifying expectations around foreign affiliation 
disclosures, financial conflicts of interest, and research support from 
foreign governments. Protecting the integrity of science is a priority 
for me to ensure that U.S. institutions and the American public benefit 
from their investment in biomedical research. If confirmed, I will work 
closely with NIH in their efforts to protect research integrity.
                                  esrd
    Question. I have heard that some Medicare beneficiaries with End-
Stage Renal Disease (ESRD) are being denied access to certain therapies 
following the inclusion of calcimimetic medicines in the ESRD bundled 
rate. For example, I've heard that some dialysis centers are requiring 
patients to change or stop using a medicine now that it is part of the 
bundled rate. It is extremely disturbing that dialysis patients, a 
group that is already impacted by significant disparities, would be 
taken off a treatment for economic reasons by the dialysis center.

    What will you do to ensure that ESRD patients will continue to have 
access their calcimimetic treatment and what will you do to monitor 
patient outcomes in this area?

    Answer. I agree that is it important for Medicare beneficiaries, 
particularly vulnerable groups such as those beneficiaries with ESRD, 
to have access to medically necessary treatments such as calcimimetics. 
If confirmed, I will work to ensure that Medicare beneficiaries 
continue to have access to these treatments and that patient outcomes 
are not compromised.

    Question. Four hundred thousand Medicare beneficiaries are on 
dialysis, and those patients have not benefited from any meaningful 
innovation in their standard of care in decades. Over the last several 
years, I have joined colleagues on both sides of the aisle and worked 
with CMS, the patient community, and innovators to encourage adoption 
of a new policy to spur innovation in medical technology for Medicare 
patients under the ESRD bundled payment system. CMS has made 
significant progress, having created the TPNIES add on payment for 
innovation in medical technology used in the provision of dialysis 
services. However, our work is not done. CMS should better align its 
metrics for innovation and clinical improvements over existing 
technologies with the lens FDA uses to evaluate such improvements and 
innovations. And CMS should also extend by another year the period of 
time during which the add-on payment can be made, having established an 
application and qualification process via rulemaking that essentially 
negates the first year of the add on payment window. I will again work 
with my colleagues on legislation to make these additional improvements 
to the work CMS has already done, and hope that you will commit to 
working with me to achieve full success on this policy for Medicare 
patients in whatever is the most expeditious and achievable path.

    Will you commit to working with Congress to implement these 
policies and bring long overdue innovation to this vulnerable group of 
patients?

    Answer. I agree that it is important to foster innovation in 
medical technology that improves health-care outcomes. If confirmed, I 
look forward to working with Congress to improve access to innovative 
technologies to Medicare ESRD beneficiaries.
                       drug pricing--rebate wall
    Question. We continue to see participants in the pharmaceutical 
supply chain, including some manufacturers and PBMs, engage in 
behaviors designed to foreclose competition. One form of potentially 
anticompetitive behavior is known as a ``rebate wall'' or ``rebate 
trap''--a practice that, while serving as Attorney General for 
California,\6\ you acknowledged can foreclose competition and raise 
prices for consumers. Rebate walls occur when a firm with dominant 
market share requires a payer to prevent patients from accessing new 
innovation by coupling volume-based discounts with retaliatory measures 
such as the clawback of rebates. Rebate walls are especially 
problematic in therapeutic areas such as the autoimmune market where 
established medicines control considerable market share (i.e., patient 
volume) and have FDA-approval for multiple indications.
---------------------------------------------------------------------------
    \6\ file://cornyn-fs01/jeffreyl/Finance%20Committee/Hearings/117th/
Becerra%20Nomination/
State_of_California,_Office_of_the_Attorney_General.pdf.

    A recent report \7\ found that removing rebate walls could save 
patients more than $6,000 for high-cost ($70,000 list price) infused 
biologics. Do you agree that a rebate wall can be problematic for 
patients, especially when it forecloses patient access to new, 
innovative, and often times lower cost brand and biosimilar options?
---------------------------------------------------------------------------
    \7\ https://www.pacificresearch.org/wp-content/uploads/2020/12/
RebateWall_F_web.pdf.

    As Secretary of HHS, how would you engage with FTC, FDA, and other 
agencies to address anticompetitive rebate wall practices? For example, 
how would you build upon the FTC and FDA's ongoing work to address 
---------------------------------------------------------------------------
competition issues in the biosimilars market, including rebate walls?

    Answer. Like President Biden, I believe we must do all we can to 
lower the costs of prescription drugs and make them more accessible for 
Americans who depend on these medications. Competition in the market 
has helped control the growth in spending on prescription drugs and as 
California Attorney General I made it my mission to ensure that the 
marketplace worked better. I believe that biosimilars have a role to 
play in containing the cost of expensive therapies by creating 
competition. I am committed to reducing drug prices and ensuring 
Americans have access to the drugs that they need. If confirmed as 
Secretary of HHS, I look forward to working with you to find ways to 
achieve these important goals. I will also work across the government 
to address barriers to reducing drug prices.
                              biosimilars
    Question. Biologic medicines treat some of the most serious 
conditions such as cancer, diabetes, and inflammatory diseases. 
Treating these conditions also represents a significant cost burden to 
the Medicare Part B program and the patients its serves. Biosimilar 
medicines are approved by FDA to be as safe and effective to previously 
approved reference biologic products that have gone off patent. This 
represents the opportunity for high-value competition with savings 
estimates up to $100B over the next 5 years.

    What role do you see high-value, off-patent products like 
biosimilars playing in the Medicare program in helping to ease Medicare 
spending and reduce patient cost?

    Will you commit to explore demonstration programs through CMMI or 
other authorities that allow savings from biosimilar adoption to be 
reinvested in patients and the health-care system?

    Seniors are paying the high cost of prescription drugs. I 
introduced the Increasing Access to Biosimilars Act (S. 4134 in the 
116th Congress) to encourage competition through the use of lower-cost 
biosimilars. The Increasing Access to Biosimilars Act would establish a 
5-year, voluntary demonstration program to allow providers to share in 
the savings created by the use of biosimilars. Medicare savings would 
be guaranteed as the shared savings payments are only available when 
the biosimilar ASP is less than the reference biologic ASP.

    Would you work with my colleagues and me to advance a biosimilars 
shared savings demonstration and test ways to encourage more biosimilar 
adoption?

    Answer. We can all agree that the cost of prescription drugs are 
too high. Seniors should never have to choose between a meal and their 
medications. Biosimilars have a role to play in containing the cost of 
innovative yet expensive biologic treatments by creating competition. 
As Attorney General, I helped to promote competition by taking on a 
number of pharmaceutical companies who restricted competition through 
``pay-for-delay'' schemes, which delayed putting a generic product on 
the market to compete with the brand-name product, therefore keeping 
the price of that brand name product high. If confirmed, I will 
continue to work on finding ways to lower drug costs and ensuring 
Americans have access to prescription drugs. As Secretary, I look 
forward to hearing your ideas for innovative models to do just that, 
and I look forward to working with you on this important issue.
                       340b--contract pharmacies
    Question. Do you agree that the 340B statute does not mention 
contract pharmacies or define any role for them in the 340B program, 
and--notwithstanding that--contract pharmacies have pursued ways to 
generate revenue from their 340B patients, ultimately at cost to the 
Federal Government?

    As HHS Secretary, how do you plan to address recent increases in 
diversion and duplicate discounting in the 340B program?

    In your December 2020 letter to Secretary Azar, you noted that 
``some manufacturers are illegally conditioning 340B pricing on the 
provision of claims data to an agent of the manufacturer with 
insufficient compliance under HIPAA.'' Assuming HIPAA were satisfied, 
would you still consider a manufacturer conditioning 340B pricing on 
the provision of claims data to a third party to be illegal?

    Answer. The 340B Drug Pricing Program is an indispensable program 
for our safety-net providers serving some of our neediest populations. 
If confirmed, I look forward to working with you and other members of 
Congress to uphold the law and ensure this vital program is able to 
support vulnerable communities.
                  unaccompanied alien children program
    Question. If confirmed as Secretary of Health and Human Services, 
you would be responsible for supervising the Office of Refugee 
Resettlement (ORR) and its Unaccompanied Alien Children program. We are 
currently seeing a huge increase in apprehensions of unaccompanied 
migrant children (or UACs) along the border, particularly in the Big 
Bend and Del Rio Border Patrol sectors, where encounters have increased 
by 141 and 122 percent, respectively.

    Many, if not most of these children will ultimately be referred to 
the ORR UAC Program. Under the Flores settlement agreement, these 
children must be placed in non-secure, State-licensed facilities or 
placed with a family member or other sponsor.

    What is your plan with respect to HHS's contracts with State-
licensed facilities? Would you ensure that HHS has sufficient capacity 
to house children until they can receive at least preliminary merits 
hearings in their cases?

    I am concerned about releasing children to sponsors while they are 
in removal proceedings. To the extent that we're releasing to family 
members, we need to be sure that they are here legally and that they 
will be responsible for ensuring that the child shows up to the court 
proceedings. And we need to be very conscious of the costs that such 
placements impose on State and local governments--which are already 
shouldering significant costs related to the COVID pandemic.

    Answer. I appreciate your attention to this issue and the 
opportunity to answer this question. A guiding child welfare principle 
driving ORR's mission, along with legal requirements, is that 
children's best interests are served when he or she can safely be 
released to their family. HHS will release children without unnecessary 
delay to the care of appropriate sponsors, who are responsible for 
ensuring that children appear for any proceeding for which the children 
are a party. When a child is scheduled for a hearing before an 
immigration court while the child is in ORR care and custody, ORR 
arranges to transport the child to their hearings. ORR funds a national 
network of legal service providers who may represent children or appear 
as friends of the court at any immigration hearing the child is 
scheduled to appear.

    ORR consistently seeks to balance permanent licensed bed capacity 
needs with being a good steward of taxpayer funds by closely monitoring 
migration patterns and reviewing historical trends in order to project 
program needs expediently and as accurately as possible. If confirmed, 
I will do everything in my power to ensure the safety and well-being of 
these vulnerable children.
    center for innovation in advanced development and manufacturing
    Question. During the Obama administration, HHS created the Center 
for Innovation in Advanced Development and Manufacturing (CIADM) 
program. This was a public-private partnership model that was created 
back in 2012 specifically to help protect Americans from the impacts of 
bioterrorism, of pandemic influenza and of other epidemics.

    In response to the COVID-19 pandemic, HHS activated two CIADMs, one 
in Maryland and one at Texas A&M, as part of its COVID-19 response to 
domestically produce COVID-19 vaccine candidates and therapeutics. 
These CIADMs are serving as domestic manufacturers for the next tranche 
of vaccine candidates expected to be reviewed by the FDA--J&J, 
AstraZeneca, and Novavax, and working around the clock to manufacture 
these promising vaccine candidates. The program has not been without 
challenges, but the foresight of the Obama administration to create the 
program and the quick action by the Trump administration to activate 
these CIADMs show that the CIADM program could be a model to strengthen 
our domestic manufacturing capacity, strengthening our vaccine and 
therapeutics supply chain and helping ensure we can end this pandemic 
and respond to future public health emergencies quickly.

    Are you familiar with the CIADM program?

    Answer. I am familiar with the CIADM program, which helps to ensure 
a sustainable domestic medical countermeasure infrastructure.

    Question. Will you commit to building on the successes of the CIADM 
program? No program is perfect of course--but this program clearly is 
playing a vital role in ending the pandemic domestically and likely 
globally.

    Answer. If confirmed, I look forward to working with the Biomedical 
Advanced Research and Development Authority (BARDA) to expand 
innovative solutions and strengthen our domestic manufacturing 
capacity.
                       medicare program integrity
    Question. I'm very concerned about the amount of Medicare funds 
lost to errors, waste, fraud, and abuse. Previously, CMS expressed the 
need to ``elevate program integrity, unleash the power of modern 
private-sector innovation, prevent rather than chase fraud waste and 
abuse through smart, proactive measures, and unburden our provider 
partners so they can do what they do best--put patients first.'' Also, 
Congress included language in the Fiscal Year 2021 appropriations 
encouraging CMS ``to consider pilot programs using AI-enabled 
documentation and coding technology to address CMS's top program 
integrity priorities and reduce administrative burden.'' I think we can 
do more to harness the expertise used in the private sector to benefit 
our Medicare beneficiaries and safeguard the Medicare trust fund. I 
hope this is an area of policy that we can work on together.

    Will you commit to working with this committee to prioritize the 
use of artificial intelligence and other emerging technologies to 
bolster Medicare program integrity and protect the Medicare Trust Fund?

    Answer. As California Attorney General, I cracked down on health-
care fraud. Fighting fraud and abuse is important for maintaining a 
strong Medicare program. It is my understanding that CMS has taken 
steps to explore the possibilities of artificial intelligence for 
program integrity purposes. If confirmed, I will work with the 
committee to make sure that we are good stewards of the Medicare 
program and taxpayer dollars.
                           children's health
    Question. As HHS Secretary, you will oversee a number of programs 
and agencies important to children from health coverage programs vital 
to children's health such as Medicaid and the Children's Health 
Insurance Program (CHIP) to programs responsible for training the 
pediatric health-care workforce like the Children's Hospital Graduate 
Medical Education Program (CHGME) to pediatric research initiatives at 
the National Institutes of Health.

    What are your priorities for child health if confirmed?

    Answer. Programs such as Medicaid and the Children's Health 
Insurance Program (CHIP) are crucial lifelines for ensuring that 
children have adequate access to quality health care. I had the great 
honor to help expand CHIP as a member of the House of Representatives, 
and have voted in support of reauthorizing the Children's Hospital 
Graduate Medical Education Program (CHGME). If confirmed, I would work 
to ensure children are receiving necessary health care so they can grow 
and thrive. I would also look to better ensure access to oral health 
and vision care for children, both necessary for children to thrive in 
school. And let us not forget that improving child health begins with 
ensuring maternal health. I will work tirelessly to reduce maternal and 
infant mortality and morbidity, using the expertise and resources 
across the many HHS agencies whose missions include ensuring child 
health. I look forward to working with Congress, and with State and 
local partners to make sure that we are improving child health.

    Medicaid and CHIP are critical programs for children, providing 
coverage for over 40 million children. Medicaid is also the backbone of 
the pediatric health-care system providing care across the continuum 
from screenings and preventive to highly specialized diagnoses and 
treatments.

    Question. What are your plans to strengthen this safety net for 
children and the providers who care for them?

    Answer. If confirmed, I would work to support and strengthen 
crucial programs such as Medicaid and CHIP to ensure that children have 
adequate access to quality health care. In particular, I would look to 
better ensure access to oral health and vision care for children, while 
working to reduce maternal and infant mortality and morbidity. In 
addition, I would work to ensure that the providers who care for our 
children receive the support and resources they need to deal with the 
COVID-19 crisis and to make sure our children have access to quality 
care from the get-go.

    The pandemic is having a profound impact on children's health and 
the providers who care for them.

    Question. What are your immediate plans to address the current 
crisis in the increasing number of children facing severe mental, 
emotional and behavioral health challenges due to social isolation and 
the serious impact of the pandemic on the health of their families and 
caregivers?

    Answer. I am deeply concerned about the impact of the COVID-19 
pandemic on the mental, emotional, and other behavioral health outcomes 
of our children and their families and caregivers. I agree this must be 
an urgent national priority. If confirmed, I commit to working on this 
issue. In particular, we must ensure that we are fully leveraging the 
Medicaid and CHIP programs to connect children to the behavioral health 
care they need to navigate this unprecedented time and available SAMHSA 
funding to support behavioral health.

    Question. The pediatric health-care safety net has been affected by 
the pandemic in different ways then the adult health care system, with 
less direct Federal financial support because they are not eligible for 
Medicare funding streams. What are your plans to sustain a stable 
pediatric health care system now and beyond the pandemic?

    Answer. Medicaid and CHIP are lifelines to children and help form 
the fabric of the pediatric health-care safety net. Over 77 million 
individuals are enrolled in those programs, and about half are 
children. It is critical that we work to support our pediatric health-
care safety net and pediatric health-care providers during the COVID-19 
pandemic and beyond. If confirmed, I would make it a priority to 
provide necessary support to pediatric providers.

    The Children's Hospital Graduate Medical Education Program (CHGME) 
provides significant support for the training of pediatricians and 
pediatric specialists. But unfortunately, the funding for this program 
still lags far behind the Medicare GME program--funding only half of 
what Medicare GME provides per resident.

    Question. What are your plans to address this gap in training 
support for our Nation's pediatric workforce?

    Answer. If confirmed, I will work to focus attention and resources 
to bolster our Nation's health-care workforce, including those who work 
with pediatric populations. HRSA's Children's Hospital Graduate Medical 
Education (CHGME) and 
Developmental-Behavioral Pediatrics programs are key pieces in the 
overall workforce landscape. If confirmed, I look forward to working 
with Congress to continue training a high-quality, skilled pediatric 
workforceto help increase access to these services.

    During the pandemic, telehealth has played a major role in 
providing access to care for Medicaid beneficiaries, including 
children.

    Question. How will HHS support the continued use and enhancements 
needed under Medicaid to ensure telehealth continues to enable access 
to care for children?

    Answer. Telehealth is an important tool to improve health equity 
and improve access to health care. Health care should be accessible, no 
matter where you live. Medicaid has made great strides in expanding 
services available through telehealth, including pediatric services, 
during the public health emergency. If confirmed, I will look at the 
telehealth flexibilities developed for the current public health 
emergency and determine how we can build on this work to improve health 
equity and improve access to health care.

    As you know, pediatric health care is organized differently than 
adult health care. Pediatric care is more regionalized and often 
results in children, especially those with complex health needs, having 
to travel across State lines for care. Under Medicaid, this can be 
challenging for them and their providers with different policies State 
to State. The Advancing Care for Exceptional Kids (ACE Kids) Act passed 
in 2019 and effective next year, is one step in addressing these 
inconsistencies and getting much needed national data to inform care 
improvements.

    Question. If confirmed, how would you approach these cross-State 
challenges that children with complex needs face when traveling for 
needed care?

    Answer. Programs such as Medicaid and CHIP are crucial lifelines 
for ensuring that children have adequate access to quality health care, 
especially those with complex needs. I had the great honor to help 
expand CHIP as a member of the House of Representatives. If confirmed, 
I will work to ensure children are receiving necessary health care so 
they can grow. I look forward to working with other departments across 
the administration, Congress, and with State and local partners to make 
informed decisions that address the specific needs of children with 
complex medical conditions.

    A major focus in health care among policy makers has been on 
pursuing delivery system reforms that improve quality and reduce costs. 
The Federal Government has traditionally focused more on adult 
populations rather than the needs of children in these reforms. As a 
result, Medicaid for children still lags behind Medicare in supporting 
improvements in care and innovative payment models.

    Question. What steps will you take to promote increased emphasis on 
these types of innovations in Medicaid targeting the unique needs of 
children?

    Answer. If confirmed, I will work with Congress and State and local 
partners to spur and encourage innovation in these important programs. 
Innovative delivery system and payment models are vital to ensuring 
that Medicaid and CHIP are equipped to address emerging pediatric 
health issues and can continue to provide children with access to 
quality health care.
                              supply chain
    Question. Regarding further distribution of personal protective 
equipment (PPE) and COVID-19 vaccines and ancillary products, how will 
government coordination with the private sector be managed? How will 
updates and information be communicated to the health-care supply chain 
in a timely manner?

    Answer. The global pandemic has highlighted the vulnerabilities of 
the health-care supply chain for many products. In order to continue 
responding to the COVID-19 pandemic and better prepare the Federal 
Government to respond to any future public health emergencies, it is 
critical that HHS work to improve and expand health-care supply chain 
capabilities. If confirmed, I'm committed to working in coordination 
with the private sector on this urgent matter.

    Question. How does the new administration plan to coordinate with 
and leverage the expertise of the commercial health-care supply chain 
to get product the last mile and get supplies into providers' hands 
across the care continuum?

    Answer. Coordination across departments, agencies, and industries 
is key to ensure the adequacy of the health care supply chain. If 
confirmed, I'm committed to working on this urgent matter.

    Question. Once the COVID-19 pandemic is under control, how do you 
anticipate partnering with the commercial supply chain to ensure that 
the country is ready for the next public health emergency? Have you 
considered solutions such as a ``vendor managed inventory'' solution to 
help guarantee that non-expired product could be available on demand?

    Answer. As the Nation begins to turn the corner on the COVID-19 
pandemic, it will continue to be important to think ahead to the next 
public health emergency. If confirmed, I will work with Assistant 
Secretary of Preparedness and Response (ASPR) to ensure these efforts 
can increase the Nation's ability to meet demand in future crises.

    Question. How does the Biden administration intend to use the DPA 
authority and will the administration do so with thoughtful 
consideration of those with expertise in the medical supply chain so 
the existing infrastructure and supply are augmented rather than 
duplicated?

    Answer. If confirmed, I commit to working closely with members of 
this committee on efforts related to the COVID-19 response, including 
the use of DPA and its potential impacts.
                            bundled payments
    Question. The health-care system needs to continue to innovate 
while maintaining high quality and improving patient outcomes. The CMS 
Innovation Center, or CMMI, has several innovative models underway, 
including the Bundled Payment for Care Improvement Advanced (BPCI-A), 
that uses bundled payments to improve care, foster provider 
collaboration and lower health-care costs. We have hospitals and 
physician groups participating in bundled payments, and many see them 
as a way to drive the health-care system towards better value and 
better patient outcomes. When utilized with patient outcomes (and 
protections) and measurable value in mind, CMMI can be used to test new 
models without disrupting the rest of the program while a model is 
being tested.

    What is your vision for CMMI, and how can leverage what we have 
learned to expand advanced payment models to meet Medicare 
transformation goals?

    Answer. Innovation is critically important to advancing goals in 
health care. The CMS Innovation Center is integral to the 
administration's efforts to accelerate promote value-based care and 
encourage health care provider innovation. If confirmed as Secretary, I 
can commit to you that we will follow the evidence generated by 
Innovation Center model tests when considering whether to expand a 
model.

    The Medicare Advantage program is currently covering about 24 
million seniors, including almost 2 million in Texas. A recent report 
shows that MA has a higher percentage of racial minorities than fee-
for-service (32 percent in MA compared to 21 percent in FFS) and MA 
beneficiaries tend to be older (almost 52 percent are between 70-84 
years of age). We also know that seniors would prefer to remain in 
their home and their community, and that some seniors have trouble 
accessing care.

    Question. How can we leverage existing tools in the Medicare 
Advantage program, particularly in home-based care, to ensure that 
seniors get the care they need?

    Answer. Medicare Advantage plays an important role in giving people 
access to care. I believe we have to take every approach we can in 
order to get people the health care they need at an affordable price. 
If confirmed as Secretary of HHS, I look forward to working with you 
and other members of Congress to achieve this important goal.

                                 ______
                                 
                Questions Submitted by Hon. Richard Burr
                                covid-19
    Question. In order to mitigate the financial challenges hospitals 
faces as a result of the COVID-19 pandemic, certain third-party 
companies are able to offer hospitals cash advances for the Medicare 
segment of their business as is currently offered by these third-party 
companies for the hospital's commercial segment. These cash advances on 
Medicare claims may be utilized by hospitals accepting Medicare 
patients to offset their loss of revenue from elective procedures that 
are not being performed as a result of the COVID-19 pandemic. However, 
many hospitals believe that accepting a cash advance from a third-party 
to cover such losses is non-allowable under Medicare regulations.

    Will you work with hospitals and third-party companies to provide 
clarity on all options available and allowed under the Medicare program 
for hospitals suffering from cash flow issues due to the COVID-19 
pandemic?

    Answer. During the pandemic, while some providers have experienced 
challenges with overcapacity, many other providers have faced financial 
setbacks related to billing disruption, the suspension of non-essential 
surgeries and procedures, and health care staff unable to work. As you 
know, Congress has provided financial relief to providers and suppliers 
through the Provider Relief Fund, Paycheck Protection Program, and the 
CMS Accelerated and Advance Payments Program, among other relief 
efforts. If confirmed, I will review Federal requirements to determine 
if there are barriers to providers obtaining financial assistance.

    Question. Operation Warp Speed was created in March 2020 to 
accelerate the development of countermeasures for COVID. This public-
private partnership with HHS and the Department of Defense is a 
historic example of American innovation. As of the end of January, five 
of the six Operation Warp Speed vaccine candidates have entered phase 3 
clinical trials--two of which, Moderna and Pfizer, have received 
emergency use authorization (EUA) from the FDA as of February 25, 2021.

    Should you be confirmed, what will your role be in this extremely 
successful public-private partnership?

    What do you plan to change about the program?

    Answer. I agree with the success of the operation in its ability to 
accelerate the development and manufacturing of COVID-19 vaccine 
candidates. If confirmed, I would work with all key partners to 
understand how to best support the ongoing development and distribution 
of medical countermeasures for COVID-19.
                          fda-cms coordination
    Question. We are in an exciting era of biomedical research and 
development, from which all generations of Americans stand to benefit. 
The development of new medical products is only half of the story, 
innovators must meet the FDA's gold standard of approval, then jump the 
hurdles of CMS's coverage and pricing decisions. This process can add 
time between when a medical product is approved by FDA and when a 
patient can use it. What opportunities do you see for FDA and CMS to 
work in parallel in order to be prepared for the next decade of novel 
medical products and reduce the time patients wait for CMS to make a 
decision on an FDA approved product?

    Answer. I agree with the goal of expediting patient access to new 
medical products. I understand FDA and CMS have taken certain steps 
towards parallel review, and I will support appropriate measures to 
enable payors to make informed decisions earlier in the process.
                            clinical trials
    Question. Last year, I worked with Senator Cardin on legislation to 
improve access to clinical trials for Medicaid beneficiaries. This 
bill, the Clinical Treatment Act, was signed in to law late last year. 
Medicaid beneficiaries have historically been less likely to 
participate in clinical trials because they had to pay for the 
associated medical care as a part of the trial. When this law is 
implemented, routine care costs for individuals participating in 
clinical trials will be covered, providing them access to treatments 
that can save and improve their lives. Additionally, by having more 
Medicaid beneficiaries participate in clinical trials, we will broaden 
the base of clinical trial participants so we can bring cutting-edge 
treatments to more Americans.

    If confirmed, it will be your responsibility to implement this new 
law. What steps will you take to ensure that Medicaid patients can 
quickly benefit from this new policy?

    Answer. If confirmed, I will work to implement your newly enacted 
legislation to broaden access to potentially lifesaving clinical trials 
for Medicaid beneficiaries. I look forward to working with you and 
States to implement the law and to ensuring that Medicaid beneficiaries 
who wish to participate in clinical trials have adequate access to the 
health care they need.
                                medicaid
    Question. You may be aware that Georgia recently gained approval of 
a unique Medicaid waiver that establishes a pathway for currently 
ineligible individuals to gain coverage by meeting Qualifying Hours and 
Activities. No currently enrolled Medicaid beneficiaries would be 
impacted by the program. Do you believe the State's ``Georgia 
Pathways'' waiver fulfills the purpose of Medicaid by providing 
coverage to currently uninsured individuals, and will you commit to 
keep an open mind about this waiver and other State-led initiatives to 
innovate within their Medicaid programs that fits their individual 
State needs?

    Question. Section 1115 demonstrations can be invaluable in allowing 
States to pursue innovative ideas through Medicaid. If confirmed, I 
will work to ensure that States' Medicaid section 1115 demonstrations 
promote the objectives of the Medicaid program and that these 
demonstrations are approved in accordance with and comply with the 
Medicaid statute.
                              transparency
    Question. Empowering consumers with health-care price information 
so they can make informed health-care decisions has long been a 
bipartisan priority. If confirmed as Secretary, are you committed to 
ensuring full implementation of the Department's Transparency in 
Coverage final rule?

    Answer. If I am fortunate enough to be confirmed, I will ensure 
that the Department continues to take steps to improve price 
transparency, so consumers can look behind the curtain to understand 
how providers and insurers are operating.
                              foster care
    Question. The Family First Prevention Services Act created a new 
Federal category for settings that deliver trauma-informed treatment 
for foster children with serious emotional or behavioral issues in a 
residential setting, known as Qualified Residential Treatment Programs 
(QRTPs). QRTPs are one of the few residential settings that are 
eligible for title IV-E reimbursement. Recently, however, the Centers 
for Medicare and Medicaid Services (CMS) indicated QRTPs with more than 
16 beds may meet the definition of an Institutions for Mental Diseases 
(IMDs), preventing Medicaid reimbursement for care in these 
circumstances. This interpretation is not consistent with congressional 
intent.

    Do you believe that QRTPs should be exempted from the IMD payment 
exclusion, allowing children in foster care to have Medicaid coverage 
in these placements?

    Answer. This is an important and complex question that I am 
committed to addressing quickly if I am confirmed by the U.S. Senate. I 
am similarly concerned that children in foster care receive necessary 
medical care without disruption. As such, I will work closely with the 
Centers for Medicare and Medicaid Services to resolve this issue, and 
will consider all available administrative and legislative vehicles to 
ensure that children in foster care receive the medical care that they 
need and to which they are entitled.

             Questions Submitted by Hon. Patrick J. Toomey
    Question. I find it deeply concerning that you supported the 
government's use of march-in rights in the case of remdesivir. Dr. 
Francis Collins has publicly testified that the National Institutes of 
Health (NIH) does not have the authority to use march-in rights to 
lower the cost of a drug. Further, I have strong concerns with the 
disincentives created for innovators once government has set the 
precedent that it will ``march in'' and steal their intellectual 
property on a whim. As follow up to my questions during the hearing:

    Can you assure me that you will not use your authority as Secretary 
of HHS to abuse the Bayh-Dole statute by invoking this march-in 
authority--that has never been used by NIH--to punish companies when 
you don't like their prices?

    Do you acknowledge that the administration does not have the legal 
authority to use march-in rights to lower drug prices?

    Your letter to the Trump administration seems to conflict with the 
original intent of Bayh-Dole. Do you acknowledge that the intent of the 
Bayh-Dole Act is to incentivize public-private partnership and 
investment in innovative products?

    Answer. Like President Biden, I believe we must do all we can to 
lower the costs of prescription drugs and make them more accessible for 
Americans. If confirmed, I look forward to working with Congress to 
build upon the good work you did in the Finance Committee on this 
important issue. If confirmed, I look forward to working with Congress 
to find ways to achieve these important goals.

    Question. Separately, I have concerns regarding the legality and 
appropriateness of tying Medicare reimbursement for certain drugs to 
the prices foreign countries pay. The most obvious issue is the 
downstream effect it will have on patient access to lifesaving 
medicines.

    If confirmed, will you advocate for reviving the interim final rule 
establishing the Most Favored Nation Model or promulgate similar 
rulemaking that ties the price Medicare pays for certain drugs to 
prices paid in other countries?

    Answer. President Biden is committed to lowering the price of 
prescription drugs. Like President Biden, I believe prescription drugs 
must be affordable and accessible for all Americans. If confirmed, I 
will work to strengthen Medicare and Medicaid, reduce the cost of 
health care and prescription drugs, and ensure we are accountable in 
spending resources wisely and effectively. You have my commitment to 
work with you and other members of Congress on this issue.

    Question. The Biden administration is requesting $20 billion for 
vaccinations. Just 59 days ago, Congress provided $8.75 billion for 
vaccine-related expenses. $3 billion has been made available to States, 
but it has become incredibly difficult to know exactly how much money 
remains available and how much has been spent or obligated in granular 
detail.

    My staff has requested certain documents from the Department of 
Health and Human Services commonly referred to by the previous 
administration as ``weekly draw down reports.'' These reports provide 
some insight into the allocation of Federal funding and subsequent 
spending by the States. It is my understanding that these reports have 
been shared with other members of this chamber and are generally used 
for press inquiries.

    Prior to any vote on COVID-19 relief, it is important all members 
are given an opportunity to view these weekly draw-down reports. If 
confirmed, will you commit to providing this information to Congress on 
a weekly basis?

    Answer. If confirmed, I commit to providing transparent and timely 
review of information.

                                 ______
                                 
                 Questions Submitted by Hon. Tim Scott
               leveraging virtual health technology and 
                  telehealth to expand access to care
Enhancing Telehealth Access
    Question. Earlier this week, joined by Senator Schatz and a 
bipartisan group of my Senate colleagues, I introduced the Telehealth 
Modernization Act, legislation aimed at increasing access to high-
quality health-care services, particularly for our Nation's seniors, by 
codifying crucial flexibilities for telehealth coverage.

    Long before the pandemic began, South Carolina had emerged as a 
leader in telehealth innovation, hosting one of just two federally 
recognized Telehealth Centers of Excellence in the Nation. High-quality 
telehealth services and networks spearheaded by cutting-edge providers 
like the Medical University of South Carolina have transformed the 
Palmetto State's health-care landscape. Unfortunately, however, for the 
majority of the State's roughly 1 million Medicare beneficiaries, 
outdated coverage restrictions have long inhibited access to telehealth 
services.

    For years, rigid rules around patient location (geographic and site 
of service), eligible services and provider sites, and other components 
of care have created substantial barriers to telehealth utilization. In 
February 2020, for instance, just prior to the COVID-19 public health 
emergency (PHE), only 0.1 percent of Medicare fee-for-service (FFS) 
primary care visits were delivered via telehealth. In any given week 
before the PHE, an average of just 14,000 Medicare beneficiaries 
received a telehealth service.

    Congress took decisive steps towards expanding telehealth access 
through the CHRONIC CARE Act, particularly for the roughly 36 percent 
of Medicare beneficiaries nationwide who have chosen to enroll in 
Medicare Advantage (MA) plans, more than three-quarters of which 
provided extra telehealth benefits, even before the pandemic struck. 
For South Carolina, however, MA penetration remained below 30 percent 
last year. For the 72 percent of SC's Medicare beneficiaries enrolled 
in FFS coverage, substantial restrictions have remained.

    While these Medicare access gaps predated the pandemic, the spread 
of COVID-19 highlighted the urgency of updating telehealth coverage 
rules, prompting Congress to provide authority for pivotal emergency 
waivers designed to ensure safe access to care for seniors and other 
vulnerable populations. As the pandemic raged, Medicare beneficiaries 
turned to telehealth services to minimize viral exposure risk and 
receive medically necessary care in safe and accessible settings. In 
April 2020, more than two-fifths (43.5 percent) of Medicare FFS primary 
care visits were provided through telehealth, and from mid-March 
through early July of that year, more than 10.1 million beneficiaries 
accessed telehealth services.

    Without congressional action, however, these emergency 
flexibilities will expire at the end of the PHE, creating an access 
cliff for tens of millions of Medicare beneficiaries, including many 
who have come to rely on telehealth for critically needed care.

    If confirmed, can you commit to making the expansion of telehealth 
access, particularly for seniors and vulnerable populations, a priority 
for the Department of Health and Human Services?

    The Telehealth Modernization Act would eliminate a number of 
outdated restrictions on Medicare coverage for telehealth services, 
including by removing geographic and originating site restrictions and 
ensuring that federally qualified health centers and rural health 
clinics can continue to serve as distant sites, even after the pandemic 
subsides. Would you support these types of policy proposals as a means 
of expanding access to care?

    Can you commit, if confirmed, to working with my office, Senator 
Schatz's office, and the offices of other telehealth champions to 
ensure that the tens of millions of Medicare beneficiaries enrolled in 
FFS do not face a telehealth service coverage cliff when the public 
health emergency expires?

    In the absence of the emergency waivers, what would you cite as 
some of the most significant barriers to telehealth access, 
particularly for seniors and those with serious health conditions, and 
what steps would you take as HHS Secretary, if confirmed, to address 
some of these barriers?

    What role or roles do you see telehealth and other virtual health 
technologies in playing within the administration's broader goal of 
combating health disparities?

    I see our digital infrastructure as a powerful tool in addressing 
health disparities. If confirmed, how would you work with other Federal 
agencies and officials to bolster broadband access and bridge the 
digital divide?

    Answer. Telehealth is incredibly important tool to improve health 
equity and improve access to health care. Health care should be 
accessible, no matter where you live. If confirmed, I will look at the 
telehealth flexibilities developed for the current public health 
emergency and determine how we can build on this work to improve health 
equity and improve access to health care. As you mentioned, access to 
broadband is critical to the expansion of access to telehealth 
services, and I look forward to working with you and other departments 
across the administration, if confirmed, on this important issue.
Improving the Medicare Diabetes Prevention Program (MDPP) Expanded 
        Model
    Question. The Medicare Diabetes Prevention Program (MDPP) Expanded 
Model (EM) leverages proven interventions to prevent the onset of type 
2 diabetes in Medicare beneficiaries with prediabetes. In 2016, the 
Chief Actuary of CMS certified that ``beneficiaries participating in 
diabetes prevention programs have achieved success with losing weight 
and reducing the incidence of diabetes'' and that the expansion was 
``expected to reduce Medicare expenditures.'' According to CMS, the 
program at the core of the expanded model ``has been shown to reduce 
the incidence of diabetes by 71 percent in persons age 60 years or 
older.''

    Unfortunately, the exclusion of innovative virtual suppliers from 
the MDPP EM has impeded the program's reach and created substantial 
access gaps, particularly for older Americans living in rural and 
underserved urban communities. Politico reported that only 202 
beneficiaries had used the program in 2018, and an American Journal of 
Managed Care study published in June 2020 concluded that ``inadequate 
MDPP access'' stemmed in part from ``severe shortages'' of suppliers, 
particularly in States with large populations of Medicare beneficiaries 
of color. The COVID-19 pandemic has highlighted and exacerbated these 
access barriers, but regulatory flexibilities remain limited.

    In order to address these access gaps, last Congress, I partnered 
with Senator Warner in leading a number of letters to HHS and CMS 
leaders, urging them to take administrative action to enable the 
participation of CDC-recognized virtual suppliers in the MDPP EM. We 
also introduced the bipartisan, bicameral PREVENT DIABETES Act, which 
would accomplish the same goal legislatively. Unfortunately, virtual 
suppliers remain excluded from the program, and even the flexibilities 
provided for the pandemic emergency period have proven unable to 
improve access for beneficiaries in need.

    The Biden administration has cited combating health disparities as 
a key policy priority. According to the CDC, 13 percent of American 
adults have diabetes, including 26.8 percent of those aged 65 or older. 
Diabetes prevalence varies substantially by race/ethnicity, affecting 
16.4 percent of Black adults, 14.9 percent of Asian adults, and 14.7 
percent of Hispanic adults, versus 11.9 percent of White adults. 
Inclusion of virtual suppliers in MDPP could help to address these 
disparities and improve outcomes for older Americans across the board.

    In your testimony, you also pointed to reducing health-care costs 
as one of your primary aims in taking on this role, should you be 
confirmed. A 2018 study that focused specifically on the provision of 
DPP services through virtual providers found statistically significant 
evidence of reduced costs and utilization pattern changes for a 
Medicare population.

    If confirmed, can you commit to working, in consultation with my 
office, Senator Warner's office, and other relevant Federal officials, 
to enhance access to the Medicare Diabetes Prevention Program?

    Can you commit to reviewing the robust evidence base and giving due 
consideration to the bipartisan and bicameral requests that I have led, 
in partnership with Senator Warner and others, to secure the inclusion 
of CDC-recognized virtual suppliers in the MDPP EM?

    Beyond the MDPP EM, what do you see CMMI's role to be in terms of 
facilitating the demonstration and evaluation of virtual care solutions 
and digital health tools?

    More broadly, can you speak to the administration's efforts to 
enable Medicare beneficiaries to leverage digital health tools for the 
prevention and treatment of disease? Are their limitations in your 
ability to expand access to these valuable resources for those that 
want to use them within Medicare?

    Answer. Innovation is important to advancing goals in health care, 
and the CMS Innovation Center is integral to the administration's 
efforts to promote high-value care and encourage health-care provider 
innovation, including virtual and digital health innovation. With 
respect to the Medicare Diabetes Prevention Program (MDPP) expanded 
model, I understand that CMS issued regulatory flexibilities in 
response to the COVID-19 pandemic, including waiving the limit on 
virtual sessions that can be provided by MDPP suppliers. If confirmed 
as Secretary, I commit to working with you on this and other models to 
reduce health disparities and prevent chronic diseases such as 
diabetes.
                     enhancing access to innovation
    Question. As co-chair of the bipartisan, bicameral Personalized 
Medicine Caucus, I have long championed the potential for cutting-edge 
innovations like gene and cell therapies to transform the treatment 
landscape. In recent years, the pace of development on these fronts has 
accelerated, with a report from last Spring suggesting that more than 
360 gene and cell therapies were in the United States' clinical 
pipeline, versus fewer than 300 just 2 years earlier. More than one-
third of these therapies aim to treat rare diseases, providing cause 
for optimism to patients across the country, as 95 percent of the 7,000 
known rare diseases currently lack an FDA-
approved treatment option. Individuals with sickle cell disease, for 
instance, which affects an estimated 100,000 Americans, could feasibly 
see a cure on the horizon.

    According to a 2019 statement by key FDA leaders, the agency 
anticipated, at that point, approving 10 to 20 new gene and cell 
therapies every year by 2025, in addition to receiving a projected 200 
investigational new drug applications for gene and cell therapy 
candidates annually, beginning in 2020.

    That said, even in the face of these potentially lifesaving 
developments, hurdles remain, even for gene and cell therapies that 
successfully gain FDA approval. A number of laws and regulations around 
Medicaid ``best price,'' the Anti-Kickback Statute (AKS), and the Stark 
Law, among other relevant statutes, understandably failed to 
contemplate this new generation of gene and cell therapies, which have 
only recently begun to come to market.

    A disproportionate share of the patients affected by the diseases 
most likely to be treated by the early waves of gene and cell therapies 
receive health care coverage through Medicare or Medicaid. With that in 
mind, would you agree that HHS should do all that it can to ensure 
access to FDA-approved cell and gene therapies when a doctor and a 
patient agree that it is the most appropriate treatment option?

    The current Medicaid reimbursement structure was not designed with 
curative therapy payments in mind. For the roughly 100,000 Americans 
affected by SCD and other painful and debilitating conditions, these 
outdated rules risk delaying patient access and hinder Medicaid's 
ability to pay for innovative therapies based on their value. How will 
HHS overcome barriers in the current Medicaid reimbursement structure 
for cell and gene therapies, giving patients access to cures and not 
just treatments?

    In December, HHS finalized the ``Establishing Minimum Standards in 
Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based 
Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug 
Rebate and Third Party Liability (TPL) Requirements (CMS 2482-F)'' 
rule, which took important steps towards ensuring that State Medicaid 
programs have the flexibility they need to hold manufacturers 
accountable for the performance of their therapies. Will HHS commit to 
implementing this rule and ensuring that patients have timely access to 
lifesaving cell and gene therapies?

    If and when HHS implements this rule, barriers to value-based 
arrangements will remain, both within the Federal health-care programs 
and in the private sector. Can you commit, if confirmed, to work with 
my office to develop the additional legislative and regulatory 
solutions needed to facilitate meaningful value-based arrangements for 
drugs, biologics, devices, and other innovative medical products?

    Answer. I believe that people should have timely access to 
lifesaving innovative therapies, including prescription drugs, 
biologics, devices, and other medical products. We need to foster 
innovation in medical technology to develop new lifesaving therapies. 
If confirmed, I look forward to working with you and other members to 
find solutions to address the high cost of new therapies.

    Question. The prior administration issued new AKS safe harbors to 
protect value-based arrangements among health-care providers and other 
industry stakeholders, but value-based arrangements for drugs and 
biologics received no such protections, inhibiting the development of 
these types of agreements and jeopardizing patient access to 
innovation. Will you commit to developing a safe harbor that would help 
promote greater innovation in the pricing of drugs and biologics?

    Answer. I look forward to working with the Office of Inspector 
General and the Department of Justice to explore whether a safe harbor 
would help promote access to beneficial innovation while also 
protecting against fraud and abuse.

    Question. Over the past decade, Congress and the FDA have worked 
together to develop a useful set of tools to ``fast track'' new drug 
and biologic discoveries through the FDA review process. These tools, 
known as ``fast track,'' ``breakthrough,'' and ``regenerative medical 
advanced therapy designation,'' have the potential to bring new 
treatments to patients faster, helping to confront some of the most 
serious medical challenges. For example, one rapidly emerging area of 
innovative discovery known as allogeneic ``T-cell immunotherapy'' for 
the treatment of cancerous tumors, blood cancers and autoimmune 
diseases, has benefited from these avenues through the FDA review 
process.

    However, even after the FDA uses these tools to find said 
treatments clinically safe and effective, applicants must navigate a 
second component of the FDA review process, known as the ``Chemistry, 
Manufacturing and Controls'' or ``CMC'' process. This part of the 
process includes an on-site FDA inspection of manufacturing facilities, 
which must be completed before a new treatment can come to market.

    Unfortunately, even before the pandemic, this stage in the review 
process had become considerably delayed, with immunotherapy products 
that have shown strong safety and efficacy in clinical studies being 
held up because of a lack of clarity and consistency from the agency on 
CMC requirements. I appreciate the challenges created by the pandemic, 
but these CMC delays existed before the pandemic, and without action, 
they will persist even after the pandemic subsides, imperiling patient 
access to lifesaving innovations.

    Can you commit to resolving this issue when you arrive at the 
Department and to expediting the FDA's CMC review process, as well as 
the requisite inspections, for these urgently needed fast-tracked 
therapies?

    Answer. I commit to do everything I can to ensure that safe and 
effective therapies get to market as efficiently as possible. While FDA 
paused all on-site surveillance domestic inspections in March 2020 due 
to the COVID-19 pandemic, FDA investigators continued mission critical 
inspections and other activities to ensure FDA-regulated industries are 
meeting applicable FDA requirements. FDA also later began resuming 
surveillance inspections in July 2020. To date, FDA has not experienced 
a significant impact on its ability to take actions on drug and 
biologic applications.

    FDA has also been employing other tools to evaluate facilities, as 
appropriate, such as requesting records and other information or 
reviewing trusted foreign regulator inspection records under existing 
Mutual Recognition Agreements. These tools have been, in many cases, 
successful to allow the agency to take actions on applications in lieu 
of an inspection.

    I will work with FDA to ensure the agency uses every appropriate 
tool to get critical safe and effective therapies to market as 
efficiently as possible.
                                vaccines
Seniors' Access to Preventive Care
    Question. While Medicare Part B covers a number of vaccines, 
including for influenza, pneumococcal, and hepatitis B, with no 
beneficiary cost-sharing, the majority of vaccines recommended for 
adults, including for older adults, are covered under Part D, where 
seniors can face substantial copays. While cost-sharing can serve as a 
useful and appropriate tool in other contexts, those rationales do not 
apply in the case of ACIP-recommended vaccinations, and studies have 
shown a direct correlation between cost-sharing and increased 
abandonment rates for vaccines.

    As a number of my colleagues and I noted in a letter we sent to CMS 
on this subject last summer, ``A 2017 report by Avalere Health found 
between 47 and 72 percent of the 24 million Medicare beneficiaries with 
Part D coverage had some level of cost sharing for vaccines, ranging 
from $35 to $70 in 2015. Another study found that only 4 percent or 
less of Medicare Part D enrollees had access to vaccines with no cost 
sharing.''

    How can the Biden administration address the issue of ensuring 
medically necessary preventive care for all populations?

    Answer. Ensuring access to health care, including preventive care, 
for all populations is a top priority of the Biden administration. If 
confirmed, I look forward to working with Congress to find ways to 
ensure preventive care, including recommended vaccination, is 
accessible for all populations, including Medicare beneficiaries.
                          health-care coverage
    Question. Many of my constituents have expressed concerns about 
your longstanding support for a single-payer health-care system, which 
many of them see as an existential threat. In addition to eliminating 
employer-sponsored health plans and replacing them with one-size-fits-
all public coverage, legislation that you supported while in Congress 
would exact unprecedented payment cuts on health care providers, likely 
triggering hospital and practice closures, early physician retirements, 
and a decline in care quality and innovation.

    Even before the pandemic began, Medicare paid just half of what 
private insurance reimbursed for the same hospital care. If SC's 
providers were to lose all commercially insured patients, confronted 
with a Medicare-only payer mix, many would be forced to close, 
particularly in rural areas, where close to one-third of the State's 
residents live.

    These concerns are not merely hypothetical, as a survey of 
countries with single-payer systems shows. During the 2018-2019 flu 
season, for instance, one in every four patients in Britain had to wait 
more than four hours in the ER to get the care they needed. Even left-
leaning sources in Britain acknowledge that rationing care had risen 
dramatically in the years leading up to the pandemic. This meant 
massive delays for cataract surgery, hip and knee replacements, 
arthritis treatments, and other high-demand procedures. Furthermore, in 
terms of medications, of the new cancer drugs launched between 2011 and 
2018, 95 percent were available in the U.S., versus fewer than three-
quarters in the U.K.

    If confirmed, this role will provide you with a powerful podium to 
advocate for your policy preferences, and many of my constituents are 
worried that your support for government-run health care will inform 
the decisions you make, whether in terms of provider cuts, efforts to 
downsize Medicare Advantage, or any number of other proposals that 
could jeopardize access to care. What would you say to address these 
concerns, given your 3 decades of public support for government-run 
health care?

    If confirmed, can you commit to working to bolster and enhance the 
employer-sponsored health care system that provides coverage to roughly 
50 percent of all Americans?

    Answer. President Biden has made it very clear that his goals for 
improving the American health-care system begin with building on the 
successes of the Affordable Care Act. If I am confirmed, I will work to 
implement his agenda, build on the Affordable Care Act, and expand 
coverage and reduce costs for all Americans.

    Question. Looking at the current coverage landscape, what are some 
of the innovations in commercial health-care coverage and benefit 
design that you see as most compelling, promising, or worthy of 
replication? If confirmed, what would you do to promote, further 
publicize, or otherwise advance these innovative models?

    Do you believe that employer wellness plans can or should play a 
role in driving positive health outcomes for Americans and lowering 
long-term health-care costs?

    Answer. I believe that there can be many innovative strategies 
which can help improve health outcomes for Americans and lower long-
term health-care costs. If confirmed as Secretary of HHS, I look 
forward to reviewing the information we have available to determine 
what approaches are working well and where there might be opportunity 
for further innovation.
Medicare Advantage
    Question. A growing share of Medicare beneficiaries, rising from 
just one-quarter in 2010 to 36 percent in 2020, have chosen to enroll 
in Medicare Advantage (MA), which is managed by private insurers and 
has a 94 percent satisfaction rate. MA has enjoyed increasingly strong 
bipartisan backing, with 64 Senators and 339 members of the House 
signing on to a letter of support for the program last year.

    MA plans cover an increasingly broad array of extra benefits, 
relative to the fee-for-service model. Of all MA plans, 88 percent 
cover hearing aids and 91 percent cover glasses and eye exams, while 92 
percent include dental benefits and 96 percent have a fitness benefit.

    Given the overwhelming bipartisan support and the additional 
benefits, as well as the growing competition in the MA market, what 
steps would you look to take, if confirmed, to continue increasing 
access to and education on MA options for seniors?

    Answer. Medicare Advantage serves millions of Americans and is one 
important option for seniors. I believe that we have to take every 
approach we can in order to provide people access to quality health 
care. If confirmed as HHS Secretary, I look forward to working with 
Congress on this important issue.
              religious liberty and conscience protections
    Question. Since long before I came to Congress, I have prioritized 
protections for religious liberty and freedom of conscience, one of our 
core constitutional rights. I have also been a committed defender of 
all human life, including the lives of the unborn. Your stated 
positions on a number of issues, included late-term abortion, life, 
conscience protections, and overreaching government policies that 
infringe on religious freedoms have raised significant concerns among 
many South Carolinians.

    Prior to taking any actions with implications for people of faith, 
can you commit to consulting and engaging with religious liberty 
advocates, including those who disagree with your previously stated 
positions on the issues above?

    Answer. As a person of faith, I certainly understand the importance 
of people's faith in their own lives, and I would always seek a range 
of views when making any decisions, if I am fortunate to be confirmed.

    Question. If confirmed, can you commit, through all of your actions 
as HHS Secretary, to uphold religious liberty and freedom of conscience 
for all Americans, including those with deeply held religious 
convictions and beliefs?

    Answer. As a person of faith, I believe deeply in religious 
freedom. I was raised in a Catholic home, and we would get up early on 
Sunday mornings to go to mass. My faith is a big part of who I am 
today, and I'm grateful that we live in a country that recognized the 
right of all Americans to exercise their religion. It's part of what 
makes the United States so special. I am also proud that, in this 
nomination, I have the support of the Catholic Health Association and 
other faith-based groups. If confirmed as HHS Secretary, in executing 
the President's agenda, I would certainly follow the law and 
Constitution in our efforts to protect people's health.
                    access to home infusion therapy
    Question. As the CDC and researchers across the world have noted, 
COVID-19 presents the most severe health risks to older individuals, as 
well as to those with underlying conditions, making the Medicare-
covered population especially vulnerable to this disease. 
Unfortunately, Medicare beneficiaries in need of medical care or 
treatment for issues unrelated to the pandemic too often face a 
grueling decision, whereby they must choose between forgoing the 
services and medications they need by staying at home or, 
alternatively, seeking care in a hospital setting or physician's 
office.

    However, many of these patients could viably receive their infused 
or injectable medications at home, relieving them of the risks 
associated with traveling to an institutional setting to receive their 
treatments.

    Considering these ongoing challenges, can you commit to 
prioritizing policies that increase access to home infusion therapy for 
patients who want to receive their treatments at home?

    Answer. I agree that we must ensure Medicare beneficiaries have 
access to quality health-care services, including access to these 
services in the home. During the public health emergency, CMS has taken 
actions to expand flexibilities under Medicare so that health-care 
services can be furnished to Medicare beneficiaries in the safety of 
their homes. If confirmed, I commit to working with you on making sure 
Medicare beneficiaries have access to the services and medications they 
need.

                                 ______
                                 
                Questions Submitted by Hon. Bill Cassidy
    Question. The CARES Act provides FDA with authority to expedite the 
facility inspections. Do you think that FDA should exercise this 
authority to address or prevent drug shortages, particularly as ramping 
up vaccine manufacturing capacity may mean redirecting activities and 
resources from manufacture of other drug products?

    Answer. While the COVID-19 pandemic strained FDA's ability to 
perform traditional foreign inspections, as I understand it, the agency 
has worked to improve inspection capabilities within the current public 
health environment. I agree that we must apply the lessons learned 
during this public health emergency to our work going forward.

    Question. How do you think that FDA can best regulate tobacco 
products?

    Answer. Tobacco use is the single largest preventable cause of 
disease and death in the United States. Each year, more than 480,000 
people in the United States die prematurely from diseases caused by 
cigarette smoking and exposure to secondhand tobacco smoke. As you 
know, FDA has comprehensive tools to protect the public from the 
harmful effects of tobacco use through science-based tobacco product 
regulation. If confirmed, I will ensure FDA effectively uses this 
authority in the interest of the public's health.

    Question. Do you support a product standard that would limit the 
level of nicotine in cigarettes or other tobacco products?

    Answer. If confirmed, I will engage in this conversation with FDA 
and other experts across the Department and will examine potential 
actions in this area.

    Question. Based on your reading of the statute and applicable 
regulations, what is the scope of FDA's regulatory authority over 
tobacco products and do you believe it extends to synthetic nicotine 
products?

    Answer. This is a legal question that I have not personally 
examined but, if confirmed, this is a question that I intend to resolve 
through consultation with the attorneys and experts at HHS.

    Question. How do you think that implementation of the 
interoperability regulations fits into data exchange efforts 
surrounding COVID-19?

    Answer. Interoperability has proven to be an important innovation 
in health care that has gained bipartisan support. I believe we need 
increased access to data because good data leads to good policy. If 
confirmed, I look forward to partnering with States.

    Question. Medicare is often slow to cover new technologies, even 
when they represent significant clinical improvements over the existing 
standard of care. This is even when we have committed significant 
Federal resources to supporting a product through the research and 
development process as well as FDA review, like we did with the 
artificial pancreas. What do you think CMS can do to make sure that 
Medicare can cover these new technologies?

    Do you support the Trump administration's final rule creating a 
new, accelerated Medicare coverage pathway to ensure national coverage 
for breakthrough products?

    Answer. I agree that it is important to foster innovation in 
medical technology, which has the potential to improve health-care 
outcomes. If confirmed, I will work to ensure Medicare beneficiaries 
have access to medically necessary innovative technologies.

    Question. How do you think that HHS could discourage rebate traps 
or rebate walls?

    Answer. Like President Biden, I believe we must do all we can to 
lower the costs of prescription drugs and make them more accessible for 
Americans who depend on these medications. I am committed to reducing 
drug prices and ensuring Americans have access to the drugs that they 
need. If confirmed as Secretary of HHS, I look forward to working with 
you to find ways to achieve these important goals. I will also work 
across the government to address barriers to reducing drug prices.

    Question. Given current events and the importance of animal 
research to address medical emergencies such as COVID-19, as well as 
research for practically every other area of disease, can you tell us 
what steps HHS and NIH plan to take to ensure that air transport of and 
access to animal models in the U.S. is assured?

    Answer. Research conducted in and supported by the NIH is 
invaluable to advancing the biomedical sciences and human health. If 
confirmed, I look forward to working with NIH and others at HHS to 
further the essential work of the NIH.

                                 ______
                                 
               Questions Submitted by Hon. James Lankford
    Question. The HHS contraceptive mandate, promulgated under the 
Obama administration, purported to offer cost-free birth control to all 
women. However, because of massive exemptions given to grandfathered 
corporate entities and even to the government's own plans for Medicare 
and the U.S. military, one-third of all Americans were not even covered 
by the original mandate. Yet the Federal Government insisted that it 
could not find an alternate solution for the relatively small number of 
religious organizations with conscientious objections to paying for 
contraceptive coverage. One of these groups was the Little Sisters of 
the Poor, an order of Catholic nuns who care for the elderly poor who 
have nowhere else to go.

    The losing attempt to force nuns to pay for birth control has now 
been to the Supreme Court three times and has lost a resoundingly three 
times. At oral argument in April of 2016, the Obama administration 
admitted that it can find ways to accomplish a policy goal of fully 
covered contraception without conscripting nuns into the process.

    Continuing this unnecessary fight is not only an affront to the 
First Amendment, but also a waste of valuable government resources and 
time. But you are leading one of the ongoing lawsuits to continue 
forcing the Little Sisters of the Poor to choose between shutting down 
their ministry to the elderly poor or violating their religious 
beliefs.

    Will you commit that if confirmed, you will not re-impose the 
contraceptive mandate on religious ministries like the Little Sisters 
of the Poor?

    Answer. President Biden has committed to building on the Affordable 
Care Act to ensure that men and women have expanded access to health 
care. I strongly believe women should not be put through unnecessary 
hurdles to access to health care.

    Question. I am concerned about the increasing trend to medically 
transition children who have self-diagnosed gender dysphoria. This has 
led to children as young as nine being prescribed puberty blockers that 
have irreversible consequences such as permanent infertility. The vast 
majority of Americans do not believe that a 9-year-old child can 
consent to puberty blockers or that a 13-year-old girl can consent to a 
double mastectomy.

    If confirmed, under your leadership, what steps will the Department 
take to ensure that children are not subjected to experimental hormone 
therapy with life-
altering effects?

    Do you believe insurance must be required to pay for and doctors 
must be required to administer puberty-blocking drugs and sex-
reassignment surgeries to children as young as 13?

    Do you agree that doctors and hospitals should have the right to 
refuse to participate in gender transition therapies and treatments due 
to medical, religious or moral convictions?

    Answer. If I am fortunate to be confirmed, I will rely on doctors 
and scientists to offer clear, scientific, fact-based information on 
issues like this because I believe medical decisions should be left to 
individuals and their health providers. As HHS Secretary, I will follow 
the law when it comes to regulating insurance and respecting 
constitutional freedoms.

    Question. As you may know, an Obama administration regulation 
change that took effect on January 11, 2017 expanded the non-
discrimination clause of title IV-E of the Social Security Act in a way 
that resulted in faith-based child placing agencies being faced with 
the dilemma of abandoning their religious beliefs and convictions or 
losing funding and possibly their licenses to operate.

    HHS issued a notice of non-enforcement for the Obama-era rule. It 
subsequently announced and published its final rule (86 FR 2257) on 
nondiscrimination requirements in grants to allow faith-based child 
welfare organizations to operate in accordance with their faith.

    If confirmed, will you commit to allowing faith-based 
organizations, specifically child welfare providers, to serve and 
partner with the Federal Government in accordance with their sincerely 
held religious beliefs?

    Answer. I believe deeply in religious freedom. I am a person of 
deep faith myself. And faith-based organizations certainly have a role 
to play in our health-care and human services mission. If I am 
fortunate enough to be confirmed, I will work with our faith-based 
partners to deliver health care to Americans who need it and respect 
our Constitution.

    Question. You have been asked a number of times over the past few 
days about the impact that Pharmacy Benefit Managers (PBMs) have on the 
pharmaceutical industry and drug prices. As you may be aware, the Trump 
administration released a number of executive orders over the past few 
years intended to decrease drug prices. While many of those proposals 
have since been temporarily frozen, one proposal that we hoped would be 
seriously looked at was not able to cross the finish line. That is 
PBMs' use of Direct and Indirect Remunerated Fees, or DIR Fees.

    Many Oklahoma pharmacists have talked to my office to share their 
frustration with the current DIR fees, specifically under Medicare Part 
D. Under the current policy these fees may not be charged at the time a 
claim is processed. When the PBMs and plan sponsors collect these fees, 
pharmacists are given almost no insight about why they were imposed. 
Also, it is virtually impossible for the pharmacy owner to assess his 
or her actual reimbursement rate at the outset of the plan year, the 
time of dispensing medication, or at the end of the contractual term.

    This leaves pharmacies, particularly small and rural pharmacies, 
with little to no financial security based on the unknown level of fees 
they may be charged for simply doing their job and providing 
prescriptions to their customers, and has many times caused local 
pharmacies' doors to close. If we do not take a closer look at this, we 
may be nearing the end of many small, local pharmacies and the 
necessary services they provide their communities.

    Will you commit to documenting the impact of DIR fees on pharmacies 
and to working with Congress toward viable solutions?'

    Answer. Small and rural pharmacies are critical to our Nation's 
health-care system. We must do all we can to ensure that Americans can 
access important health-care services, including from local pharmacies 
in their communities. If confirmed, I look forward to working with 
Congress to ensure that community pharmacists have predictability.

    Question. A little over a week ago, I sent a letter to the CDC 
asking that additional guidance be released for senior individuals who 
are isolated in long-term care facilities, but have received both doses 
of the COVID-19 vaccine. Many people who are elderly or may be more 
vulnerable to COVID have seen the vaccine as the light at the end of 
the tunnel. With little clarity on what can change after their full 
vaccine dosage, many seniors are more confused and hopeless than ever.

    Will you commit, if confirmed, to work with the CDC to ensure that 
such guidance is quickly released and that continued guidance be 
released as new updates occur?

    Answer. HHS and CDC stand committed to providing the best, most 
current data and scientific understanding available to protect the 
health, safety, and well-being of our communities. And, if confirmed, I 
will work to continue that effort and provide updated guidance as 
appropriate.

    Question. You have discussed transparency and accountability at 
great length when it comes to all areas of the current health-care 
system. What specific solutions are you looking at to provide 
transparency when it comes to health-care costs and prescription drug 
costs?

    Answer. The American people are entitled to know what they're 
buying. And, like President Biden, I believe prescription drugs must be 
affordable and accessible for all Americans. I am committed to reducing 
drug prices and ensuring Americans have access to the drugs that they 
need.

    Question. If confirmed, you will have authority over the largest 
Federal department by budget and some of our largest Federal 
expenditures like Medicare and Medicaid. As I am sure you are aware, in 
September 2020, CBO predicted that if no changes were made, the 
Medicare Hospital Insurance Trust Fund would be insolvent in 2024.

    How will you work to ensure the solvency of the Medicare trust 
funds without implementing additional financial stress on taxpayers?

    Answer. If confirmed, my team and I will be ready to sit down with 
you and other members of Congress to discuss both short- and long-term 
solutions to guarantee Medicare's future.

    Question. In 2019, the Senate Finance Committee considered a 
bipartisan amendment, of which I was a part, to reduce cost-sharing for 
seniors in Medicare Part D. Generic and biosimilar medicines can only 
provide significant savings for patients if they are covered on the 
appropriate Medicare Part D formulary tier.

    Will you work with us to ensure Part D covers newly available 
generic and biosimilar medicines and ensure proper formulary tier 
coverage?

    How will you work to encourage more use of generics and biosimilars 
in Part D?

    Answer. Competition in the market has helped control the growth in 
spending on prescription drugs. I believe that generic drugs and 
biosimilars have a role to play in containing the cost of innovative 
yet expensive therapies by creating competition. Like President Biden, 
I believe we must do all we can to lower the costs of prescription 
drugs and make them more accessible for Americans who depend on these 
medications for their health. If confirmed as Secretary of HHS, I look 
forward to working with Congress on these important issues.

    Question. During the pandemic telehealth has played a major role in 
providing access to care for both Medicaid beneficiaries, including 
children, and Medicare beneficiaries, including our Nation's most 
vulnerable elderly individuals. How will HHS support the continued use 
and enhancements needed under Medicaid and Medicare to ensure 
telehealth continues to enable access to care for people of all ages?

    Answer. Telehealth is an important tool to improve health equity 
and improve access to health care. Health care should be accessible, no 
matter where you live. If confirmed, I will look at the telehealth 
flexibilities developed for the current public health emergency and 
determine how we can build on this work to improve health equity and 
improve access to health care.

    Question. Diabetes is the seventh leading cause of death in 
America. More than 34.2 million Americans, equivalent to 10.5 percent 
of the population, have diabetes. Minorities are up to three times more 
likely to be diagnosed with the disease. About 1.25 million Americans 
suffer from type 1 diabetes alone. Insulin is the most common treatment 
option for those with type 1 diabetes. Over the past 10 years, the 
price of insulin has nearly quadrupled, even though the product has 
been on the market for almost 100 years, with no significant changes to 
warrant such a dramatic price increase. The skyrocketing price of 
insulin has put the lives and livelihoods of millions of Americans at 
risk due to many families having to make the tough choice of affording 
life-sparing medication or other necessities such as food or rent.

    Though insulin has largely remained the same, innovation in America 
is at work to create insulin products through many different means--
hoping to bring more competition to the insulin market, thus driving 
down prices.

    As of March 23, 2020, insulin is now considered a biologic product 
and is regulated under the Public Health Services Act. The Biologics 
Price Competition and Innovation Act (BPCIA) passed as part of the ACA, 
created an abbreviated Biologic License Application process for 
biosimilars. The biosimilar definition to receive access to this 
abbreviated pathway requires a product to (1) be highly similar, and 
(2) have no chemically important differences to the originator product. 
In the months and years to come, many are hopeful to see this 
transition bring about more treatment options for Diabetes patients.

    In the fiscal year 2021 appropriations bill, my office worked for 
report language that would require the FDA to prioritize the approval 
of biosimilar insulin applications, including chemically synthesized 
insulins, should such a product request approval and provide examples 
of how FDA has given express attention to biosimilar insulin 
applications and FDA's plans in place to ease the application process 
for such products.

    Will you ensure that all new insulin products have the ability to 
approach the FDA for an approval application in order to ensure robust 
competition for insulin products so the millions of Americans living 
with diabetes may have access to new and affordable insulin?

    Answer. As you note, millions of Americans are impacted by 
diabetes. If confirmed, I look forward to working with you and other 
congressional leaders to expanding access to and lowering the costs of 
insulin.

    Question. Given the severe dependence on foreign active 
pharmaceutical ingredients (API) production, what do you believe the 
Federal Government's role should be to support domestic API 
manufacturing and related pharmaceutical supply chains?

    Answer. The global pandemic has highlighted the vulnerabilities of 
the global supply chain for many products. In order to continue 
responding to the COVID-19 pandemic and better preparing the Federal 
Government to respond to any future public health emergencies, it is 
critical that HHS work to improve and expand domestic supply chain 
capabilities. If confirmed, I'm committed to working on this urgent 
matter.

                                 ______
                                 
                 Questions Submitted by Hon. Todd Young
                    united network for organ sharing
    Question. I have been championing oversight and reform of Organ 
Procurement Organizations (OPOs) for a few years now, including via an 
active, bipartisan investigation in this committee into OPOs and their 
oversight body, the United Network for Organ Sharing (UNOS), led by 
Chairman Wyden and former Chairman Grassley. Because UNOS has not been 
compliant with the investigation, however, the Senate Finance Committee 
was forced to issue UNOS a subpoena for the documents necessary for 
Congress to assess important issues related to system failures, patient 
safety lapses, and potential Medicare fraud. By virtue of the OPTN 
Final Rule, however, the HHS Secretary has broad authority to request 
any documents he or she deems necessary from OPOs or UNOS.

    As HHS Secretary, will you commit to using this authority in all 
ways appropriate to support the ongoing bipartisan Senate Finance 
Committee investigation?

    Answer. I am committed to making sure that patients who need organs 
receive the help they need with organ transplantation. To that end, we 
will work with the committee to support their oversight efforts related 
to organ procurement, where appropriate.
                         office of organ policy
    Question. On January 15, 2021, HHS notified Congress that the 
Division of Transplantation was moving from HRSA to the Office of the 
Assistant Secretary for Health, in line with calls from patient 
advocates to create a dedicated Office of Organ Policy.

    Can you commit to ensuring that oversight will be a key function of 
that new office?

    Would you be willing to work with us on oversight of OPOs and UNOS 
so we can hold these organizations accountable?

    Answer. I am committed to making sure that patients who need organs 
receive the help they need with organ transplantation. To that end, I 
will look into all options that move us closer to this goal.
           center for medicare and medicaid innovation (cmmi)
    Question. The Center for Medicare and Medicaid Innovation (CMMI) is 
charged with testing and evaluating voluntary health-care payment and 
service delivery models with the intent of increasing quality and 
efficiency while reducing program expenditures under Medicare, 
Medicaid, and the Children's Health Insurance Program. There is 
absolute value in innovating and experimenting with health care payment 
and service delivery systems. We won't know if we're truly making a 
difference unless we experiment and evaluate.

    What are your plans for CMMI?

    What issues and models do you hope to test in the innovation 
center?

    Do you plan on canceling any existing or announced models?

    Answer. Innovation is critically important to advancing the 
administration's goals in health care. The CMS Innovation Center is 
integral to the administration's efforts to accelerate the move from a 
health-care system that pays for volume to one that pays for value and 
encourages health-care provider innovation.
                              drug pricing
    Question. President Biden's health-care plan he campaigned on 
highlighted several policies to address drug pricing including allowing 
Medicare to negotiate drug prices, limiting launch prices for drugs, 
and limiting drug price increases beyond inflation.

    Which Biden policy for controlling drug pricing will be the top 
priority for implementing quickly if you become HHS Secretary?

    Do you plan on implementing all of these policies? When?

    We've heard a lot about the Most Favored Nation model--do you plan 
on going forward with this model? Or do you plan on rescinding it?

    We've also heard a lot about the Rebate Rule which has recently 
been delayed for a year--do you plan on going forward with this model? 
Or do you plan on rescinding it?

    Answer. Like President Biden, I believe we must do all we can to 
lower the costs of prescription drugs and make them more accessible for 
Americans. If confirmed, I look forward to working with Congress to 
build upon the good work you did in the Finance Committee on this 
important issue.

    Question. There have been proposals in Congress to repeal or 
significantly modify the Average Manufacturer Price (AMP) cap in the 
Medicaid Program, including a provision in the House Democrats' COVID 
relief package to repeal the AMP cap.

    What do you think the impact will be on the commercial market and 
patients if the cap is removed?

    Answer. I believe that people should have timely access to 
prescription drugs, biologics, devices, and other medical products. If 
confirmed, I look forward to working with you and other members in a 
bipartisan fashion.
                     social determinants of health
    Question. Social determinants of health (SDOH) are the economic and 
social conditions that affect an individual's health and well-being, 
such as access to reliable transportation and stable housing. 
Addressing these factors can have a meaningful impact on the prevention 
and management of chronic diseases in our communities.

    Do you have plans to address social determinants of health?

    Are you considering establishing some sort of commission or 
interagency council to address potential SDOH barriers?

    Answer. The COVID-19 pandemic has laid bare inequities within our 
society and how social and economic conditions impact an individual's 
health and well-being. If confirmed, I intend to take a department-wide 
approach to the advancement of equity, consistent with President 
Biden's charge to Federal departments and agencies, and this would 
include examination of ways to address the social determinants of 
health.
                          future of telehealth
    Question. According to the Centers for Medicare and Medicaid, 
weekly telehealth visits increased from 12,000 a week before the 
coronavirus spread in March to more than 1 million a week across the 
country. Currently, authorizations included in the CARES Act create 
additional flexibilities which allow the use of telehealth services, 
including remote patient monitoring (RPM) technologies; however, these 
flexibilities are only extended until the end of the public health 
emergency.

    Does this administration have any plans to advance policies 
specifically related to the permanency of telehealth waivers that were 
implemented during the pandemic?

    Will HHS continue to support telehealth applications like RPM 
beyond the public health emergency?

    Answer. Telehealth is an important tool to improve health equity 
and improve access to health care. Health care should be accessible, no 
matter where you live. If confirmed, I will look at the telehealth 
flexibilities developed for the current public health emergency and 
determine how we can build on this work to improve health equity and 
improve access to health care.
                           medicaid integrity
    Question. Medicaid is a very significant portion of the portfolio 
at HHS as more than 77 million people are currently enrolled in 
Medicaid and CHIP. In December 2018, the Office of Inspector General 
released a report showing that California ``made Medicaid payments of 
$959.3 million on behalf of 802,742 ineligible beneficiaries and $4.5 
billion on behalf of 3.1 million potentially ineligible 
beneficiaries.''

    As Attorney General of California at the time, were you aware of 
these major program integrity issues?

    Did your office take action to recoup any of these funds for 
taxpayers?

    How would you fix this systemic issue as head of HHS?

    Answer. The Medicaid program is a lifeline for American families 
all around the country. With this in mind, it is vitally important that 
the Department works together with States to protect the integrity of 
the Medicaid program. If confirmed, I look forward to working within 
the Department and with Congress and States to make sure we are doing 
all we can to protect the Medicaid program and the millions of people 
it serves.
                             welfare reform
    Question. A half-century ago, President John Kennedy memorably 
declared, ``A rising tide lifts all boats.'' Generations of public 
leaders have since invoked Kennedy's metaphor as shorthand for the 
notion that if enough economic growth can be achieved, every American 
will benefit. Even in the best of times, not all boats are rising--
because some boats inevitably need holes patched. Our system only works 
when everyone is able to seize the economic opportunities that are 
available. However, our complex and uncoordinated Federal welfare 
system, with its various benefit cliffs and phase-outs, discourage 
millions of low-income adults from seizing those economic opportunities 
to work and provide for their families. For some, our safety net has 
effectively become a poverty trap, keeping low-income individuals and 
families stuck in poverty for generations instead of acting as a 
springboard to prosperity.

    With so many of our health and human services programs housed at 
HHS, what are some ideas you have for welfare reform?

    Are you planning on making this issue a priority?

    Answer. HHS's Administration for Children and Families (ACF) 
administers the Temporary Assistance for Needy Families (TANF) block 
grant which, through States, provides cash assistance to low-income 
families as well as other services and supports. I welcome the 
opportunity to work with Congress to address improvements in the TANF 
program and the Federal welfare system.
                             mental health
    Question. Our Nation is facing an unprecedented mental health 
challenge in response to the coronavirus outbreak. For many people who 
live with mental illness and substance use disorders, the fear of the 
virus and increased economic hardship have created new mental health 
and addiction challenges for people across the country. A Kaiser Family 
Foundation poll found that 45 percent of adults say the outbreak has 
affected their mental health, while a separate study estimated that the 
pandemic could cause as many as 150,000 additional ``deaths of 
despair'' from suicide and overdose.

    If confirmed, how would you try to address this growing crisis?

    Answer. Unfortunately, the COVID-19 pandemic has dramatically 
impacted mental health and well-being for too many Americans. If 
confirmed, I am committed to working on this issue, including 
supporting programs and initiatives across the continuum of prevention, 
intervention, treatment, and recovery support services as well as 
strengthening enforcement of this country's mental health parity laws.

    Question. What kinds of resources and flexibilities would you 
consider providing to States in order to address this issue head-on?

    Answer. The COVID-19 pandemic has brought with it additional 
resources and flexibilities for telehealth services. Telehealth 
services are a key piece of the puzzle for increasing access to 
behavioral health services. If confirmed, I look forward to working to 
build on the lessons learned during the COVID-19 pandemic to support 
health-care access for more Americans.

    Question. What additional tools might you need from Congress in 
order to accomplish these goals?

    Answer. HHS has many tools to expand access to health-care 
services. If confirmed, I commit to thinking critically about this 
issue and supporting robust investments that will sustain and expand 
access to behavioral health services.
                    abortion/conscience protections
    Question. As a member of Congress, you voted against a ban on 
partial-birth abortions; penalties for sex-selective abortions; 
protecting minors from being driven across State lines to procure an 
abortion without parental consent; and making it a Federal offense of 
harming or killing a child in utero during a violent crime.

    Can you explain why you voted these ways?

    Will you use HHS's trillion-dollar budget to advocate for policies 
that promote abortion and attack conscience protections for health 
workers?

    Answer. Throughout my career, I have always sought to protect and 
expand men and women's access to health care. I believe in making sure 
that women have access to the health care they need under the law. If I 
am confirmed as HHS Secretary, I will follow the law.
                  coverage of innovative technologies
    Question. The COVID-19 pandemic has furthered the necessity for 
access to medical technology including medical devices and diagnostic 
testing. CMS recently has made great strides to ensure coverage and 
improved payment for new and innovative technologies, including 
``breakthrough'' technologies, which will help to make it easier for 
clinicians and patients to access life-saving or life-altering devices 
and diagnostic tests.

    How will you work to continue these efforts as HHS Secretary?

    Answer. I agree that it is important to foster innovation in 
medical technology that improves health-care outcomes. If confirmed, I 
look forward to working with you to increase Americans' access to 
lifesaving technologies.
                            private practice
    Question. Prior to the pandemic, we saw private practices start to 
disappear because of hospital mergers and acquisitions, bankruptcies, 
or physician retirements. I am concerned this trend will only continue.

    If confirmed, what steps would you take to address this issue?

    Answer. As Attorney General, I took on hospital consolidation that 
raised prices on patients and created noncompetitive markets that left 
consumers with little choice. This has been a major focus of mine on 
the health-care front, and if confirmed as HHS Secretary, I will 
continue to examine ways that we, at the Federal level, can confront 
this issue, and I hope to work with you on this front, Senator.
                             supply chains
    Question. Given the number of supply chains critical to the U.S. 
economy, what level of insight do you have into their vulnerabilities?

    Do we have the necessary levels of insight into medical supply 
chains, including pharmaceuticals and PPE, to securely source these 
critical supplies?

    What industrial supply chains were prepared or unprepared to handle 
the stresses caused by the pandemic?

    Answer. The COVID-19 pandemic has highlighted the vulnerabilities 
of the global supply chain for many products. I am aware that HHS's 
Biomedical Advanced Research and Development Authority (BARDA) has 
invested in and is working to expand pharmaceutical manufacturing in 
the United States for use in producing medicines needed during the 
COVID-19 response and future public health emergencies. This work will 
expand domestic manufacturing of raw materials and active 
pharmaceutical ingredients for drugs. If confirmed, I will continue to 
support ongoing efforts in this area, as well as support the work HHS 
is doing with the FDA and DOD to expand domestic capacity for supplies 
needed in the ongoing COVID-19 response.
                      biden's health-care promises
    Question. Last year, then-candidate Biden proposed increasing 
Federal health-care spending by more than $2 trillion--and proposed to 
offset some of that cost with direct and indirect offsets, and cost 
reductions.

    What are those offsets and cost reductions?

    Answer. President Biden has an ambitious plan to get the COVID-19 
pandemic under control and improve access to affordable quality health 
care for American families. If confirmed, I look forward to working 
with Congress to further those efforts.
                state licensure/geographic restrictions
    Question. State licensing barriers and geographical restrictions 
have made access to care difficult for some patients, especially those 
in rural and/or underserved areas.

    Do you have plans to address these barriers to access?

    Answer. As you know, provider licensing is generally under the 
purview of State governments. To date, HHS has taken steps under Public 
Readiness and Emergency Preparedness (PREP) Act authorities to expand 
the vaccination workforce and enable States to utilize qualified health 
care professionals (e.g., pharmacists) to respond to the pandemic. If 
confirmed, I look forward to working with you to explore other avenues 
to expand access to health care, especially for those in rural and 
other underserved areas.

                                 ______
                                 
                 Questions Submitted by Hon. Ben Sasse
    Question. The previous administration was criticized frequently for 
denying science in their handling of the pandemic, and yet this 
administration has done the same with regards to school re-opening. 
Study after study has shown that schools can reopen safely and that 
transmission in schools is dramatically lower than community 
transmission. We also know that there is a huge public health risk to 
keeping schools closed, with low-income children, minority children, 
and children with disabilities suffering the most. You spoke in your 
committee questionnaire about launching a Disability Rights Unit to 
``ensure that students with disabilities have received their legally 
entitled quality education,'' so I would hope that you share these 
views.

    Do you agree that schools remaining closed creates its own public 
health risk that disproportionately impacts these high-need groups?

    Answer. Schools play a critical role in promoting equity in 
education and health for groups disproportionately affected by COVID-
19. If confirmed, I commit to working with the CDC and State and local 
leaders to ensure everyone has the resources and support necessary to 
ensure children nationwide are able to attend school safely.

    Question. Do you agree with the view that access to vaccinations 
for teachers should not be a prerequisite for reopening?

    Answer. The CDC's school reopening guidance noted that vaccinations 
were a key tool for reopening, and I agree with President Biden who has 
said teachers should be a priority in any vaccination effort. At HHS, 
we will follow the science and commit to helping States and localities 
have the information they need to reopen schools safely, if they choose 
to reopen.

    Question. Setting back school reopenings even further, the CDC 
guidance released earlier this month recommends virtual-only learning 
in middle and high school and hybrid learning in elementary school for 
schools in ``red zones,'' and then defines red zones in such a way that 
it's estimated that 76 percent of students would fall into a school in 
a so-called ``red zone.'' The administration also claimed its goal was 
for most students to have the option of in-person instruction one day a 
week, even though roughly two-thirds of students already have the 
option of in-person learning.

    If confirmed, will you work with the Centers for Disease Control to 
make sure that their guidance does not directly contradict the stated 
goal of increasing in-
person learning?

    Answer. I understand the importance of providing robust resources 
and support to schools in order for them to open as safely and as soon 
as possible. If confirmed, I look forward to working with the experts 
at CDC on the issue of safely reopening schools nationwide.

    Question. Will you consider encouraging the CDC to amend or rescind 
their guidance?

    Answer. I understand the importance of providing robust resources 
and support to schools in order for them to open as safely and as soon 
as possible. If confirmed, I look forward to working with the experts 
at CDC on the issue of safely reopening schools nationwide.

    Question. Can you explain how billions of dollars provided to 
schools years from now (as seen in the American Rescue Plan Act) could 
possibly aid in a quick reopening for kids that are suffering now, many 
of whom have been out of school for nearly a year?

    Answer. I understand the importance of providing robust resources 
and support to schools in order for them to open as safely and as soon 
as possible. If confirmed, I look forward to working with the experts 
at CDC on the issue of safely reopening schools nationwide.

    Question. As California Attorney General you sued the Federal 
Government to ensure that California could force churches to pay for 
abortions in their health-care plans and sued the Federal Government to 
ensure that the Little Sisters of the Poor would not be provided an 
exemption from paying for contraception. In NIFLA v. Becerra you 
argued, incorrectly according to the justices of the Supreme Court, 
that pro-life pregnancy centers should be forced to tell women how to 
obtain State-funded abortions.

    Given your track record, how can we trust you to successfully run 
the Department of Health and Human Services and carry out the law?

    Will you commit to protecting the Hyde amendment, and if not, what 
is your justification for failing to protect the amendment, which has 
been the law of the land since 1976 and is supported by a majority of 
Americans who do not believe that taxpayer dollars should fund 
abortions?

    As a member of Congress, you also voted against the Born-Alive 
Abortion Survivors Protection Act, a bill that I first introduced in 
2015. Can you explain your opposition to babies being provided medical 
care in the rare cases where they survive abortion attempts?

    Will you commit to not re-impose the contraception mandate on 
religious ministries like Little Sisters of the Poor?

    Will you commit to ensuring that medical professionals are not 
forced to perform procedures, like abortion, that go against their 
religious convictions?

    Answer. If I am fortunate enough to be confirmed as HHS Secretary, 
I will follow the law.

    Question. Medicaid Improper Payments rates have hit an all-time 
high, and during your time as Attorney General of California we saw 
California pay out an estimated $30 billion in fraudulent unemployment 
claims.

    Can Americans feel safe putting over a trillion dollars in the 
taxpayer-funded Medicare and Medicaid programs in your hands given the 
mismanagement of your State?

    If confirmed, what are your plans to fix improper payment rates 
across all HHS programs and ensure that dollars are going to those 
individuals who need them most?

    Answer. Fighting fraud and abuse, while ensuring payments are made 
properly, are important for maintaining the strength of HHS's programs, 
including the Medicare and Medicaid programs. As California Attorney 
General, I made it a priority to crack down on health-care fraud. If 
confirmed, I will work with you to strengthen HHS programs and make 
sure resources are spent wisely and effectively.

    Question. Enrollment in the Medicaid program has exploded during 
the pandemic, partially due to problematic language in last year's 
relief bills where States have no choice but to provide services even 
to people who are not actually eligible for the program.

    Do you commit to working with States and Congress to actually 
identify which enrollees are eligible and which are not?

    Do you commit to making sure that the Medicaid program is able to 
serve those individuals who are truly in need?

    Do you believe States should have the right to remove ineligible 
enrollees, which is currently restricted by FFCRA?

    Wouldn't Medicare-for-All threaten not only the care for the people 
in the Medicare program but also those on Medicaid given the already 
weak financial status of the trust fund, which is currently projected 
to run out of funds in 2026?

    Answer. Medicaid is a lifeline for millions of Americans around the 
country. As California Attorney General, I made it a priority to crack 
down on health-care fraud, waste, and abuse. If confirmed, I will work 
with you and your colleagues to strengthen Medicaid and ensure 
resources are spent wisely and effectively.

    Question. We have too often ignored the fact that States like 
Nebraska actually lost health-care options as a result of the ACA. My 
State benefited tremendously from Trump administration rules expanding 
Associations Health Plans and Short-Term Limited Duration Plans, and 
I'm concerned about the rules establishing these plans potentially 
being rescinded due to politics rather than actual data. These plans 
are very popular in my State and often cost half as much as ACA plans 
while providing more personalized coverage.

    Can you point to any actual evidence that these plans destabilized 
the market, as you warned they would in a 2018 letter to CMS?

    Will you commit to working with Congress and other agencies to 
preserve these plan options for the millions of Americans who have 
enrolled?

    Answer. Making sure that all Americans have access to quality, 
affordable health care is one of the Biden administration's top 
priorities. If confirmed, I will examine rules and other policies to 
ensure all Americans can access the care that they need.

    Question. In Congress you voted against allowing Americans to save 
more of their money tax-free in Health Savings Accounts. Can you 
explain your opposition?

    Answer. Making sure that all Americans have access to quality, 
affordable health care is one of the Biden administration's top 
priorities. As health-care costs have continued to rise, more burden 
has been shifted to consumers in the form greater cost-sharing. We must 
work to reduce barriers to access, including excessive cost-sharing.

                                 ______
                                 
               Questions Submitted by Hon. John Barrasso
    Question. As a doctor, I have grave concerns about the impact a one 
size fits all system would have on access to care, especially in rural 
communities.

    Previously, Obamacare took a step in this direction with the 
Independent Payment Advisory Board (IPAB). This 15-person unaccountable 
board was supposed to make decisions regarding Medicare reimbursements. 
I was disturbed about giving so much power over Medicare to an 
unelected and unaccountable group of bureaucrats. Congress thankfully 
repealed the IPAB after you left Congress in 2018.

    Do you support the recreation of the IPAB or any new government 
board that has the power to reduce access to care for patients?

    Answer. Ensuring that Americans have access to high quality health 
care, including in rural areas, is a priority of mine. I believe that 
beneficiaries should come first, and if I am confirmed, I will work you 
and other members on solutions to reduce the cost of care and lengthen 
the trust fund's solvency.

    Question. Currently, illegal immigrants are not allowed to receive 
most Federal health-care benefits. In particular, they are not eligible 
to receive insurance through the ACA exchange.

    Do you support maintaining the ban on illegal immigrants receiving 
health insurance through the exchange?

    Answer. If I am confirmed as HHS Secretary, I will follow the law.

    Question. Do you support expanding Medicaid to require the use of 
Federal taxpayer dollars to pay for illegal immigrants to receive full 
Medicaid benefits?

    Answer. If I am confirmed as HHS Secretary, I will follow the law.

    Question. As a doctor, I want to ensure the United States continues 
to lead the world in medical and scientific innovation. This has never 
been more important than during the COVID-19 pandemic. We have seen 
firsthand the importance of generating new vaccines and therapeutics to 
combat COVID-19. Looking forward, we must do more to address drug 
pricing. We must do it of course without harming innovation.

    The White House Counsel of Economic Advisers found H.R. 3, the 
House Democrats drug pricing proposal, would reduce the number of new 
drugs by up to 100 over a decade.

    Are you concerned about legislative proposals that will decrease 
the number of new and innovative treatments for American patients?

    Answer. The United States is a leader in medical and scientific 
innovation. The COVID-19 vaccines were developed faster than any 
vaccine in history. Innovation can only help patients if it's 
affordable. That's why I, like President Biden, believe we must do all 
we can to lower the costs of prescription drugs. If confirmed as 
Secretary of HHS, I look forward to working with you to find ways to 
reduce drug prices and ensure Medicare beneficiaries have access to the 
drugs that they need.

    Question. It is vital for the United States to learn from the 
COVID-19 pandemic and ensure we are better prepared for future public 
health emergencies. In particular, I am interested in addressing the 
supply chain for personal protective equipment (PPE).

    How do you anticipate partnering with the private-sector supply 
chain to ensure that the country is ready for the next public health 
emergency?

    Do you believe HHS has a role in creating greater supply chain 
resiliency, in particular ensuring more PPE is made in the United 
States?

    Answer. The global pandemic has highlighted the vulnerabilities of 
the global supply chain for many products. In order to continue 
responding to the COVID-19 pandemic and better preparing the Federal 
Government to respond to any future public health emergencies, it is 
critical that HHS work to improve and expand domestic supply chain 
capabilities. If confirmed, I'm committed to working on this urgent 
matter.

    Question. Telehealth utilization has increased significantly as a 
result of the COVID-19 pandemic.

    What steps or policies is the administration considering to ensure 
the American health care system continues to move forward with more 
telehealth innovation?

    Answer. Telehealth is an important tool to improve health equity 
and improve access to health care. Health care should be accessible, no 
matter where you live. If confirmed, I will look at the telehealth 
flexibilities developed for the current public health emergency and 
determine how we can build on this work to improve health equity and 
improve access to health care.

                                 ______
                                 
                Prepared Statement of Hon. Mike Crapo, 
                       a U.S. Senator From Idaho
    WASHINGTON--U.S. Senator Mike Crapo (R-ID), ranking member of the 
U.S. Senate Finance Committee, delivered the following remarks at a 
hearing to consider the nomination of Xavier Becerra to be Secretary of 
Health and Human Services.

    The Department of Human Health and Services (HHS) is a sprawling 
department, with over 80,000 employees and responsibility for over $1 
trillion in annual spending. HHS and its agencies directly affect 
everyday life, including running programs that provide health-care 
coverage to nearly 150 million people. The HHS Secretary will shape 
Medicare, Medicaid, Obamacare, and many other important programs in the 
Finance Committee's jurisdiction. These responsibilities are formidable 
in normal times, but the COVID-19 pandemic has made the HHS mission 
even more critical, as these programs will play a key role in the 
pandemic response.

    This hearing is important for us to understand how Attorney General 
Becerra would carry out these monumental responsibilities. A few weeks 
ago, I outlined several issues in the health-care space where I intend 
to focus my efforts as ranking member, including fostering innovation 
to improve patient care and making our health-care system more 
efficient. The COVID-19 pandemic has threatened Americans' physical and 
economic health, but it has also reinforced the value of innovation and 
provided an opportunity to test changes that foster it.

    HHS has used its authority under the Public Health Emergency to 
waive numerous requirements to ensure Medicare beneficiaries and other 
patients receive care during the pandemic. Patients have benefited from 
expanded access to telehealth and expedited approval of COVID-19 
vaccines, diagnostics, and treatments.

    Going forward, Medicare and Medicaid patients should have the same 
access to innovative items and services as those with commercial 
insurance. We must carefully evaluate our response to the pandemic and 
implement appropriate reforms based on the lessons we have learned. HHS 
should partner with this committee in that effort.

    Another long-term priority for many on this committee is to finally 
address Medicare's looming financial problems. Medicare's financial 
stability was a key issue discussed by the bipartisan Bowles-Simpson 
Commission on which I served with Attorney General Becerra a decade 
ago.

    Although the Commission's proposal did not reach the required 
super-majority of 14 of 18 votes for adoption, it did produce a 
constructive, bipartisan blueprint to reform and secure our entitlement 
programs. Medicare's finances remain unsettled, with the Medicare 
trustees currently projecting that the Hospital Insurance (HI) trust 
fund will go broke in 2026, and unforeseen circumstances could move the 
insolvency date even closer. The new administration should work with 
Congress in a bipartisan way to ensure that Medicare is able to serve 
current and future beneficiaries.

    In yesterday's hearing before the HELP Committee, many of my 
colleagues raised concerns about the enforcement of California's 
restrictive actions related to COVID-19, including the ban on indoor 
religious services that was rejected by the Supreme Court. They also 
raised questions about challenges to HHS's authority to provide a 
conscience exemption from the Obamacare contraception coverage mandate.

    A coalition of pro-life Americans sent a letter to all Senators in 
opposition to the nomination of Xavier Becerra to be Secretary of 
Health and Human Services. I ask that the letter be included as part of 
the record.

    Nearly a year ago, this committee worked together to expand 
unemployment compensation programs in response to the economic 
devastation caused to workers by shutdowns. As time has passed, there 
has been substantial reporting of fraud perpetrated against 
California's unemployment insurance program. Fraudsters, including 
international criminal organizations, have siphoned off perhaps more 
than $11 billion. That raises questions regarding what specific steps 
were taken to combat unemployment fraud, and when those steps were 
taken.

    Finally, you have long been an advocate for moving all Americans to 
a government-run ``Medicare for All'' plan, raising concerns that your 
policy preferences could undermine the Medicare programs that rely on 
private insurance. You and I have talked about this privately, and I 
will discuss it further with you in the question period. I strongly 
support private insurance so patients can choose the coverage option 
that best meets their needs.

    The popular Medicare Advantage program that covers 24 million 
beneficiaries must be allowed to continue to thrive. And the successful 
Medicare Part D program must continue to serve its 47 million enrollees 
without government interference.

    The number of issues I have raised indicate the scope and 
importance of this position. I look forward to hearing your testimony 
and your responses to questions.

                                 ______
                                 
       Submitted by Hon. Mike Crapo, a U.S. Senator From Idaho, 
         and Hon. James Lankford, a U.S. Senator From Oklahoma

                           February 18, 2021

The Honorable Patty Murray          The Honorable Ron Wyden
Chairwoman                          Chairman
Committee on Health, Education, 
Labor, and Pensions                 Committee on Finance
U.S. Senate                         U.S. Senate
Washington, DC 20510                Washington, DC 20510

The Honorable Richard Burr          The Honorable Mike Crapo
Ranking Member                      Ranking Member
Committee on Health, Education, 
Labor, and Pensions                 Committee on Finance
U.S. Senate                         U.S. Senate
Washington, DC 20510                Washington, DC 20510

Dear Senators,

As organizations committed to the protection of unborn children and 
their mothers from abortion and representing millions of pro-life 
Americans, we write to you in opposition to the nomination of Xavier 
Becerra to be Secretary of Health and Human Services. Mr. Becerra is an 
enemy to every pro-life policy and law and has demonstrated complete 
disregard for the religious and moral convictions of those opposed to 
the brutal act of abortion. His radical record in public office as 
California's Attorney General and member of Congress leads our 
organizations to ask you to reject Mr. Becerra's nomination.

As Attorney General, Mr. Becerra went out of his way to attack pro-life 
policies and conscience protections. He led the charge against the 
Title X Protect Life Rule which, under the prior administration, 
successfully defunded Planned Parenthood of $60 million.\1\ Despite the 
Supreme Court already siding with the Little Sisters of the Poor in an 
earlier case, Mr. Becerra took the nuns and similar groups to court to 
force them to violate their consciences.\2\ However, perhaps most 
ironically, Mr. Becerra has argued in opposition to following an 
existing Federal law against forcing healthcare entities to provide, 
pay for, provide coverage of, or refer for abortion (the longstanding 
Weldon Amendment) calling the enforcement of such provisions 
``illegal.''\3\ Notably, if confirmed Mr. Becerra would be responsible 
for overseeing the title X program, establishing the federal preventive 
service mandates that infringed on the conscience rights of the Little 
Sisters of the Poor, and enforcing the Weldon Amendment.\4\
---------------------------------------------------------------------------
    \1\ Mr. Becerra lost in the 9th Circuit in February 2020. A request 
to review this decision was denied in May 2020. The Title X policy was 
allowed to resume March 4, 2020. See California v. Azar.
    \2\ The Little Sisters of the Poor won at the Supreme Court on July 
8, 2020 in a similar case. Mr. Becerra's case against the Little 
Sisters has been sent back to the 9th Circuit to be decided in light of 
this decision. See Little Sisters of the Poor v. Commonwealth of 
Pennsylvania.
    \3\ https://khn.org/morning-breakout/california-defends-authority-
to-require-insurers-to-cover-abortion-as-protecting-womens-rights/.
    \4\ Mr. Becerra's refusal to enforce the Weldon Amendment led to a 
loss of $200 million in Medicaid funding for California, HHS OCR Press 
Release 12/16/20.

We are also concerned about Mr. Becerra's abuse of his statewide office 
to target pro-life health centers and journalists. Taking pregnancy 
centers to court to enforce California's so-called Reproductive FACT 
Act, Mr. Becerra futilely sought to force government-compelled speech 
on pro-life individuals who refused to direct women to abortion 
centers.\5\ Furthermore, he sought to intimidate and prosecute 
investigative journalists David Daleiden and Sandra Merritt after their 
reporting uncovered the unethical and likely illegal sale of aborted 
baby body parts by Planned Parenthood. Mr. Becerra sought 15 felony 
charges for recording 14 videos against these journalists, a move that 
the Los Angeles Times Editorial Board called ``a disturbing 
overreach.''\6\
---------------------------------------------------------------------------
    \5\ Mr. Becerra lost at the Supreme Court, which found the law to 
be likely unconstitutional. See NIFLA v. Becerra.
    \6\ https://www.latimes.com/opinion/editorials/la-ed-planned-
parenthood-charges-20170330-story.html.

More recently, Mr. Becerra's actions to exploit the COVID-19 pandemic 
to expand abortion demonstrate that he will not let a crisis go to 
waste. As most Americans sought to direct resources to essential health 
services, Mr. Becerra led a letter of pro-abortion state Attorneys 
General who sought to use the public health emergency to lift federal 
restrictions on chemical abortion under the FDA Risk Evaluation and 
Mitigation Strategy (REMS) protocol. Such a change to the REMS would 
lead to mail order abortion without physician oversight, a situation 
which could have dire consequences for women and girls. Additionally, 
Mr. Becerra led another letter of pro-abortion Attorneys General 
calling for the administration to fund research involving fetal tissue 
claiming that ``no alternatives to human fetal tissue . . . have been 
shown to be as powerful conducting these important studies''.\7\ 
Neither of the leading COVID-19 vaccines, developed by Pfizer and 
Moderna, used human fetal tissue in their production, demonstrating 
that this view is out of step with current science.
---------------------------------------------------------------------------
    \7\ https://www.oag.ca.gov/system/files/attachments/press-docs/
Multi-State%20Letter%20re%
20Fetal%20Tissue%20Ban.pdf.

These radical views are not new for Mr. Becerra, whose pro-abortion 
track record extends back to his earliest years in public office. While 
a member of Congress, he voted against pro-life priorities such as the 
Pain-Capable Unborn Child Protection Act, the Born-Alive Abortion 
Survivors Protection Act, and the No Taxpayer Funding for Abortion Act. 
Becerra even voted against commonsense legislation to prohibit partial 
birth abortion \8\ and the Unborn Victims of Violence Act which made it 
a crime to harm or kill an unborn child during the commission of a 
violent crime--38 states including California currently have similar 
protections.\9\
---------------------------------------------------------------------------
    \8\ https://clerk.house.gov/Votes/2003530.
    \9\ https://www.ncsl.org/research/health/fetal-homicide-state-
laws.aspx.

Mr. Becerra's confirmation would be divisive and a step in the wrong 
direction. We understand that the president needs to assemble a 
cabinet; however, Mr. Becerra has proven himself to be an enemy of the 
health of women and the unborn. He cannot be entrusted with our 
national health programs and policies and is not qualified to serve as 
---------------------------------------------------------------------------
Secretary of Health and Human Services.

For these reasons, we ask you to reject his nomination.

For Life,

Marjorie Dannenfelser               Thomas Glessner, J.D.
President                           President
Susan B. Anthony List               National Institute of Family and 
                                    Life Advocates (NIFLA)

Tom McClusky                        Carol Tobias
President                           President
March for Life Action               National Right to Life Committee

Kristan Hawkins                     Lila Rose
President                           Founder and President
Students for Life Action            Live Action

Catherine Glenn Foster              Abby Johnson
President and CEO                   Founder and CEO
Americans United for Life           And Then There Were None

Penny Young Nance                   Ryan T. Anderson, Ph.D.
President and CEO                   President
Concerned Women for America LAC     Ethics and Public Policy Center

Donna J. Harrison M.D.              Russell Moore
Executive Director                  President
American Association of Pro-Life 
Obstetricians and Gynecologists     Southern Baptist Ethics and 
                                    Religious Liberty Commission

Fr. Frank Pavone                    Craig DeRoche
National Director                   President and CEO
Priests for Life                    Family Policy Alliance

Jor-El Godsey                       Roland C. Warren
President                           President and CEO
Heartbeat International             Care Net

Andrew M. Bath                      Anne O'Connor
Executive Vice President and 
General Counsel                     Vice President of Legal Affairs
Thomas More Society                 National Institute of Family and 
                                    Life Advocates (NIFLA)

Garrett Bess                        Travis Weber
Vice President of Government 
Relations and Communications        Vice President for Policy and 
                                    Government Affairs
Heritage Action for America         Family Research Council

David Daleiden                      Michelle Cretella, M.D.
Project Lead                        Executive Director
The Center for Medical Progress     American College of Pediatricians

Jordan Sekulow                      Brian Burch
Executive Director                  President
American Center for Law and Justice Catholic Vote

Terry Schilling                     Colleen Holcomb
Executive Director                  President
American Principles Project         Eagle Forum
Bradley Mattes                      Jonathan Keller
President                           President and CEO
Life Issues Institute               California Family Council

Steven Ertelt                       Alexandra Snyder, Esq.
Editor                              CEO
LifeNews.com                        Life Legal Defense Foundation

Michael Gonidakis                   Lois Anderson
President                           Executive Director
Ohio Right to Life                  Oregon Right to Life

Samuel H. Lee                       John Stemberger
Director                            President and General Counsel
Campaign Life Missouri              Florida Family Policy Council

Gene Mills                          John Helmberger
President                           Chief Executive Officer
Louisiana Family Forum              Minnesota Family Council

Janet Morana                        Bob Vander Plaats
Co-Founder                          President
Silent No More                      The FAMiLY Leader

Eric J. Scheidler                   Tami Fitzgerald
Executive Director                  Executive Director
Pro-Life Action League              NC Values Coalition

Cathie Humbarger                    Joshua Edmonds
CEO                                 Executive Director
Reprotection, Inc.                  Georgia Life Alliance Committee

Zach Rodgers                        Monica Migliorino Miller, Ph.D.
Executive Director                  Director
Right to Life of Northeast Indiana  Citizens for a Pro-Life Society

Joe Langfield                       Dale A. Bartscher
Executive Director                  Executive Director
Human Life Alliance                 South Dakota Right to Life

Esther Ripplinger                   Larry Cirignano
Executive Director                  DC Representative
Human Life of Washington            Children First Foundation

Deborah Tilden                      Eva Andrade
Co-Founder                          President
S.M.A.R.T. Women's Healthcare       Hawaii Family Forum

Peggy Nienaber                      Mike Fichter
Vice President                      President and CEO
Faith and Liberty                   Indiana Right to Life

Gregory Cox                         Julaine K. Appling
Lead Missionary                     President
National Pro-Life Center on Capitol 
Hill                                Wisconsin Family Action

Andrew Shirvell, J.D.               Shawn Hyland
Founder and Executive Director      Executive Director
Florida Voice for the Unborn        Family Policy Alliance of New 
                                    Jersey

Amber Haskew                        Cheryl Sullenger
Director of Public Policy           Senior Vice President
Liberty Counsel Action              Operation Rescue

Rabbi Yaakov Menken                 Honorable Joel Grewe
Managing Director                   Executive Director
Coalition for Jewish Values         Generation Joshua

Bryan Kemper                        Mike Rouse
President                           President
Stand True--Youth Pro-life Outreach 
of Priests for Life                 The American Association of 
                                    Christian Schools

                                    Marc Tuttle
                                    President
                                    Right to Life of Indianapolis

                                 ______
                                 
                   Submitted by Hon. James Lankford, 
                      a U.S. Senator From Oklahoma

                      CATHOLIC MEDICAL ASSOCIATION

_______________________________________________________________________

   Upholding the Principles of the Catholic Faith in the Science and 
                          Practice of Medicine

                      550 Pinetown Rd., Suite 205

                     Ft. Washington, PA 19034-2607

                            Ph 484-270-8002

                            Fax 866-714-0242

                            www.cathmed.org

                            [email protected]

                                                  February 22, 2021

The Honorable Ron Wyden
Chair, Senate Committee on Finance
United States Senate
221 Dirksen Senate Office Building
Washington, DC 20510

Dear Mr. Wyden, Ranking Member Mr. Crapo, and committee members,

The Catholic Medical Association is the largest organization of 
Catholic health-care professionals in the United States. We represent 
over 2,500 faithful Catholics in the medical community across the 
country who provide high quality, ethical medical care in accordance 
with their Catholic faith.

As president of this organization, I write on behalf of our members to 
strongly oppose the nomination of Mr. Xavier Becerra to be Secretary of 
Health and Human Services Department. Mr. Becerra's partisan, 
ideological record of opposing individual and institutional conscience 
rights protections, religious freedom and the sanctity of life will 
significantly impact the ability of our memberships to practice ethical 
medicine guided by their faith.

Mr. Becerra's lack of experience in health care makes him inherently 
unqualified to lead a department responsible for the health and well-
being of our citizens at this critical time of pandemic.

If appointed, Mr. Becerra would lead an agency responsible for creating 
policies that could significantly affect not only our members, but all 
Catholic and Christian health-care workers, their patients and faith 
based organizations. He has voiced support to rolling back conscience 
rights protection, instituting contraceptive and abortion mandates in 
health-care coverage, and advancing gender ideology. It would be our 
expectation that all actions taken by the Health and Human Services 
comply with the Hyde, Church and Welden Amendments. Given the 
President's expressed religious views, we ask that no actions be taken 
in opposition to the conscience rights and religious liberties of our 
members. Our organization remains willing to work with the 
administration and the Health and Human Services Department to 
accomplish these goals.

In Congress, Mr. Becerra voted against a ban on partial birth 
abortions, against making it a crime to hurt an unborn child during 
another crime, and voted in favor of taxpayer-funded abortions. As 
Attorney General for the State of California, Mr. Becerra showed he is 
willing to use the power of the state against religious organizations 
and pro-life causes. His actions have been shown to be on the wrong 
side of the constitution in cases involving the Little Sisters of the 
Poor and NIFLA v. Becerra.

With the overwhelming regulatory and financial power of the HHS, Mr. 
Bacerra will advance policies with harmful and detrimental impact on 
pro-life, religious organizations and individuals.

Catholic health care is a direct outreach of our mission as Catholics 
to love our neighbors, feed the poor and heal the sick. Catholic 
hospitals currently provide 1 out of every 6 hospital beds in the 
United States. Catholics provide adoption and foster care services; 
help resettle immigrant families and are leading the fight against 
human trafficking. We fear many of these services will be eliminated if 
Mr. Becerra is confirmed. We have reasonable concern that Mr. Becerra 
will use coercive powers to advance ideological policies of Planned 
Parenthood and special interests to force Catholic institutions to 
violate deeply held beliefs in the provision of care. Our members would 
be forced to make a decision between practicing ethical medicine or 
violating deeply held religious beliefs. Forcing out faith-based 
health-care providers risks undermining the health-care workforce and 
significantly harming the health-care capacity needed to fight current 
and future public health crises in our nation. At this critical time in 
our nation's history, we need to be supporting these individuals and 
institutions, not trying to shut them down.

Mr. Becerra is the wrong choice to be Secretary of the Department of 
Health and Human Services. His past record shows he is hostile to faith 
based organizations and individuals. Appointing Mr. Becerra will 
directly affect the ability of thousands of Catholic individuals and 
institutions to provide ethical, high quality, and compassionate care. 
His confirmation will divide this country even further at a time when 
unity is most needed.

Sincerely yours,

Michael S. Parker, M.D.
President, Catholic Medical Association

                                 ______
                                 
                        Heartbeat International

              5000 Arlington Centre Boulevard, Suite 2277

                       Columbus, Ohio 43220-2913

                              614-885-7577

                https://www.heartbeatinternational.org/

            https://www.heartbeatservices.org/services-home/

February 18, 2021

The Honorable Charles E. Schumer    The Honorable Mitch McConnell
Majority Leader                     Minority Leader
U.S. Senate                         U.S. Senate
322 Hart Senate Office Building     317 Russell Senate Office Building
Washington DC 20510                 Washington, DC 20510

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
221 Dirksen Senate Office Building  239 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Majority Leader Schumer, Minority Leader McConnell, Chairman 
Wyden, and Ranking Member Crapo:

As the world's largest network of pregnancy help centers serving 
pregnant women, Heartbeat International strongly opposes the nomination 
of Xavier Becerra for Secretary of Health and Human Services.

Every woman deserves love and support during an unexpected pregnancy. 
Heartbeat and its network of nearly 3,000 pregnancy help organizations 
worldwide work tirelessly to provide hope and help to women and 
families experiencing unexpected pregnancies.

Our network of pregnancy help provides compassionate care because no 
woman should feel alone, coerced, or so hopeless that she ends her 
child's life through abortion.

In 2019 alone, pregnancy centers nationwide served nearly 2 Million 
people with free services.\1\
---------------------------------------------------------------------------
    \1\ ``Pregnancy Centers Stand the Test of Time,'' Charlotte Lozier 
Institute's Pregnancy Center Report, published 2020.

    - 94% of these organizations provide material aide such as diapers 
and formula at no cost to families in need.
    - 86% offered parenting classes to mothers and fathers.
    - 486,213 women received free ultrasounds.
    - 21,698 women and men received abortion recovery help at a center.
    - 98% of pregnancy help organization clients report a positive 
experience.\2\
---------------------------------------------------------------------------
    \2\ Data from Next Level, Heartbeat International's Client 
Management System.

Each day, Option Line (our 24/7 pregnancy helpline) receives more than 
1,000 calls from people seeking pregnancy help. Last year alone, Option 
Line connected more than 350,000 people to their local pregnancy help 
---------------------------------------------------------------------------
organization for care.

From a free pregnancy test to a temporary home, pregnancy help 
organizations exist to meet the needs of the women they serve.

Heartbeat's network of care does all of this in an effort to realize 
its vision to make abortion unwanted today and unthinkable for future 
generations.

The approval of Mr. Becerra for Secretary of Health and Human Services 
would be devastating to the thousands of grassroots volunteers and 
staff who daily champion life-affirming choices that he sought to 
muzzle.

As Attorney General of California, Mr. Becerra sought to force pro-life 
pregnancy help organizations to intentionally direct pregnant women 
toward abortion providers, undermining their conscience and diluting 
their very purpose.

Under the so-called Reproductive FACT Act, Becerra wanted to force 
these same organizations that exist to provide alternatives to abortion 
to tell women where to get an abortion.

Despite such a mandate being a clear violation of the centers' free 
speech rights and religious conscience, Mr. Becerra was so beholden to 
the pro-abortion lobby that he took the case all the way to the Supreme 
Court in an effort to silence these centers. Thankfully, in the case of 
NIFLA v. Becerra, the Supreme Court ruled in favor \3\ of the centers' 
free speech, holding that it was unconstitutional for the State of 
California to force private organizations to speak a message that was 
antithetical to their very reason for existence.
---------------------------------------------------------------------------
    \3\ National Institute of Family and Life Advocates v. Becerra, 585 
U.S. ------ (2018), accessed 02/17/2021, https://supreme.justia.com/
cases/federal/us/585/16-1140/.

He did all this while receiving donations from abortion proponents. 
According to Open Secrets,\4\ Planned Parenthood gave Becerra thousands 
of dollars in donations over his long political career. All the while, 
Mr. Becerra received perfect scores from Planned Parenthood and NARAL 
Pro-Choice America on his abortion record.
---------------------------------------------------------------------------
    \4\ https://www.opensecrets.org/members-of-congress/
summary?cid=N00009774&cycle=
CAREER.

As Attorney General, Mr. Becerra sought to use the power of government 
to force pregnancy help organizations to support abortion, and our 
grave concern is that this same Mr. Becerra would leverage the newfound 
position and the power of the Department of Health and Human Services 
to work against the good work of grassroots pregnancy help 
---------------------------------------------------------------------------
organizations.

While opinions regarding the legality of abortion may differ, everyone 
should agree that it is a good thing to empower women so that they 
never feel that their only choice is to end the life of their unborn 
child. It is indicative of Mr. Becerra's extreme position on abortion 
that he would attempt to shut down those who are merely providing help 
and hope to women and families.

For these reasons, we implore you to reject the nomination of Xavier 
Becerra. Surely there is someone less beholden to the lobbyists of the 
abortion industry and more qualified to truly lead the Health and Human 
Services department.

Regards,

Jor-El Godsey
President

CC: All U.S. Senators

                                 ______
                                 
            National Institute of Family and Life Advocates

               10333 Southpoint Landing Blvd., Suite 107

                        Fredericksburg, VA 22407

                          Phone: 540-372-3930

                           Fax: 540-372-3929

                             www.NIFLA.org

                            [email protected]

February 19, 2021

To Whom It May Concern:

The National Institute of Family and Life Advocates (NIFLA) opposes the 
nomination of Xavier Becerra to be Secretary of Health and Human 
Services (HHS). Because of our experience with Becerra and his 
radicalized agenda, we believe that he is not qualified for this 
appointment. We respectfully ask that you reject his nomination.

NIFLA is a non-profit legal and medical organization that exists to 
train, equip and represent more than 1,600 life-affirming pregnancy 
center members across the nation. Pregnancy centers provide hope, 
counsel, medical services, material resources, housing referrals, and 
much more to mothers considering abortion, all for free. Primary among 
these is the procedure of ultrasound, which is medically necessary to 
confirm a viable intrauterine pregnancy. Statistics show more than 80% 
of mothers considering abortion decide to choose life after seeing an 
ultrasound image of their unborn child.

In 2016, NIFLA brought a lawsuit against Becerra because, as California 
Attorney General, he abused his statewide office to target our 
pregnancy centers. In his attempt to enforce California's so-called 
Reproductive ``FACT'' Act, Becerra futilely sought to force government-
compelled speech on religiously motivated pro-life centers by requiring 
them to place notices on their walls advising clients how they could 
procure a state-funded abortion. Becerra vowed to aggressively enforce 
the law and make sure that pro-life centers use the walls of their 
waiting areas as billboards to advertise for and promote abortion.

This mandated compelled speech violated the pregnancy centers' First 
Amendment rights and undermined their mission to offer life-affirming 
care to women and children. It forced such centers to speak a message 
with which they fundamentally disagreed.

May the government force Alcoholics Anonymous to post signs promoting 
the sale of liquor to its clients? Could the government force the 
American Cancer Society to promote the sale of tobacco and cigarettes? 
If Becerra had his way with pro-life pregnancy centers then such 
scenarios (which are absurd) could very well happen, depending upon who 
has the political clout to promote their agenda.

While California's so-called Reproductive ``FACT'' Act was 
unconstitutional, Becerra insisted that it be enforced. The law was 
struck down by the United States Supreme Court in the landmark case of 
NIFLA v. Becerra 138 S. Ct. 2361 (2018). The Supreme Court ruled 5-4 to 
block California's blatant discrimination against non-
profits that give life-affirming options to women facing unplanned 
pregnancies. Justice Clarence Thomas wrote the majority opinion of the 
Court which held that the free speech guarantees of the First Amendment 
to the U.S. Constitution prohibits government compelled speech when 
such speech mandates and compels people to speak a message with which 
they fundamentally disagree and which violates their consciences.\1\ In 
concurrence, Justice Kennedy stated that ``viewpoint discrimination is 
inherent in the design and structure of [the] Act'' and that California 
required ``primarily pro-life pregnancy centers to promote the State's 
own preferred message advertising abortions.''
---------------------------------------------------------------------------
    \1\ That free speech standard was distinguished by Justice Thomas 
from situations where the State is regulating the conduct of the 
physician in which that physician's speech is merely incidental to 
conduct, such as speech related to the performance of an abortion.

The Supreme Court handed Becerra a humiliating defeat in NIFLA v. 
Becerra, which ended up costing the taxpayers of California millions of 
dollars. They were ordered to pay attorneys' fees to his successful 
opponents. Immediately after this decision was handed down, Becerra 
referred to it as ``unfortunate'' and stated he would seek other ways 
---------------------------------------------------------------------------
to promote abortion services in California.

Becerra absolutely should not be in charge of such a powerful 
department as HHS. In such a position of authority and power, he will 
easily continue his attacks against pregnancy centers through 
bureaucratic rules and regulations. Such actions will guarantee further 
litigation against HHS and the government. Ultimately, under NIFLA v. 
Becerra, the government will lose, costing the taxpayers millions more 
in litigation costs.

Becerra's actions to enforce the ``FACT'' Act also caused the State of 
California to be cited by HHS, the very organization he now is 
nominated to lead, for violating federal conscience protections. The 
Office of Civil Rights Conscience and Religious Freedom Division 
conducted an independent investigation and determined that the ``FACT'' 
Act violated the Weldon and Coats-Snowe Amendments by requiring 
``licensed covered facilities'' to refer for abortion. It further 
violated the Weldon amendment by subjecting ``unlicensed covered 
facilities'' to discrimination by targeting them for burdensome and 
unnecessary notice requirements because they do not refer for or make 
arrangements for abortion.

More recently, Becerra's actions to exploit the COVID-19 pandemic to 
expand abortion demonstrate that his radical abortion agenda knows no 
limits. As most government leaders sought to direct resources to 
essential health services, Becerra led a crusade to use the public 
health emergency to expand the distribution of chemical abortions by 
removing the FDA's Risk Evaluation and Mitigation Strategy (REMS) 
protocol. Such a change to the REMS would lead to mail-order abortion 
without physician oversight, a situation that could have dire 
consequences for women and girls. The U.S. Supreme Court again ruled 
against him in this regard in Food and Drug Administration v. American 
College of Obstetricians and Gynecologists (FDA v. ACOG) in January 
2021.

Becerra's confirmation would be a very divisive action coming from an 
administration that pronounces the need for unity. He is an antagonist 
to millions of Americans who care for mothers, their unborn children, 
and who simply want to provide them with the right to choose life. As 
such, he is an enemy of the health of women and the unborn.

As Secretary of HHS, Becerra would be uniquely positioned to pass 
regulations that impact operations of pregnancy centers--particularly 
those that are licensed medical clinics. This should be concerning to 
all who care about providing abortion alternatives to mothers.

Becerra cannot be entrusted with our national health programs and 
policies. He is not qualified to serve as Secretary of Health and Human 
Services.

For these reasons, we ask you to reject his nomination.

Sincerely,

Thomas A. Glessner, J.D.
President

Anne O'Connor, J.D.
Vice-President for Legal Affairs

                                 ______
                                 
                 Prepared Statement of Hon. Ron Wyden, 
                       a U.S. Senator From Oregon
    The Finance Committee meets this morning for the second of three 
nomination hearings this week. I'm pleased to welcome Attorney General 
Xavier Becerra, President Biden's nominee to lead the Department of 
Health and Human Services.

    With a pandemic raging, so many Americans struggling to get by, and 
our health-care system strained to the max, there may not be a higher-
stakes job in the executive branch outside of the presidency itself.

    Attorney General Becerra brings more than 2 decades of experience 
in the Congress. He was a senior member of the House Ways and Means 
Committee, which overlaps with this committee on a lot of important 
health-care subjects. He was closely involved in major accomplishments 
on health care, including the ACA. For 4 years he's led the second-
largest department of justice in America, overseeing thousands of 
employees and a billion-dollar budget. Anybody who discounts the 
experience of leading a California agency that large and influential to 
the fifth-largest economy in the world is straining awfully hard to 
find something to critique.

    AG Becerra defended the Affordable Care Act from absurd and 
dangerous far-right attacks. When the pandemic hit, he went to bat for 
Californians by increasing access and affordability for COVID 
treatments, protecting workers from exposure, and securing key 
safeguards for front-line health-care workers.

    Having started my career in legal aid for seniors as the co-founder 
of the Oregon Gray Panthers, I appreciate that AG Becerra got his start 
in legal aid for the less fortunate as well. This is a nominee with the 
right policy experience, the right leadership experience, and the right 
experience fighting for the little guy. That's exactly what's needed at 
Health and Human Services after 4 years of mismanagement that took us 
in the wrong direction.

    In this committee, a special focus of our work during this Congress 
is going to be tackling inequality in every form. In America, 
inequality is a killer. If you didn't believe it before the pandemic, 
there can be no questioning it now.

    People of modest means, people targeted by discrimination, people 
marginalized in society--they're the Americans who've suffered 
disproportionately in this pandemic. That's because they were 
vulnerable before the pandemic too, and Federal policies did not do 
enough to protect them.

    I'll tick through a few examples. First, Americans are still 
getting absolutely clobbered every time they walk up to the pharmacy 
window to pick up their prescription drugs. In a country as wealthy as 
ours, it is utterly shameful that you still hear about people rationing 
their own medicine and suffering terrible consequences because they 
can't afford their prescriptions.

    Second, the pandemic has proven that there needs to be a new focus 
on mental health in America. With so many lives lost and so many people 
out of work, it shouldn't be any surprise that people in Oregon and 
across the country are struggling when it comes to mental health. 
Compared to physical health-care issues, mental health has really 
gotten short shrift for too long. The law says they're equally 
important, but that's not how they're handled in practice. I believe 
that needs to change, and I'm going to talk more about that in Q&A.

    Third, the pandemic has also shined a spotlight on a lot of long-
running disparities in health care in this country--many of them issues 
that stretch back through the generations. One of them is maternal 
health care. The American people want this to be a pro-family country. 
It is totally unacceptable that pregnancy and childbirth and the 
postpartum period are so dangerous to American women, particularly when 
you compare this country to other wealthy nations.

    This is a particularly serious problem for black and Native 
American women, and it's getting worse as the years go on--not better. 
In fact, here's a shocking statistic: women today are more likely to 
die in childbirth than their mothers were a generation ago. Addressing 
this crisis goes hand-in-hand with the need to expand and improve 
women's health care overall, since the last 4 years have been a women's 
health nightmare.

    I'm looking forward to working with AG Becerra and the Biden 
administration on those issues and more. It's been a difficult 4 years 
for too many vulnerable Americans who struggle to pay for their 
medications and find access to the health care they need.

    If AG Becerra and his team start every day actually focused on 
expanding affordable health care and improving human services instead 
of limiting them, they'll already be doing better than the last 
administration.

    AG Becerra is highly qualified. He has a valuable range of 
experience that will help him succeed in this job. And this is a 
historic nomination, because AG Becerra would be the first Latino HHS 
Secretary.

                                 ______
                                 
                     America's Essential Hospitals

                      401 Ninth St., NW, Suite 900

                          Washington, DC 20004

                            t: 202-585-0100

                            f: 202-585-0101

                    https://essentialhospitals.org/

February 1, 2021

The Honorable Patty Murray          The Honorable Ron Wyden
Chair                               Chair
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor,                              Committee on Finance
  and Pensions                      Washington, DC 20510
Washington, DC 20510

The Honorable Richard Burr          The Honorable Mike Crapo
Ranking Member                      Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor,                              Committee on Finance
  and Pensions                      Washington, DC 20510
Washington, DC 20510

Dear Chair Murray, Chair Wyden, and Ranking Members Burr and Crapo,

On behalf of our more than 300 member hospitals and health systems, 
America's Essential Hospitals extends our support for the nomination 
and confirmation of Xavier Becerra as Health and Human Services (HHS) 
Secretary.

America's Essential Hospitals is the leading champion for hospitals and 
health systems dedicated to high-quality care for all, including 
vulnerable populations. Filling a vital role in their communities, our 
more than 300 member hospitals provide a disproportionate share of the 
nation's uncompensated care, and three-quarters of their patients are 
uninsured or covered by Medicare or Medicaid. Our members provide 
state-of-the-art, patient-centered care while operating on margins a 
third that of other hospitals--2.5 percent on average compared with 7.6 
percent for all hospitals nationwide.\1\
---------------------------------------------------------------------------
    \1\ Clark D, Roberson B, Ramiah K. Essential Data: Our Hospitals, 
Our Patients--Results of America's Essential Hospitals 2018 Annual 
Member Characteristics Survey. America's Essential Hospitals. May 2020. 
https://essentialdata.info. Accessed January 25, 2021.

We believe Becerra is uniquely qualified to lead HHS at this critical 
time. He has worked on significant health care issues throughout his 
career and has a deep understanding of the process and executive 
decision-making that comes with serving in leadership positions. 
Becerra has spent his career defending key programs of importance to 
essential hospitals and their communities, including Medicare and 
Medicaid. Most recently, in his role as attorney general of California, 
Becerra defended the 340B Drug Pricing Program and championed important 
protections for immigrant communities. During his tenure as a member of 
Congress, Becerra demonstrated a deep commitment to ensuring access to 
---------------------------------------------------------------------------
health care for all Americans.

We are confident Becerra will be a champion for the nation's health and 
bring a comprehensive approach to combatting the COVID-19 public health 
emergency. America's Essential Hospitals looks forward to working with 
him to address the pressing health issues of importance to our member 
hospitals and their communities. We urge the full Senate to approve his 
nomination as soon as possible.

Sincerely,

Bruce Siegel, M.D., MPH
President and CEO

                                 ______
                                 
                 American Academy of Family Physicians

                1133 Connecticut Avenue, NW, Suite 1100

                       Washington, DC 20036-4305

                             (800) 794-7481

                             (202) 232-9033

February 5, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20515                Washington, DC 20515

The Honorable Patty Murray          The Honorable Richard Burr
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Health, Education, Labor, and 
Pensions Committee                  Health, Education, Labor, and 
                                    Pensions Committee
Washington, DC 20515                Washington, DC 20515

Dear Chairman, Chairwoman, and Ranking Members:

On behalf of the American Academy of Family Physicians (AAFP), 
representing more than 136,700 family physicians, residents, and 
medical students across the country, I write to offer support for the 
nomination of Xavier Becerra to serve as Secretary of the Department of 
Health and Human Services (HHS).

Mr. Becerra has long been a champion of ensuring all Americans have 
access to high-quality, affordable health care. As a member of 
Congress, Representative Becerra helped to pass the Affordable Care Act 
(ACA) and eliminate the flawed Medicare Sustainable Growth Rate. As 
Attorney General of California, he defended the ACA against legal 
challenges \1\ in the case of Texas v. United States. The AAFP supports 
\2\ this shared vision for meaningful and affordable health care 
coverage and stands ready to work with Mr. Becerra to further build on 
the ACA's successes and further improve our health care system in his 
new role with HHS.
---------------------------------------------------------------------------
    \1\ https://www.aafp.org/news/government-medicine/
20180621amicusbrief.html.
    \2\ https://www.aafp.org/news/media-center/statements/affordable-
care-act.html.

As the COVID-19 pandemic continues to threaten our communities, swift 
action to confirm the Secretary of HHS is urgently needed to ensure the 
agency is best-equipped to respond to the pandemic. Physicians and 
patients alike are looking to HHS for clear public health guidance, and 
they are counting on HHS to obtain and deliver COVID-19 vaccines to 
---------------------------------------------------------------------------
save lives and keep our communities healthy.

Thank you for the opportunity to offer our support for the nomination 
of Mr. Becerra for HHS Secretary. If you have additional questions, 
please reach out to David Tully, Director of Government Relations, at 
[email protected].

Sincerely,

Gary L. LeRoy, M.D., FAAFP
Board Chair

                                 ______
                                 
                 American College of Clinical Pharmacy

                  Government and Professional Affairs

                  1455 Pennsylvania Avenue, Suite 400

                       Washington, DC 20004-2514

                              202-621-1820

                           202-621-1819 [fax]

                         https://www.accp.com/

February 8, 2021

The Honorable Ron Wyden             The Honorable Patty Murray
221 Dirksen Senate Office Bldg.     154 Russell Senate Office Building
Washington, DC 20510                Washington, DC 20510

8The Honorable Mike Crapo           The Honorable Richard Burr
239 Dirksen Senate Office Building  217 Russell Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Senators Wyden, Crapo, Murray and Burr:

On behalf of the American College of Clinical Pharmacy (ACCP) I am 
writing in support of the nomination of Xavier Becerra as Secretary of 
the Department of Health and Human Services (HHS).

ACCP is a professional and scientific society that provides leadership, 
education, advocacy, and resources enabling clinical pharmacists to 
achieve excellence in patient care practice and research. ACCP's 
membership is composed of over 20,000 clinical pharmacists, residents, 
fellows, students, scientists, educators and others who are committed 
to excellence in clinical pharmacy practice and evidence-based 
pharmacotherapy.

The COVID-19 pandemic has placed unprecedented burdens on our nation's 
health delivery infrastructure. As communities across the country 
struggle to respond to the COVID pandemic, a comprehensive strategy to 
ensure a truly team-based, 
patient-centered approach to patient care, consistent with evolving 
integrated delivery models, must be prioritized.

Throughout the COVID pandemic, pharmacists have been at the forefront 
of our nation's response efforts. This includes the vital work early in 
the pandemic to help scale up testing capabilities, and now pharmacists 
and pharmacies are at the center of the largest mass-vaccination in 
history.

Beyond the urgent work of pharmacists on the front lines of the 
pandemic response effort, clinical pharmacists typically practice as 
fully integrated members of the health care team, working under formal 
collaborative practice agreements or institutional privileges, to 
assume full responsibility for managing patients' medication therapies.

Qualified clinical pharmacists are usually residency trained and are 
certified as specialists by the Board of Pharmacy Specialties (BPS) to 
fully manage complex drug therapies on behalf of chronically ill 
patients as part of clinical care teams. In California, state pharmacy 
practice regulations specifically recognize qualified clinical 
providers as Advance Practice Pharmacists (APP) who are responsible for 
delivering clinical services well beyond the important work of 
dispensing medications.

Comprehensive medication management (CMM) refers to the direct patient 
care process provided by clinical pharmacists working as formal members 
of the patient's health care team that has been demonstrated to 
significantly improve clinical outcomes and enhance the safety of 
medication use by patients.

As we reach a new stage in the global fight to contain the COVID-19 
pandemic and address the sequelae of undressed health issues resulting 
from care avoidance during the pandemic, the issue of managing the safe 
and appropriate delivery of medications across an entire population 
takes center stage. This context provides a unique opportunity to 
improve patient care and decrease overall healthcare spending by 
advancing practice models that include CMM--the patient working in 
collaboration with the physician and a qualified clinical pharmacist.

Thank you for your ongoing bi-partisan leadership on behalf of the 
country at this time. We urge swift confirmation of Attorney General 
Becerra as HHS Secretary. We would welcome the opportunity to meet with 
your respective staff to provide expertise on comprehensive medication 
management as we collectively work to advance health care delivery 
models that ensure value and high quality patient outcomes.

Sincerely,

John McGlew
Director, Government Affairs

Cc: Michael S. Maddux, Pharm.D. FCCP, Executive Director

                                 ______
                                 
                     American College of Radiology

                       505 9th St., NW, Suite 910

                          Washington, DC 20004

                              202-223-1670

                          https://www.acr.org/

January 20, 2021

The Honorable Ron Wyden             The Honorable Michael Crapo
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Senators Wyden and Crapo,

The American College of Radiology (ACR), a national medical 
professional organization representing over 40,000 radiologists, 
radiation oncologists, interventional radiologists, nuclear medicine 
physicians and medical physicists, strongly supports the nomination of 
Attorney General Xavier Becerra to be the next Secretary of Health and 
Human Services (HHS).

As Attorney General of the state of California since 2017 and as a 
member of the House of Representative s for over 20 years, Attorney 
General Becerra has both the experience of running one of the largest 
government agencies in the country as well as the proven ability to 
navigate the challenges of the federal legislative and regulatory 
processes. These skills, along with his proven track record of bringing 
people together to solve big problems, will be critical as he addresses 
the nation's worst health care crisis in over a century.

While in Congress and a member of the House Ways and Means Committee, 
part of whose jurisdiction is healthcare, Attorney General Becerra 
worked with the ACR to enact complex legislation to improve patient 
care such as the inclusion of accreditation standards for those 
facilities providing advanced imaging, as well as the mandatory 
consultation of appropriate use criteria (AUC) prior to the ordering of 
medical imaging services. Both efforts improved imaging quality and 
safety and reduced cost to the Medicare system as well as to Medicare 
beneficiaries.

Most notably, while in Congress Attorney General Becerra played a 
prominent role in the drafting and enactment of the Patient Protection 
and Affordable Care Act (PPACA), where he fought to expand Americans' 
access to healthcare. As the California Attorney General, Becerra has 
led the fight to protect the PPACA from being overturned in order to 
preserve Americans' access to health insurance regardless of pre-
existing medical conditions, as well as continuing access to lifesaving 
screening services, such as mammography, at no cost to the patient.

Therefore, for the reasons stated above, and countless more, the 
American College of Radiology urges the Committee, as well as the full 
Senate, to vote in favor of Attorney General Becerra's nomination for 
Secretary of Health and Human Services.

The ACR looks forward to working with Mr. Becerra in his new role as 
HHS Secretary and continuing its work with the Committee to improve 
care and timely access to imaging services for its patients.

Sincerely,

Howard B. Fleishon, M.D., MMM, FACR
Chair, Board of Chancellors

Cc: Members, Committee on Finance

                                 ______
                                 
               American Federation of State, County and 
                      Municipal Employees, AFL-CIO

                           1625 L Street, NW

                       Washington, DC 20036-5687

                           TEL (202) 429-1000

                           FAX (202) 429-1293

                           TDD (202) 659-0446

                      WEB https://www.afscme.org/

February 22, 2021

Members of the Committee on Finance
United States Senate
Washington, DC 20510

Members of the Committee on Health, Education, Labor, and Pensions
United States Senate
Washington, DC 20510

Dear Senators:

    On behalf of the 1.4 million members of the American Federation of 
State, County and Municipal Employees (AFSCME), I write to express our 
support for the nomination of Xavier Becerra to be Secretary of the 
Department of Health and Human Services (HHS). This is a historic 
confirmation at an unprecedented time. COVID-19 is rapidly becoming the 
leading cause of death in our nation. The pandemic has laid bare and 
deepened health inequities in our country. Our nation needs an 
experienced champion like former Attorney General Becerra to reverse 
the harms caused by the previous administration to Medicaid, Medicare, 
and the Affordable Care Act, to lead a successful COVID-19 response, 
and to continue to expand affordable health care access for everyone in 
America.

    Xavier Becerra is absolutely the right person for this job at this 
crucial moment. His whole career has been focused on fairness and 
equity. As HHS Secretary, he will ensure that our nation's COVID-19 
response does not continue to compound health care inequities, but 
instead that everyone can get fair access to health care without 
discrimination, no matter where they live, what language they speak, 
what gender they are or how much money they have.

    He has an extensive knowledge of and commitment to the health care 
laws he will be implementing as HHS Secretary. He helped lead passage 
and implementation of the ACA and Medicaid expansion as a member of 
Congress. As AG of California, he has been a champion of the ACA, 
defending it against legal and administrative attacks.

    His leadership shows that he understands and is willing to take on 
ingrained distortions in our health care system that make care more 
costly and harmful to patients. He has shown the fortitude needed to 
stand up to the drug companies' ``pay for delay'' schemes \1\ that 
unnecessarily delay access to potentially life-saving and less 
expensive generic medications. He has held corporations accountable \2\ 
for peddling dangerous addictive drugs,\3\ and challenged efforts to 
concentrate market place power to raise health care prices \4\ to the 
disadvantage of patients and employers.
---------------------------------------------------------------------------
    \1\ https://oag.ca.gov/news/press-releases/attorney-general-
becerra-applauds-ninth-circuit-ruling-denying-challenge.
    \2\ https://oag.ca.gov/news/press-releases/attorney-general-
becerra-announces-573-million-nationwide-settlement-mckinsey.
    \3\ https://oag.ca.gov/news/press-releases/attorney-general-
becerra-sues-opioid-manufacturer-purdue-pharma-its-illegal.
    \4\ https://oag.ca.gov/system/files/attachments/press_releases/
Sutter%20Complaint.pdf.

    Health care is a right, not a privilege. As HHS Secretary, Becerra 
will strengthen and expand the pillars of our nation's health care 
system--Medicaid, Medicare, and the Affordable Care Act. Our country 
needs his trusted leadership on both the health care and human service 
programs administered by HHS to ensure equity and fairness now during 
the pandemic and as our country moves forward to rebuild our economy. 
AFSCME urges you to promptly confirm Xavier Becerra to be the HHS 
---------------------------------------------------------------------------
Secretary.

Sincerely,

Bailey K. Childers
Director of Federal Government Affairs

                                 ______
                                 
                    American Federation of Teachers

                       555 New Jersey Avenue, NW

                          Washington, DC 20001

                              202-879-4400

                          https://www.nft.org/

February 22, 2021

U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510

Dear Senators:

On behalf of the 1.7 million members of the American Federation of 
Teachers, I urge you to support the nomination of California Attorney 
General Xavier Becerra to become secretary of the Department of Health 
and Human Services.

Every person in America deserves the freedom to thrive, fueled by 
economic and educational opportunity and justice, fairness and a voice 
for all in our democracy. That requires not just addressing the 
confluence of crises affecting our country--including COVID-19, 
economic insecurity, a reckoning with racism, and threats to our 
democracy such as failing to distinguish fact from fiction and 
opinion--but also creating the conditions for opportunity and justice. 
By prioritizing science, the inequities in our health-care system, and 
protections and resources for health-care workers, Becerra will be a 
true partner as we work to achieve this agenda.

The AFT represents nearly 200,000 health-care professionals, who are 
directly affected by actions taken by HHS, while our educators daily 
see the impact of healthcare on the educational attainment of students 
living in poverty. Nominee Becerra's focus on equity comes from a basic 
philosophy articulated when he said: ``For me, healthcare is a right.'' 
This crucial statement provides insight into his philosophy as 
California attorney general, and into what it would be as a HHS 
secretary. During his tenure as California's attorney general, he has 
fought to save the Affordable Care Act, support reproductive rights and 
ensure access to healthcare for immigrant families, while also seeking 
to make healthcare affordable through reducing provider market 
dominance.

As attorney general, Becerra manages more than 4,500 employees and a 
substantial budget. He has extensive background on federal healthcare 
policy from his time in Congress, including serving on the Committee on 
Ways and Means. I worked with Becerra while he was in Congress and can 
attest to both his mastery of policy and, even more crucially, his care 
for constituents, healthcare professionals, children and the nation.

Xavier Becerra has the expertise, experience and world view to serve 
the country exceptionally as the secretary of the Department of Health 
and Human Services. I urge you to support his nomination. He will 
provide the leadership we need to fight for the freedom to thrive for 
our members, our families, our communities and all those we serve.

Sincerely,

Randi Weingarten
President

                                 ______
                                 
                     American Hospital Association

                          800 10th Street, NW

                       Two CityCenter, Suite 400

                       Washington, DC 20001-4956

                             (202) 638-1100

February 18, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

On behalf of our nearly 5,000 member hospitals, health systems and 
other health care organizations, our clinician partners, including more 
than 270,000 affiliated physicians, 2 million nurses and other 
caregivers--and the 43,000 health care leaders who belong to our 
professional membership groups, the American Hospital Association (AHA) 
is pleased to support the nomination of California Attorney General 
Xavier Becerra to be the next Secretary of the Department of Health and 
Human Services.

As California Attorney General, Becerra has led the effort to protect 
the Affordable Care Act and its important protections and coverage for 
patients. The AHA has worked with Becerra throughout his long career as 
a former member of the U.S. House of Representatives, including as a 
member of the Ways and Means Committee's health subcommittee. He has 
been a champion for health care coverage and affordable health care, 
which the AHA has long supported. Throughout his time in public 
service, it is clear that Becerra has consistently made people across 
America and their health a priority.

There are many critical priorities facing the nation and the health 
care field. Nothing is more critical than the COVID-19 pandemic, and 
making sure hospitals, health systems and our heroic front-line 
caregivers have the resources and support they need to care for 
patients and win the battle against the virus. The enduring challenges 
of both caring for our non COVID patients and COVID patients, 
maintaining a healthy workforce, as well as partnering to vaccinate our 
country long term will require a significant partnership. We also need 
to make important progress on advancing the transformation of health 
care, ensuring access to coverage, making health care equitable to all 
people in America and enhancing the quality of care.

The AHA looks forward to working closely with Becerra should he be 
confirmed as the next Secretary of the Department of Health and Human 
Services to achieve our mutual mission of advancing the health of the 
patients and communities we are privileged to serve.

Sincerely,

Richard J. Pollack
President and CEO

                                 ______
                                 
                          American Kidney Fund

                    11921 Rockville Pike, Suite 300

                          Rockville, MD 20852

                           301-881-3052 voice

                            301-881-0898 fax

                         800-638-8299 toll-free

                          866-300-2900 Espanol

                      https://www.kidneyfund.org/

January 26, 2021

The Honorable Ron Wyden
Chairman
U.S. Senate
Committee on Finance
Washington, DC 20510

The Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance
Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

We are writing to share our support of the nomination of Xavier Becerra 
for the Secretary of the U.S. Department of Health and Human Services. 
Mr. Becerra has a long history of support for expanding access to 
affordable health care in his role as a longtime member of the House of 
Representatives and as the California Attorney General.

As the nation's leading independent nonprofit working on behalf of the 
37 million Americans with kidney disease, the American Kidney Fund is 
dedicated to ensuring that every kidney patient has access to health 
care, and that every person at risk for kidney disease is empowered to 
prevent it. AKF provides a complete spectrum of programs and services: 
prevention outreach, top-rated health educational resources, and direct 
financial assistance enabling the nation's low-income dialysis and 
transplant patients to access lifesaving medical care.

HHS is one of the largest and most important federal agencies--
especially now, during the deadly COVID-19 pandemic--and Mr. Becerra's 
experience as both a legislator and an executive give him the needed 
expertise to lead during this crucial time. People with kidney disease 
need a strong leader at HHS now more than ever.

Kidney disease and kidney failure, also known as end-stage renal 
disease (ESRD), have a disproportionate impact on racial and ethnic 
minorities. Compared to white Americans, Black Americans are 3.4 times 
more likely to develop kidney failure; Hispanic Americans, American 
Indians/Alaska Natives and Asian Americans are respectively 1.5 times, 
1.9 times and 1.3 times more likely. These statistics--and more 
importantly, people--have come into sharper focus as COVID-19 continues 
to spread across the country, with those same communities facing higher 
rates of hospitalizations and mortality during the pandemic. People 
with underlying kidney disease and ESRD are higher risk for COVID-19 
and death related to the disease. Additionally, COVID-19 itself can 
also cause kidney damage.

We are honored to share our support for a dedicated and experienced 
public servant like Xavier Becerra to lead HHS.

Sincerely,

LaVarne A. Burton                   Jerry D. Klepner
President and CEO                   Chairman, Board of Trustees

cc: Sean McCluskie
   HHS Chief of Staff

                                 ______
                                 
                      American Medical Association

                               AMA PLAZA

                   330 N. Wabash Avenue, Suite 39300

                        Chicago, IL, 60611-5885

                            T (312) 464-5000

                       https://www.ama-assn.org/

January 21, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
219 Dirksen Senate Office Building  219 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

The American Medical Association (AMA) strongly supports Xavier Becerra 
for the Secretary of the Department of Health and Human Services (HHS). 
Throughout his career, Attorney General Becerra has worked to 
strengthen our nation's health care system. During his time in 
Congress, Mr. Becerra served on the important Ways and Means Committee, 
which oversees Medicare and other important health care programs. Mr. 
Becerra labored to strengthen Medicare and ensure its long-term 
viability as well as address poverty issues for families that have the 
potential to affect their health. In particular, the AMA worked with 
Mr. Becerra to pass the Affordable Care Act (ACA) and to eliminate 
Medicare's Sustainable Growth Rate (SGR) formula.

As California's Attorney General, Mr. Becerra worked extensively on a 
series of health care issues of importance to the nation and to the 
AMA. Mr. Becerra led a coalition of 17 states in defending the ACA in 
the Federal District Court and the Fifth Circuit Court of Appeals case, 
Texas v. U.S., which challenged the constitutionality of the ACA. Mr. 
Becerra also led 20 states and DC in filing a petition to the U.S. 
Supreme Court seeking review of the Fifth Circuit's decision in Texas 
v. U.S. The decision held the individual mandate of the ACA 
unconstitutional and called into question whether the remaining 
provisions of the ACA could still stand, including those that protect 
and provide coverage to Americans with pre-existing conditions. Also, 
as California Attorney General, Mr. Becerra pursued antitrust 
enforcement against hospital consolidations that distort the health 
care marketplace; worked to protect access to reproductive health care 
and for LGBTQ individuals; and joined other state Attorneys General in 
suing the Trump administration over its public charge rule. In all 
these cases, his efforts targeted at promoting public health and 
protecting access to care for chronically underserved individuals and 
populations.

The raging COVID-19 pandemic demands strong and consistent federal 
leadership, and it is imperative that the Senate act quickly to confirm 
Mr. Becerra to serve as Secretary of HHS. The AMA urges the Senate to 
confirm his appointment immediately.

Sincerely,

James L. Madara, M.D.

                                 ______
                                 
                      American Nurses Association

                     8515 Georgia Avenue, Suite 400

                        Silver Spring, MD 20910

                      https://www.nursingworld.org

February 10, 2021

The Honorable Ron Wyden             The Honorable Patty Murray
Chair                               Chair
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor,
219 Dirksen Senate Office Building    and Pensions
Washington, DC 20510                428 Dirksen Senate Office Building
                                    Washington, DC 20510

The Honorable Mike Crapo            The Honorable Richard Burr
Ranking Member                      Ranking Member
United States Senate                U.S. Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor,
219 Dirksen Senate Office Building    and Pensions
Washington, DC 20510                428 Dirksen Senate Office Building
                                    Washington, DC 20510

Dear Chairman Wyden, Chairwoman Murray, Ranking Member Crapo, and 
Ranking Member Burr,

On behalf of the American Nurses Association (ANA), I offer our 
wholehearted endorsement of California Attorney General Xavier Becerra 
to become the Secretary of the U.S. Department of Health and Human 
Services.

ANA is the premier organization representing the interests of the 
nation's 4.2 million registered nurses, through its state and 
constituent member associations, organizational affiliates, and 
individual members. ANA members also include the four advanced practice 
registered nurse roles (APRNs); Nurse practitioners (NPs), clinical 
nurse specialists (CNSs), certified nurse-midwives (CNMs) and certified 
registered nurse anesthetists (CRNAs). ANA is dedicated to partnering 
with health care consumers, the Congress, and the Administration to 
improve practices, policies, delivery models, outcomes, and access 
across the health care continuum. ANA had the opportunity to work with 
Congressman Becerra during his time in Congress and it is our 
experience he shares our dedication to this cause.

While a member of the Health Subcommittee on the U.S. House Ways and 
Means Committee, Mr. Becerra championed many issues important to 
nurses, other health care providers, and patients. These included 
repealing the sustainable growth rate, repealing the per-beneficiary 
Medicare spending limits on therapy services, promoting value-based 
payment models, lowering prescription drug prices, and making health 
care more affordable and accessible to everyone.

As California Attorney General, Mr. Becerra has defended the Affordable 
Care Act and essential health benefits. He fought against hospital 
consolidation and short-term junk insurance plans which make health 
care more expensive for consumers. His experience running the 
Department of Justice in America's largest state instills confidence 
that he is very capable of running one of the largest government 
agencies in the world during the COVID-19 pandemic. Further he is a 
historic choice whose own experiences allow him to personally 
understand the health care disparities in our system that have ravaged 
minority communities across the country.

If you have any questions or require additional information concerning 
the above endorsement, please feel free to contact me or Sam Hewitt, 
ANA's senior associate director of policy and government affairs at 
[email protected].

Sincerely,

Ernest Grant, Ph.D., RN, FAAN
President

                                 ______
                                 
  American Occupational Therapy Association, American Speech-Language-
     Hearing Association, and American Physical Therapy Association
March 2, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

The American Occupational Therapy Association, the American Speech-
Language-Hearing Association, and the American Physical Therapy 
Association are writing to express our support for the confirmation of 
Xavier Becerra as the U.S. Secretary of Health and Human Services.

During his 12 terms in Congress and as a member of the House Ways and 
Means Committee, Attorney General Becerra spent much of his time 
working on health care issues, including ensuring Medicare 
beneficiaries have access to care. In 1997, Congress passed the 
Balanced Budget Act, which led to the creation of the Medicare therapy 
cap that set limits on reimbursement for outpatient physical therapy, 
occupational therapy, and speech-language pathology services. The 
therapy cap was intended as a temporary solution to control Medicare 
costs but instead acted as a barrier to care for a wide spectrum of 
Medicare beneficiaries needing rehabilitation services, from patients 
who were recovering from a stroke or traumatic brain injury, to those 
suffering from chronic conditions. The cap also created an 
administrative burden that led to disruptions in patient care and 
stress for patients.

While in Congress, Attorney General Becerra championed the elimination 
of this arbitrary cap through his sponsorship of the Medicare Access to 
Rehabilitation Services Act. Thanks to his leadership, Congress 
eventually eliminated the hard caps on therapy services as part of the 
Balanced Budget Act of 2018, ensuring Medicare beneficiaries have 
access to medically necessary therapy services and preventing 
disruptions in the continuum of care.

Attorney General Becerra also worked tirelessly to identify and support 
appropriate Medicare payment for health care services and specifically 
to avoid arbitrary payment cuts resulting from the flawed Sustainable 
Growth Rate Formula (SGR). His support for the Medicare Access and CHIP 
Reauthorization Act of 2015 (MACRA) eliminated the SGR and established 
a more solid foundation for Medicare payments to enrolled providers.

Finally, as a U.S. representative and Attorney General of California, 
Mr. Becerra has supported the Affordable Care Act's (ACA's) inclusion 
of essential health benefits such as habilitative and rehabilitative 
services and devices, which are vital to individuals in need of therapy 
services. The essential health benefits, defined in Section 1302 of the 
ACA, help ensure that Americans have access to comprehensive health 
insurance, leading to improved health outcomes and ability to 
participate in their communities.

We look forward to Mr. Becerra's continued leadership to ensure access 
to occupational therapy, physical therapy, and speech-language 
pathology services and support the confirmation of Attorney General 
Xavier Becerra to lead the U. S. Department of Health and Human 
Services as the country continues to address the array of challenges 
the pandemic presents. Thank you for your consideration.

Sincerely,

Wendy C. Hildenbrand, Ph.D., MPH, OTR/L, FAOTA
AOTA President

Sharon L. Dunn PT, Ph.D.
Board-Certified Clinical Specialist in Orthopaedic Physical Therapy
APTA President

A. Lynn Williams, Ph.D., CCC-SLP
2021 ASHA President

                                 ______
                                 
                 American Physical Therapy Association

                     3030 Potomac Avenue, Suite 100

                       Alexandria, VA 22305-3085

                              703-684-2782

                         https://www.apta.org/

January 12, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

The American Physical Therapy Association would like to express its 
support for Xavier Becerra as the Biden Administration's nominee for 
the position of Secretary of Health and Human Services.

APTA is a professional organization representing 100,000 member 
physical therapists, physical therapist assistants, and students of 
physical therapy. Building a community that advances the profession of 
physical therapy to improve the health of society is our mission.

President-Elect Biden made a wise choice in the selection of California 
Attorney General Xavier Becerra to lead the department at this time, as 
the country continues to address the array of challenges the pandemic 
presents. During his 12 terms in Congress and as a member of the House 
Ways and Means Committee, Attorney General Becerra spent much of his 
time working on health care issues impacting U.S. citizens.

As a congressman, Attorney General Becerra was a staunch advocate for 
access to health care services. He helped lead a successful effort to 
eliminate arbitrary caps on seniors' access to necessary outpatient 
physical therapy services and championed legislation to ultimately 
remedy this issue for millions of Medicare beneficiaries.

In addition to his experience on health care matters, Attorney General 
Becerra brings his experience as an administrator, having run the 
California Department of Justice since 2017. In this position he 
addressed an array of health and other matters that prepare him well to 
handle the significant challenges of running an agency as large and 
diverse as the U.S. Department of Health and Human Services.

Finally, as a Latino he brings to the agency knowledge of the 
disparities in access to health services in the U.S. He is well 
positioned to address these disparities to ensure the improving health 
of the nation.

Thank you for your attention to this matter. Should you have any 
questions regarding our comments, please contact Justin Elliott, vice 
president, government affairs, at [email protected] or 703-706-
3161. Thank you for your consideration.

Sincerely,

Sharon L. Dunn, PT, Ph.D.
Board-Certified Clinical Specialist in Orthopaedic Physical Therapy
President

                                 ______
                                 
                   American Public Health Association

                            800 I Street, NW

                       Washington, DC 20001-3710

                              202-777-2742

                         https://www.apha.org/

February 10, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education,     Committee on Health, Education,
Labor, and Pensions                 Labor, and Pensions
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden, Chairwoman Murray, and Ranking Members Crapo and 
Burr:

On behalf of the American Public Health Association, a diverse 
community of public health professionals who champion the health of all 
people and communities, I write to express our full support for the 
nomination of Xavier Becerra as Secretary of the U.S. Department of 
Health and Human Services. He has both the knowledge and experience to 
lead this vital agency at this critical time as we continue to address 
the COVID-19 pandemic and the many other health challenges we face as a 
nation.

As the attorney general of California, Becerra has played a leading 
role in defending the Affordable Care Act, the crucial public health 
law that has expanded health insurance coverage to millions and has 
provided essential funding for the nation's public health system. He 
has more than two decades of experience serving as a member of the 
House of Representatives, which included serving on the House Ways and 
Means Committee which has broad jurisdiction over the nation's health 
care delivery system, including the ACA. In addition, he has been a 
leading advocate in addressing important environmental health issues, 
including climate change and environmental justice, during his time as 
attorney general and as a member of Congress. He has consistently been 
a champion for improving the health and well-being of the nation.

We are confident that Mr. Becerra has the leadership skills and 
experience needed to lead the U.S. Department of Health and Human 
Services. We strongly endorse his nomination and urge the Senate's 
swift confirmation. We look forward to working with him and the rest of 
the dedicated staff at HHS to address the many public health challenges 
that we face as a nation. Please feel free to contact me with any 
questions regarding our support for his nomination.

Sincerely,

Georges C. Benjamin, M.D.
Executive Director

                                 ______
                                 
            American Society for Clinical Laboratory Science

                  1861 International Drive, Suite 200

                         McLean, Virginia 22102

                           https://ascls.org/

                            [email protected]

                              571-748-3770

                            fax 571-354-7570

January 21, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

The American Society for Clinical Laboratory Science (ASCLS) would like 
to express its support for Xavier Becerra as the Biden Administration's 
nominee for the position of Secretary of U.S. Department of Health and 
Human Services. ASCLS urges his swift confirmation by the U.S. Senate.

The mission of ASCLS is to make a positive impact in health care 
through leadership that will assure excellence in the practice of 
laboratory medicine. ASCLS represents medical laboratory scientists and 
medical laboratory technicians who are the backbone of our nation's 
diagnostic health care system.

President-Elect Biden made a wise choice in the selection of California 
Attorney General Xavier Becerra to lead the department at this time as 
the country continues to address the array of challenges the pandemic 
presents. During his twelve terms in Congress, Attorney General Becerra 
spent much of his time working on health care issues impacting U.S. 
citizens as a member of the House Ways and Means Committee.

As a Congressman, Attorney General Becerra was a staunch advocate for 
access to health care services. Clinical laboratory scientists have a 
critical health care role to play and we must ensure access to clinical 
laboratory services is unfettered especially during this coronavirus 
(COVID-19) pandemic. The ongoing shortage of laboratory personnel in 
the U.S. should be of great concern as we address the current pandemic 
and future access to high quality laboratory diagnostic services.

In addition to his experience on health care matters, Attorney General 
Becerra brings his experience as an administrator having run the 
California Department of Justice since 2017. In this position he 
addressed an array of health and other matters that prepare him well to 
handle the significant challenges of running an agency as large and 
diverse as the U.S. Department of Health and Human Services.

Finally, as the first Latino to head the agency, he brings to the 
agency knowledge of the disparities in access to health services in the 
U.S. He is well positioned to address these disparities, including 
workforce disparities, to ensure the improving health of the nation.

Thank you for your attention to this matter.

Sincerely,

Maddie Josephs, MS, MLS (ASCP)
President

                                 ______
                                 
                American Society for Radiation Oncology

                     251 18th St. South, 8th Floor

                          Arlington, VA 22202

                           Main: 703-502-1550

                           Fax: 703-502-7852

                         https://www.astro.org/

                       https://www.rtanswers.org/

January 20, 2020

The Honorable Ron Wyden             The Honorable Mike Crapo
221 Dirksen Senate Office Bldg.     239 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
154 Russell Senate Office Building  217 Russell Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Senators Wyden, Crapo, Murray and Burr:

The American Society for Radiation Oncology (ASTRO), on behalf of our 
11,000 members of the radiation oncology team, strongly supports the 
nomination of Xavier Becerra as Secretary of the Department of Health 
and Human Services (HHS).

Attorney General Becerra is uniquely qualified to serve in this 
position, as he has acquired a lifetime of personal and professional 
experience and expertise helping Americans access vital health care 
services. ASTRO has always appreciated the opportunity to work with 
Attorney General Becerra to ensure that cancer patients, particularly 
lower income Americans, have affordable health insurance and access to 
the highest quality cancer care. We are confident that Attorney General 
Becerra's continuous fight for those most at risk will translate 
exceptionally well to meeting the serious health care needs of all 
Americans, including those affected by the COVID-19 pandemic.

While serving in Congress for 24 years, Attorney General Becerra 
distinguished himself as a foremost health care expert and leader, 
championing critical issues such as the Affordable Care Act insurance 
expansions, ensuring appropriate Medicare and Medicaid benefits and 
reimbursement, tobacco prevention and control, reducing health 
disparities, lowering drug prices, and more. Recently, Attorney General 
Becerra has continued his extensive list of health care 
accomplishments, including dedicating himself to ensuring that 
Californians and all Americans receive the insurance benefits they 
deserve and can access COVID-19 testing, vaccines, and treatment.

ASTRO is particularly excited to work with Attorney General Becerra to 
advance health equity and reduce health care disparities, which have 
been further exposed and exacerbated by the pandemic and are evident 
across health care, including cancer care. Research consistently shows 
that adequate health insurance is associated with better cancer 
outcomes, but we know that many underserved cancer patients struggle to 
access life-saving radiation treatments in their communities. Attorney 
General Becerra understands the complexities associated with addressing 
health care disparities, and he has a proven record of navigating the 
legislative environment and agency bureaucracy for the benefit of 
Americans. As the first Latino Secretary of HHS, he is uniquely 
situated to help turn the tide against the persistent challenge of 
disparities in care.

There is no time to waste in responding to the COVID-19 pandemic and 
the myriad of health care challenges facing patients and providers. 
ASTRO knows that we can count on Attorney General Becerra to stand up 
for what is right. He brings unrivaled competency and unmatched passion 
to the position.

He is deeply familiar with the central role physician's play in the 
health care system, and their contribution to driving greater value in 
health care delivery. Attorney General Becerra is a wonderful choice to 
help us rebuild a frayed health care system and find ways to innovate 
and improve moving forward.

The HHS portfolio is as broad and expansive as any in the federal 
government, and there are few with the depth of experience to manage 
operations and drive exceptional performance. Attorney General Becerra 
is among the few with the extensive public service record of 
accomplishments that perfectly matches the important duties of HHS 
Secretary. ASTRO urges swift confirmation of Attorney General Becerra 
as HHS Secretary.

Sincerely,

Laura I. Thevenot
Chief Executive Officer

                                 ______
                                 
              American Society of Radiologic Technologists

                        15000 Central Avenue, SE

                       Albuquerque, NM 87123-3909

                              505-298-4500

                              800-444-2778

                            Fax 505-298-5063

                         https://www.asrt.org/

January 18, 2021

To whom it may concern:

ASRT Supports President-Elect Biden's Nomination of Xavier Becerra for 
HHS Secretary

The American Society of Radiologic Technologists (ASRT) supports 
President-elect Biden's nomination of California Attorney General 
Xavier Becerra as Secretary of the United States Department of Health 
and Human Services (HHS). During his time in Congress, former Rep. 
Becerra was involved and instrumental (serving on the House Ways and 
Means Committee) on a wide array of health care issues and worked 
closely with the ASRT and the medical imaging community to improve the 
American health care system and ensure patient access to high quality 
imaging care. The ASRT looks forward to working with Mr. Becerra as the 
head of HHS, Congress and other interested stakeholders to continue to 
maintain the highest quality care to the patients we serve.

Sal Martino,
CEO and Executive Director

                                 ______
                                 
               American Society for Reproductive Medicine

                           726 7th Street, SE

                          Washington, DC 20003

                             (202) 747-5261

                         https://www.asrm.org/

February 22, 2021

The Honorable Patty Murray
Chair
U.S. Senate
Committee on Health, Education, Labor, and Pensions
Washington, DC 20510

The Honorable Richard Burr
Ranking Member
U.S. Senate
Committee on Health, Education, Labor, and Pensions
Washington, DC 20510

Dear Chairperson Murray and Ranking Member Burr:

On behalf of the American Society for Reproductive Medicine, I write in 
support of the nomination of Xavier Becerra to the role of Secretary of 
Health and Human Services. Mr. Becerra has an established track record 
as a healthcare champion; for example, having led 20 states and the 
District of Columbia in a campaign to protect and uphold the Affordable 
Care Act. As an organization committed to ensuring our health advisers 
prioritize access to reproductive medicine, we are confident in Mr. 
Becerra's ability to lead and look forward to working with him, once 
confirmed.

The American Society for Reproductive Medicine (ASRM) has, for nearly a 
century, been a global leader in multidisciplinary reproductive 
medicine research, ethical practice, and education. ASRM's 
approximately 8,000 distinguished members, which include obstetricians 
and gynecologists, urologists, mental health professionals, and others, 
represent more than 100 countries and impact and inform all aspects of 
reproductive care and science worldwide.

ASRM is dedicated to the advancement of the science and practice of 
reproductive medicine. The Society accomplishes its mission through the 
pursuit of excellence in evidence-based, life-long education and 
learning, through the advancement and support of innovative research, 
through the development and dissemination of the highest ethical and 
quality standards in patient care, and through advocacy on behalf of 
physicians and affiliated healthcare providers and their patients.

As leaders in the field of reproductive medicine, we are invested in 
ensuring the swift confirmation of qualified leaders equipped and 
prepared to prioritize Americans' healthcare needs, including 
reproductive medicine.

We appreciate your consideration and support of this nomination. Becca 
O'Connor, ASRM's Director of Government Affairs, is prepared to respond 
to any questions you might have about this and as you undertake the 
important work of the 117th Congress. She can be reached at: 
[email protected] or 617-270-4465.

Sincerely,

Hugh Taylor, M.D.
President

                                 ______
                                 
                Association of American Medical Colleges

                      655 K Street, NW, Suite 100

                       Washington, DC 20001-2399

                             T 202-828-0400

                         https://www.aamc.org/

February 22, 2021

The Honorable Ron Wyden             The Honorable Patty Murray
Chairman                            Chairwoman
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor,
221 Dirksen Senate Office Building    and Pensions
Washington, DC 20510                154 Russell Senate Office Building
                                    Washington, DC 20510

The Honorable Mike Crapo            The Honorable Richard Burr
Ranking Member                      Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor, and Pensions
239 Dirksen Senate Office Building  217 Russell Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden, Chairwoman Murray, Ranking Member Crapo, and 
Ranking Member Burr:

On behalf of the AAMC (Association of American Medical Colleges), I 
write to urge you to support the nomination of the Honorable Xavier 
Becerra, JD for Secretary of the U.S. Department of Health and Human 
Services (HHS). Secretary-designate Becerra's experience in health 
policy and patient advocacy makes him a well-qualified candidate to 
serve in this role. In addition, his leadership experience will prove 
useful as he guides the many agencies of HHS as the department not only 
continues to respond to the COVID-19 pandemic, but also prepares for 
future public health emergencies and addresses other critical health 
care issues, including health coverage.

The AAMC is a not-for-profit association dedicated to transforming 
health through medical education, health care, medical research, and 
community collaborations. Its members are all 155 accredited U.S. and 
17 accredited Canadian medical schools; more than 400 teaching 
hospitals and health systems, including Department of Veterans Affairs 
medical centers; and more than 70 academic societies. Through these 
institutions and organizations, the AAMC leads and serves America's 
medical schools and teaching hospitals and their more than 179,000 
full-time faculty members, 92,000 medical students, 140,000 resident 
physicians, and 60,000 graduate students and postdoctoral researchers 
in the biomedical sciences.

HHS is critical to defeating COVID-19, as demonstrated already by the 
creation of a COVID Response Team within the agency. HHS and its 
agencies also are dedicated to promoting the nation's health and well-
being, including through medical research, patient care, the health 
care workforce, and community health. Academic Medicine has been 
defining the front lines in addressing the pandemic. In addition, the 
missions of HHS and its agencies also are key to the mission of the 
AAMC and are core for our member medical schools and teaching 
hospitals. Secretary-designate Becerra's leadership experience--such as 
the efforts to protect patients' access to health care and establish 
health equity initiatives that he led during his tenure as Attorney 
General of the State of California--will be an asset in this role. He 
also brings health policy expertise from his experience on the House 
Committee on Ways and Means where he championed affordable, 
comprehensive health care coverage for patients.

As the challenges presented by the COVID-19 pandemic continue, we urge 
the Senate to proceed quickly with Secretary-designate Becerra's 
confirmation to ensure that HHS has leadership at the helm now to 
coordinate an effective response to COVID as well as proceed on the 
other pressing health care needs of the country. We look forward to 
engaging with Secretary-designate Becerra to address important issues 
facing the nation, including our mutual goal of improving the health of 
people everywhere.

Please feel free to contact me or AAMC Chief Public Policy Officer 
Karen Fisher, JD ([email protected]) if you have any questions or would 
like any additional information.

Thank you,

David J. Skorton, M.D.
 President and Chief Executive Officer

cc: Senate Majority Leader Chuck Schumer
   Senate Minority Leader Mitch McConnell

                                 ______
                                 
             Association of Clinical Research Professionals

                    99 Canal Center Plaza, Suite 150

                          Alexandria, VA 22314

                          https://acrpnet.org/

January 21, 2020

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

The Association of Clinical Research Professionals (ACRP) would like to 
express its support for Xavier Becerra as the Biden Administration's 
nominee for the position of Secretary of U.S. Department of Health and 
Human Services. HCAOA urges his swift confirmation by the U.S. Senate.

ACRP members are individuals working on research studies in humans or 
with materials from humans. With over 13,000 members in the United 
States, ACRP's diverse population work in a variety of practice 
settings, roles, and specialty areas, with a wide range of experience 
in the field. What's common about them all is their dedication and 
commitment to promoting excellence in clinical research.

President-Elect Biden made a wise choice in the selection of California 
Attorney General Xavier Becerra to lead the department at this time as 
the country continues to address the array of challenges the pandemic 
presents. During his twelve terms in Congress, Attorney General Becerra 
spent much of his time working on health-related issues impacting U.S. 
citizens as a member of the House Ways and Means Committee.

As a Congressman, Xavier Becerra was a staunch advocate for access to 
health care. ACRP members are actively engaged in the clinical research 
necessary to discover and improve health care treatment, devices, and 
pharmaceuticals, to include vaccines. Much work lays ahead and ACRP is 
committed to ensuring the clinical competency of all clinical research 
professions.

Attorney General Becerra brings his experience as an administrator 
having run the California Department of Justice since 2017. In this 
position he addressed an array of health and other matters that prepare 
him well to handle the significant challenges of running an agency as 
large and diverse as the U.S. Department of Health and Human Services.

Finally, Attorney General Becerra brings to the agency knowledge of the 
disparities in access to health services in the U.S. He is well 
positioned to address these disparities. ACRP itself is undertaking 
efforts to produce a more diverse workforce and looks forward to 
working with the nominee to ensure the improving health of the nation.

Thank you for your attention to this matter.

Sincerely,

Jim Kremidas
Executive Director

                                 ______
                                 
             Association of Clinicians for the Underserved

                      1575 I Street, NW, Suite 300

                          Washington, DC 20005

                          Tel: (844) 422-8247

                          Fax: (703) 562-8801

                        https://clinicians.org/

     Statement on the nomination of Xavier Becerra as HHS Secretary

Washington, DC--January 21, 2021--The Association of Clinicians for the 
Underserved (ACU) strongly supports the nomination of Xavier Becerra to 
be the next Secretary of the United States Department of Health and 
Human Services. ACU was fortunate to work with Xavier Becerra and his 
colleagues during his tenure as a member of the US House of 
Representatives on the passage of the Affordable Care Act. Mr. 
Becerra's commitment to ensure affordable coverage and access to 
healthcare for the those most in need represents exactly the type of 
leadership and vision needed to lead our nation through this time of 
challenge and crisis.

As the ACU network continues to grapple with the horrible strain and 
dire impact of the COVID-19 pandemic, we are encouraged by the 
leadership Mr. Becerra can bring to our nation in addressing health 
equity, ensuring affordable healthcare access and coverage, and working 
to build the healthcare workforce needed to support and transform our 
healthcare system.

We are grateful for Mr. Becerra's long history of public service and 
his dedicated work in support of America's underserved. The ACU 
welcomes the opportunity to work closely with Mr. Becerra and all of 
HHS to advance our shared goals and mission; to improve the health of 
America's underserved populations and to enhance the development and 
support of the clinicians who serve them.

                                 # # #

The Association of Clinicians for the Underserved is a uniquely 
transdisciplinary membership association uniting clinicians, advocates, 
and organizations in the shared mission to improve the health of 
America's underserved populations and to support the clinicians serving 
them. ACU provides professional education, training and technical 
assistance, and clinical tools and programs to thousands of clinicians 
and organizations every year to improve health equity for the 
underserved. To learn more about ACU, visit www.clinicians.org, like 
ACU on Facebook, or follow us on Twitter.

                                 ______
                                 
               Association for Community Affiliated Plans

                    1155 15th Street, NW, Suite 600

                          Washington, DC 20005

                           Tel. 202-204-7505

                    https://www.communityplans.net/

February 16, 2021

The Honorable Ron Wyden             The Honorable Patty Murray
Chairman                            Chairman
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor,
Washington, DC 20510                  and Pensions
                                    Washington, DC 20510

The Honorable Mike Crapo            The Honorable Richard Burr
Ranking Member                      Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor,
Washington, DC 20510                  and Pensions
                                    Washington, DC 20510

Dear Senators Wyden, Crapo, Murray, and Burr:

The Association for Community Affiliated Plans (ACAP) is a national 
trade association representing 78 not-for-profit Safety Net Health 
Plans. Collectively, ACAP plans serve more than 20 million people 
through Medicaid, Medicare, the Marketplaces, and other publicly 
supported coverage programs. Our mission is to support our member 
plans' efforts to improve the health and well-being of people with low 
incomes and with significant health care needs.

We write to support the nomination of the Honorable Xavier Becerra for 
Secretary of the Department of Health and Human Services (HHS). 
Secretary-Nominee Becerra is unequivocally qualified to run HHS, as a 
longtime supporter of equitable access to comprehensive, affordable 
health coverage and care. Throughout his career in Washington, DC--with 
20 years of experience on the House Committee on Ways and Means--and as 
California's Attorney General, Xavier Becerra has not just led efforts 
to support and protect the Affordable Care Act, but countless other 
health care efforts. In addition to his significant policy and 
operational knowledge of health care from his time in the U.S. House of 
Representatives, his time as California's Attorney General 
unequivocally demonstrated his ability to manage a large, bureaucratic 
agency that oversees a wide swath of topics.

We encourage a swift confirmation of Mr. Becerra, so that he can 
quickly get to work addressing the multitude of health care issues that 
have befallen the American public--from the COVID-19 pandemic, to all-
too-frequent churn within the Medicaid program, to the loosening of ACA 
rules that protect consumers from inadequate, junk insurance plans. 
Throughout his career Mr. Becerra has been a stalwart supporter of 
policies to improve the lives of lower-income and vulnerable 
populations; we look forward to working with him and Congress to 
further improve the lives of Americans nationwide.

Sincerely,

Margaret A Murray
CEO

                                 ______
                                 
                               Be a Hero

                        https://beaherofund.com/

February 22, 2021

The Honorable Ron Wyden
Chairman
Committee on Finance
United States Senate
Washington, DC 20510

Dear Chairman Wyden:

I write to urge the Committee to support Xavier Becerra, President 
Biden's nominee to lead the Department of Health and Human Services.

During an infectious disease pandemic that has cost more than 500,000 
lives in the United States, it is imperative that HHS is led by someone 
who understands that SARS-CoV-2 doesn't discriminate based on income, 
immigration papers, health history, and more--but our broken systems 
do. We need a demonstrated health equity champion who can lead the 
Department during an unprecedented challenge to health equity for 
marginalized communities.

A child of an immigrant day labor and clerical worker, Xavier Becerra 
has spent his career working to help more families access health care 
and the services needed for their well-being. To name just a few of his 
efforts, as a Member of Congress, Becerra helped expand Medicaid to 
millions of vulnerable people through the Affordable Care Act. As 
California Attorney General, he led a multi state coalition to defend 
the health and well-being of children held in immigration detention. 
And throughout his career, he has fought against the structural racism 
that leads to disproportionately worse health outcomes for communities 
of color.

In the coming months, we will hopefully see your work help eradicate a 
deadly virus that has already destroyed so many lives. But too many 
people are facing this pandemic while also facing barriers to accessing 
health coverage and care. We can help ease that burden right now--we 
need an experienced manager and policy leader who knows the impact 
structural inequality has on everyday families and is willing to fight 
to ensure that no family is left behind during this pandemic and 
beyond. This begins with the committee's support for Xavier Becerra as 
United States Secretary of Health and Human Services.

Thank you for your consideration of this crucial nomination. If you 
would like more information or to discuss further, please contact 
Matthew Cortland at matthew@
beaherofund.com.
Sincerely,

Ady Barkan

                                 ______
                                 
                  California Primary Care Association

                        1231 I Street, Suite 400

                          Sacramento, CA 95814

                             (916) 440-8170

                         https://www.cpca.org//

January 26, 2021

The Honorable Dianne Feinstein
331 Hart Senate Office Building
Washington, DC 20510

Re:  Xavier Becerra's Nomination for Secretary of Health and Human 
Services (HHS)--SUPPORT

Dear Senator Feinstein,

On behalf of the California Primary Care Association (CPCA)--
representing California's 1,370 community health centers (CHCs) which 
serve 7.2 million Californians, I am writing to express our strong 
support of Xavier Becerra's nomination for Secretary of Health and 
Human Services (HHS). I have known Secretary-designate Becerra for many 
years, and I think he is the perfect choice to lead HHS at this crucial 
time. COVID-19 has reinforced the structural discrimination and racism 
within our society, and CHCs have witnessed this uneven impact of 
COVID-19 on their racial and ethnic minorities, homeless, and farm 
worker patients. Xavier Becerra is uniquely positioned to bring the 
tailored approach and leadership that is needed to support all 
Americans through this unprecedented public health emergency and 
guarantee a stronger health care delivery system when it is over.

With the Biden Administration refocusing the federal government's 
COVID-19 response and building a new vaccination infrastructure that is 
centered in community health centers, Becerra comes well-prepared to 
see that vision forward. As congressman, Secretary-designate Becerra 
represented a district that has 30 health centers with 57 sites. 
Collectively, those health centers serve over 244,000 patients, 
representing over one-quarter of the population of his former 
congressional district. Nationwide, health centers serve almost 10% of 
the population, so the Secretary-
designee's experience with health centers in his congressional district 
will be important as he transitions to a national position.

Secretary-designate Becerra has always been a strong supporter of 
health centers. He attended events at health centers in his former 
congressional district and hosted regular policy roundtables for health 
center leaders. More importantly, he fought for programs and funding 
helpful to health centers through his position as a senior member of 
the House Ways and Means Committee. He has also been involved in the 
important discussions about the federal government's role in ensuring 
coverage for all.

As Attorney General of California, Secretary-designate Becerra 
continued his work in support of access and coverage, most notably as 
leader in defending the Affordable Care Act through a legal challenge 
that united 20 states and the District of Columbia, a case that will be 
decided by the Supreme Court this Spring. Additionally, as Attorney 
General, he worked with his peers across the country to make 
pharmaceutical reforms and support a women's access to health care 
services.

As COVID continues to ravage our country, with a disproportionate 
impact on historically marginalized communities and communities of 
color, it is imperative that Secretary-designate Becerra be confirmed 
and on-the-job quickly. For that reasons, we respectfully request the 
swift confirmation of Secretary-designate Becerra as Secretary of 
Health and Human Services. I cannot recommend him more highly for this 
position, and I look forward to working with him in his new role.

Thank you for your quick consideration of his nomination.

Sincerely,

Carmela Castellano Garcia, Esq.
President and CEO

                                 ______
                                 
                     Campaign for Tobacco-Free Kids

                     1400 I Street, NW, Suite 1200

                          Washington, DC 20005

                          Phone (202) 296-5469

                           Fax (202) 296-5427

                    https://www.tobaccofreekids.org/

February 12, 2021

The Honorable Ron Wyden
Chairman
Committee on Finance
United States Senate
Washington, DC 20510

Dear Chairman Wyden:

We write to express our strong support for the nomination of Xavier 
Becerra to be Secretary of the Department of Health and Human Services. 
He is highly qualified and has the experience necessary to address the 
enormous health challenges facing our nation, including the death and 
disease caused by tobacco use.

Mr. Becerra has an impressive record of protecting public health and 
will be prepared on day one to address the COVID-19 pandemic and the 
stark health disparities it has exposed, as well as tobacco use, which 
heightens those disparities.

Tobacco use has long been the leading preventable cause of death in the 
U.S., causing more than 480,000 deaths and an estimated $170 billion in 
health care costs each year. High rates of e-cigarette use by youth is 
a new challenge that is placing another generation at risk for nicotine 
addiction and tobacco use. Tobacco use is also a significant 
contributor to health disparities, as tobacco use and tobacco-caused 
disease have become more concentrated among certain communities of 
color, people with lower levels of income and education, people with a 
behavioral health condition, and LGBT Americans. Exacerbating this 
problem, cigarette smokers are at greater risk for severe illness from 
COVID-19, which provides an urgent new reason to help tobacco users to 
quit.

As the Attorney General of California, Mr. Becerra has demonstrated 
leadership in protecting kids from tobacco. Recognizing that youth are 
particularly vulnerable to nicotine use and addiction, he worked to 
protect kids from e-cigarette marketing and tobacco imagery in streamed 
video content. He also supported California's new law ending the sale 
of flavored tobacco products, which are a key driver of youth tobacco 
use. During his time in Congress, he supported the landmark law giving 
FDA authority to oversee tobacco products, which includes a critical 
requirement that new tobacco products undergo a public health review by 
the agency before they can be marketed.

We believe Mr. Becerra will be a strong and effective leader of the 
Department of Health and Human Services and will use his position to 
prevent disease and save lives. We urge your Committee to favorably 
report his nomination to the U.S. Senate and that he be quickly 
confirmed.

Sincerely,

Matthew L. Myers
President

cc: The Honorable Mike Crapo, Ranking Member, Committee on Finance

                                 ______
                                 
                        Cancer Support Community

                     734 15th Street, NW, Suite 300

                          Washington, DC 20005

                           202-659-9709 Phone

                            202-974-7999 Fax

                https://www.cancersupportcommunity.org/

February 8, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
219 Dirksen Senate Office Building  219 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo,

The Cancer Support Community (CSC), an international nonprofit 
organization that provides support, education, and hope to cancer 
patients, survivors, and their loved ones, supports the nomination of 
the Honorable Xavier Becerra to serve as the next Secretary of the 
United States Department of Health and Human Services (HHS). While 
serving as a United States Congressman and as the Attorney General of 
California, Mr. Becerra continuously protected the rights of patients 
both state and nationwide. We are confident that he will do the same as 
Secretary of HHS.

Throughout his career, Mr. Becerra has always put patients first, 
including those impacted by cancer. Mr. Becerra was a proud co-sponsor 
of the Patient Protection and Affordable Care Act (ACA) and actively 
worked to pass this landmark legislation. As a member of Congress, he 
steadfastly fought to protect and preserve the ACA by voting at least 
nine times against efforts to repeal and replace the law. He also 
sponsored the E-Centives Act, which provided incentives for Medicaid 
providers to improve quality of care by implementing electronic health 
records.

Most recently, as Attorney General of California, Mr. Becerra led a 
coalition of over 20 state Attorneys General in defending the ACA 
against an effort to repeal the entire law in the Supreme Court case, 
California v. Texas. In their brief, the coalition underscored the 
substantial advancements in access to health care made under the ACA, 
including Medicaid expansion which has provided coverage to nearly 15 
million Americans (Kaiser Family Foundation, 2020), and guaranteed 
protections for as many as 133 million Americans with pre-existing 
conditions, such as cancer (Department of Health and Human Services, 
2017). Mr. Becerra has long stressed that the ACA is the backbone of 
our health care system and that if it were to be struck down, it will 
impact the ability of many Americans to access and afford health 
coverage, especially during a global pandemic.

The COVID-19 pandemic has significantly strained our nation's health 
care system and continues to have an enormous impact on the continuity 
of care for people impacted by cancer. HHS needs a strong leader at the 
helm who can implement policies that will protect patients both now 
during these challenging times and in the future. Mr. Becerra's record 
in advocating for policies that will strengthen the health and well-
being of patients makes him the right person for this ever important 
position at this consequential time in history. Therefore, we urge you 
to confirm Mr. Xavier Becerra as the next Secretary of HHS.

Thank you for your consideration. Should you have any questions about 
our support for Mr. Becerra's nomination, please contact me at (202) 
552-6762 or pwoods@
cancersupportcommunity.org.


Sincerely,

Phylicia L. Woods, JD, MSW
Executive Director--Cancer Policy Institute

References

Department of Health and Human Services. 2017. Health Insurance 
        Coverage for Americans with Pre-Existing Conditions: The Impact 
        of the Affordable Care Act. Retrieved from https://
        aspe.hhs.gov/system/files/pdf/255396/Pre-ExistingCon
        ditions.pdf.

Kaiser Family Foundation. 2020. Potential Impact of California v. Texas 
        Decision on Key Provisions of the Affordable Care Act. 
        Retrieved from https://www.kff.org/health-reform/issue-brief/
        potential-impact-of-california-v-texas-decision-on-key-
        provisions-of-the-affordable-care-act/.

                                 ______
                                 
              Casa de Esperanza: National Latin@ Network 
                  for Healthy Families and Communities

                   540 Fairview Avenue S., Suite 540

                           St. Paul, MN 55104

                              651-646-5553

                        www.casadeesperanza.org

February 12, 2021

U.S. Senate
Committee on Health, Education, Labor, and Pensions
428 Dirksen Senate Office Building
Washington, DC 20510

U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510

Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking 
Member Crapo, and Committee Members:

On behalf of Casa de Esperanza: National Latin@ Network for Healthy 
Families and Communities, I write this letter to express our support 
and endorsement of Xavier Becerra as someone who is uniquely qualified 
to lead the Department of Health and Human Services at this critical 
time. His diverse experience has placed him at the forefront of efforts 
to address the needs of poor and working families, legal efforts to 
protect access to affordable health care, and a demonstrated commitment 
to supporting survivors of intimate partner violence.

Casa de Esperanza is a national organization with almost 40 years of 
experience in supporting Latin@ communities with regards to anti-
domestic and sexual violence, stalking, trafficking, and dating 
violence. We were founded in 1982 in Minnesota to provide emergency 
shelter and support services for women and children experiencing 
domestic violence. In 2009 Casa de Esperanza launched the National 
Latin@ Network for Healthy Families and Communities, which is a 
national resource center that provides training and technical 
assistance, research, and national policy advocacy focused on 
addressing and preventing gender-based violence, primarily in Latin@ 
and immigrant communities. We are part of a network of domestic 
violence programs that work collaboratively to promote practices and 
strategies to improve our nation's response to domestic violence and 
make safety and justice for all families a priority. Our efforts 
involve working closely with the Family Violence Prevention and 
Services Act (FVPSA) Program, located in the Family and Youth Services 
Bureau (FYSB), Administration for Children and Families (ACF) of the 
U.S. Department of Health and Human Services.

Domestic and sexual violence impacts all areas of the lives of 
survivors and their children. The systems they access for help can 
either support or cause further harm and trauma. A holistic approach to 
domestic and sexual violence is needed to ensure the safety and well-
being of survivors and their families. This is especially critical as 
the United States grapples with the COVID-19 pandemic. The inequities 
in our nation are inescapable as Black, Latin@, Asian/Pacific Islander 
and Native American communities bear the brunt of the pandemic's 
economic and health damages. We are at a time where all of us must work 
toward outcomes that benefit and are equitable for all. Leading us out 
of this pandemic will require unwavering ethics, a leader with 
integrity, and someone who understands complex bureaucratic systems, as 
well as the issues everyday people are currently experiencing. Mr. 
Becerra, through his long-term commitment to support families, women, 
and children, has proven he is concerned about the same lived realities 
of the communities we serve at Casa de Esperanza.

The Department of Health and Human Services (HHS) is the agency in the 
federal executive branch most involved with addressing the nation's 
human concerns. In one way or another, it touches the lives of more 
people than any other federal agency. It is the agency that addresses 
the health and well-being of all people, and within that has a 
longstanding commitment of working to prevent family violence and 
provide services, ever since the enactment of the Family Violence 
Prevention and Services Act in 1984. HHS is the agency best positioned 
to advancing a more holistic and equitable approach to improving 
pathways to safety for survivors of domestic violence. It is more 
important than ever that this department be comprised of leaders 
committed to ending violence against women, addressing health equity, 
and advancing racial equity. As such, there is no better candidate to 
lead the Department of Health and Human Services than Xavier Becerra.

Mr. Becerra is a deeply qualified and passionate leader with a depth 
and breadth of experience that spans three decades of working to 
address violence against women and support survivors, ensure access to 
healthcare, and protect Social Security and Medicare. In May of 2020, 
as California Attorney General, Xavier Becerra called for the 
reauthorization of the Violence Against Women Act, stating that 
``[t]here's no place for violence against women anywhere.'' At the 
California Department of Justice, Becerra ensured that they were doing 
their part to support survivors of domestic and sexual violence and 
prevent and respond to crimes against women. During COVID-19, Attorney 
General Becerra stayed focused on the needs of survivors and worked to 
ensure that they had access to critical services during state-wide 
stay-at-home orders. At the California Department of Justice, Becerra 
ensured that they were doing their part to support survivors of 
domestic and sexual violence and prevent and respond to crimes against 
women.'' During COVID-19, Attorney General Becerra stayed focused on 
the needs of survivors and worked to ensure that they had access to 
critical services during state-wide stay-at-home orders.

We urge the Senate Committees on Health, Education, Labor, and Pensions 
and Finance to swiftly confirm Xavier Becerra as Secretary of the 
Department of Health and Human Services.

Please feel free to contact me if you have any questions relating to 
these comments.

Respectfully submitted,

Patricia Tototzintle
Chief Executive Officer

                                 ______
                                 
                      Center for Medicare Advocacy

                 1025 Connecticut Avenue, NW, Suite 709

                          Washington, DC 20036

                             (202) 293-5760

                     https://medicareadvocacy.org/

February 12, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
United States Senate                United States Senate
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
United State Senate                 United States Senate
Washington, DC 20510                Washington, DC 20510

Dear Senators Wyden, Crapo, Murray and Burr:

The Center for Medicare Advocacy (the Center) strongly supports the 
nomination of California Attorney General Xavier Becerra for Secretary 
of the Department of Health and Human Services (HHS). The Center, 
founded in 1986, is a national, non-profit, non-partisan law 
organization that works to advance access to comprehensive Medicare, 
health equity, and quality health care.

Mr. Becerra has been a champion of expanding access to health care, 
from his time in Congress to his most recent role as California's 
Attorney General. During his twelve terms in Congress, including while 
serving on the House Ways & Means Health Subcommittee, Mr. Becerra 
worked to improve the Medicare program as well as health care access 
more broadly.

Our organization strongly supported his introduction of the Medicare 
Savings Programs Improvement Act of 2007 to expand cost-sharing 
subsidies for low-income individuals dually eligible for Medicare and 
Medicaid, many provisions of which were included in the Medicare 
Improvements for Patients and Providers Act of 2008 and the Medicare 
Access and CHIP Reauthorization Act of 2015. Among other things, he 
also worked to eliminate the arbitrary caps on outpatient therapy, 
expand Medicare coverage of medical nutrition services, and require the 
HHS Secretary to conduct research on issues related to socioeconomic 
status related to Medicare's value-based programs.

As Attorney General of California, he led a group of states defending 
the Affordable Care Act (ACA) in California v. Texas; the Center was 
honored to support this effort by submitting an amicus brief along with 
AARP and Justice in Aging in support of California and the other 
states.

In his role as California AG, Mr. Becerra was at the forefront of 
challenges to policies that harm the health of older adults and people 
with disabilities, such as the previous administration's expansion of 
the ``public charge'' rule. As a strong advocate for residents of 
nursing facilities, AG Becerra led 17 State Attorneys General in an 
effort to stop the previous administration from rolling back regulatory 
protections for nursing home residents, and later opposed proposed 
revisions to the nursing facility Requirements of Participation that 
would have scaled back appropriate oversight. Further, his demonstrated 
commitment to equity includes protecting women and LGBTQ+ individuals 
from unlawful discrimination in health care, and a recognition of the 
unequal effect that environmental damage has on the health of people of 
color and other communities.

AG Becerra's extensive legislative and executive experience make him 
uniquely qualified to serve as Secretary of Health and Human Services. 
Further, his personal experience as the proud son of immigrants will 
help ground his efforts to address the disparities in our health system 
laid bare by the COVID-19 pandemic.

Mr. Becerra is the right leader for HHS at this moment, not only for 
overseeing the response to the COVID pandemic, but also for protecting 
and building health care rights for Medicare beneficiaries, and for all 
Americans. The Center for Medicare Advocacy enthusiastically supports 
the nomination of Mr. Becerra. We urge his swift confirmation.

Sincerely,

Judith A. Stein
Executive Director/Attorney

                                 ______
                                 
                    Children's Hospital Association

                     600 13th Street, NW, Suite 500

                          Washington, DC 20005

                            p: 202-753-5500

                            f: 202-347-5147

                  https://www.childrenshospitals.org/

February 15, 2021

The Honorable Ron Wyden             The Honorable Patty Murray
Chairman                            Chairman
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor,
Washington, DC 20510                and Pensions
                                    Washington, DC 20510

The Honorable Mike Crapo            The Honorable Richard Burr
Ranking Member                      Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                 Committee on Health, Education, 
                                    Labor,
Washington, DC 20510                and Pensions
                                    Washington, DC 20510

Dear Senators Wyden, Crapo, Murray and Burr:

On behalf of the Children's Hospital Association, we write to express 
our support for Xavier Becerra's confirmation as secretary of the U.S. 
Department of Health and Human Services (HHS). His experience in 
Congress, as attorney general of California and in support of health 
care access and coverage will allow him to be an effective leader for 
the department at this critical time. We also believe his commitment to 
HHS programs will help us address the unique challenges children face, 
especially as we battle the pandemic together.

It is important for HHS to have experienced leadership that is 
committed to strengthening Medicaid and the Children's Health Insurance 
Program (CHIP) and maintaining our nation's long-standing commitment to 
children's health. Over 40 million children are enrolled in Medicaid 
and CHIP. These programs provide affordable coverage with pediatric-
appropriate benefits to low-income children and are a lifeline for 
children with special health care needs or complex conditions. The 
Medicaid program provides critical support to states and the pediatric 
health care system, including children's hospitals, and plays an 
important role in ensuring children can access the care they uniquely 
need. Throughout his tenure in Congress and as Attorney General of 
California, secretary nominee Becerra has demonstrated a recognition of 
the essential role that Medicaid and CHIP play in children's overall 
health and well-being.

We believe HHS secretary nominee Becerra also recognizes the short-and 
long-term implications of COVID-19 on children and will work with us to 
address the impact. The pandemic has hit children's well-being hard and 
directly, exacerbating what was already a growing national crisis: 
rising and increasingly severe, mental, emotional and behavioral health 
(MEB) challenges to children and youth due to traumatic stress such as 
social isolation and family unemployment. While longer-term investments 
in children's health and well-being are necessary, immediate steps must 
be taken to better use existing provider capacity and telehealth to 
more effectively address the crisis. HHS secretary nominee Becerra is 
committed to improving care and supports for our nation's most 
vulnerable children and will be a strong partner as we continue to 
ensure every child has the best opportunity to thrive.

We stand ready to work with HHS secretary nominee Becerra on strategies 
that will support the pediatric health care safety net--a safety net 
that is struggling under incredible financial and operational 
challenges brought about by the pandemic. Strengthening existing 
payment systems through Medicaid and ensuring that ongoing relief 
addresses the unique needs in the pediatric sector (which does not 
benefit from relief funding through Medicare) is critical. We look 
forward to partnering with the secretary nominee to ensure that 
children's hospitals can continue providing needed specialized clinical 
care, training and research that benefits all our nation's children.

We believe Xavier Becerra as HHS secretary will be able to partner 
across the health care sector, states and communities to make health 
equity a priority. Children's hospitals care for diverse populations of 
children, including many from low-income families. They work within 
their communities to address gaps in health and social supports. There 
is more we all need to do to reduce disparities and inequities in our 
current health care system and nation, and the Children's Hospital 
Association and its members are eager to work collaboratively with the 
secretary nominee, the Biden administration and Congress to address 
these challenges.

We look forward to working with the new HHS secretary to ensure all 
children across the country have the coverage and access to care they 
need.

Thank you and very best wishes,

Mark Wietecha
Chief Executive Officer

                                 ______
                                 
                       The Children's Partnership
February 23, 2021

The Honorable Ron Wyden
Chairman
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510

The Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 2051O

RE: Hearing on Nominee Attorney General Xavier Becerra for US Secretary 
of Health and Human Services

Dear Chairman Wyden and Ranking Member Crapo:

The Children's Partnership, a California-based children's policy and 
advocacy organization committed to improving the health and well-being 
of marginalized children where they live, learn and play, strongly 
supports the nomination of California's Attorney General, Xavier 
Becerra for the role of U.S. Secretary of Health and Human Services 
(HHS).

Attorney General Becerra has spent his career fighting to expand 
people's access to health care and protect underserved communities, 
taking on powerful special interests to get results. A former Member of 
Congress who helped pass the Affordable Care Act, and an Attorney 
General who has fought to defend it against persistent attacks, Becerra 
has a long track record of advocating for everyone to have access to 
quality, affordable health care and getting results, which is exactly 
what we need in an HHS Secretary as we claw back from a pandemic that 
has killed half a million Americans and infected 14 million Americans. 
Specifically, among children, Latinx, Black, Native American and 
Pacific Islander children make up nearly 70% of cases, despite making 
up slightly over 50% of California's population of children.

As Attorney General, Mr. Becerra led the defense of the Affordable Care 
Act in the Supreme Court, and has taken on powerful special interests 
who prey on people's health, from the drug companies responsible for 
the opioid epidemic to the tobacco industry. He also led a multi-state 
coalition to protect the health and welfare of immigrant children being 
held in detention - actions that brought back painful memories of the 
darkest times in US history when Black children were separated from 
their parents due to slavery, when indigenous children were sent to 
boarding schools hundreds of miles away from their families, and when 
Japanese-American families were separated in internment camps.

During this especially challenging time, Attorney General Becerra is 
also a proven leader on COVID-19 who has taken action to keep people 
safe and protect Americans during the pandemic. He used his powers as 
Attorney General to protect workers from exposure to COVID-19, secure 
key safeguards for frontline health care workers' rights, and stand up 
for homeowners trying to make their mortgage payments during the 
downturn. He understands that the pandemic is impacting all American 
families but is having disproportionate impacts on communities of color 
and low-income Americans and that our collective efforts must center 
their needs in order to build back effectively and equitably from this 
crisis.

As the first Latino ever to run the Department of Health and Human 
Services, Attorney General Becerra will be intensely focused on 
addressing persistent health disparities, which have led to even worse 
outcomes for communities of color during the COVID-19 pandemic. He 
understands that structural racism in our country too often dictates 
where you live, what you eat, the air you breathe and the water you 
drink. It is what drives communities of color to suffer from higher 
rates of chronic conditions, including heart disease, diabetes and 
asthma. His history of representing marginalized communities in 
Congress and as Attorney General of California has instilled in him a 
career-long passion and policy for ensuring no community is left behind 
in the promise of America.

With a proven record successfully managing a large and complex agency, 
he is uniquely qualified for the job and is a historic pick ready to 
run HHS on day one. Having led the second largest Department of Justice 
in America behind only the federal DOJ, he has the proven capacity to 
lead a complex agency that has to manage many critical issues at the 
same time, a necessary qualification as we confront the pandemic.

His depth of experience will also make him an effective secretary. 
Having served in the U.S. House of Representatives for more than 20 
years, he knows how to work with Congress and has a proven track record 
of bringing people together to solve big problems. He recognizes that 
he is fighting for the well-being of all American families and as such 
will work in a bipartisan manner to listen effectively to all parties 
in Congress.

Having been born into a working-class California family, the son of 
immigrants with a father who worked the fields and in construction to 
build roads and a mother who came to this country from Mexico when she 
was 18, he also has first-hand perspective on the American family 
experience. He carries this perspective with him in his work and will 
do the same in his role as the U.S. Secretary of Health and Human 
Services.

For these reasons, we strongly urge you to support the nomination of 
Attorney General Xavier Becerra for the position of U.S. Secretary of 
Health and Human Services. He will be bring his values of equity, 
inclusion and health care as a human right to serve as an effective 
leader for the health and well-being of all families in America.

Sincerely,

Mayra E. Alvarez, MHA
President

                                 ______
                                 
     Coalition of Filipino Americans and Friends of Xavier Becerra

                          2443 Park Oak Drive

                          Hollywood, CA 90068

                    Telephone Number: (323) 467-5243

January 23, 2021

The Honorable Ron Wyden
Chairman
U.S. Senate
Committee on Finance
Washington DC 20510

The Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance
Washington, DC 20510-6200

RE: Support for the Approval of Xavier Becerra as U.S. Secretary of 
Health and Human Services

Dear Senator Wyden:

We, the undersigned below, and on behalf of the more than 374,000, 
Filipino Americans residing in Los Angeles County, request that you, to 
approve the nomination of Xavier Becerra, as the new U.S. Secretary of 
Health and Human Services. Mr. Becerra is a dedicated person, who will 
restore calmness, and will ensure fairness in providing healthcare to 
all the citizens of the United States of America. He will ensure 
continued protection of the people, especially of those who in need to 
improve the quality of care, and medicine that are cost effective. He 
will do a good job, and will deliver, equality to all people regardless 
of race because, it is the right thing to do.

Mr. Becerra helped the thousands of Filipino WWII veterans to fight on 
their struggle for justice. In 1942, the late President Franklin Delano 
Roosevelt and the 77th U.S. Congress, granted full benefits to Filipino 
American World War II Veterans who fought under the U.S. Armed Forces. 
Then, without their knowledge, the 79th U.S. Congress passed the 
Rescission Act of 1946 denying their rights and privileges. Finally, in 
2009, working closely with the Office of U.S. Congressman Xavier 
Becerra, the Filipino Veterans Equity Compensation Fund, was passed 
through both houses of Congress and was signed into law by President 
Barrack Obama.

We all love him for his passion and dedication to correct the injustice 
done to the Filipino American Veterans in passing the Rescission Act of 
1946.

Mr. Becerra is the right person for the job, and you will make the 
right decision to approve his position as the US Secretary of Health 
and Human Services. Please do not hesitate to contact us if you have 
any questions or need additional information. Thank you.

Respectfully Yours,

Susan Espiritu Dilkes
Community Activist
Retired/Exe. Director, Filipino American Service Group Inc.
Email: [email protected]

Supporters (organization name for recognition only; signatures on file)

Anna Lourdes Armada Chickey, M.D.
President, Philippine Heritage Institute
Bryan Jones
Executive Director, The HOOP Foundation Inc.
Cora Oriel
Owner, Publisher, Asian Journal Newspaper
Board Member, Asian Business Association
Eric Lachica
Executive Director, American Coalition for Filipino Veterans Inc.
Felicitas A. dela Cruz, DNSc, R.N., FAANP, Professor
Executive Director, Office of Assessment and Evaluation
Director, Center for the Study of Health Disparities
School of Nursing, Azusa Pacific University
Josie Estaris-Jesus, BSN, R.N., MA
Past President & Advisor, Philippine Nurses Association of Southern 
California
Retiree, Nursing Administration
Licerio Castro, M.D.
President, Philippine Medical Association of Southern California
Lucy Babaran, R.N., MBA
Executive Director, United Specialist Healthcare Foundation
Nena Zosa
Founder of Philippine Medical Association Auxiliary of Southern 
California
R. Bong Vergara, MSW
Executive Director, Conscious Youth Promoting Health & Environmental 
Readiness
Salvador Abiera, M.D.
President, University of Santo Thomas Medical Alumni Association of 
Southern California

Individuals:

Jeanette Sayno, Bilingual Outreach Personnel, Eagle Rock, CA
Jennifer Deborah Agbayani, Pre-School Teacher, Eagle Rock, CA
Joselito Babaran, M.D., San Fernando Valley, CA
Kathrina Abrot, Youth Community Organizer, Los Angeles, CA
Marian Gomez Espiritu, Accountant, Valencia, CA
Marilou Dischoso, M.D., Los Angeles, CA
Lawrence Espiritu, Retired, Computer Technician, Valencia, CA
Lydia Solis, Filipino American Journalist, San Dimas, CA

Footnote: 2010 census data; https://en.m.Wikipedia.org/wiki/
Demographics_of_Filipino_Americans.

Cc: Xavier Becerra
   Supporters

                                 ______
                                 
                       Commonwealth Care Alliance

                            30 Winter Street

                            Boston, MA 02108

                           Tel: 617-426-0600

                           Fax: 617-426-3097

               https://www.commonwealthcarealliance.org/

March 1, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

On behalf of the Commonwealth Care Alliance (CCA), a not-for-profit 
health care organization dedicated to improving care for people 
enrolled in both Medicare and Medicaid, I would like to express our 
strong support for the nomination and confirmation of Xavier Becerra to 
serve as Secretary of the United States Department of Health and Human 
Services.

Established in 2003, CCA serves individuals who have complex medical, 
behavioral health and social needs. With more than 38,000 members, our 
mission is to improve the health and well-being of people with 
significant needs by innovating, coordinating and providing the highest 
quality, individualized care.

Throughout his distinguished career, Secretary-designate Becerra has 
demonstrated his long-standing commitment to expanding access to high-
quality health care. He was a leader in crafting the landmark 
Affordable Care Act during his time in Congress, which has helped 
millions of Americans obtain health care coverage.

Secretary-designate Becerra is also a champion for improving public 
health and has been a leader in addressing the many challenges that 
confront our nation, including achieving health care equity and 
ensuring all patients have access to affordable medications. Secretary-
designate Becerra's proven leadership, experience and expertise are 
also critical to guide him as the nation continues to battle the COVID-
19 pandemic.

Our organization stands ready to work with Secretary-designate Becerra 
to address the ongoing challenges our nation faces and to ensure all 
patients, including those who have complex and significant health care 
needs, have access to high-quality health care. We urge the Committee 
to approve Secretary-designate Becerra's nomination and we support his 
confirmation by the full United States Senate.

Yours sincerely,

Christopher D. Palmieri
President and Chief Executive Officer

                                 ______
                                 
                           Community Catalyst

                           One Federal Street

                            Boston, MA 02110

                           Main: 617-338-6035

                           Fax: 617-451-5838

                       www.communitycatalyst.org

February 22, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee Finance
221 Dirksen Senate Office Building  239 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Senators Wyden and Crapo:

As advocacy organizations committed to advancing health equity, we 
submit the following letter in support of the nomination of Attorney 
General Xavier Becerra for Secretary of the U.S. Department of Health 
and Human Services (HHS).

Attorney General Becerra is a demonstrated leader in the fight for 
quality, affordable health care, immigrant rights and the principles of 
equity and justice upon which our health system must be based. As a 
member of Congress from 1993-2017, Attorney General Becerra fought 
tirelessly to protect and expand access to affordable health care for 
all people, which included his leadership in the passage of the 
Affordable Care Act (ACA). Since then, as California's Attorney 
General, he has continued his tireless work to protect people's health, 
most notably as the lead defender of the ACA in the California v. Texas 
lawsuit, currently before the Supreme Court. He is also a longstanding 
champion for protecting and expanding access to sexual and reproductive 
health, including abortion, which is critical for advancing health 
equity.

Now, more than ever, we need a proven champion of health equity leading 
HHS. The COVID-19 pandemic has shed light on the deep inequities that 
leave many Black and brown people without resources or recourse to 
protect their families. In particular, the pandemic has had a 
disproportionate and devastating impact on Black, Latinx, Indigenous, 
Asian American, and Pacific Islander communities, who face alarming 
rates of infection and death due to discriminatory barriers to safe 
work places, health coverage, and care. It has also exposed how our 
health system fails LGBTQ+ people, immigrants, people with 
disabilities, older adults, and every intersection thereof. We are 
confident that as HHS Secretary, Attorney General Becerra will take 
quick and decisive action to mitigate the harm the pandemic has caused 
as well to address the underlying inequities that keep our systems from 
serving the public fairly and well.

We further expect Attorney General Becerra to continue his commitment 
to working with advocates, policy makers, and agency staff to build on 
the important foundation the ACA has laid, including in the areas of 
expanded coverage, increased affordability, and improved access to 
quality care for all people. His leadership and expertise will also be 
particularly valuable in developing and implementing a plan to reverse 
anti-immigrant policies, including public charge rules and non-
discrimination protections for people with limited English proficiency, 
and to rebuilding trust between our government and immigrant 
communities going forward.

Attorney General Becerra is the right leader for the moment. We 
enthusiastically support his nomination and look forward to working 
with him to move our nation's health system forward with health equity 
and the needs of historically excluded and under-resourced communities 
at the center.

Thank you,

National

Community Catalyst

State

California

California Pan-Ethnic Health 
Network                             Health Access California

Colorado

Colorado Consumer Health Initiative Colorado Organization for Latina 
                                    Opportunity and Reproductive Rights

Florida

Florida Policy Institute            Florida Health Justice Project

Georgia

The Arc Georgia                     Georgians for a Healthy Future

Illinois

Shriver Center for Poverty Law      EverThrive Illinois

Indiana

Hoosier Action                        

Kentucky

Kentucky Voices for Health          Kentucky Equal Justice Center

Massachusetts

Health Care for All Massachusetts   Advocates

Maryland

Maryland Citizens' Health 
Initiative                            

Maine

Consumers for Affordable Health 
Care                                Maine Equal Justice

Michigan

Arab Community Center for Economic 
and Social Services (ACCESS)

Minnesota

TakeAction Minnesota

Mississippi

Mississippi Center for Justice

Missouri

Missouri Health Care For All

North Carolina

NC Justice Center                   North Carolina AIDS Action Network

New Jersey

New Jersey Citizen Action           Salvation and Social Justice

Nevada

Children's Advocacy Alliance

New York

Progressive Doctors                 Raising Women's Voices for the 
                                    Health Care We Need
Make the Road New York

Ohio

Universal Health Care Action 
Network of Ohio

Oklahoma

Oklahoma Policy Institute

Pennsylvania

Pennsylvania Health Access Network  CASA

Rhode Island

Economic Progress Institute

South Carolina

SC Appleseed Legal Justice Center

Tennessee

Tennessee Justice Center            Tennessee Disability Coalition
Tennessee Health Care Campaign

Utah

Utah Health Policy Project

Virginia

Virginia Organizing                 Virginia Poverty Law Center

Washington

Northwest Health Law Advocates

Wisconsin

Citizen Action of Wisconsin         Kids Forward

West Virginia

West Virginians for Affordable 
Health Care                         WV FREE

                                 ______
                                 
                               DataRobot
March 1, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance

Dear Senator Wyden and Senator Crapo:

DataRobot, one of the leading artificial intelligence (AI) firms in 
America, is proud to offer our strong support for Secretary-designate 
Xavier Becerra and hope that he will be promptly confirmed by the 
United State Senate.

During the Secretary-designate's testimony, he repeatedly stressed the 
need for a data-driven pandemic response that prioritizes fairness and 
equity. This approach is not only welcomed, but essential as we 
continue to fight the COVID-19 pandemic and future pandemics.

Over the last year, DataRobot put hundreds of our data scientists to 
work around the clock analyzing COVID-19 data to help bring an end to 
the pandemic with a focus on improving health equity. As one example, 
we worked with the National Institutes of Health (NIH) to help bring 
diversity to clinical trial recruitment in Operation Warp Speed. Using 
our AI solution, one vaccine manufacturer increased the percentage of 
Black and Hispanic participants recruited on a weekly basis by 400%.

To realize Secretary-designate Becerra's vision of equity during the 
pandemic response, the government needs quality data. Currently, only 
about 10% of antigen tests results are being reported, and only 57% of 
those results have crucial race and ethnicity data attached. While PCR 
test results are being reported at a much better rate of around 95%, 
only 52% of those results have race and ethnicity data.

The data we do have indicates that the Hispanic community has been 
systemically under-tested during the pandemic. In the northeast, for 
instance, the Hispanic population accounts for nearly 24% of the COVID-
19 cases but only 9% of the tests administered.

Secretary-designate Becerra stated it well during his confirmation 
hearings: we need to collect better data. DataRobot looks forward to 
working with Mr. Becerra to help improve the quality of COVID-19 data 
so that vulnerable communities can be identified sooner and resources 
prioritized more efficiently.

Secretary-designate Becerra repeatedly stressed using science to guide 
policy in his testimony. DataRobot stands ready to assist Secretary-
designate with cutting edge data science to help achieve fair and 
equitable outcomes during the COVID-19 pandemic, future pandemics and 
in other health care priorities for America.

With a distinguished career in public service, and a data-driven 
commitment to tackling the pandemic in an equitable manner, Secretary-
designate Becerra is extremely well-suited for the job. We urge the 
Committee--and the full Senate--to approve his nomination without 
delay.

Sincerely,

Steven E. Moore
Vice President, Global Government Affairs

PS--Feel free to reach out with any questions at [email protected].

                                 ______
                                 
                         Dental Trade Alliance

                  4350 North Fairfax Drive, Suite 220

                          Arlington, VA 22203

                             (703) 379-7755

                    https://dentaltradealliance.org/

January 20, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

The Dental Trade Alliance (DTA) would like to express its support for 
Xavier Becerra as the Biden Administration's nominee for the position 
of Secretary of U.S. Department of Health and Human Services.

The DTA represents dental product distributors, dental laboratories and 
manufacturers. By providing the best equipment, materials and services 
to dentists and oral care professionals, we are partners in improving 
the oral health of all Americans.

President-Elect Biden made a wise choice in the selection of California 
Attorney General Xavier Becerra to lead the department at this time as 
the country continues to address the array of challenges the pandemic 
presents. During his twelve terms in Congress, Attorney General Becerra 
spent much of his time working on health care issues impacting U.S. 
citizens as a member of the House Ways and Means Committee.

In addition to his experience on health care matters, Attorney General 
Becerra brings his experience as an administrator having run the 
California Department of Justice since 2017. In this position he 
addressed an array of health and other matters that prepare him well to 
handle the significant challenges of running an agency as large and 
diverse as the U.S. Department of Health and Human Services.

Should you have any questions please contact Patrick Cooney, DTA 
Federal Affairs Representative at 202-413-2629 or via email at 
[email protected].

Thank you for your attention to this matter.

Sincerely,

Greg Chavez
Chief Executive Officer

                                 ______
                                 
                              Families USA

                  1225 New York Avenue, NW, Suite 800

                          Washington, DC 20005

                           main 202-628-3030

                            fax 202-347-241

                        https://familiesusa.org/

February 22, 2021

The Honorable Ron Wyden             The Honorable Patty Murray
Chair                               Chair
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor,
                                      and Pensions
Washington, DC 20510                Washington, DC 20510

The Honorable Mike Crapo            The Honorable Richard Burr
Ranking Member                      Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor,
                                      and Pensions
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden, Chairwoman Murray, Ranking Member Crapo, and 
Ranking Member Burr:

On behalf of Families USA, one of the nation's leading health care 
consumer and justice organizations dedicated to high quality, 
affordable health care and improved health for all, we are honored to 
support your consideration of President Biden's nomination of 
California Attorney General Xavier Becerra to serve as the next United 
States Secretary of Health and Human Services (HHS). Attorney General 
Becerra has dedicated his career to fighting for improved health 
equity, rooting out industry abuses that contribute to sky-rocketing 
health care costs, and ensuring every person in America has affordable 
access to high-quality health care. At a time when our nation's health 
and health care is under unprecedented strain, Mr. Becerra's expertise 
on health care issues and his extensive and consistent track record of 
championing better health and health care for all in our nation make 
him uniquely qualified to serve as HHS Secretary.

During his long and distinguished tenure on the House Ways and Means 
Committee, AG Becerra was instrumental in protecting Medicare coverage 
for seniors and drafting the Affordable Care Act (ACA), expanding 
health care access to millions of people while securing critical 
consumer protections. As Attorney General of California, he continued 
this important work, leading the charge to defend the essential 
coverage protections provided under the ACA from political attacks in 
the California v. Texas case currently being reviewed by the Supreme 
Court.

AG Becerra has been a stalwart defender of equitable access to health. 
He led the fight against the Trump Administration's ``Health Care 
Refusal Rule'' which would have disproportionally harmed people of 
color, LGTBQ communities, and women seeking health care services by 
allowing medical staff to refuse life-saving care to patients at their 
discretion. He has championed bipartisan immigration reform efforts to 
find commonsense solutions that ensure no one is denied basic 
healthcare because of who they are or where they are from.

AG Becerra has also consistently and fearlessly taken on powerful 
special interests in order to put access and affordability for 
individuals and families at the center of our health care system. He 
has been a champion for lower drug costs, ending the opioid epidemic, 
and toppling health system monopolies that create perverse incentives 
that block consumer access to high-quality, high-value, affordable 
care. He took bold action to end ``pay for delay'' practices by 
pharmaceutical companies that make backroom deals to delay generic 
drugs from entering the market--deals that put the interests of 
industry over those of consumers. AG Becerra sought accountability for 
the drug companies responsible for the opioid crisis and won landmark 
settlements to be used to fund future opioid treatment. He won a 
groundbreaking settlement from Sutter Health, Northern California's 
largest hospital system, for overcharging patients through price 
gouging and monopolistic behavior--one of the largest legal actions 
against anti-competitive behavior in the health care sector.

As the COVID-19 health crisis continues to expose serious flaws in our 
health care system, it is absolutely essential to confirm a Secretary 
of Health and Human Services whose understanding of the scope of 
opportunities and challenges we face is beyond reproach. AG Becerra is 
strong leader who, I am confident, would help pave the country's way 
toward health and economic recovery.

I urge you and your colleagues in the Senate to move swiftly on AG 
Becerra's nomination so that the important work of addressing the 
COVID-19 crisis and building a better, stronger, and more equitable 
health care system can move forward in earnest.

Please don't hesitate to contact me if I can provide any additional 
information.

Sincerely,

Frederick Isasi
Executive Director

                                 ______
                                 
                    Federation of American Hospitals

                     750 9th Street, NW, Suite 600

                          Washington, DC 20001

                              202-624-1500

                            FAX 202-737-6462

                          https://www.fah.org/

February 12, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor,                              Committee on Health, Education, 
                                    Labor,
  and Pensions                        and Pensions
Washington, DC 20510                Washington, DC 20510

    Dear Chairs Wyden and Murray & Ranking Members Crapo and Burr:

    On behalf of the Federation of American Hospitals (FAH), the 
national representative for over 1,000 leading tax-paying hospitals and 
health systems throughout the United States, I would like to express 
our strong support for the nomination and confirmation of California 
Attorney General Xavier Becerra to serve as the next Secretary of the 
U.S. Department of Health and Human Services (HHS).

    FAH members provide patients and communities with access to high-
quality, affordable care in both urban and rural America. Our members 
include teaching and non-teaching, acute, inpatient rehabilitation, 
behavioral health, and long-term care hospitals and provide a wide 
range of inpatient, ambulatory, post-acute, emergency, children's, and 
cancer services.

    Throughout his distinguished career in government at both the 
federal and state level, Secretary-designate Becerra has demonstrated 
his capability to lead HHS at one of the most pivotal and challenging 
moments in our nation's history. Having the pleasure of knowing him for 
more than twenty years, I am confident that Secretary-designate 
Becerra's proven leadership, experience and expertise will successfully 
guide him as the nation seeks to defeat COVID-19.

    Along with efforts to overcome the pandemic, Secretary-designate 
Becerra has the first-hand experience necessary to bolster and 
strengthen the Affordable Care Act (ACA)--from helping to craft the 
landmark legislation to defending it as Attorney General of California. 
Secretary-designate Becerra has a keen understanding of how the ACA, if 
fully and properly implemented, can reach its true potential.

    Secretary-designate Becerra is, first and foremost, a champion for 
patients. A seasoned public servant, his lifelong commitment and 
dedication to public health will help him confront the many challenges 
that face us, from achieving health equity to reducing the cost of 
prescription drugs to reinforcing access to care in rural and 
underserved communities. He is highly qualified, time-tested, and will 
be ready on day 1.

    The Federation of American Hospitals urges the Senate Finance and 
HELP Committees to approve Secretary-designate Becerra's nomination 
expeditiously, and we support his confirmation by the full U.S. Senate.

    If you have any questions or wish to speak further, please do not 
hesitate to reach out to me at 202-624-1534.

            Sincerely,

            Charles N. Kahn III
            President and CEO
                        First Focus on Children

                      1400 I Street, NW, Suite 650

                          Washington, DC 20005

                            t: 202-657-0670

                            f: 202-657-0671

                        https://firstfocus.org/

February 16, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20515                Washington, DC 20515

The Honorable Patty Murray          The Honorable Richard Burr
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor,                              Committee on Health, Education, 
                                    Labor,
  and Pensions                      and Pensions
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden, Ranking Member Crapo, Chairwoman Murray and 
Ranking Member Burr:

I am writing on behalf of First Focus Campaign for Children, a 
bipartisan children's advocacy organization dedicated to making 
children and families a priority in federal budget and policy 
decisions, to express our strong support for confirming California 
Attorney General Xavier Becerra for Secretary of the U.S. Department of 
Health and Human Services (HHS).

As an organization dedicated to improving the health, economic 
security, child safety and protection, and overall well-being of 
America's children, we applaud Attorney General Becerra's long history 
of leadership in prioritizing children's needs, and have recognized him 
several times as a First Focus Champion for Children for his long-
standing work across the full array of these issues. HHS is critical to 
the well-being of our nation's children and it is important that the 
Secretary of HHS be familiar with the full range of HHS programs that 
impacts children, and we believe Attorney General Becerra will be.

Now, more than ever, the full array of issues that HHS oversees are 
critical to children. The COVID-19 outbreak and the resulting economic 
crisis are falling hardest on the most vulnerable among us, including 
our nation's children. It is disrupting every facet of children's lives 
and we cannot yet know all of the negative and long-lasting 
implications it will have on children's healthy development and future 
success. The programs and services within HHS directly affect 
children's lives more than any other Department. Therefore, during this 
critical time, HHS needs a leader who not only has the ability to 
manage and direct the array of programs, but who also understands and 
cares about children and their health and well-being.

Clearly, HHS has a critical role in ensuring that this historic public 
health pandemic does not threaten our children's future outcomes. 
Moreover, after two decades of progress in reducing the uninsured rate 
of our nation's children, the uninsured rate has risen in each of the 
last four years. Attorney General Becerra has a strong knowledge of the 
health care programs run by HHS from his time in Congress and as 
Attorney General, and he would play a critical role in helping get our 
nation back on track to ensuring all children have health coverage in 
this country. HHS also houses the Maternal and Child Health Bureau that 
provides expertise and oversees programs dedicated to improving 
maternal and child health services at a time when infant and maternal 
mortality rates and child suicide rates all desperately need attention.

Although health care is a critical part of HHS, it is important to note 
that HHS is not just a health agency. HHS also manages an array of 
human services issues, including poverty and family supports. Due to 
the pandemic and economic recession, for example, we know that at least 
an additional 2.5 million children have fallen into poverty since May 
2020,\1\ and through the administration of the cash assistance, child 
support, utility assistance, and other critical income supports for 
children and families, HHS leadership plays a key role in reducing 
child poverty and mitigating the impact of the pandemic on family 
economic security.
---------------------------------------------------------------------------
    \1\ Jason DeParle, ``8 Million Have Slipped into Poverty Since May 
as Federal Aid Has Dried Up,'' New York Times, October 15, 2020, 
https://www.nytimes.com/2020/10/15/us/politics/federal-aid-poverty-
levels.html.

Through the Administration for Children and Families (ACF) at HHS, 
early childhood programs are instrumental in positive outcomes in 
children and families' lives as well, and we look forward to Attorney 
General Becerra continuing to prioritize these at HHS. HHS administers 
programs vital in the lives of our youngest children and their families 
including the Child Care and Development Block Grant, Early Head Start 
and Head Start, and the Maternal, Infant, and Early Childhood Home 
Visiting Program. These programs and others at the department need a 
strong leader who recognizes the connections between programs and the 
---------------------------------------------------------------------------
children who participate in them.

ACF also oversees a number of other programs that Attorney General 
Becerra had oversight over while serving on the House Ways and Means 
Committee and that he was involved with as Attorney General, including 
those addressing the child welfare system and foster care and programs 
related to runaway youth and social services. The Children's Bureau 
funds and supports states as they provide case management to more than 
670,000 children that are in the foster care system each year and the 
Runaway and Homeless Youth program supports outreach, shelter services, 
and transitional programing for the 1.6 million to 2.8 million youth 
who run away or are ``thrown away'' annually. Coordination across HHS 
programs is essential for children and youth's time away from safe, 
supportive, and permanent families to be rare, brief, and non-
recurring.

HHS also has a critical role in reaching out to all communities that 
use the federal assistance programs, including children of immigrants 
and their families. Many of these children and families, as a result of 
the prior administration's public charge rule, avoided health insurance 
and other life-sustaining programs \2\ for which they were eligible, 
including during the pandemic when families need assistance most. HHS 
leadership is critical to ensure that the agency effectively 
communicates with children and their families, in partnership with 
local organizations, about eligibility for HHS programs and services, 
and supports them in enrolling in programs for which they are eligible. 
Attorney General Becerra's personal experience as a child of immigrants 
and experience as Attorney General of California make him well equipped 
to ensure consideration of the needs of children of immigrants and 
their families throughout HHS.
---------------------------------------------------------------------------
    \2\ First Focus on Children, ``Fact Sheet: The Public Charge Rule 
Harms Children,'' February 2020, https://firstfocus.org/wp-content/
uploads/2020/02/FACT-SHEET-Public-Charge_2-20.
pdf.

The Office of Refugee Resettlement (ORR) Unaccompanied Children's 
Program within HHS is responsible for the short-term care of 
unaccompanied children who arrive at the border without a parent or 
legal guardian. Its mandate is to place children in the least 
restrictive setting in their best interests and facilitate the prompt 
and safe release of children to a sponsor, typically family. After many 
years of ORR's increased entanglement with immigration enforcement to 
the detriment of children's safety and well-being, we look forward to 
Attorney General Becerra's leadership to ensure that child well-being 
---------------------------------------------------------------------------
is central to all the agency's departments.

Attorney General Becerra is completely knowledgeable with respect to 
all of these programs that are in the jurisdiction of the Department of 
Health and Human Services from his time working on Capitol Hill and as 
California's Attorney General. We urge the Committees and the Senate to 
swiftly confirm him as Secretary of HHS.

Sincerely,

Bruce Lesley
President

                                 ______
                                 
                        Futures Without Violence
February 12, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor,                              Committee on Health, Education, 
                                    Labor,
  and Pensions                        and Pensions
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden, Chairman Murray, Ranking Member Crapo, and Ranking 
Member Burr:

Futures Without Violence is a national social justice organization 
focused on preventing violence against women and children utilizing 
public health approaches that build strong, safe and healthy families 
and communities. We understand deeply how trauma, adversity and 
exposure to violence in childhood can have severe lifelong consequences 
that not only reproduce violence in families but also cost our nation's 
health care system significantly.

Because of this we write you today in strong support of the nomination 
of Xavier Becerra to be the next Secretary for the Department of Health 
and Human Services. As a California-based organization, we have seen 
first-hand his commitment to protecting the safety of all people from 
violence and his commitment to ensuring all people have access to 
health care, including women and our most vulnerable. We look forward 
to working with him to address the health consequences of violence, 
improve access to health care for all survivors of violence, including 
immigrant and LGTBQ survivors, advance health equity, and utilize the 
untapped potential of the Administration for Children and Families to 
reduce trauma and violence and help families who are struggling heal 
and thrive.

Xavier Becerra is a highly qualified and passionate leader with 
demonstrated depth and breadth of experience spanning three decades. As 
Attorney General of California, he joined with Attorneys General from 
across the country in 2018 and 2020 to advocate for the reauthorization 
of the Violence Against Women Act. His defense of the Affordable Care 
Act has meant essential health care access and coverage for many 
previously uninsured people, including those experiencing sexual and 
domestic violence. For victims of violence, health care is even more 
essential given the toll it takes on the body and the critical role 
providers play in helping connect them to an advocate or someone who 
can help them. The ACA specifically includes screening and counseling 
for women who are victims of interpersonal violence as part of a well-
woman visit, and the ACA also included groundbreaking home visiting 
programs that helped vulnerable new mothers and babies, including with 
support to address domestic violence.

As a Member of Congress, he was a strong supporter of legislation to 
help abused and neglected children and voted for the first Violence 
Against Women Act that included health care and youth-focused 
prevention programs. Throughout his tenure in Congress, he demonstrated 
year after year an understanding and commitment to health care access 
and the importance of programs that help lift up mental health and the 
needs of vulnerable children and families.

As America works to mitigate and recover from the harm of the COVID 
pandemic, it is essential that HHS have a leader who understands both 
the health and human services needs of our nation, and understands 
clearly that the toll of this virus has not been spread evenly. We 
believe for these reasons that Xavier Becerra is uniquely qualified to 
lead the Department of Health and Human Services and encourage you to 
quickly advance his nomination.

Sincerely,

Esta Soler
President and Founder

                                 ______
                                 
                    Home Care Association of America

                444 North Capitol Street, NW, Suite 428

                          Washington, DC 20001

                             (202) 508-3870

                         https://www.hcaoa.org/

January 26, 2020

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

The Home Care Association of America (HCAOA) would like to express its 
support for Xavier Becerra as the Biden Administration's nominee for 
the position of Secretary of U.S. Department of Health and Human 
Services. HCAOA urges his swift confirmation by the U.S. Senate.

The Home Care Association of America (HCAOA) represents over 3,000 home 
care providers across the nation that provide personal care services in 
the homes of millions of older Americans, individuals with disabilities 
and children with special needs. Our members and their staff enter the 
community each day to provide care that will enable seniors to remain 
in their homes and prevent further spread of COVID-19.

President-Elect Biden made a wise choice in the selection of California 
Attorney General Xavier Becerra to lead the department at this time as 
the country continues to address the array of challenges the pandemic 
presents. During his twelve terms in Congress, Attorney General Becerra 
spent much of his time working on health-related issues impacting U.S. 
citizens as a member of the House Ways and Means Committee.

As a Congressman, Xavier Becerra was a staunch advocate for access to 
health care services. Personal care and companionship services provided 
by qualified home care providers play an important role in protecting 
seniors and individuals with disabilities. Access to these services 
diminishes the likelihood of costly hospitalization by ensuring seniors 
have appropriate nutrition and by helping prevent falls.

Attorney General Becerra brings his experience as an administrator 
having run the California Department of Justice since 2017. In this 
position he addressed an array of health and other matters that prepare 
him well to handle the significant challenges of running an agency as 
large and diverse as the U.S. Department of Health and Human Services.

Finally, the nominee brings to the agency knowledge of the disparities 
in access to health services in the U.S. He is well positioned to 
address these disparities, including workforce disparities, to ensure 
the improving health of the nation.

Thank you for your attention to this matter.

Sincerely,

Vicki Hoak,
Executive Director

                                 ______
                                 
              International Association of Forensic Nurses

                    6755 Business Parkway, Suite 303

                           Elkridge, MD 21075

                    https://www.forensicnurses.org/

January 20, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

The International Association of Forensic Nurses (IAFN) would like to 
express its support for Xavier Becerra as the Biden Administration's 
nominee for the position of Secretary of Health and Human Services. 
IAFN urges his swift confirmation by the U.S. Senate.

IAFN is an international membership organization comprised of forensic 
nurses working around the world and other professionals who support and 
complement the work of forensic nursing. Our mission is to provide 
leadership in forensic nursing practice by developing, promoting, and 
disseminating information internationally about forensic nursing 
science. Forensic nurses are on the front lines of caring for victims 
of sexual assault, domestic violence, and elder abuse in our nation's 
health care system.

President-Elect Biden made a wise choice in the selection of California 
Attorney General Xavier Becerra to lead the department at this time as 
the country continues to address the array of challenges the pandemic 
presents. During his twelve terms in Congress, Attorney General Becerra 
spent much of his time working on health care issues impacting U.S. 
citizens as a member of the House Ways and Means Committee.

As a Congressman, Attorney General Becerra was a staunch advocate for 
access to health care services. Forensic nurses have a critical health 
care role to play and we must ensure that victims of abuse and violence 
have available services in their communities.

In addition to his experience on health care matters, Attorney General 
Becerra brings his experience as an administrator having run the 
California Department of Justice since 2017. In this position he 
addressed an array of health and other matters that prepare him well to 
handle the significant challenges of running an agency as large and 
diverse as the U.S. Department of Health and Human Services.

Finally, he brings to the agency knowledge of the disparities in access 
to health services in the U.S. He is well positioned to address these 
disparities, including workforce disparities, to ensure the improving 
health of the nation.

Thank you for your attention to this matter.

Sincerely,

Jennifer Pierce-Weeks
CEO

                                 ______
                                 
                          Lambda Legal et al.
February 22, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
Chair                               Ranking Member
United States Senate                United States Senate
Committee on Health, Education, 
Labor,                              Committee on Health, Education, 
                                    Labor,
  and Pensions                        and Pensions
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden, Ranking Member Crapo, Chair Murray, and Ranking 
Member Burr,

On behalf of Lambda Legal, the Human Rights Campaign, the National 
Center for Lesbian Rights and the 15 undersigned organizations 
representing the interests of lesbian, gay, bisexual, transgender, and 
queer (LGBTQ) people and everyone living with HIV, we write to express 
our strong support for the nomination of California Attorney General 
Xavier Becerra to be the next Secretary of the United States Department 
of Health and Human Services (HHS).

Our country is amid a public health crisis. We presently are confronted 
by the unprecedented challenges created by the COVID-19 pandemic, as 
well as the many structural barriers that diminish people's access to 
health care and exacerbate longstanding health inequities. It is 
therefore critical that HHS be led by a person with proven leadership 
ability, a deep understanding of our health care system and the need 
for equitable access to health care and human services, and an 
appreciation of the needs of communities of color and LGBTQ people. 
Attorney General Becerra is such person.

Attorney General Becerra possesses a keen understanding of our health 
care system. As a member of Congress, Attorney General Becerra worked 
on the passage of the Affordable Care Act, reducing health disparities, 
lowering drug prices, and more. As Attorney General, he has been a 
leader in ensuring the implementation and preservation of the 
Affordable Care Act, which has expanded access to health coverage for 
millions of Americans, by fighting off legal challenges against the 
Affordable Care Act, including in Texas v. United States. His 
leadership in these cases required not only a profound understanding of 
the law, but also insight in the many intricacies of the Affordable 
Care Act and our health care system.

Attorney General Becerra has also been a stalwart supporter of LGBTQ 
people's right to equality and equitable access to care. Specifically, 
with regards to health care, Attorney General Becerra has brought legal 
challenges to administrative actions and regulations that would have 
resulted in diminished access to care for LGBTQ people and other 
minorities, such as: regulations eliminating antidiscrimination 
protections under the Affordable Care Act for LGBTQ people and people 
with limited English proficiency, among others; regulations seeking to 
inappropriately expand who could refuse to provide care to people based 
on religious or moral objections, which would have disproportionately 
LGBTQ people and those seeking reproductive health care; and actions 
denying access to care to our country's transgender servicemembers.

What is more, Attorney General Becerra has not only demonstrated his 
ability to lead a large government agency, like the California Attorney 
General's Office, but also shown that he can listen to and work with a 
broad range of stakeholders. His work seeking equity and justice for 
all Californians and all persons in America is to be admired. Indeed, 
he has led multiple coalitions of attorneys general in commenting to 
proposed HHS regulations.

Put simply, we believe Attorney General Becerra is the right person to 
lead HHS, especially at this particular moment in time. His commitment 
to civil rights, health care equity, and the rights of LGBTQ people and 
everyone living with HIV is without a question.

Sincerely,

Lambda Legal Defense and Education Fund, Inc.
Human Rights Campaign
National Center for Lesbian Rights
BiNet USA
Center for Disability Rights
Center for LGBTQ Economic Advancement & Research
CenterLink: The Community of LGBT Centers
Equality California
Family Equality
Fenway Health
FORGE, Inc.
GLMA: Health Professionals Advancing LGBTQ Equality
National Coalition for LGBT Health
National Equality Action Team (NEAT)
National LGBT Cancer Network
Silver State Equality--Nevada
URGE: Unite for Reproductive and Gender Equity
Whitman-Walker Institute

                                 ______
                                 
         Leadership Conference on Civil and Human Rights et al.

                     1620 L Street, NW, Suite 1100

                          Washington, DC 20036

                           202-466-3311 voice

                            202-466-3435 fax

                        https://civilrights.org/

February 22, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
United States Senate                United States Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
Chair                               Ranking Member
United States Senate                United States Senate
Committee on Health, Education, 
Labor,                              Committee on Health, Education, 
                                    Labor,
  and Pensions                        and Pensions
Washington DC 20510                 Washington, DC 20510

Dear Chairman Wyden, Ranking Member Crapo, Chair Murray, and Ranking 
Member Burr,

The Leadership Conference on Civil and Human Rights and the 31 
undersigned organizations dedicated to the universal values of dignity, 
equity, justice, and inclusion in health care, write in strong support 
of the nomination of California Attorney General Xavier Becerra to be 
the next Secretary of the United States Department of Health and Human 
Services (HHS).

In the midst of a pandemic that has compounded our preexisting public 
health crisis of structural racism and its resulting deep health 
inequities, it is imperative that the next leader of HHS be someone 
with a full understanding of how equity, justice, and health care are 
inextricably linked. Attorney General Becerra has consistently 
demonstrated that he is that person:

      During his time as a member of Congress, Attorney General 
Becerra served on the House Ways and Means Committee, where he 
developed deep expertise on the Affordable Care Act (ACA). His 
leadership in later defending the ACA against legal challenges is a key 
reason why the ACA, the greatest advance in access to health care for a 
generation, is still in effect.

      Becerra is committed to putting patients first, and as attorney 
general, has worked to ensure nondiscrimination protections in access 
to care, particularly for women, LGBTQ individuals, people of color, 
older adults, and individuals in rural and low-income communities. In 
addition, he has shown strong support for reproductive rights, 
including for access to birth control and abortion services.

      Becerra led the country in defending against the harmful Public 
Charge rule and attacks on the Deferred Action for Childhood Arrivals 
(DACA) program, showing his dedication to protecting the rights of 
immigrants and their families.

      Becerra has worked tirelessly to help ensure the availability of 
affordable prescription drugs, once again demonstrating his commitment 
to providing equitable access to care.

      As attorney general, Becerra established the Bureau of 
Disability Rights within the Civil Rights Enforcement Section of the 
California Department of Justice, the latest example in his long record 
of working for disability justice.

      Becerra's record also indicates that he would bring to the 
position a deep understanding of the ways in which access to social and 
economic opportunities and resources contribute to health and health 
outcomes. For example, Becerra has shown a deep commitment to ensuring 
fair housing, most recently opposing efforts to weaken federal 
protections against housing discrimination as well as efforts to cut 
off housing assistance eligibility, which threatened vulnerable 
families with eviction. He also established the Worker Rights and Fair 
Labor Section within the California Department of Justice to help 
protect the health, safety, and rights of working people, linking the 
creation of the new section to the urgent need to address the impact of 
the COVID-19 pandemic on working people.

We cannot afford to have our next Secretary of Health and Human 
Services learning about our country's deepened health inequities on the 
job. Following the injustices and harms inflicted on some of our most 
vulnerable communities over the last four years, it is critical that 
the next Secretary of Health and Human Services be a person well-
equipped to handle our country's deep health inequities. In order to 
emerge from this pandemic with healthier, stronger, more resilient 
communities, we need a Secretary of HHS who has fought for, and will 
prioritize health care access and equity for all people in America. For 
this reason, we urge you to support the confirmation of Attorney 
General Xavier Becerra to be the next Secretary of HHS.

If you have any questions, please contact Gaylynn Burroughs, senior 
policy counsel at The Leadership Conference, at 
[email protected], or the co-chairs of The Leadership 
Conference Health Care Task Force: Sinsi Hernandez-Cancio, vice 
president for health justice at the National Partnership for Women and 
Families at [email protected] and Mara Youdelman, managing 
attorney at the National Health Law Program, at 
[email protected].

Sincerely,

The Leadership Conference on Civil and Human Rights
National Health Law Program
National Partnership for Women and Families
Asian Americans Advancing Justice (AAJC)
Association of Asian Pacific Community Health Organizations (AAPCHO)
Association of People Supporting Employment First (APSE)
Autistic Self Advocacy Network
Bazelon Center for Mental Health Law
Center for Law and Social Policy (CLASP)
Clearinghouse on Women's Issues
Disability Rights Education and Defense Fund (DREDF)
Equality California
Families USA
Family Equality
Feminist Majority Foundation
Hispanic Federation
Human Rights Campaign
Justice in Aging
Lawyers' Committee for Civil Rights Under Law
National Action Network
National Center for Lesbian Rights
National Education Association
National Hispanic Media Coalition
National Immigration Law Center
National Organization for Women
National Urban League
National Women's Law Center
Planned Parenthood Federation of America
Reproductive Health Access Project
SEIU
Silver State Equality--Nevada
The International Union, United Automobile, Aerospace and Agricultural 
Implement Workers of America (UAW)

                                 ______
                                 
                               LeadingAge

                      2519 Connecticut Avenue, NW

                       Washington, DC 20008-1520

                             P 202-783-2242

                             F 202-783-2255

                        https://leadingage.org/

The Honorable Ron Wyden             The Honorable Patty Murray
Chair                               Chair
United States Senate                United States Senate
Committee on Finance                Committee on Health, Education, 
                                    Labor,
                                    and Pensions
Washington, DC 20510                Washington, DC 20510

February 11, 2021

Dear Chair Wyden and Murray:

LeadingAge fully supports the nomination of Xavier Becerra as Secretary 
of the US Department of Health and Human Services and encourages the 
Committees to support his nomination. We worked closely with his office 
on long-term services and supports financing when he was a member of 
Congress and appreciated his understanding of, and commitment to 
addressing, the challenges facing our country to ensure that all older 
persons can age well wherever they call home.

LeadingAge represents more than 5,000 nonprofit aging services 
providers and other mission-minded organizations. Alongside our members 
and 38 state partners, we use applied research, advocacy, education, 
and community-building to make America a better place to grow old. Our 
membership encompasses the entire continuum of aging, including nursing 
homes, home and community-based services providers, hospice and 
affordable senior housing providers.

We support the nomination of Secretary-Nominee Becerra to be the next 
HHS Secretary to advocate for and carry out the robust health care 
platform outlined by President Joe Biden. We have confidence that he 
has the health care expertise and experience managing large systems 
that are critical to successfully leading HHS and that he will work 
with Congress to take quick action on such issues as:

      Beating COVID-19, by ensuring implementation of the Executive 
Orders mandating increased production of protective equipment, ensuring 
access to vaccinations and testing for all older persons and the front-
line staff who serve them, and implementing the provisions in the CARES 
Act and other COVID-related legislation.

      Taking strong steps to promote racial equity by addressing stark 
economic disparities.

      Implementing the Administration's commitment to advancing HCBS 
to ensure that older persons have access to quality health care in the 
community.

      Implementing the Administration's commitment to addressing the 
needs of family caregivers.

      Advancing LGBTQ+ equality for older adults.

      Acting swiftly to fully integrate HHS/CMS and HUD collaboration 
on housing and services, as directed by Congress in the fiscal year 
2020 HUD appropriations bill.

LeadingAge urges the swift approval of Mr. Becerra to be HHS Secretary.

Please reach out to LeadingAge senior vice president for policy, Ruth 
Katz, [email protected] with any questions.

Sincerely,

Katie Smith Sloan
President and CEO

                                 ______
                                 
                            Little Lobbyists

                      https://littlelobbyists.org/

February 18, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairperson                         Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
219 Dirksen Senate Office Building  219 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo,

Little Lobbyists is a family-led organization advocating for the health 
care, education, and community inclusion children with complex medical 
needs and disabilities require to survive and thrive. The U.S. 
Department of Health and Human Services is an agency charged with 
protecting the health of all Americans, as such its leader must center 
the rights of patients and endeavor to ensure access to health care for 
all. We believe Xavier Becerra will dutifully and effectively enact 
this charge, and we write today in support of his swift confirmation as 
Secretary of Health and Human Services.

For the past four years, families of children with complex medical 
needs and disabilities have lived in fear. In 2017, Little Lobbyists 
was formed as a direct response to the threat posed to our children's 
health and well-being by the Trump Administration's effort to repeal 
and defund the Affordable Care Act, Medicaid, and Medicare. Although 
their initial effort narrowly failed in 2017, President Trump and his 
Administration continued their relentless attack on our health-care 
system in myriad ways, including: executive orders weakening our health 
insurance protections, policies making Medicaid more difficult for 
families to access, a failed federal response to the COVID-19 pandemic 
crisis, and support for a lawsuit to overthrow the entire Affordable 
Care Act--including protections for people with pre-existing 
conditions, bans against lifetime caps on care, Medicaid expansion, and 
more--which is currently before the U.S. Supreme Court. In this last 
example, it was the Secretary Designate of HHS Xavier Becerra, in his 
role as Attorney General of California, who led a coalition of 14 
states and the District of Columbia to file a motion to intervene in 
Texas et al. v. United States et al. to defend the Affordable Care 
Act.\1\ It was also Attorney General Becerra who led the defense of the 
Affordable Care Act before the Supreme Court this past fall, standing 
up to ensure our children will continue to have access to the health 
care they need to survive and thrive.
---------------------------------------------------------------------------
    \1\ Attorney General Becerra, joined by 16 AGs, ``Moves to Defend 
the Affordable Care Act Against Federal Lawsuit Filed in Texas,'' State 
of California, Department of Justice, Office of the Attorney General.

Prior to becoming California's Attorney General, Mr. Becerra was a 
member of Congress, serving as a senior member of the House Ways and 
Means committee, overseeing Medicare, Medicaid and other health 
programs.\2\ He represented a largely Latino district with the second 
highest uninsured rate in the country,\3\ which inspired him to help 
write and pass the Affordable Care Act.\4\ In his role as California's 
Attorney General, Mr. Becerra led the second-largest Justice Department 
in the nation, as well as a multi-state coalition to protect the health 
and welfare of immigrant children being held in detention.
---------------------------------------------------------------------------
    \2\ https://history.house.gov/People/Detail/9147.
    \3\ ``California: Affordable Care Act (ACA) Impacts on Insurance 
Coverage by Congressional District,'' SHADAC.
    \4\ Xavier Becerra, Congress.gov, Library of Congress.

Little Lobbyists knows that representation matters. We need leaders 
with the insight that comes from the lived experience of diverse and 
marginalized communities. If confirmed, Xavier Becerra would be the 
first Latino to lead the Department of Health and Human Services. 
Representation that reflects the diversity of our great country is 
---------------------------------------------------------------------------
imperative.

Mr. Becerra has already met with and intently listened to diverse 
groups of stakeholders, including members of the disability community. 
We appreciated that he understood the great importance of issues, like 
Medicaid, which our children rely on to access the home and community 
based services they need. However, Medicaid was under constant attack 
during the previous administration's tenure, putting the lives and 
freedoms of our children at risk. In our meeting, we were also able to 
impress upon Mr. Becerra the disproportionate impact of the COVID-19 
pandemic on people with disabilities, including barriers to care, 
reduced access to home and community based services, and inequities in 
the distribution of the vaccine. These issues, and many more, are 
urgent matters that we trust the Secretary Designate will prioritize 
and act on immediately with the input of those directly affected.

Little Lobbyists strongly supports Xavier Becerra's nomination to serve 
as Secretary of Health and Human Services. Based on his history, his 
experience, and his willingness to bring those most impacted to the 
table, we believe Xavier Becerra will continue to be a champion in our 
fight to protect and strengthen the health care our children, and all 
Americans, need to survive and thrive. In our nation's history there 
has hardly been a more critical time, or a more imperative need, for 
the Department of Health and Human Services to have strong leadership. 
We urge the committee to act quickly to confirm Xavier Becerra as 
Secretary of Health and Human Services.

Thank you for all you do for our families,

Erin Gabriel
Director of Advocacy

                                 ______
                                 
                         Lower Drug Prices Now

                  https://www.lowerdrugpricesnow.org/

The Honorable Ron Wyden
Chairman
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510

The Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510

February 22, 2021

Dear Senate Finance Committee Leaders:

On behalf of Lower Drug Prices Now, a coalition of labor unions, 
community organizations, think tanks and advocacy groups that represent 
millions of people who are struggling with high prescription drug 
prices, I'm writing to urge you to swiftly confirm Attorney General 
Xavier Becerra as Health and Human Services (HHS) Secretary. Mr. 
Becerra is eminently qualified for the position. In today's public 
health and economic crisis, there is no time for delay in installing a 
leader at HHS who can lead the nation toward effective response and 
recovery as the nation reaches another dismal milestone: 500,000 COVID 
deaths.

As Congressman, Mr. Becerra was a key leader in passing the largest 
health care reform of the last 50 years, the Affordable Care Act. He 
was also a key protector of the law, defending it in court in order to 
protect coverage for millions and pre-existing condition protections 
for hundreds of millions. Without the ACA, countless Americans would 
lose access to coverage and to prescription drug medicines that are 
covered as an essential health benefit under the law. Seniors would 
lose billions in discounts in Part D and millions of Medicare 
recipients would end up back in the Part D donut hole that the ACA 
closed after a decade of implementation.

In his role leading a massive state agency in the largest state in the 
Union, AG Becerra has the experience of overseeing an agency larger 
than some departments in the federal government. He is well able to 
manage complex agencies and ensure that moving parts work together to 
serve the best interests of constituents. Protecting patients and 
ensuring access to healthcare and affordable medicines have been Mr. 
Becerra's priorities throughout his career. His record on making 
medicines more accessible and affordable through drug corporation 
accountability speaks for itself.

Over two decades in Congress, Mr. Becerra sponsored legislation that 
would lift the ban on negotiating prices on drugs in Medicare, 
supported bills that would cap or lower out of pocket costs for 
seniors, and worked with colleagues to increase transparency and 
accountability for prescription drug corporations.

In his time as Attorney General of California, Mr. Becerra earned a 
reputation as a champion of patients and consumers by taking on 
prescription drug corporation abuses, from rampant price gouging to pay 
for delay tactics that circumvent competition and allow drug 
corporations to maintain monopoly control over prices. His leadership 
on drug corporation accountability has helped California and also 
advanced national efforts to hold drug manufacturers accountable for an 
array of practices that have devastating consequences for millions of 
people who are forced to ration or go without medicine.

Mr. Becerra joined with a bi-partisan coalition of state Attorneys 
General to investigate the role and culpability of opioid manufacturers 
in fueling the man-made opioid epidemic that has devastated communities 
from coast to coast. He worked with AGs across the nation to support 
Congressional action that would stop the harmful distribution of 
synthetic opioids. In response to COVID needs, AG Becerra also worked 
with a bi-partisan group of Attorneys General to urge HHS to make 
Remdisivir more available for patients in need.

We strongly urge members of the Finance Committee to vote in support of 
this nomination and to quickly confirm Mr. Becerra as HHS Secretary. We 
are confident that he has the legislative, legal and regulatory 
expertise to excel in this role and that he will prioritize patients 
and consumers over special interests. We look forward to working with 
him to ensure access to affordable medicines for all in his role as 
Secretary.

Thanks for your consideration.

Sincerely,

Margarida Jorge
Campaign Director

                                 ______
                                 
                         Mental Health America

                    500 Montgomery Street, Suite 820

                          Alexandria, VA 22314

                            P: 703-684-7722

                            F: 703-684-5968

                          www.mhanational.org

                                                  February 22, 2021
U.S. Senate
Committee on Finance

Dear Chairman Wyden, Ranking Member Crapo, and Members of the 
Committee:

We are pleased to support the nomination of Xavier Becerra as Secretary 
of Health and Human Services.

Mental Health America is the nation's leading community-based nonprofit 
dedicated to addressing the needs of those living with mental illness 
and promoting the overall mental health of all. We advocate for the 
inclusion of mental health as a part of overall health. Our mission is 
driven by a focus on prevention for all, early identification and 
intervention for those at risk, and integrated services for those who 
need them, with recovery as the goal. We have argued that mental health 
conditions are the only chronic conditions that, as a matter of public 
policy, we have waited until stage four--the crisis stage--to treat, 
and that as we do with every other condition, we must act before Stage 
4 to advance mental health and recovery.

We support Attorney General Becerra's nomination because we believe 
that he had demonstrated a decades-long commitment as a public official 
to promoting the health and well-being of the population. As a member 
of Congress, he sponsored and supported legislation that has proven 
essential on the journey to health equity for all our people, including 
those affected by mental illnesses. As the Attorney General of 
California, his efforts in support of enforcing mental health parity, 
for example, are well-known and critically important. So, too, were his 
efforts throughout his career to build an Affordable Care Act that did 
not leave essential benefits for people with mental health conditions 
behind. His efforts to promote community health centers has also led to 
increased access to mental healthcare through integrated health and 
behavioral health services as part of their comprehensive primary care 
mandate.

Attorney General Becerra's background in lawmaking, enforcement, and 
government make him an outstanding choice to lead the Department of 
Health and Human Services. In his past work, he has demonstrated the 
skills of focusing on the most critical problems and learning from all 
stakeholders. These are the critical skills and talents needed to lead 
a large, complex, governmental agency and direct its energies to 
serving all those in need. We strongly support his nomination and urge 
you to quickly confirm him as HHS Secretary given the unprecedented 
health, including mental health, needs of the country at this time.

Sincerely,

Paul Gionfriddo (he/him/his)
President and CEO

                                 ______
                                 
                Medical Imaging and Technology Alliance

                   1300 North 17th Street, Suite 900

                       Arlington, Virginia 22209

                           Tel: 703-841-3200

                           Fax: 703-841-3392

                    https://www.medicalimaging.org/

January 19, 2021

The Honorable Patty Murray          The Honorable Richard Burr
U.S. Senate                         U.S. Senate
Washington, DC 20510                Washington, DC 20510

Dear Senator Murray and Senator Burr:

As the leading trade association representing the manufacturers of 
medical imaging equipment, contrast agents, radiopharmaceuticals, and 
focused ultrasound devices, the Medical Imaging and Technology Alliance 
(MITA) supports the nomination of Xavier Becerra as Secretary of the 
Department of Health and Human Services (HHS).

His State and Federal government service, and especially his 24 years 
in Congress, has given Attorney General Becerra a deep understanding of 
the complexities and challenges of our health care system. He has been 
a champion for healthcare access, ensuring patients receive safe high-
quality scans through accreditation of imaging centers. He also 
recognizes the importance of appropriate reimbursement for healthcare 
providers. MITA counts on the Senate to confirm Attorney General 
Becerra and we and our Members look forward to working with him in his 
new role at the earliest opportunity.

If you have any questions, please contact Holly Grosholz, Senior 
Manager, Government Relations at 703-841-3228 or by email at 
[email protected].

Sincerely,

Patrick Hope
Executive Director

                                 ______
                                 
                        NARAL Pro-Choice America
February 16, 2021

Dear Senator,

We write on behalf of our 2.5 million member-activists to express our 
support for the nomination of Xavier Becerra to the position of U.S. 
Secretary of Health and Human Services. In order to be qualified to 
lead the Department of Health and Human Services, a nominee must be 
someone who prioritizes public health and bases decisions on evidence 
not ideology. Attorney General Becerra's record makes clear that he is 
such a nominee.

As both attorney general of California and a member of the U.S. House 
of Representatives, Attorney General Becerra acted to protect access to 
healthcare and reproductive freedom, including abortion and 
contraception. As attorney general, he opposed abortion bans and 
burdensome restrictions on abortion, medically unnecessary restrictions 
on medication abortion during the COVID-19 pandemic, and a rule 
promulgated by the Trump administration which prevents patients in the 
Title X family planning program from getting full and accurate 
healthcare information and adds new restrictions to exclude providers 
that also provide abortion care from the program. While serving in the 
House of Representatives, Attorney General Becerra voted in favor of 
the Affordable Care Act, voted to protect funding for Planned 
Parenthood, and voted against bans on abortion and abortion coverage.

Now more than ever executive agencies need leaders who are fair-minded 
and committed to their agency's core mission. For these reasons, we 
urge Senators to support this nomination.

Sincerely,

NARAL Pro-Choice America

                                 ______
                                 
                National Alliance to End Sexual Violence

                 1875 Connecticut Avenue, NW, Floor 10

                          Washington, DC 20009

                             (202) 869-8520

                     https://endsexualviolence.org/

U.S. Senate
Committee on Health, Education, Labor, and Pensions
U.S. Senate
Committee on Finance
Senate Dirksen Office Building
Washington, DC 20510

February 11, 2021

Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking 
Member Crapo, and Committee Members:

The National Alliance to End Sexual Violence (NAESV) is the voice in 
Washington, DC for the 56 state and territorial sexual assault 
coalitions and over 1500 local programs working to end sexual violence 
and support survivors. The local programs we serve see the widespread 
and devastating consequences of sexual violence for survivors every 
day. On their behalf, I write to urge you to confirm the appointment of 
Xavier Becerra as Secretary of Health and Human Services (HHS).

According to the National Intimate Partner and Sexual Violence Survey:

      21% of women and 3% of men reported completed or attempted rape 
ever in their lifetime.

      Among victims of rape, 43% (11 million) of females and 51% (1.5 
million) of males reported it occurred for the first time between the 
ages of 11-17.\1\
---------------------------------------------------------------------------
    \1\ https://www.cdc.gov/violenceprevention/pdf/2015data-
brief508.pdf.

The estimated lifetime cost of rape is $122,461 per survivor, or a 
population-based economic burden of nearly $3.1 trillion (2014 U.S. 
dollars) over survivors' lifetimes. This estimate included $1.2 
trillion (39%) in medical costs; and $1.6 trillion (52%) in lost work 
productivity among survivors and perpetrators.\2\
---------------------------------------------------------------------------
    \2\ http://www.ajpmonline.org/article/S0749-3797(16)30615-8/
abstract.

The short- and long-term effects of sexual violence can undermine a 
person's physical and mental health. Based on an analysis of studies 
from 1980-2008, survivors of sexual violence have a significantly 
higher prevalence of anxiety, depression, eating disorders, post-
traumatic stress disorder, and suicide attempts.\3\ According to the 
2005 Behavioral Risk Factor Surveillance System, survivors of sexual 
violence are more likely to suffer from asthma and joint conditions. 
Studies have also found an increased risk of cervical cancer and 
sexually transmitted diseases.\4\
---------------------------------------------------------------------------
    \3\ Ibid.
    \4\ Ibid.

Many survivors encounter the problems of homelessness, substance use 
disorders, mental health problems, trafficking experiences, and chronic 
health conditions. The issue of sexual violence cuts across many HHS 
bureaus, programs, and offices: programs in the Family and Youth Bureau 
including Family Violence Prevention Services (FVPSA), Homeless & 
Runaway Youth, and Adolescent Pregnancy Prevention; the Office on 
Trafficking in Persons; the Substance Abuse and Mental Health Services 
Administration; and the CDC where the Rape Prevention & Education 
---------------------------------------------------------------------------
Program (RPE) is housed.

Xavier Becerra is a demonstrated leader who brings decades of health 
policy experience addressing violence against women and support 
services, ensuring access to healthcare, and protecting Social Security 
and Medicare. His long history of defending and protecting the 
Affordable Care Act has provided essential health care access and 
coverage for many previously uninsured people, including those 
experiencing sexual violence and trauma. His commitment to gender 
equity and women's health, and specifically reproductive health, 
positions him well to develop and promote polices that will positively 
impact survivors of sexual violence and further the administration's 
commitment to ending gender-based violence. As District Attorney of 
California, he joined with Attorneys General across the country in 2018 
and 2020 to advocate for the reauthorization of the Violence Against 
Women act, including provisions strengthen protections for the most 
marginalized and vulnerable members of our communities. During the 
current COVID-19 pandemic, he prioritized the needs of survivors 
experiencing even greater isolation to ensure they had access to 
critical services in California.

For the past decade, our nation has experienced a deep reckoning with 
the devastating depth and breadth of the problem of sexual violence. 
Under the leadership of Xavier Becerra, HHS can reach farther in 
meeting the needs of survivors and preventing sexual violence. His 
legal background and efforts with his expansive understanding of health 
and welfare issues is the perfect mix of experience to meet the needs 
of an agency that affects all members of our communities.

Sincerely,

Monika Johnson Hostler
President

                                 ______
                                 
               National Alliance of Safety-Net Hospitals

                     21351 Gentry Drive, Suite 210

                           Sterling, VA 20166

                          Phone: 703-444-0989

                     https://safetynetalliance.org/

January 25, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

The National Alliance of Safety-Net Hospitals is pleased to express our 
support for the confirmation of Xavier Becerra to serve as the next 
Secretary of the Department of Health and Human Services.

Private safety-net hospitals--large hospitals that serve large numbers 
of low-income, low-income elderly, Medicaid, and uninsured patients--
play a special role in the broader American health care system. That 
role has always been critical, and it has been magnified during the 
current COVID-19 crisis. We worked with Mr. Becerra when he was a 
member of Congress and served on the House Ways and Means Committee and 
can attest to his understanding of the distinct challenges low-income 
and underserved communities face and his sincere interest in using 
public policy to help address those challenges. We would welcome an 
opportunity to work with a Secretary who understands these challenges 
and also understands the underlying health equity challenges that we 
must address as a nation.

For these reasons, NASH enthusiastically support Mr. Becerra's 
nomination to be Secretary of Health and Human Services and urges you 
to vote to recommend his nomination to the entire Senate.

Sincerely,

Ellen Kugler, Esq.
Executive Director

                                 ______
                                 
       National Alliance of State and Territorial AIDS Directors

                444 North Capitol Street, NW, Suite 339

                          Washington, DC 20001

                             (202) 434-8090

                        https://www.nastad.org/

February 22, 2021

U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510

U.S. Senate
Committee on Health, Education, Labor, and Pensions
428 Dirksen Senate Office Building
Washington, DC 20510

Dear Committee Members,

On behalf of NASTAD (National Alliance of State and Territorial AIDS 
Directors), a leading non-partisan non-profit association that 
represents governmental public health officials who administer HIV and 
hepatitis programs in the U.S., I would like to offer our 
organization's support for Xavier Becerra to serve as the next 
Secretary of the Department of Health and Human Services (HHS). Based 
on his demonstrated leadership, expertise, and vision, NASTAD believes 
Mr. Becerra is an excellent candidate for this important role.

Mr. Becerra has proven to be a strong leader during his tenure as 
Attorney General of California. While serving the state, Mr. Becerra 
reached a settlement over a breach of patient confidentiality for 1,991 
Californians who received mailings that revealed the recipient was 
taking HIV-related medication. Mr. Becerra also led the charge to 
protect the Affordable Care Act (ACA), legislation that led to a 
substantial decline in uninsurance rates among people living with HIV. 
Through his legal actions, Mr. Becerra has shown that he prioritizes 
patients' rights, equity, and access in health care. These commitments 
will be incredibly important as Mr. Becerra works to contain and end 
the COVID-19 pandemic that has highlighted American health inequities.

With over 20 years public service experience in Congress, Mr. Becerra 
worked to represent his constitutes and strengthen health care in 
America as a senior member of the Ways and Means Subcommittee on 
Health. Mr. Becerra is a dedicated public servant who understands that 
truly protecting health requires leadership that addresses the social 
and structural determinants of health including gender inequality, 
homophobia, and poverty.

Mr. Becerra is uniquely suited to serve as the next HHS Secretary. His 
public service record as an advocate for improved health care access 
makes Mr. Becerra an exemplary nominee.

Sincerely,

Stephen Lee, M.D., MBA, DHSM
Executive Director

                                 ______
                                 
                  National Alliance on Mental Illness

                    4301 Wilson Boulevard, Suite 300

                          Arlington, VA 22203

                             (703) 524-7600

                         https://www.nami.org/

February 23, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

RE: NAMI Support for HHS Secretary Nominee Xavier Becerra

Dear Chairman Wyden and Ranking Member Crapo:

On behalf of the National Alliance on Mental Illness (NAMI), I am 
writing in support of confirmation of California Attorney General 
Xavier Becerra as the next Secretary of the U.S. Department of Health 
and Human Services (HHS). As the nation's largest grassroots mental 
health organization dedicated to building better lives for the millions 
of Americans affected by mental illness, NAMI is pleased to support 
this important nomination.

Attorney General Becerra has been a true leader on mental health and 
addiction issues, tirelessly defending the ACA and working to enforce 
federal & state mental health parity laws. As California's Attorney 
General he led efforts on the part of states to challenge measures 
taken by the previous Administration to undermine a series of patient 
protections in the Affordable Care Act (ACA). Under his leadership, 
California also stepped up enforcement and compliance with respect to 
the Mental Health Parity and Addiction Equity Act (MHPAEA) ensuring 
more equitable coverage of mental illness treatment.

In his 24 years as a Member of the House of Representatives, 
Congressman Becerra established a significant record of accomplishment 
in crafting legislation to expand access to mental health treatment. 
This includes improvements to the Medicare program including enhanced 
protections for low income beneficiaries that are concurrently eligible 
for Medicaid. He also led a number of efforts in Congress to prevent 
cuts to the Social Security Disability Insurance (SSDI) program that 
many people living with mental illness rely on.

NAMI is proud to support Attorney General Becerra's confirmation as HHS 
Secretary. We urge the Committee move expeditiously on his nomination.

Sincerely,

Daniel H. Gillison, Jr.
CEO

                                 ______
                                 
            National Association of Community Health Centers

                    7501 Wisconsin Ave., Suite 1100W

                           Bethesda, MD 20814

                            301-347-0400 TEL

                            301-347-0459 FAX

                         https://www.nachc.org/

                           February 11, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
Chairwoman                          Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor, and Pensions                 Committee on Health, Education, 
                                    Labor, and Pensions
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden, Ranking Member Crapo, Chairwoman Murray and 
Ranking Member Burr:

On behalf of Community Health Centers and the 30 million patients they 
serve, I want to express my support for Attorney General Xavier 
Becerra's nomination to be the Secretary of the Department of Health 
and Human Services (HHS). The COVID-19 pandemic continues to challenge 
health centers across the country and strong leadership at the 
department is necessary to tackle this ongoing crisis.

Attorney General Becerra has a long-established relationship with 
California health centers and NACHC. As a former Member of Congress 
from Los Angeles, and a member of the House Ways and Means Committee, 
he consistently sought feedback from local health center leadership 
through roundtable events and regular communications with the Los 
Angeles Community Clinic Consortium.

Additionally, he regularly attended health center events throughout the 
district and then acted to support health center priorities. These 
connections were incredibly important since his congressional district 
included 30 health centers that collectively serve nearly 250,000 
patients. NACHC was pleased to recognize this work in support of health 
centers by awarding Becerra with the Distinguished Community Health 
Advocate Award during his time in Congress.

Federally qualified health centers across the country are working every 
day to help address the COVID-19 pandemic. To date, over 8 million 
health center patients have been tested for COVID-19, 13% have tested 
positive and 140,000 immunizations have been initiated. A significant 
number of these patients are racial and/or ethnic minorities, who are 
bearing a disproportionate brunt of this crisis. Attorney General 
Becerra's experience representing one of the most diverse Congressional 
Districts will be critical to ensuring that all Americans have access 
to COVID-19 testing and vaccines.

NACHC appreciates the expanded role that the Biden Administration 
envisions for health centers and looks forward to working with Attorney 
General Becerra should he be confirmed. His commitment to equitable 
access to health care and experience at the state and federal levels 
make him an ideal choice at this critical moment. Thank you in advance 
for your consideration.

Sincerely,

Tom Van Coverden
President and CEO

                                 ______
                                 
                     National Association of State 
                    Mental Health Program Directors

                    66 Canal Center Plaza, Suite 302

                          Alexandria, VA 22314

                             (703) 739-9333

                           Fax (703) 548-9517

February 23, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
219 Dirksen Senate Office Building  219 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Senator Crapo:

The National Association of Mental Health Program Directors (NASMHPD)--
the organization representing the state executives responsible for the 
$41 billion public mental health service delivery systems serving 7.5 
million people annually in 50 states, 5 territories, and the District 
of Columbia--is writing to recommend a nominee for Secretary of Health 
and Human Services. State Mental Health Authority priorities focus on 
improving services in the mental health and substance use disorder 
field, particularly within the Medicaid and Medicare programs, and the 
Affordable Care Act insurance program, and this nominee has shown 
experience in supporting these priorities.

NASMPHD recommends Attorney General Xavier Becerra of California who 
has shown vast experience in handling the broad array of issues under 
HHS purview. As Attorney General, he has worked to enforce the mental 
health parity laws he helped to pass in Congress to ensure that 
insurance companies expand provider networks and guarantee equal 
treatment for mental health conditions in insurance plans. In Congress, 
he was active in the passing of the Affordable Care Act, specifically 
focusing on strengthening Medicare benefits, and expanding the 
Children's Health Insurance Program. These are vital in order to 
provide for the essential care needed by those with mental health and 
substance abuse disorders, and so that health insurance coverage for 
mental health and substance use disorder services is no more 
restrictive than coverage for medical/surgical services.

Attorney General Becerra has also shown the leadership and demonstrated 
a track record of advocating for access to quality, affordable health 
care which is essential as our nation continues to deal with the COVID-
19 public health emergency that has contributed to mental health 
crises. With the creation of the 988 suicide prevention hotline, it is 
more important than ever to improve the system to provide access to 
crisis services for those in mental health crisis, and to be diverted 
away from hospital emergency departments and jails where their needs 
will not be met. A strength of Attorney General Becerra is being a 
champion for reducing the health inequities that have been problematic, 
and exacerbated by the COVID-19 public health emergency, so that all 
have quality care readily available.

Thank you for considering this recommendation on the confirmation of 
Attorney General Becerra for the position of Secretary of Health and 
Human Services.

Sincerely,

Brian M. Hepburn, M.D.
Executive Director

                                 ______
                                 
                   National Center for Lesbian Rights

                  1300 Pennsylvania Ave., NW, #190-706

                          Washington DC 20004

February 22, 2021

Honorable Ron Wyden
Chair
U.S. Senate
Committee on Finance

Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance

Honorable Patty Murray
Chair
U.S. Senate
Committee on Health, Education, Labor, and Pensions

Honorable Richard Burr
Ranking Member
U.S. Senate
Committee on Health, Education, Labor, and Pensions

Dear Chair Wyden, Ranking Member Crapo, Chair Murray, and Ranking 
Member Burr,

The National Center for Lesbian Rights (NCLR) is pleased to support the 
nomination of California Attorney General Xavier Becerra to serve as 
Secretary of the U.S. Department of Health and Human Services (HHS).

NCLR is a non-profit, public interest law firm that litigates 
precedent-setting cases at the trial and appellate court levels, 
advocates for equitable public policies affecting the lesbian, gay, 
bisexual, transgender, and queer (LGBTQ) community, provides free legal 
assistance to LGBTQ people and their advocates, and conducts community 
education on LGBTQ issues. NCLR has been advancing the civil and human 
rights of LGBTQ people and their families across the United States 
through litigation, legislation, policy, and public education since its 
founding in 1977.

While NCLR is a national organization, our headquarters and roots are 
in San Francisco. In addition to our advocacy work at the federal 
level, we also engage in legal and policy work within California, and 
thus have extensive familiarity with Attorney General Becerra's track 
record. The nation would be fortunate to have Mr. Becerra in a 
leadership role at this unprecedented time, when addressing systemic 
injustices and a global pandemic will be at the top of the agenda for 
the new HHS secretary.

Attorney General Becerra is a longstanding friend and ally to the LGBTQ 
community, including back when it was far less socially and politically 
popular to take such a position. During his congressional tenure he 
voted for marriage equality, against discrimination in military 
service, and for inclusion of LGBTQ people in hate crimes laws. His 
commitment to equality continued when he became California's attorney 
general, and we were honored to join forces with his office in 
litigating against former President Trump's unlawful ban on transgender 
persons serving in the military.

No less important is Mr. Becerra's staunch defense of access to the 
full range of reproductive health care, including contraception and 
abortion. As someone with a deep commitment to health care access, he 
understands that this includes reproductive health care. Mr. Becerra 
helped to bring the Affordable Care Act into being and has been at the 
forefront of defending it from legal attack. He has also worked to 
protect the rights of immigrants and their families, people with 
disabilities, and so many more.

Xavier Becerra is the leader we need right now to helm the Department 
of Health and Human Services as we navigate out of the pandemic and 
toward a more just and equitable future for all in this nation. We urge 
the Senate to move quickly on his confirmation.

Should you have any questions regarding this letter, please do not 
hesitate to contact me at [email protected].

Sincerely,

Julianna S. Gonen, Ph.D., JD
Policy Director

                                 ______
                                 
              National Coalition Against Domestic Violence

                      1140 3rd St., NE, 2nd floor

                          Washington, DC 20002

                              202-714-7662

                             www.ncadv.org

February 12, 2021

U.S. Senate
Committee on Health, Education, Labor, and Pensions
U.S. Senate
Committee on Finance
Dirksen Senate Office Building
Washington, DC 20510

Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking 
Member Crapo, and Committee Members:

The National Coalition Against Domestic Violence (NCADV) writes to you 
to urge you to confirm California Attorney General Xavier Becerra 
(Becerra) to be the Secretary of the Department of Health and Human 
Services (HHS). NCADV is the nation's oldest national grassroots 
domestic violence organization, representing domestic violence programs 
and survivors directly. Established in 1978, mission is to lead, 
mobilize and raise our voices to support efforts that demand a change 
of conditions that lead to domestic violence such as patriarchy, 
privilege, racism, sexism, and classism. We are dedicated to supporting 
survivors and holding offenders accountable and supporting advocates.

NCADV envisions a national culture in which we are all safe, empowered 
and free from domestic violence, and Becerra's record proves that he 
will promote such a culture as Secretary of HHS. Domestic violence 
impacts every person in America. With one in four women and one in ten 
men experiencing intimate partner violence,\1\ everyone is acquainted 
with someone who has experienced violence--whether they know it or not. 
Black and Native women experience the highest rates of intimate partner 
violence,\2\ and they systems that ought to protect them are often 
actively hostile. White supremacy is a feature of all of these systems. 
Women who are financially unstable, and who may rely on government 
assistance such as that overseen by HHS, are also particularly 
vulnerable to intimate partner violence--or are financially unstable as 
a result of the violence they experienced.
---------------------------------------------------------------------------
    \1\ Smith, S.G., Zhang, X., Basile, K.C., Merrick, M.T., Wang, J., 
Kresnow, M., and Chen, J. (2018). ``The National Intimate Partner and 
Sexual Violence Survey: 2015 Data Brief--Updated Release.'' Atlanta: 
National Center for Injury Prevention and Control, Centers for Disease 
Control and Prevention. Retrieved from https://www.cdc.gov/
violenceprevention/pdf/2015data-brief508.pdf.
    \2\ Smith, S.G., Chen, J., Basile, K.C., Gilbert, L.K., Merrick, 
M.T., Patel, N., Walling, M., and Jain, A. (2017). ``The National 
Intimate Partner and Sexual Violence Survey (NISVS): 2010-2012 State 
Report.'' Atlanta: National Center for Injury Prevention and Control, 
Centers for Disease Control and Prevention. Retrieved from https://
www.cdc.gov/violenceprevention/pdf/NISVS-StateReportBook.pdf.

Programs within HHS are a literal lifeline for countless survivors. The 
Family Violence Prevention and Services Act (FVPSA) is the only 
dedicated funding source for domestic violence programs and is housed 
in HHS. Survivors rely on a host of other HHS programs, including 
programs that are necessary for them to rebuild their financial 
stability after leaving an abusive relationship such as Temporary 
Assistance to Needy Families and childcare assistance. HHS programs are 
integral to the health and well-being of survivors. With experience 
both as a legislator in the United States House of Representatives and 
as an executive as the Attorney General of California, Becerra is 
---------------------------------------------------------------------------
uniquely qualified to lead the agency.

Intimate partner violence is nothing short of a public health crisis, 
and the domestic violence epidemic is only exacerbated by the COVID-19 
pandemic, as survivors face added barriers to leaving abusive 
relationships, including the potential of losing healthcare coverage. 
Becerra has a proven record of fighting for access to healthcare for 
all Americans. This includes leading the legal campaign to prevent the 
Affordable Care Act from being dismantled, thereby protecting millions 
of survivors' access to healthcare.

In both elected and appointed positions, he has been a champion for 
women and for lower-income families. In 2020, he said, ``There is no 
place for violence against women anywhere.''\3\ We agree with him, and 
we know that he will continue to be a champion for survivors as 
Secretary.
---------------------------------------------------------------------------
    \3\ State of California Department of Justice (2020, May 4). 
``Attorney General Becerra Urges Congress to Renew Protections Under 
the Violence Against Women Act'' [Press release]. https://oag.ca.gov/
news/press-releases/attorney-general-becerra-urges-congress-renew-
protections-under-violence-against.

Thus, we urge the Senate Committee on Health, Education, Labor, and 
Pensions and the Senate Committee on Finance to expeditiously confirm 
Attorney General Becerra to be the Secretary of the Department of 
---------------------------------------------------------------------------
Health and Human Services.

Sincerely,

The National Coalition Against Domestic Violence

                                 ______
                                 
      National Committee to Preserve Social Security and Medicare

                      111 K Street, NE, Suite 700

                          Washington, DC 20002

                              202-216-0420

                        https://www.ncpssm.org/

February 22, 2021

U.S. Senate
Committee on Finance
Washington, DC 20510

Dear Senators:

It is with great pleasure that I write to endorse the nomination of 
Xavier Becerra to lead the U.S. Department of Health and Human 
Services.

Throughout his long and distinguished career in public service, Mr. 
Becerra has demonstrated his capabilities in the health care arena, 
from taking on a corporate health care giant that illegally drove up 
prices, to helping secure passage of the Affordable Care Act and later 
defending it in court. He knows the plight of Americans who lack access 
to affordable health care coverage and understands the government's 
fundamental responsibility overseeing the financing and delivery of 
services through large, federal agencies.

Mr. Becerra's deep background in health care policy and human services 
programs, his knowledge of underserved and vulnerable populations, his 
commitment to fiscal responsibility for both taxpayers and the 
government, combined with his leadership skills and willingness to 
listen to all stakeholders makes him the ideal Secretary to oversee 
HHS.

Attorney General Becerra's experience as a legislator and executive 
leaves little room for doubt about his ability to help the Biden 
Administration successfully guide this nation out of the COVID pandemic 
and into a stronger era of health and human services delivery for all 
Americans.

Sincerely,

Max Richtman
President and CEO

                                 ______
                                 
                       National Council on Aging

                    251 18th Street South, Suite 500

                          Arlington, VA 22202

                           Phone 571-527-3900

                           Fax: 571-527-3901

                                ncoa.org

February 18, 2021

The Honorable Patty Murray          The Honorable Richard Burr
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor, and Pensions                 Committee on Health, Education, 
                                    Labor, and Pensions
Washington, DC 20510                Washington, DC 20510

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
United States Senate                United States Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chair Murray, Ranking Member Burr, Chairman Wyden, and Ranking 
Member Crapo:

I am writing to express support from the National Council on Aging 
(NCOA) for the nomination of California Attorney General Xavier Becerra 
as the next Secretary of the U.S. Department of Health and Human 
Services (HHS).

NCOA is a trusted national leader working to ensure that every person 
can age well. Since 1950, our mission has not changed: Improve the 
lives of millions of older adults, especially those who are struggling. 
NCOA empowers people with the best solutions to improve their own 
health and economic security--and we strengthen government programs 
that we all depend on as we age.

Attorney General Becerra has been a longstanding champion for 
affordable health coverage and access, particularly for Americans in 
greatest need. He has deep knowledge and passion for improving health 
care for patients and consumers, not powerful special interests.

As a 12-term member of Congress and a member of the House Ways and 
Means Committee's Health Subcommittee, Becerra demonstrated his 
expertise on a broad range of critical health care issues facing our 
nation. While playing a leadership role in providing health coverage to 
millions of uninsured and underinsured Americans under the Affordable 
Care Act and championing improvements to women's health, he also 
authored Medicare proposals focused on improving care for beneficiaries 
in need, including those that would:

      Increase access to physical therapy by repealing arbitrary 
limits on Medicare coverage for outpatient rehabilitation therapy;
      Expand Medicare coverage of medical nutrition services; and
      Strengthen low-income Medicare beneficiary protections and 
assistance.

NCOA had the privilege of working closely with then-Rep. Becerra and 
his staff on legislation he introduced in 2007 and 2009 to make health 
care more affordable for low-income Medicare beneficiaries whose fixed 
incomes made it difficult to afford rising health care costs. His 
Medicare Savings Program Improvement Act would have made it easier to 
meet stringent asset test eligibility requirements. These restrictions 
continue to unfairly penalize low-income older adults who did the right 
thing during their working years by putting away a modest nest egg of 
savings, thereby disqualifying them from receiving the help they need. 
Becerra also recognized the need to improve protections against 
increasing copayments and deductibles only available for low-income 
older Americans with annual incomes below 100% of poverty ($12,880 in 
current dollars).

More recently, as Attorney General of the largest state in the nation 
and managing 4,800 employees, Becerra has continued to be deeply 
involved in crafting health policies that benefit consumers, including:

      Taking action to make hospital care more affordable and increase 
transparency and competition by addressing monopolistic practices that 
drive up prices and exploit market power for profit;
      Reducing prescription drug costs by addressing anti-competitive 
pay-for-delay agreements, through which brand name drug companies have 
been able to delay the entrance of less expensive generics into the 
market; and
      Leading a multistate coalition to fight against the Trump 
Administration's ``Healthcare Refusal Rule,'' which would 
disproportionately impact communities of color, LGBTQ+ communities, and 
women seeking health care services by allowing medical staff to refuse 
life-saving care to patients based on personal objection.

Attorney General Becerra's knowledge and experience will help our 
nation to effectively address our current public health crisis. 
Becerra's degrees in economics and law from Stanford University have 
helped provide him with an in-depth understanding of health care 
financing issues and how complex health laws and regulations impact 
those in need.

His skills and experience in working with Congress cannot be 
underestimated. There is much that must and can be done to improve our 
flawed health care system, such as promoting equity, addressing health 
disparities, and overcoming barriers to care. His understanding of what 
can and cannot be done, and how to combine good policy and good 
politics are desperately needed to effectively address these serious 
challenges.

Finally, his appointment would be historic. A former chair of the 
Congressional Hispanic Caucus, Becerra was the first Latinx person to 
serve as a member of the powerful Committee on Ways and Means and would 
be the first to serve as Secretary of HHS.

Attorney General Becerra is highly qualified to lead America's efforts 
to improve our flawed health care system for Americans of all ages. 
NCOA strongly urges members of the Senate Finance Committee to vote in 
favor of and for the Senate to promptly confirm his nomination.

Sincerely,

Ramsey Alwin
President and CEO

                                 ______
                                 
                    National Council of Jewish Women

                       2055 L St., NW, Suite 650

                          Washington, DC 20036

                            T: 202-296-2588

                         https://www.ncjw.org/

February 19, 2021

U.S. Senate
Committee on Health, Education, Labor, and Pensions
U.S. Senate
Committee on Finance
Dirksen Senate Office Building
Washington DC, 20510

Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking 
Member Crapo, and Committee Members:

On behalf of the 180,000 advocates of National Council of Jewish Women 
(NCJW), I write to express our strong support for the nomination of 
Xavier Becerra to serve as Secretary of the US Department of Health and 
Human Services (HHS). As a national grassroots organization fighting 
for social justice on behalf of women, children, and families, we know 
that Attorney General Becerra would be a champion for essential health 
care access and coverage at a time when we need it most.

Throughout his career, Attorney General Becerra has been a vocal 
supporter of women's health in particular. While in the US House of 
Representatives, Attorney General Becerra supported the Affordable Care 
Act (ACA) and the Lilly Ledbetter Fair Pay Act of 2019, among other 
important bills impacting reproductive and economic justice. He also 
opposed the racist and discriminatory Prenatal Nondiscrimination Act, 
which would have imposed civil and criminal penalties on anyone 
knowingly attempting to perform a sex-selective abortion.

As California's top law enforcement official, Attorney General Becerra 
has prioritized the needs of domestic violence and sexual assault 
survivors experiencing even greater isolation during the pandemic. He 
has also helped to lead legal fights across the nation, championing 
access to health care and dismantling barriers for women struggling to 
get medical services. Whether leading 20 states and the District of 
Columbia in an effort to protect the ACA, ensuring that everyone can 
receive birth control at no cost, or blocking the murder prosecution of 
a woman whose consumption of methamphetamine during pregnancy 
tragically resulted in stillbirth, Attorney General Becerra has 
demonstrated his commitment to protecting our critical rights.

The Secretary of HHS certainly does not have an easy job, particularly 
as this nation faces a once-in-a-century pandemic. Fortunately, 
Attorney General Becerra's depth and breadth of experience more than 
prepare him to lead this agency and fulfill its mission ``to enhance 
the health and well-being of all Americans.'' As Becerra has noted, the 
ACA ``has been life-changing and now through this pandemic, we can all 
see the value in having greater access to quality health care at 
affordable prices.'' Becerra's words and actions gives us confidence 
that he shares our values. We trust that he will not only tackle COVID-
19, but will also restore and strengthen our health care system to meet 
the many and disparate needs at this moment in time and in the future.

As Jews, we believe in the ultimate moral imperative to protect every 
single person's health, the obligation to care for our bodies and to 
ensure others can do the same through access to quality care. We 
believe in compassion and dignity for all and are committed to ensuring 
equity and justice for the most marginalized members of our society. 
Xavier Becerra shares these values and NCJW urges his swift 
confirmation as Secretary of Health and Human Services.

Please reach out to me by email ([email protected]) if you have any 
questions.

Sincerely,

Jody Rabhan
Chief Policy Officer

                                 ______
                                 
                      National Health Law Program

                     1444 I Street, NW, Suite 1105

                          Washington, DC 20005

                             (202) 289-7661

                         https://healthlaw.org/

February 22, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor, and Pensions                 Committee on Health, Education, 
                                    Labor, and Pensions
Washington DC 20510                 Washington, DC 20510

Dear Chairman Wyden, Ranking Member Crapo, Chair Murray, and Ranking 
Member Burr,

On behalf of the National Health Law Program, we write to encourage you 
to support Xavier Becerra's confirmation as the next Secretary of the 
United States Department of Health and Human Services (HHS). As long-
time advocates for the health rights of low-income individuals and 
families, we know that Attorney General Becerra has the skills, drive, 
and empathy to guide HHS.

Attorney General Becerra has taken on threats to health care with 
vision and boldness, both as a Member of Congress and as Attorney 
General of California. Throughout his career, he has championed access 
to health care for those who need it most: low-income individuals and 
families; Black, Indigenous, and people of color (BIPOC); people with 
disabilities; children; women; immigrants; members of the LGBTQ-GNC 
community; people with limited-English proficiency; and those at the 
intersections of multiple identities. AG Becerra possesses both a keen 
understanding of the law and a deep recognition of the challenges faced 
by everyday people. While a Member of Congress, AG Becerra sponsored 
and supported the Affordable Care Act. As Attorney General of 
California, he has led the fight against the latest effort to have the 
federal courts strike down the law. He has worked to block federal 
regulations and policies that encourage discrimination in health care 
delivery--especially against women, LGBTQ-GNC individuals, and those 
seeking reproductive health care.

The challenges facing this nation are multifold, both acute and long-
simmering. The pandemic has exposed flagrant flaws in our health care 
system and painfully revealed America's entrenched health inequities. 
President Biden was wise to nominate Xavier Becerra to be his 
lieutenant in addressing them. There is much work to do, and we are 
confident that AG Becerra will face those challenges with 
thoughtfulness and fearless energy. As an organization with deep roots 
in California, we will miss his leadership in Sacramento, but we look 
forward to working with him in this new capacity. We encourage the 
Senate to confirm his nomination swiftly and resolutely.

If you have any questions, please contact Kim Lewis 
([email protected]) or Mara Youdelman, Managing Attorney (Washington, 
DC) ([email protected]).

Sincerely,

Elizabeth G. Taylor
Executive Director

Kim Lewis
Managing Attorney, California

                                 ______
                                 
            National Mobility Equipment Dealers Association

                          3327 W. Bearss Ave.

                            Tampa, FL 33618

                              813-264-2697

                             www.nmeda.org

February 2, 2021

To Whom It May Concern:

The National Mobility Equipment Dealers Association (NMEDA) submits 
this statement in support of Xavier Becerra's nomination for Secretary 
of the U.S. Department of Health and Human Services. During his tenure 
in the House of Representatives, Congressman Becerra demonstrated a 
thorough understanding of federal programs that support the aging and 
disability communities--most notably the Social Security Disability 
Insurance, Medicare, and Medicaid programs--and made significant and 
meaningful contributions to disability-related policies. NMEDA is 
confident that Mr. Becerra's leadership will advance and strengthen 
HHS's commitment to the empowerment, integration, independence, and 
health and well-being of American seniors and people with disabilities.

Respectfully Submitted,
Danny Langfield
Chief Executive Officer

                                 ______
                                 
                National Organization for Rare Disorders

                1779 Massachusetts Avenue, NW, Suite 500

                          Washington, DC 20036

                             T 202-588-5700

                             F 202-588-5701

                       https://rarediseases.org/

February 11, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
219 Dirksen Senate Office Building  219 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden, Ranking Member Crapo, and Members of the Senate 
Finance Committee,

The National Organization for Rare Disorders (NORD) writes to express 
our support for the nomination of Xavier Becerra as the next Secretary 
of the Department of Health and Human Services (HHS). NORD is a unique 
federation of over 325 voluntary health organizations dedicated to 
helping the 25-30 million Americans living with a rare disease. NORD is 
committed to the identification, treatment, and cure of rare disorders 
through programs of education, advocacy, research, and patient 
services. We believe that all patients should have access to quality, 
accessible, and affordable health coverage that is best suited to their 
medical needs.

Attorney General Becerra has spent a career in both Washington and 
California advancing policies that have improved access to affordable 
and comprehensive health care. As a member of Congress for more than 20 
years, Representative Becerra served on the House Ways and Means 
Committee, where he focused on strengthening the programs that patients 
with rare diseases depend on and played an integral role in the passage 
of the Affordable Care Act (ACA). Mr. Becerra has continued to act has 
a champion for patients as Attorney General of California, spearheading 
efforts to safeguard the patient protections enshrined within the ACA, 
including leading a coalition of 17 states to defend the law before the 
Supreme Court. We are confident that his experience will enable to him 
to effectively lead HHS and support the implementation of policies that 
can help address pressing health needs of the rare disease community.

Should Attorney General Becerra be confirmed, he will be tasked with 
addressing many of our nation's most urgent health challenges. Over the 
past several years, many essential guardrails that protect patients and 
their families have been eroded while insurance practices that 
disproportionately discriminate against patients with pre-existing 
conditions have proliferated. Upon confirmation, Attorney General 
Becerra and the Department must take immediate steps to restore 
protections and resources that help patients get high-quality insurance 
coverage that meets their needs. In addition, we hope Attorney General 
Becerra will strengthen the vital Medicaid and Medicare programs upon 
which so many in the rare disease community rely. Medicaid, in 
particular, is an invaluable safety net for rare disease patients who 
often find their financial lives upended by the debilitating nature of 
their diseases, but its core objective of serving the health and 
wellness needs of its beneficiaries has been undermined in recent years 
through federal government approval of several harmful Section 1115 
waivers. NORD looks forward to working with HHS to reinforce the 
objectives of the Medicaid program and continue to develop new and 
innovative payment models to reward the delivery of high-quality care 
to patients.

This nomination is occurring during an unprecedented national public 
health crisis. The devastating impact of COVID-19 means that it is more 
important than ever that the Department of Health and Human Services 
has strong and continuous leadership. In addition to overseeing the 
distribution of vaccines for COVID-19 and coordinating our public 
health agencies, as Secretary, Attorney General Becerra must address 
the systemic racism and pervasive inequality within our health care 
system that has only been exacerbated by this crisis. The COVID-19 
pandemic has been particularly challenging for the rare disease 
community, as many rare disease patients are immune-compromised, 
putting them at high risk of infection and serious illness. Our 
community cannot afford for there to be any interruption in the 
operations of the Department during this pandemic.

NORD believes that Attorney General Becerra's lifetime of public 
service and commitment to patients with pre-existing conditions makes 
him the right candidate for this role. We look forward to working 
alongside Attorney General Becerra to ensure that health care is 
accessible, comprehensive, and affordable for patients with rare 
disorders. We urge this committee to take swift action to advance Mr. 
Becerra's nomination before the full Senate so that the critical work 
of the Department may proceed without any delay. For questions 
regarding NORD or our support, please contact Rachel Sher, Vice 
President of Policy and Regulatory Affairs, at [email protected], 
or 202-588-5700.

Sincerely,

Peter L. Saltonstall
President and Chief Executive Officer

                                 ______
                                 
               National Organization of Social Security 
                       Claimants' Representatives

                            January 21, 2021

The Honorable Ron Wyden             The Honorable Michael Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Senators Wyden and Crapo:

The National Organization of Social Security Claimants' Representatives 
(NOSSCR) strongly supports the nomination of Xavier Becerra to be 
Secretary of the Department of Health and Human Services (DHHS). NOSSCR 
is a specialized bar association for attorneys and advocates who 
represent Social Security Disability Insurance (SSDI) and Supplemental 
Security Income (SSI) claimants throughout the adjudication process and 
in federal court. Founded in 1979, NOSSCR is a national organization 
with a current membership of over 2,500 members from the private and 
nonprofit sectors and is committed to the highest quality 
representation for claimants and beneficiaries. NOSSCR's mission is to 
advocate for improvements in Social Security disability programs and to 
ensure that individuals with disabilities applying for SSDI and SSI 
benefits have access to highly qualified representation and receive 
fair decisions.

As both Ranking Member and as a member of the House of Representative's 
Ways and Means Social Security Subcommittee, Attorney General Becerra 
championed important pieces of legislation affecting the lives of 
millions of beneficiaries of Social Security Disability, SSI, Medicare 
and Medicaid. NOSSCR awarded then Congressman Becerra our ``Award for 
Excellence in Social Security Disability Advocacy.'' Attorney General 
Becerra understands beneficiaries' needs and the interaction between 
Social Security benefits, Medicare and Medicaid health insurance, and 
an individual's overall well-being.

As both California's Attorney General and as a former twelve-term 
Member of the House of Representatives, Attorney General Becerra will 
be ready to lead the DHHS on day one. Attorney General Becerra's 
experience and leadership will help the nation turn the corner on the 
COVID-19 epidemic while protecting and enhancing our nation's SSI and 
SSDI programs. NOSSCR enthusiastically supports Attorney General 
Becerra's nomination and calls for the Senate Finance Committee to move 
his confirmation forward without delay.

Sincerely,

Barbara Silverstone
Executive Director

                                 ______
                                 
             National Resource Center on Domestic Violence

                         6041 Linglestown Road

                          Harrisburg, PA 17112

                            Ph: 800-537-2238

                           Fax: 717-545-9456

February 12, 2021

U.S. Senate
Committee on Finance
U.S. Senate
Committee on Health, Education, Labor, and Pensions
Dirksen Senate Office Building
Washington, DC 20510

Dear Chairman Wyden, Ranking Member Crapo, Chairwoman Murray, Ranking 
Member Crapo, and Ranking Member Burr:

On behalf of the National Resource Center on Domestic Violence (NRCDV), 
I write today in support of the nomination of Xavier Becerra to lead 
the Department of Health and Human Services (HHS). His diverse 
experience on and around the issues affecting domestic violence 
survivors makes him uniquely qualified to become the Secretary of HHS 
during this critical time.

The NRCDV has worked, for the past 25 years, to strengthen the capacity 
of programs responding to domestic violence victims and their families 
by promoting effective public policy, institutional response and 
research, and engagement in prevention. Today NRCDV works with many 
other organizations and partners who bring various expertise, 
backgrounds, and perspectives, to improve community response to 
domestic violence and, ultimately, prevent its occurrence. We are part 
of a network of domestic violence programs that work collaboratively to 
promote practices and strategies to improve our nation's response to 
domestic violence and make safety and justice for all families a 
priority.

We believe that Domestic violence impacts all areas of the lives of 
survivors and their children and the systems they access for help can 
either support or cause further harm. A holistic approach to domestic 
violence is needed to ensure the safety and well-being of survivors and 
their families. This is especially critical as the United States 
grapples with the COVID-19 pandemic. The inequities in our nation are 
inescapable as Black, Latino, Asian and Native American communities 
bear the brunt of the pandemic's economic and health damages. Through 
all this, women, broadly, and survivors and their families are more 
severely affected. The devastation of this moment compels us to 
reimagine what kind of America we want to become after the pandemic--
one that is more equitable for all people.

The Department of Health and Human Services (HHS) is the agency in the 
Federal executive branch most involved with the Nation's human 
concerns. In one way or another, it touches the lives of more Americans 
than any other Federal agency. It is a department of people serving 
people, from newborn infants to persons requiring health services to 
our most elderly citizens. It is the agency that addresses the health 
and well-being of Americans and within that addresses the issues of 
Family Violence. HHS is the agency best positioned to advancing a more 
holistic and equitable approach to Domestic Violence. It is more 
important than ever that this department be comprised of leaders 
committed to ending violence against women, addressing white supremacy 
and advancing racial equity. As such, there is no better candidate to 
lead the Department of Health and Human Services than Xavier Becerra.

Xavier Becerra is a deeply qualified and passionate leader with a depth 
and breadth of experience that spans three decades of working to 
address violence against women and support survivors, ensure access to 
healthcare, protect Social Security, and Medicare. In May of 2020 as 
California Attorney General, Xavier Becerra called for the 
reauthorization of the Violence Against Women Act stating that 
``[t]here's no place for violence against women anywhere.'' At the 
California Department of Justice, Becerra ensured that they were doing 
their part to support survivors of domestic and sexual violence and 
prevent and respond to crimes against women.'' During COVID-19, 
Attorney General Becerra stayed focused on the needs of survivors and 
worked to ensure that they had access to critical services during 
state-wide stay-at-home orders.

Xavier Becerra has been at the forefront of legal efforts to protect 
the Affordable Care Act and a vocal advocate for women's health. 
Through appointed and elected office Xavier Becerra worked to combat 
poverty among working families, and as a legal services lawyer Becerra 
fought for the rights of people with mental health disabilities. At a 
time where the US is facing so many challenges, we have a nominee with 
a vast array of experience which positions Xavier Becerra to be the 
best suited leader. His legal background and efforts with his expansive 
understanding of health and welfare issues is the perfect mix of 
experience to meet the needs of an agency that touches the greatest 
number of lives.

We urge the Senate Committees on Health, Education, Labor and Pensions 
and Finance swiftly confirm Xavier Becerra as Secretary of the 
Department of Health and Human Services.

Sincerely,

Farzana Q. Safiullah
Chief Executive Officer

                                 ______
                                 
                           Oglala Sioux Tribe

                             P.O. Box 2070

                          Pine Ridge, SD 57770

                          Direct: 605-867-8487

                           Fax: 605-867-6076

                                            Office of the President
                                                       Kevin Killer

January 28, 2021

The Honorable John Thune
U.S. Senate
511 Dirksen Senate Office Building
Washington, DC 20510

Re: Support for Xavier Becerra to be Secretary of the Department of 
Health and Human Services

Dear Senator Thune:

    On behalf of the Oglala Sioux Tribe I write in support of the 
confirmation of California Attorney General Xavier Becerra as Secretary 
of the Department of Health and Human Services (HHS).

    The Oglala Sioux Tribe is a part of the Oceti Sakowin (Seven 
Council Fires, known as the Great Sioux Nation) and a signatory to the 
Treaty with the Teton of 1815, 7 Stat. 125 (July 19, 1815), the Treaty 
of Fort Laramie of 1851, 1 Stat. 749 (September 17, 1851), and the 
Treaty of Fort Laramie of 1868, 15 Stat. 635 (April 29, 1868). The 
Tribe is one of the largest land-based tribes in the United States. Our 
Tribe's Pine Ridge Indian Reservation is comprised of 3,155,200 acres 
of land in southwestern South Dakota, roughly the size of Connecticut. 
Our Reservation, however, is extremely rural and remote, and we are in 
need of adequate housing, economic development, job opportunities, 
community development and infrastructure, and quality health care. It 
is critical that nominees to cabinet positions fully understand the 
challenges facing our people and Indian Country as a whole.

    Mr. Becerra has a long track record of supporting tribal 
sovereignty, honoring treaties, and supporting improved health for 
American Indians and Alaska Natives (AI/ANs). We believe that as HHS 
Secretary, he will advance the health of all Americans, including 
indigenous peoples and adeptly serve the health needs of the nation.

    HHS has many programs that are responsible for fulfilling the trust 
responsibility toward tribal nations. As you know, Indian Health 
Service (IHS) is housed at HHS, which has the primary responsibility 
for providing health care to AI/ANs. However, IHS is not the only 
agency at HHS serving tribal communities. Virtually all HHS operating 
divisions including the Centers for Disease Control and Prevention; 
Centers for Medicare and Medicaid Services; the Substance Abuse and 
Mental Health Services Administration and the Health Resources and 
Services Administration all have important roles to play in ensuring 
that AI/ANs are included fairly and treated as sovereign nations in any 
action by the Department.

    Our IHS Pine Ridge Service Unit is notoriously underfunded and 
understaffed. This is alarming and anxiety-producing under normal 
conditions. In a pandemic, it is downright terrifying. We have a 
desperate need for: health care professionals; health care facility 
administrators and office workers; emergency medical services (EMS) 
(ambulance) personnel and equipment; hospital and health clinic 
equipment, including personal protective equipment (PPE) and 
ventilators. Having a capable Secretary who fully understands these 
challenges and these needs will be crucial in this Administration. We 
believe that Mr. Becerra's decades long experience as a policy maker 
will mean that he can bring creative solutions to addressing some of 
these complex issues for our health system.

    During his tenure as Attorney General of California, Mr. Becerra 
led a 20 state coalition to defend the Affordable Care Act (ACA) in 
Texas v. U.S. Overturning the ACA in the courts would not only create 
chaos for America's health system, but could have disastrous impacts 
for Indian Country as well. As you are aware, the Indian Health Care 
Improvement Act was permanently reauthorized as part of the ACA, and 
overturning the law would likely create serious uncertainty for the 
Indian health system and undo over a decade of process for AI/AN 
health. There are also other critical protections and benefits for AI/
ANs in the ACA outside of the IHCIA. His leadership in protecting this 
important law will be critical as HHS looks to undertake a new era of 
health policy making.

    As Attorney General of California, Mr. Becerra demonstrated his 
support for tribal nations. He led a bipartisan coalition of 27 
attorneys general in filing an amicus brief to defend the Indian Child 
Welfare Act in Brackeen v. Bernhardt. In filing this brief, he said, 
``we are proud to lead the way in defending the rights of Native 
American children and families.'' His leadership on this issue clearly 
reveals his belief in strong tribal nations, and we are confident that 
as HHS Secretary he will continue to uphold laws passed by Congress 
which are critical to tribal nations and AI/AN people.

    Mr. Becerra also had a strong record of supporting tribal 
communities during his tenure in Congress. He signed on to legislation 
that would renew the Special Diabetes Program for Indians, the Violence 
Against Women Act, and other legislation supporting tribes. As a member 
of the Ways and Means Committee, he was the lead sponsor on bipartisan 
legislation \1\ to exclude from gross income certain medical care or 
benefits provided to American Indians, clearly demonstrating his 
leadership on tribal sovereignty and the federal trust responsibility 
for health.
---------------------------------------------------------------------------
    \1\ 111th Congress--H.R. 3608, Tribal Health Benefits Clarification 
Act.

    Mr. Becerra has had a decades-long career where he has demonstrated 
his commitment to upholding tribal sovereignty and the treaty and trust 
responsibility for AI/AN health. His Tweet from November 30, 2020 
summarizes it well: ``The California Department of Justice is committed 
to supporting tribal sovereignty, preserving Native American culture, 
and fighting to improve the health, safety and welfare of our Native 
American brothers and sisters.'' Should he be confirmed as HHS 
Secretary, we believe that he will carry this commitment forward at the 
---------------------------------------------------------------------------
Department.

    We respectfully request that you vote to confirm to Mr. Xavier 
Becerra for the position of Secretary of HHS in the Biden 
Administration. We believe that he would serve as an excellent partner 
with Indian Country and work tirelessly to fulfill the federal trust 
responsibility for health, and it is our hope that you feel the same.

            Sincerely,

            Kevin Killer
            President

                                 ______
                                 
                    Oregon Primary Care Association

                       335 SW 5th Ave., Suite 200

                           Portland OR 97204

                          503-228-8852 office

                            503-228-9887 fax

                             www.orpca.org

February 5, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
United States Senate                United States Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Re: Xavier Becerra's Nomination for Secretary of Health and Human 
Services (HHS)--Support

Dear Chairman Wyden and Ranking Member Crapo,

On behalf of the Oregon Primary Care Association (OPCA)--representing 
Oregon's 33 community health centers (CHCs) who serve over 466,00 
Oregonians, I am writing to express our strong support of Xavier 
Becerra's nomination for Secretary of Health and Human Services (HHS). 
Our trusted colleagues to the south, at the California Primary Care 
Association, speak highly of Secretary-designate Becerra and his 
ability to lead HHS at this crucial time.

COVID-19 has reinforced the structural discrimination and racism within 
our society, and CHCs have witnessed this uneven impact of COVID-19 on 
their racial and ethnic minorities, homeless, and farm worker patients. 
Xavier Becerra is uniquely positioned to bring the tailored approach 
and leadership that is needed to support all Americans through this 
unprecedented public health emergency and guarantee a stronger health 
care delivery system when it is over.

With the Biden Administration refocusing the federal government's 
COVID-19 response and building a new vaccination infrastructure that is 
centered in community health centers, Becerra comes well prepared to 
see that vision forward. As congressman, Secretary-designate Becerra 
represented a district that has 30 health centers with 57 sites. The 
Secretary-designee's experience with health centers in his 
congressional district (where over one quarter of the population of his 
former district accessed care at a health center) will be important as 
he transitions to a national position. Nationally, and in Oregon, 
health centers serve almost 10% of the population (9% of Oregonians 
access care at a health center).

Secretary-designate Becerra has always been a strong supporter of 
health centers. He attended events at health centers in his former 
congressional district and hosted regular policy roundtables for health 
center leaders. More importantly, he fought for programs and funding 
helpful to health centers through his position as a senior member of 
the House Ways and Means Committee. He has also been involved in the 
important discussions about the federal government's role in ensuring 
coverage for all.

As COVID-19 continues to ravage our country, with a disproportionate 
impact on historically marginalized communities and communities of 
color, it is imperative that Secretary-designate Becerra be confirmed 
and on-the-job quickly. For these reasons, we respectfully request the 
swift confirmation of Secretary-designate Becerra as Secretary of 
Health and Human Services.

Thank you for your quick consideration of his nomination.

Sincerely,

Joan Watson-Patko
Executive Director

                                 ______
                                 
                            Patients Rising
February 17, 2021

The Honorable Charles Schumer       The Honorable Mitch McConnell
Majority Leader                     Minority Leader
U.S. Senate                         U.S. Senate
322 Hart Senate Office Building     317 Russell Senate Office Building
Washington, DC 20510                Washington, DC 20510

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
219 Dirksen Senate Office Building  219 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Leader Schumer, Leader McConnell, Chairman Wyden and Ranking 
Member Crapo:

On behalf of Patients Rising, the organization representing the voice 
of millions of Americans living with chronic illness, I write to raise 
awareness of our priorities during the Congressional hearings on the 
nomination of Xavier Becerra to serve as Secretary of Health and Human 
Services.

Patients Rising is a 100,000 member-organization of patients and 
caregivers living with chronic illness. We work with patients to 
advocate for access to the treatments, innovations and care they need. 
Our numerous patient programs and initiatives, including Patients 
Rising Concierge, Patients Rising University, Voices of Value, and 
Patients Rising NOW, educate patients about the legislative process and 
empower them to advocate for reforms to advance patient access, 
affordability, and transparency in healthcare.

The U.S. Department of Health and Human Services oversees the health 
and well-being of Americans. Together, with patients and the federal 
government, we share the agency's objective to advance sound, sustained 
advances in the sciences underlying medicine, public health, and social 
services. Our organization has engaged with HHS in the past to inform 
them of the impact of healthcare policies on Americans with chronic 
disease. These include our concern around their copay accumulator and 
six protected classes policies, as well as our enthusiastic support of 
the transparency rule.

For Patients Rising, our pro-patient agenda addresses critical 
priorities to work with the Department of HHS and Congress. The 
Secretary-designate should work to get patients out of the middle of 
the drug price wars.

Patients Rising supports a nominee who will empower patients and their 
families by:

      Addressing the root causes of financial toxicity that harm 
patients by bringing the issue of poor benefit design and not just the 
costs themselves to the healthcare finance conversation.
      Allow for and provide additional financial tools and options for 
patients to make their healthcare dollars stretch further.
      Strengthen the Essential Health Benefits and hold health plans 
accountable for covering a broad range of therapies and treatments with 
nominal out-of-pocket cost to patients.
      Give patients more control by making a variety of health plans 
available to them, including a public option.

Patients Rising supports a nominee who will support the advancement of 
medical innovation by:

      To speed up development and approvals of new medicines, empower 
regulators at the FDA to more rapidly incorporate advances in 
regulatory science, such as biomarkers, patient-reported outcomes, real 
world data, and simultaneous review.
      Develop pathways for the FDA and states to approve access to new 
therapies.
      Eliminate the Most Favored Nations rule, which threatens access 
to lifesaving medications for Medicare Part B patients and does little 
to lower the overall cost of drugs for a majority of Americans.

Patients Rising supports a nominee who truly wants to reform healthcare 
finance in the interest of patients and their families:

      Ensure states have the tools and flexibilities to offer a range 
of health insurance products to meet the coverage needs of their 
residents.
      Ensure that plans regulated under ERISA cannot avoid compliance 
with state-based regulations.
      Establish a healthcare finance and payment model that rewards 
improvements in the long-term care of patients.
      Stop incorporating flawed coverage recommendations based on 
inappropriate measurements--including the use of Quality Adjusted Life 
Year (QALY).

Patients Rising is engaged on all issues impacting patients with 
chronic disease and looks forward to working with the Department of HHS 
and the Committee on these issues during the 117th Congress. If you 
have any questions, please do not hesitate to reach out to me at 
[email protected] or at 202-750-4331.

Sincerely,

Terry Wilcox
Executive Director, Patients Rising and Patients Rising Now

                                 ______
                                 
                            People's Action

                      Chicago, IL | Washington, DC

                         www.peoplesaction.org

February 19, 2021

The Honorable Charles Schumer       The Honorable Mitch McConnell
Majority Leader                     Minority Leader
U.S. Senate                         U.S. Senate
Washington, DC 20510                Washington, DC 20510

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Majority Leader Schumer, Minority Leader McConnell, Chairman and 
Ranking Member of the Senate Finance Committee, Senator Wyden and 
Senator Crapo,

We the undersigned organizations representing millions of members and 
supporters write to express our enthusiastic support for an urgent and 
historic confirmation of Attorney General Xavier Becerra as Secretary 
of the Department of Health and Human Services. In the midst of a 
global pandemic following the deadliest year in U.S. history, we call 
on the U.S. Senate Finance committeeto advance the confirmation of 
Attorney General Becerra to the full Senate for confirmation without 
hesitation. The people of the United States need AG Becerra, an 
outstanding leader, at the helm of the Department of Health and Human 
Services immediately.

As a 12 term Congressman and current California State Attorney General, 
Becerra has been a champion of expanding healthcare to more people, 
eliminating barriers to accessing care, and protecting patient's 
rights. He played a leading role in the construction and passage of the 
Patient Protection and Affordable Care Act, resulting in over 20 
million people in the United States gaining access to healthcare 
coverage. He has championed protections against discrimination of 
women, people who are LGBTQ+, and people of color in healthcare.

Attorney General Becerra has proven that he is willing to take on the 
healthcare industry in order to protect all people and our rights to 
quality, affordable, and accessible healthcare. He has challenged 
harmful practices such as the pharmaceutical industry's ``pay for 
delay,'' which unnecessarily delayed the introduction of potentially 
life-saving generic medication. He has won major settlements over 
exorbitant prices and anti-competitive practices, for example Sutter 
Health, one of the largest healthcare chains in California. He sued 
Purdue Pharma and McKinsey and Co. for their roles in creating the 
national overdose crisis.

The people of the United States deserve a champion who will take on the 
healthcare industry and AG Becerra has proven that he is unafraid to 
stand up to corporate America in pursuit of justice and health equity 
for all patients.

As the head of a massive state agency in the largest state, AG Becerra 
has the experience of overseeing an agency larger than some federal 
departments. If confirmed, Xavier Becerra would be the first Latino to 
lead the Department of Health and Human Services, making his 
confirmation both critical and historic.

As Secretary of the Department of Health and Human Services, AG Becerra 
would be an outstanding pick to direct the urgent task of overseeing 
the agency that will guide the nation out of this pandemic. Further, we 
are confident that he will be proactive in establishing a resilient 
public healthcare system to meet the future needs of the nation.

We strongly urge members of the Finance Committee to vote ``yes'' on 
this nomination, so that AG Becerra may be confirmed by the U.S. 
Senate. The people of the United States need a leader with extensive 
direct experience improving our nation's healthcare system, and one who 
is dedicated to ensuring we all have the healthcare coverage and 
services we need and deserve.

Sincerely,


                             People's Action
AFSCME                               American Family Voices
American Federation of Teachers      Arkansas Community Organizations
Blue Future                          Brain Mind Self Adaptability
                                      Institute
Brave New Films                      Business Leaders for Health Care
                                      Transformation
California Alliance for Retired      California Democratic Party Senior
 Americans                            Caucus
California OneCare                   California Progressive Alliance
CARA                                 Center for Coalfield Justice
Center for Law and Social Policy     Center for LGBTQ Economic
 (CLASP)                              Advancement and Research
Center for Popular Democracy Action  Churches United For Fair Housing
                                      Action
Coalition on Human Needs             Common Defense
Communications Workers of America    Communities United
Connecticut Citizen Action Group     Criminalization of Poverty Project
 (CCAG)                               at the Institute for Policy
                                      Studies
DelACA (Delaware Alliance for        Demand Progress
 Community Advancement)
Equality California                  Family Equality
Generation Progress                  Hayward Area Democratic Club
Health Access California             Health Care for All--California
Health Care for America Now          Health Care Voter
Healthcare Action Committee          Healthcare for All Working Group,
                                      Sonoma County, CA
Healthy California Now               Hispanic Federation
Hometown Action                      Indivisible
Indivisible Healdsburg               Inland Equity Partnership
Iowa Citizens for Community          Jane Addams Senior Caucus
 Improvement
Justice for Migrant Women            Justice Is Global
Long Beach Area Peace Network        Long Beach Medicare for All
                                      Coalition
LULAC                                Maine People's Alliance
Make the Road Nevada                 Michigan United
Missouri Jobs with Justice           National Council of Jewish Women
National Harm Reduction Coalition    National Health Care for the
                                      Homeless Council
National Partnership for Women and   National Union of Healthcare
 Families                             Workers
New American Leaders                 New Hampshire Youth Movement
New Jersey Citizen Action            ONE Northside
OneAmerica                           OWL SacCap
Physicians fora National Health      Progressive Democrats of America
 Program, California chapter
Progressive Leadership Alliance of   Progressive Maryland
 Nevada
Public Advocacy for Kids (PAK)       Public Citizen
R2H Action [Right to Health]         Rights and Democracy NH
Rights and Democracy VT              River Valley Organizing
San Francisco Gray Panthers          Santa Clara County Single Payer
                                      Health Care Coalition
Silver State Equality--Nevada        Small Business for America's Future
Social Security Works                South Bay Progressive Alliance
Students for Sensible Drug Policy    The People's Lobby
Therapists for Single Payer          United Vision for Idaho
University of Washington             VOCAL--NY
Voice for Refuge Action Fund         Washington Community Action Network
We All Rise                          Yolo Progressives
Young Invincible
 


                                 ______
                                 
                      Port Gamble S'klallam Tribe
January 27, 2021

The Honorable Patty Murray
U.S. Senate
154 Russell Senate Office Building
Washington, DC 20510

Re: Support for Xavier Becerra to be Secretary of the Department of 
Health and Human Services

Dear Senator Murray:

    On behalf of the Port Gamble S'Klallam Tribe I write in support of 
the confirmation of California Attorney General Xavier Becerra as 
Secretary of the Department of Health and Human Services (HHS). Mr. 
Becerra has a long track record of supporting tribal sovereignty, 
honoring treaties, and supporting improved health for American Indians 
and Alaska Natives (AI/ANs). We believe that as HHS Secretary, he will 
advance the health of all Americans, including indigenous peoples and 
adeptly serve the health needs of the nation.

    HHS has many programs that are responsible for fulfilling the trust 
responsibility toward tribal nations. As you know, Indian Health 
Service (IHS) is housed at HHS, which has the primary responsibility 
for providing health care to AI/ANs. However, IHS is not the only 
agency at HHS serving tribal communities. Virtually all HHS operating 
divisions including the Centers for Disease Control and Prevention; 
Centers for Medicare and Medicaid Services; the Substance Abuse and 
Mental Health Services Administration and the Health Resources and 
Services Administration all have important roles to play in ensuring 
that AI/ANs are included fairly and treated as sovereign nations in any 
action by the Department. Having a capable Secretary who fully 
understands tribal sovereignty and the federal trust responsibility for 
health will be crucial in this Administration.

    Mr. Becerra has demonstrated his commitment to tribal nations 
during his tenure as Attorney General of California. He led a 
bipartisan coalition of 27 attorneys general in filing an amicus brief 
to defend the Indian Child Welfare Act in Brackeen v. Bernhardt. In 
filing this brief, he said, ``we are proud to lead the way in defending 
the rights of Native American children and families.'' His leadership 
on this issue, clearly shows his belief in strong tribal nations, and 
we are confident that as HHS Secretary he will continue to uphold laws 
passed by Congress which are critical to tribal nations and AI/AN 
people.

    Also during his tenure as Attorney General of California, Mr. 
Becerra led a 20 state coalition to defend the Affordable Care Act 
(ACA) in Texas v. U.S. Overturning the ACA in the courts would not only 
create chaos for America's health system, but could have disastrous 
impacts for Indian Country as well. As you are aware, the Indian Health 
Care Improvement Act was permanently reauthorized as part of the ACA, 
and overturning the law would likely create serious uncertainty for the 
Indian health system and undo over a decade of process for AI/AN 
health. There are also other critical protections and benefits for AI/
ANs in the ACA outside of the IHCIA. His leadership in protecting this 
important law will be critical as HHS looks to undertake a new era of 
health policy making.

    During his tenure in Congress, Mr. Becerra also had a strong record 
of supporting tribal communities. He signed on to legislation that 
would renew the Special Diabetes Program for Indians, the Violence 
Against Women Act, and legislation affirming the authority of the 
Secretary of the Interior to take land into trust for Indian tribes (or 
so-called ``Carceri Fix''). As a member of the Ways and Means 
Committee, he was the lead sponsor on bipartisan legislation \1\ to 
exclude from gross income for certain medical care or benefits provided 
to American Indians clearly demonstrating his leadership on tribal 
sovereignty and the federal trust responsibility for health.
---------------------------------------------------------------------------
    \1\ 111th Congress--H.R. 3608, Tribal Health Benefits Clarification 
Act

    Mr. Becerra has had a decades-long career where he has demonstrated 
his commitment to upholding tribal sovereignty and the treaty and trust 
responsibility for AI/AN health. His Tweet from November 30, 2020 
summarizes it well: ``The California Department of Justice is committed 
to supporting tribal sovereignty, preserving Native American culture, 
and fighting to improve the health, safety and welfare of our Native 
American brothers and sisters.'' Should he be confirmed as HHS 
Secretary, we believe that he will carry this commitment forward at the 
---------------------------------------------------------------------------
Department.

    We respectfully request that you vote to confirm to Mr. Xavier 
Becerra for the position of Secretary of HHS in the Biden 
Administration. We firmly believe that he would serve as an exceptional 
partner with Indian Country and work tirelessly to fulfill the federal 
trust responsibility for health--it is our hope that you feel the same.

Respectfully submitted,

Jeromy Sullivan
Chairman

                                 ______
                                 
              Private Essential Access Community Hospitals

                      1107 9th Street, Suite 1001

                          Sacramento, CA 95814

                              916.446.6000

                       https://www.peachinc.org/

January 25, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

Private Essential Access Community Hospitals (PEACH), a state-wide 
association representing California's private community safety-net 
hospitals, is pleased to convey our support for former California 
congressman Xavier Becerra's nomination to serve as our next Secretary 
of the Department of Health and Human Services.

As a 12-term member of Congress, Mr. Becerra represented a district 
that included a number of private safety-net hospitals and came to 
understand the needs of the low-income, underserved communities those 
hospitals serve. During that time Mr. Becerra served on the House Ways 
and Means Committee and showed a commitment to developing and 
supporting public policies that reflected his understanding of the 
distinct challenges low-income and underserved communities face and 
made a difference in the lives of the people he represented. We are 
confident he would do the same as Secretary of Health and Human 
Services, including pursuing a much-needed effort to address the 
underlying health equity challenges that we must address as a nation.

For these and other reasons PEACH is proud to support Mr. Becerra's 
nomination to be Secretary of Health and Human Services and asks you to 
advance his nomination to the full Senate.

Sincerely,

Anne McLeod
President and CEO

                                 ______
                                 
                               Providence

                          1801 Lind Avenue SW

                            Renton, WA 98057

                      https://www.providence.org/

February 9, 2021

Dear Chairman Wyden,

On behalf of Providence, I am urging you to support Attorney General 
Xavier Becerra's nomination for Department of Health and Human Services 
Secretary. Our health system looks forward to working with Mr. Becerra 
in his new capacity once confirmed, as we take on critical health 
issues facing our nation and communities.

As one of the largest health care provider in Oregon, our belief that 
health care is a basic human right animates much of our work. We are 
strong proponents of Medicaid expansion under the Affordable Care Act 
(ACA) and are working to preserve coverage gains achieved through the 
ACA. We are leaders and innovators on community benefit and charity 
care, and an advocate for our country's immigrants and refugees. Last 
summer, Providence pledged $50 million to end disparities in health 
care and we have been working diligently to reach communities of color 
and other populations at highest risk for COVID-19 in terms of 
education, testing, access to care and vaccinations. Many areas of 
health policy can have a profound effect on very vulnerable 
populations, and we are proud to be a leading voice on their behalf.

We know that Mr. Becerra shares these beliefs and priorities as well. 
We have had the privilege of working with Mr. Becerra during his tenure 
in Congress and as Attorney General in California, another state where 
Providence has a large footprint. We have experienced, firsthand, Mr. 
Becerra's leadership in ensuring access to care for vulnerable 
communities and addressing racial and ethnic inequities in health care.

Thank you for your consideration of Mr. Becerra's deserving and 
important nomination. Mr. Becerra is the leader our nation needs to 
stem the tide of the COVID-19 pandemic, expand health care access to 
the uninsured, and steer the nation's health care system under the new 
administration.

Please contact Jacquelyn Bombard, Executive Director of Federal 
Relations, for any follow up and to schedule a meeting. She may be 
reached at Jacquelyn.
[email protected] or (512) 569-3105.

Sincerely,

Rod Hochman, MD
President and CEO

                                 ______
                                 
             Public Health Experts and Professionals et al.
The Honorable Charles Schumer       The Honorable Mitch McConnell
Majority Leader                     Minority Leader
U.S. Senate                         U.S. Senate
Washington, DC 20510                Washington, DC 20510

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor, and Pensions                 Committee on Health, Education, 
                                    Labor, and Pensions
Washington, DC 20510                Washington, DC 20510

February 22, 2021

Dear Leaders Schumer and McConnell, Chairmen Wyden and Murray, and 
Ranking Members Crapo and Burr,

As public health experts and professionals, we write to urge that you 
swiftly consider and confirm President Joe Biden's nominee for 
Secretary of the Department of Health and Human Services (HHS), 
California Attorney General Xavier Becerra. It has been roughly one 
month since Joe Biden was sworn in as president. Given the once-in-a-
century pandemic that has infected roughly 80 million Americans and 
caused the death of more than 500,000 Americans, it is critical that 
the Department have leadership in place to guide and coordinate the 
federal response and oversee many of the nation's most urgent 
priorities, including the administration of COVID-19 vaccines, the safe 
return to in-person learning, and ensuring Americans can sign up for 
health coverage during the recently launched Special Enrollment Period.

HHS is charged with protecting the health of the nation and providing 
essential human services to the American people. The role of the 
Secretary has never been more critical as it is now--given the 
responsibility for managing efforts between its vital agencies, 
including the Centers for Disease Control and Prevention, the Food and 
Drug Administration, the U.S. Public Health Service, the National 
Institutes of Health, the Centers for Medicare and Medicaid Services, 
and the Administration for Community Living. Each of these agencies 
will play a critical role in the Biden-Harris administration's policy 
responses to COVID-19, from CDC's role in tracking the virus and 
supporting state and local health departments, CMS's role in providing 
health insurance to tens of millions of Americans, and the FDA's role 
in evaluating new treatments and vaccines.

Attorney General Becerra is the leader the Department needs during this 
crisis. As California's Attorney General he has not only led the 
nation's second-largest law enforcement agency but also prioritized 
actions to protect the health of Californians. His health care legacy 
includes challenging efforts to overturn the Affordable Care Act (ACA) 
and actions by drug manufacturers to keep lower-cost generic drugs from 
entering the market. He also secured a $575 million settlement with 
Sutter Health, one of California's largest hospital chains, after 
arguing the system was driving up the costs of medical care.

Even before his tenure as California's Attorney General, Mr. Becerra 
has been a health care leader. Attorney General Becerra's longstanding 
commitment to addressing health inequities will ensure that the 
Department's response to the COVID-19 pandemic is centered on the 
communities hardest hit by the crisis. And his service on the Ways and 
Means Committee has given him a deep understanding of the federal 
health care programs he will be charged with overseeing as Secretary. 
Throughout his years in public service, Mr. Becerra has consistently 
sought out consensus solutions, including reaching across the aisle to 
find areas of common interest. During the debate over the ACA, then-
Congressman Becerra helped resolve a dispute between members from rural 
and urban areas about the appropriate allocation of Medicare payments. 
Most recently, he has joined broad coalitions of attorneys general to 
advocate for a more robust COVID-19 federal response, such as leading a 
multistate, bipartisan effort with Louisiana Attorney General Jeff 
Landry to urge the federal government to use its legal authority to 
increase the availability of the COVID-19 treatment, Remdesivir.

As the Biden administration enters its second month, it is deeply 
alarming that the Senate has yet to confirm Mr. Becerra. We urge the 
Senate to act quickly to ensure that the Department has in place a 
capable and compassionate leader at its helm.

Sincerely,


Stacy Abrams, Physician Assistant,   Karlotta Bartholomew, Psychologist,
 Columbia University in the City of   Former Kaiser Permanante
 New York                             Psychologist
 
Carol Allen, MD, Retired             William Beardslee, Director, Baer
                                      Prevention Initiatives, Boston
                                      Children's Hospital
 
Ivye Allen, President, Foundation    Pamela Behrman, PhD/Adjunct
 for the Mid South                    Professor, Department of
                                      Psychology, College of Mt. St.
                                      Vincent
 
Luzann Ampadu, FNP-BC, Highland      Ann Behrmann, MD, Pediatrician,
 Family Medicine                      ICATCH Program Director
 
Mari Armstrong-Hough, Assistant      Leo Beletsky, Professor of Law and
 Professor, NYU School of Global      Health Sciences, Northeastern
 Public Health                        University
Marice Ashe, Lecturer, Public        Trude Bennett, Associate Professor
 Health Law, UC Berkeley Law          Emerita, Gillings School of Global
                                      Public Health, University of North
                                      Carolina, Chapel Hill
 
Heather Barr, RN, Public Health      David Celentano, Professor and
 Services Supervisor, Heather         Chair, Epidemiology, Johns Hopkins
                                      Bloomberg School of Public Health
 
Cheryl Berenson, Public Health       Susan Cheng, Associate Professor
 Nurse Practitioner, RN, MS, MPH,     and Chair, Benedictine University
 Seattle King County Public Health
 Reserve Corps/ Medical Reserve
 Corps
 
Barbara Berney, Producer, Power to   Andrew Young Choi, Ph.D.,
 Heal: Medicare and the Civil         Psychologist Fellow, The
 Rights Revolution; Associate         University of Hawai'i at Manoa
 Professor of Public Health Policy,
 City University of New York
 (Emeritus), BLB Productions
 
Robert Berry, MD, Attending          Kim Clark, Attorney, Legal Voice
 Physician, CHA
 
Sierra Black, Clinical Social        Nancy Connolly, Clinical Assistant
 Worker, Cambridge Health Alliance    Professor of Medicine, University
                                      of Washington
 
Susan Bonadonna, MD, Montefiore      Robin Cooper, Associate Professor
 Medical Center                       of Psychiatry, Physician
 
Julia Boyle, Psychology              Dominick DeFelice, Physician,
 Postdoctoral Fellow                  University of Rochester
 
Paula Braveman, Professor of Family  Carlos del Rio, Distinguished
 & Community Medicine, University     Professor, Emory University
 of California, San Francisco
 
Elizabeth Brown, MD, MPH, Associate  Mary Dewar, Nurse Educator for
 Professor, University of Rochester   Public Health Nursing (Retired),
                                      PNHP Metro
 
Loraa Burke, Professor of Nursing    Victoria DiCicco, PhD, Clinical
 and Epidemiology, University of      Psychologist, Retired
 Pittsburgh
 
Scott Burris, Professor of Law and   George DuPaul, Professor and
 Public Health, Temple Law School     Associate Dean for Research,
                                      College of Education, Lehigh
                                      University
 
Robert Byron, MD, MPH                Maria Ekstrand, Professor,
                                      University of California, San
                                      Francisco
 
Jesus Casas, Retired Psychologist,   Ronald Epstein, Professor of Family
 University of California, Santa      Medicine, University of Rochester
 Barbara
 
Sara Casey, Assistant Professor,     Kathleen Fagan, MD, MPH
 Heilbrunn Department of Population
 and Family Health, Mailman School
 of Public Health, Columbia
 University
 
Joe Feinglass, Research Professor    Gail Goodman, Distinguished
 of Medicine, Northwestern            Professor of Psychology,
 University Feinberg School of        University of California, Davis
 Medicine
 
Marie Fioravanti, Director of        Rhoda Goodwin, Ph.D., Psychologist
 Nursing, University of Pittsburgh
 School of Nursing
 
Joan Fiorello, Ph.D.                 Andrea Gordon, Faculty Physician,
                                      Tufts University Family Medicine
                                      Residency at Cambridge Health
                                      Alliance
 
Kevin Fiscella, Professor, Family    Scott Greer, Professor, Health
 Medicine and Public Health           Management and Policy, University
 Sciences, University of Rochester    of Michigan
 Medical Center
 
Rachael Fite, Clinical               Jodie Guest, Professor and Vice
 Psychologist, Private Practice       Chair, Department of Epidemiology,
                                      Emory University School of
                                      Medicine and Rollins School of
                                      Public Health
 
Kenneth Freedland, Professor,        Vincent Guilamo, Professor, NYU
 Washington University School of
 Medicine
 
Bryony Freij, LCSW, Private          Jhumka Gupta, Associate Professor,
 Practitioner                         George Mason University
 
Emily Galpern, Public Health         Ravi Gupta, Physician, NCSP,
 Consultant, Emily Galpern            University of Pennsylvania
 Consulting
 
Shelley Geballe, Assistant           Michael Gusmano, Professor, Rutgers
 Professor of Clinical Public         University
 Health, Yale School of Public
 Health
 
Elizabeth Gershoff, Professor,       Perry Halkitis, Dean and Professor,
 University of Texas at Austin        School of Public Health, Rutgers
                                      University
 
Robyn Gershon, Clinical Professor,   Lindsay Heckler, Supervising
 NYU College of Global Public         Attorney, Center for Elder Law and
 Health                               Justice
 
Carly Goldstein, Assistant           Tamara Henry, Professor, George
 Professor (Research) and Research    Washington University
 Scientist, Alpert Medical School
 of Brown University/The Miriam
 Hospital
 
Andrew Goldstein, MD, Assistant      Jennifer Hirsch, Professor of
 Professor, NYU School of Medicine    Sociomedical Sciences, Mailman
                                      School of Public Health, Columbia
                                      University
 
Gregg Gonsalves, Assistant           Natalie Hogan, RN
 Professor, Yale School of Public
 Health
 
Jennifer Huer, Managing Director,    Joseph Ladines-Lim, Resident
 Center for Health Policy and Law     Physician, Michigan Medicine
 at Northeastern University School
 of Law
 
Samuel Jackson, MD, Kings County     Marc Lavietes, MD, Physicians for a
 Hospital Center                      National Health Program
 
Peter Jacobson, Professor Emeritus   Jane Leavitt, ARNP, Retired
 of Health Law and Policy,
 University of Michigan School of
 Public Health
 
Elizabeth Jarpe, Clinical Assistant  Jane Lester, MD, Seattle King
 Professor, University of Illinois    County Public Health
 at Chicago
 
Jonathan Kahn, Professor of Law and  ...................................
 Biology, Northeastern University
 
Leslie Kantor, Professor and Chair,  Jeffrey Levi, Professor of Health
 Department of Urban-Global Public    Policy and Management, George
 Health, Rutgers University School    Washington University School of
 of Public Health                     Public Health
 
Matthew Kavanagh, Assistant          Beth Linas, Infectious Disease
 Professor, Georgetown University     Epidemiologist, Johns Hopkins
                                      Bloomberg School of Public Health
 
Susan Kegeles, Professor Amerita,    David Loud, Retired, Health Care Is
 Department of Medicine, University   a Human Right WA
 of California San Francisco
 
Albert Ko, Professor and Department  Mark Lowenthal, Psychologist, NJPA
 Chair, Yale School of Public
 Health
 
Margaret Kozel, Pediatrician,        Karina Maher, Physician
 Retired
 
Barbara Kraft, MSW, Retired          Duncan Maru, Associate Professor,
                                      Mount Sinai School of Medicine and
                                      NYC H&H/Elmhurst Hospital Center
 
Nancy Krieger, Professor of Social   Marilyn Matthews, MD, Self Employed
 Epidemiology, Harvard T.H. Chan
 School of Public Health
 
Sunny Kung, Resident Physician,      Kenneth Mayer, Medical Research
 Brigham and Women's Hospital         Director and Professor, Fenway
                                      Health/Harvard Medical School
 
Theanvy Kuoch, Executive Director,   Amy Mayfield, Family Nurse
 Khmer Health Advocates               Practitioner, NPA
 
Therese McGinn, Professor Emerita,   Ann Mayo, Professor of Nursing,
 Mailman School of Public Health,     University of San Diego
 Columbia University
 
Aimee McHale, Assistant Professor,   Mary Ann McCabe, PhD, ABPP,
 University of North Carolina at      Associate Clinical Professor of
 Chapel Hill                          Pediatrics, George Washington
                                      University School of Medicine
 
James McKeever, Pediatric            Susan Opotow, Professor, John Jay
 Psychologist, Seattle Children's     College, City University of New
 Hospital                             York
 
Molly McNulty, Assistant Professor   Melissa Palma, MD, MPH, Council of
 of Public Health Law and Policy,     Young Filipinx Americans in
 University of Rochester              Medicine
 
Gail McVey, Psychologist, Gail       Wendy Parmet, Professor of Law,
 McVey, Psy.D. LLC                    Northeastern University
 
Emily Mendenhall, Provost's          Terence Patterson, Psychologist,
 Distinguished Associate Professor,   USF
 School of Foreign Service,
 Georgetown University
 
Angelica Millan, Registered Nurse    Joanna Perkins, Medical Director,
 and Nursing Faculty, Los Angeles     Hematology-Oncology, PRA Health
 County Community Colleges            Sciences
 
Shan Mohammed, Clinical Professor,   Janet Perlman, Physician, Stanford
 Northeastern University              Children's Health
 
Marjaneh Moini, MD, JMH              ...................................
 
Donald Moss, Dean, College of        Nina Piazza, MD, Family Physician,
 Integrative Medicine and Health      University of Rochester
 Sciences, Saybrook University
 
Elizabeth Naumburg, Associate Dean,  Tonia Poteat, Assistant Professor,
 Advising; Professor of Family        University of North Carolina at
 Medicine, University of Rochester    Chapel Hill, School of Medicine
 
Gina Novick, Associate Professor,    Tracy Rabin, Associate Professor of
 Yale School of Nursing               Medicine, Yale University School
                                      of Medicine
 
Joseph Nunes, Ph.D., Practicing      Michele Ribeiro, Licensed
 Mental Health Clinician              Psychologist, APA Div 49
 
Iyabo Obasanjo, Assistant            Kayla Ringelheim, MBA, MPH, Yale
 Professor, College of William and    University
 Mary
 
Elizabeth Samuels, Assistant          Tamara Rissman, Epidemiologist, CT
 Professor of Emergency Medicine,     Emerging Infections Program
 Brown Emergency Medicine
 
Javier Sanchez, MD, Associate        Cheryl Ritenbaugh, Professor
 Professor of Family Medicine, UC     Emerita of Family and Community
 Riverside School of Medicine,        Medicine, University of Arizona
 Southern California Permanente
 Medicine, UC Riverside School of
 Medicine
 
Andrew Saxon, MD, Professor and      Dr. Ellen Rosenberg, The Chicago
 Director, University of Washington   Psychoanalytic Institute
 School of Medicine/ VA Puget Sound
 Health Care System
 
Manisha Sharma, MD, FAAFP,           Margie Sable, Professor Emerita,
 Physician                            Retired Social Work
 
Mark Siegel, MD, Professor of        Catherine Stanger, Associate
 Medicine, Yale School of Medicine    Professor, Geisel School of
                                      Medicine at Dartmouth
 
Vincent Silenzio, Professor of       Steffanie Strathdee, Associate
 Urban-Global Public Health,          Dean, Global Health Sciences,
 Rutgers University                   University of California, San
                                      Diego
 
Jennifer Silverstein, LCSW           Lara Sucheston-Campbell, Associate
                                      Professor, The Ohio State
                                      University
 
Robin Simon, Professor of            Mary Tinetti, Professor of Medicine
 Sociology, Wake Forest University    and Public Health, Yale School of
                                      Medicine
 
Heidi Sinclair, MD, Doctors for      Kelly Vinehout, Clinical
 America; American College of         Psychologist, IL Psychological
 Physicians                           Association
 
Nirbhay Singh, Professor, Augusta    Anna Walden, Psychologist
 University
 
Stephen Soldz, Professor and         Echo Warner, Postdoctoral Research
 Director of Research, Boston         Associate, University of Arizona
 Graduate School of Psychoanalysis    Cancer Center
 
Sandra Springer, MD, Associate       William Watson, Psychologist,
 Professor of Medicine, Yale School   Associate Professor of Psychiatry
 of Medicine                          and Neurology, University of
                                      Rochester Medical Center
 
Sanjeev Sriram, Senior Advisor,      Linda Webb, LCSW, Clinical Social
 Social Security Works                Worker, Catskill Addiction
                                      Coalition
 
Judy Wessler, Retired Community      Amy Williams, Clinical Health
 Health Policy Director               Psychologist, Henry Ford Health
                                      System
 
Jennifer Weuve, Associate            Kathryn Wouk, PhD, Postdoc
 Professor, Boston University
 School of Public Health
 


                                 ______
                                 
                   Purchaser Business Group on Health

                     275 Battery Street, Suite 480

                        San Francisco, CA 94111

                             (415) 281-8660

                         https://www.pbgh.org/

The Honorable Ron Wyden             The Honorable Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
Washington, DC 20510                Washington, DC 20510

February 24, 2021

Dear Chairman Wyden and Senator Crapo:

On behalf of the Purchaser Business Group on Health (PBGH), I write to 
offer our strong support for the nomination of Xavier Becerra for 
Secretary of the Department of Health and Human Services. PBGH is a 
nonprofit coalition representing nearly 40 private employers and public 
entities across the U.S. that collectively spend $100 billion annually 
purchasing health care services for more than 15 million Americans and 
their families.

As a national health care focused business coalition based in 
California, PBGH has had the opportunity to work closely with Mr. 
Becerra on numerous initiatives, including his successful efforts to 
stop anti-competitive business practices by large health care systems, 
saving consumers and purchasers millions of dollars and improving 
access to care. During his four years as the attorney general of the 
most populous state in the country, Mr. Becerra demonstrated 
exceptional leadership in his efforts to improve the affordability and 
quality of health care. He has a deep knowledge of health policy and 
law, and he understands how health care markets should work to benefit 
consumers and employers.

Before returning to California to serve as Attorney General, Mr. 
Becerra had a distinguished career on Capitol Hill, serving as a senior 
member on the Health Subcommittee of the House Committee on Ways and 
Means, where he was widely recognized for his leadership on health care 
legislation. We are confident that he will provide effective leadership 
in his role as Secretary, and we look forward to working with him. 
Thank you for your consideration.

Sincerely,

Elizabeth Mitchell
President and CEO

                                 ______
                                 
                 Service Employees International Union

                      1800 Massachusetts Ave., NW

                          Washington, DC 20036

                              202-730-7000

                         https://www.seiu.org/

February 19, 2021

Dear Senators:

On behalf of the two million members of the Service Employees 
International Union, I write to express strong support for the 
confirmation of Attorney General Xavier Becerra as the next Secretary 
of the United States Department of Health and Human Services (HHS). 
With more than one million home care workers, nursing home workers, and 
hospital workers, we are the largest health care union in the country 
and have a long-time commitment to ensuring high quality universal 
health coverage, including our work to pass and implement the 
Affordable Care Act (ACA). Our commitment to these issues has only 
deepened during the pandemic, when many of our members--especially in 
nursing homes and hospitals, but also in other sectors of the economy--
have been on the front lines of the COVID-19 pandemic, risking their 
own lives to provide essential services.

Now that more than 27 million Americans have contracted COVID-19 and 
more than 488,000 have died of the disease, it is clear that the 
country needs leaders like Attorney General Becerra. Attorney General 
Becerra will work to help correct course to finally create and 
implement a national strategy to get the pandemic under control, 
improve access to affordable quality healthcare, and strengthen the 
country's care infrastructure and vital services that are essential to 
ensuring an inclusive and successful economic recovery. We also believe 
that we must finally begin to address the issue of health disparities, 
both in the context of the pandemic--which has had a disparate impact 
on communities of color--and in the longer term, and are pleased that 
Attorney General Becerra has committed to addressing this issue in 
policy and practice. His extensive background in governance, together 
with his expertise in healthcare policy, demonstrate his extraordinary 
qualifications for the role of HHS Secretary.

During his 12 terms in Congress, where he served in Congressional 
Leadership and as the first Latino Representative on the Ways and Means 
Committee, Attorney General Becerra fought for significant improvements 
to the US healthcare system and helped extend quality, affordable 
coverage to millions of Americans. Attorney General Becerra played a 
significant role in the construction and passage of the ACA and then 
stood up against repeated repeal attempts that would have disrupted 
access to healthcare for millions of people. He regularly championed 
the Medicare and Medicaid programs and their beneficiaries, tirelessly 
working to make benefits and prescription drugs more affordable by 
supporting premium and cost-sharing assistance for low-income older 
Americans, improving the generosity of Medicare benefits for physical 
therapy, and providing incentives to expand the use of electronic 
health records.

As Attorney General for California, Mr. Becerra continued his work to 
improve the American healthcare system. He once again demonstrated his 
strong commitment to preserving and strengthening the ACA by leading 
more than twenty states in the defense against the legal challenge to 
the ACA intended to invalidate the law that now sits before the Supreme 
Court. In addition, through his work with the California State 
Legislature, Attorney General Becerra gained a keen understanding of 
the evolving healthcare system and the importance of protecting 
consumers from the negative impacts of consolidation. He required the 
California Attorney General's office to review affiliations and 
acquisitions of healthcare systems, facilities, and provider groups to 
ensure that patients, especially those who live in underserved 
communities, do not lose access to care because of these transactions. 
Furthermore, he continued his long pursuit to make sure prescription 
drugs are affordable by defending a California state law banning ``pay 
for delay'' agreements used by the pharmaceutical industry to delay 
making cheaper and equally effective generic drugs available to 
consumers.

Attorney General Becerra has been at the forefront of fighting the 
COVID-19 pandemic, stepping into a leadership role when the past 
Administration's federal response caused uncertainty and chaos. He 
repeatedly called on President Trump to invoke the Defense Production 
Act in order to increase the supply of personal protective equipment. 
In May 2020, Mr. Becerra joined with other attorney generals to demand 
CMS improve nursing home transparency and accountability as COVID-19 
ravaged facilities. In August 2020, he joined a bipartisan group of 
attorney generals who banded together to urge HHS to increase the 
availability of groundbreaking and life-saving COVID-19 medical 
treatments. Additionally, Attorney General Becerra supported the 
implementation of an emergency temporary standard by the California 
Division of Occupational Safety and Health to protect workers from 
COVID-19 exposure hazards.

The COVID-19 pandemic has only worsened the disparities that have 
always existed in our healthcare system and economy with devastating 
consequences. Attorney General Becerra is a trusted and admired leader 
in impacted communities, and we believe that he is well positioned to 
bring stakeholders together to begin to address these issues. For 
example, we remain deeply concerned and disturbed by data demonstrating 
COVID-19 vaccinations lag significantly behind in communities of color 
even though these communities are among the hardest hit. SEIU and our 
members are currently engaged in aggressive outreach and education. We 
have done over 100 events, including education events through social 
media, city, state and national town halls, making events available in 
nine different languages. We have already worked closely with the Biden 
Administration to move our vaccination outreach and education program 
forward and stand ready to get to work with Attorney General Becerra as 
soon as the Senate moves his confirmation forward.

As a union, we also deeply appreciate Attorney General Becerra's 
support for the rights of working people and families. This commitment 
is not only evidenced through his work to ensure people have access to 
affordable healthcare and his most recent work to address the COVID-19 
pandemic including worker health and safety, but also in understanding 
the essential role home care workers, 90 percent of who are women and 
mostly women of color, play in our long term care system and in our 
lives. When the Trump Administration tried to weaken the rights of home 
care workers paid through Medicaid to be able to join together in 
unions and have self determination over how to use their own pay, 
Attorney General Becerra led a challenge to this ill-designed rule, 
which a federal judge recently deemed was based on an erroneous reading 
of Medicaid law. This action to defend the home care workforce and 
preserve access to in-home care for older Americans and people with 
disabilities was yet another example of Mr. Becerra's commitment to 
health care and vulnerable populations. He understands that the 
strength of our long term care system, and the care system overall, is 
tied directly to the quality of this work and these jobs. President 
Biden has articulated a groundbreaking economic plan that finally 
recognizes care, including home- and community-based services such as 
home care, as essential American infrastructure that holds the promise 
of building back a more inclusive and thriving economy. We believe 
Attorney General Becerra has the expertise necessary to make this plan 
a reality.

The HHS mandate is expansive. Not only will the Secretary oversee 
health care and public health, but also vital human services and early 
childhood education programs that help our communities thrive, as well 
research, training, and education activities. Attorney General 
Becerra's career and actions demonstrates that he has a holistic 
approach and understanding of community well-being and that our 
nation's health and safety requires that all people--no matter where we 
come from or what we look like--have access to healthcare and crucial 
support. He challenged the Trump Administration's public charge rule, 
also known as the wealth test, that has made immigrant families afraid 
to access critical care and services that keep them and our communities 
healthy. HHS contains the Office of Refugees and Resettlement, an 
agency that implemented some of the previous Administration's cruelest 
policies and will continue to play a key role in reuniting children 
with their families. We have full confidence that Attorney General 
Becerra, the son of immigrants and, if confirmed, the first Latino to 
hold the office of Secretary of HHS, has the skills and expertise 
necessary to correct the humanitarian crisis caused by past policies 
such as family separation.

For all these reasons, we urge you to confirm Attorney General Xavier 
Becerra to Secretary of HHS. We may add this vote to our legislative 
scorecard. Should you need any additional information, please contact 
Rebecca Wasserman, SEIU's Government Relations Director, at 
[email protected].

Sincerely,

Mary Kay Henry
International President

                                 ______
                                 
                              Ujima, Inc.

                          5 Thomas Circle, NW

                          Washington, DC 20005

                            O: 202-299-1181

                            F: 202-299-1193

                      https://ujimacommunity.org/

February 12, 2021

U.S. Senate
Committee on Health, Education, Labor, and Pensions
U.S. Senate
Committee on Finance
Dirksen Senate Office Building
Washington, DC 20510

Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking 
Member Crapo, and Committee Members:

Ujima, Inc. is a national Culturally Specific Services Issue Resource 
Center funded by the Administration of Children and Families, Family 
and Youth Services Bureau within the U.S. Department of Health and 
Human Services by and through the Family Violence Prevention and 
Services Act. The name Ujima was derived from one of the Kwanzaa 
principles which means Collective Work and Responsibility. This 
principle is critical to addressing violence against Black women in the 
United States. Ujima Inc. through its education and outreach; training 
and technical assistance; resource development; research; and public 
policy efforts mobilizes the Black community and allies to strengthen 
our families, recognizing that the safety and viability of our families 
is connected to the health and well-being of our individual 
neighborhoods and communities at large. We are part of a network of 
domestic violence programs that work collaboratively to promote 
practices and strategies to improve our nation's response to domestic 
violence, sexual assault, and community violence.

Survivors of domestic violence seek help from a multitude of systems 
for safety and healing, however those same systems can cause harm and 
are often difficult to navigate. Black women are almost 3x as likely to 
be killed by an intimate partner than white women--we are particularly 
concerned that this statistic will increase as we grapple with the 
COVID-19 pandemic and dearth of resources. We believe Xavier Becerra is 
uniquely qualified to lead the U.S. Department of Health and Human 
Services during this unprecedented time. His depth and breadth of 
experience over the past thirty years includes addressing violence 
against women and supporting survivors, ensuring access to healthcare, 
and protecting Social Security and Medicare. These are life-saving 
safety nets for survivors.

In May of 2020 as California Attorney General, Mr. Becerra called for 
the reauthorization of the Violence Against Women Act stating 
``[t]here's no place for violence against women anywhere.'' He has been 
at the forefront of legal efforts to protect the Affordable Care Act 
and a vocal advocate for women's health. His legal background and 
expertise in health and welfare issues exemplifies his commitment to 
social change that promotes access to services and justice for all 
people. We fully support the confirmation of Xavier Becerra as 
Secretary of the U.S. Department of Health and Human Services by the 
Senate Committees on Health, Education, Labor and Pensions and Finance.

Respectfully,

Karma Cottman
Executive Director

                                 ______
                                 
                          United Steel Workers

                       60 Boulevard of the Allies

                          Pittsburgh, PA 15222

                              412-562-2400

                           412-562-2598 (Fax)

                              www.usw.org

February 23, 2021

U.S. Senate
Washington, DC 20515

        RE: United Steelworkers supports the confirmation of Xavier 
        Becerra as Secretary of Health and Human Services.

Dear Senator:

    On behalf of the 850,000 members of the United Steel, Paper and 
Forestry, Rubber, Manufacturing, Energy, Allied Industrial and Service 
Workers International Union (USW) and working people everywhere, I 
write in strong support of the nomination of Xavier Becerra to serve as 
the Secretary of Health and Human Services.

    As a former member of the House of Representatives and the current 
Attorney General of the state of California, Mr. Becerra will bring 
years of health policy experience to this role. During his 24 years in 
Congress, he served as a member of the House Ways and Means Committee, 
fighting to protect, strengthen, and expand Medicare and Social 
Security. He supported numerous measures to expand healthcare access to 
thousands of Americans and has been a strong proponent of making 
healthcare more affordable for all working families across the country.

    In his current role as the Attorney General of California, he has 
challenged hospitals for their anti-competitive actions which had 
driven up healthcare costs for thousands of consumers throughout the 
state. He has pursued settlements that limited out-of-network costs and 
increased transparency, improving medical services for patients across 
California. He's taken on the powerful pharmaceutical industry in an 
effort to curb skyrocketing drug costs, pursuing violations of 
agreements that delay generic drugs from entering the market and take 
money out of consumer's pockets by keeping drug prices high. And during 
the COVID-19 pandemic, he not only called on the previous 
Administration to invoke the National Defense Production Act to ensure 
that workers had access to personal protective equipment, he called on 
the Centers for Medicaid and Medicare Services (CMS) to increase 
transparency and accountability at long term care facilities hit hard 
by the virus.

    Having devoted countless hours to expanding access to healthcare, 
reducing drug prices, and fighting the COVID-19 pandemic, we are 
confident that Mr. Becerra will work to strengthen the health and well-
being of our country. Under Mr. Becerra's direction, we look forward to 
the Department of Health and Human Services taking a more active role 
in addressing the healthcare needs and skyrocketing healthcare costs 
plaguing our nation's working families. We urge you to confirm Mr. 
Becerra as the new Secretary of Health and Human Services.

            Sincerely,

            Thomas Conway
            International President
                        University of California

                        Office of the President

                           1111 Franklin St.

                           Oakland, CA 94607

                https://www.universityofcalifornia.edu/

February 4, 2021

The Honorable Ron Wyden
221 Dirksen Senate Office Building
Washington, DC 20510

Dear Senator Wyden:

I write to express my support for the Honorable Xavier Becerra to be 
the next Secretary for the U.S. Department of Health and Human 
Services.

Mr. Becerra has spent a lifetime in service to California and the 
nation. As a Member of Congress for more than 2 decades, Mr. Becerra 
gained a deep understanding of the health care needs of his 
constituents, which informed his important work on the House Ways and 
Means Committee--the panel with jurisdiction over health care and 
health delivery systems.

He left Congress to serve Californians as attorney general, managing 
thousands of lawyers, investigators, peace officers, and others. 
Throughout his tenure in that office, Mr. Becerra demonstrated a deep 
and consistent commitment to the well-being of his constituents. He has 
been a fierce advocate for patients, health care access, and health 
equity.

Mr. Becerra is a committed leader whose personal and professional 
skills have prepared him well to lead HHS.

There is no doubt that the tasks before the next HHS secretary are 
daunting. Mr. Becerra will meet those challenges with experience, 
empathy, and leadership. For these reasons, I encourage the Senate to 
approve Mr. Becerra's nomination.

Sincerely,

Michael V. Drake, M.D.
President

cc: Senator Richard Burr
   Senator Mike Crapo
   Senator Patty Murray

                                 ______
                                 
                     Submitted by Hon. Todd Young, 
                      a U.S. Senator From Indiana
STATE OF INDIANA
OFFICE OF THE GOVERNOR
State House, Second Floor
Indianapolis, Indiana 46204

Eric J. Holcomb
Governor

_______________________________________________________________________

February 1, 2020

Mr. Jeffrey Zients
COVID-19 Response Coordinator
The White House
1600 Pennsylvania Ave., NW
Washington, DC 20500

Dear Mr. Zients;

Thank you for your service as the COVID-19 Response Coordinator at the 
White House. We look forward to working closely with you to manage the 
pandemic and rebuild our economy safely and quickly.

Indiana, like all states, has suffered great loss due to this scourge. 
However, there is hope and healing in our great State. The viral spread 
is trending in the right direction in the majority of Indiana counties; 
hospitalizations are the lowest they have been in a month; and the 
majority of schools in Indiana have largely been open for at least 
hybrid instruction between online and in person learning.

As we get closer to a return to some form of normalcy with each 
vaccination, I write to express my appreciation for all of the work 
your team has done in just two weeks and to request a call with you at 
your earliest convenience to discuss the following issues of critical 
importance to Indiana.

First, the Moderna vaccine is manufactured in Bloomington, IN at 
Catalent Pharma Solutions. We respectfully request an additional supply 
of 4,000 vaccines (2/worker) so that we are able to offer vaccinations 
to their workforce immediately to ensure there are no disruptions to 
this national priority manufacturing facility. As most of their workers 
do not meet our current guidelines (65+/healthcare worker in direct 
patient contact/first responder), they are not eligible under our state 
policy. With an allocation from the federal government for the express 
purpose of this national priority, we would set up on onsite clinic 
expressly for the Catalent workforce.

Secondly, while we fully support and applaud increased federal 
assistance for vaccination supply, I respectfully request close and 
complete coordination with state governments in developing your plan 
and priorities. In Indiana, we have worked to develop a vaccine 
administration network of over 200 sites and have plans to grow this 
network to over 1,000 sites as soon as vaccine allotment allows. These 
sites have been carefully selected to ensure we are reaching all of our 
disparate populations, and it includes the utilization of mobile units 
to reach disparate populations, and federally qualified health clinics.

Indiana ranks among the top states nationally and first in the Midwest 
in vaccination delivery because we have put in place a statewide system 
that includes centralized scheduling suppo1ted via online 
(ourshot.in.gov) and a statewide call center (2-1-1) that allows 
Hoosiers to s directly and efficiently schedule their vaccine. We are 
successfully making first and second dose appointments with no lines or 
situations where vaccination runs out before fulfilling appointments. 
We also have partnered with our public libraries, aging agencies, and 
the AARP to train their staffs and volunteers to help citizens with 
appointments. Soon, we will begin a homebound vaccination program in 
cooperation with EMS professionals.

All of this has allowed us to closely monitor our program's 
effectiveness, including being just one of a few states which closely 
monitors and publicly reports vaccinations by race. In short, our 
distribution system has high integrity and credibility with our 
citizens. Any disruption to this system could have a detrimental impact 
to ensuring we vaccinate all Hoosiers in a rapid and equitable manner.

I am concerned the yet to be announced Federal Pharmacy Retail Program 
which calls for additional vaccine to be shipped directly to federally 
selected pharmacies outside of state's current allotment process could 
create confusion among Hoosiers. Our robust communication and outreach 
plan focuses on ourshot.in.gov and 2-1-1 as THE way to get a vaccine, 
especially as we work through the first few phases and supply is 
limited. I strongly urge you to hold off on moving away from the 
current state-based system of distributing vaccine or consider giving 
states the option of participating in this federal program or opting 
for an increased allotment to be included in the state's weekly federal 
allocation.

Once again, thank you for your service to our great nation and I look 
forward to our continued partnership.

Sincerely,

Eric Holcomb
Governor

                                 ______
                                 
                     National Governors Association

                  444 N. Capitol Street, NW, Suite 267

                          Washington, DC 20001

                              202-624-5300

                          https://www.nga.org/

February 15, 2021

President Joseph R. Biden Jr.
The White House
1600 Pennsylvania Avenue, NW
Washington, DC 20500

Dear Mr. President:

The Nation's Governors again congratulate you on your victory and look 
forward to a working partnership as we battle these difficult times 
together. We thank you for the coordination that your team has already 
extended to the Governors. We are the front line in the battle against 
COVID-19 and we will only succeed if we work together.

We have two immediate issues of concern. First, we believe it is 
essential that the American people understand the vaccine distribution 
process and the extent of the effort that governments on both the 
federal and state level are extending. There has been an ongoing issue 
since last year with which we would ask your assistance. Due to the 
anxiety created by the demand and supply of the vaccine, it is 
imperative that the American people fully understand the process.

Currently the Centers for Disease Control and Prevention (CDC) provides 
public information on a state and territory level as to the number of 
vaccines distributed to each state and the number of vaccinations 
performed. The CDC reporting mechanism has created unnecessary 
confusion. We would ask that the CDC reporting accurately reflects the 
reality.

The vaccine is delivered and administered through several different 
programs. By one program, the federal government administers a program 
in which it contracts with private pharmacies for vaccinations in 
nursing homes and long-term care facilities (LTCF program). The program 
is not controlled by the states. Your Administration has started a new 
federal program to directly deliver vaccines to certain pharmacies in 
our states the federal government selects. Your Administration has also 
announced another new federal program whereby the federal government 
will directly distribute to Federally Qualified Health Centers (FQHC) 
that it selects. These are three separate federal efforts beyond our 
control.

State and territorial governments then receive vaccine allocations for 
``first doses'' and ``second doses'' from the federal government. We 
appreciate transparency, accountability and our responsibility for the 
administration of the first and second doses. However, the federal LTCF 
program, federal pharmacy program and the federal FQHC program, are 
federally administered and beyond the states' control.

We believe it is important that the CDC in its reporting distinguish 
between these separate efforts to avoid confusion and provide a clear 
understanding to the American people. States also need visibility into 
the federal vaccination efforts at the facility level happening in our 
borders.

Second, we believe that federal decisions to use pharmacies and FQHCs 
should be coordinated with state governments. States also allocate 
doses often to these same pharmacies and FQHCs. We understand the 
capacity of the individual entities and we know the range of the 
individual entities throughput and their inventory. As usual, some 
pharmacies and FQHCs are better suited for the task than others. 
Following the performance data on these entities is essential. We also 
know the need in the respective communities they serve and other 
efforts in the geographic vicinity. If the federal government 
distributes independently of the states to these same entities without 
state coordination and consultation, redundancy and inefficiency may 
very well follow.

We are most appreciative of our relationship with your administration 
and Mr. Jeff Zients in particular, who has been doing great work, and 
we look forward to working through these issues in a mutually 
productive manner. Thank you in advance.

Sincerely,

Governor Andrew Cuomo, New York     Governor Asa Hutchinson, Arkansas
Chairman                            Vice Chairman

Governor Charlie Baker, 
Massachusetts                       Governor Larry Hogan, Maryland
Member, NGA Executive Committee     Member, NGA Executive Committee

Governor Kay Ivey, Alabama          Governor Doug Ducey, Arizona
Member, NGA Executive Committee     Member, NGA Executive Committee

Governor Michelle Lujan Grisham, 
New Mexico                          Governor Jared Polis, Colorado
Member, NGA Executive Committee     Member, NGA Executive Committee

Governor Gretchen Whitmer, Michigan
Member, NGA Executive Committee

                             Communications

                              ----------                              


             Letter Submitted by Cassandra Alcala
To United States Senate HELP and Finance Committees:

I want to take the opportunity to first say that I am so very sorry, as 
a fellow citizen, to all those who were at the U.S. Capitol doing the 
people's work and who were forced to experience those horrific events 
of January 6th. I deeply sympathize with the ongoing concern expressed 
in news coverage about the safety concerns of working around others in 
the workplace. That is a big part of the reason why I am writing this 
letter--attempting once again to express to the U.S. Senate in its of 
the harmful events I've been through in a space that the U.S. Senate 
has oversight capacity on--and compelled because I also saw Senator 
Murray's interview with PBS's Judy Woodruff detailing out her 
experiences in her workplace on January 6th. I began to feel perhaps 
she and other senators will now be better able to understand what I am 
going to express in these pages and help me find some answers as well, 
or at least be in some way responsive to it in some humane way. The 
scale of those events were on a different level, but the reaction not 
so different from my own experiences of observing troubling events from 
a very unique and specific vantage point and thus having to be a 
whistleblower and title IX complainant and the stress and worry of that 
and having that process completely disrupt my successful career and 
only to ultimately lead to experiencing retaliation and spending so 
much time (like so many other University of California whistleblowers 
and title IX complainants) trying over a years long process to get 
answers and conclusive findings for my cases. This took place at a 
significantly federally funded research university known as University 
of California, Berkeley, which has been under title IX compliance 
review at both the federal and state level for many years and 
complainants continue to detail procedural problems and anomalies in 
case handling. UC continues to boast claims of great positive economic 
impact on their graduates, they don't talk about their negative 
economic impact on whistleblowers and title IX complainants who are 
also their alumni.

The work I was doing was in support of and was being conducted as a 
result of funding from the California Attorney General's Office. The 
funding for the creation of the center came from federal anti-trust 
case settlement funds. The work I did and the retaliation I experienced 
long predate AG Becerra's appointment as AG but my inability to get 
answers or a response from the CA AG office when I have contacted the 
AG multiple times and asked about their understanding of the status on 
the case findings in my whistleblower and title IX case has continued 
into the Becerra administration because each AG has continued to rely 
on the research produced by the center that is directed by the 
professor I complained against and the AG continues to be non-
responsive to me when I inform them of my case and his prior history. I 
was told by the Locally Designated Official at UC Berkeley that the 
AG's office was aware of my case and was weighing in on it as it was 
investigated. The AG office has some of their Deputy AG in their anti-
trust division continuing to serve as active advisory board members for 
the research center where I worked and offering up their writings for 
research purposes to be cited by the university; they are also claiming 
the creation of the research center in their accomplishments in their 
CVs--but they have never approached me to find out the details of my 
experiences at that center. In my whistleblower case the campus 
Director of Audit and Advisory found that the professor had engaged in 
bad business practices and also misused university resources. The 
findings substantiated what I claimed. Many of the financial 
transactions funded travel and entertainment transactions for multiple 
intimate relationships and personal expenses over years--yet in the 
title IX concurrently investigated case the campus refused to address 
the financial transactions as part of the title IX evidence. I could 
not get an opinion/finding/conclusion from the title IX officer on the 
financial transactions as part of the title IX case. I was told that I 
was under the protection of the general counsel for the campus but if I 
discussed the case with anyone I would lose that protection. After a 
period of no response to the questions on the title IX case, I sought 
answers from AG Becerra's predecessors (Lockyer, Brown, and even 
Harris) but they did not respond to me either. In later years, I sent 
certified mail to then-U.S. Senator Harris and received no response. 
Yet, they all continued to collaborate with and relied on the ongoing 
partnership with the UC Berkeley professor I had to blow the whistle on 
and who I filed a title IX complaint about. AG Becerra has held 
multiple press conferences with that same UC Berkeley professor as he 
and the CA DOJ proceeded intensively over the past 2 years with the 
complex litigation case of Sutter Summit.

https://petris.org/california-attorney-general-holds-press-conference-
dr-scheffler-announce-new-petris-report-californias-healthcare-market-
concentration/

https://petris.org/los-angeles-times-discusses-ca-attorney-general-
lawsuit-sutter-health-based-new-petris-center-report/

Now that a settlement has been reached and is about to be finalized AG 
Becerra has gone on 60 Minutes news magazine show to be interviewed by 
Lesley Stahl. Politicians and universities covet such media attention 
when they can tout a figure of over $500 million dollar settlement. Any 
researcher at the principal investigator/professor level at a public 
university--one who began as an expert witness on a paid consulting 
contract with then--AG Lundgren; and who was next awarded a $2+ million 
dollar endowed chair by then-AG Lockyer to start up a research center; 
and who has spent years working with the AG and CA DOJ offices on 
crafting multiple attempts at a successful anti-trust case with (albeit 
only a fraction of the real $3 billion in damages to CA residents but) 
with a high number fraction of damages as settlement of the case--a 
researcher would be only to eager to have a moment with Lesley Stahl on 
60 Minutes to talk about that result. Interestingly though, that 
interview excluded the UC Berkeley faculty member AG Becerra was on a 
first name basis with in their earlier press conferences--instead 
suddenly 60 Minutes included a faculty member from University of 
Southern California as the researcher the AG office highlighted as 
collaborator. The UC Berkeley professor the AG's office has 
collaborated with over years via a CA AG sponsored funded research 
center--a research center that at inception prominently featured the 
current AG's photo on its materials and office entry walls--none of 
that was included or referenced during the 60 Minutes interview.

https://www.cbsnews.com/news/california-sutter-health-hospital-chain-
high-prices-lawsuit-60-minutes-2020-12-13/

Perhaps because two months prior to the 60 Minutes piece on Becerra and 
Sutter Summit, I submitted a declaration to the San Francisco Superior 
Court that was ruling on the terms of the settlement agreement and I 
paid significant fees to expedite service to the Judge and attorneys--
that declaration went to both lead attorneys in the case which includes 
Becerra's anti-trust division staff. But I still have not heard any 
outreach from AG Becerra to respond to what I experienced and ongoing 
issues resulting from my whistleblower and title IX cases. It seems AG 
Becerra's approach to my cases involving the professor is either: to 
ignore, be non-responsive or not see my experiences OR perhaps his 
staff have kept the intake of the details from him entirely--I don't 
know which is true . . . perhaps he and former CA AG Harris have a 
policy to maintain distance from correspondence so that the staff can 
just make invisible a long term collaborator once something like a 
declaration to the court on the settlement raises those trouble facts 
about him, and then they don't have to deal with the complainant or any 
details they might have. I don't know. It is something I need AG 
Becerra to speak to if I am to believe his testimony when he went 
through confirmation hearing as AG in CA where he claimed he would 
champion the rights of workers, or if we are to believe him when he 
testified to the HELP committee on February 23, 2021 and said many 
times all the ways that he believes in ``transparency in order to get 
Americans to believe in the science,'' equity, equality etc. Politico 
has a story from February 22, 2021 stating ``Becerra will pledge to 
protecting government scientists and career workforce from political 
interference''--but protection from basic harassment, retaliation, etc 
is important as well. In her closing comments in that February 22nd 
session Senator Murray even highlighted discrimination and bias and all 
the factors that weigh on getting and keeping women into or back into 
the workplace and his response was in support of all of that, yet. . . 
 

I also need to make the committee members aware of some other important 
facts:

- The professor at UC Berkeley was under investigation for over a 
decade and a half prior to my hire to work for him. It was a scandal 
known as the Western Consortium for Public Health and UC scandal. 
Several articles cover the few details that were made public and there 
is a very small group of UC community who actually know what really 
transpired. Ultimately the University had to repay the U.S. Government, 
specifically and ironically HHS, back $600,000.00+ circa 2000 that was 
considered a significant amount of research money at that time and it 
still is now:

One telling of it: https://www.sfgate.com/education/article/UC-
Professors-Cleared-After-Federal-Probe-Into-2932967.php

And another:

https://cshe.berkeley.edu/sites/default/files/publications/
2003_dont_ask_dont_tell_
evolution_of_the_uc_conflict_of_commitment_policy.pdf

- And it occurred just before the professor was awarded the $2 million+ 
anti-trust case settlement funds as an endowed chair by the CA AG as 
the funding agency.

- Further compounding my distress in trying to assess who could be 
trusted, during the then CA AG Harris term there was a sexual 
harassment case that originated in the immediate office of AG Harris, 
who is now U.S. Vice President Harris. There was a human resource 
manager who was blamed for the non-disclosure settlement agreement that 
the complainant had to sign in order to achieve a settlement 
resolution. This has been downplayed during the election year and not 
much of a response has been required. Harris has stated she did not 
know about it and the can was kicked over to Becerra's staff were 
responsible for the handling of the resolution. I believe it is 
important to highlight the case because the human resource manager was 
someone who was former staff to Senator Feinstein and Senator Stabenow 
and she has either been scapegoated as being responsible for the failed 
handling of the complaint, the handling of the case and the resulting 
non-disclosure agreement which during the era of #MeToo many 
progressive and Democrats have frowned on such instruments to dispose 
of difficult cases. The public is left an unclear understanding of who 
authorized the NDA and whether or not it is a common practice the CA AG 
office uses with their employees.

See:

https://www.rollcall.com/2018/12/14/harassment-claim-arrived-at-
california-doj-months-before-sen-kamala-harris-left/

https://www.washingtonpost.com/politics/longtime-aide-to-sen-kamala-d-
harris-resigns-amid-sexual-harassment-allegations/2018/12/06/b748934c-
f94b-11e8-8c9a-860ce2a8148f_story.html

https://www.usatoday.com/story/news/politics/2018/12/06/kamala-harris-
aide-resigns-sexual-harassment-settlement/2223882002/

https://www.latimes.com/politics/la-pol-ca-sexual-harassment-
settlement-20181206-story.html

https://www.presstelegram.com/2018/12/12/harassment-case-tarnishes-sen-
kamala
-harris/

https://www.sacbee.com/news/politics-government/capitol-alert/
article223053155.
html

In the above, it reads like the staff member was blamed for the 
handling: ``the first Latina chief of staff in the history of the U.S. 
Senate.''

https://www.igs.berkeley.edu/people/amanda-renteria

- The Hartley case raises those NDA questions about the real policy 
position the AGs have on it:

The Harris and Becerra AG administrations were employing NDA to resolve 
cases involving employees in the immediate office of the CA AG Harris. 
Harris has repeatedly claimed she is in touch with her staff--interacts 
with them, appreciative of them. It seems the ``body person'' (the 
person who travels with the principal) for the AG was the person who 
was the respondent in the case. I found this treatment of that case by 
Harris and Becerra really chilling and not dissimilar to the worst 
aspects of my experiences.

There is the outward expression of CA AG Becerra's stance on title IX :

https://oag.ca.gov/system/files/attachments/press-docs/
Memorandum%20of%20
Law_IX.pdf

Source: CA. DOJ

https://goldrushcam.com/sierrasuntimes/index.php/news/local-news/23792-
california-attorney-general-leads-multistate-lawsuit-challenging-
erosion-of-title-ix-protections-for-survivors-of-sexual-violence-and-
harassment

``California Attorney General Leads Multistate Lawsuit Challenging 
Erosion of title IX Protections for Survivors of Sexual Violence and 
Harassment''

- but then they don't match up to my own experiences with the CA AG 
over time.

Adding to my deep concern and inability to really trust the stance of 
the CA AG on sexual harassment cases and equity issues is an almost not 
talked about aspect of the Sutter case, it was a development that 
occurred in the last half of 2020 and revolved around the appointment 
of a monitor or administrator of the case settlement funds.

- Stunningly in the court documents of the Sutter Summit case dated 
circa October 2020 the Judge in the case places into the record a 
shocking rebuke of both the plaintiff and respondent--both the CA AG 
office and Sutter Summit attorneys in their failure to conduct an 
equitable recruitment of an administrator of the case settlement funds. 
They apparently did not seek to include female candidates in the 
applicant/potential candidates pool. See:

The full context of the Judge's remarks and frustration with the 
applicant process Becerra headed up is in 13 pages of her decision 
here: https://2zele1bn0sl2i91io41
niae1-wpengine.netdna-ssl.com/wp-content/uploads/2020/10/Sutter-Order-
09.22.20
20.pdf

and some coverage here:

https://sourceonhealthcare.org/sutter-case-watch-court-officially-
rejects-sutters-proposed-settlement-due-to-inadequate-compliance-
monitor-selection/

includes:

The court found such a ``limited and confidential selection process in 
which applications to be monitor were solicited by personal invitation 
only'' to be unreasonable and inadequate, particularly as it resulted 
in ``an applicant pool in which all of the candidates interviewed were 
white men.'' Judge Massullo noted that given the parties had identified 
potential candidates while negotiating a settlement on the brink of 
trial, it necessitated the selection process to move quickly and 
quietly. As such, it resulted in applications to be solicited in 
confidence, without sufficient time for the parties to conduct a 
nationwide search for applicants. In summary, Judge Massullo found 
``the idea that in 2020 there are only five white men in the United 
States who are qualified to be interviewed for this position is 
anathema to what are today basic notions of fairness, equity, and 
justice.''

In denying the motion to appoint . . . as compliance monitor, the court 
also denied the motion for preliminary approval of the settlement, both 
without prejudice, as the identity of the monitor is a material term of 
the settlement. The court order provides that the parties may refile 
both motions after addressing the issues the court identified. In the 
renewed motion, the parties should describe their efforts to broaden 
the applicant pool and consideration of any additional applicants, 
whether they agree on a new monitor or determine that . . . is still 
the best candidate.

[Sutter Case Watch] Sutter Health Preliminary Approval of Settlement 
Agreement Held up by Compliance Monitor Selection

See case page: UFCW & Employers Benefit Trust v. Sutter Health

https://sourceonhealthcare.org/sutter-case-watch-sutter-health-
preliminary-approval
-of-settlement-agreement-held-up-by-compliance-monitor-selection/

With regard to research, I now need to turn back to the University of 
California and the UC Berkeley professor who collaborates with AG 
Becerra on Sutter Summit. That UC Berkeley professor has now been 
highlighted by the current UC Berkeley Chancellor for his interest in 
research on the subject anxiety in students and mental health services 
for students. The basis of his research is data that also claims to see 
connection between the level of mothers' education with increased 
levels of anxiety for their children. The UC Berkeley professor who 
created an environment where I had to make a title IX claim and a 
protected disclosure and in doing so threw me into an abyss the UC 
creates for such complainants, that professor recently laughed about 
that aspect of the research when he shared the stage with the current 
UC Berkeley Chancellor in presenting that research.

See:``Rising anxiety on campuses linked to finances, phones in UC 
Berkeley study''

https://www.sfchronicle.com/bayarea/article/Rising-anxiety-on-campuses-
linked-to-finances-13781698.php ``Students with a mother who has a 
college degree have a 45% higher chance of having anxiety.''

- you can watch the professor laugh about that part in this talk here:
https://www.youtube.com/watch?v=5xil1eP9HRg

Currently female faculty are also being told that they are lousy 
mentors by other unrelated research findings--this stuff can be toxic 
to the academy and become harmful to young scholars if not presented in 
a thoughtful manner, with a light on the full context and with rebuttal 
or counter arguments or findings.

And those who offer such research findings should also be trusted and 
reliable figures who don't have history of investigations on their work 
practices over decades or title IX complaints against them.

I appreciate that Democratic Senators and their staff are pushing for 
President Biden's nominees to clear all hurdles and be confirmed. In 
many ways I am in support of that effort and there are many 
commonalities between myself and Vice President Harris's and AG 
Becerra's upbringing that they have detailed out over this past year. 
We are all very proud of the particular part of California where we 
were born and raised in and we have all grown up in a tradition that 
has lifelong connections to and respects the research university--but I 
believe the questions I raise in this document need answers from AG 
Becerra while he is still in his capacity as CA AG, to fill in gaps, 
get answers to important questions and make clarifications and avoid 
the same shortcomings in a transition to HHS , and to make clear what 
direction he will take HHS which will have nationwide impact.

I also worry about the continued collaboration after Becerra become HHS 
secretary and this sort symbiotic relationship:

``What To Expect From Biden In Health Policy And How Will It Affect 
YOU?''

https://www.youtube.com/watch?v=nvE3c0_OaEE

and

https://publichealth.berkeley.edu/news-media/what-does-california-att

and

I also raise this because there will be other title IX complainants and 
whistleblowers who attempt, like me to FOIA documents from HHS to 
understand in some way the history or origins of the behavior that led 
to their title IX or WB cases at their home research institutions, 
ultimately AG Becerra as HHS Secretary will be responsible for how 
those requests for records are responded to or not. I had great 
difficulty finding out the details of the WCPH-UC scandal that occurred 
before my hire but played a huge role in my work life. I also had no 
assistance from any federal agency or state agencies in getting a 
resolution either.

There are also news stories on access for journalists and lists and 
public records access decisions that have not come up as questions to 
answer for Becerra in the confirmation hearing on 2/23--but prior to 
COVID-19 they were important issues in CA and it seems there is the 
danger that things are viewed only through a COVID-19 centered 
framing--forgetting other issues and values that are important in 
normal times and those values and clear mission need to be buttressed 
and communicated and nominees need to speak on them.

At the state level I also had the misfortune of reaching out to state 
politicians for help those who shortly thereafter were investigated and 
had serious cases that shocked the state's residents. So even reaching 
out to your state representative who speaks to your issues is a fraught 
experience and even more so today. I ask that you remember this as I 
submit this letter to your committees.

When I talk about retaliation some of what I am referencing is what 
occurred to me after I gave my whistleblower statement and title IX 
statement. I was placed in the campus administration's Human Resources 
department in the HRIS section--Human Resources Information Systems 
unit. There were all sorts of behaviors there that ran counter to the 
ideals of human resources but my specific concern was that job 
applicants could see other job applicants profiles and the university's 
systems analysts did not know how frequently this was occurring but it 
was being detailed in the system's task database and by alarmed users 
alerting us to it. I was an administrative analyst who worked on the 
functional team side of maintaining the system and we were tasked with 
highlighting to counterparts on the technical team these issues--when I 
noticed these issues unaddressed and raised them--I was shut out, 
ostracized and my coworkers referenced my placement on waiver into the 
unit because of my earlier whistleblower case, this also happened in 
other instances. I detailed all of this out to then CA AG Harris in 
that certified letter, and prior to that to her predecessors. I also 
informed the CA State Auditor, but CSA has no enforcement power over 
UC--only the AG does and the CA AG as I have said before has been non-
responsive to me. Shortly after I sent that letter to the CA AG Harris, 
the UC President at that time basically gave a blank check to a project 
called UC PATH which has become so botched the state auditor believes 
it will come in at almost $1 billion in costs for the HRIS project.

https://www.auditor.ca.gov/reports/2016-125.2/auditresults.html

https://www.courthousenews.com/california-auditor-blasts-1-billion-
system-latest-look-uc-president/

This handling of cases involving electronic records also lends itself 
to scenarios of handling of digital medical records and I don't 
understand why the CA AG did not respond back to me on this aspect if 
only to do away with my concerns with facts to the contrary, debunk 
them if they have facts from the university that run contrary or to at 
least tell me they feel it is already being addressed. Senator Romney 
asked CA AG Becerra yesterday if CA is just big and a mess of an 
example and CA AG Becerra replied back about many of the good things 
about California but the tech sector does not benefit from just 
remaining a blind spot on oversight of the products they put out and 
just a lucrative locale for political contributions. There are other 
nominees coming from CA into the Biden cabinet, administration and it 
would be refreshing if they would state that what CA is wrestling with 
is what the country is also wrestling with--so CA big approaches to 
resolving can inform nationwide attempts to bring real advancements--
things are running smoothly in CA and the commitment to transparency 
has to be real from the state level to the federal.

I also want to highlight to the HELP and Finance committee that I sent 
email to the senate email account Senator Grassley highlights on his 
web pages it is set up to receive whistleblower testimony of procedural 
complaints. I also received no response to that and have no idea what 
was done with that information and that exacerbated my anxiety rather 
than being a source of support for whistleblowers. I thought I could 
trust that contact point because of Grassley's assistance to Dr. David 
Kessler, who is now assisting the White House in the COVID-19 response, 
in Kessler's years long whistleblower case on budget finance anomalies 
at UCSF:

https://www.nytimes.com/2009/12/12/education/12kessler.html

https://www.latimes.com/local/la-me-ucsf15dec15-story.html

https://www.bizjournals.com/sanfrancisco/stories/2010/01/18/story5.html

- but I did not get even a courtesy acknowledgement from Grassley's 
office and I also did not hear from my home state senators Feinstein 
and Boxer at that time who I also addressed the emailed correspondence 
to back then. Even to this day I remain concerned that the U.S. Senate 
has this email account in existence over all these years and it is 
directed at whistleblowers in need of help but does not explain to 
those constituents who use that account what is done with the content 
or who has access to it or what level of confidentiality or type of 
response can be assured. In the current climate in DC I think that 
needs to be made clear and protected disclosures need to be handled 
appropriately.

This is what I can provide to you in a very short time frame and there 
is much more to state. I only just learned of the confirmation hearings 
for AG Becerra but if you need additional back up documentation or 
examples or for me to fill in any gaps, please let me know via reply to 
my email submission of this testimony. I would be very grateful for an 
acknowledgement ensuring committee members receipt and I ask that a 
courtesy copy be provided to the U.S. Senate Majority Leader Schumer 
and the President of the U.S. Senate VP Harris.

Sincerely,

Cassandra Alcala

                                 ______
                                 
                    California Hospital Association

                499 South Capitol Street, SW, Suite 410

                          Washington, DC 20003

                        Telephone: 202-488-3740

                        Facsimile: 202-488-4418

                          www.calhospital.org

February 22, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
219 Dirksen Senate Office Building  219 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Dear Chairman Wyden and Ranking Member Crapo:

On behalf of the California Hospital Association (CHA) and our more 
than 400 member hospitals and health systems, I write in strong support 
of the nomination of Xavier Becerra as Secretary of the Department of 
Health and Human Services (HHS).

In his time as California's Attorney General and his many years 
representing Los Angeles in the U.S. House of Representatives, Mr. 
Becerra has been a strong advocate for ensuring access to health care 
for all. As a champion of the Affordable Care Act--from the time of the 
law's conception to leading its defense in the courts--he has expanded 
and protected health care access for millions of Americans. Mr. Becerra 
also shares our goals of addressing disparities and health equity, as 
well as improving access to behavioral health services.

CHA looks forward to working with Mr. Becerra as HHS Secretary while 
hospitals continue to respond to the most challenging health crisis of 
our time. We believe Mr. Becerra is well-equipped to provide leadership 
as the ongoing public health emergency has exposed the need for a more 
centralized, stable, and coordinated approach to managing the COVID-19 
pandemic.

We urge the Senate to act swiftly to confirm Mr. Becerra as HHS 
Secretary. If you have any questions about CHA's support, please do not 
hesitate to contact Anne O'Rourke, senior vice president, federal 
relations, at [email protected].

Sincerely,

Carmela Coyle
President AND CEO

                                 ______
                                 
                     Law Office of Patrick J. Evans

                    16897 Algonquin Street, Suite F

                    Huntington Beach, CA 92649-3832

               Tel.: (714) 594-5722; Fax: (714) 840-6861

                   E-mail: [email protected]

                           February 17, 2021

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
221 Dirksen Senate Office Building  239 Dirksen Senate Office Building
Washington DC 20510                 Washington DC 20510

The Honorable Patty Murray          The Honorable Richard Burr
Chairwoman                          Ranking Member
U.S. Senate                         U.S. Senate
Committee on Health, Education, 
Labor, and Pensions                 Committee on Health, Education, 
                                    Labor, and Pensions
154 Russell Senate Office Building  217 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

RE: Secretary of Health and Human Services Nominee Xavier Becerra

Dear Chairman Wyden, Ranking Member Crapo, Chairwoman Murray and 
Ranking Member Burr:

My senior citizen clients comment and provide information regarding 
Xavier Becerra, the Biden administration nominee for Secretary of 
Health and Human Services (``HHS''). Based on his California attorney 
general record, the committees should consider if Mr. Becerra is 
suitable for the secretary post.

Attorney General (``AG'') Mr. Becerra has been hostile and obstructive 
to government transparency, police and prosecutor accountability, and 
applying rule of law to judges.

Mr. Becerra derailed new law for disclosure of police misconduct 
records. In 2018 he obstructed the ``Right to Know Act,'' which 
mandated public access to police misconduct records. AG Becerra 
declined to prosecute district attorneys that engineered a clandestine 
and illegal ``jailhouse snitch'' informant program. The scheme trampled 
the rights of suspects and victims. It is documented that Mr. Becerra 
gives preferential treatment, a ``pass,'' to judges engaged in criminal 
conduct from the bench.

Xavier Becerra acts to undermine justice on all levels: (1) police 
misconduct; (2) prosecutorial wrongdoing; and (3) judge corruption. Mr. 
Becerra's cover up of police misconduct records and not prosecuting 
``snitch'' scheme district attorneys are reported in the attached 
references. My clients have experienced Mr. Becerra's misuse of his 
attorney generalship to allow judge crime under apparent ``quid pro 
quo'' with the judge oversight commission.

I.  Transparency and Open Government--Mr. Becerra Fought to Keep Police 
                    Misconduct Records Secret

The Biden administration will ``bring transparency and truth back to 
the government to share the truth even when it's hard to hear.''\1\ Mr. 
Becerra has been adverse to transparency and accountability. From 2019-
2020 Mr. Becerra wasted taxpayer resources on litigation he brought to 
keep police misconduct records secret despite public access rights to 
the records.\2\ His zeal to keep the records clandestine went against 
the open government laws.\3\
---------------------------------------------------------------------------
    \1\ President Biden's press secretary Jen Psaki stated the 
administration and the press ``have a common goal, which is sharing 
accurate information with the American people,'' and that Biden plans 
to ``bring transparency and truth back to the government to share the 
truth, even when it's hard to hear.'' (1/20/21)
    \2\ In California, ``access to information concerning the conduct 
of the people's business is a fundamental and necessary right'' of 
every person in the state. See, California Government Code Sec. 6250.
    \3\ See, i.e., the California Public Records Act, Government Code 
Sec. Sec. 6250-6276.48.

The Mercury News and East Bay Times editorial boards referred to Mr. 
Becerra as a ``coddler of bad cops.''\4\ The Orange County Register op-
ed title was ``Xavier Becerra's empty words about police abuse.''\5\ 
``Becerra's decision to keep misconduct records secret betrays public 
trust and the law'' stated the editorial board of the Sacramento 
Bee.\6\ Courthouse News Service pointed out that Mr. Becerra's 
objective was to ``dodge police transparency law.''\7\
---------------------------------------------------------------------------
    \4\ ``Becerra, Coddler of Bad Cops, Offers Hypocritical Post-Floyd 
Reforms.'' San Jose Mercury News, East Bay Times editorial June 21, 
2020.
    \5\ ``Xavier Becerra's Empty Words About Police Abuse.'' Orange 
County Register editorial bd. June 9, 2020.
    \6\ ``Becerra's Decision to Keep Misconduct Records Secret Betrays 
Public Trust and the Law.'' Sacramento Bee editorial board, February 9, 
2019.
    \7\ ``California AG Faces Tough Slog in Bid to Dodge Police 
Transparency Law.'' Maria Dinzeo, Courthouse News Service, December 19, 
2019.

Mr. Becerra's vain attempt to undermine police transparency came to an 
end on January 29, 2020 when, in a published opinion,\8\ a California 
Court of Appeal ruled against the attorney general, enforcing the 
citizen initiative law and ordering police records release.\9\
---------------------------------------------------------------------------
    \8\ Becerra v. Superior Court, (2020) 44 Cal. App. 5th 897.
    \9\ See, i.e., ``Appeals Court Rules California Must Release Police 
Misconduct Records.'' Maria Dinzeo, Courthouse News Service, January 
29, 2020; ``State Attorney General Must Disclose Police Misconduct 
Files on Local Cops, Appeals Court Rules.'' Alex Emslie, NPR-KQED, 
January 29, 2020.
---------------------------------------------------------------------------

II.  Failure to Prosecute Prosecutors that Conducted Illegal 
                    ``Jailhouse Snitch'' Scheme

In October 2011 Orange County California suffered its worst mass 
shooting. A deranged armed man stormed the hair salon where his ex-wife 
worked. He shot and killed her and seven more people. With eyewitness 
and substantial evidence, the perpetrator faced swift conviction.

While in jail, the perpetrator was taken in by another prisoner who was 
part of an Orange County District Attorney created and implemented 
illegal ``jailhouse snitch'' operation. Working for prosecutors, the 
``snitch'' informant would befriend the fellow prisoner to elicit 
confessional or self-incriminating statements.

The public defender uncovered the ``snitch'' scheme, and the case had 
to be delayed. For the victims' families and friends, the ``snitch'' 
compromised prosecution, protracted the anxiety of anticipating and 
going to trial, excluded a possible death penalty choice for the jury, 
and caused all manner of complications to what otherwise would have 
been a straightforward prosecution.

The Orange County District Attorney and Sheriff deputies conducted the 
``snitch'' operation for years. Its exposure tainted the validity of 
many criminal convictions. The California Attorney General, then Kamala 
Harris, stepped in. After Ms. Harris became Senator, AG Becerra took 
over. Ultimately the shooter was convicted and received life sentence. 
But many asked, what should be done about the District Attorney and 
deputies that had illegally created and conducted the ``snitch'' 
operation?

The ``snitch'' scheme tormented the victims' families and friends by a 
prolonged and complicated prosecution that ended up being more about 
``snitch'' prosecutor illegality than the mass murder tragedy and 
grief. Families and friends of the murdered called for criminal 
prosecution and legal action against the Orange County attorneys that 
had trampled constitutional constraints in order to notch higher 
conviction rates for their resumes.

There ensued a four-year examination of the scandal with inquiry into 
the Orange County Sheriff's Department and District Attorney's office. 
Mr. Becerra heard the victims' survivors' grief and outrage. The 
inquest dragged on.

In April 2019, AG Becerra abruptly dropped inquiry into the jailhouse 
informant scandal.\10\ AG Becerra exonerated the offenders by letting 
the statutes of limitation lapse. He squandered public resources on an 
investigation that he ultimately squelched to shield wrongdoer local 
prosecutors and deputies.
---------------------------------------------------------------------------
    \10\ ``State Ends Four-Year Investigation into O.C. Jail Snitch 
Scandal,'' LA Times, 4/19/19; ``California Ends Orange County Jailhouse 
Informant Probe without Explanation from Attorney General,'' KABC, 04/
27/19.
---------------------------------------------------------------------------

III.  Crime Committing Judges Not Prosecuted; Judge Oversight 
                    Commission Disciplines Becerra's Republican Rival 
                    in 2018

My clients lived in Palm Beach Mobilehome Park, situated on a valuable 
coastal parcel in San Clemente, Orange County, CA. A self-dealing real 
estate broker and HOA President with accomplices perpetrated a 
fiduciary fraud on the seniors to sell the Park. They bribed a judge to 
``fix'' a case to enable the Park sale by which they stole millions in 
real estate equity from seniors.

The judge ``fix''\11\ happened when the seniors filed for temporary 
restraining order (``TRO'') to stop the fraudulent give-away of their 
Park. The judge, previously disqualified by presiding judge decision, 
suddenly called in from vacation, ordered himself re-qualified, and 
issued an order to thwart the TRO. Four (4) hours later the Park sale 
real estate deed was recorded.
---------------------------------------------------------------------------
    \11\ The California Judicial Conduct Handbook, 4th Ed. 2017, 
describes ``quintessential'' judicial misconduct where the judge puts 
in a ``fix'' for the benefit of a relative, friend, or other person. 
(Id. pgs. 174 et seq., Sec. 3:32, and pg. 468, Sec. 7.52) The judge 
breaks the law in order to award the ``win'' to whomever the judge is 
fixed to favor for whatever the judge will receive as benefit or bribe. 
See, In re Koven (2005) 134 Cal.App.4th 262, 271 ``The term `fix' 
carries the connotation that for money consideration, a certain result 
can be purchased from a judge. This is also known as bribery.'' CJP 
warns that judge fix makes for ``both the appearance and the reality of 
a two-track system of justice--one for [the judge's] friends and family 
and another for all others.'' (See, Inquiry Re: Judge William R. 
Danser, No. 172 (6/2/05; CJP); Danser v. CALPERS (2015) 240 Cal.App.4th 
885).

The facts and evidence of the fiduciary fraudulent sale and judge 
``fix'' were provided to Attorney General Xavier Becerra. He said he 
``lacked resources'' to investigate and prosecute the judge.\12\ It 
turned out that AG Becerra policy was not to investigate judge crime. 
Instead, he referred those who sought his help with judge criminal 
misconduct to the Commission on Judicial Performance (``CJP''), the 
judge oversight arm of the judicial branch.
---------------------------------------------------------------------------
    \12\ Attorney General ``no action'' and ``lacks resources'' letter 
to seniors, 03/03/17.

AG Becerra did nothing about the judge ``fix'' reported to him. In 
April 2016, the seniors had complained about the judge to the CJP. Over 
4 years later, on May 14, 2020, CJP sent its ``no action'' letter.\13\ 
The judge commission, like AG Becerra, did nothing about the judge 
``fix'' that took the seniors' homes.
---------------------------------------------------------------------------
    \13\ CJP letter acknowledging receipt of complaint against judge, 
4/26/16, and CJP ``no action'' letter, 5/14/20.

About judge crime generally, AG Becerra's office stated it had no way 
to find any records of it. In contrast, the CJP publicly declared that 
it referred ``judge crime'' to prosecutors on ``multiple 
occasions.''\14\ But no evidence or information shows that CJP has ever 
referred judge crime to prosecuting authorities. CJP asserts that its 
rule compliance data as to referral, or lack thereof, is ``secret.''
---------------------------------------------------------------------------
    \14\ Report Concerning [review of] Rules of the CJP 8/29/2017, page 
15, item 10, CJP website.

The CJP and AG Becerra collude to conceal and suppress judge crime 
evidence and to not investigate or prosecute judge crime. This 
unconstitutional collaboration that shields wrongdoer judges is 
reflected in the California State Auditor 2019 audit report, 
``Weaknesses in Its [CJP] Oversight Have Created Opportunities for 
Judicial Misconduct to Persist.'' The auditor recommended drastic CJP 
constitutional amendment reform.\15\
---------------------------------------------------------------------------
    \15\ https://www.auditor.ca.gov/reports/2016-137/index.html.

For 2015, the Center for Public Integrity, in its ``comprehensive 
assessment of state government accountability and transparency,'' 
flunked California, grading it an ``F'' on ``Judicial Accountability.'' 
``[California's] . . . failing mark was for judicial 
accountability.''\16\
---------------------------------------------------------------------------
    \16\ https://publicintegrity.org/politics/state-politics/state-
integrity-investigation/California/.

Attorney General X. Becerra, in collusion with the CJP, allowed a judge 
crime, the ``quintessential'' judge ``fix'' [See, fn. 11] The fixed 
sale stole millions in real estate equity from seniors. Becerra does 
not prosecute judge crime that inflicts catastrophe on seniors and 
---------------------------------------------------------------------------
veterans--the fraudulent taking of their homes.

AG Becerra's ``no prosecution'' policy emboldens dishonest judges. They 
know that AG Becerra puts judges above the law. Indeed, the judge that 
``fixed'' the case against the seniors, having suffered no 
repercussions for his ``fix,'' perpetrated more judge crime, perjuring 
affidavits to collect his paychecks. The judge committed more crime, 
comfortable nothing would be done about it.

The claims and contentions cited herein are documented in federal and 
state courts. D. Padilla and F. Chodosh vs. Commission on Judicial 
Performance, Xavier Becerra, in his official capacity, Sacramento 
Superior Court Case No. 34-2018-00242031 (filed 10/5/18; on appeal in 
Third Dist. Ct. of Appeal No. C091221) and Floyd Chodosh, et al. v. 
John Saunders, et al. (U.S. Dist. Ct. no. 8:20-cv-01326-CJC-KES (filed 
7/22/19; on appeal, Ninth Cir. No. 20-56252).\17\ In the federal court 
RICO action, AG Becerra is an unindicted co-conspirator.
---------------------------------------------------------------------------
    \17\ D. Padilla and F. Chodosh vs. Commission on Judicial 
Performance, California Department of Justice, Office of the Attorney 
General, and Xavier Becerra, in his official capacity as Attorney 
General, Sacramento Superior Court Case No. 34-2018-00242031 (filed 10/
5/18; judgment 10/25/19; on appeal in Third Dist. Ct. of Appeal No. 
C091221) and Floyd Chodosh, et al. v. John Saunders, et al., (U.S. 
Dist. Ct. no. 8:20-cv-01326-CJC-KES (filed 7/22/19; on appeal, Ninth 
Cir. No. 20-56252).

Apart from giving judges a ``pass'' to break the law, AG Becerra and 
the CJP appear to have coordinated and colluded on publicly filed pre-
election charges against retired judge Steve Bailey, the 2018 
Republican attorney general candidate opposite Becerra. There is 
appearance of ``quid pro quo'' where CJP strategically and timely 
launched charges against the Republican candidate in exchange for 
Becerra not prosecuting judges for crimes reported by the public.

IV.  Conclusion and Information Available

AG Becerra abuses his office to curry and keep favor on all levels in 
the justice system, police, prosecutors, and judges, to secure 
political support.

Documents, evidence and analysis that demonstrate the above stated 
facts and contentions are available upon request. We appreciate your 
consideration.

            Sincerely,

            Patrick J. Evans

cc. Committee's members

                                 ______
                                 
               Hispanas Organized for Political Equality

                    634 S. Spring Street, Suite 920

                         Los Angeles, CA 90014

                             (213) 622-0606

                        https://www.latinas.org/

The Honorable Ron Wyden             The Honorable Mike Crapo
Chairman                            Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
219 Dirksen Senate Office Building  219 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

Re: Letter of Support for Xavier Becerra to serve as Secretary of the 
U.S. Health and Human Services Agency. Senate Finance Committee, 
February 24, 2021.

Dear Honorable Chair Wyden and Senator Crapo:

The leadership and national alumnae of Hispanas Organized for Political 
Equality (HOPE) strongly supports the nomination of Xavier Becerra as 
Secretary of the U.S. Department of Health and Human Services (DHHS). 
We feel confident that he is exceedingly qualified to lead and will 
execute the duties of DHHS with a strong commitment to health equity 
for all Americans.

We are writing to strongly urge you to swiftly confirm Xavier Becerra 
to serve as the Secretary of U.S. Department of Health and Human 
Services.

As a longstanding champion of health equity and women's health, and a 
dedicated public servant, we are certain that Mr. Becerra will serve as 
the head of the Department of Health and Human Services with the strong 
leadership and dedication that is needed to move our country forward.

Attorney General Becerra has an expansive legacy of leadership in his 2 
decades in the U.S. House of Representatives and as California's 
Attorney General since 2017. As an elected official and public servant, 
Attorney General Becerra has proven that his values are rooted in 
community, justice and fairness for all Americans. We are certain that 
Mr. Becerra is the best candidate to fulfill the mandates of the 
Department of Health and Human Services, whose mission is to enhance 
the health and well-being of all Americans.

If confirmed, Xavier Becerra will be the first Latino to lead 
Department of Health and Human Services in its history. This historic 
nomination further highlights that it is time that the Latino Community 
is fairly represented at all levels of our government. As the COVID-19 
pandemic has disproportionately impacted Latinos across the nation, 
this representation is critical to forging the path ahead to refocus on 
health equity.

California Attorney General Xavier Becerra has demonstrated through his 
experience, expertise and dedication to public service that he is 
exceptionally qualified to serve in this role, and we strongly urge you 
to swiftly confirm him as the next Secretary of the U.S. Department of 
Health and Human Services.

Sincerely,

Lydia A. Aranda, M.A.               Susana Mendoza
South Arizona                       Illinois State Comptroller
President, Chicanos Por La Causa

Sindy Benavides                     Ina Minjarez
Chief Executive Officer, LULAC      Texas State Representative, 
                                    District 124
Washington DC

Julissa Ferreras Copeland           Nathalie Molina Nino
Former New York City Council Member BRAVA Investments
                                    New York

Melisa Lopez Franzen                Eve Rodriguez Montoya
Minnesota State Senator, District 
49                                  Founder & President
                                    Rodriguez Media Communications
                                    Illinois

Jane Gonzalez                       Nathalie Rayes
President, MEDWheels                President and Chief Executive 
                                    Officer
Texas                               Latino Victory
                                    Massachusetts

Janie Martinez Gonzalez             Helen Iris Torres
Chief Executive Officer             Chief Executive Officer of HOPE
WebHead Group                       California
Texas

Maria Regan Gonzalez                Elizabeth Balli Van Sickle
Mayor of Richfield, Minnesota       Managing Attorney and Owner
                                    Van Sickle Law Firm, Texas

Rosario Marin
Former U.S. Treasurer under 
President George W. Bush

                                 ______
                                 
                 National Hispanic Medical Association

                      1920 L Street, NW, Suite 725

                          Washington, DC 20036

                           Tel (202) 628-5895

                           Fax (202) 628-5898

                            [email protected]

                        https://www.nhmamd.org/

January 22, 2021

Senate Committee on Finance
Dirksen Senate Office Bldg.
Washington, DC 20510-6200

Chairman Ron Wyden (D-OR)
Ranking Member Mike Crapo (R-ID)
U.S. Senate Committee on Finance

Dear Chairman Wyden and Ranking Member Crapo:

On behalf of the National Hispanic Medical Association (NHMA), I 
strongly support the nomination of Mr. Xavier Becerra to the position 
of Secretary, U.S. Department of Health and Human Services (HHS).

I have known Mr. Becerra since the 1970s when we were college students 
at Stanford University and met his family. Like most of the Chicano 
students accepted to Stanford at that time, we were all first 
generation from working class families of immigrant parents or 
grandparents and understood the opportunity afforded us to help our 
families with our education trajectories. During that time many of the 
Chicano students were close and supportive of each other's strong 
interest to pursue careers that would take us to decision-making 
positions and public service efforts to give back to our communities.

I have worked with Mr. Becerra in Sacramento, California when he served 
as Assemblyman and led a briefing on the healthcare workforce diversity 
needs for the state and again in Washington, DC as Congressman and as a 
member on the Ways and Means Committee and on the Congressional 
Hispanic Caucus. He spoke at the first Annual Conference of the NHMA in 
1997 and advised us to become advocates for the lifestyle of our 
communities and not just to change the health care system.

I worked at HHS from 1994-1998 in the Office on Women's Health, and 
following that, started at the NHMA. He and his staff met with NHMA 
physicians and staff through the years and spoke at our Congressional 
Briefings to discuss priorities for medical education and research 
diversity, Medicare and GME, prevention and access to care issues, the 
ACA and other areas that would improve policies and programs for the 
health of Latinos and other underserved.

In summary, Mr. Xavier Becerra has the vision and the strong leadership 
experience to build the programs and policies for HHS to support the 
most vulnerable as well as healthcare institutions, public health 
agencies, private sector companies which partner with the department, 
and to lead HHS officials to support President Biden's vision for a 
healthier America.

Sincerely,

Elena Rios, M.D., MSPH, FACP
President and CEO
National Hispanic Medical Association

                                 ______
                                 
                    National Human Services Assembly

                          1501 16th Street, NW

                          Washington, DC 20036

                             (202) 347-2080

                   https://www.nationalassembly.org/

February 23, 2021

Senator Ron Wyden                   Senator Mike Crapo
Chair                               Ranking Member
U.S. Senate                         U.S. Senate
Committee on Finance                Committee on Finance
221 Dirksen Senate Office Building  239 Dirksen Senate Office Building
Washington, DC 20510                Washington, DC 20510

RE: Hearing to Consider the Nomination of Xavier Becerra, of 
California, to be Secretary of Health and Human Services; February 24, 
2021; 2pm ET

Dear Chairman Wyden and Ranking Member Crapo:

The National Human Services Assembly (NHSA) offers its enthusiastic 
support for the confirmation of Xavier Becerra as U.S. Secretary of 
Health and Human Services. NHSA members are 35 of the nation's largest 
human services organizations which together, with their local service 
networks, collectively serve nearly every household in America--as 
consumers of services, donors, or volunteers. NHSA members comprise a 
$32 billion sector that employs some 800,000 workers, operating from 
over 100,000 locations.

In the midst of a global pandemic NHSA calls on the U.S. Senate 
Committee on Finance to advance the confirmation of Xavier Becerra to 
the full Senate without delay. As a twelve term Congressman and current 
California State Attorney General (AG), Mr. Becerra has been a champion 
of equity, fostering human services, and expanding access to quality 
healthcare for all.

Both his life experiences and professional career have given him a deep 
understanding of the importance and role of human services to foster 
opportunity for all. Mr. Becerra was a leader on the Ways and Means 
Committee for reauthorization of the Promoting Safe and Stable Families 
Act and efforts to reform TANF to make poverty reduction an explicit 
purpose of the program. His work to incorporate support in TANF for 
human services demonstrate his commitment to advance opportunity for 
all families and children. Furthermore, as a key architect of the 
Affordable Care Act (ACA) and a member of the House Ways and Means 
Committee he showed a deep understanding of the financing of health 
care; and, as California AG was a national leader in state efforts to 
protect the ACA.

As the head of a massive state agency in the largest state, Mr. Becerra 
has the experience of overseeing an agency larger than some federal 
departments. If confirmed, he would be the first Latino to lead the 
Department of Health and Human Services (DHHS), making his confirmation 
both critical and historic.

The people of the United States deserve a champion who will effectively 
direct the urgent task of overseeing the agency that will guide the 
nation out of this pandemic. We need a leader of DHHS who understands 
that equity must be a guiding principle in meeting the nation's health 
and human services challenges, including reversing the chapter of 
harming immigrant children and ensuring that family reunification gets 
accomplished without delay. Xavier Becerra is uniquely qualified to 
lead DHHS to meet the challenges our nation is facing.

NHSA, on behalf of our national human services organization members and 
those we serve, strongly urge members of the U.S. Senate Committee on 
Finance to vote ``yes'' on the nomination of Xavier Becerra to be the 
25th Secretary of Health and Human Services. The people of the United 
States need a leader with extensive direct experience improving our 
nation's health and human services systems, and one who is dedicated to 
ensuring equity in advancing our national health and well-being.

Sincerely,

Jeff Fleisher
Chair, Board of Directors

Membership of the National Human Services Assembly --

[GRAPHIC] [TIFF OMITTED] T2421.001


                                                                  
                   Letter Submitted by Anne C. Taffe

Dear Finance Committee,

I object to Xavier Becerra due to his radical support for late term 
abortion and his attack of the Little Sisters of the Poor. The 
appointment of such a radical supporter of abortion is an affront to 
all pro-life citizens. The failure of senators to protect the life of 
the unborn goes directly against their constitutional right to life.

Anne C. Taffe

[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

                                 [all]