On April 27, Secretary of Health and Human Services (HHS) Xavier Becerra testified before the House Energy and Commerce Subcommittee on Health on the department’s fiscal year (FY) 2023 budget request, highlighting key investments in pandemic preparedness and response and access to mental and behavioral health services. The hearing followed Becerra’s testimony before the Senate Finance Committee and House Labor, Health and Human Services, Education, and Related Agencies Subcommittee [refer to Washington Highlights, April 8, April 1].
In his opening statement, committee Chair Frank Pallone Jr. (D-N.J.) applauded the budget’s proposed investments in strengthening pandemic preparedness, addressing the mental health crisis, expanding access to care, and promoting prescription drug affordability. “The funding priorities in this budget provide a roadmap to continue to get back on track in the wake of the pandemic,” he said.
Subcommittee Chair Anna Eshoo (D-Calif.) commended the budget’s proposed investments in mental and behavioral health as well as investments to advance mental health parity, stating, “The president's budget outlines a strategy to use $20.8 billion to improve our nation's mental health, including increasing the availability of crisis care and — this is so, so important — achieving full parity between physical and mental health care coverage.”
Both committee Ranking Member Cathy McMorris Rodgers (R-Wash.) and subcommittee Ranking Member Brett Guthrie (R-Ky.) called for greater transparency and oversight related to the department’s COVID-19 response and, in particular, the decision to terminate the public health emergency. In her opening statement, McMorris Rodgers noted, “We are not in the same place we were two years ago. It’s why I asked in February for the administration’s plan to properly unwind the [public health emergency]. I have yet to receive a response. It is unacceptable.” Guthrie echoed this sentiment in his opening statement.
In his testimony, Becerra reflected upon his department’s ongoing response to the COVID-19 pandemic, including the distribution of $186 billion through the Provider Relief Fund to compensate for COVID-19-related financial losses. “That's 441,000 hospitals, community health centers, doctors, pharmacies, nursing homes, and so many other healthcare providers. Real money, real relief, real results,” he stated. Becerra also highlighted the department’s success in expanding access to coverage, observing, “today, more Americans have insurance for their healthcare than ever before in the history of our nation.” He concluded his testimony by underscoring the need for continued investment in pandemic preparedness, noting that the budget “also asks for $82 billion for the President's pandemic preparedness proposal to get ready for whatever might come next after COVID-19. Considering that COVID has cost our country more than $4.5 trillion in direct support from the federal government so far, this is a no-brainer to prepare for the next pandemic.”
Eshoo inquired about the department’s decision to house the new Advanced Research Projects Agency for Health (ARPA-H) under the existing National Institutes of Health, as announced in an April 20 Federal Register notice. Becerra explained that this is a temporary designation and that once a new director for the agency has been identified, “It will be an agency that has its own authorities and its own direction.” Eshoo is the lead sponsor of the ARPA-H Act (H.R. 5585), which would establish the agency as its own entity within the HHS [refer to Washington Highlights, March 18, Feb. 11, Dec. 10, 2021].
Several representatives raised questions about the department’s activities in addressing the nation’s mental health crisis. In response to one such query from Rep. G.K. Butterfield (D-N.C.), Becerra emphasized the department’s commitment to advancing the mental and behavioral health of young people, stating, “we know COVID has exposed ... a true problem with mental health being experienced by our youngest Americans, so we're going to do everything we can to focus on that.” The Energy and Commerce Committee previously considered legislation to authorize and/or reauthorize key HHS programs to promote mental and behavioral health [refer to Washington Highlights, April 8].
In a similar exchange, Rep. Michael Burgess (R-Texas) asked about Medicaid’s prohibition against reimbursement for mental health services delivered in what are referred to as “institutes of mental disease.” Becerra acknowledged that this exclusion is a barrier to care. “I believe it's a statutory restriction that makes it tough for Medicaid to cover mental health services in many cases,” he stated. He also highlighted his willingness to collaborate with Congress to address this issue.
Becerra is expected to testify on the administration’s HHS budget request on May 4 before the Senate Labor, Health and Human Services, Education, and Related Agencies appropriations subcommittee.