WASHINGTON — Wednesday’s Senate hearing on the HHS budget for fiscal year 2022 left no doubt on the areas in which Republicans and Democrats don’t see eye to eye when it comes to healthcare.
“The budget would … eliminate the Hyde Amendment, which is a critical step toward ensuring every person is trusted to make their own individual choices about their life and future based on their own values — no matter who they are, where they live, or how much money they make,” said Sen. Patty Murray (D-Wash.), chairwoman of the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, during her opening remarks.
“I recognize that’s an area of strong disagreement among some members of this committee, but for too long, Hyde has made abortion accessible only to those with means, while women of color, and women who are paid low incomes, struggle to get care,” she continued. The Hyde Amendment bars federal funds — including those invested in Medicaid — from being spent on abortions.
Differences on Budget Outlines
Sen. Roy Blunt (R-Mo.), the subcommittee’s ranking member, saw it differently. “I wholeheartedly disagree with the administration’s removal of the long-standing Hyde Amendment,” he said. “One of the things I’ve had a chance to do in both the House and the Senate is count [votes], and I don’t believe we can get a bill out of this committee without having the Hyde Amendment in there. That has been in the Appropriations bill for 40 years, every person on this committee who has ever voted for a final Labor-HHS bill has voted for Hyde since it first appeared in 1976 … This is an issue we’re going to vigorously discuss in this committee.”
Murray expressed overall approval for the proposed HHS budget, which includes $131.8 billion in discretionary spending and $1.5 trillion in mandatory spending.
“I’m pleased to say this budget represents a world of change from the last few years on healthcare, and a roadmap for progress for the years to come,” she said. “I always say a budget is a reflection of your values. And all in all — this budget paints a clear, encouraging picture of President Biden’s values on healthcare. It shows he values public health, science, equity, women, children, families, and, critically, the health and well-being of every single American.”
Blunt again demurred, saying that while he appreciated certain items in the budget, such as the increased funding for NIH and money for ending the HIV epidemic, “the devil is always in the details, but I hope we can move forward on those things and others. The administration is obviously requesting a huge increase in non-defense discretionary funding in the Department of Health and Human Services alone — a 23% increase, or an increase of $23 billion. That’s compared to a Defense Department budget with an increase of 1.6%; that doesn’t even keep up with inflation.”
The opioid epidemic was one issue mentioned by several senators. Sen. Patrick Leahy (D-Vt.), chairman of the full Appropriations Committee, asked HHS Secretary Xavier Becerra, the hearing’s lone witness, for his thoughts on developing alternatives to opioids for chronic pain management.
“We’re going to try to be as flexible as we can because the solutions to opioids will not come from Washington, D.C.,” said Becerra. “The support will, and we could provide some resources so there are any number of ways to tackle substance abuse disorders. And quite honestly, and one of the things I found as the attorney general of California is that even the medications differ in their utility, state by state. And so we have to be able to provide our state partners, local partners with flexibility. They’re the ones that are going to do the work.”
Concerns About Overdose Deaths
Sen. Joe Manchin (D-W.V.) was concerned about drug overdose deaths. “The problem that I have seen is that basically they’re putting more and more products on the market — manufacturers are producing larger and larger volumes; it just doesn’t stop … We need the treatment centers and we have not enough.”
Manchin asked Becerra whether he would support a bill that Manchin is co-sponsoring, which would levy a penny-per-mg tax on opioids, to be used to support treatment centers. Becerra responded positively, saying the administration would look forward to working with Manchin on the issue.
Avoiding Past Mistakes
Blunt also expressed concern about the fate of previously approved COVID-19 funding for rural hospitals and for other healthcare providers. “Congress has provided $178 billion over the course of the last year for the Provider Relief Fund,” said Blunt. “There was another $8.5 billion in addition to that, for rural hospitals in the American Rescue Plan that passed in January. I think most of that money has to be spent by June 30.”
Blunt noted that Becerra said during a House hearing that he didn’t want to “make the mistakes of the past” when it came to allocating these funds. “What are a couple of those mistakes and how are you trying to move forward without continuing what you think was a mistake?” he asked.
“Most people will tell you … that there wasn’t enough transparency in the process and how the money was allocated,” Becerra replied. “Why was one provider provided dollars — in some cases quite a bit of money — and in other cases, other providers, who were also in need, didn’t [get the money]. And so what we want to try to do is provide that transparency.”
The senators also mentioned the concerns around the Strategic National Stockpile of medicines and personal protective equipment (PPE). “We’re all concerned about PPE; we had a wake-up call during the pandemic,” said Sen. Jack Reed (D-R.I.). “And we are concerned about how you’re stockpiling it in terms of prioritizing U.S. manufacturers, or at least manufacturers that are consistent allies of the United States and not potential competitors.”
Becerra thanked the committee for the “sizable pot” of money — $10 billion — that is being allocated for the Strategic National Stockpile. “That will help us make sure that we’re doing all we can to create increased domestic manufacturing of that, not just the PPE, but the types of material and the types of product that we need in the event of a future pandemic or a future crisis,” he said.