On April 27, the House Energy and Commerce Health Subcommittee held a hearing to discuss the Fiscal Year 2023 Department of Health and Human Services (HHS) Budget. HHS Secretary Xavier Becerra testified and fielded questions from members of the subcommittee.

In his testimony, Secretary Becerra touted the administration’s success in the COVID-19 response through the vaccination campaign and efforts to increase access to testing, treatment, and masks. He also highlighted health insurance coverage gains through the American Rescue Plan Act. Looking forward, Secretary Becerra listed Afghan refugee resettlement, 988 suicide prevention line implementation, maternal health, and pandemic preparedness as ongoing priorities.

Many Democrats on the subcommittee echoed Secretary Becerra’s messages about the success of the COVID-19 response and the expansion of insurance coverage. Both Subcommittee Chairwoman Anna Eshoo (D-CA) and full Committee Chairman Frank Pallone (D-NJ) referenced the landmark number of enrollees in the health insurance marketplace and the record low uninsured rates in the United States in their respective testimonies. Chairwoman Eshoo applauded the allocation of $8.7 billion over five years in pandemic preparedness, $28 billion to rebuild the Centers for Disease Control and Prevention (CDC) and expand the public health workforce, and $20.8 billion to improve the nation’s mental health system.

There was bipartisan interest in investments in mental health and substance use programs and treatments, with members of both sides of the aisle hoping to work with the administration on those issues. Reps. G.K. Butterfield (D-NC) and Tony Cardenas (D-CA) both highlighted the newly implemented 988 suicide prevention lifeline. Reps. Kurt Schrader (D-OR), John Sarbanes (D-MD), and Annie Kuster (D-NH) described the alarming rates of adolescent mental illness in their communities, and asked Secretary Becerra to expand local resources such as school-based health centers. In response, Secretary Becerra highlighted the President Biden’s commitment to providing $40 million to integrate behavioral health in community settings.

Subcommittee Ranking Member Brett Guthrie (R-KY) and other Republican members of the subcommittee detailed their objections to the President’s Budget, asking for more oversight and transparency on COVID-19 spending and response. They repeatedly criticized the administration’s response as “politicized” and questioned if the public health emergency should still be in place. Energy and Commerce Committee Ranking Member Cathy McMorris Rodgers (R-WA) and other Republican members also described their opposition to school closures and mask mandates, and described an increasing lack of trust in public health institutions. In response to repeated mentions from Republicans about an erosion of trust in public health, Chairwoman Eshoo countered that some members of Congress had contributed to that problem, for example by publicly villainizing public health leaders like National Institute of Allergy and Infectious Disease Director Anthony Fauci.

Title 42 – a policy that was initiated under the Trump administration and allows for the expulsion of migrants at the Southern border during the COVID-19 pandemic – was also a frequent topic of discussion. The Biden administration has proposed to end the policy on May 23, but is currently blocked from doing so by court order. Although Republicans were most vocal about the issue, Chairwoman Eshoo cautioned Secretary Becerra that HHS must have a plan to deal with the consequences if the policy is rescinded.

Individual members brought up a few additional public health topics to Secretary Becerra. Congressman Fred Upton (R-MI) highlighted the need to address antimicrobial resistance and pointed to the PASTEUR Act as legislation to combat superbugs. Secretary Becerra expressed support for the legislation and thanked the congressman for his attention to the issue. Congressman Cardenas noted the importance of replenishing the Health Resources and Services Administration’s COVID-19 Uninsured Program, which NACCHO has also advocated. Secretary Becerra agreed and reiterated that the administration had requested more resources for the program. Congresswoman Kim Schrier (D-WA) asked Secretary Becerra how the CDC will work to make up for the lag in childhood vaccinations observed in the wake of COVID-19. In response, Secretary Becerra said the administration will work with states and localities to provide screenings and will ensure access through Medicaid and the Children’s Health Insurance Program.

Congressional budget hearings are one step in the annual appropriations process. Throughout the next few months, NACCHO will work with congressional appropriators to advocate for the resources local health departments need to carry out their vital work in fiscal year 2023 and beyond. More information on the President’s Fiscal Year 2023 Budget is available here.