Chairwoman DeLauro Opening Remarks for House Appropriations Subcommittee on Labor, Health and Human Services, and Education Hearing with Secretary Azar on the Fiscal Year 2020 Budget Request
(As prepared for delivery)
Good afternoon, Secretary Azar. Welcome to our Subcommittee for our first budget hearing of the year. However, it is our fourth hearing on programs related to the Department of Health and Human Services.
First, we examined the administration’s intentional policy choices to undermine the Affordable Care Act. Those policies have raised prices for Americans already struggling with skyrocketing health care costs. And, the president’s budget makes clear that the administration has not abandoned its attacks on the ACA or protections for those with pre-existing conditions with junk insurance plans. We examined these polices, specifically with regards to affordability, the increasing number of uninsured, and the quality of benefits available to people.
We also held an oversight hearing on the Unaccompanied Children program, a manufactured crisis of policy. Over the past two years, this administration has separated thousands of children from their parents. And, we continue to hear reports that family separation is still occurring, despite a judge’s order to stop it. We are also learning that it may have started earlier than previously known in July 2017. The administration may have separated thousands more children before Congress and the public learned of this immoral policy.
And as I have said repeatedly, I believe separating children from their parents is government-sponsored child abuse. And HHS is complicit. The Memorandum of Agreement between HHS and the Department of Homeland Security (since last April) has turned HHS into a de facto extension of ICE. As a result, children are languishing in custody inflicting mental and physical trauma, all at considerable costs to taxpayers.
We know, based on legal precedent, that separation as deterrence policy is illegal.
HHS needs to return the Unaccompanied Children program to its core mission of taking care of vulnerable children and placing them with sponsors, rather than being an immigration enforcement agency. We have to understand how this happened, why it happened, and who is responsible. It is happening now. What has been the impact on children? What are its long term consequence, including mental health and trauma? How do we stop this? How do we fix it? What resources are necessary?
I am willing to provide resources. What I cannot do is condone policies that are putting children at grave risk at considerable cost to taxpayers, especially when there has not been real accountability. We cannot throw good dollars after bad.
I want everyone to know that we plan to hold another hearing on the Unaccompanied Children program.
And, we expect HHS to send the senior officials who were in charge at the time of the family separation policy. That includes the former Acting Assistant Secretary for Administration for Children and Families (ACF) and the former Director of the Office of Refugee Resettlement (ORR). We need to question those individuals who directly implemented these policies.
Finally, last week, we held a hearing on gun violence prevention research. Gun violence is a public health emergency. In 2017 alone, guns killed nearly 40,000 Americans. That same year, opioid overdoses killed 47,000 Americans. We have dedicated immense public dollars, especially in this subcommittee, to addressing and examining one, but not the other.
And, suicides by firearms accounted for nearly 24,000 deaths in 2017 and is an epidemic in our veteran community. They are twice as likely to die by suicide as the general population and two thirds of those veterans who died used a gun.
Last week, President Trump announced an Executive Order, a Roadmap to Empower Veterans and End a National Tragedy of Suicide. It establishes a task force that includes VA, Defense, HHS, and Homeland Security.
CDC must be involved. It is our foremost public health agency.
Let me also touch on the barrage of attacks on Title X, the program which ensures that people have access to reproductive health care. I want to note my strong opposition to the administration’s proposed changes to Title X. That includes the Trump administration’s “domestic gag rule.” It would ban any health care provider from receiving Title X funding if they even talk about abortion or abortion-related services with their patients.
Mr. Secretary, yesterday you made a comment at the House Energy and Commerce Committee that I want to address. You said Title X subsidizes abortions. That is inaccurate. It flies in the face of years of federal law and it is simply not true. So, I want to correct the record.
And, we will continue to oppose these attacks on Title X funding.
Now, let me turn to the FY 2020 President’s Budget for the Department of Health and Human Services.
Let me start by saying I am encouraged by the administration’s HIV Initiative and their request for additional HIV funding in the Health Resources and Services Administration and the Centers for Disease Control and Prevention. At the same time, I strongly oppose the President’s proposed cuts to the National Institutes of Health’s HIV research portfolio and to PEPFAR and the CDC global AIDS program, which I will note was a priority of Mr. Azar’s former boss President George W. Bush. And along with deep cuts to Medicaid and the proposed repeal of the Affordable Care Act, these reductions will be counterproductive to the goal of reducing HIV infections.
So, despite a few areas that appear to be bright spots, including efforts with regards to pediatric cancer, we need to take a hard look at this budget because of its deep cuts.
Many of these budget proposals are retreads of bad ideas that Congress has already rejected on a bipartisan basis. The administration is not shy about spending, of course, including its $1.5 trillion dollar tax law that was rigged for corporations and the richest Americans. No, the administration opposes spending when it aids the vulnerable, when it promotes the common good, or when it makes opportunity real for people.
Your Budget proposes to…
- Cut HHS agencies under the purview of this subcommittee by $12.7 billion, a 14 percent cut;
- Cut NIH research by $5 billion, as I mentioned.
- Cut the Centers for Disease Control and Prevention (CDC) by $750 million. That includes cuts to lead poisoning prevention, food safety, laboratory capacity, and dozens of others;
- Cut $1 billion from HRSA, including hundreds of millions from programs to train low-income and minority populations for careers in health professions, like nursing;
- And, eliminate the Low Income Home Energy Assistance Program. LIHEAP helps low-income households, predominantly elderly households in cold northern states, to heat their homes in the winter months, and low-income elderly households in hot southern states to cool their homes in the scorching summer months.
Let me also touch on the cuts on the mandatory side as well because again, it is important that we are looking at this in totality. The president’s budget …
- Cuts Medicare by $845 billion;
- Cuts the Supplemental Nutrition Assistance Program (SNAP) by more than $20 billion per year;
- Cuts Temporary Assistance for Needy Families (TANF) by more than $2 billion per year;
- Eliminates the Social Services Block Grant (SSBG) (cutting $1.7 billion per year);
- And, it advances another Republican repeal and replace plan (known as Graham-Cassidy-Johnson) that would undermine strong existing protections for Americans with pre-existing conditions and cut $1 trillion dollars of Medicaid coverage for Americans with disabilities or struggling to overcome opioid addiction, for example.
But areas you identify as priorities are those which the committee has previously funded, including the $50 million to address the national crisis of maternal mortality, a quote priority of yours that you level fund. We passed this increase for 2019.
It appears the administration’s priorities are not areas you support. They are areas you spare.
It is the obligation of this subcommittee to ensure that the middle class, working families and low-income families are not harmed by reckless cuts.
We will reject these cuts to health programs, medical research, public health, home heating assistance, and so many others; instead, we are going to invest in health, education, and protections for the middle class.
Mr. Secretary, I look forward to finding out whether you support these reckless cuts. I truly hope not. Thank you, and I look forward to the discussion.