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Seven Key Moments from Ways and Means Hearing with Health and Human Services Secretary Xavier Becerra

March 23, 2024

WASHINGTON, D.C. – The Ways and Means Committee held Health and Human Services (HHS) Secretary Xavier Becerra accountable for playing politics with health care during a hearing on the Biden Administration’s HHS budget request for Fiscal Year (FY) 2025. Members called out the Biden Administration’s policies that will lead to more shuttered nursing homes, reduced drug and medical device innovation, and less access to care for America’s seniors. Secretary Becerra wasted no time lauding President Biden’s proposed FY25 budget, which hands Obamacare subsidies to wealthy families earning nearly $600,000 annually and seeks a $7 trillion tax hike on Americans. 

By contrast, members exposed how the Biden Administration’s health agenda robs working families of health care options through actions such as:

  • Their flawed implementation of the No Surprises Act, the historic law that banned surprise medical bills. The Administration s botched implementation has resulted in more patients unable to find doctors that accept their insurance and more providers that are facing financial difficulty. 
  • The influx of migrants from President Biden’s border crisis taking up hospital beds from American patients and displacing American children in the foster care system.
  • Democrats’ price-setting scheme which could kill up to 135 new life-saving drugs and increase launch prices, according to the Congressional Budget Office, reserving new cures only for the wealthy, while also taking steps to stop Alzheimer’s patients from receiving innovative drugs.
  • The failure to address waste, fraud, and abuse in Medicare hospice programs, harming beneficiaries. 

“If You Like Your Doctor, You Can Keep It” Part 2: Seniors Supposedly “Will Find” Nursing Homes Despite Biden Staffing Mandate

The Biden Administration’s proposed nursing home staffing mandate imposes a massive $40.6 billion burden on nursing homes. The result will be more facilities around the country forced to downsize or turn away seniors seeking care. In just the last four years, more than 400 nursing homes have closed, the proposed nursing home rule will only make that worse. In response to Ways and Means Committee Chairman Jason Smith (MO-08), Secretary Becerra made a statement that evoked many of the same false Democrat promises about health care during the Obamacare debates: “if [seniors] need a nursing home, they will find one.”

Chairman Smith: “Earlier this month, the Committee passed legislation introduced by Representative Fishbach to block the implementation of the unworkable, one-size-fits-all nursing home staffing mandate. Estimates show this rule will impose a $40.6 billion cost on nursing homes, 94 percent of which currently wouldn’t be in compliance, jeopardizing access to care for 1.2 million Americans. Can you commit to the Medicare beneficiaries watching this hearing that no nursing home will close and patients won’t lose access to care as a result of this rule?”

Secretary Becerra: “I can commit to you, and I commit to each and every one of the Medicare beneficiaries that is out there, that if they need a nursing home, they will find one that offers them quality care.”

Because of this $40.6 billion government mandate, estimates reveal 280,000 seniors could lose their spot in a nursing home. 

Secretary Becerra Commits to Working With Committee to Reform and Strengthen TANF

The Temporary Assistance for Needy Families (TANF) welfare program has not been truly reauthorized since 2005, almost 20 years ago. Earlier this month, Ways and Means Committee members introduced legislation that reauthorizes TANF, refocuses the program on connecting recipients to work, and creates guardrails to protect against waste, fraud, and abuse. Yet the President’s proposed budget has no mention of a reauthorization of TANF, despite Secretary Becerra’s previous public commitment to work with Congress to reform TANF. Work and Welfare Subcommittee Chairman Darin LaHood (IL-16) asked for, and received, Secretary Becerra’s commitment to work with the Ways and Means Committee to find bipartisan ways to strengthen and reauthorize TANF.

Rep. LaHood: “In your prior testimony before this committee, you indicated your intent…to work with Congress to make the needed changes to the TANF program…Unfortunately, as we look at this year’s budget, it did not include language regarding the reauthorization of TANF and it appears the Administration’s intent is to sidestep Congress through this rulemaking process…We’ve clearly demonstrated our intent to reform TANF through legislative action. The first of these reforms was included in the Fiscal Responsibility Act last year. Continuing our work on TANF we have held two hearings, initiated a GAO investigation of non-assistance spending, and earlier this month, members of this Committee introduced several bills to put in place guardrails to ensure TANF dollars are intentionally focused on removing barriers to work. I would also add, several of the reforms, Mr. Secretary, mirror the administration’s own proposals and what you’ve talked about with TANF. Mr. Secretary, I ask you again, will you work with the Committee to develop a bipartisan proposal with our subcommittee with legislative changes to strengthen the accountability of TANF?

Sec. Becerra: We’re absolutely ready to work with you. I think we’ve been in dialogue with not just your team, but many of the members on this committee’s team, when it comes to what we do on TANF…What we certainly want to make sure we do is avoid court litigation on what we can and cannot do under TANF. That’s where I think you all are very, very important, because to the degree that there are some questions about how far we can go with our regulations, you all have the statutory capability to make sure that we reform TANF in bipartisan ways that get us moving.

Biden’s Budget Mentions “Fentanyl” One Time, Mentions “Equity” 77 Times

Fentanyl has exploded as a leading public health crisis in large part because of President Biden’s open border policies. However, it only merits one mention in the HHS FY 2025 proposed budget, compared to the word “equity” which is mentioned more than 70 times. Rep. Kevin Hern (OK-01) exposed how the Biden Administration’s border crisis is putting the lives of Americans in danger. 

Rep. Hern: “The word ‘fentanyl’ is mentioned in President Biden’s 2025 HHS budget a whopping one time – one time – even though this is clearly a public health emergency. Can you tell us how you expect to curb these fentanyl deaths and help [those] struggling [with] addiction when the southern border continues to stay wide open and allow the free flow of fentanyl to our country?”

Secretary Becerra: “I can tell you what we are doing, what the President has asked us to do and the resources given us at HHS on the health care side to deal with fentanyl. We are moving forward to try to make Naloxone and other treatments that can counteract the effects of a fentanyl overdose to keep a person alive, more available…We are continuing to make the types of services that work to keep people from dying available…”

Rep. Hern: Wouldn’t it be better if we just stopped the flow across the southern border?

“You Can’t Make Them Out of Thin Air”: Not Enough Nurses to Meet Biden’s One-Size-Fits-All, Unworkable Nursing Home Mandate

President Biden’s nursing home staffing mandate is unworkable in part because of the lack of qualified employees in the health care workforce. In the last four years, 190,000 staff left nursing homes for other employment. In this context, 94 percent of nursing homes and 97 percent of those in rural areas, would have to hire more staff to comply with this mandate. Dr. Greg Murphy (NC-03), a practicing physician, highlighted this reality and urged the Biden Administration to not rush to implement a rule that would hurt seniors.

Dr. Murphy: We don’t have the nurses. We have closed beds at my institution, at my medical center, because – guess what? – we don’t have the nurses. I’m fine if we work on some program to get nursing homes up to par. I believe it’s absolutely necessary, but you can’t make them out of thin air. You can’t make them out of thin air. I would urge you to postpone this until we can reasonably do this.”

Sec. Becerra: “Congressman, are you saying that they don’t need nurses in a nursing home?”

Murphy: “No, I’m not saying that at all. Please don’t try to change my words. I’m saying there are not enough nurses in this country.

Correcting Secretary Becerra: Biden Nursing Home Mandate Affects Rural and Urban Nursing Homes the Same

During the hearing, Secretary Becerra falsely claimed that the Biden Administration’s proposed nursing home staffing mandate would impose different requirements for urban nursing homes versus rural facilities. In fact, the rule’s requirements are the same for all nursing homes, regardless of location. The proposed rule also states, “we fully expect” nursing homes will be able to comply with the requirements, a statement that is stunningly oblivious to the realities of the nursing home staffing crisis in rural America. Rep. Michelle Fischbach (MN-07) corrected the record, making clear that the proposed rule’s requirements are the same for both rural and urban nursing homes, even though rural nursing homes will face greater challenges hiring and retaining staff.

Rep. Fischbach: “I want to correct the record. The staffing requirements proposed in the rule are the same for urban and rural nursing homes. There is a difference in implementation timelines, but the requirements are the same.”

Biden Administration Fails to Promote Americans’ Access to Care 

Just months into his term, Biden repealed a Trump-era policy, known as the Medicare Coverage of Innovative Technologies (MCIT) Rule, to give seniors immediate access to innovative new devices approved by FDA’s breakthrough designation pathway. Despite promising a swift replacement policy, the Biden Administration has only proposed a more limited replacement and has yet to finalize a pathway forward.

In response to a question from Rep. Blake Moore (UT-01) about the timeline for the Biden Administration’s replacement proposal, Transitioning Coverage for Emerging Technologies (TCET), despite the comment period ending seven months ago, Secretary Becerra still could not provide a timeline for the final rule. 

Rep. Moore: “In June of last year, CMS published its transitional coverage for emerging technologies, TCET, the notice for that. The comment period for the notice closed last August. When do you expect CMS to finalize the TCET notice, and will you commit to providing an update soon on the agency’s work?”

Sec. Becerra: “I know that this was an important one, and I appreciate the work that you’ve done. I wish I could give you a specific timeframe… it’s not just us. There are a lot of agencies that are involved, and OIRA, the OMB, are working through this as well.”

Biden’s Border Crisis Is Creating Foster Care Crisis 

President Biden’s open border policies have placed massive strains on all kinds of public services, including the foster care system. Recent reports indicate a staggering influx of over 130,000 migrant children have exacerbated the nationwide shortage of foster care placements and made it difficult to find safe, loving foster homes for American-born children.

As Rep. Beth Van Duyne (TX-24) noted, the Biden border crisis and the Administration’s response have resulted in HHS seeking placements for migrant children competing for already scarce foster homes for American-born children, sometimes resulting in migrants being placed in unvetted homes, with which HHS loses contact in just a matter of weeks. 

Rep. Van Duyne: “Since President Biden took office, Border Patrol has encountered over 473,000 unaccompanied alien children. Not only has the Office of Refugee Resettlement [ORR] reportedly lost contact with more than 85,000 of those children, now we’re also hearing concerns that ORR is diverting already scarce foster care resources to respond to the surge at the border, in addition to reports that ORR has failed to properly vet in place these children. Due to this Administration’s crisis at the border, has HHS assessed the burden that you are placing on state welfare agencies, particularly in states like mine in Texas, that already have high numbers of migrant children?”

Sec. Becerra: “Congresswoman, let me first begin by saying that you have inaccurately depicted the work that we do. So it’s hard to answer.”

Van Duyne: “I’m simply asking have you assessed the burden that you are putting on these agencies that are already stressed for services?”

Van Duyne: I highly recommend that you actually talk to your employees. When I went to the Kay Bailey Hutchison facility in Dallas, your employees are so upset with what’s going on. They’re looking at the border and they’re saying, ‘We are sending these kids to places, we have no idea what their future is going to be. We know that they have been sexually assaulted, a high number of them have been raped on the way here, and the immense amount of mental services they’re going to need in the future; those services are outside of our range. Talk to your people and I would really hope that you would talk to this Administration about what they’re doing at the border…”

Cyberattacks Are a Growing Threat to America’s Health Care System

Recent cyberattacks forced massive parts of America’s health care system to come to a standstill, affecting patients’ access to timely medical care, and provider, hospital, pharmacy, and insurer operations. Cyberattacks can target some of a patient’s most sensitive medical and financial information. Health Subcommittee Chairman Vern Buchanan (FL-16) asked what steps can be taken to prevent another cyberattack from happening again.

Rep. Buchanan: “I want to touch on the cyberattack. They claim $1 billion a day. What created that scenario? Is it more industry, government, or what? What happened that we’re in that situation?…Businesses might have to close. It’s a big issue, and we need to learn from this to make sure, ideally, it doesn’t happen again.”

Secretary Becerra: “Consolidation, if it means efficiency, can be a good thing, but consolidation, if it means you rely too much on one big player, can be very dangerous. UnitedHealth, the owner of Optum – the company that essentially does billing for about a third or half of the entire health care sector that provides medical data back and forth electronically – when it got attacked through this cyberattack, it went down. When it went down, it took pretty much all those providers who depend on them to pay their payroll, to do their billing. The result was essentially a crash in the industry.