House Lawmakers Squabble Over HHS Budget

— Republicans slam increased Title X funding, question funding of transgender surgery

by
Shannon Firth, Washington Correspondent, MedPage Today
March 28, 2023

Republicans and Democrats on the House Appropriations Committee sparred on Tuesday over provisions in President Biden’s budget request for the Department of Health and Human Services (HHS).

Committee chair Robert Aderholt (R-Ala.) said he found it “disappointing” that the proposed budget “continues to double down on out-of-control government spending, which only adds to our already high inflation rate.”

The fiscal year (FY) 2024 budget, which requests $1.7 trillion in mandatory funding for the agency and $144 billion in discretionary funding (about $17 billion over the 2023 budget), funnels money into “partisan priorities,” such as NIH’s Sexual & Gender Minority Research Office, he told HHS Secretary Xavier Becerra during the hearing.

It also nearly doubles funding for the Title X program, which under the Biden administration made grants to abortion providers, said Aderholt, referring to a rescinded Trump-era rule stipulating that providers make a “clear financial and physical separation” between Title X-funded initiatives and facilities where abortions are provided.

Investing in these programs “does not seem to be the best use of taxpayer dollars,” the chairman said.

Ranking member Rosa DeLauro (D-Conn.), by contrast, said she “couldn’t be more pleased” with the 2024 HHS budget request.

She cited “strong funding increases” for public health, maternal health, behavioral health, mental health, childcare, and early learning, while at the same time criticizing “unrealistic, unsustainable, and unacceptable” cuts proposed by Republicans.

If such cuts were enacted, she said, 200,000 children would no longer have access to Head Start, an early learning program; another 100,000 would lose access to childcare; and close to 1 million people experiencing a suicidal or mental health emergency would lose access to support from the 988 Suicide & Crisis Lifeline.

In addition, “thousands of people could be refused opioid use disorder treatment, denying them life-saving healthcare,” said DeLauro, and cuts to the CDC would “dramatically impact” the agency’s support for state and local health departments, making communities “much more vulnerable to public health crises.”

Title X Programs

DeLauro and her Democratic colleagues also defended the 79% increase in funding for Title X programs.

After the Supreme Court overturned Roe v. Wade, the “need to support reproductive healthcare and family planning has become even more pronounced,” said DeLauro.

Title X serves “millions and millions … of young people, of young adults, who have no access to healthcare,” explained Rep. Lois Frankel (D-Fla.). “It does wellness exams, lifesaving cervical and breast cancer screenings, birth control, contraception, education, testing, and treatment for sexually transmitted diseases.”

State bans on abortion have had serious consequences for women’s health, said Frankel, adding that Republicans have made it their mission to achieve a ban nationwide.

Asked by Frankel what HHS has found in its research on abortion bans, Becerra said that during childbirth, “pregnant women in states with abortion bans are nearly three times more likely to die regardless of their income or their education.”

Transgender Surgeries

Turning to a separate hot-button issue, Rep. Andy Harris, MD (R-Md.), asked about funding for what he called “gender-denying mutilation surgery,” referring to mastectomies and penectomies.

“Is the president serious? He wants to take our childhood health insurance program and pay for this?” Harris asked Becerra.

The HHS secretary started to explain that the federal government wants “to make sure that everyone in America has access to the healthcare that they need.”

“So, the answer is ‘yes,'” said Harris. “The president perceives and you perceive that mutilation surgery is what the child needs?”

Harris then asked whether the government should be paying for “underage surgery” in states where it’s illegal.

Becerra asked for an example of where such surgeries were happening. “At the federal government, we spend our money compliant with the law,” he said.

COVID-19 Funding

Rep. John Moolenaar (R-Mich.) said that over $6 trillion has been spent on this public health emergency and “it just seems that spending dollars toward an emergency … where there’s no longer an emergency… would be wasteful.”

Becerra said he guaranteed that some of the hospitals in Moolenaar’s own district and providers still need protective equipment and manufacturers are being asked to prepare it.

“That’s what that money that’s left is going to be used for. It’s still related to COVID,” said Becerra. “We may not be in a public health emergency the way we were 3 years ago, but there’s still a need for us to protect against” infection.