You to the subdmooit committee. Were looking forward to hearing your testimony. Mr. Secretary, your responsibilities are many. Your departments responsible for ensure properly payments of medicare and medicaid dollars for overseeing buy kbroe medical research that could save millions of lives, for helping families break the cycle of poverty and protecting our nation against bioterror and pandemic events. The cuts promodes this month are extensive and span the reach of your agency. I believe theres always fat that can be trimmed and priorities that can be reordered, but i will ask you some questions this morning about whether this budget leaves america sufficiently prepared to respond to a pan demmic, a new disease like zika or bioterrorism event. Ill ask questions about how youll fulfill your mission of enhancing the health and wellbeing of americans at these levels of funding and ill ask how you will work to solve some of the challenges in your agency including those related to the Indian Health service. And ultimately this subcommittee needs to know in detail what cuts you propose and what missions you are either downgrading or eliminating. I know some of these details will be forth coming in the weeks ahead, but we look forward to hearing what youre able to share with us today. And we recognize there are limitations in that regard. As a reminder the subcommittee and witness will abide by the fiveminute rooil rule so everybody will have a chance to get their questions asked and answered. Now im going to going off script for a minute. I want to begin also just welcoming you here as our former colleague, 12 years, and not only had the privilege of serving with you and obviously in congress but in the same conference and on your committee which you chaired. And i couldnt have been more pleased with your selection by the president. I think you are not only a very good person and extraordinarily well qualified for this job, i have no doubt youre going to do a brilliant job for the American People during your tenure in health and humaner is vitss. Having worked with you i know you know how to balance a budget and make the tough decisions that have to be made for the country Going Forward. And, you know, we achieve of that balance in the bugts that you were the that you crafted and some cases i think with appropriate balance between entitlement spending and Discretionary Spending. And i think thats probably one of this committees chief concerns. I think the president is absolutely correct that we need to spend more on defense, dont have any doubt about it at all. And i think hes absolutely correct as well that it needs to be done in a fiscally responsible way, with off jetti youve setting other budgets. Were operating off a skinny budget, we may see Something Different in may and we may see Something Different in the years ahead, but in my personal view, these are focused too tightly on nondefense discretionary offsets and particularly with respect to your agency. I take considerable pride in the fact and i know my colleagues on both sides of the aisle do, that in the light 90s and early part of the 21st century congress, Republican Congress frankly but with democrat support was able to double the budget at nih and our predecessor speaker gingrich deserves considerable credit and mr. Porter, my good friend, Ranking Member of both the full committee and the subcommittee often point out, they did a tremendous job, i think, for the American People. We then had about a dozen years of flat funding, and i take considerable pride that it was Republican House and senate again in 2016 that restarted the cycle of increasing funding at the nih. And when i say flat funding, i know my colleagues would be the first to point out flat funding means reduce funding because youre obviously loose on the count of inflation. I can give the numbers in terms of the number of grants we were funding in 2003 verse whats we were funding in 2015. Went down from 1 in 3 to 1 in 6. That was a lot of good science i think left on the table. So im pleased that we were able to restart that what a call a virtuous psych until 2016. I take considerable pride it was Republican Senate and Republican House that did it but with our support of our friends on the other side of the aisle. And we did that again in the 2017 budget which im hopeful you will get to operate without a continuing resolution before the end of next month, and youll see there will be never very substantial increase for the National Institute of health. Going forward, and also for the center for Disease Control. And youve heard me say this before, but i really believe it. These two institutions in particular, theres lots of good things in your budget, but these two in particular are every bit as important for the National Defense and National Security of the American People as the pentagon is because, frankly, youre much more likely to die in a pandemmic than a terrorist attack. So maintaining the ability to rerespond to be terrorist attacks, to respond to unexpected things like ebowla and zeke i can, extremely important for the country. I know you see it that way as well. Youre in a tough position and have to make tough decisions and i respect that, but this committee and certainly me personally will be very hesitant about about looking at cuts to the nature that were talking about. And frankly pretty insistent on finding a way in the total budget to not only maintain the offsets that the president wants to, but spread them more broadly across the full budget, but do it in ways that we can continue this investment in what i think is really cutting edge and important Biomedical Research and certainly at the center for Disease Control whats literally the frontline of defense. Id much rather fight ebowl la in west africa than dallas. So i just i say that sought there just up front because we will have some differences, but i want to make it clear theyre not differences in the basic thrust of what the president s trying to do. Its just that doing what congress is supposed to do and trying to think maybe more broadly across the entire bubt budget, as i know youve done before, ive seen do you it. And try to make sure that we prioritize whats generally important. And defense is genuinely important. These things are part of the defense of the country and its development too. I look forward to our discussion, i know it will be thoughtful. I know you will make good decisions on behalf of the American PeopleGoing Forward because i know who you are and ive had the opportunity to serve with you. And this committee looks forward to working with you fully and openly and transparently. We had an excellent relationship with your predecessor and secretary burwell whos someone i think very highly of but i know well have an excellent relationship with you. And i know how well youll serve the American People so this Committee Republican and democrat alike looks forward to working 2000 achieve that common goal. And i know thats the president s goal as well. Had is the beginning of a process, i hope we get to the end of a process where all of us can take a great deal of satisfaction and that weve achieved the objectives that we all share and frankly discharge the duties that were all obligated to discharge. With that, i want to turn to my good friend the Ranking Member from connecticut for any opening remaerkz shee cares to make. Thank you very much mr. Chairman and welcome mr. Secretary to the subcommittee and your first appropriations hearing. Certainly not welcome to the congress which say place that you know well. We meet during perilless times for the future of healthcare in our country. With the threat of rising premiums, rising did he duct ablds and the uninsecured, americans were protected last week when speaker ryan pulled a bill from the floor that would have repealed the Affordable Care act, the fate of their healthcare now lies in your administrations hands. I have been deeply disturbed by President Trumps recent threats to sabotage Health Insurance for the millions of americans that rely on the Affordable Care act every day. And last week from the oval office he said, and i quote, the best thing we can do politically speaking is let obamacare explode, end quote. On february 27th, he told the National Governors association, again i quote, let it be a disaster because we can blame the democrats. Politically it would be a great solution. I find this speech to be insulting to the millions of workers, children, and Older Americans whose futures are on the line. The healthcare of the American People is not a political bargaining chip. The idea that the president of the United States would intentionally undermine the health and the Financial Security of millions of americans for personal political gain, my view, is malicious. Mr. Secretary, i hope that you will assure us today that you intend to be use your position to strengthen the individual market place thats used by millions of americans instead of sabotaging it for any political gain. I hope you will tell us today that you concur with speaker ryan when he says that the Affordable Care act is the law of the land and that we will there will be no further attempts to repeal it. But rather take a look at the ways in which we can improve and strengthen the Affordable Care act. Moving from the failed repeal of the Affordable Care act to the Budget Proposal. I think you know what my response is on the Budget Proposal. Unfortunately, i do not have anything complementary to say about your budget request. In fact, i think it say disaster that will have literal life and death consequences for american families. 15 billion in cuts to hhs is untenable. Much like speaker ryans Health Care Bill that failed last week, the Trump Administrations budget request for the department of health and Human Services would eliminate Critical Resources and programs for lowincome and working families. It would also decimate the National Institutes of health, the worlds foremost Biomedical Research institution, severe negative consequences for Public Health departments across our country. To be clear, President Trump is proposing to cut nih funding by 6 billion. This is really an understatement since we just saw that the administration wants to cut an additional 1. 2 billion from nih in 2017 as well. And i hope you will tell us whether or not you agree or disagree with that additional cut. Cutting billions from nih would be devastating. Cancer research, alzheimers research, hiv aides research as well as research to prevent any cure of any other disease that is causing misery for millions of americans and their families. Make no mistake, this cut will turn back the clock on lifesaving Biomedical Research that you know and i know and the chairman knows and everyone on this committee knows has the power to save lives. Mr. Secretary, we know today, we need to know today, do you agree that we should cut 6 billion from the nih . And i would just might add that this is 6 billion below what you voted for in the a. M. That bus last december. We are choosing to hamper our progress as a nation, we are choosing to ravage our medical community. President trump is also proposing to eliminate the low Income Home Energy assistance program, lie heap which allocates 3. 4 billion each year for heating and cooling homes for nearly 7 million lowincome households. Earlier this week i heard subpoena from constituents who depend on this. Susan derk by, connecticut roar anguish creased faces and please for help filled the room. They came from people like amanda diaz who works 40 hours a week while taking care of two Young Children and a sick mother. Chris an keenny, a former nurse left disabled, a girl that recently graduated from a griffen hospital training program. These programs are vital. Amanda diaz said. She said people like me dont just stay home, i work, i have a fiveyearold daughter who has asthma and my mom has lupus. Diaz says minimal heating assistance she received probably kept her daughter and mother from getting sick last winter. Ms. Keenny said, and i quote, how does this government think we can just cast people aside . A disabled former nurse, she wiped tears from her eyes and she said, they are putting numbers down but we are talking about humans. These are the words of folks. They rely on this program to keep their kids healthy, to keep their families safe. And President Trump is also proposing to eliminate the Community Service block grant program, a Critical Program that connects people with job training, nutrition programs, lie heap and more. He would propose slashing funding for the centers for Disease Control which gives to state Public Health departments, drafltically reduces surveillance, epidemiology, Laboratory Testing as well as immunizations and Emergency Preparedness activities in the states. I was pleased to read in your testimony about your commitment to Emergency Preparedness and how we need to foster that effort. In each of these cases, President Trump is proposing to eliminate programs that help lowincome workingclass families, often the same families that put their faith in him during last years campaign, or hes proposing to cut programs like the nih, the cdc that benefit all americans and at the same time hes preparing to introduce a maxsive tax cut for corporations and millionaires just as he did in the failed healthcare bill last week. For decades, republicans have advocated massive cuts to hemg and education funding, such as with hr 1, the very first thing that republicans did when they took the majority, which proposed cutting the nih by 1. 6 billion and 10 . Unfortunately, President Trumps budget is finally showing the destructive impact that those cuts would have on our communities. Cuts to medical research, cuts to Public Health departments, cuts to home heating and cooling for lowincome families, cuts to meals on wheels for Older Americans, cuts to nurses training, cuts to family caregivers, cuts to Family Planning service and the list goes on. My insesincere hope is that President Trumps budget is dead on aifr rifle. Its cynical, vindictive and will cause real harm to millions of american families. Mr. Secretary, i look forward to finding out whether you support these reckless cuts. I sincerely and truly hope not. Additionally, i read your testimony and i know that you do not have all the numbers yet and i would ask the chairman if we could have the secretary return in may to testify when we know the full extent of this budget when it comes around to may. I thank you and i look forward to your testimony and to our discussion. Thank the general lady. We have the privilege this morning of having my good friend the Ranking Member of the full committee here as well, and just for the record, i want to say i was very privileged last night to be with her when she received lifetime award from Alzheimers Association for the distinguished work shes done over the worse of her career. We have some of those folks associated with that effort here and we thank you for your good work as advocates and we certainly thank you for honoring our colleague and dear friend. With that the general ladys recognized for whatever remark she cares to make. Now youre being so very gracious, but i think we should tell the group that i was honored to be honored with you, my friend. And i also want to say. I was kind of hoping youd bring it up, but. And i do want to say, because i was glad you referenced it in your opening remarks, i was part of this committee when the republican, john porter, doubled the money for the nih. And i know of chairman coles commitment to alzheimers, to the whole range of diseases which we focus our efforts and find cures and prevent the terrible pain that this illness has caused. I also remember, mr. Chairman, when we used to say there are democrats, republicans, and appropriate eightors and we have to get our work done. So i am very optimistic that at the end of this process we will make major changes to the bugts, the skinny bugts that have been submitte