Before the Senate Finance community, topics include rural melt care and telehealth flexibilities. We are meeting today to discuss with senator becerra, the budget and the department of services. The budget comes down to a simple proposition, helping working families and the middle class get ahead. Reducing the federal deficit, they are not mutually exclusive. Today, we are committed to doing both. When it comes to health care, that means protecting medicare for the next generation by making sure that the wealthy pay their fair share in taxes, strengthening medicare, negotiating the cost of medication, and investing and priorities Like Mental Health care, and the health care workforce. Thats sharp contrast to the republican approach to the federal budget. Since the beginning of the year, there has basically been a demand for secret negotiations on unspecified cuts to specified programs wall hosting hostage the full faith and credit of the United States government. Budget chair Committee White house and the Budget Office to run the numbers, and its clear that republican promises to spare certain parts of the budget like Social Security, simply do not add up. Sparing essential lifelines for seniors, in addition to republican priorities means essentially zeroing out Everything Else in the federal budget. I would like to take a moment to address press reports. Some house members are considering proposals that cut earn benefits and medicare, or Social Security for those who are not yet at retirement age. I want to be clear. As long as i am chair of this committee, i will fight any effort to engage in intergenerational warfare. There are plenty of ideas that do not include forfeiting the benefits of current workers. Now, i am going to take a minute to talk about what that means in practical terms. Starting with medicaid. Contrary to pop contrary belief, medicaid acts as our countrys backstop for nursing home care, not medicare. Since my days as director of the i have been stunned at how many people still believe medicare leads in the effort to fund nursing home care. Thats just not accurate its. Medicaid. When the parents are in their 80s or 90s, and require medicaid is there to help cover the cost once they have gone through all of the hard earned Retirement Savings everything they did to try to plan for retirement while they were working. For public in 2017 by catering federal support and state Medicaid Programs, and giving states free reign to pare back benefits, that guaranteed backstop of nursing home care for seniors is ripped away. That means a return to distant times before the social safety net was created, when Older Americans who ran out of savings could not count on a Family Member or were consigned to a poor form. Nobody wants america to return to that way. Lets look for ways to Work Together and take on big challenges of our time. Rather than pursuing cuts that imperiled the countrys older people. Now, a couple of important priorities in the president s. Budget first the jugular of drugs. They have several proposals to that holds pharma accountable for years of high prices while lowering costs for seniors. That includes speeding up medicare negotiations, increasing the numbers of drugs, subject to negotiation. I strongly support this approach, especially as a center for medicare and Medicaid Services continues to steadily implement the laws that are already on the books. For example, last week the Biden Administration announced that the anti price gouging law that was written in this committee, in this room on a bipartisan basis in 2019 will lower cohen churns payments for 27 drinks in Medicare Part b. Part b pays for prescription, drugs that treat diseases like cancer and rematory arthritis administered in a physicians office. That includes humira. Folks, humira is exhibit a for why drug pricing reforms were needed in the first place. Important steps like these coinsurance reductions free vaccines, and the insulin cost cap and medicare are just the beginning of the big impacts of this law will have on Americans Health care costs. I want to make clear that ive said from the beginning thats when the federal government leads on Flagship Health reforms and medicare in key programs. That the private sector is going to follow, and that is exactly what is happening. Next, Mental Health, care very fitting since my has been of the cause. Last, congress the committee wrote black letter law and to move the country towards reality were all americans can get quality module health care, when and where they need it. I specially want to thank my partner here on the finance committee, senator crapo, at the beginning of 2021, we set on Mental Health clear, we are going to be ready on every single bill, every single one to make sure that we dance the cause of Mental Health needs, we were able to do that on the gun safety outlaw, weve improved Mental Health care in schools, funding for Community BehavioralHealth Centers. That, as i mentioned, senator coverage for therapists and medicare. New slots for psychiatrists, and senator crapo and i talk of often about this, and we intend to continue our Mental Health work in this congress again in a bipartisan way. One final point with respect to Mental Health care to clear off a little confusion. When it comes to Mental Health parity, the Congress Passed a landmark law in 2008, based on the proposition that physical and Mental Health would be treated equally. That, unfortunately does not happen today. 15 years after the law was written the Insurance Companies, the Big Insurance Companies are still finding ways to drag their feet on carrying out the parity law with respect to Mental Health. The challenge for the committee to stop the footdragging that is taking place under current law colleagues. Give americans what they thought they were getting in 2008. The president s budget takes important steps in that direction, and senator bennett, also is leading a way to put Mental Health care on a better footing. We are also pleased that the president s budget takes a big step when it comes to postpartum coverage for new mothers in medicaid, at the end of last Year Congress came together on a bipartisan basis to create an option for every state to cover postpartum care for new not theirs, 12 months. President s step budget to its credit takes annexed up to make that coverage available for the country. Finally, i want to say i think all of us had a chance over the last few days to read a stunning report about cracks in a Health Care System for disabled folks, it was reported on the washington post, we are going to need to develop smarter policies that provide Long Term Care options for families to get that is best for them. One option is offered by our colleagues from president ials censure senator casey based services. We are going to continue to promote that. So, this is all about making some Smart Investments in Better Health for the people of this country, consistent with showing that you can do that while reducing the federal law deficit. After senator crapo has a chance to make his opening remarks, i will introduce senator and we will get underway. Senator crapo,. Think you very much, i thank you senator for being here today. Before we begin, let me let you know that i have at this very time to be introducing a judicial nominee for an idaho district judge position. When i finish my remarks and i step out, i am not walking out on you. I will be back. Before i get to my prepared number marks. I do want to respond a little bit on the question about the debt ceiling negotiations. I want to make it very clear, the republicans are asking for negotiations on the debt ceiling process to add some fiscal restraint into the debt ceiling extension. I ask you, senator sarah to take back to the president might play that he engaged with us in negotiations. I want to make it clear. We are not talking about trying to produce benefits in medicare, or Social Security for our seniors. What we are talking about is reasonable reforms that can help us get some kind of fiscal response straight on our spiraling doubts. I encourage all of my colleagues in the senate, but particularly the president to engage with this in those kinds of negotiations. I want to start my formal remarks on the positive. You have testified before, and talked me privately about the fact that although we have our differences on a lot of policy areas, we want to fall in those areas where we can Work Together and we have found some last year. Last, year as senator wyden has already indicated, we came together on a bipartisan reform to produce common sense solutions, ranging from Mental Health improvements to comprehensive telehealth coverage for seniors and working families. Moreover, we accomplished all of this by reducing the deficit by billions of dollars. The administration and you, secretary mr. Work with us on this, and we have made good progress. I look forward to partnering with hhs as well as with my colleagues on both sides of the aisle to advance for the reforms like this and this congress to improve Health Care Access, affordability and choice for all americans. That being said, i do have concerns. With the budget that the president has put forward. Unfortunately, many of the proposals and the president s budget were indestructible to these kinds of additional ads that i have discussed. I have serious concerns with the focus on partisan policies that risk harming Health Care Access and affordability for both current and future patients. We talked about some of this yesterday. The budget central proposal for its would dramatically expand the size and scope of the bureaucratic government run Drug Pricing Program enacted last year in the i. R. A. Prior to that laws passage, my republican colleagues and i warned repeatedly that imposing sweeping price controls would prove disastrous for patients, biomedical research, and development, and domestic manufacturing jobs. Many of our fares have already come to pass. We pointed to the risk of higher lunch prices, and distorted pricing practices based on projections of validated by the nonpartisan congressional office. Sure enough, the wall street journal reported in january, and i quote, the impact in 2023 may actually be higher drug prices. We also expect concerns around live starving r d as the University Chicago would result in 135 fewer drug approvals and the next two decades, that figure would inevitably skyrocket under the budget proposed expansion. Already numerous manufacturers have signaled plans to table certain projects in light of uncertainty created by the i. R. A. In recent months weve also seen a russian of drug shortages. Even leading u. S. Food and Drug Administration officials have attributed to pricing dynamics. Doubling down on the price controls would exacerbate the laws most harmful consequences. Americans deserve better and more Affordable Access to Prescription Drugs, and we can find bipartisan results Oriented Solutions to advance that goal. Government price mandates, however are a step in the wrong direction. Ive also profound concerns, with the budgets bold claims of averting the medical trust funds looming insolvency largely through massive tax hikes and budget. This unbalanced approach does nothing to address medicare scott drivers. It would also punish the small job business and entrepreneurs who drive our economy. Unfortunately, the budget takes a similarly shortsighted approach to medicaid, reviving a number of rejected policies from past proposals, including hundreds of billions in new spending, tied to burdens of conditions and efforts to circumvent state leaders. The federal government should focus on supporting states, as they work to return medicaid to post pandemic normalcy. Rather than imposing new topdown mandates. Instead of turning to a one size fits all solution we should look to proven models for federal programs, such as Medicare Advantage. With skyhigh Patient Satisfaction rates. Medicare advantage shows that Consumer Choice and Market Forces can produce more benefits, and better outcomes, as we move forward i encourage or department to focus on our shared goals from cost cutting competition, to sustainable telehealth access, and other similar issues, rather than on these partisan priorities. I think you again for being here today, and i thank you mister chairman. I think my colleague, and my colleague and i are going to go back and forth about who said what when im just going to put into the record by unanimous consent that at this point, the House RepublicanStudy Committee proposals to cut medicaid and medicare, so specifically thats what we are talking, about so, secretary sarah, we welcome you, 25th secretary of the department of health and so Human Services. First latino to hold the office in the United States. You have dedicated your career to political service, most recently serving the attorney journal of california. Prior to, that he served 12 terms in congress, as a member of the house representatives, while serving in congress he was the first latino member of the committees on ways and means, he served as. On Social Security and Ranking Member of the subcommittee on health. Secretary we welcome you. I have appreciated the chance to work with you often over the years, and i appreciate your commitment advocating for the people served by the department of health and Human Services. Go ahead with your remarks. Chairman. , thank you for the invitation. A lot has happened in the year since i last spoke to you about budgets. More than 16 million americans have secured Health Insurance with the affordable her care act. Thats an alltime high. Altogether, more than 300 million americans now carry insurance to cover their health care nears, a show historic high as well. The president s new lower cost Prescription Drug law has kept insulin at 35 per month, and made preventative vaccines like the flu, covid and shingles vaccines, available for free under medicare moving forward this new law gives us the right to finally negotiate lower Prescription Drug prices for americans. Two capitol off, the Biden Harris Administration has safely and effectively executed the Largest AdultVaccine Program in u. S. History, achieving nearly 700 million shots in arms during the covid pandemics, without charge. The fy 2024 budget proposes 144 billion dollars and discretionary funding and 1. 7 trillion dollars in mandatory funding for the hhs. It positions us to tackle the challenges we face including a crisis in future Public Health threats. It also phones operations and Mission Critical infrastructure needed to create a healthier america. Moving the two a Wellness Care system. An illness care system leaves our most vulnerable families behind, i wanna scare system invest in providing the full spectrum of health care to all americans. Illness care allows the price of Prescription Drugs to skyrocket. Wellness care starts by prescribing fruits, vegetables, an exercise. Food as medicine illness care requires you to get it a referral by your family physician to see a specialist for Mental Health services. Want to scare, it lets you get Mental Health care the moments you walk through the door of the Family Physicians office. Illness care forces hardworking americans to deplete their life savings, to get the Long Term Care they need wallace care invests early and Long Term Care like so our oldest American Adults and our americans with disabilities can thrive at home and in their commu