WASHINGTON — Republicans hammered the health secretary in hearings Tuesday, previewing a line of health- and science-related political attacks likely to dominate the 2024 elections.
GOP members of the House Appropriations Committee repeatedly interrogated Health and Human Services Secretary Xavier Becerra about issues like gender-affirming care, reproductive rights, and migrant children at the border, continuing a theme laid out by two Senate committees last week as Becerra embarks on a committee tour to sell President Biden’s proposed 2024 budget.
The rounds of questioning come as the Biden administration struggles to shield abortion rights in the wake of Roe being overturned, and as it prepares to end a Trump-era freeze on asylum at the border with promises that officials will enact new policies to reduce unlawful border crossings.
Presumed Republican candidates for president including former President Donald Trump and Florida Gov. Ron DeSantis have also blasted the administration repeatedly over these policies. In Florida, DeSantis last year banned gender-affirming care for minors and barred abortions past 15 weeks, but more recently signaled support for an even more restrictive ban on the procedure past six weeks.
DeSantis has not officially announced his intent to run for office, but has polled virtually on par with Trump.
On reproductive care, several Republicans questioned whether a federal reproductive care program, Title X, is actually authorized to operate, pushing on a technical difference between authorization and appropriation of funds. While authorization for the program — which provides contraceptives, breast and cervical cancer screening, and STI testing, but not abortions — ended in 1985, every president including Trump has portioned funds to Title X over the years.
The Trump administration implemented a so-called gag rule in 2019 prohibiting providers who receive Title X funds from referring patients to abortion services or counsel. The Biden administration rescinded that rule in 2021.
HHS is asking for $512 million for Title X in 2024, a 76% increase over current funding. Rep. Andrew Clyde (R-Ga.) asked if any of that increase would go toward pointing patients towards abortion care, a question Becerra sought to swerve by noting Title X has not received a funding increase for more than a decade and “obviously family planning services are more needed than they were 10 years ago.”
Republicans also repeatedly questioned whether federal funds could be used to provide gender-affirming care to minors even in states that ban or restrict such care, as Florida and an increasing number of red states have done. More than 400 anti-LGBTQ+ bills — ranging from banning transgender children from playing sports with their identified gender to investigating parents who let their children receive gender-affirming care — have been introduced in state legislatures’ most recent sessions, according to the Trans Legislation Tracker, which pulls data from difference advocacy organizations.
Biden last year directed HHS to bolster protections for minors’ gender-affirming care and end conversion therapy. But the issue has already become a political lightning rod that DeSantis and Trump have put at the forefront of political messaging.
Rep. Andy Harris (R-Md.) asked Becerra whether the president would allow funds from the federal children’s health insurance program, CHIP, to go toward gender-affirming care and, more specifically, surgery. Pediatrician groups say gender-affirming care for minors is largely rooted in therapy and social recognition rather than medical procedures, which, if they occur, typically happen when someone is an adult.
“We cannot provide any taxpayer dollar for any service that isn’t eligible under federal law,” Becerra told Harris. “But we make sure that if it is eligible under federal law, we will do everything in our power to make sure that child, that adult, gets that care.”
Georgia’s Clyde asked how much HHS has spent on gender-affirming surgery and therapies such as hormone blockers since Becerra assumed office in 2021. The secretary said he did not have those numbers on hand and a complete figure could be difficult to compile because states track care in different ways, but said he would look into it.
Finally, Republicans across each committee reviewing the budget request have criticized the health agency’s oversight of thousands of migrant children who have been placed in homes across the country, usually with family members, after crossing the southern border. A recent New York Times investigation found that more than 100 children, many in unstable homes, have been forced to work in menial jobs.
The Biden administration has long argued that immigration through the southern border has steadily increased over the past three administrations. But while the Trump administration froze asylum in 2020, citing the coronavirus pandemic, Biden plans to rescind that ban in May along with the end of the Covid-19 emergency, a move that could bring a new influx of migrants.
Becerra defended his agency’s handling of migrant children and follow-up with their families, though he acknowledged during Texas Republican Jake Ellzey’s questioning that HHS narrowed aspects of background checks during home placements — especially for children being released to a parent in part because at the time, “we were getting more kids than we had capacity to absorb.”
Trump health secretary Alex Azar also fielded questions about migrant children during his tenure, though many questions centered around a child-separation policy spearheaded by the Department of Homeland Security.
Democrats sought to defend the administration’s handling of the border by pointing to funding requests and Republicans’ hesitation to grant increases in the midst of a massive federal deficit.
Ranking member Rosa DeLauro (D-Conn.), for instance, argued that rollbacks on background checks in homes where migrant children were being placed began during the Trump administration because they found the expanded checks did not improve children’s safety. But she also ended the hearing by criticizing calls to reduce the budget.
“We’re looking at cuts to the border patrol. We’re looking at gutting border protections,” she said. “That means that there’s even more of an opportunity for fentanyl, for [human] trafficking, to continue to happen. I just asked people to please look at what it means.”
