House GOP lawmakers repeatedly grilled Health and Human Services Secretary Xavier Becerra on Tuesday on topics ranging from reproductive health services, gender-affirming care and migrant children.
Becerra, who was testifying about the Biden administration's FY 2024 budget in front of the House Ways and Means Committee as well as a House Appropriations subcommittee, also defended the administration's implementation of Trump-era legislation aimed at stopping surprise billing, as well as payments to Medicare Advantage providers.
In both hearings, Becerra faced questions from lawmakers who are also physicians about the No Surprises Act, which Congress passed to protect patients from unexpected medical expenses when they receive care at facilities or physicians outside their insurance network.
Under the law, mediators help out-of-network providers and payers with billing disputes to decide how much each should get paid.
"We created a bill that created incentives for doctors to want to be in network and for insurance companies to want doctors in network. But you decided to implement the law in a manner that unfairly tips the scales in favor of insurers," said Rep. Brad Wenstrup (R-Ohio), who was also a podiatric physician, during the Ways and Means Committee hearing. "You directly defied the law as written."
Becerra said the administration has been working within the law, but has been overwhelmed with payment disputes.
The questions about migrant children come as the White House faces constant GOP attacks about unlawful southern border crossings. The administration in May is planning to end Title 42, which allows U.S. border officials to quickly expel foreign nationals at the border under public health protections related to the pandemic, and enact a new policy.
HHS is responsible for taking care of migrant children who cross the border unaccompanied by an adult, and placing them in the home of a relative already in the country.
Lawmakers have been pressing the administration on the potential exploitation of migrant children amid the ending of Title 42, after a New York Times investigation found that more than 100 children have been forced to work in hazardous jobs.
Becerra acknowledged to the Appropriations Committee that HHS loosened some background check requirements for children being released to parents, because there was an influx of minors and the agency couldn't keep up.
On reproductive health, the White House is asking for $512 million for the Title X program, which funds contraception, preventive screening for breast and cervical cancer, and family care planning.
The Biden administration in 2021 revoked a Trump-era rule that prohibited Title X providers participating in the program from performing abortions or referring patients to abortion clinics.
Becerra said Title X has not received a funding increase for more than a decade.
“Obviously family planning services are more needed than they were 10 years ago," he said.
But he dodged questions from Rep. Andrew Clyde (R-Ga.)about whether any of the new funds would go towards abortion care.
Separately, Becerra also defended proposed regulations for private insurers who operate Medicare plans under Medicare Advantage. The plans are increasingly drawing federal scrutiny, as they engage in a massive lobbying blitz to fight the proposed payment rate.
"Our proposal increases the amount of money those insurance companies will get from last year. How anyone can claim that there is going to be a cut I don't understand," Becerra said.
Under the proposal, the administration would increase payments by 2 percent, far less than plans have received in past years. Democrats and administration officials have argued the plans routinely make patients appear sicker to get bigger payments, and the proposed policy would eliminate those excess payments.
But plans and their allies, including some GOP members of Congress, said the proposal amounts to a massive cut of Medicare benefits.
"If these insurance companies are claiming that they're going to have to cut benefits, it's because they don't want to provide them," Becerra told the Ways and Means Committee.
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