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tv   HHS Secretary Nominee Xavier Becerra Testifies Before Senate Health...  CSPAN  February 23, 2021 9:35pm-12:10am EST

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you are watching c-span, your unfiltered view of government. c-span was created by america's cable television companies in 1979. today, we are brought to buy these television companies that provide c-span to as a public service. >> the senate health committee considered the nomination for the health and human services repertory. he was asked about covid-19 distribution, guidelines for reopening schools, rural health care access, and prescription drug costs. he previously served 12 terms in the house of representatives until 2017 when he became the california attorney general. his confirmation hearing is 2.5 hours.
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>> the senate's health education committee will come to order. today, we are holding a hearing on the nomination of attorney general becerra to be secretary of health and human services. senator burr and i will have an opening statement and then i will recognize senator feinstein to introduce attorney general becerra. after attorney general becerra gives his testimony, senators will have five minutes and i will be happy to stay for a second round if any senator has her many questions. -- has remaining questions. before we begin, we will follow the advice of the instruction on conducting this hearing. we are grateful to everyone who has worked so hard to get this set up and to help everyone stay safe and healthy. members are kept six feet apart.
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some senators are participating by videoconference. while we are no longer able to have a hearing over to the public, video is available on our website at health. senate.gov. thank you attorney general becerra for joining us. i appreciated our conversations so far about how to tackle the challenges our nation is facing, starting with this pandemic and our past experience working together to help families stay safe and healthy. i look forward to hearing more from you today and working with you both virtually and hopefully in person soon. if there is one thing is clear on a it is that this -- it is that we have a lot of work to do and no time to wait. after president trump
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relentlessly attacking healthcare and refusing to lead the fight against this pandemic, our country is in crisis. the uninsured rate has gone up, confidence in our public health agencies has plummeted, painful inequities have grown deeper and more damaging for communities of color and the trump administration left the covid-19 -- let the pandemic spiral out of control as testing, contact tracing and vaccinations fell behind. hospitals were overcrowded. healthcare workers pushed to the brink and hundreds of thousands of people lost their lives. they did not just send things off the rails, they left us in a deep ditch. the days of president trump are thankfully over. this pandemic is not. we need to work with the biden administration to quickly take additional steps on covid relief
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and moved swiftly to make sure they have clear routines in place, including strong leaders at the department of health and human services who will work with us to end this pandemic and rebuild a stronger country. given the urgency of this crisis, i am hopeful that after today's hearing and the finance committee hearing tomorrow, the senate will move to confirm attorney general becerra. attorney general becerra has the experience and principles needed for this role. he knows how to work with congress after serving as a member of the house of representatives for 24 years. he did not spend his time trying to repeal laws. he did work to pass laws that expanded coverage like the children's health insurance program and the affordable care act. as california's attorney general, he has proven himself as an executive leader by seeing
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one of the nation's largest justice department through one of the most challenging period in history. as attorney general, he has fought for patients, not pharmaceutical companies, and even won a $70 million settlement against drug companies for blocking cheaper generics. he has fought to defend families health in court and as secretary, he will work with congress to make sure every patient can get quality, affordable healthcare. while the trump administration ignored crises that impact public health like this pandemic and climate change and racism, attorney general becerra has taken them on. he has held companies accountable for flouting safety rules and putting workers at risk. he established a new office in his department focused on environmental justice including how pollution and public health tactics disproportionately hurt communities of color.
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he has worked to advocate on behalf of communities of color across health, immigration, education and more. overall, his record tells a story that is clear, compelling and persuasive. he has fought against pharmaceutical companies, opioid manufacturers, tobacco companies and polluters. more affordable healthcare for every patient including women, communities of color, the lgbtq community, people with disabilities and migrant children. i have no doubt that as a secretary, he will put special interest on notice with patients and public health experts and put science, data and experts back in the driver seat. he is also bringing an important perspective as a first generation college student and the first latino secretary of health and human services. i look forward to working with him and the biden administration to not only address the
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immediate challenges of this pandemic, getting testing and contact tracing scaled up and continuing to increase vaccinations, but also to make progress on so many other fronts like making sure healthcare is a right, not a privilege. reversing the effect -- attack on women's health. helping every child get affordable healthcare, re-unifying children with the parents they were separated from by the trump administration. rooting out system make racism in healthcare that has inflicted a deadly toll on communities during this pandemic. establishing a strong health system to tackle future pandemics. the maternity mortality crisis, mobile epidemic and so many other challenges. there is much work to be done. with this pandemic, the clock is ticking and the reality is we are already behind. we all want this pandemic to end
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which means we should all want the biden-harris administration to succeed and we should be getting qualified nominees like attorney general becerra on the job as quickly as possible. i hope to see strong support on both sides of the aisle for your nomination, attorney general becerra and i look forward to working with you. finally, enter into the record, 54 letters of support for attorney general becerra's nomination signed by individuals representing patients, healthcare providers, hospitals, public health experts, advocates and researchers. so ordered. i would 90 recognize ranking member -- i would like to recognize ranking member byrd. >> thank you for scheduling this hearing today and the consideration of the nomination of xavier becerra to be secretary of health and human services and i welcome my colleagues on both sides of the
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general. as i said, senator murray and i have worked together on a range of issues including fda user fee agreements, public health reauthorization and efforts to fortify our nation's public health preparedness framework. i look forward to our collaboration to help america's patients and families and believe that the key to our success in addressing the most pressing health challenges facing our country will be the strong leadership from this committee working together in a bipartisan fashion with this new administration. general becerra, welcome. i appreciate the opportunity yesterday to sit down with you and talk and our relationship goes back a number of years in the house. i want to take a moment to recall the health committee hearing for former hhs -- hss secretary. she came as an obama administration nominee, not as a
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nominee of my political party. at the end of my five minutes of questions, i informed my colleagues that i would be supporting her and urged them to do the same. i provided key reasons for the support. the portfolio of expertise in addressing the challenges faced by hss, she held a deep knowledge of the issues at hand and had experience in the management, execution of complex healthcare issues facing our country. the need for extensive healthcare experience at the helm of hss -- hhs has never been more important than today. i hear from families in north carolina about the problems caused by federal overreach into their healthcare choices. a decade after the passage of the affordable care act, people are still burdened by its policies and struggling to make ends meet as a result. not only have you supported the expansion of the affordable care act, you have been an advocate for more government interference
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between americans and their doctors. during your time, you supported medicare for all proposals which would end private insurance and remove the private sector from healthcare coverage, denying the american people the innovation and affordable healthcare coverage models it offers. as example five by the pandemic -- as exemplified by the pandemic, with the development in treatments, the private sector is vital to solving the most pressing health care issues facing our country and cannot be ignored or in any way undervalued. over the last year, the pandemic caused by novel coronavirus has brought the public health agencies under the jurisdiction of this committee to the forefront of the debate. january 31 marked one year since secretary azar declared a public health emergency with only a couple of covid cases in the united states. the framework this committee
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developed under the pandemic preparedness act and its continued bipartisan reauthorization laid out a roadmap for our response and allowed for early prioritization of the development of countermeasures to mitigate, treat and prevent an emerging disease like covid-19. this important law created barda, the biomedical advanced research and development authority, to bring countermeasures through a risky phase of drug development. we recently received a report about the obama administration's mismanagement of this agency from the office of the special counsel and we will be examining that very closely to ensure that such blatant failures do not happen again under this administration. barda's capabilities with assistance from other partners have allowed us to reach yet another critical juncture in our covid-19 response, a lifesaving
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vaccine. this effort is making history and breaking scientific ground, bringing a vaccine to americans and the world in a matter of months. american innovation and ingenuity are rescuing us from a devastation of a global pandemic. general becerra, your actions as attorney general for california during your tenure in congress reveal a disregard for the value of this ingenuity, calling for policies that undo decades of investment in and support of america's biomedical research, the incentives to innovate has been and always will be the linchpin in our ability to bring hope to american patients. countermeasures for covid-19 platform technologies to treat a multitude of rare diseases and breakthroughs to delay the devastating effects of alzheimer's and dementia will
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all come before this administration. an hhs secretary nominee that has demanded protections and discouraged the development of treatments for life-threatening diseases should be cause for concern for all members of the committee and the senate. as a congressman, you advocated for the use of marche in right or authority for drugs with priority review designation that the fda had signed a letter urging hhs to use this authority to address increasing drug prices. in fact, the act which was passed in 1980 is prescribed on the criteria for exercising margin rights and formative senator -- former senator dole said it did not intend to set prices or omitted referencing prices. francis collins and the director of an eye j -- nih, someone who
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was widely respected, has rejected this approach and as usual, we would all be wise to listen to francis. as a lawyer and former legislator, you know better than to try to distort the law beyond the reason for a preferred policy objective. in the midst of the pandemic, the hhs secretary should not be someone who advocates for this deliberate misuse of the law or discourages the development of treatments for life-threatening diseases. the utilization of march in rights in these circumstances as you have advocated can have a chilling effect on countermeasure development and the next generation of treatments and cures for the american people. as i look at the status of the pandemic, i believe we must identify those areas of success, those that need work, and the challenges we did not anticipate in our earlier efforts. it is important for us to agree
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that there were successes and there were failures in the past year so that we can learn. accelerating the administration's covid-19 and applying we have learned are complex health challenges, but they are only the first set of tasks and the next leader at hhs will face this. following the immediate response the department will play a more -- play a role in modernizing programs, the efficiencies gained in regulatory agencies, and building the architecture of a healthcare delivery system for the future. these tasks will require sound policy experience. by the time secretary azar arrived, we had an extensive career in biopharmaceutical sector. secretary price was a physician.
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secretary burrell tackled health issues. secretary sibelius served as the kansas commissioner of insurance. this level of expertise that the american people deserve and that continued to respond to pandemics. members of congress are granted security clearances because they become members of congress, it is automatic. members of congress do not become subject matter experts just because they are members of congress, just because they sit on a committee that has health responsibilities. i have said often that i think you could count on both hands and both feet the number of members of congress that can actually understand the healthcare system in america. i may be wrong, but i think i'm right. it does not automatically give you expertise because we serve on this committee. i'm concerned at this time, in
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congress, as attorney general, as the attorney general sits before us. i will say what i have said to him privately. i am not sold yet. i am not sure that you have the experience or skills to do this job. i am not sure that you have the appropriate respect for the private sector and innovation and intellectual property needed to bring more exciting treatments and cures to save lives in this country. general, you have an opportunity today and tomorrow in public hearings to prove that that expertise is there. i told you i would remain open for this hearing and tomorrow's finance hearing which i think i may be the only one in both of them. you will be tired of seeing me
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by then, i will assure you that. i do come with an open mind and now the job is up to you. thank you, madam chairman. >> thank you so much. we will turn it over to senator feinstein to introduce attorney general becerra. >> thank you very much. >> make sure that microphone button is on. >> hello? >> you got it, thank you. >> chairman murray, 19 member, members of the -- ranking member burner -- ranking member burr. i have known xavier becerra for years as a friend and a colleague. he spent decades serving california. he is currently the attorney general and previously served a 12 year term as congressman for los angeles.
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mr. becerra was the first in his family to receive a four-year college degree, congratulations, earning his bachelor of arts in economics from stanford university and later, sanford law school. as a member of the house of representatives, he was an advocate for the healthcare of his constituents and he fought to make affordable care affordable. as california's attorney general, he has been a defender of the affordable care act, leading 20 states and the district of columbia in defense of the affordable care act before the supreme court. as part of his focus on protecting the health of americans, mr. becerra worked with nebraska attorney general doug peterson, a republican, to lead a bipartisan coalition of 43 attorney general to reduce
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exposure to tobacco products like e-cigarettes, which continue to pose significant health risks to children. he has also worked on a bipartisan basis with multistate coalitions of attorneys general and with other health priorities that align with the work of this committee which include increasing access to covid-19 treatments as well as addressing the opioid epidemic and the considerable harm it has done to families. as our state's attorney general, xavier becerra leads the nation's second-largest department of justice and has major experience leading large and diverse organizations. we believe this positions him to successfully lead the department of health and human services. which is the nation's largest federal agency by budget.
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as secretary, he will lead the nation's top health agency, charged with enhancing the health and well-being of all americans. he comes well-equipped to do an excellent job and personally, i am very proud of him. so it is with great pleasure that i am here both to endorse and to support his candidacy. thank you, mr. chairman. >> thank you so much, senator feinstein. great to have you with us. and now we will turn to senator sabia for his introduction. >> thank you, chair, ranking member, for inviting me to address the committee today to also introduce my friend, california attorney general xavier becerra. it is an honor to introduce a fellow californian for this important post. our nation is going through one of the toughest times we have
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faced in recent memory, the covid-19 pandemic has taken an incredible toll on our lives and on communities across the united states. as we all know, covid-19 deaths in the united states just surpassed half a million people. the devastation has disproportionately impacted communities of color, very similar to the very neighborhoods that attorney general becerra and i grew up in. these communities are hurting and dying at alarming rates and they desperately need someone who knows these communities to their core. the los angeles times published an article on saturday showing the disparity in vaccination rates across los angeles county, for example, where wealthy
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neighborhood like beverly hills are being vaccinated at five times the rate of minority communities, such as south los angeles. that is why i am honored to introduce attorney general becerra today as the nominee for secretary of the department of health and human services. if confirmed, attorney general becerra will be the first latino secretary of health and human services, an honor he will not take lightly because it will not just be an honor. he would use it as a tremendous responsibility. throughout his upbringing and time as a public servant, he has shown his passion for people and his commitment to improving the lives of those he serves. as you have heard, his parents immigrated from mexico, just like my parents did, with the dream of building a better life for themselves and their families. as senator feinstein mentioned,
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attorney general becerra was the first and his family to graduate from college earning both his undergraduate and law degree from stanford university. while at stanford, he also met his wife, a widely respected obstetrician who helps care for women with high-risk pregnancies in underserved communities. attorney general becerra's first job out of law school was working with individuals with mental health disorders, a health issue that is too often overlooked, especially in communities of color. he also worked at the california department of justice before serving in the california state assembly. he was elected to congress in 1992 where he gained and maintained a reputation for being a strong supporter of reproductive health, protections for seniors, mental health parity, and the children's health insurance program which we refer to as chip.
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yes, he was instrumental in drafting and passing the affordable care act which has helped provide access to quality health care for millions of americans who were previously uninsured. but his work has not stopped there. as attorney general of california, he made it his mission to tackle structural inequalities within our healthcare system. attorney general becerra was the leading force behind the lawsuit to protect the affordable care act and maintain protections for people with pre-existing conditions and for those suffering from a mental illness. over the past year, attorney general becerra fought to protect frontline healthcare workers from further exposure to covid-19 and he stood up for homeowners struggling with their mortgage payments. i know public service is not just a job for xavier. this is a commitment to honor the sacrifices of parents and an
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opportunity to bring greater equity, greater opportunity, and greater hope for all americans. xavier is a proven leader who is uniquely qualified to take on the challenges of this moment with a vision of equity and compassion. i urge the committee to support this nomination. thank you. >> thank you very much. great to have both of you here today. and now, attorney general becerra welcome. thank you for being here today. you can now begin your testimony. mr. becerra: thank you, madam chair, ranking member and members of the committee for this opportunity to speak to you. to senator feinstein, a special thanks for your kind introduction.
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i would also wish to thank my family, my northstar, who is here with me and our daughters, natalia, olinia, and claricia. everything i do is a family affair. my parents had only their hope and health when they settled in sacramento. they taught me to earn the american dream. a construction worker with a sixth-grade aggregation -- 6th grade education, they never saw the inside of a college classroom. but they sent all of their kids to one or to the military. we lost my dad last year on new year's day. when the end came, my dad knew we were there with him at his side in our home. sadly, hundreds of thousands of americans have not had that
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closure this past year. that, senators, is why i am here today. the covid pandemic has took 500,000 americans. many of them alone without their family. millions of lost their jobs. that is not the america my parents thought possible. to meet this moment, we need strong leadership. that is what president biden is demonstrating and i look forward to joining the president in this critical mission. i understand the enormous challenges of work and our responsibility to faithfully steward this agency that touches almost every aspect of our lives. i am humbled by the task and i am ready for it. the mission of hhs to enhance the health and well-being of all americans is core to who i am. when i was a child, a mom had a health scare. she was rushed to the hospital after hemorrhaging at home. the images in the memory.
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we were lucky. my mom is 87 years young. better put, we were blessed. my dad, a laborer, had insurance through his union, laborers local 185. we did not have much, but we did not have to face the threat of unpaid medical bills or bankruptcy. over to gated -- two decades, i worked to ensure every family had the care that mine had. i helped expand the children's health insurance program. i helped pass the affordable care act here from the ways and means community -- i helped pass the affordable care act. as attorney general, i've created a health care and access unit. we cracked down on medicare and medicaid fraud. i helped to hold opioid manufacturers accountable for the crisis. i have taken on drugmakers who unfairly jacked up prices on patients. i have protected patient's
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privacy. if confirmed, i will work with you to continue this work and to address hhs's biggest challenges and that starts with covid. the president has ambitious hope 100 million vaccine shots on arms in his first 100 days. sequencing the virus so that we are prepared for the variants, reopening schools and businesses. hhs has a central in meeting these goals safely. as attorney general, i saw the importance of this on the front lines. i worked with my colleagues in other states, republicans and democrats to make covid treatment more available. i am ready to work with you with our state and local partners and across the government to get this right. next, we must ensure people have access to healthcare. if confirmed, i will work with you to strengthen our medicare and medicaid lifeline, to reduce the cost of healthcare and
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prescription drugs and ensure we are accountable, spending resources wisely and effectively. i will not forget the other h in hhs, human services. i want to work with you supporting vulnerable children, those in foster care, strengthening head start and expanding access to childcare. finally, we must restore faith in our public health institutions. that starts with putting science first and showing respect for our workforce. no one understands your state and your community better than you. we may not always agree, but if i am fortunate enough to be confirmed, i will always listen to you, i will keep an open mind , i will look for common cause, and i will work with you to improve the health and dignity of the american people. i want to thank you for this opportunity to share my vision. >> thank you very much, attorney
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general becerra. we will begin a round of questions and i ask our colleagues, please keep track of the clock, stay within the five minutes. we have a lot of senators today. if any of you have additional questions for a second round, i will try to keep us within the five minutes on the first round. since the pandemic began, more than 28 million people in our country have been diagnosed with covid-19 and 500,000 have died. it is a tragedy made worse by a failure in leadership. the trump administration's denial of the severity of this emergency and constant attempts at political interference devastated public health and lowered public confidence. the trump administration refused to stand up adequate testing agency, they left the states to compete against each other with limited supplies, they failed to
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provide guidance in workplaces and elevated conspiracy theories. they rejected science, exacerbating existing racial inequities. even with vaccines, we have had delays in deliveries, lack of communication between federal state and local officials, and now the nation faces major challenges with vaccine confidence, the inevitable outcome of political interference and false information. we need a strong response driven by evidence with a comprehensive plan. my question to you is if you are confirmed as secretary, will you empower hhs's scientists and experts to be leaders in the nations: response? mr. becerra: thank you for the
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question and the work you have done in all of these efforts to move us forward and i agree with what you have said. science must come first. we must ensure that people trust what we say. we have to earn their respect and trust. we want them to participate in the vaccination program. we want them to continue to mask and socially distance and wash their hands. i look forward to working with you to ensure that we gain the trust of the american people and we do it in a transparent way so that people know that when we took action, it was because science demanded it. >> good. i pushed the trump administration hard for a detailed vaccine plan for six months and i am glad the biden administration is taking that talent seriously now. we need to work together to make vaccination a reality. i want to encourage you to make sure there is widespread trust and confidence in a covid-19
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vaccine. mr. becerra: as i mentioned, what is probably most important is that people believe that what we are asking them to do is the best course of treatment and action for their health. we have a ways to go to regain the trust of the american people. if we let the experts, the scientists lead, i believe so people will see the results and if they see the results, we know they care about their families and loved ones, no one wants to see the number of 500,000 grow in the number who have died. if we are transparent, show accountability, do this in a way that earns respect, we will make progress. i thank president biden for his ambitious goal, 100 million vaccine shots in 100 days, moving forward to try to reopen the majority of our k-8 bank
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schools safely. all of those goals are critical and i look forward to working with you and -- if i am fortunate to be confirmed. >> good. in addition to knowing they can trust their government to respond to a crisis, people should be able to trust they have the healthcare available to them when they need it. you have been a leader in the fight to bring healthcare to everyone and over the last four years, the trump administration did not just attempt to repeal the aca, jeopardizing coverage and protections for people with pre-existing conditions, it sabotaged the law through executive action, issuing rules that make healthcare harder to get, more expensive, patients and families paying for more out of pocket and stuck with junk insurance plans. we have work to do to reduce the damage and get people the care they need. will you work with us to ensure everyone has access to quality
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affordable healthcare? mr. becerra: i can guarantee you that is part of my core of what i have done. my father used to tell us the stories of when he was a young man how he could not walk into establishments because a scientist said no need rose or mexicans allowed -- no negroes or mexicans allowed. i have always thought -- fought to make sure it is inclusive based on race. americans are entitled to know that we are counting them as well. i look forward to making sure that we close all caps and reach every corner of our country to make sure everyone is safe covid. sen. murray: my time is expired. i will turn it over to senator vitter. -- senator byrd. >> i'm going to yield my time to senator collins. rep. collins: --
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sen. collins: i want to talk to you about our nation's schools. about half of k-12 students are still not spending any time in classrooms, resulting in losses of academic achievement, social and emotional development, not to mention the stress on their parents. experts tell us that these extended absences are causing large learning problems, especially for lower income students. in a recent op-ed in the washington post, two public health experts were critical of the new cdc school reopening guidelines. they suggested that while you need six feet for adults, that it is safe if you have other
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procedures for students to only be capped three feet apart. it is not just these public health experts, the american academy of pediatrics has said that schools should weigh the benefits of strict adherence to the six feet spacing rule with the potential downside if remote learning is the only alternative. my question to you is this. won't maintaining this six-foot recommendation, despite these alternative views by healthcare experts prevent many schools from resuming full-time in person learning this year and possibly, even into next year? keep in mind, some of these students have not been in school since last march.
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mr. becerra: you posed a question that is on the minds of parents throughout this country every day. the preeminent concern must be the safety of our families. no one wants to risk the life of their child and no one wants to have a child become the reason an adult becomes ill from covid. i will tell you what i believe is the best approach and that is to let science guide us and let the experts determine when it is safe. remembering that schools and education are a local issue and where the federal government has a partnership, we provide the guidance, we should not be the ones making the final decision on how and when a school will reopen because those are local decisions. but we must work with them and provide the guidance, support, the resources to make sure that those fools do reopen as soon as possible -- to make sure those
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schools do reopen as soon as possible. i will work with you to make sure you and leaders of congress, especially local leaders to make sure we have provided the partnership no -- they need to know when it is safe to reopen schools. sen. collins: i would suggest that when the american academy of pediatrics is suggesting that we need to broaden who we are listening to. let me in my remaining time switched to another issue. as chairman of the senate aging community past chairman, i held the first congressional hearing on the impact of covid on seniors living in nursing homes and other congregate care settings. i've heard from numerous healthcare providers about the difficulty and expense of paying for additional staff and covid-related facility
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improvements, ppe, etc. in my state, more than one does in nursing homes closed in the past six years and many more are struggling to keep open. i was astonished that in a $1.9 trillion covid package the administration did not include any money for provided relief funds which would help these nursing homes. do you support providing additional assistance to long-term care facilities or rural hospitals, community health centers and other providers? mr. becerra: senator, thank you for the question. i know how hard you have worked on these matters. i can tell you, if i were fortunate to be confirmed, it would be a top priority to make sure we are providing the resources necessary.
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we have seen how so many of these assisted living facilities and nursing homes and other facilities that care for disabled americans have not had the resources. they are short on workers. we have seen the crisis of covid hit them hardest. we have to provide the help. i believe it is important. president biden will be there to provide the support whether it is through provider relief fund or simply by making sure that we are providing resources that are already allocated to make sure we are working closely with those facilities that have been hit the hardest. sen. collins: thank you. there is an excellent proposal in the package that 10 republicans have resented to the white house that i hope you will take a close look at. thank you, senator burr. >> thank you so much. senator sanders. >> mr. attorney general, welcome.
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let me start off by stating what you already know, the united states is the only country on earth not to guarantee health care to all people. today, 90 million americans were either uninsured or underinsured. despite that, we are spending twice as much per capita on healthcare as the people of any other nation. on top of that, we pay the highest prices in the world for prescription drugs, resulting in one out of four americans not being able to afford the medicine they need. my first question is what are you going to do, if confirmed, to move this country forward to provide healthcare to all people and also substantially lower the cost of prescription drugs? mr. becerra: senator, thank you very much for the question and for your commitment to making sure all people in this country have healthcare.
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i believe president biden made it very clear. if we work hard to build on the affordable care act and if we continue to make improvements, we will get to that point where we will finally be able to say that we cover all of our people. no one should have to experience what i saw as a child when my mother was risk -- whisked away to the hospital, not knowing if they will be able to afford the care. president biden has committed, he has said that we are going to build on the affordable care act and that is what i hope to do. in that regard, i have to mention that there is bipartisan support for tackling the high cost of prescription medication. i can assure you that that will be one of my priorities is to deal with it swiftly. i tried to tackle it as the attorney general. i tried to work on that in the
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house and i look forward to working with you and members of this body in the future. sen. sanders: can you give us a more specificity as to how to lower the cost of prescription drugs? members of congress have been talking about this issue for decades. yet, the pharmaceutical industry is enormously powerful. they make huge amounts of campaign contributions, billions over years on lobbying. they continued to be in a position where they can charge americans any price they want. we patent times more than our neighbors in canada -- we pay 10 times more than our neighbors in canada. mr. becerra: i think we can all agree that the price we are paying for some of these prescription drugs is higher than it should be.
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all you have to do is travel to another country, whether canada, to find we are paying way more than the people in some of these countries are paying. i took on a number of pharmaceutical companies, drugmakers, by trying to go behind the curtain of how they reach their pricing. we were able to prove that there is collusion at times going on. there is a process called pay for delay where companies will collude with each other to not have a second company put a generic product on the market to compete with the brand name product and keeping the price of that brand name product high. we were able to succeed in going behind that curtain and trying to undercut that type of activity. sen. sanders: mr. attorney general, in the midst of a dysfunctional healthcare system, a primary healthcare system is
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awful in the sense that many millions of people, even those with insurance cannot find a doctor when they need to. are you supportive of a significant growth in qualified community health centers around this country so we can make sure that every american, regardless of income, has access to decent quality healthcare? mr. becerra: absolutely, that is one of the ways we were able to reduce by almost one half the uninsured rate in my formal congressional -- former congressional district because our community health centers where they are to be supportive to people who did not have access to hospitals and doctors. sen. sanders: we have a crisis and we do not have enough healthcare providers, doctors, nurses, others in underserved areas, whether urban or rural.
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are you supportive of expanding the national health service? mr. becerra: absolutely as well. i want to thank that -- thank the work that you and the members of congress have done to increase the number of graduate medication slots available throughout the country so we can place future doctors in places where they are needed most in some of our rural committees, inner-city communities, making sure we are meeting the need of people moving forward. sen. sanders: we recently learned shocking information that life expectancy in the united states as a result of covid has gone down for the african-american community. it is unbelievable in terms of what we are talking about. 2.7 decline. what can we do to make sure that we have healthcare access to minority communities in this country? mr. becerra: i have worked a
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long time on these issues and others who believe we should not have the gaps in our healthcare system. what i can tell you is that if we collect better data that helps us understand where the shortages are, who we are missing, we will also be able to provide better treatment. first thing is we need to make a better effort at collecting the data that we need. i want to thank the scientists and experts who make sure that when we are doing the study for the search of a vaccine, these studies did include these oftentimes forgotten communities. we have to make sure that we are reaching out and the best way to reach out is use the local religious leaders that are trusted in that community. >> madam chair, thank you very much. >> thank you so much. >> general, nice to see you.
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i echo what senator burr said which is that i am concerned -- you are a very highly trained attorney. you have some impeccable credentials. what would you think if i were nominated to be the united states attorney general as opposed to merrick garland? you would say these guys not qualified. certainly not attorney general. you can imagine the concern that i have regarding your nomination. with that said, i have an open mind and just want to go through it. just going to talk about some of the things that we had talked about on this health committee and seeing what your thoughts are and to give us a sense of comfort about the training that you bring. a huge issue has been the 240 b
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program. we have it -- we have had at least two or three beatings on this. big stakeholders, all of them claiming that they are totally righteous and the truth being somewhere in between. in that, two key questions, do we need a statutory definition for contract pharmacy and a secretary -- statutory definition for patient, and if yes, what would they be? you may not have thought about this. i get that. just some different sort of questions. i will be at finance tomorrow to let us know that you are prepared for this job. mr. becerra: senator, thank you for the question and thank you for the opportunity previously to discuss these matters. it is an indispensable program for some of our most underserved
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communities. i know you know this. for the public that may not understand what the program is, it works with our safety net providers to make sure that some of these forgotten communities have access to some of the essential medications that they need for a reasonable price. what we must do is make sure that the law is followed. your question asked if we should have a statutory definition for a contract pharmacy or for a patient. the first thing we have to do is enforce the laws that we have in place. >> let me say, the law currently does not have statutory definitions. do you think it important that they have them? if so, how would you define? mr. becerra: i am more than willing to work with you and members in congress to see if we have to move in that direction. >> that is a process. i am asking more than a process
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question. i am asking you a philosophical, or am i familiar enough to have an opinion. mr. becerra: what i'm hoping to say is we have had the program in place. it was only recently that we had an issue arise from the drugmakers saying they want to change the way it operates. we had the previous administration issued an advisory opinion that said that the program should move forward as is. >> i have limited time. i'm going to move on. when i was in the house with you, probably 10 years ago, the industry was raising the issue of 340 b as an issue. just to say that. let me ask you again,, senator sanders asked about diabetes. some stakeholders suggest that we counter insulin price increases five requiring health plans to pass 100% of rebates
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onto patients. what would be your thoughts regarding that? mr. becerra: i do believe, and thank you for the question, that we must continue to see the cost of prescription drug medication go down. especially some of these life-saving treatments where people don't have a choice. i do believe the rebate program must be enforced. i also do believe that we have seen instances where there have been providers, there have been -- you cannot play a game with indispensable -- >> should 100% of rebates be required to be passed back to the patient? mr. becerra: i will look into that and we are more than willing to work with you. right now we have a proposal that i believe was rushed out
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that would in many ways take sides in this debate and i would say that we have to protect the program for our seniors and do with the right way. i'm more than willing to look at this program if i'm fortunate to be confirmed and work with you on it. sen. cassidy: thank you, i yield. sen. murray: thank you, senator cassidy. senator casey? sen. casey: chair, thank you for your leadership in this committee. i want to welcome the attorney general and thank you for his continued public service not only to the people of his home state up until this point but to the people of our nation. your story is a great american story, story of your own success and that of your parents and we are grateful for that method of public service. i think you are well-prepared to lead this critical agency during
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the worst public health -- worst public health crisis in a century and a jobs and economic crisis. if you excuse my long predicate to my question i want to get a few things off the record. dealing with an important piece of legislation that both chair murray and ranking member per worked with me to pass, all hazards preparedness act. in the last reauthorization we extended a national advisory committee on children and disasters and that was a good step forward. we also created two new national advisory committees. one on seniors and disasters and the second national advisory committee on individuals with disabilities and disasters. they national advisory committee on children and disasters provided valuable recommendations for the federal government since it was first established in 2013 to respond to different types of
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emergencies that can impact children. in 2019 we passed the most recent reauthorization of pandemic all hazards preparedness. we included two additional advisory committees for those populations that are frequently left out of disaster planning. both seniors and those with disabilities. it has been a source of real frustration of mine that the last administration took no action at all to stand up these national advisory committees. one on seniors and disasters and the other individuals with disabilities and disasters. despite having the infrastructure in place, the advisory committee on children and disasters, the original advisory committee has also not been reestablished despite a call for applications last year. in a pandemic where seniors and people with disabilities have
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been disproportionately and adversely impacted, both have been overlooked and at the same time children's daily lives and their education has been disrupted. we have to take action to make sure these advisory committees are up and running. my question is simple. as secretary, upon confirmation, will you ensure that the department is fulfilling its obligation under the law to establish and maintain these three advisory committees? mr. becerra: thank you for the question and all the work you have done with your colleagues. you had me at hello on this one. absolutely on these advisory committees we need to move forward. my first job as an attorney was representing americans who needed disability services. i established a disability rights bureau at the california department of justice. we have a very aggressive and
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active children's justice bureau in the california department of justice that was established by now vice president harris. i will tell you that on this i look forward to the partnership if i'm fortunate enough to be confirmed. sen. casey: my second and final question in the interest of time is, throughout your career you have been interested in the question of social determinants of health and how the lack of life enhancing resources, whether it is food or housing or education or health care are considered to be among the root causes of the health disparities we have heard so much about. when you were in the house we worked together on this and i know you have worked with others. we have seen how covid-19 imposes a greater risk for people with existing conditions as well as to black americans and others who live in communities of color.
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if you speak about her desk can he speak about your interest in social determinants and how that will start to address the health for racial and ethnic disparities that confront our nation. sen. casey: it was a pleasure to work on the impact act and the social -- mr. becerra: was a pleasure to work on the social impact of health and addressing those disparities. we know we need the data. we know we have to fill those gaps and i'm thrilled to see that so many members on both sides of the aisle are working towards addressing disparities and i look forward to continuing a partnership i had with you previously and with members on the committee. sen. casey: thank you, chair murray. sen. murray: thank you senator. senator murkowski, are you ready to go?
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>> senator murray, recognizes senator murkowski next. sen. murkowski: thank you, i couldn't hear her so i was not sure where we were. sen. murray: can you hear me now? >> we are recognizing senator murkowski next. sen. murkowski: thank you and welcome to the committee. i appreciated our discussion some days ago and the opportunity to drill down just a little bit further and you have come to this nomination with the background and experience you have had over in the other body. you are one who comes from a pretty urban area where we have had an opportunity to think about some of the specifics that are alaska specific but more broadly to rural itself.
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as a member of this committee as health matters are brought to bear i will always ask a question or many questions about rural health care along with senator collins here. i will start with that generally. you represented a population -- what we both acknowledge is sorely needed with regards to health care in both urban and rural parts of the country. specifically how do you make sure that we have adequate representation when it comes to the priorities of hhs, when it comes to accessing rural health care? our challenge is access to the care. when you don't have access to a
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care it is costly and very generally challenging. mr. becerra: thank you for the opportunity to chat with you previously. i enjoyed your laser focus on these issues and i think it's appropriate. the challenges that folks in your state face are unique, unique to rural communities and other states face it. even for alaska sometimes it's unique even among our rural communities. what we must do is make sure we are prepared to meet those unique needs, whether it is the workforce, the transportation obstacles that folks in the state of alaska will face, dealing with broadband, just making sure there is access. telehealth has become important. we discussed that as well. the most important thing i can do is trying to assure you that
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as much as the needs in rural america are unique i always tell folks when i was a member of the house that while i represented one of the most densely populated areas of the country, we had some of the greatest disparities. we did not have to travel 1500 miles to find the disparities, we can travel 15 miles from east los angeles to beverly hills. rural communities to face a different challenge, 15 miles is different from having to travel 1500 miles in one state. i will say to you that what i should do more than anything if i'm fortunate enough to be concerned -- confirmed his take you up on the invitation to go to alaska to see the challenges people in alaska face. sen. murkowski: i would encourage that and i would encourage that visit early. one of the areas where we have been innovative with regards to distribution of the covid-19 vaccines that are out there is
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how, through the ihs we have really been utilizing the experience of a distribution system that has been set up, and an ability to make things happen , not because we are following someone else's guidelines about because we know the need is there. we will be making key decisions with regards to funding allocations for providers for testing for vaccine distribution. what i have been hearing from folks back home is when we get the vaccine we are really good at pushing it out. we are number one in the country in terms of percentage of alaskans that have been vaccinated. i will ask for your support to be sure that when these funding allocation decisions are made that funding for rural areas is going to be prioritized as well. mr. becerra: i know that you and
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senator manchin are working on legislation to do that. i commit i will be at that table walk -- talking with you and those who understand the unique needs of rural america. the last thing i need would be one that does not address these disparities in an aggressive manner. i am fortunate that my mother is now 87 years of age. most people in my neighborhood at that time did not have health insurance and probably would not have survived such a difficult time like having your mom whisked away to the hospital. i'm committed to working with you to make sure that we whether it is for resources or for the workforce providing a type of services needed in rural america. sen. murkowski: one thing about covid-19 is we have shined a spotlight on where these health disparities are and focusing on those in rural areas is key. thank you.
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sen. murray: thank you, senator murkowski. i think we all agree on that. >> thank you, chair murray. welcome to the health committee. always good to see a familiar face from our days working together in the house on the affordable care act. as chair murray indicated in her opening statement, the previous administration never put a priority emphasis on public health. they did not work to protect those with pre-existing health conditions in the midst of the covid-19 pandemic, previous administrations doubled down on their efforts, many different efforts to stop improvements to our health care system actively seeking to overturn the affordable care act in court.
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as you note this particular court case threatened to take away coverage to millions of americans. a woman from green bay, wisconsin at 11 days old she was diagnosed with a serious heart defect and was airlifted to children's hospital in milwaukee, wisconsin to undergo closed heart surgery. she is now 24 years old and because of the affordable care act and the nearly 20 operations that she has undergone. she has had coverage and she wrote to me that all of these procedures are the reason i am alive. health care should be a right for all americans -- i could not agree more. i wanted to start with two
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overarching questions before digging down into specifics. as secretary, we have basically to provide greater access we have to not only repair the damage but also build back better with our health care system. what are the key ways in which you would strengthen our health care system after the damage that has been done in the previous administration, what would you go after first? how would you work to build back better in ensuring even more people have access to affordable quality health care coverage? mr. becerra: thank you for the question and great to see you again. i hope if all goes well and i am fortunate to be confirmed to once again work with you as i did for so many years when you were in the house and went to the senate.
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i can just take the words of our president himself. he has said that health care should be a right, not a privilege. that's a great place to start. if you have the most powerful person in the world saying that. we must build on what we have had with the affordable care act to make it stronger and provide better quality care and more affordable prices. two things i can tell you right off is something that the administration has moved on. to have an open enrollment period, a special open enrollment for americans who have lost their insurance, who never had it. right now during covid this is the worst time to not be insured. they open enrollment period will give a lot of americans a chance to get covered again. i know this is important to you and members of the congress. we have to deal with this cliff that so many americans face that
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when they are at middle-class status if they happen to get too high on their income, may be middle-class you have a pay bump after last year. all of a sudden you find it and you fall off a cliff when it comes to tax credits made available under the affordable care act to help you afford your insurance plan under the market exchanges in the affordable care act we have to do something to address the cliff too many families are facing to make affordable care act a reality for bore families. i want to mention those two principal ones and then i can go forward. sen. baldwin: thank you. i wanted to get into a very specific area of covid-19 pandemic. at the start of the pandemic increasing our ability to test was essential to our ability to track down and slow the spread of the virus. the same is true for funding and
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tracking areas that we find emerging. we cannot afford to make the same mistakes we did at the early stages where health care is unavailable. introducing bills to assist the cdc with resources and support the needs and dramatically scale up the coronavirus mutations. as secretary how would you ensure our federal health agencies are working together to do their part to take on the next phase of this pandemic and tracking the emergence of these mutations? mr. becerra: i know time is short to respond but i will say we need to coordinate much better. whether it is with the department of labor when it comes to people who have insurance through their employer or if they have to lose their job, whether it is working with the department of education on how we reopen schools, we need
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to coordinate much better. we have to be transparent. we have to use data to drive our decisions and let the american public understand how we do that. if we do it right people will have faith that what we are proposing will work. i look forward to working with you and your colleagues to make sure that we have a partnership with the american people because they believe it will work. sen. baldwin: thank you. sen. murray: senator braun? sen. braun: during our lengthy conversation when we visited the first time, i think it went well over a half an hour. i will tell you that upfront. for many of us, your record has been as very extreme on abortion issues, other pro-life groups have put a lot out there claiming that you have been
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against pro-life on the record. also issues with religious liberty manifest in where you actually took the court, little sisters of the poor. i'm not going to go into the details of that. i do want to ask you this question. if you get through the proceedings intact and you are the hhs secretary, you will be representing everyone. this is a very said sink question to the point. will you commit to not using taxpayer money to fund abortions and abortion providers? mr. becerra: if i can start by saying thank you for the lengthy conversation we had him i appreciate it. while we probably will not agree on all issues i can say that we will follow the law when it comes to the use of federal resources. there i can make that commitment that we will follow the law. sen. braun: not really the
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particular answer i was looking for, but i will take that. i want to move onto the next question. operation warp speed, in the early discussions we had with the fda, the cdc, there was squabbling within the bureaucracies about how we were going to get this effort made that we all knew at that time with the peculiarity of the disease that it was going to be the real light at the end of the tunnel. being an entrepreneur and knowing how the business world works, knowing that pharma has been so stodgy with its record in terms of coming to the forefront with new cures and so forth mostly impeded by some of the regulatory impediments. will you acknowledge that was probably the most important variable in this whole tough journey with covid-19 that we broke the paradigm of how things normally work by galvanizing
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pharma to come up with vaccines that took basically one fourth to 1/5 of time predicted before. mr. becerra: let me agree that had it not been that we knock some heads and said everybody has to come to the table, and it had to be the private sector working with government and local leaders we would not have had that success. what we have learned from covid, fda has learned i hope, if i'm fortunate to be confirmed i will make sure they learn that we can do things with a fast pace and still ensure safety. i think the gist of what you are asking is something we agree with. we should take the lessons we got from covid so we can do this faster, smarter, sen. braun: and safer. sen. braun:would -- sen. braun: would it be a stretch to give that credit to the trump administration? mr. becerra: they worked on it hard and it was a whole of
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government along with private sector response. without the work of the previous administration we would not be here. sen. braun: let's get to the part we spent our discussion on. i as the most vocal senate republican have said since i've been here that the health care system is broken. anything that costs twice as much as what it does elsewhere delivering results, i know we have some things that are stellar, but generally not good. we had a robust discussion about whether to throw more government into a broken system and here i think there would be republican support, if you are embracing the most popular next to term limits, that means it is around 90%. health care transparency across the board, before you answer i noticed that you are supported by the american hospital association. american medical association. 55% to 60% of the cost of our broken health care system.
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the association of insurance plans. the only one missing is pharma and i think i know i've. tell me that you would be there to push health care transparency to fix the system for you throw more government at it. mr. becerra: i want to thank you for the work you have done on this issue and that congress has done to move us forward. the american people are entitled to know what they are buying and especially if it's a life or death situation. we will do robust enforcement to make sure that price transparency is there for all americans. people never have an idea of what they are going to pay when they walk into a hospital. sen. braun: thank you. sen. murray: thank you, senator braun. senator murphy? sen. murphy: just because you sit on a committee of jurisdiction in congress does not make any of a subject matter experts on the areas in which we
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hold hearings. sitting before us is a health care expert. i have worked with him very closely in the house on the development of the aca and i have watched his work as attorney general. this is someone who is in the weeds of health care policy and health care coverage. i know we are lucky to have him lined up to be the next secretary. i wanted to build off of senator braun's comments because i think the health-care industry delights when we spend all of our time talking about who pays instead of how much we are paying. we talk about health care in this country as if it's primarily coverage. whereas the real problem here is the problem of price and you have done a lot of work in this area. i think a lot of the sutter health case in which you went after a huge health care provider that had essentially
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cornered the market such to drive up the costs of deliveries in the sacramento area so that nobody in the country was playing more then families were to deliver a baby there. from your experience working in this area of trying to assure competition in the provider space and the insurers space so as to drive down prices, what do you envision the federal government is able to do to try to make the marketplace. i think transparency is a piece of this, but some of it is anti-competitive practices amongst providers and insurers. what can the federal government do to have a functional marketplace in which prices are going down rather than being set? mr. becerra: i appreciate the question and it's great to see you again and i hope to have a chance to work with you in the future. i think senator braun hit on something important. transparency, if consumers do --
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they would push to make sure prices go down, not just that they know the price, but that the price goes down. that's why this was supported in california when we enacted the largest health care provider in northern california. people had a distinctive feeling that the prices they were paying was too high. we have to go it behind the curtain and see how they are operating. that is important and you all can help in congress to give us the tools to enforce. i would hope that i can work with you in the future to make that happen should i have the good fortune to be confirmed. we want to always spur innovation and we need the pharmaceutical industry in america to always feel like we have their back to innovate. covid is a perfect example of how we can come up with vaccine but we have to make sure we are getting our dollars worth. i think there is where we can give you tools to make sure we are getting our money's worth
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from all the different stakeholders in the industry. sen. murphy: i think transparency is a great place to start and there are limits to the gains you can get with respect to transparency alone because the most expensive interventions people have with health care systems are often at the moment where they are least able to shop around. i think the work you have done to go after these monopolies or because i monopolies i think is important. my second question is around another issue that i know is important to you, that is mental health parity. we have a great bipartisan coalition on this issue because we already have a law on the books that says insurers have to cover mental health just like physical health. we know that is not really how it works out there. anyone with a child with a mental health diagnosis knows they have to go through hoops and red tape that nobody has to go through when they are trying to get cancer treatment or reimbursement for more
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orthopedic procedures. tell us about your commitment to this issue and how you think hhs can really push forward. we don't have to spend more money here, we can just make sure insurance companies are providing the benefits they have promised to people and we will get a whole bunch more mental health coverage paid for. mr. becerra: he said it right and i could go back more than 30 years when i started working on this issue representing full with mental disabilities. we have to do the oversight and i would look forward to working with you to do that oversight to make sure that stakeholders in our health system are enforcing -- implying the law correctly. we have to ensure that we don't let people fall through the cracks. we have to coordinate with the department of labor because the department of labor has a lot to do with how these programs are implemented to get us to parity
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when it comes to mental health services. we can do a lot and i know many of you will work on this. i look forward to working with you on this. everybody knows about the need to do more, often what is left in the crevice is reaching parity when it comes to mental health services. sen. murphy: thank you, madam chair. senator romney? sen. romney: good to see you again. a couple of comments based on the conversation with sender murphy and senator braun. in the state of massachusetts we did put in place an extensive transparency program, it gives a very good data on the cost of various procedures in different hospitals as well as their success rate in those procedures. the consumer has very little interest in that data because
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for them the price is zero. in our system, individuals do not have an incentive to shop around for bypass surgery even if they have time to prepare it, because it's free. once you go past your deductible, and many people have, it is paid for 100% by the insurer or federal government. it is free so they don't care whether it costs $10,000 or $100,000 in bypass surgery. it is important in your role to look at how we create a true marketplace which means that the consumer has interest in what something costs and is anxious to shop around for elective surgeries and other high cost treatments, health savings accounts do that, and other countries they have coinsurance as a way of increasing a marketplace. there is a division in our country with regards to the issue of abortion as you know and mainstream republicans and
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mainstream democrats disagree. most people agree that partial-birth abortion is awful. you voted against a ban on partial birth abortion, why? mr. becerra: i understand that people have different, neatly held beliefs on this issue. i respect that. i have worked, as i have mentioned, for decades trying to protect the health of men and women young and old and as attorney general my job has been to follow the law and make sure others are following the law. i'm also sitting in front of a high risk ob/gyn who for several decades had the work of protecting the health of women and future babies. i will tell you that when i come to these issues, i understand that we may not always agree on where to go, but i think we can find some common ground on these issues.
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everyone wants to make sure that if you have an opportunity you are going to live a healthy life. i hope to be able to work with you and others to reach that common ground on different issues. >> i think we can reach common ground on many issues, but on partial-birth abortion it sounds like we are not going to reach common let me turn to medicare. you want to expand medicare. our current medicare program is unpacked -- is on track to go bankrupt. the trust act will be completely insolvent. how are we going to expand something that is always stashed already on the track to go bankrupt? what is the answer? this is of great concern with regard to not just medicare but medicare is the largest portion of our federal spending that is going much faster than the economy and which has the potential to sink our economic standing. mr. becerra: i think all of us
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would agree that our medicare beneficiary seniors who pay into the system for so many years should not be the ones that suffer -- sen. romney: nobody near retirement ought to see a change in the program that would affect the quality of the care they receive. mr. becerra: that means we are on track, if we have consensus, that we have to find a solution. one of the things president biden has proposed is to allow some americans to essentially buy into what is considered medicare at an earlier age. rather than use the current medicare system which involves a trust fund, he would try to bring some revenue in from the general fund so that we are not impacting the trust fund. there are ways to do this. >> we spend a lot of money on the general fund now. >> the priority should be to make sure americans have good quality health care. sen. romney: i think we pointed out we have a problem here.
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if it's already running a huge reading program, expanding it is not going to make things easier. we are going to have to find some way to make things work and i'm not sure that it administration has determined what that is. california has a lot going for it. the high-tech sector, great universities, but it is known for high taxes and high regulation. businesses have been leaving california and my state is a great beneficiary of that. republicans say watch out, if democrats get in charge they will make the country like california. his california working or is it making a mess of things? mr. becerra: thank you for applauding many of the things california does. california has recognized that we are one of 50 states. we may be one of 50 states, but we are the fifth economic power in the world. sen. romney: well you are big. mr. becerra: there are a whole
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bunch of countries who can't do what california does. we have been successful at graduating more people from college anyone else and having the number one industry in high-tech and agriculture and number one in manufacturing -- we have been able to bring innovators to the state. we have faced a lot of challenges as well. i think california has recognized that. we are fortunate to be part of this great country. i think you for giving me a chance to boast about my state. sen. murray: thank you, senator romney. we will turn to senator kaine. sen. kaine: thank you, congratulations on your nomination. there has been discussion around the table about your experience and i was reflecting, as lieutenant governor i have worked with six hhs secretaries. five have been attorneys or
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business people and they have had multi-year 10 years. one was a position and his tenure was measured in a matter of months. that's not to say the position cannot -- we have had plenty of good business folks and lawyers who have been strong hhs secretaries for both parties. here is what i like about your experience, not only your time in congress working on pivotal laws that will inform much of the work you do, but i like that you are coming from a state government. at the beginning of the biden administration i was nervous when i saw the covid panel put together -- the fact that you are coming as the attorney general of california with state level experience -- you have a nominee to be assistant secretary for health who was the chief official for the commonwealth of pennsylvania and the president of the national association of state and territorial health
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officials. i think that would put the top two health spots in hhs a strong state focus. we can do all kinds of great things if they are not able to be implemented at the state level. what good are they? i appreciate that aspect of your experience. so many things i want to ask you about, i'm concerned about the mental health needs of our health care workers and what they have experienced before covid and since march. an unprecedented scale and having to manage end-of-life discussions with patients holding ipads in front of their faces so they can talk to their family. this is going to have a significant consequence on our health care profession for a long time. we have health care workers who still today are worried about seeking mental health counseling because of stigma and concern about licensing or credentialing or that they could through some regulatory move at the state
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level face career ending or jeopardizing consequences. you are married to a physician. tell me the ways in which you would prioritize the mental health of our doctors, nurses, and health care professional should you be confirmed as hhs secretary? mr. becerra: thank you for the work you have done on this issue for so long. you are right, at the state level, the rubber hits the road and what you all do in congress, what i used to do when i was a member of the house is come up with the ideas and we pass it into law. it is the state elected leadership that has to make it work. i have to do everything i can to make sure that california through the leadership of our governor and state leaders is putting into effect the safety protocols necessary to make sure that we move forward. on the mental health of our workers, public health workers especially, we have to make sure we provide them with resources.
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they will be priority one when it comes to vaccine. we have to make sure they are rewarded and should not have to worry about whether they have enough money and coming home to feed the family. we have to make sure that we don't give stigma to getting mental health services. i faced this a lot in law enforcement with peace officers who are afraid to get mental health services because they are afraid it will go on their record and deprive opportunities to continue forward. we have to make providing mental health services something that is part of life. just like you get an annual checkup mental health should be a part of it. back to a previous conversation of making sure we treat mental health the same way we treat physical health, provide resources and parity to mental health and prove to people that we are serious about addressing mental health concerns. hassan: today, senate -- sen. kaine: today, senator
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bennett and i are introducing a public options bill similar to what president biden campaigned on. i hope to have the opportunity to work with you. this is back in the -- the acting hhs secretary recently indicated that it is likely that the public health emergency related to covid mice -- might be extended through 2021. talk about how you would work with governors and others as the administration is making that decision so they can have ample planning time for the ending of the emergency period. mr. becerra: science and data have to drive our decisions. if there is going to be a declaration of a health emergency or continuation it has to be based on real data, something that gives us that information. we have to be a partnership with the folks who have to implemented. we can say what we have to do but the folks who have to do it have to make it work.
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we have to do that in partnership. that means bringing the information to them early so they are part of data-driven solutions. i want to be respectful of my colleagues. -- sen. hassan: madam chair contest sen. kaine: madam chair, i yield back. -- sen. murray: i understand senator marshall has not returned. i will turn it to senator hassan? sen. kaine: thank you -- sen. hassan: thank you. welcome and thank you for being here for your interest and service and thank you to your family. this is a family commitment and we deeply appreciate your service. i want to start talking to you about the opioid epidemic and as you know it has devastated the communities across the state. since 2017i worked with colleagues to secure billions of dollars in state opioid response including more than $86 billion for new hampshire.
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this funding has enabled states to expand access to life-saving treatment -- beginning to see results with death rates decreasing. i am deeply concerned that progress is in jeopardy because the hardest hit states including new hampshire are at serious risk of a dramatic cut in state opioid response levels under the program's current funding formula. if confirmed will you commit to working with me and the substance abuse and mental health services administration to ensure that states do not experience dramatic cuts in state opioid response grant funding, cut that could jeopardize efforts to turn the tide on the opioid epidemic. mr. becerra: absolutely you have that commitment. sen. hassan: i want to turn to another issue connected with substance abuse. one major hurdle that keeps people who have substance abuse
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disorder from accessing this important treatment is the existence of the so-called x waiver, the requirement that doctors who want to prescribe medication assisted treatment receive a waiver or permission in order to prescribe the drug. the waiver limits the number of medical professionals who are neighbor -- able to prescribe this treatment even though it's considered a gold standard in medication assistance treatment. the waiver requirement does not include patient safety but limits access to care. 40 percent of counties across the united states lack a wavered practitioner who is able to provide this treatment. senator murkowski and i plan to reintroduce our bipartisan act that would eliminate the waiver requirement. we sent a letter to president biden inviting him to work with our bipartisan -- do you agree with president biden about the need to eliminate this waiver and will you commit to working with a
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bipartisan group on this much-needed reform? mr. becerra: thank you for the work you have done on this issue. president biden is supportive of moving forward. on a number of rules that are in place, i think there is a commitment on the part of this administration to make sure we are providing that treatment that is indispensable for so many families. sen. hassan: it is one of the sad and disturbing ironies of this crisis, that doctors do not need special permission to prescribe opioids, but they need special permission to prescribe medication that would help people combat the disorder and get better. mr. becerra: if i could add, i think the president's goal is to get it right. we don't want to end up in court and delay further. sen. hassan: senator cassidy and i spent several years working with a former health care committee and current chair marie on the bipartisan legislation to end the practice
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of surprise medical billing. a great example of the bipartisan work that can be accomplished in the congress when we work together to find common sense solutions. now that this private medical bill and legislation has been signed into law the responsibility to implement these protections will fall under the department of health and human services. if confirmed he will be responsible for implementing these policies quickly and in a manner that protects consumers and reflects congressional intent. you commit to working with us on a bipartisan basis to ensure that one year from now the rule issued by hhs includes strong protection for consumers that reflects the priorities and intent of our legislation? mr. becerra: we have until the beginning of 2022 to get this done. i know this was important to you so many -- thank you for the work you did to make it succeed and i hope they are partnered with you on this. i know we have to get this arbitration light -- right.
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just one last thing. scientist and public health experts work quickly to develop the moderna and pfizer vaccines. i believe in their effectiveness, but we also know that we are seeing the emergence of covid-19 variance and that we will need to continue research and surveillance efforts so that we can continue to develop effective treatments and vaccines. what steps do you believe we have to take to be prepared to of the emergence of these new variants and protect vulnerable populations? mr. becerra: sequencing is so critical. we have to have a scientist tell us what the next iteration of that virus may look like. we have to stay ahead of the game because with this vaccine we are getting a grip on covid. if a variant takes off, we don't want to go back to square one. we need to do sequencing and provide what they need and rely
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on data. we have a tremendous job to stay ahead of the variance. sen. murray: senator hassan, thank you so much. i believe we have -- senator burke, did you want to go next? senator, as i'm going to go over and vote and return. on our side i believe we have senator rosen and senator smith. i will let them go. do you want to go in between or after? 1 >> we will keep the order if another republican comes and i will slot him in. sen. murray: if we can do that then we will go to senator rosen, senator smith, and if a republican comes in we will put him or her between you. sen. rosen: thank you.
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-- thank you, madam chair and ranking member. thank you, mr. becerra for being with us today and thank you for your commitment to serving our nation. i appreciate the great and productive conversation that we had at the meeting last week and i look forward to learning more about your plans to combat the pandemic to distribute quickly the vaccine, to address our nation's provider shortage and increase access to quality, affordable health care. i urge this committee to facilitate a swift confirmation for mr. becerra so he can get immediately to work. the vaccine is on everybody's mind. the pandemic is hitting us particularly hard, especially with so much of our economy relying on travel. the best way to revive on economy is to increase the number of vaccines that continue to build on the good work of
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president biden. working together to make sure that no one is left behind and that the response is equitable. we have seen more vaccines coming into our state over the past week. the allocation formula is updating with the most recent population data -- so states like nevada get their fair share. will you commit to being sure that all the data is optimal as we begin -- continue to distribute vaccines across the country? mr. becerra: thank you for the question. and for the yeoman's work you have done in the state of nevada which is probably one of the hardest hit states. we will work with you to make sure the data is accurate. we want to make sure that we are sending the product, the vaccines, all that is needed where it is needed most. we will definitely look look forward to working with you to making sure nevada gets its fair
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share. sen. hassan: -- sen. rosen: we always have this problem in nevada and across the country, but the pandemic has shined a spotlight on that, a provider shortage issue in every county in nevada, a shortage of health care providers. the pandemic has accelerated the urgency for us to address these issues and all the challenges that surround it. our state ranks last per capita number of general surgeons, 48 for primary care and 45th for physicians overall. traveling about 300 miles just to find -- increasing the number of doctors, the university of las vegas nevada school of medicine is graduating their inaugural crest this year -- class this year. we have to increase our medical education, these are critical to
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addressing our provider shortages. we have to do more. would you commit to working with us to ensure that nevada is -- other states with similar issues receive their fair share of medical education slots -- what else can you help us to increase our provider shortages across -- professionals, let's talk about those. mr. becerra: thank you for the question. thank you to you and your colleagues for including the 1000 slots for graduate medical education so that we can actually see those future doctors in places like nevada and throughout the country. thank you for that. president biden has made the commitment, he wants to put 100,000 new public health workers out there to help states like nevada and make sure that you are reaching all of your communities and protecting them with vaccines and different
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things we have to do for to protect them from covid. we have to be there generally speaking long-term. my wife mentioned how it looks like there is an increasing number of americans who are applying to medical school. maybe it's because they have seen the efforts performed by so many medical professionals and they see it as a truly worthy profession to be in. we should take it and reward those going to the health profession. look forward to working with you and your colleagues to make that a reality so we can service the needs of all of our people. sen. rosen: thank you. in the quicktime i have i want to know what you think we should do in communities of color, our minority community's that covid has hit hardest. how do we ensure the greatest protection for them? mr. becerra: i look forward to working with you. let's use data to drive decisions so they are done transparently.
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let's ensure we make every effort to reach everyone. some communities will need mobile clinics so they can make sure they get the covid vaccination. we can do things but we have to work with those communities -- to want to reach populations that too often have gone absent. sen. rosen: i think my time is expired and i look forward to working with you in this administration. >> attorney general, this is senator smith calling in. i think since everybody is in the midst of voting i will jump in here and have a chance to ask my question. it's great to see you. i want to congratulate you on your nomination. i enjoyed the chance to talk with you a couple of weeks ago. i could hear in your comment, your commitment to public service and the potential to do
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good for people which i appreciate. we are nearly a year into the public health -- we are not going to get out of this economic crisis before dealing with public health crisis. we know this is going to require significant leadership and a national strategy and this is what many of my colleagues have been talking about today as we ask questions about this. i want to say at the outset that you clearly have the experience and the record of accomplishment to lead the department of human services. this is a complicated, massive agency with significant responsibilities. i want to point out that as california attorney general you ran one of the largest state departments of health and the country and you have also sent -- spent over 30 years of your
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career in public service fighting to help patients and families get the care they need. your record standing up to part -- price gouging by large hospital chains and taking on big opioid manufacturers, defending the health care of millions of americans is a qualification for this position. thank you. mr. becerra: thank you. i look forward to working with you on some of these issues. i hope you will invite me to your great state. i have so many good friends including your attorney general who i would love to see and there are many things to do. >> you and the attorney general have joined forces on many issues and especially including holding these pharmaceutical companies accountable for price gouging. i'm grateful for your work. in my time i have left i want to talk to you about another area of great importance to me and to so many families and businesses,
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the issue of child care. even before the pandemic, families were really struggling to find affordable, high-quality childcare. this is an issue across my country and the state. both in rural areas and metropolitan areas. i've spoken to parents in minnesota who are confronted with driving 15 miles -- 50 miles to take their children to childcare -- this challenge has become worse than covid because so many childcare providers have literally gone out of business or had to close their doors because of the challenges. this is why i have worked so closely with senator murray and senator warren [indiscernible] for relief [indiscernible] infrastructure for our economy and our families. [indiscernible]
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i know you understand the importance of elevating human service as a part of health and human services. can we talk a little bit about your priorities when it comes to childcare, about high-quality affordable childcare and how you see this happen and what it's like to make sure childcare is available. to keep women in the workforce and ensure -- mr. becerra: senator, thank you for the question. you are breaking up but i do believe you are asking how to meet this challenge and provide childcare to american families. i know you had great success in moving your legislation forward. childcare providers have been some of the hardest hit in america because of covid. especially when they are done well and safely they are indispensable to the rest of
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america that needs to get back to work. i hope to work with you if i'm fortunate enough to be confirmed to move on this. i think now in america, maybe 30 or 40 years ago we had not settled on this. i hope you have success moving forward and you the tuples hhs has to help you get there. sen. rosen: i look forward -- sen. smith: i look forward to working with you on that. chair murray, i will give back my time. sen. murray: thank you, so much senator smith. we turn to senator tupper ville. sen. tubeville: good morning. a couple of questions real quick. i'm concerned about president biden's freeze as we talked about some of his regulations
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that president trump put in as hhs secretary how are we going to get the price of insulin down? we have to get it down. people can't afford it. mr. becerra: on the issue of the freeze, i think that pretty much every administration wants to take a look at the landscape and see where things are. as they come in they can move forward. there is a pause in many of the rules that were proposed moving forward but i guarantee as quickly as the president and his team can we will get back to moving forward on these administrative actions and in terms of insulin, thank you for -- i thought it was a great conversation, i hope i did not take up too much of your time. on insulin, patients have to come first. we have to make sure they are not going to get caught in this mess of how much it costs. there's no reason the price of insulin should jump by 100% overnight. we have to deal with that. we want to make sure the drug
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manufacturers are properly compensated, but at the same time these are life-saving medications that people need and we have to make them available. i look forward to working with you and your colleagues to do that. sen. tuberville: one thing i'm concerned about with drugs. rural pharmacies especially in the state of alabama, they are like hospitals or doctors offices. they are the only connection they have to health care and some of these areas. they are losing some of them because of pbm's. they getting priced out. i saw the work you did with several attorney general's across the country to explain your plan with pbms and cutting out the middleman where our pharmacies can make money. >> the pharmaceutical benefit managers have a role. sen. tuberville: i hadn't figured it out yet. mr. becerra: the road can't just
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be middlemen to couch the price. they did not take too big a cut. they play an indispensable part in the way we run through the process of dispensing medications. we have to keep them on their toes. a number of state attorney generals took on the pbm's because at the end of the day they are supposed to serve a purpose of getting a good price for medicare for the drugs that our seniors need. we have come up with a solution just as the state a.g.'s, much has to be done at the federal level. i look forward to working with you on that. they serve a purpose but it has to be the purpose of getting good priced medication to our seniors. senator tuberville: seems like they are working for the bigger pharmacist and hospitals, and the rule the smaller pharmacies are paying these rebates and paying the profits. we can't lose them in these rural areas across the country f we do, we are going to be in
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serious trouble. alabama, for instance, we have lost 14 hospitals in 10 years. rural hospitals. the only thing they have left is a pharmacy. when you are confirmed, i would love for you to pay close attention to them. make sure these people make a little money. make a little money so they can stay open. mr. becerra: i'm looking forward to working with you. the little guy who is, especially since they service some of the small communities, should not be the one that is lose because the big guys are trampling all over them. look forward to working with you. senator tuberville: thank you, mr. chairman. chairman murray: senator marshall, believe that senator marshall -- senator moran is not back, is that correct? i believe that is true. attorney general becerra, we had folks and members coming and going. i know that senator burr is going to return in a minute. is senator marshall available? senator marshall: yes. chairman murray: i turn it to
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senator marshall. senator marshall: thank you so much. welcome to the hearing here, mr. becerra. we are glad to have you. i want to first if i could just submit for the record the vaccine distribution plans from every state in the union. i think that we had most of these back in october, maybe there was some confusion about those. we've got all 50 of them here. if that's ok with you, madam chair. chairman murray: yes. senator marshall: let's talk about pharmacy prices. over the past three to four years, pharmacy price vs. pretty well stabilized in this country -- prices have pretty well stabilized in this country. my question is what stabilized the price? and what role do you feel pharmacy benefit managers have to do with the price of pharmacies at the counter? mr. becerra: senator, thank you very much for the chance to answer the question. senator tuberville just touched on that issue. as i mentioned p.b.m.'s play a
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role. they have an important role to make sure we get these prescription medications to the source, the consumer, the senior on medicare. we have to make sure everyone is doing their part. and right now we see that there is a growing fight developing between the manufacturers of these medications and p.b.m.'s and the providers. we have to make sure that at the end of the day our seniors around the ones paying the price. they are the ones that need the drugs. we have to make sure they get them at good cost. i can't tell you, i can give you the solution in the time you have, in the five minutes, but i am willing to work with you. that is before us right now. senator marshall: how many pharmacy benefit managers are there and how much of the market do they control? mr. becerra: great question. i can try to get back to you. senator marshall: i think there are four and they control over 80% of the market. one of my concerns as i look over at h.h.s. and the office here, been there once or three times, and i look around. there's lots of lawyers.
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lots of bureaucrats. but how many nurses and pharmacycieses -- pharmacists and doctors and those type of people working here in washington, d.c., at h.h.s.? what percentage of your staff of 80,000 people? mr. becerra: you are gracious to call them my staff. i have not yet been confirmed. i hope that's a signal i will be confirmed. a great number of them are health care professionals. certainly the people that are at the top levels of some of our important agencies, c.d.c., n.i.h., f.d.a. have health care and medical backgrounds. and we are going to make sure that the team -- know this from speaking to the president. that the team in place at h.h.s. will have the expertise that we need to do all the work because h.h.s. isn't just about delivering on services on health care, it's about being stewards of the purse. as someone said earlier, h.h.s. has the largest budget of any federal agency, including
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department of defense. senator marshall: talk about value based health care for a second. some of the legislation that we worked on is legislation called the regulatory sprint to coordinated care. what that had to do with was start anti-kick back for doctors participating in value-based care. and another one of our signature legislations we worked on is prior authorization issues. practicing doctor, myself, it's pretty cumbersome to have a person who's never practiced medicine tell me i can't do a surgery i think is necessary. just in general how do you feel about value-based health care and what its impact could be on frankly the cost and quality of health care? mr. becerra: first, if i could comment and say this is where the practical work that you have done informs the work that congress must do, because you can talk about these things not just from your own thoughts, but because of your practice. what will i tell you is that when it comes -- what i will tell you is that when it comes to making sure we are
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administering these programs -- can you pose the question again? i was going to go on a different tangent. senator marshall: what do you think value-based health care and in particular allowing physicians to participate in value-health care arrangements. mr. becerra: we have been moving -- remember during the entire affordable care act debate it was all about making sure we are talking about value versus volume. instead of having people coming through your door and not really tracking them, it's are we extracting value out of the service that you as a doctor, hospital provider so that we follow that patient all the way through. if we truly do this is right way, we will reduce the number of visits, we'll reduce the number of incidents, and we'll provide quality care instead of quantity of care. senator mashe shall: i think about patient outcomes. i think about the patient experience divided by the cost of that. i look forward to a secretary round of questions. that went by pretty fast.
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thank you. mr. becerra: thanks, senator. chairman murray: thank you very much. we'll go to senator moran. senator moran: thank you very much. attorney general, nice to see you. thank you. i'll try to get through three topics as quickly as i can. let me start with 340-b drug pricing. mr. attorney general you led a multistate letter to h.h.s. to address the discounts and the drug manufacturers discounts in the program, our kansas attorney general joined in you that letter. but i continue to hear 340-b has been a significant issue for as long as i have been in the senate, maybe as long as i have been in the congress. we continue to hear of dire circumstances with our health care providers, our hospitals, particular our -- particularly our community health centers. the community health center of northeast cans is expecting to lose $300,000 in revenue this year alone due to the 340-b issue. le bfment et health.
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-- lebet health. if you are confirmed, how do you protect the integrity of the program and make sure it works for the provider as well as the patients. mr. becerra: thank you for the question. here i will tell you in a the previous administration issued some guidance. they issued an advisory opinion. we'll try to build on the work that's been done in the past, but what we must do we cannot sacrifice patients. they should not be the one that is suffer of the consequence of the fight. i will guarantee if i am fortunate to be confirmed i look forward to sitting down and working with you and others interested in addressing this issue. 340-b has become an indispensable program for some of these providers helping some of our neediesty populations. senator moran: the rure hospitals are on the culp. covid has not been helpful. but they are always hanging on by a thread. the 340-b program is perhaps one of the most important. if it disappears in providing
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resources to hospitals and their patients, we are going to lose another series of hospitals in kansas. i assume california and across the country. mr. becerra: agreed. senator moran: let me ask you, attorney general, i want to talk about the nation's health care infrastructure in the world of transplants. this country has the world's leading transplant surgeons and hospitals, but thousands of people die every year because of a scarcity of donated organs. currently there are 100,000 americans waiting on a kidney transplant. do you agree that h.h.s. should be working to increase the number of kidney transplants nationwide? mr. becerra: we have to do much more because, you're right, there are too many people going with unmet need and dying. senator moran: if you are the secretary at h.h.s., will you fact against policies expected to reduce the number of kidney transplants nationwide? mr. becerra: i certainly will try to work with you on some of these issues. it would be difficult to make a commitment right now before i have a chance to step into the shoes.
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senator moran: secretary alex azar, told us, he was powerless to prevent changes in policies from taking effect. i hope at h.h.s., as a secretary, you would have the capabilities in dealing with the agencies within your department who deal with this issue. would that be your desire? mr. becerra: those subagencies that will be my desire. senator moran: h.h.s. contractor responsible for organ transplants, the united network for organ sharing, is currently under a bipartisan investigation by our finance committee. but is still set to implement a policy in mid march that feakts kidney transplants. i set the stage for you in asking my questions. this policy was opposed by a large majority of transplant professionals and the government's data predicts it will result in fewer transplants and more patients dying. i need your commitment that you will work with me and others in similar circumstances to see that the transplant program is improved, not harmed. and that transplants that --
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organs donated in a region are able to stay within that proximity to be donated to those who need them within that region. mr. becerra: senator, you have my commitment to work with you on that. senator moran: thank you very much. let me highlight the importance of telehealth. we have seen this for as long as i have been in congress. we have been working to increase broadband services across the country. we have seen in the covid-19 response the inability to do so in the area of education and health care. there are a number of provision that is were provided in the cares act and other legislation that waives certain requirements for telehealth including reimbursement at rates as if you were in the office of the provider as compared to on the telehealth. those, i hope, will garner your support. i think what we have learned is they are not just necessary during covid, they are necessary into the future after the days
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of covid are behind us. and again i would ask you if you agree with that sentiment and will work to see that the provision that is we have made to enhance the availability of telehealth continue. mr. becerra: senator, hole heartedly i believe we are going doing expense of telehealth. it's also the issue of broadband, making sure communities have access to broadband f we don't learn from covid how telehealth can help save lives we are in trouble. i look forwarded to working with you. senator moran: thank you for your answers. chairman murray: thank you very much. senator burr has not yet returned. we are waiting for senator hickenlooper. i'm going to go ahead with my second round of questions and hopefully senator burr will return. senator marshall wanted a second round. he'll be able to do that. attorney general becerra, this pandemic has really caused significantly more hardship for communities of color. worsening, under mining health inequities result interesting a
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long history of structural racism, discrimination, and i am deeply frustrated by how the trump administration ignored those inengeck which is in the pandemic response and many cases made them worse. i issued a report on the impact of the pandemic on communities of color last year that included several recommendations about the need to address health inequities in this country. we've got to make progress in addressing those recommendations. we need to offer support to black, latino, tribal communities, and other communities of color to make sure that those who are suffering the most from this pandemic are at the forefront of our response. we need to address discrimination within our health care system by investing in health care providers who serve those communities. and we have to work to make sure all people including families of color and people who are paid low income have access to high quality affordable care. and we need to make some new
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financial investments in the health communities of color. we have to do better not just on covid but a lot of our health care issues that are particularly harmful for communities of color, issues you know well, maternal mortality, insuring people of color, pregnant, and lactating women, and other underserved populations are included in research and clinical trials. work to combat health inequities must be woven into the fabric of everything we do to advance public health and create a fair health care system. attorney general becerra, you have expressed that health care equity will be a priority for you. and i actually have been very heartened to see the president appoint leading experts to his covid-19 health equity task force. can you comment on how you will incorporate health equity across your work as secretary? mr. becerra: senator, you said it so well. what i can add is that we will
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have a team at h.h.s. that lives and breathes the desire to have health equity. we will have people who have experience in that field and we will move to make sure we have the resources put in place. something as simple as making sure i mentioned before that our surveys are when n.i.h. is doing a study or c.d.c. is doing work that we are including these population that is have often been left behind so that when we get results, we get results that are good nor -- for everyone, especially those communities left out in the past. we have to make sure we reach out to these communities because they are just starving to hear from us. they want to know that they count. if we turn to their respected religious, risk leaders, we'll have -- civic leaders, we'll be able to have access t does start here to make sure our policies reflect our words t does help to have the leader of this country, the president of the united
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states, say she's committed to it and demonstrated by one of the first things did he is empaneling this covid task force. chairman murray: i look forward to working with you on that. i do want to take a moment to highlight h.h.s.'s role in childcare and early childhood education. we know that even before this pandemic our nation was facing a childcare crisis. parents across the country were paying more than they could afford for childcare and they were really struggling to find available childcare in their communities. early childhood educators were earning quality level pages despite doing critical work each day to split our children, families and economy. now the coronavirus pandemic has further destabilized our childcare sector and childcare providers are now at risk of merm closure while parents are continuing to serve their childcare needs. this is unfortunately still a responsibility that disproportionately falls on women. and is one of the reasons we are
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seeing so many women leave the work force today. so we need a strong childcare system to advance our nation's economic recovery so parents can get the childcare they need to return to work. attorney general becerra, you have advocated during the pandemic for additional investments in the childcare sector. you have been a supporter of early childhood education since your time in congress. i wanted to just ask you to comment on that. on what action you see we need to take four affordable childcare for working families. mr. becerra: i think the covid pandemic has made clear to so many americans how indispensable childcare workers are. they are worth their weight in gold. i hope that what we see as a result of covid is a true recognition of the value of childcare workers, of our teachers, and reward them properly so that we can make sure we have the professionals we need taking care of the future leaders, perhaps a future president, future senator of
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america. and it is in their hands that we put our most precious possessions and future of our country. chairman murray: thank you very much. i know that senator burr has returned. we are waiting for senator hickenlooper to jump online. is he available yet? if not, did senator hickenlooper, you are on if you are ready. senator hickenlooper: yes, i am. appreciate your -- we are trying to get the vote in. i apologize for being a little late to the party. i wanted to first off congratulate our nominee for secretary of health and human services. i think he's going to bring deep experience and clearly your passion for public service to the department. health care and small businesses are -- they go hand in hand.
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i think small businesses are the heart of our community but they facial a razor-thin margin, a challenge made worse by the pandemic. even before the pandemic in 2019, a commonwealth poll found that 74% of small business owners had considered the cost of providing health insurance to their employees as a major or minor problem. how would you suggest, think about -- how would you plan to support small businesses and their employees and help them make sure they can access the health insurance that they need at an affordable cost? mr. becerra: senator, first thank you very much for having given me a chance to sit down with you. i appreciated the conversation we had. president biden made it very clear in his rescue package. we need to do more. some of the support, the resources will be focused on our small businesses. we have to make sure we don't forget those. one of the things we can do at the federal level because we contract out so much of the work
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that we do, is to make sure that our agencies are looking to hire small businesses to do the work, the contracting work that we must have done. we should have an emphasis. i hope to be able to work with our small business administration administrator to make sure that so much of the work that will emanate from h.h.s. does go to our small businesses throughout the country. senator hickenlooper: we agree with that. i think -- as you know many of the providers, primary care physicians, dentists, eye doctors, nurse practitioners are often small businesses serving the health care needs of towns across the country. and yet the american association of american medical colleges projects by 2033 we could have a physician shortage upwards of 100,000. the main shortage will be in primary care, but hardest hit will be rural and underserved, urban communities. what can we do to provide more
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support and increase the number of primary care practices, especially in those rural and underserved areas? mr. becerra: i speak as someone who, at the kitchen table, hears this constantly from my better half about what we can do to really get the medical community to be moreau bust. -- more robust. one of the things is give them a chance to know they'll be rewarded for everything they do. too oftentimes those future doctors go into the specialty care fields. there is more remuneration in those fields. primary care, everyone has to go through their primary care doctor before they see a specialist. it's important that we reward the work that's being done by those primary fir physicians. you made a major investment in getting more doctors out there in the future when you put in 1,000 slots in the g.m.e.
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program to bring out more future physicians. will i tell you it's become clear how indispensable our health care workers, especially our medical professionals, are. i hope that what we find is that our medical schools, our nursing schools, all our health care teaching institutions see a rise in the number of people who are applying to become the next generation of health care givers who save lives. senator hickenlooper: we agree with that. my next question, i should have started off and thank you for spending time with me before this hearing. we talked a little bit about climate change. i appreciate very much your perspective and we agree that climate change does really pose a major threat to public health. we have directly seen the devastating effects of wildfires in colorado and growing natural disasters are harming
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communities across the country. look at texas and especially the south this last week. increasingly frequent national disasters they are harming air quality, water quality, and public safety around the country. as h.h.s. secretary how would you respond to the growing health impacts of climate change and how would you go about addressing the fact that these public health impacts disproportionately harm communities of color and other vulnerable communities? mr. becerra: i could spend all the time we have to talk about it. let me mention a couple. just last year places like san francisco, sacramento, very urbanized areas lost sight of the sun when we saw these wildfires raging outside of our areas. but the smoke reaching our densely populated urban areas. we have to do something much more. we have to do it for those communities hit first and worst. that's why at the california department of justice i
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established the environmental justice bureau because too often decisions made today won't be seen until later having an effect on our communities. those that are hit first and worst will be those disadvantaged communities. our environmental justice bureau works with our local leaders to make sure as we think about development we think about the future and what the impact will be. there is no doubt in the breadbasket of the world, the central valley of california, one in every four children has asthma. that should not be. and we have to tackle this now because if we don't it won't just be one in four children who has asthma. it will be far worse. i look forward to working with you and your colleagues to make sure we can truly address the health effects of high klatt mange. senator hickenlooper: thank you very much. i look forward to working with you as well. chairman murray: thank you. senator marshall, i understand you had additional questions. senator marshall: thank you again, chairwoman. maybe just a couple quick ones.
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ru-486 is a drug i never prescribed but unfortunately had to take care of people with complications from t cramming, bleeding, hemorrhaging in the emergency room. i have been told is that you supported removing current safety regulations just wanted to know your position on that. not only am i concerned about the physical care of that patient, but anyone that's taken this pill for an abortion obviously need emotional support. i hate to see those drugs, and birth control pills for that matter handed out like candy. these drugs do have serious complications. i do want women to have access to family planning. but this ru-486 drug very much concerns me. mr. becerra: senator, thank you for the question. when i took action along with many that all members may have five legislative days to revise and extend their remarks state a.g. colleagues it was to try to make sure that all americans had access to the care they needed without having to worry about covid becoming a danger.
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the fact that we are able to dispense care without having to have our families actually show up at the doctor's office to telehealth -- through telehealth and other means is something we should build on. and any obstacles to getting safe care should be removed. and our letter that we directed on ru-486 was to make sure women who wanted to make -- take advantage of health services that they had within their reach didn't have to do so by risking the contraction of covid in order to get that health care. that was the purpose of that letter is to make sure that like any american we don't jeopardize the health through contracting of covid for americans who need to access certain care. senator marshall: covid's not an execution for sloppy medicine. the office of global affairs is the diplomatic voice of h.h.s. frankly i have a lot of concern with the world health organization. we need a strong world health
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organization, but i think they have lost their way. i think they have helped cover up the origins of the virus and there is so much we could learn from getting access to the original records. going back and understand how this virus has mutated. they probably have 20 years' of data studying bat dung and what this virus has done would help us prepare a vaccine for the future. but instead of world health organization appears to be working for the communist party of china. do you support us getting back in the world health organization? we give 24% of their budget, yet they have not become -- they are not being a good friend to america or the rest of the world right now. mr. becerra: senator, thank you for the question. and for expressing your concerns to make sure that if we are going to be involved in these international organizations that there is value not just for us but for everyone. what i can tell you is that president biden has made it very clear he's committed to getting back into the world health organization. at the g-7 meeting that recently
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occurred, h.h.s. was represented so we could try to move forward to try to deal with covid beyond our borders, because our security, our economic, our health security really depends on not just controlling covid within our borders, but outside our borders. and so it is important that we engage with our community, global partners, as best we k as you said, we make sure that everyone is held accountable, not just the u.s. but everyone is held accountable when we participate in these global bodies. senator marshall: lastly, believe with all my heart we can have herd immunalt from this virus in april or may if the president and his team, you, do your job and governors do their job. there is incredible news coming out this last week that the vaccines, after one shot, are 75% to 80% effective. we have given 75 million people vaccinations. we'll have 90 million by the end
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of this month. this country has the compass to the do three million flu vaccination as day. we do that every year. we can give three million covid virus vaccinations every day. that should put us over 150 million by the end of march. many of us think that 2r5% or 50% of americans have already been exposed to the virus or had the virus. i think that it's fezzible to have herd immunity in april or may. i know thaur' not going to promise we can do that. if we don't have a goal-to-cheemb what others don't think we can do, we are not going to ever get anywhere. what would be your goal to have herd immunity? what time frame? mr. becerra: senator, great question. i know this is something 23450er and -- near and dear to you. i think president biden's been very clear. he's going to push the limit in making us get there and do it safely. that's why he said before he even took office and knew what he was inheriting that his goal was to have 100 million shots in
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american arms within the first 100 days. but if these trends continue, as you just mentioned, that does bode well for all of us. so we are not going to give up. the president has now secured another 100 million doses of vaccines. so we are now on course to have the 600 million vaccines. you are talking now about two shots. enough to cover every adult in america with the vaccine. i hope what you just articulated is where we are going because if that's the case, then not only is the health of america going to improve quickly, but our economy will as well. senator msh shall: 100 million in 100 days not acceptable. that we can get there by april or may if we do our jobs. good luck. we are here to put wind beneath your sails as we go forward. thank you. mr. becerra: we look forward to that wind beneath our wings. chairman murray: senator burr. senator burr: thank you, madam chairman. thank you for holding this
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hearing. thank you for taking over two hours of fire from every member of this committee. madam chairman, i'm going to submit my questions for the record. no sense taking up additional time. i would like to conclude by saying this. if we don't handle covid correctly, we are going to see the most dramatic demographic shift in america, and you and i may not be claiming the successes of our state because they may be in far-flung rural areas hunkered down and operating off of the internet in some fashion, zoom or webex or something. if we don't get our kids back in school, you know what, we are not going to grow the talent we need in the future. the jury's out whether one year interruption or two years' interruption kills a whole
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generation. none of us know the answers but we ought to be doing everything we can to minimize that today. the last thing, if we don't learn from what we have gone through, we don't learn from our experiences with covid, like the changes we need to re-authorize the things that worked, plan on others -- other disease that is could jump top humans and invest in companies that can develop the technologies that make vaccine production even shorter than what we have seen with covid-19, then i will assure you this will be devastating to our children and our grandchildren. we may not be here as legislators. we may not be here as citizens. but our children and our grandchildren are counting on us to make the right decisions. i am convinced that the table has been set. and the question is, will we collectively go to that table and handle some very tough issues? sir, i thank you for being here.
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chairman murray, thank you for holding this confirmation hearing. and i look forward to working with you and we can get -- actually, i'll see you tomorrow. then i'll work with ranking member crapo and chairman widen -- wyden to see when your nomination goes to the floor. thank you, madam chairman. chairman murray: thank you very much. that will end our hearing for today. i want to thank attorney general becerra for joining us to talk with how he's going to work with congress to end this pandemic and help people get quality affordable health care and systemic racism in our health care system and tackle many challenges facing our families and patients and health care workers. i want to thank all of the members of this committee for participating. given the continued urgency of this pandemic, i hope the senate can work together to confirm attorney general becerra in a quick party way. for any senators who wish to ask
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additional questions of the nominee, questions for the record will be due by wednesday, february 24, at 5:00 p.m. the hearing record will remain open for 10 days for members who wish to submit additional materials for the record. on thursday, february 25, we will convene in this room at 10:00 a.m. for a hearing on the nomination of the surgeon general and the assistant secretary of h.u.d. committee stands adjourned. [captions copyright national cable satellite corp. 2021] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org]
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>> health and human services secretary nominee javier becerra will be back on capitol hill tomorrow for his second capitol hill hearing. he will be testifying before the senate finance committee. you can also listen live on the free c-span radio app. you are watching c-span, your unfiltered view of government. c-span was created by america's cable television companies in 1979. today, we are brought to you by these television companies to provide c-span to viewers as a public service. president biden held his first formal meeting with canadian prime minister justin trudeau to talk about bilateral cooperation on covid-19, climate change and

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