Hearing the Hill

March 09, 2023 | Devon Page

Main reading room at the Library of Congress. ASTHO Federal Health Policy Update banner in upper left.CSPAN is no Netflix. But that’s not to say this endless stream of content fails to entertain. In one short month, the new Congress has held several richly informative—and sometimes lively—hearings regarding the nation’s most pressing public health topics. The debates over COVID-19 funding, government oversight, and substance control—to name a few—illuminate the multiplicity of party agendas, how members of Congress are grappling with different issues, and opportunities for bipartisan collaboration.

Since assuming the majority, House Republicans have been dutifully fulfilling their promise to scrutinize the origins of, funding for, and agency response to COVID-19. Three hearings were held in the first two weeks of February alone.

The House Committee on Oversight and Accountability held a Feb. 2 hearing to discuss what Chair James Comer (R-KY) called “the greatest theft of taxpayer dollars in American history,” namely the fraud and improper payments that occurred within pandemic relief programs such as the Paycheck Protection Program, the Economic Injury Disaster Loan Program, and the Unemployment Insurance program. the fraud and improper payments that occurred within pandemic relief programs such as the Paycheck Protection Program, the Economic Injury Disaster Loan Program, and the Unemployment Insurance program.

The hearing spotlighted the tradeoff between urgency and accountability: essentially, getting loans out the door quickly created vulnerabilities for fraud. To make matters worse, agencies were slow to implement modernization policies, such as data sharing between agencies, which only exacerbated the problem.

While politicking reared its face in some cross-aisle imputations, committee members on the whole recognized that the issue warranted attention and demonstrated a willingness to work together to produce solutions to avoid similar instances of fraud in the future.

Just down the hall, the House Committee on Energy and Commerce was holding a hearing titled, “Challenges and Opportunities to Investigating the Origins of Pandemics and Other Biological Events.”

Here again, agreement penetrated party lines. Proactively addressing pandemics seemed a unanimous priority, albeit with some caveats: House Republicans focused chiefly on identifying the origin of the COVID-19 pandemic to help the U.S. better prepare for the next pandemic, where House Democrats tied this into preparedness and infrastructure.

The blockbuster event of the COVID-19 hearings occurred a week later, featuring Lawrence Tabak of NIH, FDA Commissioner Robert Califf, and CDC Director Rochelle Walensky. Representatives, with a markedly more partisan fervor, explored a myriad of topics—from the impact of CDC guidance on declining public trust to NIH laggard interventional clinical trials for long COVID research—and expressed a mix of dissatisfaction and approval.

Amid criticism from largely the conservative members, Walensky was steadfast in requesting broader public health data and workforce authority, as well as robust funding for public health core capacities. Rep. Diana DeGette (D-CO) echoed the director, calling for updated agency data infrastructure. The strong partisanship and serrated critiques of the agencies made clear the canyon-sized gap separating Democrats and Republicans on the federal COVID-19 response.

In each of these hearings, at least one representative made mention of a different priority of this Congress: the fentanyl crisis. On Feb. 1, a House Energy and Commerce Health Subcommittee hearing was devoted entirely to the subject. And while Chair Brett Guthrie (R-KY) and Ranking Member Anna Eshoo (D-CA) appear postured to produce bipartisan legislation, differences in how the parties want to approach the issue are not insignificant. Republicans, on the one hand, favor classifying fentanyl as a Schedule 1 drug and cracking down on smuggling across the United States-Mexico border, while some Democrats strongly resist such measures. These points will likely be hashed out in future debates concerning H.R. 467, the Halt Fentanyl Act, and similar legislation.

The committee also touched on the importance of investing in mental health. Rep. Tony Cárdenas (D-CA) emphasized the value of the 988 Hotline, and introduced H.R 498, the 988 Lifeline Cybersecurity Responsibility Act, to protect the hotline from cybersecurity incidents.

Additionally, Rep. John Sarbanes (D-MD) requested that SAMHA’s Chief Medical Officer Neerja Gandotra, one of the hearing’s witnesses, explain why continued investment in mental health programs is paramount. Gandotra noted that the investments, specifically in youth, lead to decreased criminal justice involvement, fewer hospitalizations, and improved performance in school.

There was also a Feb. 9 Senate hearing examining the state of the U.S. territories, which included testimony from the governors of the U.S. Virgin Islands, Guam, Puerto Rico, American Samoa, and Commonwealth of the Northern Mariana Islands. Both parties were resolute in supporting the governments. Several senators, including Ranking Member John Barrasso (R-WY) and Senator Mazie Hirono (D-HI), emphasized the importance of supporting Compacts of Free Association (COFA) citizens’ health and social safety nets.

With just about 90% of this Congress’s session ahead of them, these issues, among others, will certainly be probed further as the object of congressional concern. Regarding public health, much remains to be said and—hopefully—done. Bipartisanship, no doubt to the surprise of many commentators, seems to be the reigning attitude: a sign of things to come or merely pretense? Only time will tell.