Testimony from Alex M. Azar II on The President's FY 2021 Budget before The United States Senate Committee on Finance

As Prepared for Delivery

Chairman Grassley, Ranking Member Wyden, thank you for inviting me to discuss the President’s Budget for Fiscal Year 2021.

I am honored to appear before this committee for budget testimony as HHS Secretary for the third time, especially after the remarkable year of results that the men and women of HHS have produced. With support from this committee in many respects, this past year, we have seen the number of drug overdose deaths begin to decline for the first time in two decades; another record year of generic drug approvals from FDA; and historic drops in Medicare Advantage, Medicare Part D, and insurance exchange premiums.

The President’s budget aims to continue delivering these kinds of results and move toward a future where HHS’s programs work better for the people we serve; where our human services programs put people at the center; and where America’s healthcare system is affordable, personalized, puts patients in control, and treats you like a human being, not a number.

That is the vision behind this budget.

I want to note that HHS has the largest discretionary budget of any non-defense department, which means that there are, again this year, difficult decisions made in order to put discretionary spending on a sustainable path.

The President’s Budget proposes to protect what works in our healthcare system and make it better, and I’ll mention two ways we do that: first, by facilitating patient-centered markets in healthcare and, second, by tackling key, impactable health challenges.

The healthcare reforms in the President’s budget aim to put the patient at the center. It would, for instance, eliminate cost-sharing for colonoscopies, a life-saving preventive service. We would reduce patient coinsurance and promote competition by paying the same for certain services in hospitals and outpatient settings.

The Budget endorses bipartisan, bicameral drug pricing legislation like the plans formulated by Chairman Grassley and Ranking Member Wyden, and supported by many members of this committee, as well as price transparency efforts that many of you have championed.

These reforms will improve Medicare and extend the life of the hospital insurance fund for at least 25 years.

We propose investing $116 million in HHS’s initiative to reduce maternal mortality and morbidity, and we propose reforms to tackle the rural health crisis in America, including expansions of telehealth and new flexibility for rural hospitals. The Budget increases investments to combat the opioid epidemic, including the State Opioid Response program, which we have focused on providing medication-assisted treatment while working with Congress to give states flexibility to address stimulants like methamphetamines.

We request $716 million to expand implementation of the President’s initiative to end the HIV epidemic in America by using the effective, evidence-based tools we have at our disposal, as we’ve already begun doing, with Congress’s help, in four jurisdictions.

Finally, the Budget reflects how seriously we take the threat of other infectious diseases—such as the China coronavirus, which has been a top priority for me as I’ve led the federal government’s coordinated response as chairman of the President’s Coronavirus Task Force.

The Budget prioritizes funding for CDC’s infectious disease programs and maintains effective investments in hospital preparedness.

Last night, we announced the 14th confirmed case of the China coronavirus in the U.S., and this morning, CDC will be announcing the 15th—both of whom came from Wuhan and are in quarantine. As of today, I can announce that the CDC has begun working with health departments in five cities to use its flu surveillance network to begin testing individuals with flu-like symptoms for the coronavirus. Many questions about the virus remain, and this effort will help see whether there is broader spread than we have been able to detect so far.

On the human services side, the goals of the Budget are similar: We cut back on programs that lack proven results, while reforming programs like TANF to drive state investments in supporting work and all the benefits it brings for well-being.

This year’s Budget aims to protect and enhance Americans’ well-being and deliver Americans a more affordable, personalized healthcare system that works better, rather than just spends more. I look forward to working with this committee to make that commonsense goal a reality.