Ranking Member DeLauro Statement at Provider Relief Fund and Healthcare Workforce Shortages Oversight Hearing

2023-04-26 10:20
Statement

Congresswoman Rosa DeLauro (D-CT-03), Ranking Member of the House Appropriations Committee and the Labor, Health and Human Services, Education, and Related Agencies Appropriations Subcommittee delivered the following remarks at the Subcommittee's oversight hearing on the Provider Relief Fund and Healthcare Workforce Shortages:

Thank you so much, Mr. Chairman, for holding this hearing. And welcome to today’s witness, Ms. Carole Johnson, Administrator of the Health Resources and Services Administration, or HRSA.

Happy that you took over the job in January of 2022.

Thanks for being here today. And thank you for dedicating your career to the work of saving lives by increasing access to high‑quality health care, especially for historically underserved and rural communities across this country. You make our communities healthier and safer by expanding a skilled health care workforce.

You are here today, in part, to discuss healthcare workforce shortages — an issue that impacts communities all over the nation. Even before the pandemic, healthcare workforce shortages were a major concern. In 2019, the American Association of Medical Colleges predicted a shortage of 122,000 physicians by 2032. And that is just physicians.

As you know, 1.5 million health care jobs were lost in the first two months of the pandemic. While we are mostly back to pre-pandemic staffing levels, issues still endure. And though the Bureau of Labor Statistics projected that 275,000 additional nurses are needed before 2030 to meet demand, it is increasingly more difficult to hire new, qualified nurses.

Given the need to address these and other enduring shortages made much worse by the pandemic, this Committee made significant investments through the 2022 and 2023 appropriations bills to strengthen HRSA’s health workforce programs. This included a nearly $100 million increase in the 2023 package passed and enacted in December. We increased funding for nursing and midwife programs, mental and behavioral health workforce education and training, and Children’s Hospital Graduate Medical Education programs to train resident doctors.

But more must be done. That is why I am pleased to see the President’s Budget for 2024 prioritizes training programs for the healthcare workforce. I’d like to run through some of this funding.

The request includes $190 million more for mental and behavioral health workforce education and training to address our mental health and substance use crises by expanding health care professionals.

You also request an additional $50 million for nursing programs, including to increase the nurse faculty essential to growing our workforce. To be honest, I am concerned that increase is not large enough given the need for a robust nursing workforce.

I am pleased to see your request for $50 million in new funding to expand the National Health Service Corps, which offers scholarships and loan repayment to professionals who commit to serving in underserved areas. As you note in your testimony, National Health Service Corps participants are more likely to remain practicing in high‑need communities after their service is completed.

And your budget would invest in innovative approaches to recruit, support, and train new providers.

Americans depend on a skilled and robust health care workforce that keeps us safe and healthy.

That is why I must mention how deeply concerned I am over some of my House Republican colleagues’ calls for massive spending cuts to many of the programs that keep families and communities healthy. These cuts would be harmful to children, families, seniors, veterans, and our rural communities. And they would be deadly.

Just last week, Speaker McCarthy introduced a bill to cut funding back to the 2022 level and to impose caps for the next 10 years. Caps that are really just more cuts. And apparently, we are getting prepared to vote on that legislation today.

Though we should be doing everything to support health care workers and expand the workforce, these spending cuts would gut nursing programs, exacerbating our shortage of skilled nurses. There would be fewer mental health providers and substance abuse specialists as the country continues to combat an opioid and fentanyl crisis. And it would mean fewer doctors and other health care professionals choosing to serve in rural and underserved communities because we removed incentives to serve there.

These proposed cuts would reverse much of the progress we have accomplished over the past two years—progress that began as we recovered from the COVID-19 pandemic.

Ms. Johnson, when you came into office, hospitals and health care providers across the country were overwhelmed by Covid patients. At the peak of the pandemic, more than 4,000 Americans were dying every day from Covid.

Many hospitals, health care providers, and nursing homes would have gone bankrupt without emergency intervention from the federal government.

That is why I am proud that while I served as Chair of the Labor-HHS Appropriations subcommittee, we responded quickly and forcefully to the Covid-19 pandemic, including by creating the Provider Relief Fund in March of 2020 to support our health care providers and to avoid a complete collapse of our health care sector. In 2020, this Committee provided a total of $178 billion for hospitals, health clinics, skilled nursing facilities, nursing homes, and other health care providers.

Unfortunately, the Trump Administration did not allocate those funds according to congressional intent. The truth is — this subcommittee should be questioning HHS officials from the Trump Administration. First and foremost, they sent too much money to hospitals that did not need it and not enough money to the areas that did. As reported by both the Wall Street Journal and the Washington Post, hospitals were reimbursed based on their overall revenues and their Medicare billing rates—instead of their financial need—which put safety-net hospitals at a severe disadvantage.

It has become overwhelmingly evident that hospitals that serve a disproportionate share of uninsured patients and Medicaid patients needed much more support. It should concern all of us that the financial need and condition of providers were not properly assessed. And children’s hospitals, behavioral and mental health providers, dentists, and some of our smaller hospitals were left behind.   

 I know this firsthand from providers in Connecticut. Connecticut’s seventeen small- and medium-sized hospitals struggled immensely, especially in the early months of the pandemic when the Trump administration used arbitrary dates to determine eligibility for “hotspots” funding.

When the Biden administration took office, you changed this process to ensure that aid targeted the providers most in need. And though this change was critical, for some hospitals and health care providers, it had already been far too late.

And now, Speaker McCarthy and some of my Republican colleagues are trying to rescind unspent Covid funds, which would further exacerbate the challenges faced by hospitals and health care providers that serve people most in need.

As I have made clear, I will not stop fighting these drastic proposals that would hurt the communities that most need our help.

Ms. Johnson, we have a lot of ground to cover today on these two topics. I look forward to working with you to ensure we continue to invest in our health care workforce and support our health care providers. Thank you so much for being here.

With that, Mr. Chairman, I yield back.

118th Congress