▶ 0:08:01Remember day hearing. Uh, we look forward to taking testimony from our colleagues this morning. Uh, here in the subcommittee. This is an opportunity for any member of congress to come before this panel and draw our attention to issues of importance, both to their districts as well as across the nation. I look forward to hearing from my colleagues about the challenges they see and how this subcommittee can help address those challenges. Before we begin, I'd like to turn to the ranking member for any remarks that she would care to make at this time. >> thank you so much, Mr.
▶ 0:08:32Chairman, for holding this, uh, member day on the hearing on the 2027 budget, uh, the programs in the labor, health and human services education appropriations bill directly impact the lives of americans across our country, especially children, families, and seniors. The labor hhs education bill funds programs like head start levels the playing field for low income children looking to get a good education. It provides pell grants for students to go to college, pursue their dreams.
▶ 0:08:58It funds life saving biomedical research as well as public health. It funds programs that help americans get the skills they need to live successful and fulfilling lives. And the list goes on. It's why it's so important for the appropriations committee and the congress to enact the labor hhs education bill for fiscal year 2027, and our communities need assurance that these are critical lifelines that will continue to be available to them.
▶ 0:09:27Uh, it's the administration's responsibility to implement these important programs at their legally required funding levels and according to congressional intent, as we hear from our colleagues about their top priorities for fiscal year 2027, uh, which is incredibly important. Um, I would implore our colleagues to remain vigilant about this year. The constitution is clear. Congress holds the power of the purse.
▶ 0:09:53We pass the labor hhs education bill on a bipartisan, bicameral basis. And now it's time that we hold the administration accountable. Thank you. And I yield back. And I thank you for the hearing, Mr. chairman. >> thank you, ranking member. And now I'd like to recognize our first witness, representative luttrell from texas. You have the floor. >> Mr. chairman. Thank you. Mayor. Thank you for having me today. You both mentioned the importance of health.
▶ 0:10:18I'm specifically going to speak on brain health, which I believe is something that we don't pay attention to either in the medical space, nationally or globally. As we move through these appropriations, I want to focus on the brain research of innovative neurotechnologies through the nih funding back in 2014. This was started in 2014. I was exiting the military and actually in grad school studying neuroscience.
▶ 0:10:44I didn't specifically get to touch that grant funding, but I saw how it started to change the landscape. And from 2014 to 2026, what we know about the brain and brain health has changed every second of every minute of every hour of every day. And currently the cures act, which provides funding for this, for this program is sunsetting. >> yes.
▶ 0:11:12>> and if everything that we do in this wonderful place, one thing that we absolutely need to remember is how important that gelatinous substance between our ears is. It gives us capabilities. It allows us to do amazing things. It allows us for you to understand what I'm saying, contemplate thought, contemplate the contemplation of thought, put a man on the moon, everything.
▶ 0:11:31If we had the ability to train and educate and cure the diseases of the brain, because we primarily focus from the neck down, and we've been doing that at an exceptional level since we've been walking around. Decreasing funding. I'm I'm actually asking for an increase in funding in this program, and this is the reason why this place always asks for a return on the investment. It does.
▶ 0:11:55If any program has provided or given the american people and the public something. It's this specific program, amongst many others. But this one specifically. Has provided brain mapping because today, currently we still have no idea how this wonderful organism works. We just don't. We haven't figured that out yet. But the scientists and researchers that are in this space have created brain mapping neural pixels.
▶ 0:12:25They've given us the ability for deep brain stimulation that directly affects parkinson's disease. I have a family member who has who had parkinson's. Still does currently, convulsions and shakes were out of control. Deep brain stimulation paused it. This money directly affects that.
▶ 0:12:47And because of the advancements of artificial intelligence, machine learning and language models that live and breathe in laboratories and institutions of higher education, instead of baby steps, we're taking profound leaps forward. I had a traumatic brain injury when I was in the military. I spent in the military and my post-military life addressing that issue. It's the reason I went back to school.
▶ 0:13:16And having a pause, purposeful pause. In these programs would kill a momentum that will never get back. My professor said this was the decade of the brain, and that was ten years ago. These computational analytics are allowing real time diagnostics. We're able to see things at different levels inside the human brain.
▶ 0:13:44And I've always been asked, why can't we figure this out? How can this be so challenging if we've been funding and doing these studies for decades? And one of the many issues is, sir, your brain is different than mine, young lady. Yours is different than mine, ma'am. Yours is different than mine. You can't have a control group of 1000 people, because every single human brain is different.
▶ 0:14:15And you have to see it that way. And that is one of the many challenges that our doctors and clinicians and scientists and neuroscientists and data scientists are facing. But they've got a lane and they're moving in a at an amazing speed. And in washington, dc, I, you know, I share this house with you. And if one thing, if we can get rid of something, we can add something.
▶ 0:14:44If we can do anything to help the american people, a side of that. If a mother brings her baby into the emergency room with a head injury, the neurologist can look at her and go, we've got this. I can give you your child back. Because currently, with brain disease and brain injury or brain distractions. We're dead in the water.
▶ 0:15:10And these this program specifically is breaking through those barricades. Mr. chairman, ranking member thank you. For your testimony. Thank you so much. >> Mr. chairman. Just before our colleague leaves, um, I thank you very much for your passion around the issue. I think you actually, you know, it's so true.
▶ 0:15:36We somehow divorce the head from the rest of the body. Uh, we do that with with vision, with teeth, etc. And long and short of it, you make a good point. The brain initiative, the research from the brain initiative, as I understand it, is producing a heck of a lot of, uh, further action in terms of, um, you know, grants, uh, etc. You're actually you're right that that's sunsets 20, 26.
▶ 0:16:05It's sunsets. And what we did was we enacted $195 million, uh, for the 2026, uh, whatever money will be forthcoming will come from, from this, this, this committee. And I think you make a, you know, an important strong argument here for us to look at. I, I will just say to you, it no one can tell you that you know where that number will be.
▶ 0:16:32Obviously, you know, uh, 195 um, if you would flat fund it, it would be a victory. But I understand where you're coming from and where I'm coming from. And your committee is, how can we increase it and not lose the, uh, uh, the great work, uh, and the money that we put into the brave initiative initiative over a ten year period. So thank you so much for, you know. >> to your point, you can't take your head off and put it on the bedside table at night. >> no. Hell, no. Them both.
▶ 0:17:02Why do we divorce that? And, you know, I think that is a big item on mental health as well. And it's also traumatic brain injury. And, you know, thank you for your service. But thank god for your, your, your, your amazing recovery from a traumatic brain injury. I'm glad to serve with you. Thanks. >> thank you. Thank you here today. Have a blessed day. Thank you.
▶ 0:17:29>> next, I'd like to recognize, uh, miss representative laura gillen from new york. Welcome to the subcommittee. We look forward to hearing your, uh, your testimony. >> well, thank you, Mr. chairman. Thank you. Ranking member. Um, thank you for the opportunity to appear before you today.
▶ 0:17:50So I'm here as a colleague, as a mother, and as a proud member of the bipartisan black maternal health caucus to ask you to continue to make critical, life saving investments to help reduce inequities in maternal health. Mr. chairman, having a baby and starting a family is a fundamental part of the american dream. For so many people in our country.
▶ 0:18:13We should do everything that we can to ensure that mothers of all backgrounds are able to safely deliver happy and healthy children. Speaking with women and families across my district on the south shore of long island in nassau county, I've heard about the real impact of enormous disparities in maternal health outcomes that women of color face.
▶ 0:18:34The facts are clear black women are three times more likely to die from a pregnancy related cause than any other group of women. They're also twice as likely to lose an infant to a pregnancy. Premature related death. I promised my community that when I came to congress, I would join the black maternal health caucus and work with my colleagues on both sides of the aisle to fix these devastating inequities.
▶ 0:19:02We can do much more to support mothers at every stage, from fertility to pregnancy, delivery and postpartum care. In fiscal year 2026, congress provided $10 million, a $10 million increase in the funding for the nih improve initiative for research into maternal mortality.
▶ 0:19:21Today, I am urging you to provide another $10 million increase, bringing total funding for the improved initiative to $73.4 million and target funding for populations that are disproportionately impacted. I also urge the subcommittee to increase funding for the special programs of regional and national significance.
▶ 0:19:43The brand's portion of child and maternal health block grants, particularly the maternal health research collaborative for minority serving institutions, or msis. This program strengthens research capacity, it trains providers and helps develop evidence based solutions to address maternal health disparities.
▶ 0:20:06Investing in programs like the improve initiative brands and msis will make a real difference for mothers across our country. These programs support data driven research and projects. They strengthen our health care delivery system and they help save lives. Mr. chairman and ranking member, let's help give more mothers a better chance at a safe and healthy pregnancy and safe and healthy babies.
▶ 0:20:30I look forward to working with you and all of our colleagues on both sides of the aisle to reduce disparities, improve black maternal health, and help mothers, children, and families all across our country. Thank you. And I yield back. >> thank you members, I appreciate your, uh, words there. And, uh, bringing this to our attention. Thanks so much. >> I want to say a thank you to you for, uh, highlighting maternal health.
▶ 0:20:58You know, for so many years, uh, it has been on the back burner, uh, and given the statistics and particularly with black maternal health, and we know that is just a result of the the lack of resources and investments in making sure, uh, as you pointed out, that there is, uh, the work that's done all along the, uh, the spectrum of needs, um, for women in terms of childbirth, I think that oftentimes people just
▶ 0:21:32Don't understand the risks involved in childbirth. Excuse me for this. It's I think it's just a slam dunk, you know? There it is. You know, you're going to have a baby, and it's going to all be okay. That is not the case. So our efforts in terms of increasing the opportunity for us to understand what is happening, how we can turn the tide, uh, with some of these disparities.
▶ 0:22:01So thanks so much for being a champion of women's health. Thank you. >> all right. Next, I'd like to be ready. Come on. Uh, representative debbie wasserman schultz from florida. Uh, one of our colleagues here on appropriations look forward to hearing from you. >> thank you. Chairman.
▶ 0:22:28Um, thank you, chairman and ranking member delauro. I'm here because I am not on the subcommittee. And so even though I ultimately have an opportunity to help shape what's in this bill, I do. As you begin the outset of appropriations season, I want to just highlight a couple of priorities. Um, the hhs appropriations bill is is more, as you know, than just budgetary line items. Um, you protect the health of our communities.
▶ 0:22:56We give our children a fair shot, and we ensure our seniors can age with dignity. As we begin the fy 27 appropriations cycle, we really have a clear choice. We can weaken these life saving investments or we can strengthen them. Um, I'm here today to strongly urge that we strengthen them. And I want to speak about two deeply personal priorities, um, which I know you both have heard me talk about many, many times fighting cancer and drowning prevention over 18 years ago. I know, you know, I heard the three words that no one ever wants to hear.
▶ 0:23:27You have cancer, rosa. You also have heard those words and forgive the familiarity. Familiarity. But we're friends here. And family. Um, and the crushing weight of that, and the way I've always described it, is that it hit me like an anvil. Um, I battled cancer with everything I had, I survived. I'm here today to to to to fight for others. But survivorship gave me more than gratitude. It gave me purpose and passion.
▶ 0:23:50And I decided to use my voice for the women who feel alone in that doctor's office, for the young women who never imagined cancer could happen to them, for the families who fear the worst, no woman, no one should fight a battle like that alone. And that mission, as you know, led me to author and champion the early act, a law that includes a national education and awareness campaign that targets younger women and women at higher risk about the importance of paying attention to their breast health.
▶ 0:24:17It also funds a grant program to assist with the unique challenges facing young women with breast cancer, and I'm thankful that the early act received nearly $7 million in fy 26 with breast cancer cases, though on the rise in younger women. And that is a recent development that is really disturbing. Approving the full funding of $9 million is critical to help other women catch breast cancer early. Early detection is the key to survival. It is why I'm here.
▶ 0:24:46And with full funding, cdc can expand outreach, strengthen provider education and grant funding, and they can reach more young survivors and previvors. And they can even help make sure that young women know that they have to pay attention to their breast health, that they know what's normal for them, so they know when something feels different. These are dollars that do not sit idle. They empower women with knowledge, connect them with care, and save lives.
▶ 0:25:12Since the early act was signed into law, over 600,000 young breast cancer survivors now have access to critical educational resources. Millions more have access to grant funding that helps the. There are organizations that the grant funding assists in helping young women and women at higher risk deal with the unique challenges that we face when we get a breast cancer diagnosis, so we can't take our foot off the gas. Cancer doesn't wait, wait.
▶ 0:25:38But when we detect it early, when we expand access to screenings, when we educate and empower women, we reduce mortality and we increase survivorship. And we can turn fear into hope and anxiety into action. And I mean, if there's if there's any issue without a party affiliation, it is fighting cancer.
▶ 0:25:57And I have felt that all of these years, and I know rosa has it all has as well as appropriators, though I'm thankful that we ultimately gave nih and nci, nih got $128 million more. Uh, excuse me, nci got $128 million more. Nih got a $415 million increase. But the president proposed hundreds of millions of dollars in cuts. That would have been devastating.
▶ 0:26:24It would have left patients waiting for treatments that might never come. We have to implement guardrails to ensure cancer research funding isn't being illegally withheld by this or future administrations. That's the prerogative of the appropriations committee. We have to stand up for article one as appropriators. It's right on. It's a banner right underneath the the dais in front of the chairman because researchers needs to ability. Our scientists need certainty. And cancer patients deserve to see progress. Lives depend on it.
▶ 0:26:51I want to briefly touch on another crisis, one that unfolds quietly, often without headlines, but one that devastates families just the same. And that's drowning. Last year in florida, a record high 119 lives were lost to drowning. Since 2009, nearly three quarters of florida's drowning deaths have been children under three years old. And nationally, drowning remains the leading cause of death for children through accidental death from ages 1 to 4. These are not accidents that we have to simply accept.
▶ 0:27:20This is an urgent public health crisis and one we must call out. The heartbreaking truth is, a drowning is preventable. When we invest in drowning prevention at the cdc, we equip communities with the tools to save children's lives. Which is why I'm requesting $5 million in fy 27 for drowning prevention activities conducted at the cdc's national center for injury control and prevention. We have funded them the last several years, and I want to urge the continued funding. With these resources.
▶ 0:27:47Cdc can strengthen drowning surveillance, identify at risk communities, and expand access to proven preventive strategies like swim lessons and water safety education. We also know that drowning does not strike evenly. Individuals with autism spectrum disorder face a risk 40 times higher than the general population. Children in low income and rural communities also face greater barriers to swim lessons or water safety resources. But we can change that. No parent should experience a preventable tragedy in their backyard or at the public pool.
▶ 0:28:16No community should accept the preventable loss of a child. So thank you again for the opportunity to testify today. I know I'll have many more opportunities to to talk with you about this. When we're sitting down the hallway together for hours on end in markups. Um, but I stand ready to work, as we always have with both of you, with our colleagues on both sides of the aisle to protect cancer research, early detection information and resources, and to end this preventable drowning crisis. Thank you so much. >> thank you for calling both of those issues to our attention.
▶ 0:28:46Uh, of course, obviously very important. And, um, cancer, uh, you know, impacts, I think, about every person's life, uh, either directly or indirectly. So, uh, thank you for bringing that. But as well as the drowning issue as well. So we look forward to working with you. >> thank you, Mr. chairman. >> I really want to say just such a thank you to you. I mean, start with the drowning issue that is preventable. Oftentimes people say, well, you know, that's that's a fringe.
▶ 0:29:13That's a fringe issue, right? You know, I worked in a volunteer in a community school many years ago in new haven, which had a pool in which low income kids, kids with disabilities were there, they had swim lessons, etc. All of a sudden there was a determination that this was frivolous. Why are we funding a community pool? And it was gone.
▶ 0:29:41And actually they used it for storage, for books. There are books piled up and it goes. And the point is that kids are drowning. You said the statistics and we have the ability. This is not, you know, not not everybody has a father like mine or a family like yours that took you to the beach, taught you how to swim, etcetera, etcetera. That's not the case. So thank you for highlighting the issue.
▶ 0:30:03And look your words about, you know, your survival and purpose and passion that I think are the bywords on this and what we need to do to deal with cancer research and the nci. So thank you so, so much. You know, oftentimes people think that we create issues here or we champion issues that, you know come out of nowhere. Not the case comes out of experience.
▶ 0:30:31What your experience is and how you can translate that experience helping to make a difference. Thank you on both those scores. >> thank you my sister survivor. Thank you. Thank you both. And my friend the chairman. Thank you. >> uh. >> next, we'd like to recognize Mr. chuck edwards, uh, congressman from north carolina. We look forward to hearing, uh, your testimony here about some issues that we, uh, you want to call to our attention.
▶ 0:30:57Thanks very much, chairman aderholt, ranking member. >> delauro and members of the labor hhs subcommittee, I appreciate the opportunity to testify here before you today. I represent north carolina's 11th district in western north carolina.
▶ 0:31:14Over the last five years, the largest hospital in my district, mission hospital in asheville, owned and operated by hca healthcare, has received four immediate jeopardy citations from cms. That's for immediate jeopardy citations.
▶ 0:31:36To put this in perspective of how atrocious this designation is nationwide, fewer than 1% of hospitals receive even one such citation any given year, reflecting hca's repeated failures. An immediate jeopardy designation is the most serious enforcement finding cmmi. Cms may issue.
▶ 0:31:58It means that a provider is noncompliance, has placed patients at risk of serious injury, serious harm, serious impairment or death. The people of western north carolina are demanding corrective action. The question is whether cms has adequate tools to enforce accountability in our hospitals.
▶ 0:32:23Under current law, cms has limited options short of terminating medicare and medicaid participation. Termination must remain an option in extreme cases, but due to hospital consolidations in recent years, terminating medicare and medicaid participation is just not an option because it would leave countless patients with no option for health care, and it threatens their access to essential services and can
▶ 0:32:55Destabilize the only hospital network serving thousands of families. We should not have to choose between accountability and access. I'm introducing the healthcare accountability act, or hca mission act. This legislation would give cms immediate and effective enforcement tools when immediate jeopardy is identified.
▶ 0:33:18Currently, when a nursing home is cited for immediate jeopardy, cms may impose civil monetary penalties, required direct training and mandate plans of correction. Uh, even. They may appoint temporary management or implement state monitoring. This framework allows cms to compel compliance and protect patients without immediately terminating federal program participation.
▶ 0:33:46Hospitals, however, operate within a far more limited enforcement structure. My proposal would extend similar authorities to hospitals, whether for profit or nonprofit. The goal is correction, patient protection, and sustained access by equipping cms with immediate remedies, congress can address serious deficiencies while maintaining continuity of care in rural communities.
▶ 0:34:13As my office reviewed hospital immediate jeopardy findings nationwide, we found that it wasn't consistently tracked in a centralized, publicly accessible manner. If immediate jeopardy represents the highest level of patient safety concern, it also warrants full transparency. Without consolidated data, congressional oversight becomes reactive rather than proactive.
▶ 0:34:40Policymakers, patients, and communities should be able to find how often citations occur, how quickly they resolved, and what corrective actions are taken. For that reason, I believe the fiscal year 2027 labor appropriations bill should include report language directing cms to systematically collect and publish data related to hospital immediate jeopardy findings.
▶ 0:35:03Finally, we must ensure adequate resources with a requested $28 million budget increase in the state survey and certification line item, cms needs the capacity to conduct timely inspections, which is the foundation of effective hospital oversight. Regular inspections are the foundation of the enforcement system.
▶ 0:35:28These surveys identify deficiencies, determine whether immediate jeopardy conditions exist, and initiate corrective action. If survey backlogs grow or staffing levels fall short, oversight weakens and my goals are clear improve hospital enforcement practices without compromising rural access to healthcare.
▶ 0:35:49Strengthen oversight by requiring systematic data collection and public reporting on hospital immediate jeopardy findings, and ensure cms and state survey agencies have the resources necessary to carry out patient safety. Rural communities across the country deserve safe and reliable hospitals that protect its patients. I look forward to working with the subcommittee on these reforms, and I thank you and I yield back.
▶ 0:36:19>> thank you. >> for your testimony. And and again, calling this to our attention. And that's certainly what this is, is for. And, um, and as you know, there's so many issues that the labor, health and human services and education subcommittee covers that, uh, knowing, uh, having a little bit of knowledge about some of these issues that may need a little more attention is very important. So thank you. Ranking member, would you like. >> to thank you very, very much for your for your your testimony.
▶ 0:36:47I want you to know that the state surveys are funded within this, within this bill and would support the increase for that. I think that's really critical. I also think this goes beyond I think what you're talking about is rural areas, but this goes beyond rural areas. And I think we should be very, very concerned about that and would love to work with you on report language and see what we can do. And I'm hoping that you're in touch with the authorizers as well on this issue. So I really thank you. And, um, for citations.
▶ 0:37:16It's really pretty, uh, severe. It is. And you're between a rock and a hard place. What's the penalty? And then what would be the level of service? It's going to be applied in areas that were, you know, are have limited, you know, opportunity for access to, uh, to healthcare. It shouldn't be that way. So let's see how we can, you know, turn this around in some way. Thanks so much. Appreciate it. Thank you. >> thank you, um, for your testimony here today.
▶ 0:37:44And, um, that concludes all of our witnesses. Uh, however, uh, uh, representative chris smith has submitted a request, uh, for the record, and that will be included. But, um, other than that, I think we have, uh, that's all of our witnesses that's in the queue. And at that, uh, I will we will adjourn.