Alex Azar, secretary of the Department of Health and Human Services, went before Congress to once again defend the Trump administration's 2019 budget for the agency.
The proposed budget "strongly supports ongoing work HHS does," Azar told the House Committee on Appropriations' Subcommittee on Labor, Health and Human Services, Education and Related Agencies on Thursday morning.
Azar previously testified on the budget before the House Ways and Means Committee and made a similar argument that the proposed funding levels back central HHS priorities like combatting the opioid epidemic and fostering the healthcare industry's transition to value-based care.
"The budget makes significant strategic investments in HHS' work," Azar said Thursday.
The White House's initial budget for fiscal year 2019 proposed $68.4 billion in funding to HHS, a 17% cut. However, after Congress reached a two-year funding agreement, the Office of Management and Budget issued an addendum that boosted HHS' allocation by $27 billion.
Representatives from both sides of the aisle highlighted some of the positives in the budget—including $10 billion for opioid programs—but also expressed concern about cuts to programs at agencies such as the Centers for Disease Control and Prevention and the National Institutes of Health.
Rep. Rosa DeLauro, D-Conn., the subcommittee's ranking member, said there's "no amount of magical accounting" that can fund programs facing significant cuts, such as the Agency for Healthcare Research and Quality.
"It's like playing Three-card Monte with funding for life-saving programs," DeLauro said.
Rep. Rodney Frelinghuysen, R-New Jersey, who chairs the full appropriations committee, said that concerns about cuts to agencies such as NIH are worrying to members of both parties, as NIH, CDC and other such groups enjoy bipartisan backing.
He also noted that the budget guts investments to the healthcare workforce, which also has bipartisan support.
Democrats on the panel expressed concern about elements in the budget that anticipate a repeal of the Affordable Care Act and new initiatives at HHS that could make it harder for some women to access contraceptive coverage.
Rep. Nita Lowey, D-N.Y., the appropriation committee's ranking member, said that it's evident that the Trump administration doesn't "care about women having access to affordable birth control." She expressed concern that recent changes, such as the agency's new focus on religious freedom, could pose significant barriers to women accessing care they need, and might even lead to an increase in unwanted pregnancies.
Azar said HHS is working to find a middle ground between access to contraceptive coverage and moral and religious objections from companies.
"We're trying to balance strike a delicate balance between very important interests on all sides," Azar said.
A video of the full hearing is embedded below: