00:00 Thank you, Mr. Chairman. Secretary Becerra, you must be exhausted, but we're delighted
00:05 you're here. You can see the light at the end of the tunnel. Great to have you with
00:10 us. The Department of Health and Human Services plays a critical role in protecting the health
00:15 and well-being of our country, and this budget proposal reflects just that. The budget reflects
00:21 this administration's commitment to ending the mental health and substance use disorder
00:26 crisis, which has been my number one priority for 12 years in Congress. Last year, the FDA
00:32 approved the first over-the-counter overdose reversal medication, naloxone nasal spray.
00:39 This is truly an exciting first step to making this life-saving drug more accessible and
00:45 reducing deaths from overdose. And I'll point out, New Hampshire is the site of one of the
00:50 very first vending machines for naloxone to make it available to everyone in the community.
00:56 However, I'm concerned that seniors with Medicare Part D plans and Medicare Advantage plans may
01:03 actually lose access to the drug now that a prescription is no longer needed. As you
01:10 know, 52,000 Medicare beneficiaries overdosed in 2022. The Office of the Inspector General
01:20 believes this could actually be an undercount. The OIG also found over 1 million seniors
01:27 enrolled in Medicare struggle with opioid use disorder, including relatives of mine.
01:35 Secretary Becerra, what steps can be taken to ensure that seniors can access over-the-counter
01:40 naloxone? Congresswoman, you point out something that's critically important. Most folks think
01:46 of young people when it comes to the need for naloxone to save a life from overdose.
01:53 But we need to make that available to all people, including our seniors. We are right
01:57 now in communication with Medicare Advantage plans and Medicare Part D sponsors to try
02:02 to encourage them. Remember, we can't force them to do things. They are the ones that
02:06 decide what they cover and what they don't. We don't have the legal authority to require
02:12 them to do certain things. But we're talking to them because it just makes total sense.
02:16 This is about saving a life. They might even save a lot of money by making sure naloxone
02:20 is available because if someone doesn't end up ODing, they may still cost a lot of money
02:25 for the care that they're going to receive while they're in the hospital. So we're right
02:29 now in the process of talking to the health insurance companies, those who offer Part
02:33 D plans, to make sure they're clear. It makes total sense to make sure naloxone is available,
02:39 even though it's no longer necessary through prescription but can be available over-the-counter.
02:44 Thank you, and I hope that more plans will expand their supplemental benefits and take
02:49 action to help seniors maintain their access to naloxone. And I stand ready to work with
02:55 you on this important issue with my colleagues. I'd also like to discuss the work HHS is doing
03:01 to better serve hard-to-reach populations. I applaud the Biden administration's effort
03:06 to expand medication-assisted treatment and opioid treatment programs within the federal
03:12 prisons. This is another area where I believe there's much work to be done, and I make it
03:18 a priority in my months left in Congress. States and localities continue to struggle
03:25 with the cost of providing mental health and substance use disorder services to incarcerated
03:30 individuals under custody due to what's called the Medicaid inmate exclusion. Studies show,
03:39 however, that for every dollar we spend to treat substance abuse in prison, we can save
03:45 up to $7 down the road. That's a decent return on investment. We should maximize effective
03:52 cost-saving treatments, and that's why I introduced my Rehabilitation and Recovery During Incarceration
03:59 Act. This bill, which has bipartisan support, would reform the Medicaid inmate exclusion
04:05 policy so that incarcerated individuals who are eligible for Medicaid can continue to
04:11 receive mental health and substance use services. Secretary Becerra is our nation's top health
04:17 care advisor and the former Attorney General of California. Can you explain how providing
04:23 mental health care and substance use treatment in prison could actually keep our communities
04:30 safer and healthier? Congresswoman, we know that prison is supposed to be a place for
04:36 rehabilitation. We know that most prisoners are at some point going to be released into
04:41 the community again. It makes no sense to release someone into the community who is
04:47 addicted or is still having behavioral health challenges. The more we do to get a prisoner
04:55 ready for exit, the better prepared our community will be to bring them back into the fold.
05:00 In fact, we are now making investments through Medicaid with states so that they can prepare
05:07 those who are incarcerated in their process of exiting to be ready, so Medicaid will be
05:12 available to them so they start right away with the health care they need. They may not
05:16 have a place to live. They may not be integrated into society, but we'll make sure that at
05:21 least health care is something that's available to them. Thank you, and I encourage my colleagues
05:25 to join our bipartisan bill, the Rehabilitation and Recovery During Incarceration Act, and
05:32 it's a delight to have you with us. I'm so proud of your service, and with that, I yield
05:36 back. Thank you. The gentlelady yields back. Chair recognizes Mr. Obernolte from California
05:40 for five minutes for questions. Thank you very much, Mr. Chairman. Secretary Becerra,
05:44 thank you for being here today. I appreciate your willingness to engage with us on the
05:49 issue of the HHS budget. I'm one who believes that we don't have enough
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