Lawmakers weigh exempting health emergency response funds from budget caps

A leading GOP appropriator proposes a health emergency fund akin to the Pentagon's overseas war account

Rep. Tom Cole, R-Okla., ranking member of the House Appropriations Labor-HHS-Education Subcommittee, says it's a good idea to create an emergency health fund exempt from spending limits. At right is Rep. Andy Harris, R-Md.  (Tom Williams/CQ Roll Call file photo)
Rep. Tom Cole, R-Okla., ranking member of the House Appropriations Labor-HHS-Education Subcommittee, says it's a good idea to create an emergency health fund exempt from spending limits. At right is Rep. Andy Harris, R-Md. (Tom Williams/CQ Roll Call file photo)
Posted May 6, 2020 at 2:49pm

A top Republican appropriator said Wednesday he wants to consider designating health defense funds to deal with disease outbreaks and other emergencies.

Rep. Tom Cole, R-Okla., the ranking member of the House Appropriations Labor-HHS-Education Subcommittee, said he was interested in setting up health defense spending funds that would operate somewhat like the Pentagon's Overseas Contingency Operations account. That means the funding would be exempt from discretionary spending caps imposed in the past by Congress.

“I think it's a very good idea,” Cole said, adding he has discussed a similar idea with Subcommittee Chairwoman Rosa DeLauro, D-Conn.

Cole also said he hopes to boost the panel’s appropriations allocation for the next fiscal year because of the pandemic.

Former Centers for Disease Control and Prevention Director Tom Frieden, the president and CEO of the health care organization Resolve to Save Lives, proposed providing a designation to certain health agencies to operate outside of budget caps during a hearing of the appropriations subcommittee Wednesday morning.

Frieden said such a designation would ensure that the United States would be better prepared for viral or biological events without affecting other parts of the budget.

“What we’ve seen is if it’s in discretionary, no matter how well intentioned everyone is, there are going to be problems. If it’s in mandatory, no matter how fixed we think it is, it isn’t,” Frieden said. “What we’ve suggested is something similar to the Overseas Contingency account that allows for a professional judgment of what’s needed.”

The hearing comes as the Senate returned to Capitol Hill this week but House leaders have not yet said when the full House would return to vote.

Seven committee members attended the hearing, while others who could not attend because of the COVID-19 pandemic submitted questions, said DeLauro.

Lawmakers on both sides of the aisle lamented that Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, did not testify before the panel. The White House told congressional committees that members of the White House coronavirus task force or their key deputies could not testify without permission from White House Chief of Staff Mark Meadows.

Cole said he had urged that Fauci testify before the committee, saying it would be “useful” to the country.

“This is a bipartisan panel. Dr. Fauci has appeared before our subcommittee dozens of times. He has testified whether it was a Democrat or Republican as chair,” DeLauro said. “He has testified hundreds of times on Capitol Hill working with Democratic and Republican presidents.”

Fauci will testify next week before the Senate Health, Education, Labor and Pensions Committee chaired by Republican Lamar Alexander of Tennessee.

Testing and preparation

Witnesses and committee members lamented the lack of a national testing strategy as states begin to reopen some businesses and lift social distancing restrictions.

Rep. Katherine M. Clark, D-Mass., said she could not underscore more "the need for a national plan and that states are interconnected."

Caitlin Rivers, an assistant professor and epidemiologist at Johns Hopkins Bloomberg School of Public Health, said she believes the U.S. should administer 3.5 million tests per week and go up from there, but said the country does not have that capacity right now.

Still, the tricky balance between public health and opening the economy that has emerged as somewhat of a partisan difference within the U.S. was on display at the hearing.

Rep. Andy Harris, R-Md., said that increasing testing would lead to a higher number of reported cases and suggested using the number of hospitalizations or ICU capacity to determine when states could lift restrictions, instead of the number of reported cases. He suggested widespread education on how to stop the spread of respiratory diseases, rather than contact tracing, arguing education could be more effective.

“To train 100,000 people nationwide to institute contact tracing could take weeks. I have small businesses owners in my state, in my district, tell me they can’t last weeks," he said.

Frieden said that education efforts are important but that people would be safer if contact tracing were in place when states lift restrictions. He added that people should continue to keep a physical distance from others when they leave their homes.

Still, Harris said people will have to accept some element of risk and argued that many of the stay-at-home directives are too stringent.

“We’re safer from death if we’re not born, right?” he said.