r c r c says the convoy was, i was unable to leave humanitarian aid because it did not have permission from russia. ukraine's president says at least 3000 people were able to lee the city, ukraine's president that he was russia of mining and booby trapping errors. they retreated from near the capital, keep not penal janasia. great occupiers are retreating in the north of our country slowly but noticeably they are pushed away with fighting and leaving their positions after their withdrawal, the situation is catastrophic, and there is so much danger. first of all, air strikes, my continues. secondly, they are mining the entire territory, houses, hardware, even the bodies of those killed. there are so many trip wires and other dangers that's holding us in the east of our country. the situation remains very difficult . russian troops are building up and the don bass in the car, key region. they are preparing for new powerful strikes. we are preparing for even more active defense and russian forces of targeted ukraine's 2nd largest city car key for a month. more than a 3rd of the 1400000 population has fled to fighting many left behind our underground train stations turned into makeshift bomb shelters. our reporter acid bag visited the worst area in the city with it's pure relief with they shelled so much last night says atlanta shattuck over the shell so much but were holding on with the emerge from their shelter and the subterranean existence they have been forced to live because of this war. why is it happening to us? why did he come to us? so spoke would you think it's too much for some when you are you will put you mama inches long since march. i haven't been able to reach my mother and maria paul, the house was hit by 4 shelves. the police offer of buy to lifeline for these people. i sell to africa, the worst hit area of her give. few live here. even few have venture here. this is building 2 to 5 on friendship of nation street. the irony is another nation. soldiers stand a few kilometers away, obliterating this neighbourhood. yo yo prefer through washington. there's more people over there. can you evacuate them? they have disabled children. asked this resident. we can only evacuate people if you have somebody who has them all the metro stations a full shot, says officer. yes, i don't over with you. but still there's more were taken to a basement all over will go watch and pitch black darkness. ah, they've got torches. going in one room than another. and finally flo will go to look after business i have conducted among those crammed into this room, we find 6 year old kiera. that'll get a minute. she is preparing for school and a school that may never open. she wants to be a break dancer, and recites a poem about the love for a mother. of course, my culture darmesh. wow. so i'm pretty sure i shall sheeman. hey, mario, my not outside you re cooked for the family, the silly citizen and says his daughter hasn't been outside for 2 weeks. i live in some of the law was versatile. you can hear it because every 20 to 30 minutes, it's normal. it's normal. it wasn't for the shelling my daughter would be outside, break dancing guys, or would you be careful? be careful and the lawyer about my yeah. well for the police accompanying us, this is personal. the all used to live in that neighbourhood, yan still has a home here. the only way to get in is through the window. to recreate them. oh, he doesn't live here anymore. but passes by from time to time to check up on it. yes. oh no not so it was your of opening. so today the flat is intact and hall tomorrow might not be great. thank you. rush, other incoming the shelves fall near by the onto her to start fine. be crazy. she's trying to get us on 2 days from now, and you're from state to state. oh, oh, i said big al jazeera, her keith ross's foreign minister said a lab roverson speaking with leaders in new delhi, moscow's hoping india will maintain its neutral line on the warn you crane. but india has been warned of consequences if there seem to help the kremlin evade western sanctions. ms with parent reports with sergei laval receives of rail. welcome. on the international stage. the russian foreign minister came to india after a visit to moscow's ally, china. neither india nor china have condemned to russia's invasion of ukraine with india, abstaining from all vaults on the war at the united nations leverage said russia appreciates india's independent foreign policy. and along with china, they're working to bypass sanctions by using different currencies. many years ago we started looking at, you know, religious was india was china, was many other countries for amusing dollar euros to more and more use of national guards on the this, the circumstances abuse driven through, i believe will be those who fight with riches natural them on the eve of lab, rob's visits, the indian government defended its decision to substantially increase all imports from russia. when oil prices go up, i think it's natural for countries to go out into the market and look for what are good deals for their people. but i am pretty sure if he wait 2 or 3 months and actually look at who are the big bios, russian gas and oil. i suspect the list won't be very different from what it used to be. and i suspect we won't be the top 10 of that mr. india era, say india is putting it's on mash, our interests 1st like any other country or what i think is upsetting the western nations. that is the fact that the russians are willing to offer some oil to india with a huge discount and order of almost $35.00. so that, of course, the western nations would like to be great to profiteering. but i would imagine that that is what any consumer will do when they go to the supermarket. if they find there is a sale or something they want to buy, they will utilize it. indeed, as russia is also india, the biggest arm supplier and love for all said the lauren, ukraine won't disrupt that. india is walking a tightrope as it tries to keep good relations with russia and the he with america's deputy national security advisor for international economic felipe sing visited indian officials earlier this week. indian government has said o pressure from western nations to take a stand against russia. the latest comment come from the architect of us sanctions against moscow, who warned on his visit new delhi on thursday, they will be consequences for country circumvent. elizabeth moran and al jazeera you daddy, molly's army says it's kill more than $200.00 fighters under arrested doesn't german operation in the center of hell states? it said to have taken place in the village of mortar, in the multi region in the last week of march. the military says it's also confiscated large quantities of weapons. molly's spent years trying to defeat groups in the region so so, so to come here now does air including ah, why pope roms. this is asking for forgiveness from canada's indigenous peoples exclusive access to military drills between the u. s. and the philippines. we'll look at what the new alliance could mean for the region. our last name. ah, here's your headlines for the americas here. every one more storms bubbling up around the golf. but i think the bulk of the activity will stay in the golf. although for central areas of florida, we could see some severe thunderstorms bubble up here. after the northeast and for the canadian province of newfoundland, we've got some snow swirling through. we may even see a brief period of some freezing rain, otherwise temperatures in toronto, getting up to a hive 6 degrees on saturday. i think saturday is going to be the better day of the weekend for vancouver. some sunny spells there before more wet weather moves in temperatures of once again climbed in billings up to a hive. 18 degrees settle conditions for california desert, southwest and temperatures, and many spots here. also, above average, we've got a high of 30 degrees in vegas. central america looks like this, fairly settle conditions. we've got some pulses of what, whether to be found cursory, get into panama, and then we've got this band of rain pretty much stretching from the now straight into kito right through to that pacific coast. in her, the other day, rio de janeiro had a red weather warning in place for the potential to see upwards of a 100 millimeters of rain. most of that heavy rain will push out toward the south atlantic. i stay and not to the day though on saturday, with the height of 22 degrees. ah, from the world's is populated, reach and deck, and untold stories across asia and the pacific. to discover the current events with diverse coaches. and conflicting politics. one 0 one east on al jazeera. ah ah, welcome back. a quick reminder about top stories here. this are the rival size in yemen. nearly 8 year war have agreed to a 2 month troops from saturday. both sides of also agreed to allow fuel shipments into her date of port. i'm let commercial flights operate from a capital santa israeli forces of shopping killed 3 palestinians in the occupied west bank. it happened in the town of out of that south west of geneva. israel says the men were on an open fire on the military. british military intelligence says an attack on a russian and fuel depot will likely strain. their armies already struggling mitchell sticks ukraine denies it. carried out the early morning helicopter taught the russian city of belgium. while the war in ukraine has been at the heart of talks between china and the european union, brussels press beijing for assurances, it won't supply arms to russia or help moscow circumvent western sanctions. dominant came reports from berlin. arising for the virtual summit, e. u leaders, we're keeping their thoughts to themselves ready for a meeting, which was meant to be about trade, but which many believe would be dominated by the war in ukraine. so we also made very clear that china should, if not support, at least not interfere with our sanctions. we discussed that and also the fact that no european citizen would understand any support to russia's ability to wage war. the view in beijing is more nuanced as traditional friends and allies of the russians. they have not supported sanctions against ministers in moscow. underlying this summit is the reality of bilateral trade between the e, you and china, 10 times bigger than that, between china and russia, and worth hundreds of billions of dollars to both sides every year. these links are so extensive that neither side wants them threatened, but there are some industrialists here in europe, who worry. they may be too dependent on chinese imports, while governments have a new determination to prioritize both dealing with the war in ukraine and with the human rights situation in china. some analysts believe that in doing so, ministers on not understanding the strategic view of the government in beijing, china as follow its own interest overs has been following his all inches. it is one of our biggest mistakes to look at china loser lenses of our inches. and in that perspective, china's only making mistakes on why should they follow our inches and do what we ask them or even order them to do. sometimes a child is proud enough, self confident enough to follow its own interest, and that will not change today. meaning that if the europeans want chinese helped to end the war in ukraine, they need 1st to persuade them it's in their interests. and so far that has not happened, dawn, it came, al jazeera berlin, a drawer for the 2022 football world cup has taken place in the host nation cattle tournament will be the 1st in the middle east and the only one to take place. so late in the year, i was cut off and handed a tough draw in a group, including the netherlands, and african jump in senegal, feet, while european heavy weight, spain and germany are together in the same group. and argentina have been drawn in groups, see with saudi arabia, mexico and poland. teresa bo has more from the capital one. as iris, we've been watching television, radio station website. everyone is talking about the world car on the possibility of these being. the last world cup aren't in times are in love with the argentines whom they're in love with the mfc. they are in love with a coach. so lots of people here are very, very excited about the world cup in cox had a well being able to travel is a big question. argentina is in the middle of a big crisis, there is a storing inflation ways. it's difficult for arguing times to buy us dollars to be able to travel, and the flight for carter is 17 hours. so that's going to make it a bit difficult for most arjun times. however, it is important to know that among the top 10 countries who get ticket, well, argentine you are among them. so it is expected that many are going to make it all the way to cut our processes. apologize to canada's indigenous people. following decades of child abuse in church run schools under 50000 children were taken from their families and forcibly sent to the residential schools mostly run by the catholic church. while the aim was to assimilate 1st nations and you went and met his children into mainstream society, but from 1831 until the 990 is more than 3000 children, died in the schools. there was a bidding from speaking their native languages and sexual abuse was commonplace. but steve sea food as a member of the penny, like a tribe, he says, more needs to be done to try to heal the pot. words are words. we'd like to see auction, i think any person would in this particular situation. you know, coming to canada, i think is the next step. i think there was a little bit of, of angst, anxiety, surprise for sure. it's something that i think a lot of people never really expected. we know the delegation of indigenous peoples from canada that have gone there. i've been pushing. ready for this type of apology from, from this is petition, and it's a welcome 1st step of many to come. i'm one of many of thousands of attended and we all have different views on how you know his apology, whether it came or not would make a difference in one's life. for me, i'm not. i wasn't really waiting for it. i don't think it'll affect me more or less, but i know. ready of my fellow people who've attended survivors. apology means a lot and i know for the people that are attending within the delegation means a lot. so lanka is under a state of emergency a day after hundreds of protest has tried to storm the presidents palace. the order from president got a by a roger potter give security forces sweeping powers to arrest, entertain suspects. people been protesting against the worsting economic crisis. now malaysia is easing what have been some of agers titus. cobit 19 travel restrictions, the government's also relaxed. some of its other pandemic safety protocols from st . louis has more from a capital calling in for y 0 o y a r o w. after 2 long years of border closures, malaysia is welcoming back taurus from abroad. your quarantine requirements for fully vaccinated travelers are lifted from friday during to your same festival. the gum? yeah, impossible. and certainly very good eddie. open again. so i'm here for the 1st day and very happy to be here. melissa again, visitors still have to show a negative cov 19 test result before they leave their home nations and undergo another test on arrival. foreigners miss also have travel insurance with a minimum value of $20000.00. travel agencies like this one have already seen a surge in the number of malaysians traveling overseas. after the government lifted a travel band last october. there now hoping they'll also be a boom in visitors from abroad. request are there, but i think we have to wait a couple of more months to see whether or not they do me to with ice. and i think i think part of it is that the government still has ah, restriction imposed. so unless is r

c e o r j scar inch had to say. well really in c, e o, r j's carriage has issued a warning and it goes as follows. if you think the automotive computer chip shortage is bad, well, pretty much hold as coffee because a shortage of electric vehicle batteries will make that current shortage. looked like small potatoes, the might the minor leagues because literally in a report to the in the wall street journal, the c e. o was issuing a tour of his company's plant in illinois. and then he surprise some of those reporters by saying that semiconductors are a small appetizer to what we are about to feel on battery cells over the next 2 decades. and if you're wondering how does he know this? well, he simply did the math and in his own words, he said, put very simply, all the world cell production combined represents well under 10 percent of what we will need in 10 years. meaning that 90 to 95 percent of the supply chain currently does not exist. and that caught a lot of those reporters and apparently the entire globe off guard today. okay, and james, just briefly, is this inevitable or can somebody be something be done to avoid it? future well, if you're asking, if this can be resolved, that can be resolved. the easy answer would be make more batteries, build more suppliers, but it's not really that simple. you can diversify your suppliers. it's not like anyone can just grab a bag in a shovel and start

c r c is continuing this process. it's gone on now for days it is a problematic to say the least the i c r c basically say that the conditions yesterday friday were simply made it impossible for them to proceed. they need to have in place safety guarantees from both of the warring sides. it is only a small contingent. it's only 3 vehicles from the i, c r c a 9 members of stuff, but hugely important because they would lead a convoy of more than 50 buses provided by the ukrainians to get many, many people out of matter. you paul, who be waiting weeks in we know deteriorating conditions to escape. so this convoy does represent refuge and safety for an awful lot of desperate people. meanwhile, ukrainian officials have said that yesterday, friday, around 3000 people managed to get out of matter. you, paul, despite the fact that despite the lack of a cease fire managed to get out by themselves, but many more people obviously still waiting to get out and escape the conditions in that city. i'm mostly just rub on the russian withdrawal or is it from the the care of region like others have been more attacks? that's right, that have b

my dad to send me out a question i miss it say well, so you have to get one p c r a we haven't so we only we can take the p c r so fast plus friday morning. and if you don't have the results by our flight, you go through flash on earlier, you take the hope that us back, at least we have a plan. mm hm. mm hm. okay. yeah. other than me, it has gone. i love the physical package, but we're ta morling our letter. we still haven't met the had and then to towson limited the floor in the ocean to more to help them with it than wilson did. demarco been so severe semi in colorado, they go memorial. so they arch must shaw the government freshness, bathrooms, they lean new aim for them both on homeless challenges for all throughout most of the the lesson took the 1st name, have kinney this morning on of this and start and when will darn oceanography. so let the thumping on scope for the you with have have to get this good morning off some the buchanan dog, a dog also for mans come for because of thumb, filter. so while the you with the more powerful temperature involved. well, there davis go down in the front door and the

c r. c, the international committee of the red cross on the ukrainians are still trying to organize this humanitarian corridor. the latest we have from the i c r c is that the 2 warring sides have agreed and in theory the to open this corridors that officials have given agreement. so it does seem to be something happening around barrier paul, there are now we understand 50 full buses by sent by the ukrainians hoping to get into the city. also the i c r c is hoping to send humanitarian aid into the city. but until now, from the deputy matter of maria paul, he has said that until now the situation is too dangerous for anybody to be leaving . and the city had also accusing the russians. i've been the last couple of days stopping even small amounts of humanitarian aid getting into the city. all right, rob, thanks very much. i roemer bride a johnny's from live if well, an oil dep her in the russian city belgrade, on the border with ukraine is on fire. and governance says to work as have been injured in some areas of being evacuated. he says ukrainian military helicopters attack, trips with keith was not claim responsibility and ammunition. their po

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medicate statutes, including 42, crs 48 point 206 availability of services. 42 c f r 48 to 1 for, provider selection. 42 c f r for 38 point 12, provider discrimination prohibited. and a large amount of regulations and guidance that flow from these laws. notably, time and distance standards. network adequacy, in particular, as well as state guidance to see as a criteria from medicaid career contract. your agency just released in january of this year. with that information, i would ask you, mister secretary, would you be prepared to reject a contract, a contract amendment or a state plan amendment that undermines access to care by denying medicaid beneficiaries the access to only hospitals in their county are in their service area? >> congressman, let me commit to you that we are certainly willing to work with you if you believe that a, there is estate plan for your state of pennsylvania that is not working in the best interest of any medicaid patients. certainly, we will take a close look at that. we are in the process of reviewing any number of requests from different states on how to implement their medicaid

c f r 48 to 1 for, provider selection. 42 c f r for 38 point 12, provider discrimination prohibited. and a large amount of regulations and guidance that flow from these laws. notably, time and distance standards. network adequacy, in particular, as well as state guidance to see as a criteria from medicaid career contract. your agency just released in january of this year. with that information, i would ask you, mister secretary, would you be prepared to reject a contract, a contract amendment or a state plan amendment that undermines access to care by denying medicaid beneficiaries the access to only hospitals in their county are in their service area? >> congressman, let me commit to you that we are certainly willing to work with you if you believe that a, there is estate plan for your state of pennsylvania that is not working in the best interest of any medicaid patients. certainly, we will take a close look at that. we are in the process of reviewing any number of requests from different states on how to implement their medicaid program. we always, as i said, try to make sure that we move toward increasing access to care, quality care for those patients would receive it through medicaid. >> thank, you mister secretary. i look for the working with you on that issue. it is important and it is beneficial that medicaid patients have access to more facilities, regardless of the presence of qualifying relationships with organized labor. thank you for agreeing to address that with us. >> gentleman yields back. chair now recognizes the gentlewoman from california, miss barragan, for your five minutes of questions. >> thank you, madam chair. thank, you mister secretary, for being here today and all your work to make sure that there is a strong vaccination campaign to get the vaccine across the country and to people who are most vulnerable. and that we continue to fight covid as we see new variants come through. i heard you testify about the difference between the fda and cms, and i just want to comment on the decision that i disagree with, with cms. on finalizing a coverage policy to tighten and restrict coverage of fda approved alzheimer's treatments for an entire class of drugs. i had a chance to speak to the administrator, and i had a chance to hear your response. there seems to be a disconnect. we are saying that the fda can say something is safe, but then the cms will decide whether it's reasonably necessary. that, to me, seems like we're saying the fda can't judge clinical data, but cms can. it's also telling me and sending me a message that this is about access. once the fda passes it, people who have money and can pay for it will get it. people who are under a cms program won't. and that, to me, it's an access issue that continues to trouble me and something that i continue to have an issue about. talk about access to health care, this is access to health care. the decision should be between the patient and their doctor. and so, i will continue to speak out, because i am just so disappointed. this is the first time that we have had a drug that has been approved under the accelerated approval process that hasn't been covered by cms, a drug. so, that's the comment i have, i'm going to move on to my questions. and those around different topics. the first one is on the children's health insurance program. secretary becerra, the children's health insurance program or chip has been a success, reducing -- rate by 20%. in 2021, chip enrollment included over 7 million individuals per month. making it an essential part of children's health coverage. during the pandemic, chip help to ensure that children and pregnant women had free access to covid-19 testing in treatment. despite its success, chip it's the only federal insurance program that isn't permanently funded. so, every few years, congress scrambles to prevent chip from running out of money. can you speak to the importance of chip, and your thoughts on having it permanently funded? >> congresswoman, first, thank you for all the work that you've done on these issues. i will be many more children living in poverty if we didn't have the chip program. there will be many more children who would discover later in their life that they are suffering from illnesses that might be life-threatening. but are able to get the care that they need to prevent that from ever taking a life, with the chip program. it just, as i said earlier, my mom would always tell me [speaking spanish] , better to prevent that the media. chip house families that are lower income to prevent illness in their children from becoming life-threatening. we would be in disastrous shape if we did not reauthorize chip. >> thank you, i want to talk about the cancer moon shot and multiple myeloma. mister secretary, an important factor in reducing the mortality of cancers research in early detection of rare and aggressive forms of this disease. for example, multiple myeloma is a rare, fatal cancer of blood plasma cells with racial disparities in all ages, all stages of the disease. african americans account for 20% of patients diagnosed with multiple myeloma. despite being only 12% of the u.s. population. my own sister, who is only a year older than me, was diagnosed and is now battling this. and we will have it for the rest of her life, there is no care. various to treatment are also present. latinos have the lowest themselves transfer rate. for the treatment of multiple my. wilma given that mortality associated with rare cancers and lack of treatment options, youth can you discuss how the reinstated moon shot would affect the lives of people with rare, aggressive diseases such as multiple my wilma? >> excellent question. one of the things that we are doing to help launch the presidents moon shot proposal is to start by getting people back into doctors offices to get screened. there are estimates that nine to 10 million americans failed to make their screening appointments for cancer, because of the pandemic. we are going to launch an effort to encourage americans to go back and get checked, because the sooner you get checked the quicker you can address some of those cancers like can be preventable. i will tell you that we are also making every effort to make sure that we take equity into account in who participates in these clinical trials and the work that is done to make sure that we have treatments for everyone. >> thank you, mister secretary. madam, chair i yield back. >> gentlewoman yields back. the chair is pleased to recognize the gentleman from texas, mr. crenshaw. for your five minutes to question. >> thank, you madam chair. thank you ranking member for holding this important hearing. thank you, mister secretary, for joining us in prison. i've got to say, it seems like there is some bipartisan agreement on how cms does approval. so, that's good to hear as well. not one i want to talk about, though. i want to talk about title 42, as you can imagine. mr. becerra, i want to ask you why do you want to end the expulsions at the border, currently authorized under title 42? i want to understand this. >> congressman crenshaw, let me try to explain. we don't based terminations about title 42, which is a health care law that deals primarily with quarantine activities, we don't pesos on what is ink occurring in terms of the border on immigration. it is a health care measure, title 42, that israeli applied. when it is applied it is because the health conditions are such that cdc has recommended that we use it to try to keep populations from intermingling in ways that could lead to worse results. when something like covid-19 has us. >> i would take that as the answer, if you didn't also support title 42 authority to continue the mask mandate on airplanes, two masked children and head start programs. to authorize the eviction moratoriums. you've got to be consistent. you either believe that title 42 is still a necessary thing to do, because of covid, or you don't. so, which is it? >> well, in the various instances that you've raised, you'll see that the guidance of the cdc as provided has changed. whether it's four cruise ships, whether it's for children in school settings. they've all been adapting to the facts and the medicine and the science, what they tell us should be the case with regards to -- those >> i find it hard to believe that the science tells us that there is still covid on airplanes, even though that's been debunked wildly. many, many times, given the filtration systems on airplanes. they're still pushing for that mandate. but there's no covid on the border? with 8000 people crossing every single day? and, with title 42 rescinded, all estimates, this isn't even a partisan estimate, point to about 18,000 a day. again, which is it? it's covid still a problem or is it not? >> congressman, maybe you disagree but we are losing more than 300 americans a day. we still have over 1000 americans being hospitalized every day. >> so, it is a problem? then why not keep title 42 at the border? why not allow those expulsions? >> because, as i explained, a law that i used to declare public health emergencies log in the it's different than the title 42 that you're mentioning. it is yours principally, and only very infrequently, to deal with quarantines -- >> again, there is clearly no consistency here and that's a problem. >> there's absolutely consistency and with the cdc has done. cdc has been using the facts and the sciences to drive what it does. cruise ships are different in schools, which are different in the border. it's not a cookie cutter approach, the use of health care authorities. title 42 is not the same as the emergency declaration. >> i think we have utterly failed to provide the scientific data and scientific backing for saying that covid measures are still required for children over two years old and on airplanes. when both of those things have been debunked many, many times. versus the border, with 18,000 potentially crossing every day. and, by the way, filling up our hospitals, filling up on buses, moving into the united states, getting tickets to wherever they want. this is the problem, and also to say that hhs doesn't deal with immigration and that you look at this completely separately, that's also not true. because you oversee orr, right? which is the unaccompanied minors. so, how on earth can hhs deal with a tripling and quadrupling of unaccompanied minors coming to your system when you recent title 42? >> congressman, once again, by law we are the entity, orr, office of refugee resettlement, which takes custody of a child that isn't accompanied by an adult found at the border. by law, department of homeland security cannot hold that child for more than 72 hours. we, then, provide accommodation -- >> i understand what your job is. i'm saying there is no way you can do it under these conditions. i don't care how much money we gave you -- your, not the. you're letting people go and bask quantities -- >> congressman, you understand title 42, we understand, congressman, that title 42 has not applied to those children -- >> i understand, that but here's what happens. you have an excessive number of people crossing the border and, along with, that is more people. they come in large groups. this will happen by extraordinary numbers -- >> gentleman's time has expired. >> -- everyone agrees with that. >> the gentleman's time is expired. the chair now recognizes the gentlewoman from delaware, congresswoman rochester for her five minutes to question. >> thank, you madam chairwoman. and thank you so much, secretary becerra, for joining us today to discuss the presidents fiscal year 2023 budget for the department of health and human services. i want to start off by saying that i applaud the administration's efforts to make sure that americans get health care coverage and also to protect us from this historic pandemic. it is not lost that we have come a long way, and we still have a ways to go. but today, i'd like to focus on an issue that is really a priority for me and so many others. the pandemic has exacerbated it, social challenges have exacerbated this. i'm extremely pleased to see the administration's budget requests include several important proposals to strengthen access to mental health and substance use care and services. my colleagues on this committee and i have led efforts to provide your department and the departments of treasury and labor with new tools to strengthen the enforcement of existing mental health parity laws. the departments recently released report found that insurance companies are failing and falling short of providing parity and mental health and substance use disorder benefits. and the report documented numerous parity violations. secretary becerra, can you briefly discuss the report's findings and why mental health parity is so essential for our constituents? >> congresswoman, thank you for the focus you placed on this issue overtime. and thank you for the work that you've done. we can't say that we're really going to try to treat the health care needs of americans if we leave at mental health services -- . especially at a time when, because of the pandemic, we've seen how dramatically the increase for need for mental services is out there. especially for our children. so, we're going to do everything we can to make it clear that the president is willing to invest 50 billion dollars over the next ten years to change the way we deal with mental health services. and we're going to start doing far more work to aggressively enforce the law, to make sure that is compliance with the middle of parity laws we have in the books. >> you, know the fact that some insurance companies are still failing to deliver parity is unacceptable. that's why i'm really pleased to see the budget request includes funding for grants, to help states enforcement of health parity requirements. can you briefly discuss the challenges and stays face in the enforcement and oversight of existing parity laws and why this funding is critical? >> as a former attorney general in the state of california, i will tell you that it is tough when you have a good partner in the federal government helping you go to do some of this enforcement, you far more than just a federal government itself. i think many states will appreciate, if congress provides us with this funding, the grant help that will provide states who want to be out there and aggressively enforcing these parity laws. >> for far too long, frontline workers have lacked access to coverage for mental health and, due to loopholes in the current law that allows state and local plans to opt out of mental health parity, i'm also hard to see that the budget includes a request to finally close this loophole. can you discuss the importance of ensuring that frontline workers are protected by mental health parity laws? >> isn't it tragic, when you find out that you're working real hard and you're doing everything to keep someone else healthy and then you don't have access to the kind of care you need? we're going to do everything we can, congresswoman, to eliminate those kinds of barriers that really don't belong in the 21st century. not in america. >> lastly, medicaid and chip cover 40 million children. therefore, medicaid and chip investments in needed mental services are critical to addressing the national child mental health emergency. what are you proposing in your budget to specifically address children's mental health challenges, under medicaid and chip? >> congresswoman, where trying to ensure first that medicaid is available to all, families and we still have some states that are not taking up the medicaid opportunity to provide their families with that care. secondly, we're trying to make sure that we expand coverage into places and community settings. so it's not just reimbursement at a hospital, but there is more and more conversation about the possibility that medicaid could actually be there in schools. to provide those kinds of services, mental health services, that many of our children need. i've been in conversation with secretary cardona and the department of education, we're going to continue to work together to see if we can expand access to health care for our children. including in our schools. >> first of, all i want to thank you again for this focus. we have experienced individual trauma, as well as collective trauma as our country through all of this. your efforts are going to make a big difference, and thank you so much for being here. i yield back, madam chair. >> gentlewoman owns back. the chair now recognizes the gentlewoman from minnesota, miss craig, for her five minutes of questions. >> thank you so much, madam chair. secretary becerra, thank you for being here today to testify in front of the committee. as a member of congress, i know that you know one of my top priorities has been to lower the cost of health care for my constituents. a priority that i was so happy to see reflected in hhs 2023 budget. when discussing the high cost of prescription drugs, those who rely on insulin, specifically, we understand why prescription drug reform is so critical. according to the research by rand corporation, drug companies charge more for insulin in the united states than nearly three dozen other countries. the average price in america, across all types of insulin was more than ten times higher than all the other countries combined. that is why, any solution to increasing drug prices must include reductions of the cost of insulin. i am incredibly pleased at the house recently passed my bill, the affordable insulin now act. which would cap the head of pocket cost for insulin at $35 for those with private health insurance coverage or medicare part d. but we know that capping the cost, out of pocket cost, alone is not enough. we must continue to work on solutions to effectively lower the list price of lifesaving medications like insulin, including through drug price negotiations. so, secretary becerra, insulin has been available for roughly a century and yet the cost that patients face is increasing year after year. in your view, mister secretary, is there any justification for this? congresswoman, first, thank you for the work that you're doing on this subject. it makes no sense that a drug that has become so readily available continues to increase in price. it shows how broken our system is for drug pricing in this country then why americans pay far more than others around the world for the same drug, a drug oftentimes manufactured here in the u.s. i applied your effort. i hope that you succeed in making it clear to corral these prices is a necessity for the american people. i hope you are able to pass a measure that goes beyond just one particular medicine. there are so many drugs that have been overpriced here in this country. when i can tell you is that, no american should not be able to get the drugs that they need. every american should be aware of the effort you are making to make those drugs more affordable for them. >> thank you, thank you so much mister secretary. i want to just dig in a little bit about your view here. how do you measures already passed by the house, like the insulin bill, such as empowering medicare to negotiate drug prices, inflationary rebates, how do all of those things work together to lower insulin cause? i will follow it up by saying, any comments you have on other efforts the administration is undergoing to address the high cost of prescription drugs in america? >> congresswoman, by opening those curtains to how these drug manufacturers operate, how they praise their products, that transparency would give everyone insight on how this would be done, probably not in the best interest of patients. secondly, we are a country that believes in competition. it makes no sense that, the biggest purchaser of drugs the u.s. government whether for medicare or medicaid or through the veterans administration program they can't try to get the best price for all of those patients, all of those americans, who deserve to have that treatment. we know that if we are able to get the best price, then we will save americans not just a lot of money but will probably add years to their life. they will be able to afford their medication! one in every three americans tells us right now that they skimp on their medication because they have to make it last longer, they don't have enough money to use it the way it is supposed to be used. that is not right! we need to tackle that. that is where your efforts are going to be indispensable to make it possible for americans to get the drugs that they need. >> mister secretary, i will slip and one last question around your directive to cms to reevaluate the medicare premium update. any thing you can share? i know my constituents really do need the relief. >> congresswoman that is underway, it isn't -- the cms is working hard so we can give you an answer in. >> thank you so much for being in front of the committee today. we appreciate your partnership, with that madam chair i yield back. >> gentlewoman yields back, chair is pleased to recognize the gentlewoman from washington state, dr. schrier to question for five minutes. >> thank you madam chair, thank you secretary becerra for coming before this committee today to talk about the hhs but it and priorities. as a pediatrician i want to thank you for prioritizing children in your budget in so many ways. one thing i am especially pleased to see is the expansion of the vaccine for children program. the cover of ship enrollees. it is in line with the provisions in the bipartisan bill that i sponsored which sponsors this already excellent and really important program. i was also really happy to see the proposal to improve access for more children by expanding the network of providers who participate in the vaccine for children program. this is really important, we are seeing a drop in routine childhood immunization rates. just last week it was reported that hundreds of thousands of students are no longer adequately student from common diseases, used to be commented visas like measles, mumps, and protesters. this is particularly dangerous for the tweens and middle school who are particularly behind on their vaccines where we already see outbreaks of whooping cough. on the topic of vaccine nation, as a pediatrician mom the best way to help anxious parents feel comfortable about vaccinating their children is a conversation with a empathetic, caring provider. we also know from experience that these conversations may take time, trust is not built overnight. the medicaid program acknowledges this last summer. it is not recognizing the considerable timeline effort that this can take in a clinical visit. implementing programs to make sure that everyone who wants a vaccine can get it. so secretary becerra, how will hhs work with the cdc to ensure that children get caught up on routine childhood vaccinations. how can you make sure that the pediatricians can take adequate time to have these thoughtful conversations? >> congresswoman, first you have really pointed out how important it is that those trusted voices that get americans to take the leap how essential they are in this effort. pediatricians are among the most trusted individuals when it comes to encouraging families to take important safety measures for the children. we are going to be working with trusted voices, including folks like you and other pediatricians who can really reach out and connect with families in ways that others can't. we are going to continue to make every effort to provide states and local governments with the capacity to do more screening, they can get the type of information that they need. if we find out they have not yet received a vaccination those families will take the steps to let those children be vaccinated. we are going to try to do everything we can to ensure under the health programs that the federal government helps administer, medicare and medicaid in chief of children, ships are available to help those families who have lower incomes variable to include those kids when it comes to the protection of the vaccine provides. >> i appreciate that. i appreciate having multiple locations where kids can get the vaccinations. and also made sense because those conversations are so long, they can take away from other important conversations we have with patients. even having the ability to do a visit distributing vaccines. i want to highlight your comments about ensuring that americans have access to affordable health care. with the help of the american rescue plan there has been a dramatic drop in insurance premiums last year. in fact in my state nearly 16,000 washingtonians enrolled in new coverage, and more than 100,000 washingtonians pay hundred dollars or less every month thanks to the new cost cutting subsidies. i want to thank you and express how important these new cost cutting subsidies are and implore you to not let them run out at the rend of the year. is there anything secretary becerra, that congress can do to work with you to keep health care affordable for americans with the affordable care act plants? >> congresswoman, i think you mentioned one of the most important things that you can do. it is continuing those subsidies that have made quality health care, these are robust plans, not skinny junk plans that some people have to buy because they only pay a small amount upfront premiums. but when they actually and abusing how services a pay a ton of money out of pocket. these plants as you mentioned $100 a month in premiums for some family, under $10 a month for some families. it is a way to go, for your help we can make it possible! >> gentleman's chair is expired. the gentleman recognizes the gentleman from georgia mr. carter. >> thank you madam chair. mister secretary, along with 12 other members of congress i sent a letter to you and commissioner caliphate on february 16th about an important issue on blood testing. and the policies in regard to the american red cross. the bacterial mitigation method in question has been implicated in several occasion of sepsis and two patient deaths. in december the fda said they were investigating more cases. are you aware of any results of this investigation? >> congressman no i don't know of any final results in that. we can check back in, oregon how the folks doctor caliphate the folks from the fda go back to you as well. >> i would hope so, this is very concerning to me. as you know there are three different methods that can be used here. one that the american red cross is using, they are the primary supplier broad, the one that they are using not only is it the most expensive of all of them, and has a shorter shelf life. and we have had these instances of sepsis which have been recorded, and have resulted in a loss of life. that is of concern for a number of reasons. particularly in a district like mine where i have a large rural area. you don't have a large shelf life on some of the things, rural hospitals suffer because of it. and longer the shelf life, better it is for them. obviously cost is a factor as well. i am really concerned about the choice, to hospitals choices being limited and the customers are only being provided with one bacterial mitigation methodology. can you understand what my concern here, when the american red cross requires the most expensive, the shortest shelf life, and the one that has been indicated to cause sepsis? that is the only choice they have? can you understand my concern there? >> absolutely, i hear what you are saying. certainly i can make sure we follow up with you whether it is the fda or other folks on team we can try to follow up with you. >> i hope so, i look forward to that. this is extremely important. mister secretary as you know i'm a pharmacist and a health care professional. i have been fighting for years to get rid of g.i. fees, you know with those. our callback fees. it was put best i think by one of my colleagues, representative peter welch. drc, a pharmacy may get paid $10 and then six months, a year, two years later the insurance company will come back and say, we should have only paid $7 so you owe us $3. it's just not a sustainable business model. this is about the pbms have been doing. it makes it tough on small businesses and small pharmacies, as well! pharmacist are the most accessible health care professionals in america. 95% of our population live within five miles of a pharmacy. we need to keep pharmacies open. it is important to our health care delivery system. i was very encouraged that in january or department proposed a common sense policy that would require pricing concessions at the point of sale, where it should be. we know that it is going to the patient, and not to the third party, not to the middleman, the pbm that serves and brings no value whatsoever to the health care system, in my opinion. i wanted to make sure, do you agree that your rule of actuary in analysis that seniors would save on 21.3 billion dollars over the next ten years. >> congressman as you know when we are rulemaking out to be very circumspect and when i say. we have to stand with what we have produced so far. i have to have final measures very soon. >> i hope that he will implement this rule. i have heard some chatter, if you will, some noise that it may be delayed, again. i hope that this is not the case. this is the actual situation where we can decrease prescription drug costs for patients without inhibiting research and development, without discouraging research and development, by simply having transparency in the drug pricing chain. making certain that the discount are at the point of sale where they are going to a patient. >> congressman, i can say emphatically that we are looking forward to working with you on this issue. by the way if you will permit me, i would just like to salute all of those pharmacists who have been real heroes to try to tackle covid. >> why thank, you i am very proud of my profession. very proud of the work they have done. and as you mention, as i mentioned earlier, most accessible health care professionals in america. >> they stepped up. >> it's extremely important. >> the gentleman's time is expired. >> i thank you, i yield back. >> gentlemen time has expired. chair recognize as gentleman from massachusetts. representative trey hand. for five minutes to question followed by the gentleman from texas, mr. fletcher. followed by, understand the secretary has agreed to this, the gentleman from alabama who is waving on, that will conclude the hearing today. all right? this lori trahan, you are recognized. >> thank you madam chair, mister secretary thank you for being here with us today. the f-1:23 proposed budget indicates that once again this administration prioritizing the accessibility of high quality health care for all americans, including those in underserved communities. my district in massachusetts no one have done more to deliver quality affordable care for the underserved then the nurses, doctors, and administrators at lawrence general hospital in lawrence, mass. as you may recall from your visit to lawrence last august, the hospital serves the 80,000 residents of a beautiful bustling, diverse and historic city. 80% of the city's residents are of hispanic or latino descent. you may remember that the area was struck by a series of natural gas explosions in december of 2018, which devastated the community. just as a city was recovering the pandemic struck, setting progress back. on a per capita basis the city has suffered a greater number of per capita covid than any of the other 350 cities and towns in massachusetts. at 1.3 quarters in beijing capacity with dedicated to recovering covid-19 patients. time and again lawrence general has come through for the community, particularly the 20% living in poverty. indeed approximately 75% of its patient population is public payer, primarily medicare and medicaid. however, by caring for a underserved and covid ravaged community lawrence general has experienced an unprecedented -- paused or force them to postpone more lucrative. the budget does not include more funding for our safety net hospitals like lawrence general who were particularly hard hit by covid-19 and are now financially unstable. mister secretary i am curious how you see the fy 23 budget helping hospitals like warren's general keep their doors open as they continue to provide critical care to our communities through covid 19. >> congresswoman, thank you for the question. thank you by the way for your constant, consistent, advocacy for the people in your district who use lawrence general hospital for their workforce, the men and women the health care workers at lawrence, for all the good work that they do, as well. we are going to continue to do everything we can, and whether it is through the medicaid program or the medicare program to provide services to those, you have the resources to those providers who are out there providing services, especially to our left well-served families throughout the country. i will tell you that as we have had conversations in regard to the provider release fun, lawrence and other providers throughout the country are utilized in an attempt to cover the covid cost that they have had. we think it would be a phenomenal opportunity for congress to provide us with additional resources to supplement the provider relief fund. it is now essentially out of dollars. we can continue to provide services and support those providers who have stepped out. as i have explained to you before, we try to do the distribution of the dollars in a very transparent way. we can't speak for what was done before we came to office but anytime we distribute $1 under the provider relief and you will know exactly how it got distributed. >> i appreciate that. just curious the hhs did not request additional funding for safety net hospitals, or relief in the covid supplemental. could you just speak to, you know, the priorities that were reflected in the supplemental and how we can go about working together so we do get the safety net hospitals the funds that they need to get through. >> congresswoman, if you will look at the original request remained for a supplement much earlier this year it did include funds to be made available to the provided relief fund. that request was substantially more than, what's at this stage is being discussed in negotiations with congress in regards to a supplemental package. we would love to see dollars included in its of mental package that would require additional resources for the provider relief fund. we do not have a vote in that process. it is you in your colleagues here in the house and then in the senate will make that decision. we hope that in your wisdom he will include funding for providing relief funds that we can continue to provide the services. those hospitals other providers have dispensed to many of our uninjured population, we will need that support. >> thank you, thank you mister secretary. i am out of time, i yield back. >> gentlewoman yields back, the chair recognizes the gentleman from texas, miss fletcher for her five minutes to question. >> thank you chairwoman eshoo, and thank you chairman becerra for coming today to discuss the 2023 budget request for the health and human services agencies. i have three issues i would like to add to my time today. first i am thrilled that congress authorized the advanced research project agency health department h this year. recent advances in biomedical sciences from nino therapy to treat cancer too highly effective covid-19 vaccines have demonstrated the strength and successes of the u.s. medical enterprise. such advances present an opportunity to revolutionize how we prevent, treat, and even cure where diseases, including cancer, alzheimer's, infectious seasons, and many others that affect a significant number of americans. secretary becerra, in march you announced that arpa-h would be part of nih but the physical location would not be at the locations campus in maryland. my colleagues on this committee have heard many times before, i represent many people who work in the texas medical center in houston, which is the largest medical center in the world! and home to some of the most innovative medical research in the world today. the texas medical center is uniquely situated to house arpa h with its existing infrastructure, world leading research institution, and incredible people. the people who work there are willing and eager to ensure this new agency is successful, so i want to ask you first when you plan on announcing the location of arpa-h, and what you are taking into account when making this decision about its location? >>, congresswoman thank you for your interest and your support of arpa-h. we are right now in the process of making some of those decisions. we would like to try to work as closely as we can with the inaugural director of arpa-h before we launch too far. but i can tell you is that we wanted to have as much independents as possible, untethered from some of the previous ways that we have done some of the research. this research we want to have the applicability as quickly as possible as opposed to some of the basic nature that we see. phenomenal research which is done by nih. you have duly noted that there is a great sight there in texas that could accommodate arpa-h. i will tell you there are a whole bunch of folks who have reached out to us and told us the same thing. it is a fabulous opportunity for america to launch, just as darpa for the department of defense, we hope that arpa-h will do the same on health care. >> terrific, thank you so much. also want to touch on two other issues with affecting texas. a little less positive but i'm hoping to get your insights here in range these issues with you. i have races first issue directly with cmf, patients who use medicaid have been unable to access basic and critical reproductive health care services and planned parenthood for almost a year because of the continued termination of planned parenthood from the texas medicaid program. it has had a disastrous impact and really just decrease access of care and lead to poor health of comes. it is a violation of the medicaid free person and flies or requirement. i saw your exchange with representative eshoo when you testified in front of the budget committee. i look forward from strict action from sea of mass to enforce this requirement. the second issue i want to ask you about was well is on a similar topic really incredibly important component to ensure reproductive autonomy is access to medication abortion. it's is a effective option in early pregnancy, now some of those mitigation strategy requirements have been eliminated from the request. one is medication used during medication abortion care. i want to make sure that hhs is doing everything's power to expand access to this. garishly in a state where there are so many restrictions increasing every day. i really appreciate you took steps to improve the health care access task force. i was hoping you could update the committee on the steps of the department in the task force are taking to ensure medication abortions continue to be accessible here. what specifically is agents doing to facilitate this in terms of provision of clinics, male and telehealth pharmacies. if you could share that with us, and prioritize this issue we would very much appreciated. thank you. >> congresswoman respecting the time is left of saying, i can fall it will be more specifically. when i can tell you is when a medication is made available because the fda is decided safe and effective and we have a job to ensure that we have care of as many americans as possible, we will do everything we can to enforce the law, including women, including for abortion care, get the services in the products the medical products that they need to be able to exercise their rights. >> thank you so much mister secretary. i have gone over my time. madam chair, i yield back. thank you. >> gentleman yields back, mister secretary i want to ask you to do something. i know that you're ten minutes past where you want to be. mr. palmer is waving on, mr. palmer of alabama. would you take his questions? >> certainly. >> the gentleman from alabama is recognized for five minutes to question. >> thank you madam chair. i truly appreciate your indulgence. secretary becerra, i have expressed this concern in other hearings. i think we are facing a crisis of confidence in our nation, public confidence in many of our institutions. a lot of it has been borne out of the handling of covid. we are even more divided at the nation. it's impacting health care. the trust in health care, when i want to ask you about and i hate to do this but, hhs has just issued a medicare physician final rule that includes a provision that will provide a financial incentive for doctors and implement an anti racism plan. that is raising a lot of concerns among people. and just want to hear from you a little bit about how this is going to operate. i'll tell you my concern. i think it undermines public confidence in two ways. it raises questions in the minds of minorities that if they see a physician who is not of the same race or color, that they are not gonna get quality care. i think it undermines the confidence of people who are white that they are going to be discriminated against how would you address that? >> congressman i want to be as thoughtful in my answer as you were in the question. first we don't have a policy as you have described. our policy is to try to tackle the disparities bc in health care access. i can tell you a number of stories of heard from women, mostly black women, who go in to get care and they are not believed when they say there are in pain. because of sickle cell, they experience deep, deep, pain when they present an emergency room and they don't get the treatment they should be provided as someone who is suffering from sickle cell disease. we know that this happens. to ignore is to ignore a travesty in our system. we are simply trying to say that no one should be denied health care simply because of the disparities that exist which prevent you from getting the care that you need. we are trying to tackle those. >> we already have those rules. by the way, one of my best friends doctor tim towns one of the leading researchers in the world of alabama burma hamza a cell research, he is why. he has devoted his entire career to that. i just, i want you to understand that mayer is a divide that is being created here. it is going to further undermine public confidence. we are going to be extremely, extremely careful. it creates serious concerns that, you know if you go into a doctor's office and you think that you're going to put down your way you -- >> congressman, to that point if you will commit me much of this is driven by the miss and disinformation. i would challenge you to show me in our policies we call anything we are doing anti policies. we are simply trying to ensure that everyone has equal access to health care. >> if there are doctors out there that are discriminating against anybody for any reason, they need to be dealt with in another manner. that is totally unacceptable. totally unacceptable! >> i agree with you. >> i just want to raise that point, let you know that this is an issue. there are people out there who have raised concerns to me about. it i intend to address it further at the appropriate time. i do appreciate, very much you answering the question and your assurance that it is not the intent of hhs to discourage against anyone. i will hold you to. that again, i sincerely appreciate you staying 30 minutes past the original time you would give us. for that, madam chairman i will yield the remainder of my time. >> gentlemen, yields back the remainder of his time. mister secretary, thank you for accommodating the you're a former member of congress, you know that you wanted your questions answered when you addressed those that were representing agencies. i think the assistant secretary of legislation has some work to do. some catch-up work here. both sides of the aisle, members have made reference to writing but they haven't had their questions answered. and secondly, i think that it's important as secretary of hhs, to have a plan if in fact title 42 is lifted. you have responsibility for a plan. a public health plan, so that there is not any public health disaster relative to those at the border. so, that is your responsibility. i know that 42 seems to be kind of up for grabs right now. because of the court case. but, nonetheless, hhs has to have a plan. yeah i don't know with that plan is, but i expect that you would come out with one and outline it. >> madam chair, on that point. if you're referring to the situation at the border, we do have a plan to address that situation post title 42. speaking more generally, in terms of what happens to the country without title 42, we have been working on that as well. we can present that to you in the committee members if you'd like. >> no, it was the former, not the latter. >> remember, madam chair, that title 42 doesn't apply to the individuals at the border that the hhs doesn't have jurisdiction over, the children. we haven't had title 42 applied to unaccompanied minor children since december 2020. >> anyone that comes into the country that is admitted into the country, there are public health issues there. we've had to deal with them before and we might be presented with that case, i don't know. he's given the courts or what the administration is going to do. you always have to have a plan. i don't think we can walk away from that. all right, i just have a unanimous consent request to enter two items into the record. >> no objection. >> no objections. so, without objection, so, ordered members have ten business days to submit additional questions for the record. the witness, we ask that the secretary respond promptly to any questions that are received. and, at this point, the subcommittee is adjourned. 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