[House Hearing, 115 Congress]
[From the U.S. Government Publishing Office]
REGULATORY REFORM TASK FORCES CHECK IN: PART II
=======================================================================
JOINT HEARING
BEFORE THE
SUBCOMMITTEE ON
INTERGOVERNMENTAL AFFAIRS
AND THE
SUBCOMMITTEE ON HEALTHCARE,
BENEFITS, AND ADMINISTRATIVE RULES
OF THE
COMMITTEE ON OVERSIGHT
AND GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED FIFTEENTH CONGRESS
FIRST SESSION
__________
NOVEMBER 14, 2017
__________
Serial No. 115-57
__________
Printed for the use of the Committee on Oversight and Government Reform
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.fdsys.gov
http://oversight.house.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
30-244 PDF WASHINGTON : 2018
----------------------------------------------------------------------------------------
For sale by the Superintendent of Documents, U.S. Government Publishing Office,
http://bookstore.gpo.gov. For more information, contact the GPO Customer Contact Center,
U.S. Government Publishing Office. Phone 202-512-1800, or 866-512-1800 (toll-free).
E-mail, [email protected].
Committee on Oversight and Government Reform
Trey Gowdy, South Carolina, Chairman
John J. Duncan, Jr., Tennessee Elijah E. Cummings, Maryland,
Darrell E. Issa, California Ranking Minority Member
Jim Jordan, Ohio Carolyn B. Maloney, New York
Mark Sanford, South Carolina Eleanor Holmes Norton, District of
Justin Amash, Michigan Columbia
Paul A. Gosar, Arizona Wm. Lacy Clay, Missouri
Scott DesJarlais, Tennessee Stephen F. Lynch, Massachusetts
Blake Farenthold, Texas Jim Cooper, Tennessee
Virginia Foxx, North Carolina Gerald E. Connolly, Virginia
Thomas Massie, Kentucky Robin L. Kelly, Illinois
Mark Meadows, North Carolina Brenda L. Lawrence, Michigan
Ron DeSantis, Florida Bonnie Watson Coleman, New Jersey
Dennis A. Ross, Florida Stacey E. Plaskett, Virgin Islands
Mark Walker, North Carolina Val Butler Demings, Florida
Rod Blum, Iowa Raja Krishnamoorthi, Illinois
Jody B. Hice, Georgia Jamie Raskin, Maryland
Steve Russell, Oklahoma Peter Welch, Vermont
Glenn Grothman, Wisconsin Matt Cartwright, Pennsylvania
Will Hurd, Texas Mark DeSaulnier, California
Gary J. Palmer, Alabama Jimmy Gomez, California
James Comer, Kentucky
Paul Mitchell, Michigan
Greg Gianforte, Montana
Sheria Clarke, Staff Director
Robert Borden, Deputy Staff Director
William McKenna, General Counsel
Katy Rother, Senior Counsel
Michael Koren, Professional Staff Member
Kiley Bidelman, Clerk
David Rapallo, Minority Staff Director
Subcommittee on Intergovernmental Affairs
Gary Palmer, Alabama, Chairman
Glenn Grothman, Wisconsin, Vice Val Butler Demings, Florida,
Chair Ranking Minority Member
John J. Duncan, Jr., Tennessee Mark DeSaulnier, California
Virginia Foxx, North Carolina Matt Cartwright, Pennsylvania
Thomas Massie, Kentucky Wm. Lacy Clay, Missouri
Mark Walker, North Carolina (Vacancy)
Mark Sanford, South Carolina
------
Subcommittee on Healthcare, Benefits, and Administrative Rules
Jim Jordan, Ohio, Chairman
Mark Walker, North Carolina, Vice Raja Krishnamoorthi, Illinois,
Chair Ranking Minority Member
Darrell E. Issa, California Jim Cooper, Tennessee
Mark Sanford, South Carolina Eleanor Holmes Norton, District of
Scott DesJarlais, Tennessee Columbia
Mark Meadows, North Carolina Robin L. Kelly, Illinois
Glenn Grothman, Wisconsin Bonnie Watson Coleman, New Jersey
Paul Mitchell, Michigan Stacey E. Plaskett, Virgin Islands
C O N T E N T S
----------
Page
Hearing held on November 14, 2017................................ 1
WITNESSES
Mr. Robert Eitel, Senior Counselor to the Secretary, Department
of Education
Oral Statement............................................... 5
Written Statement............................................ 7
Ms. Rebeckah Adcock, Senior Advisor to the Secretary, Department
of Agriculture
Oral Statement............................................... 16
Written Statement............................................ 18
Mr. Charles Keckler, Associate Deputy Secretary, Department of
Health and Human Services
Oral Statement............................................... 20
Written Statement............................................ 22
APPENDIX
New York Times article titled, ``An Open Door for Pesticide
Lobbyists at the USDA,'' submitted by Representative Watson
Coleman........................................................ 50
Questions for the Record for Mr. Robert Eitel submitted by
Representatives Krishnamoorthi and DeSaulnier.................. 51
Questions for the Record for Ms. Rebeckah Adcock submitted by
Representative Krishnamoorthi.................................. 61
Questions for the Record for Mr. Charles Keckler submitted by
Representative Krishnamoorthi.................................. 66
REGULATORY REFORM TASK FORCES CHECK-IN: PART II
----------
Tuesday, November 14, 2017
House of Representatives,
Subcommittee on Intergovernmental Affairs, joint
with the Subcommittee on Healthcare, Benefits and
Administrative Rules,
Committee on Oversight and Government Reform,
Washington, D.C.
The subcommittees met, pursuant to call, at 10:08 a.m., in
Room 2154, Rayburn House Office Building, Hon. Gary J. Palmer
[chairman of the Subcommittee on Intergovernmental Affairs]
presiding.
Present: Representatives Palmer, Grothman, Walker, Meadows,
Mitchell, Demings, Krishnamoorthi, DeSaulnier, Norton, Watson
Coleman, and Kelly.
Mr. Palmer. The Subcommittee on Intergovernmental Affairs
and the Subcommittee on Healthcare Benefits and Administrative
Rules will come to order. Without objection, the chair is
authorized to declare a recess at any time.
I now recognize myself for 5 minutes for my opening
statement.
First of all, I want to welcome three more agencies to
discuss the administration's efforts to clean up and reduce the
country's out-of-control regulatory state. Last month, the
committee heard from the Department of Defense, the Department
of Transportation, and the General Services Administration on
their implementation of Executive Orders 13771 and 13777. These
executive orders create a process by which agencies must refill
two regulations for every new regulation it wants to issue.
The regulatory reform task forces help identify regulations
for repeal and coordinate the review process within the agency.
I can say that it is truly impressive to see the focus that the
agencies have placed on this initiative and the work that is
being done for the American public and the enthusiasm with
which it's being conducted.
At our last hearing, the Department of Defense reported
identifying over $10 million in savings and is on track to
review all of its regulations by the end of 2018. The GSA has
generated nearly 1800 proposals to reduce regulatory burden on
vendors and the public stating it is optimistic the work of its
task force will have a significant impact on improving GSA's
regulatory and operational landscape. And when you hear that
1800 proposals have been submitted, I would--it sounds like
it's more than a task force, that there are a lot of people
engaged in this. That's exactly what we hoped would happen.
The Department of Transportation shared how its reviews
have been able to save the American public significant time and
money without reducing the safety of the Nation's
transportation system. And by way of example, in fiscal year
2016, under the previous administration, Department of
Transportation issued rules opposing an estimated $3.2 billion
in cost. The rules issued in 2017 have resulted in
approximately $21.9 million in savings. This is meaningful
progress. In many cases, it's the task forces and the staff
that are the driving force and expertise behind the agency's
reviews and recommendations. And, again, what we've seen in our
first hearing is not only a commitment to do it but enthusiasm
for doing it.
We look forward to hearing how your task forces are working
with these subject matter experts, many of whom intimately
understand what is duplicative, outdated, or imposes the most
burden on the public. I'm also encouraged that my colleagues
across the aisle identified important areas for review, such as
agency guidance documents which often have the effect of a
regulation, and I'm pleased to hear the progress that agencies
are making in their review.
I would finally like to echo the praise Chairman Meadows
bestowed at our last hearing and applaud your efforts and the
time you've taken testify today. Ultimately, the work you are
doing with these task forces represent an important first step
in a necessary culture change with respect to how our
government works with and not at States, local governments, and
the American public.
I now recognize the ranking member of intergovernmental
affairs, Mrs. Demings, for 5 minutes for her opening statement.
Mrs. Demings. Good morning, everyone. I'd like to thank
Chairman Palmer for holding this important hearing today on
agency regulatory reform task forces. I would also like to
thank our three witnesses for joining us this morning.
Regulatory review and reform need not be a partisan
exercise. President Obama too created a retrospective review
process in 2011 to review outmoded, ineffective, insufficient,
or excessively burdensome regulations. But the Trump
administration, I believe, has not taken a balanced look back.
The Trump regulatory review process is aimed at removing
regulations that protect the public, including student loan
borrowers, those in need of health insurance, and even meat
processing workers. The regulatory reform task force at the
Department of Health and Human Services is undermining the
Affordable Care Act to make it harder for average Americans to
get health coverage.
The Department of Health and Human Services has undermined
the open enrollment period by unnecessarily shortening the time
for enrollment, reducing the number of individuals providing
enrollment assistance, and cutting the advertising budget by 90
percent.
And even when individuals are able to buy health insurance,
the regulatory reform task force has proposed allowing States
slash what the plans actually cover. The task force at the
Department of Agriculture is speeding up production lines and
poultry and hog slaughter facilities and reducing the number of
inspectors required to be onsite. High-speed production lines
have been shown to increase risk to health workers and
potentially lead to contamination of meat products consumed by
American families.
The task force at the Department of Education is actively
rolling back regulations meant to protect the next generation
of K through 12 and higher education students. They are
obstructing the gainful employment rule meant to ensure that
college students taking out loans will receive an education
enabling them to get higher-paying jobs by stopping the
necessary data collection that would make the rule operate.
They have halted the borrowers defense rule which created a
process for defrauded borrowers to apply for loan forgiveness
to which they are legally entitled and protect American
taxpayers by requiring certain schools to set money aside to
cover the cost of loan forgiveness rather than requiring the
public to bear the burden of fraud.
The Department of Education has been long rolling back
several Title IX regulatory guidance documents which permit
schools to make it much more difficult for victims of sexual
assault to obtain justice and causing confusion about whether
transgender students have any legal protections at all. This is
very, very concerning to me. I hope it's concerning to others.
And it's certainly concerning to the American public.
During today's hearing, I hope we can understand the aims
of the task forces at these three agencies and how they intend
to protect American families' health, safety, and economic
security. I look forward to hearing from our witnesses today,
and we thank the chairman for holding this very important
oversight hearing.
I yield back.
Mr. Palmer. I'll now recognize the ranking member of the
Subcommittee of Healthcare, Benefits and Administrative Rules,
Mr. Krishnamoorthi, for 5 minutes for his opening statement.
Mr. Krishnamoorthi. Thank you, Chairman Jordan and Chairman
Palmer, for convening this hearing today. I'd also like to
thank Ranking Member Demings for her friendship and leadership
and all other witnesses for participating today.
This is the second hearing our subcommittees have had on
regulatory reform task forces, and I'm very pleased that we
have the witnesses here today that we do. In particular, I am
pleased we have a representative from the Department of Health
and Human Services.
My constituents know that having health insurance saves
lives. It is for this reason that I am deeply troubled by
recent Trump administration actions that undermine the health
protections and coverage that millions of Americans have come
to depend on through the Affordable Care Act, also known as
ObamaCare. The administration's actions and proposed
regulations are literally making it harder for Americans to
receive health coverage.
The Department of Health and Human Services has cut in half
the open enrollment period for plans to be purchased on the
health exchanges, meaning that some individuals will either not
have health insurance or will be penalized for obtaining
insurance late. The administration has cut the open enrollment
advertising budget by 90 percent and is waiving requirements
that States contact difficult-to-reach individuals, meaning
that many people living in rural areas may not even know they
need to sign up for health insurance.
The administration has refused to provide funds to
stabilize the healthcare market as required by law. Failing to
do so has raised premiums and deductibles for families buying
health insurance on the exchanges and will end up costing
American taxpayers more in the long run.
HHS has also permitted all employers to deny female
employees no copay access to contraception. HHS has proposed
allowing States to lower standards for essential health
benefits so that States can engage in a race to the bottom in
terms of what health insurance plans are required to cover.
Similarly, the administration has proposed expanding short-
term, limited-duration plans which need not meet the
requirements of traditional health plans permitting healthy
individuals to circumvent the ACA's requirements nearly in
total. HHS has also proposed loosening the medical loss ratio
so that insurance plans can spend more on advertising and
executive salaries and less on doctors, nurses, surgeries, and
medications for those who need it.
These are just the beginning of all the actions the
administration is taking to undermine the Affordable Care Act.
There is an old saying that there is no Republican or
Democratic way to pick up the trash or fill a pothole. The only
thing that matters is that you deliver for your constituents.
I think we should increase inefficiencies and cut
unnecessary regulations as long as doing so improves the
quality and availability of healthcare for all Americans.
Unfortunately, that does not appear to be what the Trump
regulatory task forces are doing. Instead, in this case, their
task force is making it harder for Americans to get quality
health coverage.
I'm very grateful to the chairman for calling this hearing
so we can further investigate the reasons behind the
administrative actions at issue and the policy goals they
serve. However, I will be asking some important questions about
the effects of these actions on the availability of healthcare
coverage on the exchanges. I look forward to discussing this
and other issues with the witnesses today.
Thank you, and I yield back.
Mr. Palmer. I thank the gentleman.
I'm pleased to introduce our witnesses. Mr. Robert Eitel,
senior counsel to the Secretary at the Department of Education;
Ms. Rebeckah Adcock, senior adviser to the Secretary at the
Department of Agricultural; and Mr. Charles Keckler, associate
deputy secretary at the Department of Health and Human
Services. Welcome to you all.
Pursuant to committee rules, all witnesses will be sworn in
before they testify. Please rise and raise your right hand.
Do you solemnly swear or affirm the testimony you're about
to give is the truth, the whole truth, and nothing but the
truth, so help you God?
The record will reflect all witnesses answered in the
affirmative.
Please be seated.
In order to allow time for discussion, please limit your
testimony to 5 minutes. Your entire written statement will be
made part of the record.
As a reminder, the clock in front of you shows the
remaining time. Unlike a traffic light, when the light turns
yellow, you do need to speed up, you have 30 seconds left, and
red when your time is up. And I'll remind you if that doesn't
get your attention.
Please also remember to press the button to turn your
microphone on before speaking.
I would now ask Mr. Eitel to give his testimony.
WITNESS STATEMENTS
STATEMENT OF ROBERT EITEL
Mr. Eitel. Good morning, Chairman Palmer, Ranking Member
Demings, Ranking Member Krishnamoorthi, and members of the
subcommittees. I'm delighted to be here today to present the
work of the Department of Education in the area of regulatory
reform and to provide you with an update on its progress.
Regulatory review and reform are a top priority of
Secretary DeVos in the Department. It is critical that the
Department maintain regulations and guidance that are
understandable, clear, and effective, and that they actually
serve the interests of students, parents, teachers, and other
stakeholders. To that end, in April, Secretary DeVos convened a
task force of career civil servants and noncareer appointees
appointing as co-chairs a senior civil servant from the Office
of the General Counsel, who is also our regulatory policy
officer, and myself, its regulatory reform officer. She also
directed that the task force conduct itself with three guiding
principles in mind: Transparency, stakeholder engagement, and
thoughtful deliberation.
So with regard to transparency, the task force has taken
transparency seriously. Indeed, to that end, it has posted on
the Department website two reports: A progress reported dated
May 25 and a status report dated October 18, together with
extensive attachments describing the activity of the task force
to date. We will continue to provide public updates as the
Department's regulatory reform work continues.
With regard to stakeholder engagement, the task force has
also taken to heart the Secretary's direction to engage the
public concerning its regulatory review. This public engagement
is, in fact, a requirement of Executive Order 13777 and, for
that matter, Executive Orders 12866 from 1993 and Executive
Order 13563 from 2011.
So how did the task force accomplish this worthy goal of
stakeholder engagement? First, the Department published a
Federal register notice in June asking for public comment on
which, if any, regulations and guidance to repeal, modify,
replace, or to keep. The Department provided the public with 90
days to submit comments to regulations.gov and received in
excess of 16,000 comments about its regulations and guidance by
the time the comment period closed on September 20th. The
Department is presently reviewing those comments.
Second, at the request of the task force, each principal
office in the Department engaged in stakeholder outreach to its
constituency. So for, by way of illustration, the office of
post-secondary education has public hearings at South Lake
Community College in Utah and at the Department of Education.
Other offices conducted their own outreach efforts.
With regard to the principle of thoughtful deliberation,
the task force has taken several considered steps to comply
with the executive orders. The first step that the task force
took was simply to catalog all of the Department's regulation
and guidance. That is to ask what do we have in terms of
regulations and guidance on the books?
Turning first to regulations, we found that the Department
maintained in excess of 150 departmental regulations. As part
of its initial review, four regulations or proposed regulations
in the area of elementary and secondary education were
identified for withdrawal, mostly because they were simply out
of date and related to programs that had not been authorized by
a Congress. And two regulations in the area of higher education
were identified for negotiated rulemaking. The Department will
be withdrawing the elementary and secondary rules in the coming
months and has begun negotiated rulemaking on the higher
education rule.
Turning to guidance. We discovered, to our amazement, that
the Department maintained an astounding 1,772 policy-oriented
guidance documents, including Dear Colleague letters, FAQs,
policy memos and the like. Of these, nearly 600 items were
simply out of date, some of them dating back to the early
1980s, and interpreting laws that were no longer in effect or
relating to long-ago events, such as the flooding in the upper
Midwest that occurred in 1997.
Based on recommendations from career staff in each
principal office and with the approval of career attorneys in
the office of general counsel, and I would like to stress that,
based on the recommendations of career staff and after review
by career attorneys, the Department took steps to withdraw this
out-of-date guidance to provide clarity to the public. That
guidance is attached to our October 18th report on the Web.
With that, I thank you for the opportunity to be here
today, and I look forward to answering your questions.
[Prepared statement of Mr. Eitel follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Palmer. Thank you.
The chair recognizes Ms. Adcock for her testimony.
STATEMENT OF REBECKAH ADCOCK
Ms. Adcock. Chairman, ranking members, and members of the
committee, thank you for the invitation to testify before your
subcommittees today. As a designated regulatory reform officer
for the Department of Agriculture, I am pleased to share with
you Secretary Perdue's commitment to fulfilling the President's
promise to reduce unnecessary regulatory burdens and barriers
within the Department.
In line with Executive Orders 13771 and 13777, Secretary
Perdue is determined to obey the practice of legislating
through Department regulations and guidance and staying within
the bounds of congressional authority. USDA embraces the five
regulatory reform principles of reducing regulatory burdens and
process barriers, regulating effectively and efficiently,
promoting due process, providing fair notice and transparency,
and respecting individual freedoms and property rights.
Consistent with the executive orders, it's our goal to
collaborate with the public and identify regulations that are
creating more problems than they're solving. And to achieve
that goal, we published a call for public input on July 17th,
2017, and that lasts through next July 2018. USDA is receiving
comments during this time during four rounds of review:
September and November of this year; February and July of next
year. To date, USDA has received and begun the review of over
145 comments. And I believe, actually, the number rose a little
bit over the last a couple of days.
Last month, the Secretary held a public listening session
on cutting the red tape where policy experts, nonprofit
organizations, and industry groups aired their concerns about
different regulatory burdens. Those event materials should have
been supplied to you via the committee for your review. USDA
listened, and with our submissions to the spring agenda
released in June and those that will be released in the
upcoming fall unified regulatory agenda, we are taking actions
to revise and reconsider regulations and, where appropriate,
deregulate.
Additionally, as a function of the Secretary's leadership
of the President's interagency task force on agriculture and
rural prosperity, USDA held listening sessions with
stakeholders across the countryside, not aimed solely at
regulatory reform or barriers. But during his travels through
rural America, he did hear from producers, business people,
rural residents, and community leaders on everything from farm
programs to forest service directives to wetlands and the
challenges we have there. Some of those ideas and concerns may
be issues that can be and will be addressed during our ongoing
review of regulatory and reform process at USDA.
USDA is a very large organization, and it touches the lives
of virtually every American in ways they don't ever know about.
We have nearly 100,000 employees made up of dedicated civil
servants who believe in the work we do to support the
production of food, fiber, and fuel, as well as the rural
communities we support.
Our internal regulatory reform task force is composed
almost exclusively of career-level senior staff from each of
our mission areas, agencies, and offices. During their first
round over the course of the last summer and early fall,
preparing for the fall agenda, the task force identified over
275 potential recommendations aimed at decreasing duplication
and working more efficiently and effectively as an agency.
Some recommendations were administrative actions that were
as simple as making it happen. And they've been already adopted
and are underway. But over half of the recommendations were
potential regulatory reforms, many of which will be reflected
in the upcoming fall agenda from OMB.
The Secretary views regulatory and operational reform as an
ongoing process aimed at improving the culture of how USDA runs
and relates to our customers and constituents. He expects that
final regulatory decisions will be lawful, fact-based, and
supported by data collected through sound scientific
methodology.
In addition to the President's five principles, we do our
best to consider how each regulation or action will--reviewed,
has an impact on jobs and the economy as well as weighing the
cost, the benefits, the burdens, and the opportunities to
stakeholders.
At USDA, we trust in the American people, especially those
in rural America, to do the right thing for their businesses,
their communities, and their country. The Federal Government
must also do our part at minimizing burdens and reducing
barriers. We know we can do better, and Secretary Perdue and
the dedicated people of USDA are committed to making that
happen.
Thank you again for the opportunity to testify today on
behalf of USDA, and I look forward to answering your questions.
[Prepared statement of Ms. Adcock follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Palmer. Thank you.
The chair now recognizes Mr. Keckler for his testimony.
Thank you.
STATEMENT OF CHARLES KECKLER
Mr. Keckler. Thank you. Good morning, Chairman Jordan,
Chairman Palmer, Ranking Member Krishnamoorthi, Ranking Member
Demings, and members of the subcommittees. Thank you for the
opportunity today to discuss the Department of Health and Human
Services' efforts regarding regulatory reform.
HHS is committed to improving the regulatory process as
laid out by the President's executive orders, and our
Department is always willing to engage with both the members of
this committee and your staff to help us improve our work.
On February 24th, 2017, the President signed Executive
Order 13777. It required the head of each agency to designate a
regulatory reform officer. This officer would oversee the
implementation of regulatory reform, initiatives, and policies.
The order also requires agencies to establish a regulatory
reform task force. This task force was instructed to evaluate
existing regulations and make recommendations regarding the
repeal, replacement, or modification of those regulations.
The President's February executive order instructed each
task force to identify regulations that eliminate jobs or
inhibit job creation and to find regulations that are outdated,
unnecessary, or ineffective. The task forces must also review
regulations that impose costs that exceed benefits and evaluate
regulations that create a serious inconsistency or otherwise
interfere with regulatory reform initiatives and policies.
Importantly, this executive order also instructed agencies
that the task force should seek input and other assistance from
those entities significantly affected by Federal regulations.
In particular, agencies should seek input from State and local
governments, small businesses, and consumers.
HHS established its regulatory reform task force on April
13th, 2017. The task force meets once per week to evaluate
deregulatory proposals from operating and staff divisions
across HHS using instructions and criteria outlined in
Executive Orders 13771, and 13777, and OMB guidance documents
M1721, and M1723.
The deregulatory proposals are presented to the task force
for consideration only after they have been evaluated by
regulatory reform working groups. The working groups are
designed to offer a forum for the Department's subject matter
experts to carefully assess deregulatory proposals using
criteria that complement the goals of the executive orders.
Each working group meets regularly and consists of 15 to 23
career staff experts from across HHS.
Each operating and staff division has a regulatory reform
officer who is responsible for submitting deregulatory
proposals once per month to the relevant working groups. The
deregulatory proposals are then assessed by the working groups
and ultimately the task force. The RRO is also charged with
communicating important information on regulatory reform to
their respective division. Once a month, a call is held with
the RROs to answer questions and share best practices.
The regulatory reform process at the Department of Health
and Human Services encompasses all agency rulemaking including
the Centers for Medicare and Medicaid Services. CMS is
committed to putting patients first and easing the regulatory
burden that is harming the relationship between a patient and
his or her doctor and other type of healthcare provider.
Regulations have their place and are important to ensuring
quality, integrity, and safety in our healthcare system. But,
if rules are misguided, outdated, or too complex, they can have
a suffocating effect on healthcare delivery by shifting the
focus of providers away from patients and toward unnecessary
paperwork and ultimately increase the cost of care.
CMS Administrator Verma has launched a review of all
quality measures, for example, to ensure they are most
meaningful. Too often, healthcare quality measures focus on
process and not whether on that process has improved the
quality or safety of healthcare. Clinicians and hospitals have
to report an array of measures to different payors. These
measures are often different, and there are many steps involved
in submitting them, taking time away from patients. For
example, across CMS hospital quality reporting programs, in-
patient hospitals report up to 61 quality measures.
According to the American Academy of Family Physicians,
some family practitioners have to report nearly 30 measures to
seven different payors which can lead to less time focused on
patients and contribute to clinicians' burnout.
Through CMS' review, we will focus measurement on assessing
those core issues that are most vital to providing high quality
care and improving patient outcomes.
Thank you for your opportunity to testify today. I am glad
the committee is taking the time to review the complex and
often overbearing regulatory system that exists in the United
States.
Stakeholder feedback is critical to the part of work we are
undertaking at HHS to reduce regulatory burden. As we reach out
and listen to providers, patients, experts, and consumers, I
wish to note that Congress remains our most valued stakeholder.
Please know that our Department is always ready to discuss any
regulations that you believe are problematic or those that need
to be strengthened.
In preparing for this hearing, we've had several productive
conversations with both majority and minority committee staff.
I want to thank them for their thoughtful effort they put into
this matter. We look forward to working with them even more in
the future.
I'm happy to answer any questions you may have.
[Prepared statement of Mr. Keckler follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Palmer. Thank you.
The chair now recognizes the gentleman from Michigan, Mr.
Mitchell for, 5 minutes.
Mr. Mitchell. Thank you, Mr. Chair.
I came to the hearing today in admittedly the naive hope
that we'd actually talk about regulatory improvement and
streamlining and not simply the political environment. You'd
think after 10 months I'd learn better.
My colleagues on the other side of the aisle say they don't
want to be this political process and then immediately proceed
to suggest or directly indicate that any action that you take
to repeal regulations has some stealth political aim rather
than simply be a belief that regulations need to make sense. In
fact, it would be nice if they weren't outdated.
Mr. Eitel, let me start with you. I note you were talking
about 150 regulations for review and 1772 guidance documents,
with your colleague letters, policy letters.
My understanding, having experience with some of that, is
that those letters aren't subject to a most political
rulemaking, comment, review. They're issued by the Department,
and they have the effect of law unless challenged in court,
correct?
Mr. Eitel. It is true that guidance is supposed to be
simply that, that it is guidance from the Department to assist
our stakeholders in navigating the laws and regulations that
they have to abide by. Guidance, as a consequence, as it can be
simply issued by the agency, can be simply withdrawn by the
agency in accordance with OMB guidance.
Mr. Mitchell. Right.
Mr. Eitel. Rules, on the other hand, that is the
regulations, must go through the rulemaking process. So that
rule which we wish to promulgate must go through the rulemaking
process, the MPRM, et cetera. To withdraw it, we have to a
follow a similar procedure.
Mr. Mitchell. But one of the challenges with ``Dear
Colleague'' letters and the like is that the Department takes
action based on their interpretation of regulations without any
public comment or discussion, whether that interpretation, in
fact, is a valid interpretation. And that happens a number of
times in a variety of agencies, including the Department of Ed.
How was it that we get beyond a huge number of policy
guidances and just have some regulations that make some sense?
How do we reduce that burden?
Mr. Eitel. I think there needs to be a return to the
requirements at the APA. And that is when an agency, a Federal
agency, desires to bind the public with a rule, it should go
through notice and comment rulemaking, generally, in accordance
with OMB guidance and the APA.
Mr. Mitchell. Let's talk briefly, since my colleague wanted
to make a comment, in my opinion, a political comment, about
gainful employment and the fact you withdrew the regulation
pending, an NPRM, and rewriting that regulation. What was the
rationale of the Department for withdrawing that regulation,
sir?
Mr. Eitel. I was not personally involved in the decision to
commence negotiated rulemaking on gainful employment. I am
personally recused from that matter, and I've had no role in it
personally.
Mr. Mitchell. Sorry. I should have known that.
Mr. Eitel. I would also add that, based on what I have read
in the media and the Federal Register, that rule will be
undergoing negotiated rulemaking, and it would be, I think,
inappropriate for me to comment anyway on that issue.
Mr. Mitchell. Well, allow me to take a moment to comment on
it, which was one of the fundamental problems of gainful
employment, which my colleagues should know, is that it only
assessed, theoretically assessed, was questionable data. The
success rates of private career schools. They failed to provide
information to consumers or the Department on the success rates
of universities, colleges, community colleges.
In fact, it was politically targeted, and the data is
flawed. That's the underlying reason why we're dealing with
gainful employment again, or some version of that. And it will
be an issue we'll deal with in education workforce. So I look
forward to engaging in that conversation.
Ms. Adcock, in the few minutes I've got left, for better or
for worse, you gained more name ID. I'm sorry for you. I truly
am.
In the last--since you joined the Department, how many
meetings with various stakeholders have you had roughly, do you
think? Estimate. I understand it's an estimate.
Ms. Adcock. I would really--a dozen, a half--or a dozen or
two. I--a lot more internal meetings. Most of my effort has
been focused on regulatory reform and rural prosperity.
Mr. Mitchell. I understand. And the point I wanted to make
was that there's no one sitting in this room in a policymaking
position, including on this dais, that does not spend quality
time meeting with stakeholders throughout the industry that we
deal with. Take the transparency, Mr. Eitel and I have met
previously. I can't tell you the number of education groups I
met with, agriculture groups I met with, both businesses as
well as farm bureau and others. The reality is that's part of
the job.
So I am sorry that your integrity was questioned by
comments that you had actually had the temerity to groups that
you folks would deal with that were in the industry. It
shouldn't happen, and I'm sorry for you, and welcome to
Washington.
With that, I yield back, sir.
Mr. Palmer. The chair now recognizes the ranking member,
Mrs. Demings, for her questions.
Mrs. Demings. Thank you so much, Mr. Chairman. And I feel
compelled to comment--make a comment regarding my colleague's
comment. Perhaps he's a little overly sensitive today because
he finds himself another year older. Today is his birthday. But
everything's going to be okay, Paul.
I don't--I have not heard anyone say that any action or any
effort to remove any regulation is totally unacceptable. That
is not what we are trying to do here. What we are trying to do
is make sure that every action that is taken either by Congress
or by you and your agencies protects the American public. And I
think that is all of our responsibility, whether it is our
birthday or not.
The Obama Department of Education issued the borrower
defense rule which created a process, as you all know, for
defrauded borrowers to apply for loan forgiveness to which they
are legally entitled and protect American taxpayers by
requiring certain schools to set aside money to cover the cost
of loan forgiveness.
Mr. Eitel, was the idea of postponement that we're seeing
out of the current administration originally your idea? And if
it was or wasn't, which role did you personally--or what role
did you personally play in the postponement or the rewrite?
Mr. Eitel. Congresswoman, as you know, the rule is
undergoing revision in negotiated rulemaking as we speak. It
would be inappropriate for me to talk about the subject matter
of the borrower defense regulation while that negotiated
rulemaking is occurring.
Mrs. Demings. Was the postponement your idea?
Mr. Eitel. To say that it was my idea would not be
accurate. There is an entire infrastructure in place at the
Department that deals with borrower defense matters and other
regulatory matters.
Mrs. Demings. Are you involved in the rewrite?
Mr. Eitel. No. That matter is undergoing, negotiated
rulemaking, as we speak. And I cannot comment on negotiate
rulemaking that is occurring presently.
I would also add that the borrower defense rule is being--
or the decision by the Department has been challenged in
litigation. And for that matter, I also cannot speak on the
borrower defense regulatory matter.
Mrs. Demings. So can you answer did you speak with anyone
at the White House about the rule? Yes or no.
Mr. Eitel. I cannot speak to that given the posture of
litigation and given the fact that we are engaged in negotiated
rulemaking on this issue.
Mrs. Demings. And please explain your reason again for not
being able to answer yes-or-no questions about who you spoke
with about it, whether the Secretary of Education or anyone at
the White House. What's your rationale again, please, for that?
Mr. Eitel. The rationale is that the matter is in
negotiated rulemaking. It would be inappropriate for me to
comment on the rule in any way, shape, or form. And in addition
to that, the rule--the decisions of the Department on this
matter have been challenged in litigation, and there is ongoing
litigation proceeding as we speak in Federal court. I cannot
comment further.
Mrs. Demings. Can you tell me, between February 13th and
April 5th, when the OMB report came out, were you employed at
Bridgepoint Education?
Mr. Eitel. I was on unpaid leave of absence from
Bridgepoint Education during that time----
Mrs. Demings. So you were employed at Bridgepoint, if you
were on a leave of absence.
Mr. Eitel. That's correct.
Mrs. Demings. You were still employed.
Mr. Eitel. It was an unpaid leave of absence from
Bridgepoint Education.
Mrs. Demings. But you were employed by Bridgepoint
Education.
Mr. Eitel. I was on an unpaid leave of absence from
Bridgepoint Education. And to explain further, I consulted with
the Department's ethics officer prior to coming to the
Department. I met with her, received advice, and complied with
that advice fully and completely.
Mrs. Demings. And what was the advice that you received?
Mr. Eitel. That I could come to the Department, that I
could work at the Department on an unpaid leave of absence and
recuse myself from matters--particular matters involving
specific and prior employers that I worked for in the past.
Mrs. Demings. Okay. And how long were you in that unpaid
status? Do you remember?
Mr. Eitel. Well, to be clear, I was in an unpaid status
from Bridgepoint Education.
Mrs. Demings. Right. How long were you----
Mr. Eitel. I joined the Department on February 13th----
Mrs. Demings. Okay.
Mr. Eitel. --and formally resigned in early April.
Mrs. Demings. Okay. Thank you so much, Mr. Chairman. I
yield back.
Mr. Palmer. The chair now recognizes the gentleman from
North Carolina, Mr. Meadows, for 5 minutes.
Mr. Meadows. Thank you, Mr. Chairman. Thank you for
conducting this hearing. And as we look at regulatory reform, I
guess--is it Eitel?
Mr. Eitel. Eitel, sir.
Mr. Meadows. Eitel. Okay. All right. That's a little tough
for a North Carolina Member to get it correct on the first
drop.
So, Mr. Eitel, let me come to you. If we're looking at
regulatory reform, and as you have just demonstrated to my
colleague opposite, during negotiations it would be
inappropriate to talk about the negotiations that go back and
forth, will Congress be able to review that, any
recommendations that you made coming back to Congress in the
formal rulemaking process? Is there a statute that would allow
us to do that?
Mr. Eitel. Not to my knowledge. In connection with
negotiated rulemaking under the----
Mr. Meadows. But when you make your final decision, does
that not come back to Congress?
Mr. Eitel. Well, there is a notification requirement.
Mr. Meadows. Right. And so we would still have a review
period as outlined for our congressional responsibility; is
that correct?
Mr. Eitel. I believe so, under the congressional review act
sir.
Mr. Meadows. All right. So let me go back to guidance,
because you talked about guidance a little bit ago, and that's
one of those areas that I have, I guess, a keen sense of
guidance being offered that is never noticed to Congress and
yet has the same effects of a rule. How many would you say
guidance is out there? How many different guidance memos would
be out there that have the effect of a rule in your particular
agency?
Mr. Eitel. Well, we did do a canvass at the beginning of
the process, and we discovered that we had 1,772 pieces of
guidance in the form of ``Dear Colleagues,'' policy memos,
FAQs, and the like. The question is to what extent do they have
the force of law.
Mr. Meadows. Well, but we know that they, many times, do
have the force of law, because we've actually had that
litigated when you--in their juris prudence that would suggest
many times the guidance has the enforce of a rule.
Mr. Eitel. That is correct, sir. The guidance is----
Mr. Meadows. So out of those 1700-plus guidance memos and
Dear Colleagues, how many of those were noticed to Congress?
Mr. Eitel. I do not know that for sure, but I would
imagine----
Mr. Meadows. Can you get that back to us?
Mr. Eitel. Yes, I think so.
Mr. Meadows. You would think there would be none, right?
Mr. Eitel. Yes.
Mr. Meadows. So if it has the effect of being a rule, and
it wasn't noticed to Congress, would you not see a problem with
that from a standpoint of being enforced as a rule? Would you
not see that as a way to get around the rulemaking notice
provision that is in statute?
Mr. Eitel. It could present a problem to the agency.
Mr. Meadows. Because you could just pass one rule and do 20
guidance memos, and Congress would never be able to weigh in.
Do you not see that as a problem?
Mr. Eitel. I do see that as a problem.
Mr. Meadows. Okay. Can you get that to this committee in
terms of how many guidance memos were not noticed?
Mr. Eitel. Yes.
Mr. Meadows. Okay. Ms. Adcock, can you do the same for
USDA?
Ms. Adcock. Yes, sir.
Mr. Meadows. All right. So would you see it as a problem?
Ms. Adcock. Yes, sir. We are in the process of cataloging,
understanding better where our breadth of guidance documents
are throughout the agency, yes, sir.
Mr. Meadows. So what would you estimate your guidance
documents, the breadth of that would be?
Ms. Adcock. I----
Mr. Meadows. More than 1700 that Mr. Eitel has----
Ms. Adcock. I would think less. I would think less.
Mr. Meadows. You would think less. Okay.
Mr. Keckler.
Mr. Keckler. Yes, sir.
Mr. Meadows. You probably figured I was coming down the
road, so I guess you prepared for this answer.
All right. So----
Mr. Keckler. Sir, we have begun a review of the extensive
number of guidance documents within the Department. But I, as I
sit here today, am not in a position to give you an estimate or
a number, but we can certainly get back to you with----
Mr. Meadows. What's a reasonable amount of time to get that
to this committee?
Mr. Keckler. With regard to how many----
Mr. Meadows. Yeah. I mean, if you've started your canvass,
is it going to go on for 2 years or--I mean, can you get that
number to this committee in the next 45 days?
Mr. Keckler. We can make a determined effort whether----
Mr. Meadows. You're starting to sound like a politician. I
need a time.
Mr. Keckler. We'll give you an answer, with an estimate, in
90 days.
Mr. Meadows. With an estimate of what?
Mr. Keckler. Of our policy documents.
Mr. Meadows. I tell you what.
Mr. Keckler. Okay.
Mr. Meadows. Let's change this.
Mr. Keckler. Okay.
Mr. Meadows. Within 14 days, get to this committee your
plan of action on how you're going to address that request. How
about that?
Mr. Keckler. Yes, sir.
Mr. Meadows. All right. Thank you.
I yield back.
Mr. Palmer. The chair now recognizes the gentleman from
Illinois, Mr. Krishnamoorthi, for 5 minutes.
Mr. Krishnamoorthi. Thank you, Mr. Chairman.
I'm deeply worried that actions that HHS have taken leading
up to and during this 2018 open enrollment season will cause
more Americans to go without health coverage. From cutting the
funds for outreach to cutting the open enrollment season in
half from 90 to 45 days, to shuttering healthcare.gov every
Sunday from 12:00 a.m. To 12:00 p.m. During the open enrollment
season, one could be forgiven for assuming that HHS wants fewer
Americans to have health insurance. I'm pleased that Ranking
Member Cummings has taken a keen interest in this and that we
have been investigating the, quote/unquote, ``maintenance
windows'' that are going to be happening every Sunday and their
affect on American's ability to enroll in health coverage.
Mr. Keckler, are you aware that, on September 29th, Ranking
Member Cummings and I sent a letter to HHS requesting documents
relating to the decision to schedule website maintenance
downtime during open enrollment?
Mr. Keckler. No, sir, I'm not personally aware of that
letter.
Mr. Krishnamoorthi. Were you aware that, on November 3rd,
HHS officials briefed us and said they would provide the
documents that we requested within 1 week?
Mr. Keckler. No, sir, I was also not part of that process.
Mr. Krishnamoorthi. Are you aware that, on November 13th,
HHS finally replied and sent a letter that failed to provide
the documents we had requested?
Mr. Keckler. No, sir, I was not aware of that.
Mr. Krishnamoorthi. In fact, what they provided us were
these four sheets of paper, the sum total of their document
production. These four sheets of paper are insufficient.
They're the only data they provided in yesterday's letter. I'm
not sure if you can see it from here, but this is hardly the
full data that we requested regarding the decision to
maintain--quote/unquote, maintain the website and take it down
for 12 hours every Sunday during open enrollment. In fact, one
of these pages is nothing but a screenshot that tells people
the website is down without even telling them when to come back
to enroll. This is unacceptable.
Mr. Keckler, are you aware of CMS administrator Verma's
claim on November 7th that increasing Medicaid enrollment
numbers was a, quote/unquote, ``hollow victory?''
Mr. Keckler. I'm not--I did not participate in that
statement or I have seen a report in the media to that effect.
Mr. Krishnamoorthi. Do you agree with her that more
Americans having access to healthcare via increased Medicaid is
a ``hollow victory?''
Mr. Keckler. I'm not certain what that--what her meaning
was in that statement.
Mr. Krishnamoorthi. Okay. What is the plain meaning of that
to you? What does ``hollow victory'' mean to you, and would you
characterize increased Medicaid enrollment as a hollow victory?
Mr. Keckler. That's not a term that I would use as I'm not
sure precisely what is meant by it.
Mr. Krishnamoorthi. And that's not a term I would use
either. I agree with you. And I hope that you admonish
Administrator Verma from using terms like that to describe
increased Medicaid enrollment numbers.
Mr. Keckler, I have to say that I profoundly disagree with
Administrator Verma that more Americans having access to
healthcare through Medicaid is a hollow victory. It's not a
hallow victory for people who no longer have to decide between
paying for their groceries or paying for their healthcare. It's
not a hollow victory for people who are finally able to get
treatments for chronic debilitating conditions.
I've never met a beneficiary of the expanded Medicaid
expansion program who called it a hollow victory to me. In
fact, they thought that it was life-changing. And I'd be happy
to introduce them to you or to Administrator Verma. Mr.
Keckler, I have one final question. Is it now the policy of HHS
that fewer Americans should have health coverage through the
Affordable Care Act?
Mr. Keckler. I'm not familiar with any such policy.
Mr. Krishnamoorthi. It's a--so you're saying the answer is
no?
Mr. Keckler. Not to my knowledge.
Mr. Krishnamoorthi. I find it hard to square that sentiment
that you just uttered with the very real actions taken by HHS
this year, actions that will harm people and that are harming
people. If you want to increase health coverage, HHS should not
have cut the ACA outreach budget, should not have cut the open
enrollment period in half, and should schedule website
maintenance in a way that does not interfere with people's
ability to purchase health coverage.
I yield back.
Mr. Palmer. The chair now recognizes the gentleman from
Wisconsin, Mr. Grothman, for 5 minutes.
Mr. Grothman. Yeah, I've got some general questions for
you.
How many recommendations has your task force reported, or
your agency had to repeal or amend duplicative, outdated, or
unnecessary regulatory actions or other policies? Do you just
have a general number, any of you? Any of you. We'll go to Ms.
Adcock first.
Ms. Adcock. Yes, I'll start.
Yes. We identified, through the regulatory reform task
force, over 275 broad actions, and about half of those were
regulatory. And we're getting ready to dig back in again and
sort through public comments and dig deeper in what we consider
round two. So that was our first go at it.
Mr. Grothman. Do you other folks have any----
Mr. Eitel. As for the Department of Education, we have
identified, as of today, six regulations for deregulatory
action. We have additional items pending on our fall agenda
that is under review with OMB for the fall. And in addition to
that, we have withdrawn approximately 600 out-of-date guidance
documents of various types.
Mr. Keckler. The Department of Health and Human Services,
our regulatory reform task force gets sort of a--only some of
the overall regulatory activity that goes on. But thus far, the
task force itself has made 34 recommendations after receiving
reports from our working groups for deregulatory actions at
this time.
Mr. Grothman. Okay. I'll ask you to respond to something
that could be criticism to what we're doing here, or a concern
I have. Obviously, they're good regulations--I--``good
regulations''--but there are mandatory regulations in the sense
that Congress passes bills that demand interpretation. And so
you publish new regulations that actually are less burdensome
on business, less burdensome on other areas in Government. And
I don't necessarily think that's a bad thing.
Could you give me just general statements as far as when
you withdraw regulations or begin to promulgate new regulations
as to what you're aiming at. I guess what I'm getting at, like
I said, is sometimes the only way to deal with a bad regulation
is to not repeal it because then maybe you offer the underlying
statute but to improve it or make it less burdensome.
And I guess I'd just like a comment from each of you as how
you're approaching regulations or what you plan on doing. Like
Mr. Eitel, I don't know if I got that right, you know, a lot of
us feel the Department of Education is really kind of a thorn
in the side of local school districts. But your guiding
principles as far as what principles you use to get rid of
regulation or promulgate new ones.
Mr. Eitel. I think that the--there's a number. I think the
first is legal sufficiency. That is our reacting with the
intent of Congress based on legislative language and the
history and the intent of the law, are we going beyond the law.
Second is to provide clarity and better understanding for
stakeholders, whether it be a State educational agency or a
local school district or an educational institution, parents,
students, and teachers.
I think the third would be to examine what is the cost of
the regulation and what is the benefit to the public.
Mr. Grothman. Okay. Any others?
Ms. Adcock. We have followed very closely with the
principles laid out by the President's relating to due process,
many of the considerations the Department of Education has
mentioned. We also, at USDA, at the behest of the Secretary,
are looking into very strongly the cost, the benefits, the
barriers, the opportunities, what is the impacts on jobs and
the economy, how does it serve the rural constituents and
customers that we have through our various agencies, everywhere
from the Forest Service to our frontline offices at NRCS and
FSA and our food and nutrition program.
So we are very going through and trying to be very
thoughtful and using--we're relying very heavily on the
expertise of the folks that have been at the agency for a long
time to weigh what they know about how we can do better and--
whether it's operational, regulatory, or otherwise. And as you
mentioned, it's not always remove the regulation. Often it is
modernize it or revise it or combine it and find deficiencies
in those manners.
Mr. Grothman. Okay. I'm almost out of time, so I'm going to
jump back to Mr. Eitel.
Have you looked at all at the special ed regulations, which
I think can kind of be unintentionally damaging to some
children? Is that something you'd review over there or try to
read to give more flexibility to the local school districts?
Mr. Eitel. We are looking at that, but we have not made any
final decisions on how to proceed.
Mr. Grothman. Thank you for letting me go over.
Mr. Palmer. The chair now recognizes Mrs. Watson Coleman
for 5 minutes.
Mrs. Watson Coleman. Thank you, Mr. Chairman.
I am very concerned about the lack of disclosure around
these task forces at many of the agencies. The task forces are
making major decisions about the fate of the health, safety,
and the education of Americans. For example, it is very
important that the public know who is on the task forces. The
perspectives and the backgrounds of individual members may
determine whether a regulation stays or it goes.
Mr. Eitel, the names of the Department of Education's task
force members is on your website. Why did the Department decide
to put the name names online?
Mr. Eitel. For purposes of public disclosure, so that the
public would know who is on our task force.
Mrs. Watson Coleman. Thank you. Good answer.
From today's New York Times, this is an article entitled
``An Open Door for Pesticide Lobbyist at the USDA.''
Mr. Chairman, I ask unanimous consent to insert this
article into this record.
Mr. Palmer. Without objection, so ordered.
Mrs. Watson Coleman. Thank you, Mr. Chairman.
I quote from that article: At a private meeting in
September, congressional aids asked Rebeckah Adcock, a top
official at the Department of Agriculture, to reveal the
identities of the people serving on the deregulation team that
she leads at the agency. Ms. Adcock, a former pesticide
industry executive, brushed off the request.
Ms. Adcock, you are here before the oversight committee,
which is a principal investigative committee of Congress, and I
do have a question for you.
Who are the members of the regulatory task force that you
lead? What are their respective backgrounds, and what is their
status as a political appointee or a civil servant?
Ms. Adcock. My understanding is from the committee, and I
apologize if your staff thought that I brushed off that
request. That was not my intention. My intention was to share
with them that we had not made the list public. We hadn't asked
the members whether that would be acceptable, and then I would
take that back to see if we could share that list. So if there
was a misunderstanding, I apologize for that.
Mrs. Watson Coleman. Thank you. Have you gone back to the
task force and discussed with these Federal employees whether
or not it is appropriate to release their names and their
backgrounds and their status?
Ms. Adcock. It is my understanding that that list has been
forwarded to the committee through our office of congressional
relations.
Mrs. Watson Coleman. When was that?
Ms. Adcock. I--it could have been in the last few days. I'm
not certain.
Mrs. Watson Coleman. All right. Mr. Chairman.
Ms. Adcock. But I'm happy--the bottom line is you will be
provided a name. I can give you a brief summary. It's
approximately 40 people, almost exclusively composed of career
staff throughout USDA.
Mrs. Watson Coleman. I'm very interested in that list. Mr.
Chairman, I would expect for our side to receive that, to share
that information with us as soon as possible.
Mr. Palmer. It will be.
Mrs. Watson Coleman. Thank you.
Mr. Keckler, are the names of the HHS task force members
available on its website?
Mr. Keckler. No ma'am.
Mrs. Watson Coleman. Why not?
Mr. Keckler. It's not--this is an internal group, the
deliberative group. We normally thus far have handled most of
the outreach via the component agencies of HHS, with a
stakeholder outreach.
Mrs. Watson Coleman. Well, Mr. Keckler, let me just say to
you that this is a particularly unique situation, and the
decisions that they would be considering have a tremendous
impact of both positive, I hope, and negative on the
constituencies that I define as the people of the United States
of America.
So, given that this may be an internal sort of operational
situation, it is vitally important that you share this
information with the public so that we know the kind of people
and the background and the things that they would be
considering, because we do know that who you are will affect
how you react to certain things.
Can you possibly make those available to us?
Mr. Keckler. Yes, ma'am. We'll be happy to send that list
to you. In my written testimony today, the composition of the
task force, in terms of the positions of persons, is provided,
but we can also send you a list of the current members.
Mrs. Watson Coleman. Yes. And you know what, this request
is not only for your three agencies in general, Mr. Chairman.
We should ask each of the departments to share this information
with us. These are very important considerations that are going
to take place, and transparency is very important as well as
ensuring that there are no conflicts of interest anywhere in
the deliberations of these issues. And sometimes that whole
issue of conflict of interest has arisen very much in this
current administration.
With that, I thank you, Mr. Chairman. I yield back.
Mr. Palmer. I thank the gentlelady.
The chair now recognizes the gentlelady from Illinois, Ms.
Kelly, for 5 minutes.
Ms. Kelly. Thank you, Mr. Chair.
I'm deeply concerned about the way the Department of Health
and Human Services is treating the neediest among us. Medicaid
was created to ensure that the Nation's poor had access to
quality healthcare.
A provision of the Social Security Act, Section 1115, gives
the HHS Secretary the authority to approve State experimental,
pilot, or demonstration projects that are, quote, ``likely to
assist in promoting the objectives of the Medicaid program.''
This administration has received a number of 1115 waiver
requests, and I am concerned that not all of the proposed
projects will actually help ensure that Medicaid recipients get
the healthcare they need.
Mr. Keckler, what are the objectives of the Medicaid
program?
Mr. Keckler. That's beyond--it's sort of general sort of
programmatic goals. That's not an area that I've been briefed
on for today.
Obviously, it's designed to provide healthcare for low-
income Americans.
Ms. Kelly. Well, for example, some States have proposed
imposing work requirements on Medicaid recipients.
Does imposing a work requirement promote the objective of
ensuring all income-eligible for Medicaid receive health
insurance?
Mr. Keckler. I think that my answer to that would be I can
take that back for something that can be analyzed by our
subject matter experts in that and their views, and we can
answer that in a fuller way in a written form.
Ms. Kelly. I look forward to your answer.
Also, some States have proposed adding premiums. This means
that individuals on Medicaid who are often already below the
poverty level would pay for health insurance that should be
their right.
Does adding premiums promote the objective of ensuring all
people income-eligible for Medicaid receive health insurance?
Mr. Keckler. Again, ma'am, I think that a better answer for
that would be provided in terms of a policy analysis and answer
that we can provide to you in a written form.
Ms. Kelly. Well, I have another one for you. Some States
have proposed limiting retroactive eligibility, meaning that
States will not provide Medicaid for months prior to the month
in which the individual is enrolled.
Does limiting retroactive eligibility promote the objective
of ensuring all people income-eligible for Medicaid receive
health insurance?
Mr. Keckler. Again, I think a better answer could be
provided to you by those that are--have a deeper familiarity
with the policy elements.
Ms. Kelly. Is that true for the case of States that have
proposed drug screening for applicants? Are you going to give
me the same answer?
Mr. Keckler. Yes, ma'am.
Ms. Kelly. Okay. Well, thank you.
Just yesterday, President Trump announced Alex Azar to be
the new HHS Secretary. It's been reported that Mr. Azar has
been critical of the ACA's Medicaid expansion and has proposed
block granting the program in the past.
I hope, if confirmed, he will not attempt to undermine
Medicaid. We should not make it more difficult for Americans to
obtain life-saving health insurance, which is a right.
Thank you, and I yield back.
Mr. Palmer. I thank the gentlelady.
I would like to enter into the record a letter from the
Department of Health and Human Services to our member Mr.
Krishnamoorthi, and point out that the downtime that was
scheduled on November 5th for maintenance was completed before
5 a.m., so it was down less than 5 hours.
And on Sunday, November 12th, the downtime from scheduled
from midnight to noon, but no maintenance was needed and no
downtime occurred.
So it will be entered into the record.
Mr. Palmer. The chair now recognizes the gentlelady from
the District of Columbia, Ms. Holmes Norton, for 5 minutes.
Ms. Norton. Thank you, Mr. Chairman.
I have concerns, which I hope can be cleared up without
referring everything back. I think we're supposed to be talking
with people who can give us the information.
And these are the changes that are being made, Ms. Adcock,
at USDA about the line limits, the speedups. A study has found
that three-quarters of those who work on these--under these
fast speeds believe that their jobs are dangerous.
As I look at what these speeds are, I must say I can't
blame them as I try to imagine working, for example, under what
most--where most poultry plants now operate, up to speeds of
140 birds per minute. But then some plants operate under
another system. Apparently, it's called the New Poultry
Inspection System, NPIS. And that allows plants to operate not
at 140 birds per minute, but 175 birds per minute. And in
addition, most Federal inspectors are replaced with company
workers under this NPIS system. I don't understand that at all.
This past September, the National Chicken Council filed a
petition with USDA's Food Safety and Inspection Service to
allow the remaining plants--and this is getting incredible--the
remaining plants to operate under this NPIS system and
increasing the line speeds without any upper limit.
Am I still living in the United States of America? Are
these figures coming out of some Third World country? Ms.
Adcock, will the Department act on this petition to allow some
plants to operate under this NPIS system, increasing the line
speeds without any upper limit? Will the Department act on this
petition?
Ms. Adcock. I am not personally aware of the petition, and
I don't know that I can tell you today what its status is, but
I am certainly happy to check in and----
Ms. Norton. You know, Mr. Chairman, I don't know if the
administration is sending us people who deliberately can say to
us, we don't know the answer to your question, but this is not
how the Oversight and Government Reform Committee has ever
operated before, to allow people to say, I'm sorry, I don't
know.
Now, this is a perfectly obvious question of systems and
petitions that are before the agency now, and you haven't heard
of this?
Ms. Adcock. This is not an issue which has come before my
desk and so I'm not personally aware of it, but I will
certainly get back to you with a response.
Ms. Norton. Well, I guess you will. What else can you say
if you are unaware. And I'm amazed that--what is your position
again, Ms. Adcock?
Ms. Adcock. I am a senior adviser, working on regulatory
reform and rural prosperity.
Ms. Norton. And you never heard of this?
Ms. Adcock. I am not familiar with this particular
petition, because it's not in the subject matter----
Ms. Norton. All right. Let me ask you this, since you claim
ignorance, but you know about these speeds. Given your
expertise, should the Department grant waivers to say you can
operate at any speed you like?
Ms. Adcock. I'm not familiar with the waiver, so I don't
know the details. I am familiar with the regulatory proposal on
line speeds. I'm not familiar with the petition.
Ms. Norton. No, I'm not asking you that. I'm asking you
whether or not--since you said you didn't know anything, so I'm
not going to ask somebody who tells me I know nothing.
But I'm asking you, in your expertise, should a waiver ever
be granted to increase speeds without any upper limit?
Ms. Adcock. I simply don't have the expertise to answer
that question in either direction. It would be a disservice to
those who----
Ms. Norton. What is your background, Ms. Adcock?
Ms. Adcock. I have primarily worked on agriculture and
environmental issues.
Ms. Norton. Yeah. Well, that's what these are.
Mr. Chairman, I have to say I've heard, you know, these
answers, these I don't know answers. I hope you will not
tolerate this, because I'm telling you you're having hearings
where--for the Oversight and Government Reform Committee where
you're allowing people to come forward without any information.
And I just want to protest absolutely that the Department
would send us people who could get away with saying I don't
know anything and maybe I can get back with you. And, Mr.
Chairman, who knows whether those matters will ever be made
public. I know you would want to make them public, but the
hearing is over.
So I'm going to cease asking Ms. Adcock any questions.
She's having the same responses that Mr. Keckler had: We'll get
back to you. We've been sent to respond to you, but please know
that we know nothing, even though we are the responsible
officials in the Department.
And I yield back.
Mr. Palmer. I thank the gentlelady.
I think one of the reasons why the witnesses have been
unable to answer some of the questions is that their scope of
responsibility is in regard to the task forces. It was not
policy. So I think some of the questions that have been asked
have been outside their area of expertise and outside the area
that they're focused on.
So I think that it is inappropriate to focus on a witness'
background instead of their subject matter. I think it's
inappropriate to focus on things outside their area of
expertise when they've indicated that they don't have expertise
in that area or don't have knowledge of it.
I think the purpose of this hearing is to talk about the
work of the task forces. And in that regard, I want to
recognize myself for 5 minutes for my questions.
Mr. Eitel, you said you received over 16,300 public
comments. What would you say was the reform that was most often
recommended?
Mr. Eitel. Probably the area of civil rights and Title IX.
Mr. Palmer. Civil rights and Title IX. And then I would
assume that the task force made that a priority to address
those areas?
Mr. Eitel. It had--yes. It was actually a personal priority
of the Secretary, given the delicate issues in play,
particularly with the Title IX guidance that we recently
rescinded.
Mr. Palmer. In regard to the task forces, for all three of
you, I direct this question.
When you're looking at regulations and you're looking at
what's obsolete, what's duplicative or contradictory, are you
also taking into consideration whether or not a program has
been reauthorized?
Mr. Eitel, I'll begin with you.
Mr. Eitel. Yes. Indeed, we are in the process of
withdrawing three regulations for programs that have not been
reauthorized by Congress.
Mr. Palmer. How about you, Ms. Adcock?
Ms. Adcock. Yes.
Mr. Palmer. Mr. Keckler?
Mr. Keckler. That's certainly a concern of the Department
generally. I have not heard it discussed in those terms in the
task force.
Mr. Palmer. Okay. Sticking with you, Mr. Keckler, there are
numerous concerns raised about FDA regulations regarding access
to new drugs. Is the task force looking at FDA regulations that
are outdated or unnecessary that impede access to new drugs,
particularly experimental drugs?
Mr. Keckler. Yes, sir. The FDA working group has that as a
general concern and thus far has--we have worked particularly
on looking at access to some generics in that space. But that's
an overall concern over at the FDA.
Mr. Palmer. So you say they've been looking at it. Have
they identified any outdated or duplicative or overly
burdensome regulations or guidance to date?
Mr. Keckler. Yes, sir. In my written testimony, we have
discussed briefly some of the goals here to improve the access
to generics. FDA is reviewing how rules concerning new drugs
are being used in ways that may create obstacles in the timely
entry of generic competition, and they are making sure that the
current policies aren't misused in ways that would thwart the
competition that Congress intended when it created the modern
generic drug framework. So that's an area where we are already
working.
Mr. Palmer. Okay. Just in general, can you give me an idea
of how many regulations have been recommended for removal, or I
guess you've identified regulations that you could make less
complicated, less burdensome, Mr. Eitel?
Mr. Eitel. Well, as I've said, we are engaging in
negotiated rulemaking on borrower defense and gainful
employment. And the hope is that there will be a better rule
that better protects students and also provides due process to
institutions. That would be two primary initial examples.
Mr. Palmer. But I hope you got more than two.
Mr. Eitel. We do. Those have a large impact. We are looking
at our guidance in the Office of Elementary and Secondary
Education.
Please understand that we are--we have a duty to go through
the comments that we've received. And we are organizing those,
studying those, and developing priorities, based on the
comments we receive from the public.
Mr. Palmer. Well, I want to encourage you to continue to do
that. I think the task forces have done good work, and I think
it's being conducted the way it should be conducted.
Ms. Adcock, do you have an idea of how many regulations
that the Department of Agriculture has identified that could be
eliminated or made less complicated?
Ms. Adcock. Our early--our first round, because we're going
at this for over a year. We've divided it up. We've identified
probably somewhere in the area of 140 possible options, and
then we're working through those methodically. As you know,
there's many requirements: The APA, OMB guidelines, those sorts
of things.
So when you identify an action that you think is likely for
revision or deregulation, you have to go through many steps,
including often certain requirements for, depending on where it
is in the process, public comments and all those sorts of
things. So those things inherently mean that you're not
automatically deregulating, you're not automatically revising.
We have had three to four very significant deregulatory
actions that have been announced over the course of this summer
up to as early as a few days ago, and there will be a
significant number more that you will see reflected in the fall
regulatory agenda when it is released by OMB.
Mr. Palmer. Mr. Keckler, I know you guys are working on
things. I just want to emphasize that in regard to the
Department of Agriculture and HHS, I grew up in rural northwest
Alabama on a farm, so I really want to do what we can to
improve the opportunities for people in rural areas,
particularly in giving people access to healthcare. So I really
appreciate the work that's being done.
I want to emphasize that the purpose of this hearing is to
hear from you about the progress that is being made to improve
the ability of all Federal agencies to serve the American
public efficiently and with the least burdensome rules and
regulations. That's the purpose of the task forces. That's the
purpose of these hearings, to hear a report back from you.
It has been reported that regulations cost the average
American family $15,000 per year. That's--you know, for a
household earning $70,000 a year, that's over 20 percent of
their average income. It's more than they spend on practically
everything else in their budget. This cost falls
disproportionately on lower income households like the one I
grew up in, which makes the work of this task force even more
relevant and important.
And I'd like to believe that making our regulations
effective, yet less burdensome, would be and should be a worthy
bipartisan objective.
I'd like to thank the witnesses for their testimony today.
And I remind the members of the committee the hearing
record will remain open for 2 weeks for any member--the chair
recognizes the ranking member Mrs. Demings for one more
question.
Mrs. Demings. Yes, just one more. Thank you so much.
Just a point of clarification from Ms. Adcock.
Regarding the roster of the task force members, when did
you submit that roster to----
Ms. Adcock. I did not submit it. I think our Office of
Congressional Relations submitted it very recently. But we will
make sure we get it to you----
Ms. Demings. Do you know----
Ms. Adcock. --the first time we have it.
Mrs. Demings. Before the hearing, though, was it submitted?
Because I'm just receiving some conflicting information and I'm
just trying to make sure we----
Ms. Adcock. I did not send it, so I don't want to misinform
you. But if you don't receive it, contact me personally and I
will make sure you get it.
Mrs. Demings. So you aren't sure when it was submitted?
Ms. Adcock. I'm not sure, no, ma'am.
Mrs. Demings. Okay. Thank you.
Mr. Palmer. Just for clarification, we do have that, and it
has been shared with the members of the committee.
With that, the hearing record will remain open for 2 weeks
for any member to submit a written opening statement or
questions for the record.
If there's no further business, without objection, the
subcommittee stands adjourned.
[Whereupon, at 11:28 a.m., the subcommittees were
adjourned.]
APPENDIX
----------
Material Submitted for the Hearing Record
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
[all]