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It could also open the government to further scrutiny of a border strategy President Joe Biden has been pursuing for months as government officials struggle to stem the influx of tens of thousands of unaccompanied children into the US
The $ 2.13 billion in diverted money alone exceeded the government’s annual budget for the unaccompanied child program for the past two fiscal years. It’s also well above the roughly half a billion dollars the Trump administration shifted in 2018 towards protecting a migrant child population that was swollen due to its strict immigration policies, including separating children and adults at the border.
In addition to transferring funds from the Strategic National Stockpile and Covid-19 tests, HHS withdrew approximately $ 436 million from a number of existing health initiatives across the department.
“They had to expand their capacity very quickly, and emergency capacity is much more expensive,” said Mark Greenberg, senior fellow at the Institute for Migration Policy, who headed HHS’s Children and Family Administration from 2013-2015. “You can’t just say it there will be a waiting list or we will stop the admission. There is literally no choice. “
HHS spokesman Mark Weber told POLITICO that the department had been working closely with the Bureau of Administration and Budget to find ways to financially support the unattended operation of smaller businesses amid rising costs.
“All options are on the table,” he said, adding that HHS has traditionally tried to raise funds from parts of the department where the money is not needed immediately. “This program relied on the money transfer year after year.”
Health Minister Xavier Becerra has the option to move money between programs within the sprawling department as long as he notifies Congress, an authority his predecessors have relied on frequently during the influx of migrant children in the past.
However, these transfers come as HHS has publicly sought to pump new funds into the Strategic National Stockpile and Covid-19 testing efforts, highlighting the critical role that it has to play in both pandemic response and future preparedness efforts.
“The fight against Covid-19 is not over yet,” Becerra testified before a House panel on Wednesday to defend a budget request that would provide $ 905 million for the supply. “As HHS works to fight this pandemic, we also prepare for the next public health crisis.”
Becerra later stressed the need to “make sure we have the resources” to replenish the strategic national reserve, which was under scrutiny at the start of the pandemic after officials discovered the abundance of protective equipment and medical supplies were in short supply the crisis had to be responded to.
“We have learned that this will be a critical component in being able to respond appropriately and quickly to future health crises,” he told Rep. Debbie Dingell (D-Mich.).
In another exchange, Rep. Markwayne Mullin (R-Okla.) Becerra repeatedly urged whether HHS would benefit from Congress investing more in other parts of its operations rather than funding another expansion of Covid testing. Mullin specifically cited the record numbers of migrant children arriving at the border.
But Becerra turned down that suggestion, telling him that “we need to continue an aggressive testing strategy”.
“We must continue to invest to prevent the spread of Covid and its variants,” he said.
Weber couldn’t immediately tell what other areas within HHS were affected.
However, if money is tossed away from existing HHS programs, it risks undermining other critical health initiatives and irritating the public health groups and lawmakers who campaign for funding each year.
The Trump administration was criticized in 2018 for transferring hundreds of millions of dollars in biomedical research, HIV / AIDS services, and other causes to cover costs associated with an unaccompanied child population that peaked nearly this year Would reach 14,000.
This examination was fueled in part by the two parties’ disapproval of then-President Donald Trump’s zero-tolerance policy of separating children from their parents HHS was responsible for carrying out costly reunification efforts.
In contrast, the Biden administration has sought to get rid of some of the most restrictive immigration policies of the Trump era. However, given the need to care for an even larger number of migrant children, health groups have hesitated at the prospect that it could affect public health priorities even if the US were to tackle a pandemic.
“It’s about whenever funds have to be diverted from their originally intended purpose due to limited resources,” said Erin Morton, executive director of the Coalition for Health Financing. “We have consistently asked our public health system to do more with less, and we have underfunded important programs that are vital today to address the multitude of challenges facing the country.”
The transfers could also extend funding for other programs within the HHS administration for children and families overseeing various social services including childcare and support for newly arrived refugees.
Biden cited concerns about the burden on the HHS refugee office, which is tied to both assisting refugees and caring for unaccompanied children, when he initially refused to raise the maximum admission limit for refugees from historic lows – a decision he later reversed in the face of a quick setback.
“Obviously, this will have a significant impact on the ORR’s ability to serve refugees and asylum seekers,” said Bob Carey, who headed the Refugee Resettlement Office from 2015-2017, of the potential need to allocate more funds to housing migrant children .
Nonetheless, Carey and others defended the renditions as unfortunate, yet necessary, and as a consequence of the urgent need to remove increasing numbers of unaccompanied children from prison-like facilities on the border.
After effectively sealing the southern border last year, the Trump administration never expanded its protective capacity to the levels HHS has identified as critical to its readiness, Greenberg said, leaving the department understaffed when Biden again allowed migrant children into the country .
The pandemic further hampered HHS and halved the number of beds available as Covid-19 precautions had to be followed. That forced a struggle to build a dozen shelters, which in the past have cost each child on average more than twice as much a day to house as in licensed facilities.
More than half of the migrant children in HHS detention are now in emergency shelters, Weber confirmed.
HHS has also signed hundreds of millions of dollars in contracts with a number of emergency and logistics companies over the past few months to expand services and staff in the shelters.
“If they had started this year with 16,000 beds instead of 8,000, they could have done it in February and had time to determine how to properly expand capacity for the very large numbers in March,” Greenberg said. “Basically, it’s this mix of: the number was greater than expected, the capacity was less than required, and there was tremendous pressure to reduce the crowd [the border]. ”
This dynamic is expected to continue for at least the next few months as hundreds of new unaccompanied minors arrive at the border every day and are placed under the care of the Ministry of Health.
And with no previous evidence that the Biden administration will seek new border aid from Congress for emergencies, it means that HHS spending will likely only continue to grow, forcing additional costly transfers within the department.
“It’s going to be expensive,” said Carey. “I can’t imagine a more complex situation.”