The Senate Finance Committee heard opening statements and extensive questioning Thursday for two nominees to senior Health and Human Services posts: Gus Chiarello, nominee for assistant secretary for financial resources, and Michael Stewart, nominee for general counsel.

Committee members pressed the nominees on whether they would follow the law when allocating or withholding federal funds, and on specific programs including Title X family planning, Head Start grants, CDC contracts and SAMHSA grants. Senators also sought commitments on protecting emergency-care obligations under EMTALA and expanding access to medication-assisted treatment for opioid use disorder.

The hearing opened with nominees giving biographical remarks. Chiarello said he would “follow the law when it comes to appropriations and managing,” and described his antitrust-and-finance background at the Federal Trade Commission and House Judiciary Committee. Stewart, who previously served as U.S. attorney for the Southern District of West Virginia and as a West Virginia state senator, said he would “follow the law” and described his prosecutorial work on Medicaid fraud and opioid-related cases.

Why it matters: HHS oversees roughly $1.7 trillion in federal spending in FY 2024 and administers programs — from public-health grants to Title X family planning and Head Start — that directly affect hospitals, clinics and early-childhood providers. Senators said recent department actions have left some grantees unsure whether appropriated funds will be delivered and asked how nominees would restore predictability.

Key exchanges and commitments
- On grants and contract cancellations: Senator Jon Ossoff (questioning pattern similar to colleagues) and others pressed Chiarello and Stewart to investigate recently canceled or paused multiyear CDC contracts and to report findings to the committee. Chiarello committed to “work with the committee on their inquiries” and said he would follow applicable law and procedures. Stewart said he would advise the secretary to “follow the terms and conditions” of statutes and agreements.

- On Title X and Head Start funding: Senators asked whether the nominees would distribute appropriated Title X funds and restore stability for Head Start providers that reported payroll uncertainty after federal holds. Chiarello answered that he would “follow the law” and lean on operating divisions to identify mission-critical funding. Stewart said his approach would be to “follow the law” and rely on legal and factual review before taking action.

- On EMTALA and emergency reproductive care: Senator Ron Wyden pressed Stewart three times about whether EMTALA requires hospitals to provide stabilizing reproductive care before a patient becomes septic. Stewart repeatedly said he would “provide guidance with respect to the law” and that “nothing in the law today prevents pregnant women from getting life-sustaining emergent treatment,” but he declined to offer a detailed enforcement plan on the floor and said he would follow up in writing if confirmed.

- On opioid treatment and medication-assisted therapy: Sen. Maggie Hassan and others asked whether nominees support expanding medication-assisted treatment, including methadone and buprenorphine, for opioid use disorder. Stewart said he “supports Secretary Kennedy” and would back medication-assisted treatment and wraparound services as a priority.

- On preventing fraud and stewarding taxpayer dollars: Stewart emphasized plans to form multidisciplinary teams to pursue fraud and recover improper Medicaid payments, citing past prosecutorial results. Chiarello said he would use his antitrust and financial-management experience to scrutinize grant processes and reduce waste.

Context and background
Senators repeatedly framed questions against recent actions by HHS leadership that, according to lawmakers, have paused or canceled grants and contracts and withheld some appropriated funds. Committee members urged nominees to produce clear, legally grounded guidance and to ensure that department actions do not leave providers without payroll or services. Several senators asked for specific, timely written follow-up after the hearing.

What’s next
The committee signaled it will seek written follow-up from the nominees on legal interpretations and on findings about canceled contracts and withheld grants. Final confirmation votes, if scheduled, will take place later on the Senate floor.

Ending note
Nominees repeatedly pledged to “follow the law” and to work with the committee. Senators from both parties said they expect written guidance and prompt responses if the nominees are confirmed and assume responsibility for HHS’s legal and financial programs.