The Biden administration’s request for supplemental COVID-19 funding is sharply down from the initial amount, but congressional Republicans have indicated many are still opposed until they receive an accounting of money already appropriated.

Shalanda D. Young, acting director of the Office of Management and Budget, sent a letter to Speaker Nancy Pelosi on March 2 requesting $18.25 billion for the domestic COVID-19 response and $4.25 billion to aid the foreign response, a total of $22.5 billion for COVID-19 in a total request for $32.5 billion. The Department of Health and Human Services had reportedly sought aid closer to $30 billion, drawing Republican criticism from both chambers. 

Thirty-six GOP senators, led by Utah Sen. Mitt Romney, wrote to President Joe Biden on Wednesday with concerns about providing additional COVID-19 funds to the administration without oversight on existing money. And two influential Republican lawmakers last month wrote HHS Secretary Xavier Becerra with concerns about the spending. 

“Before we would consider supporting an additional $30 billion for COVID-19 relief, Congress must receive a full accounting of how the government has already spent the first $6 trillion,” the Senate Republicans wrote. “Since passage of the American Rescue Plan in February, questions are mounting about where exactly the additional money has gone.”

The American Rescue Plan is the name of a $1.9 trillion 2021 pandemic relief law.

Rep. Cathy McMorris Rodgers, R-Wash., the House Energy and Commerce ranking member, and Sen. Richard M. Burr, R-N.C., ranking member of the Health, Education, Labor and Pensions Committee, wrote Becerra last month about the concerns with the rate of spending to reimburse health care providers for uninsured individuals. Among their concerns was $3 billion sought for the Health Resources and Services Administration. The request on Wednesday asked for $1.5 billion.

“We have serious concerns with providing more funding without additional measures to protect uninsured patients and taxpayers from the seemingly indiscriminate spending, given HRSA has already subsidized providers for services that they do not provide or, in some cases, are not even licensed to provide,” Rodgers and Burr wrote in the Feb. 22 letter.

Young’s letter Tuesday said the HRSA request would reimburse health care providers for testing, treatment and vaccination of the uninsured and vaccination of the underinsured. “Available funding is projected to be exhausted in late April or early May of this year, and HRSA would need to stop accepting claims for the funds as soon as this month unless additional resources are provided,” she said.

Young said she hopes the request could ride along the fiscal 2022 omnibus appropriations package being negotiated as the March 11 expiration of the latest continuing resolution approaches. 

The largest share under the latest request would be $15.7 billion for the Public Health and Social Services Emergency Fund. That sum would include $12.2 billion to invest in countermeasures such as purchasing oral antivirals and monoclonal antibodies that can help prevent severe illness in patients with COVID-19 and to purchase vaccines for future variants. It would also include pediatric vaccines for boosters for children ages 5 to 15, and third doses for children under 5 when they are authorized by the Food and Drug Administration.

The $15.7 billion would include $2 billion to add manufacturing capacity and increase the supply of rapid antigen tests. This $2 billion would also be used to invest in the accelerated pathway for emergency use authorizations for additional at-home tests and to broaden health laboratory capacity to process testing.