The Fiscal Year 2027 Department of Health and Human Services Budget
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House Energy and Commerce Subcommittee on Health U.S. House of Representatives
Follow its sittingsSpeaker 2
Secretary Kennedy canceled research and development relating to mRNA technology, potentially setting back promising cures by years. And Secretary Kennedy directed the addition of safety warnings on Tylenol use in pregnancy, even though the evidence suggests that Tylenol is safe, while fever in pregnancy, which Tylenol treats, can be profoundly damaging. Madam chair, I want to tell you two stories from across the country about the direct impacts of the last year. First, ending the HIV epidemic was a priority of the first Trump administration. But under Secretary Kennedy's leadership, locally driven programs to get effective medications to prevent HIV to at-risk individuals are in doubt.
I was told of a project to increase access to long-acting HIV prevention medication for at-risk men in high-incidence areas that has been unable to continue because of funding terminations, restrictions, and instability. That means only one thing: more HIV infections in the long run. In Colorado, this administration's systemic refusal to execute the laws Congress's mandate for the Agency for Healthcare Research and Quality led to disruptions of clinical trials and wasted research time and money. A trial on pediatric medication therapy management, which tested using different medications to treat children with complex medical conditions, was forced to halt enrollment and go on hold. Now, the funding did just come through, but unacceptably late and suspiciously close to this hearing today.
The damage is done. The trial had to temporarily close, leading to primary outcome data being lost and diminished access to cutting-edge care. That has a short-term and a long-term harm. Kids who could have benefited from the trial did not. And since the data was lost, it will be longer before any beneficial findings from the trial get integrated into practice more broadly.
These stories represent a failure of leadership and a failure of vision. If we want to truly make America healthy, we need to follow the evidence, empower the scientists, and be willing to change when we're wrong. Public health fails when we make decisions based on ideology. We are seeing the very failures of that kind of decision-making before our very eyes. This HHS does not have the confidence of scientists, doctors, or the American people.
The Secretary of Health and Human Services must be a fourth force for improving public health, not dismantling it. The secretary and this committee must ask a hard question. What is the legacy this HHS and this HHS secretary are leaving? We're rapidly losing our position as the gold standard in the world for medicine and science. For the sake of ourselves, our children, and future generations, we must stop the bleeding, and we must start to rebuild.
I yield back.
Speaker 1
General lady yields back, and I now recognize the chairman of the full committee, chairman Guthrie, for five minutes for an opening statement.
Speaker 3
Thank you, vice chair Harshberger, for holding this hearing, and thanks secretary Kennedy for being here with us today, discuss the priorities of HHS, the budget, and your department's priorities. So this Congress, Republicans have worked hard to take on some of the major health care challenges facing Americans, ranging from mitigating the influx of illicit drugs to cleaning up waste, fraud, and abuse that have plagued our safety net programs. We've held a series of hearings to examine the major cost drivers across the entire health care system. And just last week, we held our first hearing in another series of promoting a healthier America, which I know is important to you, mister secretary, as well. So, Secretary, I look forward to hearing from you today on everything you've been doing to improve health care for all Americans.
In particular, I wanna commend you on the release of the new dietary guidelines, and your work with medical schools across the country to increase nutrition training. These are important initiatives that are long overdue. I also wanna commend you for your continued partnership in taking on waste, fraud, and abuse in our health care system. When bad actors exploit these programs, patients who rely on care ultimately suffer. This is not a victimless crime.
With initiatives like this, the committee's ongoing investigation into fraud schemes, combined with the administration's new anti-fraud task force, Republicans are committed to protecting patients and preserving crucial government health programs for decades to come. We look forward to continuing to collaborate with the Trump administration and your department to restore the integrity of our health system, and to implement solutions that put patients first. I thank you for being here. We thank you for your participation, and I look forward to our discussion today. And I will yield back.
Speaker 1
Gentlemen, yields back, and I now recognize the ranking member of the four committee, Representative Palom, for five minutes for an opening statement.
Speaker 4
Thank you, madam chair. Since Secretary Kennedy last testified before this committee in June, our nation's entire health care system has been driven into chaos, thanks to his actions and the actions of Republicans here in Congress. Health care is less accessible and less affordable, thanks to the trillion-dollar health care cuts and the big ugly bill that Republicans jammed through last summer to pay for giant tax cuts for the wealthy, and Republicans' refusal to extend the ACA enhanced premium tax credits. Americans' health, particularly our children's health, is at risk because of Secretary Kennedy's complete upheaval of our nation's vaccine infrastructure and the endless barrage of misinformation spewed to push the secretary's ideological agenda. And this administration actively worked with Congress to pass the big ugly bill.
You can't cut a trillion dollars without dramatically impacting the care Americans receive. 15,000,000 Americans are expected to lose their health care coverage, forcing people to once again rely on emergency rooms for care, and leaving millions of Americans buried in medical debt. Medicare is also cut by hundreds of billion dollars, reducing access to care for seniors. It strips states of funding to provide health care to their lowest-income residents and shutters hospitals and nursing homes, especially those in rural and underserved areas. And as a result of this Republican cruelty, we're watching in real time as hospitals and health clinics are closing at a rapid rate, while states are being forced to slash payments to providers, raise out-of-pocket costs, and cut benefits.
And the Trump administration and congressional Republicans drove up monthly health care premiums for more than 24,000,000 Americans at the beginning of this year because they refused to extend the ACA's enhanced premium tax credits. People have seen monthly premiums double or triple, leaving some people with no choice but to go without health insurance altogether. And now there are reports that Republicans, through further reconciliation initiatives, intend to make further cuts and take health care away from more people to pay for Trump's reckless war of choice in Iran. In Trump's America, we can't afford health care, but apparently, we can spend a billion dollars a day in a war with Iran. In fact, Trump himself said that it's not possible for the federal government to pay for Medicaid and Medicare when we're fighting wars.
Now the chaos does not end with skyrocketing costs and coverage laws. As secretary Kennedy is creating chaos and confusion in our nation's vaccine policy, your handpicked antivaccine members of the advisory committee on immunization practices altered recommendations for multiple vaccines, including measles, hepatitis B, and COVID. These actions left patients, health care providers, and parents confused about what vaccines were recommended, when, and whether they would be covered by their insurance. And the uncertainty drove skepticism and made it harder for people to access vaccines that can keep themselves and their families healthy. At the same time, the Trump administration has frozen or terminated millions or billions of dollars in scientific research grants and funding, halting ongoing clinical trials to find the next generation of treatments and cures.
You know, Republicans preached for years on this committee about their concerns regarding protecting pharmaceutical innovation, but it's quite ironic they're noticeably quiet now as we watch the United States get left behind as the global leader in medical research thanks to the Roan administration's actions. And, mister secretary, you are presiding over one of the most consequential departments within the federal government. And this is no small job, but, unfortunately, your actions are dangerous to health care in our country, and it's going to take decades to repair the damage that you've done. So finally, I wanna mention your unprecedented obstruction of congressional oversight, and your refusal to respond to our inquiries or requests over the last year. The radical transparency that you talked about, you know, from the very beginning of your time as secretary, even before, that radical transparency that you promised appears to have been an empty promise.
And I expect you to fully and respectfully answer the questions of the democratic members of this committee today, and to respond to all written requests that we have sent you in the past. There are so many I haven't gotten responses to any of them. But with that, Madam Chair, I yield back the balance of my time.
Speaker 1
Gentlemen, yields back. We now conclude with member opening statements, and the chair would like to remind members that pursuant to the committee rules, all members' opening statements will be made part of the record. We wanna thank our witness for taking the time to testify before the subcommittee. Although it's not the practice of this subcommittee to swear in the witness, I would remind our witness that knowingly and willfully making materially false statements to the legislative branches is against the law under title 18, section 1001 of The United States code. You will have the opportunity to give an opening statement, followed by questions from members, and our witness today is the honorable Robert F. Kennedy Jr., secretary of the US Department of Health and Human Services.
In per committee custom, the witness will have an opportunity for a five-minute opening statement, followed by a round of questions from members. The light on the timer in front of you will turn from green to yellow when you have one minute left. And I now recognize Secretary Kennedy for five minutes to give an opening statement.
Speaker 5
Thank you, chairwoman Harshberger and ranking member Toomey. On members of the committee, thank you for the opportunity to appear before you today to discuss the president's fiscal year 2027 budget request. We stand at a generational turning point. Our children are of the sickest generation in modern history, and decades of failed policies, captured agencies, and profit-driven systems caused it. Parents across the country demand a change, and we are delivering it.
We are ending the era of federal policies that fueled this chronic disease epidemic, and replacing them with policies that put the health of Americans first. President Trump and I are challenging the status quo and the institutions that defend it, as we work to make America healthy again. In just 15 months, HHS has delivered historic wins. We negotiated a most favored nation drug prices with 16 of the largest pharmaceutical companies, so that Americans no longer pay more than people in other wealthy countries for the same medications. We are bringing real transparency to health care pricing so that patients know the cost of care before they receive it.
I use the full convening power of the federal government to bring health insurance CEOs to the table to reform prior authorization. We are cutting red tape, speeding decisions, and demanding transparency. We're also cracking down on ways of audit and abuse. This year, HHS and USDA issued new dietary guidelines that put real whole food at the center of the American plate. We flipped the food pyramid upside down.
We sent a clear message to Americans: eat real food. HHS has opened the door to partnerships with industry, trade associations, nonprofits, and advocacy groups. More than 50 medical schools have committed to expand nutrition education from an average of 2 hours to 40 hours. Food manufacturers are stepping up to more than 40% of the food industry is committed to phase out petroleum dyes by the end of the year, and many have already eliminated them. In conjunction with these efforts, FDA approved six natural food colorings derived from fruit and vegetables.
President Trump's Great American Recovery Initiative at HHS is matching compassion with action to help Americans break the cycle of addiction. At HHS, we are prioritizing patients with ultra-rare diseases and their families, and driving faster access to lifesaving treatments. We are restoring gold standard science and integrity across the agency for the first time in decades. We are protecting children from sex-rejecting procedures that expose them to irreversible harm. We're eliminating outdated and misleading warning labels on hormone therapies used to treat women during menopause.
We're strengthening oversight of organ procurement. We're implementing operations to work at speed to ensure the safety and quality of infant formula. I can feed the 405 largest tech companies to agree to stop information blocking so that for the first time, every American is gonna be able to get their access, their own health records on their cell phones. We're implementing operation stored speed to improve baby formula. We're applying that same focus and urgency to rural America.
Rural Health Transformation Fund delivers the largest investment in rural health in our nation's history. $50,000,000,000 over five years to strengthen rural hospitals and ensure Americans can access the care they need, no matter where they live. Members of Congress on both sides of the aisle have made rural health a clear priority in their conversations with me, because every state is feeling the strain of hospital closures and workforce shortages and gaps in access. HHS announced more than a $135,000,000 investment this month to expand rural residency programs and nutrition services. The data is clear: when physicians train in rural communities, they're far more likely to stay and serve there.
The president's budget puts all these priorities into action and invests in prevention, because preventing disease costs less than curing it. As my uncle, President John F. Kennedy, progress is a nice word. A change is its motivator, and change has its enemies. We see those forces clearly. Defenders of the failing status quo, institutions that put profits ahead of the American people.
That resistance underscores the urgency of this moment. We can reverse chronic disease, improve public health, and lower costs. I stand ready to work with Congress and this committee to seize this opportunity to implement and codify lasting generational reform in American health care for our country, for our children, and for the health of the American people. Together, we can make America healthy again. Well,
Speaker 1
Thank you to the witness for your testimony. We'll now begin questioning, and I'd ask that members not begin a new question to our witness as their five minutes expire, and would encourage members to submit written questions for the record. And I now recognize myself for five minutes of questions. Mister secretary, I agree with all the initiatives that you mentioned that'll be in the budget because this is something I've not only preached, but I've practiced for over 40 years in health care. The first thing I wanna ask is, you know, as a pharmacist, I know patient trust depends on clear communication and sound science, and I appreciate your focus on restoring confidence in public health.
There's been a lot of misleading commentary about your approach to the measles vaccine and vaccine policy. Let me start off by saying, would you like to take a few moments to set the record straight and explain how HHS is strengthening measles prevention while rebuilding trust with patients and families?
Speaker 5
Thank you for that question, Madam Chairman. And this became a talking point for Democrats that somehow I caused the measles epidemic. The measles epidemic started in January 2025, before I came into office. Mhmm. And most of the people, almost most of the people who are affected, are over five years old, meaning their decision to not vaccinate predated my appointment to this office.
We had about 2200 measles cases last year. We've had 1700 this year. This is not unique to the United States. This is a global outbreak. Mexico had three times the number of measles cases that we did.
We've done better than any country in the world at controlling the epidemic. Mexico has three times the number, and it has one-third of our population. Canada has twice the number, and it has one-eighth of our population. Europe had 33,000 cases last year and 127,000 the year before, and they have one half of our population. The problem is not me.
There are people in this country who do not vaccinate. A major outbreak was in the Mennonite population. The Mennonites have not been vaccinated since 1796. That was long before I was born. I haven't been to these countries recently, where the outbreaks have occurred.
I will tell you a story. There were two little girls who died from measles during the meta in the Mennonite population. I've been to the funeral service for one. I spent a day with the family of the other. Both of them said that when they showed up at the hospital, they were not offered real treatment.
They were instead treated as pariahs. They were shamed. They were isolated. And both of them believe that if their children had been properly treated, they would have lived. Their children had comorbidities.
Their own doctors, their personal doctors, believe that children could have been saved. There's no child who should die in this country of measles. No. One of the things I've done since coming into office is to make sure that for people who do get measles, that they're treated decently, they're treated with compassion, and they're given the kind of treatments that exist that are given by other countries and are refused in this country because of the bias toward a vaccination only policy. We need to treat people who get sick, no matter what.
They all should be treated with compassion.
Speaker 1
Well, I've always looked at how conventional and nonconventional medications or therapies can coexist, and we've done it forever. It should be up to the prerogative of the patient as to what they choose to do. I appreciated our recent discussion on expanding the therapeutic potential of peptides, which are increasingly used across a range of clinical areas. And as FDA's Pharmacy Compounding Advisory Committee meets in the coming months, I believe it's important to ensure it includes practitioners with real-world compounding and patient care experience. And as policy evolves, we should also ensure reliable access to pharmaceutical-grade ingredients that manufacturers can scale for legitimate medical use.
So will you work with me on those priorities, sir?
Speaker 5
Absolutely, madam chairwoman. And we just moved 14 peptides off of category two where they were wrongly put there.
Speaker 5
During the Biden administration, which created a huge black market in this country for research-grade peptides, which millions of Americans are using. They're coming from China. They're from uninspected labs. We need to bring it back into a real marketplace where legitimate, honest formulation pharmacies with integrity and ethics are formulating them for Americans.
Speaker 1
Thank you, sir. My time is up. So now I turn it over to the ranking member to get her five minutes of questions.
Speaker 2
Thank you, madam. Thank you, madam chair. Mister secretary, I spend a lot of my time here on this committee promoting maternal and child health. And I'm proud to have worked alongside my friends Buddy Carter, Robin Kelly, and Cat Hammack in a bipartisan way to get the Preventing Maternal Death Reauthorization Act signed into law just this February. I think I speak for all four of us as well as the bill's other champions when I say we're very proud of this legislation and the work HHS did to implement the original Preventing Maternal Deaths Act, which was passed under the first Trump administration.
So because of the data collected by the maternal mortality review committees, we know 80 percent of maternal deaths are preventable, and we can direct resources into saving those moms and keeping those families whole. I think you would agree that is useful data to have, correct?
Speaker 2
Thanks. And work fostered by HHS has also helped reduce infections in newborns, reduce preterm births, improve treatment for mothers with substance use disorders, and much, much more, which is, again, much-needed progress. Wouldn't you agree, sir?
Speaker 2
Okay. Now, all those great initiatives are part of CDC's safe motherhood program, which should present preventing maternal deaths reauthorization act reauthorized. So I have to ask you this. Are you aware, sir, that the fiscal year 2027 HHS budget, which you're testifying about here today, seeks the elimination, not the restructuring, not the relocation, but the elimination of CDC's safe motherhood program.
Speaker 2
Okay. It's also my understanding that this administration is prioritizing, quote, family formation. Is that correct?
Speaker 2
The administration is prioritizing, quote, family formation. Is that correct? That's the words of the agency.
Speaker 2
So your agency says family formation is a priority. Wouldn't you say it should be a priority to make pregnancy and childbirth safer, and improve outcomes for all moms and babies?
Speaker 2
that than any administration. Okay. Your answer is yes. Now, the fiscal year 2027 HHS budget also seeks to eliminate the Title X family planning program. Title X provides more than 2,000,000 low-income people access to critical services like contraceptive care, helping people have kids or not have kids as safely and on their own time.
Contraceptive care, as defined in HHS's regulations, includes things like birth control pills, IUDs, implants, and condoms. Mister secretary, are you aware that 8 in 10 women of reproductive age have used some kind of contraception in the last year?
Speaker 2
Are you aware that these people have used contraception in the last year yesterday?
Speaker 2
Are you aware that eight in ten women of reproductive age have used contraception in the last year? Yes or no?
Speaker 2
Too low for maternal health. Are you aware that nearly a third use it for medical purposes other than preventing pregnancy? Yes or no?
Speaker 5
If you care about the outcome of maternal health, you should be supporting what we're doing.
Speaker 2
Okay. So you don't have, are you aware that every dollar invested in family planning saves the public over $7?
Speaker 2
So I wanna ask you something right now, and this is really important. Will you commit right now before the American people that HHS, under your leadership, will not take any action that will limit people to the birth control method of their choice? Yes or no?
Speaker 5
As I said, we have done more for maternal health than any administration in our history. We have one program, the peritoneal pilot program, that has already dropped maternal health deaths by 42 percent and 220.
Speaker 2
I only have six seconds left. Let the record reflect the secretary refuses to tell the American women whether he will let poor women use the contraception method of their choice. And let the record also reflect, it is 2026, Madam Chair. I yield back.
Speaker 1
Gentlemen, lady yields back, and I now recognize the chairman of the full committee, representative Gathry, for his five minutes.
Speaker 3
Thanks, mister secretary, over here in the corner. When we reformed Medicaid and the working family tax cut, we wanted to make sure that people that were ineligible, illegal, unable to work, and so Medicaid served people it was intended to serve. We also knew that states were creating their own financing system to essentially draw down federal dollars without putting their money in, which the program is supposed to. We reform that, but we knew that as states had to reform the way they do it. It was gonna, we wanted to have a specific focus to give them money to focus specifically on rural hospitals.
And so the Rural Transformation Fund, can you talk about your experience of the agency in administering the Rural Transformation Fund? And what are you most excited about that you've seen implemented?
Speaker 5
Yeah. You know, we have a crisis now in rural health care. Urban hospitals, by and large, are doing very well. Rural hospitals are, there's an epidemic of closures. We've lost 120 rural hospitals since 2010, and that pace was accelerating when I came into this job.
Under President Trump's leadership, we put the largest investment in rural health in American history. Typically, Medicaid pays about 7% of its funds to rural hospitals and rural areas, and it's about $20,000,000,000 a year. So we're increasing that amount by $10,000,000,000 a year. So it's a 50% increase to rural hospitals to help transform them, help them rebuild infrastructure, to recruit and retain workers, bring in technology, AI, and telehealth to completely transform rural health in this country. So we're.
Speaker 3
Actually spending more in rural hospitals. I just got a couple more questions I wanna get to. So on waste, fraud, and abuse, we we've had criticism that we wanted people to make sure they were eligible to be on the program more than once a year. Now that we're seeing waste, fraud, and abuse in Minneapolis, other places, not just in Medicaid, but home health and others in California, what has surprised you about what you've seen about the race, fraud, and abuse? And, what more do we need to be doing to deal with it?
Speaker 5
I've seen? I mean, the most shocking thing to me was the Biden administration opening the door to waste, fraud, and abuse. They implemented a new program called pay and chase, where we have to pay people. We've ended this. We pay claims that we know to be fraudulent.
That's what they did during the Biden administration. And then go and try to claw back that money, which never happens. Another thing they did was we had a program integrity office. There were 80 people in it, which was not enough to cover the 50 states and six territories. They fired immediately all but six of them.
So we have no program integrity department. They instructed people in my office that they should not be doing program integrity, that they could only validate enrollments, the legitimacy of enrollments once a year, and that there was no prevalidation before them signing up. So they were just inviting people onto the rolls we found. I mean, as, you know, you pointed out in Minnesota where this analytical, behavioral analysis, the ABA therapy, people with high school diplomas and nothing else were being paid $600 an hour. We went from paying $7,000,000 a year for autism services in many Minneapolis to $200,000,000 a year, and most of that was stolen.
In Florida, the durable medical equipment, we found one hotel with 129 rooms, and every one of them was a durable medical equipment company. None of them had ever sold durable medical equipment. We were just paying their bills.
Speaker 3
Well, thanks for working. I do wanna have one more, and we're gonna work together on that. So on, competing against China, our pharmaceutical industry is number one in the world. We know China has targeted to become the number one producer of cutting-edge therapies. They've increased by 20% in 2025.
What is the HHS and particularly the FDA focused on to make sure we stay ahead of China in pharmaceutical research and production.
Speaker 5
China is now eating our lunch. They got more drugs approved last year. 50% of the drugs that were approved in the world were approved in China. So they went from running 3% of clinical trials to running 30%, and Australia is taking about the same amount. Oh, we are losing scientists.
We're losing our IPs. We're losing physicians. We're losing the best researchers, and we're going to lose our biosecurity. And what I
Speaker 5
We're doing it right now. We are fast tracking approvals now in our country to at record levels this year. We approved 67 new drugs, 39 metal, all of these are records, 39 medical devices, 91 generic drugs. We are reducing the clinical trials from two trials to one trial, where appropriate. Mhmm.
We are fast-tracking approvals so companies can get them. We just approved the two fastest drugs in history, two oncology drugs, one in 45 days, the other in
Speaker 3
55 days. We'll continue to work. My time has expired. Know the chair's about to gavel me down. So, I appreciate it.
We'll continue to work together.
Speaker 1
I'll gravel you down, chairman. I now recognize the ranking member of the full committee for his five minutes of questions, Representative Pauline.
Speaker 4
Thank you, madam chair. You know, Secretary Kennedy, I'm shaking my head because you mentioned President Kennedy. And, I went with my dad to work on his campaign, and we worked on your dad's campaign for president. But these guys were tough. I remember during the Cuban missile crisis when president Kennedy forced Khrushchev to back down.
He was a tough guy. But at the same time, he was determined to help the little guy. And we talk about President Johnson and the Great Society, but most of those Great Society initiatives started under President Kennedy. Johnson continued. But we don't have a strong president now.
We have a weak president. Trump lets Russia and China walk all over us. You mentioned yourself that China is eating our lunch. You know? And president Trump doesn't care about the little guy.
He just cares about billionaires, about corporate interests. On April 1, President Trump actually stated, and I quote, it's not possible for us to take care of daycare, Medicaid, Medicare. They can do it on a state basis. You can't do it on a federal basis. We have to take care of one thing, military protection.
So my question is, do you know what Trump's reckless, illegal war with Iran is costing us right now? Do you have any idea?
Speaker 4
Get because you're not gonna answer the question. As of April 10, the American Enterprise Institute estimated the incremental cost of the war at between 25 and $35,000,000,000, and it has been reported that the Pentagon has submitted a $200,000,000,000 war supplemental spending request to the White House in anticipation of sharing it with Congress ahead of another likely reconciliation bill. So I have a question, Secretary Kennedy. Do you believe that further cuts to health care programs, including Medicare, Medicaid, and the ACA, are necessary in order to pay for Trump's ongoing war with Iran? Yes or no?
Speaker 5
There's no cut to Medicaid. Oh, okay. So, yeah. Look at the Congressional Budget Office report. Secretary.
We're increasing Medicaid spending by 47 percent in ten years. Is that a.
Speaker 4
cut? Commit here say that you will oppose any cuts to federal health care programs to fund the ongoing war with Iran. Will you commit to that?
Speaker 4
I'm okay. Let's say, let's forget about the past. Will you commit to oppose any federal health care programs to fund the ongoing war with Iran in the future? Forget the past.
Speaker 5
Frankly, you know, I wanna talk to you about what you said about my family.
Speaker 4
You know, let me just say, it would cost to provide two years of funding for the enhanced tax credits so families can afford their insurance premium, which is, you know, which this administration and congressional Republicans have refused to extend. It would for two years of that funding, let me just give you some statistics about how this compares. The fact is extending the enhanced premium tax credit for two years will cost a fraction of the cost of the Iran War. Just over a quarter of that supplemental funding request is what we expect to come from the Pentagon. So you can argue what you like, but the reality is that this administration and congressional Republicans are making a choice.
The choice to fund another endless war that is only raising prices for working families, when they could be helping millions of American families here at home afford the health care that they need. But what concerns me the most is not only that we've had these trillion dollars worth of cuts under the big ugly bill, and that all our hospitals are suffering, and that people can't afford their health insurance. But the administration dares to come forward and say, even with all that, we're gonna do more reconciliation with more cuts to health care, and says that the reason that we're doing this is because we have to pay for the ongoing war in Iran. It is simply not acceptable to do that. And I don't wanna keep bringing back, you know, President Kennedy.
But the bottom line is that president Kennedy, who you mentioned, you know, I wouldn't have brought it up, you brought him, you brought it up. He was tough on Russia. He believed strongly in a strong military. But at the same time, he wanted to help the average person. He wanted to, you know, provide better health care.
He wanted to provide housing. He wanted to provide help to people who were suffering. He who's concerned about poverty and started the war against poverty. But this president doesn't want to do that. He just wants to fight wars, and he says blatantly he doesn't care about the little guy.
He doesn't care about, you know, their concerns. So with that, I yield back, Madam Chair.
Speaker 1
Mister Pologne yields back, and I remind the witness that you need to call the members by their appropriate title.
Speaker 1
Thank you, sir. I know you know him as Frank. I know him as Frank, but we have to call him.
Speaker 5
I have a long history with the congressman, so we were on a first name basis for most of our
Speaker 1
Okay. Thank you, sir. I now recognize representative Bill Rocas for his five minutes.
Speaker 8
Thank you. Good morning, Secretary Kennedy. Thank you for being here and for your work making America healthy again. We appreciate it so much. As you know, rare disease innovation is a key priority area for me.
Last year, with HHS support, Congress reauthorized the FDA pediatric priority review voucher program, a critical incentive for rare disease companies to develop pediatric treatments. I was pleased to see a legislative proposal on the president's budget this year to make the PRV program permanent, and I look forward to working with you on this proposal that will bring stability to the rare community. So thank you very much for that. First question, rare disease advocates were also encouraged to see the addition of two conditions to the recommended universal screening panel for heritable newborn screening. What will the process look like for adding new conditions to the newborn screening panel moving forward, sir?
Speaker 5
Yeah. We added two new diseases, metachromatic leukodystrophy and Duchenne Duchenne's microdis microdistrophy to the panel. We intend to add a lot more of those diseases. In addition to that, we have a new initiative called the plausible mechanism pathway that will facilitate, quickly facilitate new drugs getting to market, new rare disease drugs without going through. Clinical trials of a similar molecule have already gone through the process, and there's a plausible mechanism for approval.
In addition to that, we have a rare pediatric priority review voucher, that is going to, again, facilitate quick approval of rare disease drugs. So this is a center focus at the FDA right now. We're doing more than any administration has done in history.
Speaker 8
And I appreciate that. I look forward to working with you on that. Also, I appreciate your efforts on chronic and age-related diseases that impact my constituents and, of course, millions of Americans. According to a recent report by the Michael J Fox Foundation, the federal government spent more than 25,000,000,000 on care in one year for Parkinson's disease and related conditions, and these costs are only increasing, you know. We must do more to understand why so many Americans are diagnosed with neurodegenerative diseases.
Question number two, Secretary Kennedy, research increasingly shows a link between environmental toxins and neurodegenerative diseases. A 02/2025 study found that living within one mile of a golf course is associated with a 126 percent increased risk of developing Parkinson's disease due to high pesticide use. With recent new initiatives at CDC on toxins, do you see an opportunity for HHS to further engage on this potential link between toxins and neurodegenerative diseases?
Speaker 5
We are, you know, we should know the answers to these. It's really regulatory malpractice that we do not already know the answer to that question, but there was a taboo against, before I came into this office, there was a taboo against allowing studies of environmental exposures that might put to disadvantage the mercantile ambitions of certain industries. And we have ended that taboo. We are studying these issues specifically, the links between environmental exposures and the neurodegenerative diseases, neurodevelopmental diseases, at NIH. And I hope by the end of my term, we'll have a lot of those answers.
Speaker 8
Very good. Thank you. Again, thank you. I'm proud to co-lead a bill called the Healthy Brains Act that would create a center for collaboration on this exact issue at NIH, and would welcome the opportunity to work with you. Thank you, Mr. Secretary.
And I wanna give you a couple seconds. I have about twenty-five seconds to respond to mister Pologne.
Speaker 5
Yeah. I mean, congressman Pologne unfavorably compared the political courage of my family to mine. But I was with congressman Pologne in the early two thousands when he was the champion in this body for people who had vaccine injuries. And suddenly, he did a one-eighty when the pharmaceutical industry of New Jersey turned him around, and that was a template.
Speaker 2
to instruct this witness not to impugn the motives of the members of this committee, as
Speaker 2
As he tried to do the last time he was in front of this committee, Madam Chair.
Speaker 1
Well, it's best for everybody to just simmer down, and, let's try not to talk about the witnesses or the members. So it's, I recognize Doctor Ruiz for his five minutes of questioning.
Speaker 11
Thank you. Mister secretary, do you approve of President Trump's nomination for Doctor Erica Schwartz to be the next CDC director?
Speaker 11
Did you speak to the president directly about this choice before she was nominated? Did you speak with the president before her nomination about her?
Speaker 5
I have not spoken to the president directly, but my staff, Chris Klump, spoke directly to the president.
Speaker 11
Alright. So you didn't speak with the president about a major decision that they were all gonna make that you, on an agency that you oversee. Did you speak with Erica Schwartz prior to her nomination to vet her?
Speaker 11
K. Well, here, let me remind you what she said about vaccines. Quote, when I was a military physician, my job was all about readiness. It was all about public health, prevention, vaccines, early detection. If we get that right, we change lives before illness even begins.
It was all about vaccines. And if we get that right, we can change lives. So this runs contrary to your dangerous anti-vaccine crusade, mister secretary. These questions are important because you fired the last CDC director, Susan Monarez, because she refused to, quote, give blanket approval, unquote, and rubber stamp your efforts to dismantle the childhood vaccination schedule without any scientific evidence to do so. Remember that?
Speaker 11
Well, it's what was reported where she testified in front of the senate.
Speaker 11
But you dismantled the program, replaced the ASAP board with anti-vaxxers anyway. Things that she said you were gonna do, and you did them. So when we talk about truth and who is being honest, I would trust her because that's what you did, even though you were denied to Senator Cassidy that you wouldn't do that, Mister Secretary.
Speaker 11
Ask you a question because you and her have very different opinions on vaccines. Did you change your views on vaccines?
Speaker 5
You want a soundbite, or do you want to have a discussion? Because what you're saying is absolutely wrong.
Speaker 11
What you have demonstrated throughout your entire time as secretary is the dismantling of the childhood vaccination programs that has been detrimental to our nation and puts our nation at risk of getting more communicable diseases, which has been shown through the flu, through the measles. Those cases have been rising, Mr. Secretary. Putting billion dollars agree with Doctor Schwartz and her vaccine position.
Speaker 11
Mister secretary, if doctor Schwartz is confirmed, will you commit on the record today to implement whatever vaccine guidance she issues without interference? I'm not gonna.
Speaker 11
You probably won't fire her as well as you did doctor Mornarez because you will not accept the recommendations based on science.
Speaker 11
It has been reported by Bloomberg that the president and the White House have sidelined you. They've benched you because you are making the president look bad. Are you aware of that?
Speaker 11
mean, wracking. Want to sound bad. After the Bondi discussion. Especially after the Bondi and secretaries Noam and Chavez, the rimmer got fired for making the president look bad. You see, I think the reporting is correct, Mr. Secretary.
You're just making stuff the president look bad, especially before the midterm elections. You talked publicly about snorting cocaine off a toilet bowl seat. Your words, not mine. You said that if you were president, you would, quote, unquote, reparent black children. Again, in other words, taking them away from their parents.
Your words, not mine. Furthermore, the American people think your anti-vaccination crusade is too extreme. A KFF polling shows that 55% of the Americans disapprove, with 37% strongly disapprove of your work, mister secretary. 56% have little or no confidence. The majority have little to no confidence in your work with vaccines, and you keep losing.
Americans are sicker now than ever. Measles cases were up to 2,288 in 2025, more than the previous year. This year is gonna be worse, with cases already at 1,748. So, mister secretary, you should resign for your dangerous dismantling of our public health and before the president fires you too. And when you do get fired, don't sign up.
Members' time is up.
Speaker 9
Secretary, thank you for being here today, and thank your staff for being here. And thank you for your efforts that you are making in trying to make America healthier. Mister chairman, mister secretary, I apologize. Mister secretary, do you have anything you wanna respond to? I wanna give you some time if you want to respond to anything.
Speaker 5
I'll also respond by saying a couple of things. One is I'm not vaxx anti-vaxx. I've never been anti-vaxx. I'm putting a billion dollars into vaccine research right now at NIH and NCI. If I was any vax, I wouldn't be doing that.
We're developing a universal flu vaccine, and cancer vaccines. I don't believe all vaccines are bad. I've never said that. What I've said is they should be safety-tested. None of the 92 vaccines, with one exception, none of the 92 doses of 18 vaccines now given to our kids has ever gone through a randomized controlled placebo trial.
No other medication would be able to do that. And all I'm saying is we should know a risk profile so that we can inform the parents. I fired Susan Menares because I asked her an outright question, can you are trustworthy? And she said no. And I said, can I trust you?
And she said no. That's why she got fired, not because of her vaccine issues. I really had nothing to do with that.
Speaker 9
Okay. Thank you, Mr. Secretary. Mister secretary, I want to talk about the budget. I think that's why you're here, is to talk about the budget, and I appreciate it very much. One of the things, and as you know, I'm the oldest pharmacist in Congress,
Speaker 9
Chairperson Harshberger is the youngest. But nevertheless, I've seen a lot of these federal programs in my practice of pharmacy over the years and the policies that are implemented, and I've seen them misaligned. And one of them that I'm particularly interested in is the 340B program. I am not trying to end the 340b program, but I think it has evolved into something it was never intended to be. It was intended to be for the rural hospitals, for the FQHCs, and it has evolved into something much more than that.
And I'm interested. I've got legislation to call for more transparency in 340b, but I wanted to ask you what kind of reforms is the agency looking at to try to reform the 340b program? Well, and you're right. In the way.
Speaker 5
That you characterize it, originally, it was intended for rural hospitals to look for patient populations who couldn't afford medicine, to lower the cost of medicine to those hospitals. It was mandatory. Originally, there were 90 facilities, 90 different entities in the program. Today, there's 12,000 with about 60,000 outpatient offices, and it has become a boondog. We saw in one situation in Virginia, a hospital in Virginia, that was taking the discount from the pharmacy drugs and selling them at list price to the patients, using the profits from that to build a hospital in an affluent area in Virginia.
It's exactly the opposite of what, and I could tell you horror stories about it all day. Absolutely. There are a lot of good things about 3 40 b. It's absolutely critical. I couldn't agree more.
Many functions. We need congressional help because the change has gotta be statutory, and we wanna work with you to figure out the best way to read. We're trying.
Speaker 9
to give you that congressional help. Let me assure you of that. But, you know, it's even worse than what people think because not only has it prolificated into something that it was never intended to be, but also it's leading to consolidation in health care, which is leading to higher cost in health care. There are health care systems that are buying oncology practices for no other reason but to get the pricing of $3.40 billion. And then the hospitals have become so dependent on it.
And I get it, but I can't help them if they are masking costs by using that program. Then if I can't see those other costs, I can't help them with that cost. And that's exactly what they're doing, and that's why we're trying to reform the program to make it better for who it was intended to be for, for the rural hospitals and for the 340B's. Wanna make sure for the FQHCs, excuse me. Wanna make sure that I get to this real quickly, and that is the streamlining the regulatory process and trying to give additional investments in domestic manufacturing.
Can you tell me real quickly what the agency is trying to do there? For manufacturing? For just regulatory process and trying to support additional investments in domestic manufacturing.
Speaker 5
In pharmaceutical manufacturing. Yes. For drugs. Absolutely. Yeah.
I mean, we're putting in, through the MFN agreements, the companies that the 16 companies that negotiated with us, almost all of them have agreed to reshore their pharmaceutical production. So we're seeing huge, vast investments now in pharmaceutical production. In addition to that, my agency is putting in $325,000,000 into the strategic national stockpile to reshore API manufacturing in this country. Good. Thank you for your efforts.
We have a pandemic that we don't, you know, have these supply chain difficulties that we have. Okay.
Speaker 1
For your efforts. I'll now recognize Representative Dingle for her five minutes questions.
Speaker 6
Thank you, madam chair. Mister secretary, my concern is that under the current leadership at HHS and quite frankly out of the White House, America is grappling with an unprecedented destruction of our public health infrastructure. You talked about measles. Other people have talked about measles. We eliminated them.
The United States announced they were eliminated in 2000. I'm one of the counties that has some outbreak. Mine's like March.
Speaker 6
We let in 2000, we said we had eliminated measles in this country. It's back. You acknowledged it. Others have 3,000 cases in the last few months. Every patient, every child with measles should be treated with compassion.
But I had seven cases just in the last couple of weeks in my county. And they've been, the contagious spots have been grocery stores and colleges. You can't stop it. I've met with the family on one of them. And I said, why didn't you get immunized?
And they said, we're listening to our government. Our government tells us not to. So you may think that you're pro-vaccine, but people aren't hearing that. And I'm talking to the people who are actually sick right now. So, that's what worried me.
And you're hiring, you're hiring people that are vaccine skeptic health appointees, and they are spreading, quite frankly, lies about vaccine safety. And now polio is coming back. That's why I'm worried. While Americans are continuing to get sick, the Trump administration is cutting staff and funding for public health efforts at critical agencies. And not only are we seeing measles and polio come back, the case at NIH is also doing long-term damage to the future of health research in America.
I agree with you when you say that researchers are going overseas. I've met with these kids. They are being recruited. We are losing a generation of researchers, and they're headed to other countries, including bad actors with big wallets, where they can count on stable funding. That got called into the University of Michigan by the chairs who just and I fight you've been wonderful at HHS last year, giving them this year, they don't know what the hell's gonna happen.
Kids have said to me, we're leaving. We can't count on it. I say, please stay. So do you believe that the US should remain a global leader in health research? Yes.
Speaker 6
Do you believe that the US should remain a global leader in health research? Yes or no?
Speaker 6
My time is short, but it's a document. In fact, US Fed was eliminated in 2000.
Speaker 5
We eliminated it. Europe eliminated it. Canada. And now, guess what? Canada has lost its elimination status.
England has lost its elimination status. All across Europe, they've lost their elimination status. It has nothing to do with me. It has to do with that we have a global epidemic. And if you're asking why people stop vaccinating, it's because the government lied to them during COVID.
That's when the vaccination rates dropped because if you're worried about polio and tuberculosis, you should look at the immigration policies in this country because the place where it's occurring are the places where the immigrants are going because they're not vaccinated, and they got to break.
Speaker 6
It's low. A lot of people have stopped getting vaccines, and I can't go, I can't agree with you on that, but I'm getting low on time. And another thing I'm very worried about is, your agency rescinded a rule implementing a minimum staffing standard in nursing homes. This rule would have saved.
Speaker 6
Agency rescinded a rule implementing a minimum staffing standard in nursing homes. This rule would have saved lives, improved care, and strengthened the nursing home workforce. The rule is not going to be implemented until 2035, providing nursing homes a decade. What plan does your agency have to address the staffing crisis in nursing homes?
Speaker 5
That rule was putting out of business thousands of nursing homes in rural areas in this country that could not meet the federal standard.
Speaker 6
And people were dying because there wasn't enough care in those nursing homes, and I've met with families whose people died.
Speaker 5
Dying because they had to move to city nursing homes where the families couldn't visit them anymore.
Speaker 6
You have to have a standard that there are enough people to take care of the people that are in those nursing homes. Let me ask you a question. The New York Times reported that several nursing home CEOs got paid $2,100,000 to have lunch with President Trump at Mar-a-Lago and urged him to rescind the minimum staffing week rules. Weeks later, he put that out. Did the president talk to you?
Was there any connection?
Speaker 1
Gentlemen, time is up, and you can answer that via written notice. I'm now recognized voice. I now recognize, doctor Joyce, for his five minutes of questioning.
Speaker 13
First of all, Secretary Kennedy, I wanna thank you for appearing here today, and thank you for your leadership and the concrete steps that you've taken to root out the fraud, hold bad actors accountable, and improve access to care and training for new physicians. Your leadership in the fraud space, including the crush initiative and RFI, pose an opportunity to fundamentally change how we approach these fraudsters who prey on the government, and they prey on government programs to divert precious government funding away from true areas of need. Moving away from the current model of pay first, attempt to recover later, which you mentioned in your statement is very difficult to recover any of that funding, to a real-time detection model will enable government to stop payments before they're even made, which will lead to billions of dollars in annual savings. And that's what this hearing is all about, and I congratulate you for that aggressive stance. Last year, you also acted on bad actors in the Oregon procurement space, leading to the first ever mid-contract decertification of an OPO.
Like you, I share concerns that more needs to be done in this space, and look forward to partnering with you and Administrator Oz to address any additional authorities required from Congress. Finally, I am encouraged as a physician by the recent announcement that 53 medical schools are now committing to at least 40 hours of nutrition education as part of their curriculum. I did 4 years of medical school. I did six years of postgraduate studies. I had zero at zero hours in nutrition training.
It is so important that you've addressed this, and I would encourage all medical schools, not just the 53 that have made that commitment, all to participate and provide that training for our future doctors. In your testimony, you mentioned affordability and actions that you and this administration have taken to lower costs. In our previous hearings on this subject, at this committee, one of the biggest issues driving higher costs is the issue of hospital consolidation. Secretary Kennedy, independent physician practices are disappearing, in part due to hospital systems offering compensation arrangements that may exceed fair market value and are not commercially reasonable. In 2020, CMS made it clear through rulemaking that physician compensation must meet standards for fair market value and commercial reasonableness under the STARC law.
This is a growing concern that these standards are not being properly enforced, particularly in hospital hiring practices that may be declining to the independent physician hospitals and independent physician practices. What is HHS doing to ensure that these standards under the Stark law are enforced?
Speaker 5
First of all, thank you for raising that issue. And one of the ways that we've tried to address this is through reforming the site neutrality rule so that hospitals in rural areas are not getting paid less and that the compensation is not less for the doctors in those areas. In terms of investigating that particular fraud, I'm happy to work with your office and with Doctor Oz to make sure that we're targeting it along the long list of other things that we're doing to combat fraud.
Speaker 13
Thank you for that commitment. I look forward to working with you and Dr. Oz on that issue. Another issue of concern will lead to more independent practices closing or selling to hospital systems is the recent reimbursement reductions impacting radiation therapy and oncology. As you know, radiation therapy is a key part of cancer care and requires significant capital investment, advanced technology, and highly specific clinical staff. Abrupt reductions in reimbursement threaten the financial viability of community-based radiation oncology practices and freestanding radiation facilities.
I plan on sending a letter on this subject to administrator Oz. Will you commit to look into this issue with us as well, to work for a potential solution?
Speaker 5
Absolutely. Those offices are critical again, particularly in rural areas, isolated areas of the country.
Speaker 13
In the remaining seconds, are there any additional issues with the barrage of questions that you've been posed by the other side without adequate time to answer? Is there anything that you would like to comment to the committee at large here today?
Speaker 5
I mean, you know, I would say this. We hey. People said that I'm breaking the health-care system. The health care system was broken when I got here. We spend 48¢ out of every dollar that Americans pay in taxes that the federal government is going to health care.
90% of that is going to chronic disease. That's if you include my agency, the Department of Funds and Social Security. Well, our lifespan is plummeting.
Speaker 1
Okay. Witnesses, our witnesses' time is up, but we are going to take a short five-minute recess, and we'll come back and resume the hearing as soon as that recess is up. Five minutes. Thank you. Okay.
The hearing has resumed, and I want to say this one more time. We ask that members not begin a new question to our witness as her five minutes expire, because we have Secretary Kennedy here for a very short period of time, and we want as many members that are here to ask questions. So I will recognize Miss Kelly for her five minutes questions.
Speaker 10
Thank you, Madam Chair and Ranking Member. Secretary Kennedy, when you appeared before this committee in June 2025, the big ugly bill had not yet been enacted, but you claim that your department would not be cutting Medicaid. You said, and I quote, we're not cutting Medicaid. There are no cuts to Medicaid. Despite active plans underway to dramatically change the program and severely reduce federal funding to states.
You have actually repeated that today. And I just want a yes or no. Is it still your position that a $900,000,000,000 reduction in federal Medicaid funding to states is not a cut? Yes or no?
Speaker 5
That would only be a cut in Washington, D.C. A 47% increase in spending. How is that a cut?
Speaker 10
I just want people to say yes or no. That's all. So you're saying it's not a cut?
Speaker 10
Question. Did your department find 900000000000 worth of fraud in Medicaid to justify?
Speaker 10
Did your department find $900,000,000,000 worth of fraud in Medicaid to justify these cuts?
Speaker 5
lot of Medicare. Fraud? There are millions of people on Medicaid. There were 3,700,000 people who were getting Medicaid in two states, or they're getting Medicaid and Obamacare at the same time. There were 1 million illegal immigrants on Medicaid, so that's fraud.
We're getting rid of those people.
Speaker 10
question. Do you have any evidence to justify eliminating the funding for critical programs like the CDC's safe motherhood initiative? You talked about maternal mortality, which is a devastating problem in the United States. We had Do you have evidence to justify eliminating the funding for that critical program? Yes or no?
Speaker 5
We had 27 maternal mortality programs. We consolidated them. We're doing more on maternal mortality. I can show you the data than any administration in the history.
Speaker 10
You don't have to show me the data. I'm the one that brought the issue to congress.
Speaker 10
So you're saying you eliminated the program because you're merging programs.
Speaker 5
We eliminated programs that were duplicative or redundant. We are laser-focused. We're serving 59,000,000 women. They.
Speaker 10
How many women are dying, and definitely too many Black women are dying. Before I can. Is not getting better.
Speaker 10
The national average is at our perinatal program. Three to one in Chicago was higher than that in a lot of places.
Speaker 10
Retaking my time, please. The American people are not falling for what you're saying. Your attacks are minority health, women's health, LGBTQ plus health, and basic preventative medicine. Through illegal funding freezes and mass firings, will lead to decades of consequences for all Americans. We're already seeing hospital closures, a reduction in services, and staffing cuts. For example, a 28-bed obstetrics unit in Elk Grove Village, which is not rural, earlier this year.
Mister chairman, I'd like to enter, or miss chairman, a Newsweek article about the closure into the record, as well as a report from energy and commerce and senate finance that document dozens of similar stories throughout the country.
Speaker 10
Labor and delivery units and maternity care are some of the most vulnerable health care services to funding cuts, which means pregnant and postpartum women must drive further to seek care. Change providers when clinics and hospitals close and face longer wait times and more risks in the case of an emergency. Secretary, are you concerned by these closures, particularly in rural and low-income parts of the country, but not just in those parts of the country? Because my district is urban, suburban, and rural, and I've seen the effects.
Speaker 5
We're putting more money into improving access to rural health care than any administration in history.
Speaker 10
Before my time closes, you talked about, you know, food. And, there's approximately 150,000 people in Illinois that may lose their food because of the snaps to cut. And you talk about eating real food, not medicine. Real food is expensive. And when all those snap cuts that have already happened and will continue to happen, it'll be really hard for people to stay healthy.
I yield back.
Speaker 1
Gentle ladies, time's up, and I recognize mister Walterson for his five minutes' questions.
Speaker 15
Thank you, madam chair, and thank you, mister secretary, for being here today. My first question, mister secretary, is the budget for 2027 proposal centers around promoting the health and wellness of every American due to the reduction of chronic disease burdens. How does the department see wearable technologies contributing to earlier detection and prevention strategies?
Speaker 5
It's a key part of our response. And I'll give you an example. Glucose meters can tell you while you are eating, while you are chewing on the food, what it's doing to your insulin levels, what to your glucose if it's causing your glucose to spike. People who wear those glucose meters for even 3 or 4 weeks change their diet. It has a dramatic impact because now they know.
They can eat certain things. They may be buying a yogurt thinking it's healthy, and they'll see that their glucose spikes. It gives them insight into health care, and it can also mesh with their personal health records. So it can help them. Now there are apps that can look at their personal health records, look at the feedback from their wearable, and tell them how to shop.
Tell them that the item is good for you. This item is not. And then here's some alternatives. Oh, he can revolutionize chronic disease prevention in this country.
Speaker 15
Agree, sir. Follow-up to that. Are there policy barriers Congress should consider addressing to support the responsible adoption of wearable devices?
Speaker 5
I mean, the more that Congress can do a lot more than we can. And I would love to work with you on proposals for what congress could be doing to incentivize the use of wearables.
Speaker 15
Okay. Thank you, sir. Look forward to that. We are in a new era of Alzheimer's treatment and innovation. Yet only half of Americans living with Alzheimer's are diagnosed, and many primary care providers report they do not feel prepared to manage dementia care, even though they make about 85 percent of initial diagnosis.
How important is it to ensure that federal investments in research and chronic disease innovation translate into stronger detection and diagnosis in primary care, and how will you prioritize that effort?
Speaker 5
Well, it's absolutely critical because we now know that early treatment of Alzheimer's can postpone its onset. And, you know, it's almost, again, kind of regulatory malpractice that we do not have early screening already. And one of the things that we're working on right now is to reform the United States Preventative Service Task Force, and we will be putting in a federal register this week solicitations for new members of that task force. That task force has been lackadaisical. It has not been doing its job.
If it had been doing its job, we would have early screening for Alzheimer's.
Speaker 15
Okay. Thank you. In Ohio, many community health centers report difficulty recruiting behavioral health providers and primary care clinicians. How does this budget strengthen the pipeline of providers serving health professional shortage areas?
Speaker 5
Well, first of all, I would point to the rural health transformation plan, which a lot of the states, when they filled out their applications, included the retention of workers in addition. So that there's gonna be a lot of money going into the recruitment and retention. We also just put in a $135,000,000 to community health services or to community health organizations, community health centers, which treat about 32,000,000 Americans, and they're by far the best facilities for treatment of Americans for preventative care and for, you know, twenty four hour care.
Speaker 5
They're mainly targeted to poor Americans. We put $135,000,000 into that for nutrition, to improve nutrition in them, but also for retention of workers. We're also expanding GME, general medical education, so that, to increase rural residencies. We know that when doctors train in rural areas, about 30% of them end up staying there. The more doctors, the more residencies we can get funded in rural areas, the more doctors we're going to have.
Speaker 1
Yields back, and I recognize Representative Barragan for her five minutes of questions.
Speaker 16
Thank you, Mr. Secretary. I wanna bring something to your attention, since you just brought up glucose meters. I'm not sure if you're aware, but if you're a patient that's on Medicaid and Medicare, the US health system will not cover the glucose meters unless your A1C is so bad, like over 8, before they will cover that. So you talk about preventive care and making sure we invest in preventive care.
Speaker 16
Unless you're a one c, your sugar level is so high, like, over eight, that they will cover it. In other words, there's no investment in preventive care. It's only you're so bad, then we're gonna cover the glucose meter.
Speaker 16
And I'm just telling you this because I hope you will go fix it. This happened to my mother. Her a one c got over 8. They gave her the glucose meter. As soon as she got under eight, they said, we're not gonna cover any more.
We're gonna take it away. That's the opposite of preventive care. I hope you're going to fix it. I just wanted I don't want your comment. I just mentioned it because you brought up glucose meters.
I will follow up with your office.
Speaker 16
I appreciate that. Now, do you think women should have access to birth control pills?
Speaker 16
No. Do you think that women should have access to birth control pills? Should they have access?
Speaker 16
Then why eliminate Title X funding from the budget? That would make it harder for women to have access to birth control pills and the contraception of their choice.
Speaker 5
I am sorry that I can't talk about that because the case is under litigation.
Speaker 16
Okay. Well, you're here to talk about the budget, and this is an elimination of the budget of Title 10. You just said that women should be entitled to birth control. By the way, I agree with you. I agree with you.
And I can tell you, surely you know how common, either from personal experience or men you know, will ask women before sex. Are you on the pill? I mean, that's a common question. What do you think they're asking? It's because of family planning or unwanted pregnancies.
So I'm really disappointed that you are here to testify about the budget, yet you will not talk about this issue. This is an elimination of Title X funding, which is directly to birth control pills. So I will move on. I want to thank you for last year, when you came before this committee. I asked you about Alzheimer's research funding.
You followed up with me in your letter. In the letter, you said, as the global, and this is a quote, as the global leader in research on Alzheimer's disease and Alzheimer's-related dementias, the Department of Health and Human Services considers funding this research area a high priority. So you said it was a high priority, yet your budget proposes a $312,000,000 cut to the National Institute on Aging, which does research on Alzheimer's disease, research centers. Do you think that's consistent, Mr. Secretary?
Speaker 5
We are putting a lot of money into Alzheimer's research, a very high priority at NIH and at the CDC.
Speaker 16
Okay. So, you know, you used the worst regulatory malpractice when you talked about Alzheimer's research a moment ago with my Republican colleague. I'll just say that I think this is also malpractice. On the one hand, you say this is a high priority. On the other hand, you're cutting $312,000,000 in research funding to the Alzheimer's Disease Research Centers.
Mr. Secretary, last week you spoke about Medicaid programs that allow family members to care for their parents at home, and you testified, and I'm quoting you, these are family members who are getting paid to do things they used to do as family members for free, end quote. Okay. You said this. Do you remember saying this?
Speaker 16
It seems, ranking member, that most of our time is being taken on what the secretary cannot hear. And I would suggest that you add time because I could tell you, thirty seconds in the last one, just what he can't hear. And I am trying to speak slowly and articulately. Last week, you testified for Medicaid programs that allow family members to care for their parents at home. You said that family members who are getting paid now to do things that they used to do for free.
Do you remember that?
Speaker 16
Right. So are you suggesting women should quit their jobs to provide free care for their family members who are elderly, instead of getting them health care?
Speaker 5
I said that in the context that that kind of program is significantly vulnerable. To fraud, which is impossible to detect.
Speaker 5
And that program has doubled the cost of Medicaid over the past 4 years.
Speaker 1
Up, sir. Members' time is up, and I'll now recognize Doctor Miller Meeks for her five minutes of questioning.
Speaker 17
Thank you, Madam Chairman, and thank you, Secretary Kennedy, for testifying before the health subcommittee today. As our time is limited, I'll jump in, but perhaps I can give you a chance to respond. Mister secretary, I have a bill on oral contraception over the counter. I introduced this bill as a state senator in 2019. This is something we've been working on in Congress.
There are several bills on this. In response to your question from my colleague on the other side of the aisle whether or not you support oral contraception for women, would oral contraception over the counter be something you would support, which would increase access? Yes. Thank you, sir. I'd also like to bring your attention to one of my bills, the welfare abuse laundering zillions, which you just mentioned, fraud or WALDS Act, legislation designed to stop large scale welfare fraud and restore accountability to government programs nationwide.
Specifically, this bill would require HHS, Office of Inspector General, to open investigations into any program that sees a 10% or greater increase in total payments over a six-month period within a fiscal year. Under the bill, HHS would no longer have discretion to ignore sudden increases in billing that critics often say signal fraud schemes, particularly in large entitlement programs, such as a rapid increase in the billing for autism services. My staff, along with the Energy and Commerce Committee, have been working with HHS OIG to ensure the bill has stringent guardrails in place to prevent the level of negligence and fraud uncovered in Minnesota, California, and Washington from happening again. Would you be supportive of something like my Bill, the Waltz Act, and commit to providing technical assistance?
Speaker 5
I think the bill is a great idea. I would look at the details and work with you on it at HHS, but I think it would have prevented a lot of the fraud that we've seen in the last four years.
Speaker 17
I also wanna thank you for your leadership on the MAHA initiative, because as a physician and a former nurse and someone who represents a largely rural district in Southeast Iowa, I've seen firsthand how health is shaped long before a patient ever walks into a clinic. The Maha Movement rightly emphasizes better nutrition, chronic disease prevention, and improving the quality of the food supply. So from changing the food pyramid to encouraging nutrition, I just wanted to say that I did not have any nutrition education in medical school. It came in nursing school prior to medical school, and I think that your advocacy for nutrition education in medical school is worthwhile. There are several bills in Congress for nutrition education in medical school.
Would this be something that you'd support?
Speaker 5
Absolutely. And I, you know, I point out that many of the states now, over 50 of the states, have now passed laws requiring, for continuing medical education, that the curriculum includes nutrition. So, you know, the more the doctors know about nutrition, the healthier our people are gonna be.
Speaker 17
I think your leadership has helped to spur that movement. I also wanna highlight the great work done by congressional Republicans and HHS for delivering the largest federal investment in rural health care in American history through the rural health transformation program, and I heard you mention that earlier. I've hosted three roundtables in the past year in my district with all our hospitals, meeting with hospital leaders, FQHCs and community health centers, and advocating at the federal level to ensure Iowa is prioritized for this historic investment. And, in fact, Iowa is the first state to disperse funds related to the rural health care transformation. Congratulations. Investment legislation.
During my last roundtable earlier this month, hospital leaders brought up a few questions of eligible expenses under the rural health care transformation grant. And you just mentioned the workforce. So one of the questions that was brought up was recruitment is extraordinarily difficult in rural communities. And I had one of our hospital systems had to pay a recruitment bonus of $200,000 for an OB GYN. And so would this be something where there could be flexibility in the grant program to allow some of the workforce funds to be utilized for recruitment bonuses?
Speaker 5
You mean under the rural transformation? I do not know the answer to that question, but I will get it from Doctor Oz and get back to you.
Speaker 17
Thank you, sir. And then lastly, I just wanted to say that affordability is an issue that all of us are looking at, including you, which is why tackling waste, fraud, and abuse in the system is so important. I've introduced the Lower Health Care Premiums for All Americas Act, which passed the House in December 2025. The bill takes a targeted approach to lowering premiums, and I would certainly wanna partner with HHS, as my time expired. But hope to partner with you on lowering health care premiums for all Americans.
Speaker 1
I yield back. The gentleman yields back. I now recognize Doctor Schrier for her five minutes of questions.
Speaker 18
Secretary Kennedy, last week, you testified that newborns should only get the hepatitis B vaccine at birth if their moms test positive or haven't been tested. This is a massive departure from a 35 year recommendation for all babies to get the vaccine at birth. Secretary Kennedy, how often does that test miss hepatitis B in moms who actually have it?
Speaker 18
It's a really important piece of data. It's not a perfect test. It turns out there's a false negative rate of 1 to 2 percent, and that might be enough for screening the general population, but not when a baby's life is at risk. And so let me just translate. That means if there's 100 moms out there with hepatitis B, two of them are gonna be told that they don't have it.
Their children will not be vaccinated based on your recommendations. And then there's a 90 percent chance that those two children will end up getting chronic hepatitis B. Mister secretary, do you know what happens when you get chronic hepatitis B?
Speaker 5
I do. I also know that the death rate in children was practically zero for hepatitis B prior to the introduction of the vaccine.
Speaker 18
So it's interesting to say that because, generally speaking, what happens with these children is that they don't die as children, but they can spread hepatitis B to other people. But they go on later in life to get cirrhosis of the liver and liver cancer, and they might need liver transplants, and they die prematurely when they are younger adults. And so you're basically sentencing thousands of kids to a terrible, chronic illness that you want to prevent for no reason. At the same time, you're suggesting to parents that there's something wrong with the vaccine, that it might not be safe. Because after all, why not just give them to every child and not have anybody fall through cracks?
That's your underlying message. Now there's another shot that babies get at birth. It's vitamin K, and it prevents catastrophic brain bleeds. And now that you've made parents distressed, doctors in shots, some parents are now refusing the vitamin K shot and other routine care, putting these babies at risk for bleeding out. This has a name.
It's called the RFK Jr. Spillover Effect. You spread misinformation. You scare parents and confuse them. Parents don't immunize their children or give them other routine care, and then the kids get sick, and they might even die. And right now, Secretary Kennedy, given what I just told you about vitamin K, will you just tell pregnant women out there, for the record, yes, you should get your babies the vitamin K shot?
Speaker 5
What I, well, first of all, anybody can get a hepatitis B shot and have their insurance company pay for it.
Speaker 18
Secretary, the point is that you're discouraging it. You're suggesting it's unsafe. This is what parents are hearing. Why else, all of a sudden, are parents saying no to vitamin K? Will you just tell them for the record, there are women out there delivering today that they should get the vitamin K shot for their babies?
Speaker 18
No. I'm saying vitamin K. Should women allow their babies to get the vitamin K shot so they do not have brain bleeds?
Speaker 18
The FDA has approved it. It was a recommendation, but parents are listening to you, and they are doubting science.
Speaker 5
I've never said anything about the case. I don't see how they're talking. They're listening to me. I've never said anything about it.
Speaker 5
When I talk about it, there is no vitamin B shot in Denmark, and they have the same rate. I mean, hepatitis B.
Speaker 18
Sir, this is about vitamin K. It is a spillover effect. Just like measles vaccine and pertussis vaccine,
Speaker 18
That's exactly the point. You don't say anything about it, but the doubt you've created about all of medicine and science is causing parents to make dangerous decisions.
Speaker 18
Mister Secretary, I'm reclaiming my time. The last time we spoke, I told you I would hold you accountable for every vaccine-preventable illness and death in this country. And now I have to add newborns bleeding out because these same parents who are listening to you are not giving their babies the vitamin K shot, and your records. This policy is going to be your legacy. I never said that. Secretary that caused kids to die.
Your secretary of HHS, your job is to protect us, and you are putting kids in danger. And I believe you should resign, or you should be fired. I yield back.
Speaker 1
General Lady yields back, and I now recognize Representative Kemeck for her five minutes of questions.
Speaker 20
Thank you, madam chairwoman, and thank you, Secretary Kennedy, for appearing before us today. I am going to try very hard to resist responding to what I just heard. But I do wanna just say thank you for actually trusting moms to make the best decisions for themselves and their families rather than continuing to perpetuate the narrative that only bureaucrats in Washington can make recommendations, and force people into doing things that they know is not best for them and their children. As we review the fiscal year 27 budget, Secretary Kennedy, I think it's important that we focus not just on how much we are spending, but whether or not we're actually improving health outcomes for the American people. Now too often, we say that we have a health care system, but I personally believe that we have a sick-care system.
And we have a culture that perpetuates a system of maintenance rather than prevention. And I think much of what your initiatives do is trying to address the cultural issue as well as the structural issues within HHS. So I appreciate the administration's focus on prevention, nutrition, innovation, and I look forward to continuing the discussion on how this budget can move us in that direction, while improving access and lowering costs. So recently, we hosted doctor Bhatacharya in the Gator Nation, North Florida. And I would like to extend a similar invitation to you to learn more about what we are doing at the University of Florida, the number one public university in the country.
I would be remiss if I did not mention that. But what we are doing, particularly in the health care space and within R and D, is to advance better outcomes and health care discoveries. So, we would welcome the opportunity to host you.
Speaker 5
I would love to come. My sister-in-law teaches at the University of Florida. My wife's family lives there. My wife is an alumni, so I'm, I'd be delighted to come.
Speaker 20
Go Gator. Alright. That's what I'm talking about. So let's talk about the spending and whether our federal health spending through HHS is actually changing outcomes and not just maintaining the status quo. Walk us through some of the challenges that you're facing and how we can be helpful in advancing those changes that really disrupt the status quo, and drive us towards better health outcomes.
Speaker 5
I mean, I would say there's a whole ways for an abuse issue that you're familiar with. So I won't dwell on that. But I would say the overarching issue that we're trying to create is the perverse incentives. We have a sick care system where people get compensated more for keeping patients sick.
Speaker 5
And, you know, Medicare Advantage was supposed to be the template for outcome-based care. We have other templates for outcome-based care. The whole system ultimately has to be moved to that. EVER services is not a way that we're gonna get Americans healthy.
Speaker 5
We need to align the economic incentives with the outcome of good health for all Americans.
Speaker 20
Absolutely. I agree. And to that point, we've seen the use of Qualys, right, that has been prohibited when we talk about Medicare because they undervalue the lives of our seniors and people with disabilities and chronic conditions. That's just fundamentally wrong, in my opinion, to have an algorithm, a formula, determine whether or not you are of value enough to receive certain treatments. So as we're going through this, can you confirm that HHS will continue to uphold this safeguard and ensure that coverage and payment decisions are not based on discriminatory measures like qualies, and would you be willing to work with us to extend and clarify this protection across all of the federal health programs?
Speaker 20
Excellent. I know people around the country are celebrating that answer, for sure. And, shifting a little bit to the FDA while I've got some remaining time here. I would like to hear about how you guys are improving the clarity and predictability in FDA as you review different applications. That's something that I hear often, particularly from startups in the process.
It's still bogged down. We need to move faster. Can you just talk a little bit about that?
Speaker 5
The process at FDA for approving Correct. New drugs. Well, we're now using AI. 90% of FDA is on it. Using it, we've been able to condense the time for reviewing final applications from typically sixty to ninety days to two hours.
Speaker 1
Can answer her question via written circumstances. And thank I now recognize Representative Treyhan for her five minutes of questioning.
Speaker 7
Thank you, madam chair. Secretary Kennedy, since day one of your administration, the Department of Health and Human Services has made it much harder for Americans to enroll in health coverage and afford their health care. Americans are currently experiencing an accessibility and affordability crisis in our country due to the Trump administration's actions. Now before President Trump came into office, a record-breaking 24,000,000 Americans were enrolled in health care coverage through the ACA marketplace. Millions of families were saving thousands of dollars each year in premiums.
Secretary Kennedy, you're aware that at least 1,200,000 Americans have lost ACA marketplace coverage this year under your leadership? Yes or no?
Speaker 5
They were people, the only people who lost coverage were people who were never entitled to coverage.
Speaker 7
aliens. Look. That's not how the law works, and I would explain that. Undocumented immigrants aren't eligible to enroll in.
Speaker 7
This reflected in the 1,200,000. They wouldn't be reflected in that number. So don't offend us by.
Speaker 5
Oh, I didn't mention illegal aliens, although that is part of the issue. People, yeah. We've found 3,700,000 people.
Speaker 7
Okay. I know. It's all fraud, waste, and abuse, even though we know the paperwork that you're now putting on more people is causing them to drop their insurance coverage. And the price of premiums has gone up so much that eligible Americans are dropping coverage because they can't afford it anymore. And I'd like to enter into the record the 2026 marketplace open enrollment public use files.
Further, that doesn't even tell the entire story. We're seeing growing evidence that many Americans have gone through the process of selecting coverage, but they never actually receive it because they can't afford to activate their plans. Independent analysis of 2026 insurer data suggests roughly 3,000,000 Americans who selected marketplace plans have never paid their first month's premium, and never actually got covered. Mister secretary, do higher premiums lead to fewer insured Americans? Yes or no?
Speaker 5
87% of the people who, oh, it's just exchanges now, are paying less than $96 a month. You can't pay 50544%.
Speaker 7
I know. I'm reclaiming 90 my time. This question is simple. If people can't afford their premiums, does that lead to more insurance of Americans or less?
Speaker 5
Like I said, the Democrats had a chance to expand Obamacare three times.
Speaker 7
Yeah. Know. I've heard to blame Biden, too. Like, this is a common theme with all of you. Look.
When coverage becomes unaffordable, healthier people are often the first to drop it, leaving behind a smaller, sicker group of people who need more care. That's what insurance calls a risk pool. Now if that risk pool gets sicker, premiums go up. Right, Miss Secretary?
Speaker 7
course. Nothing about your agency's harsh policies, including the $1,000,000,000,000 cut to Medicaid, reduces.
Speaker 7
That trillion dollar cut, it doesn't reduce the number of strokes, heart attacks, cancer diagnoses, or car accidents. So what your policies do mean is that more people will show up in emergency departments without the appropriate coverage.
Speaker 7
And when that happens, the cost doesn't disappear, does it, Mr. Secretary? It shows up in uncompensated care, which experts have shown is often shifted onto insured patients through higher premiums and out-of-pocket costs. When hospitals treat more uninsured patients, mister secretary, and they have not paid for that care, where do you think those costs go?
Speaker 5
There have been no cuts to Medicaid. Look at the Congressional Budget Office last week.
Speaker 7
And it's insulting that you would keep framing the increase in Medicaid costs as anything but an increase in population growth and inflation. Look. We know that more paperwork, more eligibility checks, stricter reporting requirements, people lose coverage not because they're ineligible, but because the system is harder to navigate. The downstream impact of this administration's policy is clear to everyone except, I guess, you. More uninsured patients means more strain on hospitals, fewer services, higher costs for everyone.
It makes care more expensive, harder to access, and weakens our health care infrastructure. That's not making America healthy. And I've just sat here and listened to you. You managed to give a go Gators from the witness table, but not a go-k shot. I mean, it's incredible that you are heading up the secretariat as secretary of health.
Speaker 1
and government. I now recognize Representative James for his five minutes of questioning.
Speaker 23
Mister secretary, I want to thank you for your courage. As somebody who's a Democrat his entire life and this time, what, two, three years ago, ran as a Democrat, now sitting here choosing the people over a party, I wanna thank you for your courage and your leadership. Mister secretary, the Department of Health and Human Services issued a rule in 2020 requiring health care providers to clearly label prices so that patients can make informed decisions about where to get treated. Under the Biden administration, that rule was not enforced, sir. As a result, patients end up paying radically different prices for the exact same services and the exact same level of care.
We're talking hundreds of thousands of dollars difference. That's wrong. Dober cartoonist Scott Adams had a term for this kind of system, confusopoly. He called it that because the friction makes it difficult to shop around, by design. In 2025, President Trump issued an executive order to make America healthy again, which included an April 1 deadline for health care providers to comply with price transparency laws.
Sir, that deadline was three weeks ago, and yet a third of hospitals in Michigan, and I have to imagine around the country, have not fully complied. A big part of the problem is that HHS does not have strong enough enforcement mechanisms. That's why I introduced Patients Deserve Price Act to require price transparency by law with consequences for health providers who continue to hide their prices from consumers. Mister secretary, will you support my efforts to lower prices and increase access, transparency, and quality of care for Americans who are struggling in today's sick care system in America?
Speaker 5
Yes. I thank you for that legislation. We have already finalized regulations that are now requiring all hospitals in the country to dispose and certify their prices. And so patients will be able to, if you go into a restaurant, you are able to see the price on the menu. If a car dealer told you, you can buy this car, but I'm not gonna tell you the price till afterward, you would not buy it if that is what the hospital is asking you to do.
Speaker 23
Thank you for increasing transparency. Your choice. Thank you, Mr. Secretary. I would appreciate your support on making that permanent so that it cannot be ripped away from the American people after this administration's conclusion.
Speaker 23
Thank you, sir. Mister Secretary, ticks are becoming a bigger problem in Michigan and around the country. My wife and son have Lyme disease and other coinfections, but they don't show through standard antibody testing. If you have the ability to pay for a high cost test like Igenix, it shows the strains and confirms Bartonella in her red blood cells, and my son has Babesia in his red blood cells. We know that undiagnosed Lyme causes fatigue, autoimmune conditions, and neuropsychiatric issues in the elderly and even schizophrenia in younger patients.
We also know that with proper diagnosis, many of these symptoms can be treated, and the disease reversed. My concern is that many Michiganders who are suffering from unexplained symptoms may think they've been tested for Lyme when, in reality, they have not because the standard test is not thorough enough. What can we do together to make sure that people are getting thorough and accurate testing for Lyme disease to stop these types of spread, sir?
Speaker 5
Yeah. I mean, this is a priority for us as congressmen. We, you know, Lyme disease has been a hidden disease because the government has been denying its existence prior to me getting it. Heads of my agency, the leading heads of NIH, are telling the American people it's a myth. It doesn't really exist.
We've changed all that. We've conducted a Live Roundtable with the best experts from around the country. Many people from this body have participated in it. We're putting up a web page. I'm not sure if it's up yet, but it should be up so that people can find the best physicians for treating it.
We're putting large amounts of money into Lyme research, and absolutely, we should be doing prescreening for people to see if they have it. So many millions of Americans have this disease and don't know it, and it's absolutely debilitating to their lives.
Speaker 23
Mister secretary, in the time that I have remaining, are there any questions, comments, or concerns that you feel you have not had the opportunity to address?
Speaker 5
I mean, I would say the same thing about long COVID, and we're addressing that too. We're getting the best physicians in the country together. We're identifying the treatments and the protocols that work and those that don't, and we're giving patients for the first time good information about it.
Speaker 23
Thank you, Mr. Secretary, for your leadership and your patriotism. God bless. With that, madam chair, how do you hold?
Speaker 1
Thank you. Representative gentleman yields back, and I now recognize Representative Visi for his five minutes. Question.
Speaker 24
Thank you. Secretary Kennedy, I noticed something kind of funny today. You don't really want to talk about vaccines. And your written statement doesn't even mention vaccines once, which is odd, because you've basically spent your entire career and life trying to shatter American trust in vaccines. Under your leadership, we're in the midst of literally the worst measles outbreak this country has seen in over 30 years.
And in my home state of Texas, we're ground zero. Ninety two percent of the over thirty six hundred cases we have seen are an unvaccinated people. And, mister secretary, tragically, two Texas children have died from measles. If you look here at the poster that I have up, two Texas children have died from measles. And this is all under your watch, Mr. Secretary.
I don't know why you won't look at the poster. This happened under your watch.
Speaker 24
Mister secretary, you are the author of a book in which you insisted that the measles outbreaks have been fabricated by government officials to create fear. And so here's my first question. Who in this administration should Texans blame for fabricating the deadly measles outbreak in our state?
Speaker 24
I let me take my time back. Four days ago, you told my colleague, representative Suzanne Bonomichi, that you, quote, have never been anti vaccine. That's a ridiculous lie because you're probably the most anti vaxx figure that I can remember in my lifetime. And in 2007, you found that the anti-vaxx group Children's Health Defense. In 2021, you were literally banned from Instagram because you said baseball legend Hank Aaron, an American icon and hero.
You suggested that Hank Aaron died due to the COVID-19 vaccine. And in 2022, you compared vaccines to the Holocaust. And in 2022, you said, quote, there is no vaccine that is safe and effective. And just last year, you dismantled the advisory committee on immunization practices and replaced independent scientists with anti vaxx pseudoscientists who removed six vaccines from the childhood vaccine schedule. And after an unvaccinated little girl died from measles in my home state, you told her father that, quote, you don't know what's in vaccines anymore.
So I'm curious as to why such a vocal vaccine skeptic has all of a sudden gone silent on these issues. And, secretary, I have a question for you. Please answer yes or no. Did Susie Wiles or anyone in the White House instruct you or suggest that you stop talking about your controversial vaccine skepticism? No.
Okay. It was reported late last year that Republican leaders were briefed on a memo that made it clear that anti vaxx candidates would negatively impact their party's performance in the most competitive congressional districts in the upcoming 2026 midterms. I would like to enter this memo from the Republican polling firm for RZR Ward into the record, Mr. Madam Chairman.
Speaker 24
Were you made aware of the Fabrizio word? Know what that memo is. Okay. Well, if you look here and at chart five, you'll of this memo, it says that 70% of all voters do not think that the federal government should remove recommendations for childhood vaccines, including measles. Do you agree that the majority of American people oppose your anti-VEX actions according to your own administration's internal polling?
Yes or no?
Speaker 5
We've never removed recommendations from this, and I've never been anti-VEX. Yes or no? I've never been any, everything you said, I'm reclaiming my time. Lie.
Speaker 24
I'm reclaiming my time. Conveniently, since the White House received this memo, it seems that you are miraculously no longer an anti-vaxxer. But the American people are not dumb, sir. The American people are not dumb. You and I both know what is going on here.
You have absolutely not had to change your heart. You do not care about this child with this rash from measles on him. And it took this polling. It literally took this polling to change your public posture about vaccines. This is real life, mister secretary, and you have blood on your hands.
I honestly hope that Donald Trump tells you to get stepping next. I yield back my time.
Speaker 1
Gentlemen yields back, and I recognize representative Bentz for his five minutes questioning.
Speaker 25
Thank you, madam chair, and thank you, mister secretary, for being here today. The Wall Street Journal on April 12, John C. Goodman wrote in the opinion page, Trump is making the best of Obamacare. And in that article, he talks about the 2027 ACA exchange rule, which would allow health insurers to offer non-network plans on market exchanges. Health insurers would be able to set reference prices. And, actually, this is a really clever idea, and I'm just curious, you know, what you're thinking on it.
And if it's one of those things that someone has been trying to get in place for years, I happen to think it's excellent, but perhaps I'm wrong. What do you think?
Speaker 25
Yes. The idea is that a nonnetwork plan on an exchange would be able to set reference prices. For example, you can say $30,000 for a knee replacement, and then the person who enjoys that insurance coverage could shop around and select other providers to do the work. They wouldn't be stuck inside the space that they might have been required to obtain the coverage from. It's very clever, and it requires suggests competition as opposed to being stuck someplace.
But there's lots going on in this insurance space, I would enjoy your thoughts.
Speaker 5
Yeah. I mean, that, you know, that is President Trump's solution, that we need markets. Markets bring down prices. And, Congressman James just talked about price transparency. When we looked at pregnancy, deliveries in New York, within a mile of New York, we found 30 hospitals.
The lowest was $1,300. The highest was 22,000, exact same procedure. In Detroit, it was 6,060 thousand. The reason you have that market chaos is because nobody can choose the prices. The more that you impose market disciplines on a market, the lower costs are gonna go.
It's ultimately the only way we're gonna get health care costs down, that and ending the chronic disease epidemic.
Speaker 25
Well, it seemed to me that in studying this situation, this kind of thinking is exactly what we need because when I go back to my district, the amount that people are paying for health insurance is through the roof. And so this kind of transparency is one step. I'm sure there are others, I think, in the budget. I note a few. Do you have, I think you've put in your testimony what you think would drive down prices, but perhaps you can share with us other ideas that will drive down prices.
Just so I may share with you, one of my brothers is paying $26,000 a year for coverage with a $10,000-$13,000 deductible covering two people. So what in the world can I go back to him and say, hey? The administration's working on trying to drive these prices down.
Speaker 5
I mean, we have literally dozens and dozens of programs and initiatives for driving prices down. The biggest one is ending the chronic disease epidemic. In 1961, my uncle was present. We spent 0 on chronic disease in this country. Now we spend about 4,300,000,000,000 a year, and it is rising exponentially.
So that's one issue that we are addressing for the first time in history. The drug pricing, the MFN, you know, we were paying the highest price in the world. 10 times, in some cases, what Europeans were spending for the exact same price that was made in a factory in New Jersey. And now we're paying the lowest prices in the world. The cost sharing, which is the president's proposal, lowers costs and will lower premiums by 10%.
And then, I'm sorry. Let me just price the transparency. Obviously, if we have markets, it's gonna drive down prices. The waivers fraud and abuse, which is costing us $100,000,000,000 a year. That will drive down prices.
Ending up coding and Medicaid, which we are finally doing with the first administration that's ever done it. That will lower prices. And then cleaning up the risk pool, cleaning up people who don't belong on Medicaid or Medicare or in the exchanges. You know, when you do that, you improve the risk pool, that's going to lower prices. And all of those things and many others are being done by this administration.
Speaker 1
Thank you. Gentlemen, Yield's back, and I recognize Representative Cluster for her five minutes of questions.
Speaker 21
Thank you, chairwoman. Secretary Kennedy, the last time you sat before this committee last June, I expressed to you my concerns about the funding cuts to medical research. And I know many of many people across the country share these concerns. I represent a lot of people who do, and a lot of them do this work in medical research at the Texas Medical Center in Houston, the largest medical complex in the world. And in response, last year, you told me it's not our intention to cut critical research.
We need to keep America as the hub of this critical research. And yet for the past year, I've continued to hear from these medical professionals about their serious concerns about the cuts that this administration has made to scientific research. And the United States has long held the well-earned position of the world leader in cutting-edge scientific research and innovation. But the cuts that this administration has made and is proposing to make in the budget that you are here to support to our institutions, to the National Institutes of Health, they're threatening the United States' position as a leader in this research. So I have a few questions.
I know you had a conversation about this with mister Guthrie and with chairman Guthrie, and it prompted some more questions. So I wanna ask, first of all, do you know how many jobs NIH funding supported in fiscal year 2025 across the country?
Speaker 21
Jobs, research, supported jobs for researchers through NIH grants and funding.
Speaker 21
Not internal NIH funding, but the NIH grant funding process supports jobs across the country in all kinds of medical research. Do you know how many jobs there are?
Speaker 5
There were something like 62,000 grants. So there could be entire research teams on each of those.
Speaker 21
There are research teams. The answer is 391,000 American jobs are supported by this NIH funding. And so, you know, more than 80% of NIH's budget supports these cutting-edge research grants through a competitive, merit-based process that annually awards, as you said, more than 300,000 researchers at more than 2,500 universities, medical schools, and institutions in all 50 states. So it's concerning to me that the fiscal year 2027 budget request that we're talking about today renews the prior push to cap indirect costs at 15%, and doesn't address the significant funding delays that we talked about earlier at NIH. At the same time that the US is cutting funding for research, other countries are investing in research.
And, for example, as you discussed with Chairman Guthrie, China has made no secret of its ambition to dominate biomedical research. I believe you testified earlier. Made a note. You said China's eating our lunch. And China is graduating more STEM PhDs than any other country, dramatically increasing its state investment in biomedical research infrastructure.
And, secretary Kennedy, do you understand that cutting federally funded research, as this budget does, will cede US leadership on biomedical research to China and create national security and global competitiveness challenges for The United States?
Speaker 5
You want me to answer that question? You want me to give a thoughtful answer to that question?
Speaker 5
Yeah. We still pay for almost 80% of the biomedical research on Earth at NIH, much more than any other country does. I don't wanna cut the NIH programs. Russvot doesn't wanna cut NIH programs, but we have a $359,000,000,000 debt. We've been asked to cut across the board at HHS 12% of our $111000000000 budget.
And so we're making cuts that are painful. Some of those are gonna be to NIH, but I can also say that Mister secretary, I fund a lot of crazy stuff.
Speaker 21
I do appreciate. I have limited time. So if you wanna elaborate on that, I ask you to do it in writing. I do wanna ask a couple of other questions, because in addition to the cuts, there are also just delays. And in response to Chairman Guthrie's question about what to do about some of these issues and competitiveness, she said we're doing it.
But in the first thirteen months of the administration, do you know how many notices of funding opportunities were issued compared to 2024? We're not gonna have time for you to answer unless you know it off the top of your head. But I will tell you, NIH, yeah. Issued 84 NOFOs.
Speaker 21
Seven in 2024. So, you know, if we are falling behind here, we need to figure out the funding that we are doing. We gotta get it out the door. So I have more questions for you. I will submit them for the record.
I thank.
Speaker 5
You, Madam Chairwoman. And I come back. Appreciate you allowing me to answer something. So I can answer that other one for you, but I'm also happy to work with you on it.
Speaker 1
Ladies, time is up, and now I recognize Representative Ruley for his five minutes questions.
Speaker 14
Thank you, mister secretary, for visiting the Ohio State House during COVID, and helping the Ohio Senate and the entire Ohio State House go through that crisis together. Your efforts in expanding patient affordability and access to lifesaving drugs are always appreciated. Last August, however, though, the FDA classified desiccated thyroid extract or DTE as a biologic, giving DTE manufacturers one year to cease production or face enforcement. This action of enforcement is destroying it. This classification also limited the ability of pharmacists to compound DTE, meaning that patients had to switch to much more expensive alternatives.
So the question, mister secretary, is what was the basis for the FDA to classify DTE as a biologic?
Speaker 5
I would say that there is controversy within my agency about that decision, and I am very happy to work with you on that, on resolving it. I appreciate you. I invite you to contact my office and contact me directly, and I will work with you on that.
Speaker 14
With patients facing this August deadline, do you have any steps that you think you could, you know, maybe influence several congress members and to reassess how we look at this to help your department move forward and get these conversations going to an elevated level? On which subject? On the DTE subject. Is there anything that Congress could do to help your staff move forward?
Speaker 5
If you call me about it, I will convene a high level meeting where we can talk to you and answer your questions and see if there's a resolution.
Speaker 14
I really appreciate that, Mr. Secretary. And I do have a couple of minutes left. Is there anything you'd like to clarify during the last couple of hours that maybe you weren't given the opportunity to? Please feel free to do so.
Speaker 5
Yeah. I mean, there was a number of statements again made about my so called anti vaccine. I've always said for 20 years I'm not anti vaccine. I just want the same kind of safety testing done for vaccines. Hepatitis B vaccine was tested for four days with no placebo, a product that is given to millions of children every year.
You would never allow a medical product to do that. And so all I want is good testing. I'm not anti-vaccine, or I wouldn't be putting a billion dollars into developing new vaccines right now. So it's counterintuitive. Look at my record here and say I'm anti-vaccine.
I'm pro science. I wanna ask the right questions. I don't think there are any taboos. I don't think this religious belief you have is to say all vaccines are safe for everybody, and they're all effective for everybody. We all have to accept that, and anybody who disagrees with that is marginalized, vilified, and deplatformed.
I think we ought to be able to talk about science and do it in a way that's dignified and congenial and open minded.
Speaker 14
Mister secretary, I will say in the last five years that I've known you, the one thing that anyone who knows you would say is you welcome conversations and open debate. That's how we grow, and I appreciate your time. With that, I yield my time back to the chair.
Speaker 1
Okay. Thank you for yielding back to the chair. And now I represent Ocasio Cortez for her five minutes.
Speaker 19
No. Of course. Of course. I'm not sure if you remember, our last chat about a year ago, where we talked about Medicare Advantage. But, you know, I think one area of agreement that we have, I hope, is that these insurance companies are fleecing the public.
Right? Can we agree on that?
Speaker 19
And they are, I mean, it's highway robbery on the American people, on people who are sick, on seniors. We're on the same page about that. Right? Yes. And last year, I brought up Medicare, the Medicare Advantage program to you because these corporations like UnitedHealthcare, Aetna, are known to be defrauding the public.
And, really, we know that with Medicare Advantage, it's to the tune of about $80,000,000,000. And the Department of Justice has, in fact, opened an actual.
Speaker 19
So you remember this. Right? Okay. I'm glad that we're able to, kinda jog the memory on there. We chatted about this, and we actually chatted about it afterwards too.
And so we know this. We're all on the same page here at United, CBS, and Aetna. They're defrauding the American public to the tune of $80,000,000,000 a year. We know that they're doing this to the public. You know it.
I know it. We've even had some bipartisan chat about this. And so I was surprised to see about two weeks ago, you had decided to give them another $13,000,000,000. And it was used through the mechanism of the MA reimbursement rates. But I want to know why you did that?
Speaker 5
And first of all, I agree with you on everything you said. We, you know, we have to look at the reimbursements that the industry gets, which they said there'd been a 5% increase in cost. That if we didn't give them the full 5%, they were gonna lose, that would impair patient choice, particularly in some regions of the country. The industry would leave. We gave them a 2% raise.
Right.
Speaker 19
And I hear what you're saying, mister secretary, that the industry is saying that they're increasing these costs, but the industry is defrauding the public. So we know they're lying. We know they're lying through their mechanisms. They are upcoding. They are telling us, the public, the government, Medicare, our systems, that people are sicker than they are so that they can get more money.
They're lowering their reimbursement rates. They're increasing the denial. So we know that these folks are lying. We know that they're bad actors. And if I'm hearing you correctly, we are giving them more money because they're saying they need it.
Speaker 5
Can I answer the question? First of all, I appreciate everything you've done, and you speaking out about upcoding. We are ending upcoding. We're using AI now to detect it, prosecute it, and to end it. Yeah.
They're lying. But my job as HHS secretary, I have to balance the impact on patients if there are no options in those areas. So we do a lot to verify. We don't trust. We do a lot to verify.
Speaker 19
What you're saying. I mean, even when you talked about that 2%, it's something that I found interesting too, because that 2.48% wasn't initially what you were gonna go for. You had announced in January that, in fact, CMS had proposed an increase of 0.09%.
Speaker 19
Which would have essentially kept payments flat at a minimum to these corporations like United and Aetna that are robbing us. And so there was an interesting amendment that you had made. We've got the experts saying, okay. Even when you start looking at that inflation rate or that cost rate, even that at most is point zero nine percent. But then it seemed as though there was some industry backlash.
And now we're at 2.48%. We're giving them $13,000,000,000 when they are stealing $80,000,000,000 a year as it is. I say we let them eat it. Why not?
Speaker 5
Well, you can see from what we originally published what our intention was, to give them essentially nothing.
Speaker 5
And we got a huge blowback not only from the industry, but from providers and everybody else who said we are gonna experience closures. We're gonna experience places where you cannot get insurance. It is gonna leave all these patients high and dry. We did our own investigation, and, you know, you could look at health care providers.
Speaker 5
Appreciate you giving me a chance to answer questions. I can't thank you enough for that.
Speaker 1
We'll hear more about that. Now I recognize Representative Houchin for her five minutes of questioning.
Speaker 26
Thank you, madam chair. Thank you, Mr. Secretary. Appreciate your patience today. An issue that has been brought to my attention is the vital need to simplify and expedite the FDA approval process for pharmaceutical manufacturers who already are operating in the United States or seeking to expand operations in the United States. This is part of the Biomedical Advanced Research and Development Authority trying to expedite our national security for manufacturing medicines here in the United States.
Indiana is a national leader in pharmaceutical production and exports, and the industry continues to expand its research and development. In the last couple of years alone, Eli Lilly and Company, Diagnostics, and Novartis have announced billions of dollars in investments in manufacturing facilities and drug development. Areva Pharmaceuticals is a critical manufacturer of generics in my district, which I'm proud to have headquartered in Southern Indiana. And they've been manufacturing pharmaceutical products in Indiana since 2011. They're continuing their efforts to expand production to include the manufacturing of raw materials.
They make fludarabine phosphate, which is a key pretreatment for CAR T cell therapy and stem cell therapy for cancer treatment. The only place they can source the precursor to make that medication is in Wuhan, China. They are facing a lengthy and complicated approval process with uncertain timelines, making it extremely difficult to expand these productions of raw materials. Mister secretary, what are HHS and the FDA doing to accelerate US pharmaceutical domestic manufacturing of these precursors and minimize regulatory roadblocks while still maintaining high safety standards?
Speaker 5
And thank you for asking me that. It's been a huge stumbling block for the production of generic drugs in this country, which are the majority of the drugs that we use. And, we're getting them all from China and from India, almost all of them from China and India, and it is a vulnerability in our supply chain. It's a national health threat, a national defense vulnerability as well. So we're doing everything that we can to ease the production pains of construction and expanding plants here and getting quick approvals.
We have a new FDA program called the PRECHECK program that fast tracks these proposals. I'm happy to talk to you or to the people who run this plant, to make sure that they're aware of that program, and that they can take advantage of it.
Speaker 26
Thank you. And when we were talking about the cost of medicines in The United States as well, just importing that precursor is $40,000 in shipping. So it would be great to, for the cost of our prescription drugs here, particularly for cancer treatment, reduce those costs by helping to onshore that manufacturing. I wanna switch now to an issue, the issue of long COVID. Long COVID.
Yeah. We believe that as many as 44 million people could be affected by long COVID. The more times you get COVID, the more likely you are to develop that. There is research ongoing, including treatment for long COVID, which can be very debilitating to some Americans. I just wanna encourage additional attention and research into long COVID, for treatment for that.
I have some concerns that fibromyalgia might be being diagnosed rather than long COVID, and would be grateful, having a family member who has experienced that, to just encourage you to continue focus on research for the treatment and diagnosis of long COVID.
Speaker 5
I mean, we are putting this as a priority for me personally. I have a son who was really debilitated by long COVID. We've had a roundtable at HHS for the first time in history. We brought in the best experts from around the country, people like Jordan Vaughan from New Jersey, and the best people who have the most experience at treating it successfully from California, from all over the country. And we are targeting diagnostics to make sure that there's uniform diagnostics, a very complex illness that manifests differently in almost every person.
Treatment protocols are different for people. There is no panacea. And, but there are biomarkers that can tell us what kind of treatments work best for which populations.
Speaker 5
And we're working on identifying those biomarkers, matching them with the treatment, and then getting the patients together with the appropriate physician.
Speaker 26
Thank you. My time's expired. I appreciate your service and leadership, Mr. Secretary.
Speaker 1
Lady yields back, and I'll now recognize representative auction clause for his five minutes of questions.
Speaker 27
I wanna talk about the Food and Drug Administration, which reports to you. And by law and by logic, the FDA should make decisions on science, not politics. Right?
Speaker 27
And I also know that, as an environmental litigator, I mean, you really emphasized lifting up the voices of scientists when politicians were trying to pressure them. Right? That was a big part of your litigation against environmental toxins. Right?
Speaker 27
Yes. So I wanna make you aware of some of the findings of an investigation I've been doing about the Food and Drug Administration under the leadership of Doctor McCarrie. We opened up a whistleblower channel to FDA career scientists and have spoken to a multitude of them. Now these are career scientists. They've worked for Republican and Democratic administrations, including Trump's term one, without complaint or concern.
But now, in this last year, they are ringing alarm bells. And I wanna just have you listen to three quotations from very senior FDA scientists who are currently employed at the agency. One, quote, FDA staff have been subject to a steady, unrelenting compromise of our scientific standards to support ideologically driven policy goals, more focused on media sound bites and their own self-promotion than our nation's health. That's one senior scientist. Another, currently employed.
Quote, I was pressured into withholding a recommendation for approval for a drug that was intended for a rare disease by Dr. Prasad and other FDA leadership. I know the drug would have been approved had it not been for the political pressure. Number three, another senior career scientist currently employed. Quote, doctor McCarrie's approach has made direct lobbying to the commissioner's office a smart and productive business practice for companies to get what they want. Secretary, you spent your career trying to lift up, on the environmental front, scientists beating back political pressure.
Does this sound like an agency that is effectively lifting up science over politics?
Speaker 5
I can tell you that all the decisions that have been made at that agency are based with the approvals of panels of career science.
Speaker 27
So that's just not true. So let me reclaim my time. That is categorically false because there's, in fact, a program called the Commissioner's National Priority Voucher Program. I've been investigating that as well for the last 6 months. This program expressly allows political leaders to short-circuit science and pick and choose politically favored treatments.
Now White House and FDA leadership have pressed staff to award vouchers to certain companies as part of White House pressure campaigns. And most recently and egregiously, the FDA just issued three of those vouchers for psychedelics based on a test from Joe Rogan. And one of those psychedelics was denied by the FDA in 2024. So let's just go through what happened here. Joe Rogan had a guest on his podcast, and the guest was talking about psychedelics.
Joe Rogan texted the president of The United States, and the president texted back, quote, sounds great. Do you want FDA approval? Let's do it, end quote. That was from the president of the United States. So just to be clear, is the president of the United States allowed to grant FDA approval?
Speaker 27
Is the president of the United States allowed to grant FDA approval? Because he thinks he is. Is he wrong?
Speaker 27
Issued three priority vouchers from this illegal unauthorized program to respond to political pressure from the White House. Secretary, this flies in the face of your stated commitment to putting science over politics. We are literally seeing politics put over science. Now let's just understand why the president might have bent over to do the bidding of Joe Rogan. He has a disastrous war in Iran that has led even his most committed supporters in his base, like Joe Rogan, to question his competence.
And in order to appease Joe Rogan's ire, he grants FDA approval. Safety and efficacy should be the standard for these. You wanna grant stand or do.
Speaker 27
Stand or do you want an answer? I want safety and efficacy to be the standards by which psychedelics are approved, not the president's attempt to shore up support from his base for a disastrous war in Iran. It should not be Joe Rogan's decision what psychedelics are approved. It should be the decision of randomized controlled trials.
Speaker 5
And we are doing non-politicized science for the first time in history. Let me close with.
Speaker 27
A final question here, reclaiming my time. You had talked, you had said about the research here to my colleague from Texas that you wish that the NIH didn't have to cut the billions. Right?
Speaker 27
The NIH did not have to cut money. You had said that to the congresswoman's question.
Speaker 27
The NIH, the National Institutes of Health. Of course. Right. Do you think it'd be a better use of money to spend a billion dollars a day on the NIH or a billion dollars a day on bombing Iran? Which do you think would be a better use of money?
A billion dollars a day on bombing Iran or a billion dollars a day.
Speaker 1
Numbers' time expired. I'll now go to representative Langworthy for his five minutes of questions.
Speaker 28
Thank you very much, madam chair. Mister secretary, thank you very much for being here today and for your leadership. As this committee reviews the fiscal year 27 HHS budget, we're focused on how these efforts will support American families, rebuild our trust in our health systems, and make America healthy again. Secretary Kennedy, in your testimony, you highlight efforts to require hospitals and insurers to disclose actual prices and make them comparable for patients. One concern that we hear even when pricing data is available is it can be difficult for patients to understand and comparatively make a decision.
We've seen proposals around tools like advanced explanation of benefits that aim to give patients clear, upfront cost estimates. What steps is HHS taking to ensure that this information is presented in a way that's clear, actionable, and useful to patients?
Speaker 5
You mean information from our agency or from the insurers? Throughout the medical ecosystem. I mean, we're doing more on transparency than any agency in history. We've got transparency and coverage rules. We're forcing the insurance industries to tell us what their margins are, and what they're charging for every procedure.
Our transparency rules for the hospitals: the first time, we're gonna force them to post their price, all hospitals and all providers, to post their prices, to certify them, to post them ahead of time. And then, you know, we're doing prior authorization where 80% of the insurance industry has now agreed on prior authorization for 80% of conditions and procedures within a year by 2027.
Speaker 28
That's great. I appreciate your efforts on that. And in just about every other part of life in this country, people know what something costs before they commit to it, and that is critically important. You wouldn't make a major purchase. You wouldn't book travel, or sign up for a service without at least a general sense of price, and this is going to be very helpful as make people make their health care decisions.
But, unfortunately, in health care, you know, to this date, patients have often been expected to make important decisions first, and then they find out the cost after the fact, when they get a bill in the mail. And that's an unacceptable way to go forward, and we can't get our arms around the rising creep of cost of health care in this country until we really can see in layman's terms where the dollars are going. So, you know, what specific enforcement actions is HHS taking to ensure that providers are actually complying with the transparency requirements that your agency is putting forward?
Speaker 5
I mean, during, you know, the Trump administration, the first Trump administration passed transparency and coverage requirements during the Biden administration. They passed at the end of his administration. During the Biden administration, they just didn't enforce it. So there was no resolution of the problem. We've now sent out 1,000 letters.
We're enforcing discipline. We have hardened the regulations, just finalized new regulations that will provide draconian penalties for hospitals that fail to comply. So we are gonna end that problem.
Speaker 28
Well, thank you very much. We look forward to working with you and HHS on this issue. On biosimilars, Secretary Kennedy, you noted in your testimony that HHS is taking steps to streamline the development of biosimilars. What specific actions is the department taking to accelerate uptake and ensure that these lower-cost options actually reach patients?
Speaker 5
We've changed the approval process for biosimilars so that they will get fast-tracked. And biosimilars are basically the generic version of biologics. They're 35% cheaper. And we are doing everything that we can to maximize their access to the market as quickly as possible.
Speaker 28
I appreciate that, mister secretary, because at the end of the day, this is really about affordability for patients and making sure that they have availability of low-cost options. Another key piece of that is increasing competition in the system, and that's why I'm working on legislation to help speed up the development and the approval of biosimilars, cutting unnecessary red tape while still keeping the FDA's strong safety and effectiveness standards in place. We appreciate your time with us today, mister secretary, and we look forward to working together to make health care more transparent and affordable for everyone. And I yield back, Madam Chair.
Speaker 1
Thank you. Gentlemen yields back, and I now recognize Representative Carter for his five minutes of questioning.
Speaker 12
Thank you, madam chair. Like many of our colleagues, Mister Secretary, I'm appalled by the chaos that has transpired in HHS in the past year, including at SAMHSA. On January 13, SAMHSA canceled some $2,000,000,000 in grant funding for mental health and substance use programs, putting grantees in a state of uncertainty. Approximately 2,000 grantees received a letter stating there were no that they were being terminated immediately, and that no corrective action could align the award with agency priorities. Madam Chair, I'd like to enter a copy of that letter into the record.
Speaker 12
Miss Mister Kennedy, Secretary Kennedy, you stated that you weren't aware of these cuts. Are you not aware of this letter that went out relative to these? I was not aware.
Speaker 5
Of it prior to going out, but as soon as I found out about it, I withdrew it within 24 hours.
Speaker 12
And then, how does such a mistake happen? In an agency of the size of yours, how does something like this happen that sends a reverberating fear throughout the hearts and minds of people who are suffering in our country?
Speaker 5
We have a $2,300,000,000,000 agency. It's the biggest agency in the history of the government. It has the size of the sixth largest economy in the world. We have hundreds of agencies and sub agencies. We have careers working for us who oftentimes are hostile, who are not aligned with the president and his agenda.
Speaker 5
Because of the corruption during the Biden administration, we did a lot of things that some of them.
Speaker 12
We're overconnected. So respectfully, can I cut you off? I asked you about these egregious cuts. You said there was a mistake. A mistake by the Biden administration during your administration.
Speaker 12
how do you then inject something about the Biden administration? I'm asking you about something you want me.
Speaker 5
Because we had to do an extra amount of surveillance because of all the corruption that was happening within our agencies.
Speaker 12
Corruption caused your mistake? Go ahead. Corruption caused your mistake?
Speaker 12
No. Corruption caused you to mistakenly cancel these grants for Samsa. The surveillance procedures and protocols that we had to put in place to stop money from flowing out the door to people who, okay. Let's leave that because you're not respectful. You're just not answering it either intentionally or by
Speaker 12
You are I asked you about a mistake that you admitted was from your agency. It was from ISA. But then you go on to tell me about corruption in the previous administration. It's nothing to do with you canceling these grants. So let's move on.
A lot to do. Is there any chance that this could happen again? Have you corrected whatever caused the error? May I ask, sir? Have you corrected whatever caused the error to ensure that these grantees will not have to suffer as so many did?
Our phones are ringing off the hook. A bipartisan group of legislators, Republicans and Democrats, sent a letter that caused you to immediately reverse it. Has a mechanism been put in place to fix it so it doesn't happen again?
Speaker 5
Yeah. Well, I can't tell you that a mistake will never happen again in a 2.33.
Speaker 12
I've got about a minute and 16. I wanna touch on a couple of things. Secretary, you publicly shared your experience about your 14 years of heroin addiction. You've also gone on to say a day doesn't go by that you do not think about heroin. So certainly, understand the gravity of the people who are suffering.
Certainly, you understand the gravity of people who have addictions, and they need resources. But how do we expect that you really understand that when your own budget undermines substance use prevention, treatment, and recovery services, block grants, state opioid response, and community mental health block grant programs by consolidating them into behavioral health innovation grant. How do we expect mental health and substance use providers and administrators of high quality evidence based care that they'll be able to compete against the other same limited funding under your proposals. How what message are we sending to people back home?
Speaker 5
We're making the system more efficient, and I'm putting more money into it than any other HHS secretary in history. Not only that, we're putting 49,000,000 into opioid response and putting 100,000,000 into sober housing.
Speaker 12
I got two seconds. Respectfully, you know what? I really wish you'd spend more time on it. More time thinking about the American people, less time talking about whale heads, bear heads, and raccoon parts. Okay.
Talking about what's important to the American people and how they can.
Speaker 5
I don't talk about any of those things. Okay. You guys don't talk enough.
Speaker 1
Time is up, and we have one more original member of the committee. And we'll let him ask his questions, and I know you've got a heart out, and we appreciate you staying over. I'll turn it over to Representative Lansman for his five minutes of questions.
Speaker 22
Thank you, Mr. Chair. Good afternoon. A couple of things. One, I'm from Cincinnati. As I mentioned last time, our community action agency, as you know, they do head start utility assistance.
They were awarded a grant. Their CDBG grant was awarded to them, but it hasn't come yet. And so I got a frantic call from a constituent saying that they were gonna get furloughed or fired because of the delay in the grant going out. Can we work together to try to get that grant out?
Speaker 22
Okay. Thank you. This is the this is You're welcome to call me. Yeah. We sent a note to them today.
Speaker 22
We've sent a note to your office, but I wanna make sure we can get these out the door so that no one gets fired. You had mentioned the rural hospital piece, $50,000,000, largest investment. But there's a reason why the Senate Republicans asked for a $50,000,000,000 rural hospital investment, and it is because of the trillion dollar, nearly trillion dollar cut to Medicaid. There would not have been a request for that. It was the only way to get a few of them to vote for this massive spending deal.
They spent 4.5 trillion dollars. Most of that went to tax cuts that overwhelmingly benefited the super-wealthy. It was about a $2,000,000,000,000 increase in the debt. So you said there's no cuts to Medicaid. In order to balance that spending bill, it was $2.02 and a half trillion dollars in deficit spending, a trillion-dollar cut essentially in Medicaid.
Was it 3 and a half trillion for deficit spending, or was there truly, as we have been saying, a nearly trillion dollar cut to Medicaid and why these Republican senators push for a rural hospital fund of $50,000,000,000, which is nowhere close to a trillion dollars in cuts to Medicaid.
Speaker 22
From this back then just do the math with me, then that means that they added 3 and a half trillion dollars to the deficit. You gotta find 1 trillion dollars. You either added a trillion dollars to the deficit, or you cut Medicaid by a trillion dollars.
Speaker 22
Yeah. But the congressional budget office, they're lying. No. They're saying that there was this.
Speaker 22
They're saying they're saying that about 15,000,000 Americans are going to lose their Medicaid health coverage. That is a trillion-dollar cut.
Speaker 22
gonna lose? We sat in this committee and made a decision. I voted against it. My colleagues over here voted against it to cut nearly a trillion dollars in Medicaid in order to cut Medicaid. It's not true.
Speaker 22
It's not true. The I wanna get back to, everyone knows, every hospital, every doctor, every provider, every patient in this country knows that you all cut nearly 1 trillion dollars in Medicaid. On the Medicare Advantage.
Speaker 5
You guys keep saying it, but it's a lie. Look at what the CBO says. Are they lying to us? No.
Speaker 22
I wanna go back to the Medicare Advantage piece that you mentioned. Medicare Advantage is private health insurance. Correct? Yes. And so when they pushed you to increase the fee, as miss Ocasio Cortez mentioned, you said the reason you agreed to it is because they said there would be no other options.
Speaker 5
We determined that people would lose coverage. They wouldn't lose coverage?
Speaker 22
Exactly. Medicare. Which means that they could go back to what? Medicare. You could have sent them back to Medicare, where they get more coverage, and we pay less.
Why didn't you do that? Why do you give them an additional $1,013,000,000,000 dollars when the option was just to go back to Medicare?
Speaker 5
Because Americans want to prefer Medicare Advantage. Because they think it's Medicare. Because they.
Speaker 22
I think it's Medicare. Because of the name. Do you agree it should be called Medicare Advantage when it's not Medicare?
Speaker 22
Like it. I think we should change the name to something that says this is private health insurance.
Speaker 22
Great. Next time you have a chance to negotiate, send people back to Medicare. It's better health insurance, and it costs you less money.
Speaker 22
I wanna add I have a bill. I'm excited. Maybe you'll endorse it. It does say if you can't be if you can't hear adhere to everything that Medicare offers, you can no longer use the name.
Speaker 5
Okay. I mean, the reason that people prefer Medicare Advantage, even like my agency, is because it's output-based care. Okay.
Speaker 1
Thank you. Okay. I know, mister Hector, we had one more wave on number. She won't have time to ask her questions, but I would remind members I could submit questions for the record. I ask unanimous consent to insert in the record the documents included on the staff hearings document list, here.
Without objection, so ordered. I'd like to thank our witness again for being here today, and members may have additional written questions for you, sir. And I'll remind members that they do have 10 business days to submit questions for the record, and I ask the witness to respond to the questions promptly. Members should submit their questions by the close of business on Tuesday, May 5. And without objection, the subcommittee is adjourned.
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