HHS Secretary Robert F. Kennedy Jr. testifies at House hearing — full video

[0:00] trying to protect a sick child, that nothing was done about that, and the Secretary still [0:04] doesn't know much of anything about it. [0:07] As far as fraud, Paul Wozak is one who had $10 million of wages that he kept some of [0:14] to buy a $2 million yacht. [0:17] His mother contributed to the Trump campaign, and he no longer has to pay $4.4 million or [0:24] stay in prison. [0:25] Mr. Secretary, I want to know what role you play in the soft-on-crime approach to healthcare [0:30] fraudsters. [0:32] Have you recommended that any of these healthcare fraudsters should get pardons or commutations, [0:37] or did the campaign contributions speak for themselves? [0:39] I don't think there's anybody in this country, I don't think there's anybody in this country [0:49] who believes that this administration is soft-on-fraud. [0:53] We're the first administration in history. [0:54] It's just the fraudsters who have the money in the cottage industry to get themselves pardoned [0:59] and not even have to restitute what they've taken from those they've defrauded. [1:03] It's really a disgrace. [1:04] I'm surprised you would defend it. [1:06] It's not a credible story. [1:08] It's a fact, sir. [1:10] It's not a story. [1:11] It's a fact. [1:12] Mr. Kelly. [1:13] More fraudsters pardoned by any president in American history. [1:16] Your time has expired, Mr. Doggett. [1:18] Thank you. [1:19] Mr. Kelly. [1:20] Thank you, Chairman. [1:21] Mr. Secretary, thanks for being with us today. [1:23] And as usual, the beatings will continue until our morale improves. [1:28] I did want to just talk about one thing real quickly. [1:32] I'm really wishing you success in the rollouts of the bridge and balance models, expanding [1:36] seniors' access to weight loss drugs. [1:38] And as Mr. Buchanan talked about, this is really critical. [1:41] But at this point in today's hearing, I'm going to turn my time over to Mr. Swikert from [1:46] Arizona. [1:47] I think it would take more than four minutes for him to go through all the things he wants [1:51] to ask you. [1:52] But again, thank you for walking out of where you were into this. [1:55] I appreciate what you're doing, and your family has always been a hallmark of American service. [2:00] So thank you so much, Mr. Secretary. [2:01] Mr. Swikert. [2:02] Thank you, Mr. Kelly, and I appreciate him doing this. [2:08] Let's actually do some waste and fraud where we have real money. [2:12] I actually want to talk about what's often referred to as CPAP, the CDPAP, New York Health. [2:20] Let's actually use New York because that's actually what EFSA and Oversight have been looking [2:23] at. [2:25] Something is wrong when the biggest job creator in New York City over the last few years [2:31] turns out to be a home visitation program that you all manage. [2:37] We have some data here that basically says for every 1,000 residents 65 and up in New York [2:43] State, the whole state, 171 are receiving these stipends, these payments. [2:50] In New York, if New York itself was actually at the Medicaid population average, it would [2:59] save $43 billion a year. [3:06] When we start to actually examine and dive into the numbers, the disproportionate, yes, we [3:11] have frauds here, frauds there, but we have entire states that seem to be helping this fraud [3:17] along. [3:18] What do I do to help a program like this that substantially expanded during COVID that we [3:24] now have not only New York, but a handful of other states that seem to be using it as [3:28] a jobs program and not a health program? [3:31] Senator, that is a huge problem. [3:34] New York State pays on average 80% more per capita on Medicaid than any other state. [3:45] 80% over the average, and part of the reason for that, as you point out, are these waiver [3:52] programs that many of the states have now applied for and received. [3:58] In the old days, Medicaid paid for medical procedures, so if you got a hernia operation, [4:04] we could figure that out at CMS. [4:06] We could see you had a scar, it was done by a licensed doctor, by a licensed nurse, and [4:12] we could track to make sure it actually happened. [4:16] Waivers allow people, family members, who are taking care of an elderly parent to get paid [4:25] for balancing the checkbook, for picking up the groceries, for driving somebody to a doctor's [4:31] office appointment. [4:32] Today, the biggest job in New York, 650,000 people, the biggest employment niche is home [4:39] care. [4:40] These are family members who are getting paid to do things that they used to do as family [4:45] members for free. [4:48] And this is rife with fraud, because we have no way at CMS to determine whether they actually [4:56] perform that duty or not. [4:58] We don't know whether you drove your grandmother to a doctor's office, so it's an opportunity [5:03] for fraud. [5:05] And states, corrupt people, fraudsters, are taking that opportunity all over the country. [5:12] And it's one of the reasons that Medicaid doubled during the Biden administration, because we [5:18] are paying for fraud now as much as for medicine. [5:23] Thank you, Mr. Secretary. [5:24] And we get a round two. [5:25] I yield back. [5:26] Mr. Thompson. [5:27] Thank you, Mr. Chairman. [5:29] And thank you for your persistence in getting this hearing scheduled. [5:33] And Mr. Secretary, thank you for finally appearing before our committee. [5:38] Mr. Secretary, let's start with an easy one. [5:41] Do you have a medical or public health degree? [5:43] No. [5:45] No? [5:46] No. [5:48] Yet you're overruling doctors, scientists, and public health experts across our country. [5:53] Your dangerous conspiracy theories are undermining safe and effective vaccines? [5:59] Mr. Secretary, I want to echo my friend the ranking member's comments about polio. [6:04] I remember as a kid, kids older than me, in school with me who got polio. [6:11] They lived with the lasting impacts of that infection for the rest of their lives. [6:17] I was fortunate to get the polio vaccine. [6:20] And I was fortunate to never get polio because of that vaccine. [6:26] And because we're about the same age, I'm sure you have similar experiences. [6:31] But now you undermine vaccines and are helping make diseases deadly again. [6:36] Mr. Chairman, I ask unanimous consent to submit for the record this article from the Sacramento [6:42] Bee about the rising measles cases in California. [6:46] Without objection. [6:47] Thank you. [6:48] In 2000, measles were declared eliminated in the United States. [6:53] And I've got a graph behind me that shows that. [6:59] Under four years of President Biden, there were 514 measles cases in the U.S. [7:06] Under just one year of President Trump, there are nearly 2,300 cases. [7:12] Mr. Secretary, kids have died because measles is running rampant under your watch. [7:18] In large part because President Trump allowed your conspiracy theories to run our public health. [7:27] Americans need serious leadership grounded in evidence and science. [7:32] Instead, we have you and this President elevating misinformation and undermining basic public health. [7:41] HHS should be led by professionals who respect science and data, listen to doctors, and put patients first. [7:49] Not by rhetoric, not by conspiracy, and not by ignoring established medical facts. [7:55] So today, Mr. Secretary, this is not just about policy differences. [8:00] It's about whether this department is going to protect the health of the American people [8:05] or put them at greater risk. [8:08] Right now, it looks like the latter. [8:11] Let's not sugarcoat this. [8:13] Americans are paying more for health care, not less. [8:16] Families are being squeezed at every turn. [8:19] And instead of relief, they're being handed policies that will make things much worse. [8:26] You and this administration promised to lower costs. [8:29] Instead, costs are rising. [8:32] And you and this administration ripped health care away from millions of people. [8:37] HR1, the big, ugly, big, beautiful bill, whatever it's being called these days, cut a trillion dollars [8:45] from Medicaid. [8:47] That means fewer doctor visits, delayed care, and more people showing up in already overcrowded [8:54] emergency rooms. [8:56] Let's be honest where this leads. [8:59] People will get sicker, preventable conditions will go untreated, and people will die. [9:05] Mr. Secretary, you shouldn't be in this office. [9:09] I yield back the balance of my time. [9:12] Mr. Schweikert. [9:13] Mr. Secretary, you are actually the first person I've had in my 16 years who's actually [9:20] willing to have conversations with me on how to have the revolution of lowering the cost [9:25] of health care and help our brothers and sisters be healthy. [9:28] But I want to go to one that makes the lobbyist community pucker up, because every other lobbyist [9:34] seems to be working on this. [9:36] These are just some of the MedPAC reports. [9:41] You pay for them. [9:42] They basically say Medicare Advantage, Medicare Part C, has a misalignment on the math. [9:50] We need to come to a final conclusion. [9:53] Are these accurate? [9:55] Or the stories I get from the lobbyists accurate? [9:58] Are the insurance companies accurate? [10:01] Because the latest report says Medicare Advantage comes in at 114 percent of fee-for-service. [10:09] In 2005 when we set up Medicare Advantage, which I'm a big supporter of a capitated model where [10:15] you make your profit by helping your brothers and sisters be healthier instead of a model [10:20] where you make your money by constantly risk scoring them as sicker. [10:24] And you saw last year's Wall Street Journal series showing how many people had been scored [10:29] as being sick, and they didn't have that disease. [10:32] They had never been tested for that disease. [10:35] 114 percent compared to 95 percent fee-for-service is about $1.75 trillion over 10 years, making [10:47] it the single biggest misalignment in the federal government. [10:52] And I beg of you, and I know Dr. Oz and others, we need to put everyone in a room, maybe our [10:59] actuaries, maybe my economists from the Joint Economic Committee who have been working on [11:03] this for three years. [11:05] It's a stunning amount of money. [11:07] How do we use Medicare Advantage, a managed care model, to have your vision of they make [11:12] a profit because you helped people be healthier? [11:14] It may require a multiple-year enrollment, so there's a payoff for the investment. [11:20] Thirty-one percent of Medicare spending is diabetes. [11:28] What can I do to work with you? [11:29] What can I do to move CMS and HHS to a vision here of health care for seniors? [11:35] Thank you, Congressman. [11:38] I'd love to have those discussions with you. [11:41] I'll say the fraud, part of it is perverse incentives, as you pointed out, and part of [11:48] it is fraud. [11:49] Medicare Advantage was created to end perverse incentives to give us value-based care, as [11:57] opposed to traditional Medicare. [12:00] In some ways, it's doing that. [12:02] In every metric that we look at, people who have Medicare Advantage are better off, are healthier, [12:08] they're getting treated better, they're more compliant, and people who are getting costs [12:13] or fee-for-cost programs. [12:18] One of the other problems is that one of the major problems is upcoding. [12:23] And it's just rampant fraud throughout the system, as you point out, and we are fixing [12:27] that now for the first time. [12:29] And I can tell you that we're already seeing some change in the discrepancy. [12:35] This year, we raise the premiums for, or we're proposing to raise the premiums for Medicare [12:43] Advantage by 2 percent, whereas Medicaid and Medicare are going up by 5 percent. [12:47] Mr. Secretary, I want to propose a more radical solution of alignment of incentives. [12:55] Get rid of the risk scoring. [12:56] I would get rid of the star rating. [12:59] And do those scoring at the beginning, and then design a system where, as you help the [13:05] enrollee get healthier, they benefit. [13:08] We're almost out of time. [13:09] I want to thank you and the agency for also starting the things of wearables, the thing [13:15] you can wear on your wrist, the thing you can wear, and the ability to allow Americans [13:20] to sort of have their own medical lab attached to them. [13:23] Now we have to figure out how to allow it to prescribe. [13:26] With that, I yield back to Mr. Chairman. [13:28] Mr. Larson. [13:29] Well, thank you, Mr. Chairman, and Mr. Secretary, welcome to the Ways and Means Committee. [13:36] I want to first associate myself with the remarks of Leader Neal, especially as it relates [13:46] to the great legacy of your family. [13:50] Thank you. [13:51] There wasn't, on my paper route, there wasn't a house that was door I didn't knock on where [13:57] there was a picture of Pope John XXIII and John F. Kennedy. [14:03] That's how deep and incredible influence that the President of the United States, the first [14:12] Catholic elected, had on generations of people and still every bit as much relevant today as he was in the 1960s. [14:30] Your family and its legacy of public service deserves always to be acknowledged for the enormous sacrifice [14:39] and their willingness to serve and to serve in the public interest. [14:45] What Mr. Neal also pointed out, as my other colleagues, I think you can understand and appreciate the incredible frustration. [14:54] President Kennedy said that science is the quiet power and whether it comes to sending a man to the moon or vaccinations, [15:10] President Kennedy was out front in terms of his belief in government and his belief in making sure that vaccines were provided for the health [15:27] and well-being of the American people and the children were all sworn to serve and protect. [15:35] I would like, Mr. Chairman, if you would, to submit for the record the Connecticut Department of Public Health testimony [15:44] on the establishment of vaccine standards. [15:48] Without objection. [15:50] Thank you, Mr. Chairman. [15:51] I would also, Mr. Chairman, like to submit for the record a stark divide, Americans more confident in career scientists at the U.S. health agencies than leaders. [16:09] Without objection. [16:09] And I guess that's what it all comes down to when we look at the vaccination process. [16:18] And I think everybody's entitled to their opinions and views, but we're not entitled to our own facts. [16:28] And the facts, I think, speak clearly on this. [16:32] When I confront doctors in my community, they say they're spending more time counseling people about taking their vaccination shots. [16:46] We know what we were able to do. [16:48] Just four years ago, the state of Connecticut braced for what they thought might be an outbreak of measles because a case was reported. [16:59] But as it turns out, that was the only case. [17:04] And it was attributed to the fact that people were vaccinated. [17:09] And that's what prevented that. [17:11] And as Mr. Neal and others have mentioned, whether it's polio, whether it's measles, whatever the case may be, [17:18] I think you can appreciate how deeply concerned people are about this and how the contrast between what your uncle [17:32] and the president of the United States said in his beliefs and yours with respect to vaccinations. [17:39] And with that, I see my time has run out. [17:42] I'll yield back my time. [17:43] Thank you, Mr. LaHood. [17:44] Thank you, Mr. Chairman. [17:46] Mr. Secretary, welcome. [17:48] I want to get your opinion on the FDA. [17:52] There's been broad reporting in the press on concerns that and mismanagement and bungled drug reviews [18:01] at the FDA have chilled investments in lifesaving innovative cures and that China is rapidly becoming [18:09] the recipient of those investment dollars. [18:11] I also serve on the Select Committee on China. [18:13] And as we look at how do we win the strategic competition when it comes to investment and innovation, [18:20] it's very important that we have a vibrant, efficient FDA. [18:24] And I understand that you aren't involved in those drug review decisions. [18:27] And I intend to take that up with Dr. Markery. [18:30] But it seems like a squandered opportunity to maintain America's position as the premier [18:36] destination for investment in medicine and modern technology. [18:40] Can you comment on that, Secretary? [18:41] What I would comment is I acknowledge that Congress is eating our lunch. [18:46] And that happened during the Biden administration. [18:50] We are redressing that. [18:53] We have broken every record for drug approvals. [18:55] We approved 67 drugs. [18:58] This year, new drugs. [18:59] We approved, which is a record. [19:01] We approved 39 new devices, which is a record. [19:06] We approved 91 new generic drugs, which is a record. [19:10] We are 100% online to make all of our Pitufa deadlines, which does not usually happen. [19:22] We have dramatically shortened the period from approval, from conception to commerce. [19:30] We just approved two new drugs, two new oncology drugs in record time, one in 45 days. [19:37] The closest before that was 310 days. [19:40] The other in 55 days. [19:42] These are two drugs that are so effective that they can bring people out of hospice. [19:49] We've moved from two to one trials to one to one trials where it's appropriate. [20:00] We're using AI to dramatically shorten the times to approval. [20:07] We're doing things that no other agency has with greater competence, greater efficiency than any other [20:12] agency in history. [20:14] You hear these stories about a drug that's been refused. [20:17] You read about them in the Wall Street Journal this week. [20:20] They were talking about a melanoma drug. [20:23] Every panel within FDA, all the career panels, the career scientists who looked at that drug [20:31] said it was not effective. [20:33] The drug maker was told to do a two-arm trial. [20:36] He did a one-arm trial. [20:38] And all the people who were tested also received a chemotherapy drug. [20:42] So we don't know what the effect was. [20:45] And Marty made the correct decision to not approve that drug. [20:50] But everybody goes after him because the industry is so powerful. [20:53] They own Congress. [20:55] They own the media. [20:56] And they can beat up Marty McCary because he's trying to do change over there. [21:01] Gotcha. [21:01] I want to switch subjects. [21:03] I'm also the chair of the Work and Welfare Subcommittee, which has jurisdiction over [21:06] foster care and the Chafee programs. [21:09] Yesterday, we had the First Lady here to talk about Fostering the Future, her initiative, [21:13] when it comes to foster care. [21:16] Can you comment on the role HHS is playing in implementing the Fostering the Future [21:21] Executive Order to help improve outcomes for foster youth? [21:24] President Trump and the First Lady, who's been extraordinary for us to work with, [21:30] have said their vision is one family for one child. [21:36] Right now, we have a two-to-one ratio. [21:39] And part of the reason for that is that the Biden administration was excluding an entire class of [21:46] people because of their religious beliefs. [21:49] We are told the states to actually pass laws, instructed them to pass laws, refusing [21:56] families who had certain religious beliefs, mainly Christian religious beliefs, not be allowed to [22:03] have children. [22:03] And that dramatically constricted the pool of available parents. [22:08] We are changing that. [22:09] We're also addressing one of the big issues, which is to allow children to stay with their [22:17] families of origin. [22:19] One of the biggest drivers of those separations is drug abuse. [22:23] And we are aggressively going after these issues. [22:27] And partially as a result of our work, number of foster children has dropped from 425,000 to 325,000 [22:36] because there's more kids who are doing our early preventative services on [22:42] and intervening early with parents who have drug addiction problems. [22:45] Thank you, Mr. Secretary. [22:46] I yield back. [22:47] Mr. Davis. [22:49] Thank you, Mr. Chairman. [22:51] Secretary Kennedy, thank you. [22:54] And I, too, share the admiration of your family's legacy and contributions to the development of [23:02] this nation. [23:04] In my district in Chicago, child care can be hard to find. [23:09] And when parents can't find child care, they can't go to work. [23:15] Last week, President Trump said, and I quote, [23:18] The United States can't take care of day care because we're fighting wars and need to spend our money on those. [23:28] Do you agree with President Trump that we should cut child care to pay for his war in Iran? [23:37] I don't think that that's what President Trump meant, Congressman. [23:42] And I appreciate you very much for actually giving me an opportunity to answer your question, [23:48] which none of your colleagues have done. [23:50] They've all shut me up. [23:51] And they've talked about science, but science is about debate. [23:55] They give a little speech that they can go and market, you know, for fundraising. [24:00] And then they don't allow me to answer the question. [24:02] And I deeply appreciate the respect that you've shown in this budget. [24:08] We were told to make a 12 percent cut across our department because Congress wrote a $39 trillion debt. [24:17] We're now having to tighten our belt. [24:19] The two programs that I protected and that Russell had protected were the Head Start program. [24:27] It is getting no cuts. [24:28] And incidentally, there have been no cuts to Medicaid. [24:31] I've got another question that I need to ask. [24:36] Black women are nearly three times as likely to die from pregnancy-related causes as white women. [24:44] Yet the Trump administration is undermining black maternal health from all sides. [24:50] The GOP slashed over a trillion dollars from Medicaid, [24:56] which pays for over 40 percent of births in the United States. [25:00] President Trump just proposed cutting maternal and child health programs by over $800 million. [25:09] Doge canceled funds for several research projects that could save countless black mothers, [25:17] like the Morehouse School of Medicine Research, on improving the health of black pregnant and postpartum women. [25:24] How can we lower black maternal health experiences if we're cutting funds for these critical programs? [25:32] And the administration says that you can't consider race or ethnicity in health care. [25:41] We are this administration under my leadership and President Trump's leadership [25:49] is doing more to advance maternal health than any other administration in history. [25:54] It was tremendous duplication of departments. [25:57] We had 42 different maternal health services in our department. [26:01] And we cut some of those and consolidated them. [26:06] Right now, we are investing huge amounts of money in maternal health. [26:10] We serve 59 million American mothers. [26:13] Our perinatal program, which is a groundbreaking program, we're now in 220 hospitals, [26:19] has reduced maternal mortality in those hospitals by 42 percent. [26:25] Nobody's done that in history. My time is going to expire, but let me ask you. [26:32] The community health centers are excellent stewards for the 340B program, [26:39] and they've done a great job with them. Now they're burdened with a new model [26:43] and reporting requirements. Would you consider exempting the health centers from that model [26:50] of rebate, all of the reporting things that are making it difficult? [26:55] I'm happy to talk to you about that. I can say that we are giving, we are increasing the budget, [27:03] our community health services centers in this country, in this budget, where everything else is [27:08] getting cut, because we understand that they do a better job at treating their patients, [27:14] and particularly patients in poor community, than any other system in our country. And we strand. [27:19] I just gave another 143 million dollars to them last week. [27:24] In addition to the proposed increase in their budget that are in this budget, proposed budget. [27:30] Thank you, Mr. Chairman. Now you're back. [27:32] Thank you. Mr. Estes. [27:34] Thank you, Mr. Chairman. And thank you, Secretary Kennedy, for being here today. [27:38] You know, I want to start by commending the Department of Health and Human Services for [27:43] establishing the Maha Commission and Administration for a Healthy America to fight chronic disease and [27:49] promote healthy living for all Americans. As mentioned earlier, the statistics are staggering. [27:53] The six in 10 Americans have at least one chronic disease, and that 90 percent of our health care [27:58] spending is dedicated to fighting these conditions. We've got to look at ways to reverse this trend [28:04] and focus on how do we improve wellness. We're strongly supportive of a pivot away from this [28:11] reactionary sick care towards the preventive maintenance and strategic alignments for particularly rural health. [28:17] We also need to recognize the importance of patients' access to quality care and availability of providers. [28:23] A bold vision for a healthy America doesn't work if we can't succeed to support our rural communities [28:30] with the essential medical workforce and emergency transportation required. [28:36] In my district in South Central Kansas, institutions like the Kansas College of Osteopathic Medicine and [28:41] the future Wichita Biomedical Campus are working hard to generate the next generation of doctors that will be supportive for us. [28:50] You know, Mr. Secretary, air ambulances are an essential lifeline in rural America, and when emergency happens, [28:56] sometimes those helicopters are often the only way a patient gets to a medical treatment in time. [29:01] Many of our bases are at risk of closing because of the Medicare reimbursement rates haven't been [29:09] meaningfully updated for a couple of decades. And part of that's because the federal government hasn't [29:13] been doing its job. Five years ago, the No Surprises Act required the Department of HHS and Department of [29:21] Transportation to collect those costs and operational data. And to date, those rules haven't been finalized. [29:28] And I wanted to just ask, you know, how can we work together? How can we get HHS and Department of Transportation to [29:33] to work to update that? I am happy to work with you on that. I can tell you that the No Surprises Act was [29:41] was passed with the best intentions and it was a great law, but it was not implemented by the Biden administration. [29:49] And those proposed regulations on the No Surprises Act were left to languish. We are now in the final [29:56] process of finalizing them. And I'm happy to work with your office to talk about the air ambulance problem. [30:04] And, you know, these are huge. This is a huge issue, particularly in Alaska. [30:10] So I hear from them all the time about the same issue. And we've also found a lot of fraud in that area. [30:17] So we need the kind of audits that you're talking about and the kind of information that you're talking about. [30:22] We're really interested in that. And I look forward to working with you on it. [30:25] Great. Well, thank you. And, you know, one of the things we're also concerned about is the [30:29] the real threat of retirement of so many providers in the physician workforce. And, you know, as we look [30:36] particularly of how that's going to impact patients, particularly in rural communities, many of the [30:41] communities lack specialists. And particularly with the number of physicians at an older age in our rural [30:49] communities. And we're seeing now more patients are approximately seeing 50 percent more specialists [30:56] than in the year 2000. And so I want to see if there's things that you're doing in the administration [31:02] to help ensure that our rural patients can get access to some of these specialty care. [31:07] I think one of the most important things that we've done to address that very, very grave problem [31:13] is the the site neutrality rules, which we have recently finalized. And that will end the disparity [31:21] between what's paid to rural providers and what's paid to urban providers and hopefully dampen the [31:29] appetite for consolidations, which are destroying rural economies and and rural health care and allow [31:39] them to get a living wage, which they don't have right now. Right. Well, thank you. Thank you for all [31:44] your hard work. I yield back. Ms. Sam Chess. Thank you, Secretary Kennedy. We appreciate your appearance here today. [31:51] To win the support of skeptical senators during your confirmation hearings, you claimed and I'm quoting [31:57] here, I support vaccines. I support the childhood vaccine schedule. I was skeptical about those comments [32:04] because prior to your nomination, you espoused numerous disproven theories that childhood vaccines, [32:11] including the measles vaccines, were linked to autism, death and other adverse effects. Not surprisingly, [32:17] we were right to be skeptical of your promise to support the childhood vaccine schedule because at your [32:22] direction, the CDC removed its universal vaccine recommendations for children covering seven [32:28] immunizations, including things like flu, COVID, hepatitis A, hepatitis V and rotavirus. [32:35] On Fox News last year, you stated, and I'm quoting you again here, there are adverse effects from the [32:40] vaccine. It does cause deaths every year. It causes all the illnesses that measles itself causes. [32:47] A deadly measles outbreak in Texas killed an unvaccinated six-year-old, the first such death in a decade. [32:54] So simple yes or no question. It's not that we don't want to let you answer. It's that we all have limited [33:00] time and you have plenty of time to answer questions and you have plenty of time to give testimony at the [33:05] beginning. So simple yes or no answer will do here. Do you agree with the majority of doctors that the [33:11] measles vaccine could have saved that child's life in Texas? It's possible, certainly. [33:18] Okay, thank you. I want to look at some very important data. In 2024, under the Biden administration, [33:25] which apparently seems to be responsible for every ill in the world. In 2024, under the Biden [33:31] administration, there were 258 cases of measles. And in 2025, under your leadership at HHS, it ballooned to [33:41] over 2,000. That's a 675% increase. And we are now on track to surpass that this year with over 1,600 [33:52] confirmed cases in just three and a half months. If we project those numbers out for all of 2026, [33:59] we can expect a whopping 6,400 cases of measles. That's a 2,380% increase in a preventable disease. [34:10] CDC data also shows that about 80% of children who died from flu this season were not vaccinated. [34:17] The anti-vaccine rhetoric you ran on and the anti-vaccine actions you have taken over the last year [34:24] clearly correlates with the dramatic increases, again, in preventable diseases. As a mother, [34:30] this horrifies me. Stopping the spread of communicable diseases is one of HHS's primary [34:36] responsibilities. And a strong public health messaging campaign on the importance of vaccines [34:42] could have stopped this surge of measles cases as it had in past outbreaks. But I was appalled to learn that [34:49] the CDC suspended public health messaging on vaccines last February. It ended a successful [34:57] flu vaccine campaign as well. My question is, did President Trump approve your decision to end CDC's [35:04] pro-vaccine public messaging campaign? You've got a lot of misinformation there, first of all. [35:09] I'm asking you a question. I appreciate a response to the question. Let me respond to the misstatements [35:14] that you've made. No, you have other opportunities. I have limited time. Please answer my question. [35:20] You're the only opportunity I have to respond. Did President Trump approve your decision to end [35:24] CDC's pro-vaccine public messaging campaign? Allow me to answer to respond to a lot of the misinformation. [35:31] No, answer my question, please, sir. I have limited time. There's a global measles epidemic. [35:36] We've done better in preventing it than any country in the world. There is no country that has seen [35:41] a bigger percentage increase. That's not true. Mexico has three times our measles and they have [35:46] one eighth of our population. Did President Trump approve your decision to end the CDC's pro-vaccine [35:51] public messaging campaign? Canada has doubled the measles and they have one eighth of our population. [35:57] Did he approve that? We've done better at preventing measles than any country in the world. [36:02] President Trump approve your decision to end the CDC's pro-vaccine public messaging campaign. [36:08] We've done better at preventing measles. That's not answering my question, sir. [36:11] And ending the epidemic than any country in the world. That is not answering my question. [36:14] And I think you don't want to answer the question because I think you know that you are making [36:19] terrible decisions that impact very, very real lives, especially the lives of children. Now, [36:29] one thing that I find incredible is that you suspended this pro-vaccine messaging campaign, [36:34] but somehow you're spending taxpayer dollars to drink milk shirtless in a hot tub with Kid Rock. [36:42] And somehow you think that's a better public health message than informing the public about [36:47] the importance of vaccines? General Lady's time has expired. Really? I yield back. [36:51] You don't have anything to yield. Mr. Smucker. Thank you, Mr. Chairman. Thank you, [37:01] Secretary, for being here today. I'd like to first thank you for your work. Thank you for your willingness [37:07] to do this. Thank you for your courage, because taking on entrenched systems does take real courage. [37:14] And I think future generations will thank you for the work that you're doing today. [37:20] I want to talk just two quick things. You've spoken extensively about the role of diet in preventing [37:27] chronic disease. And I have two specific policies, bills that I'm working on that we've talked with [37:34] the department about, but I'd love to get your public comments about them today. The first is [37:40] food is medicine interventions, like produce prescriptions, medically tailored meals, which [37:49] there's growing evidence that they can really improve outcomes for patients with chronic disease. So I [37:56] think there's a role for these approaches in federal health programs. And of course, you know, CMMI [38:03] is created specifically to test new health care delivery models that improve outcomes and lower [38:10] costs. And I appreciate that under your leadership, CMMI has started to prioritize prevention-focused [38:17] models. So I've been working on and planning to introduce actually this afternoon a bipartisan bill [38:23] that would test a bundled payment that provides certain chronically ill patients with a comprehensive [38:29] package access to healthy produce, nutrition counseling, remote monitoring, with the goal of [38:34] preventing disease progression and reducing avoidable health care costs. I'd just like to get your [38:40] reaction to that and love to have the continued support of the department for a policy like this. [38:44] I mean, we have the highest chronic disease burden in the world. Congressman was talking about [38:51] the deaths from infectious disease, which are a couple of thousand a year. 90% of the people who die in the [38:59] three million people who die in this country die of chronic disease and nobody's paying attention to [39:03] this. And all of these members have ignored this for as long as they've been in office. This is the [39:10] real threat to American health. In fact, during COVID, we have the highest death rate of any country in the [39:16] world. And when you ask CDC, why is that true? They say, well, it's because we're the sickest population. [39:24] The average American who died from COVID had 3.8 chronic disease. What was killing them? [39:30] COVID or the chronic disease? You have to understand chronic disease, infectious disease has a very [39:37] hard time killing healthy person. It kills people with chronic disease. And we are, I'm looking forward [39:45] to you, you know, up to 70% of type 2 diabetes can be reversed and people can even lose the diagnosis [39:54] simply by changing their diet. Well, thank you. I do want to bring up [39:58] one additional piece of legislation that we're working on. You know, food manufacturers are moving [40:05] in the right direction due to your leadership on reducing additives, reformulating products, [40:10] responding to consumer demand for healthier options. There's still a gap, though, in what's [40:18] in the generally recognized as safe or grass pathway where companies can self-determine a substance is [40:24] safe. They determine that themselves, often relying on their own expert panels with limited transparency [40:31] into potential conflicts of interest or underlying data. So that's another piece of legislation [40:37] I'm working on. I think we should establish clear standards for self-crast panels, strengthen [40:43] public confidence in our food supply. Just wanted to get your thoughts. Do you believe reforms like that [40:49] Yeah, that's absolutely critical. We have finalized in my agency a closing the grass loophole and that [40:58] regulation is now going through the interagency process. We're a little bit hobbled in what we can [41:04] do and Congress can do much more. So my office would love to work with your office on getting a much stronger [41:11] bill, much stronger regulations. The grass loophole has been hijacked by the food industry. [41:19] And because of that, we have 10,000 ingredients in our food. In Europe, they only have 400. And most of [41:26] those have never been safety tested. We don't even have a list of them. We have no idea what they are. [41:31] It essentially allows the industry to put in any chemical they want, any chemical they devise and lab [41:39] into our food without even the slightest regulations. And that needs to be changed if we're going to make [41:47] America healthy again. And I appreciate your help and your leadership, Congressman. Thank you. Look [41:52] forward to working with you on that. Ms. Sewell. Mr. Secretary, you've made a number of outlandish and [41:59] frankly disturbing comments both before and during your tenure as Secretary of Health and Human Services. [42:05] I want to draw your attention to one of those times. In a 2024 broadcast interview, you suggested that [42:14] black children on ADHD medication should be reparented. You said every black kid is now just [42:24] as standardly put on Adderall, SSRI benzos, which are known to induce violence, and that those children [42:33] are going to have to go somewhere to get reparented. There is a lot to unpack in that comment. [42:40] I know that you've already answered several of the questions I was going to ask, and so I'm just [42:44] going to rephrase them. Mr. Secretary, you've already admitted that you are not board-certified physician, [42:51] and you've already admitted that you did not go to medical school. Have you ever reparented or parented, [42:58] I should say, a black child? I don't even know what that phrase means, and I doubt that I said it. [43:04] Yes or no answer. I doubt that I said that phrase? No, I'm not going to answer something that I didn't say. [43:10] You absolutely said it. Oh, I'd like to hear the recording. [43:14] So to be clear. It doesn't make any sense. I don't even know what it means. I don't either. [43:19] That's why I'm asking. And by the way, of 26. So to be clear, you're not a doctor, [43:23] you have no medical degree, and you have no formal medical training, and you have never [43:28] parented a black child. As of 24 of the 26 HHS secretaries have not had medical degrees. [43:35] My time. And I say to the chairman, I want to reclaim my time. Um, so you are not a doctor, [43:43] have no formal medical training, and you've never parented a black child, and yet you are suggesting [43:48] that the federal government should take black children away from their families and reparent them, [43:53] and send them off to some wellness farm instead of providing them with evidence-based medical [43:58] You're just making stuff up. I am absolutely not making this up. Mr. Secretary, in your opinion, [44:04] what factors should the federal government consider when reparenting a black child [44:09] who has been on ADHD or ADD? That's rhetorical. I don't even know what you're talking about, [44:14] Congressman. I don't know what you're talking about. I don't know what reparenting either means. [44:20] I don't either, but you said that. I did not say that. Mr. Secretary, [44:24] for black families of the United States, the issue of family separation is not new. [44:29] Our nation has a long and painful history of separating black children from their families. [44:34] During slavery, black children were taken from their parents and sold with no regard [44:38] for their humanity. And after slavery, black families continued to face forced separations [44:44] through Jim Crow laws, discriminatory policing, and child welfare systems that too often assumed [44:50] that black parents were unfit. Even today, black children are removed from their homes at higher [44:56] rates than white children, not because of their greater harm, but because of longstanding bias [45:02] and built-in institutionalism. For you to suggest that black families are not capable of raising their [45:08] own children is deeply offensive. Sir, you are the Secretary of Health and Human Services for [45:15] the world's most powerful country, and your words matter. When you suggest that reparenting black children, [45:24] when you so doubt about the safety of vaccines, and when you promote unproven statements that have no [45:31] basis in science, you endanger the lives of everyone across this nation. Those children have parents, [45:42] and to suggest that they have to be reparented is offensive. I never suggested that. Your words matter. [45:50] When those words are careless, communities pay the price. When your words are imprecise, they create [45:57] confusion. And when your words are dismissive, they cause real harm. So you don't have the pleasure, [46:04] because of your position, to speak first and think later. Not in this job, and not because of your [46:12] responsibility. I expect, and the American people expect, that you choose your words with sincereness, [46:20] and with seriousness. The seriousness that your position demands. American lives are at stake, [46:27] and it's time that you start acting like it, sir. Thank you. Ms. Hearn. Mr. Hearn. Mr. Hearn. [46:39] Thank you, Mr. Chairman. It's good to be with you today. Mr. Secretary, thank you so much. [46:47] It's good to have you here today. I really appreciate it. I want to use my time to bring an issue [46:54] to your attention. Last month, a young man from Oklahoma, Jacob Toe, came to meet me in my office. [47:00] He told me a story that stuck with me, one that can make a huge difference for children in our country. [47:05] In 2024, Jacob was in the midst of a custody dispute for his three-year-old son, Leonardo, [47:10] or Leo, as they called him. One day, Jacob got the call no parent ever wanted to receive. [47:16] While Leo was in his mother's care, the young boy passed away. Jacob learned that Leo died from an [47:21] accidental ingestion of fentanyl that was left within the reach of his mother's home. [47:26] Jacob fought to figure out how this could possibly happen. In doing so, he learned that the drug [47:30] screening panels used in the child welfare process did not test for fentanyl, which is not detected by [47:35] standard drug panels. While talking to lawmakers back home, they, like me, were shocked that fentanyl was [47:41] not already included in the child welfare drug screenings. I believe other states across the [47:46] country do not realize this gap in care and safety exists. While grieving the death of his son, [47:52] Jacob decided to get involved. He told his story all around the state of Oklahoma, urging lawmakers to [47:57] correct this deadly gap in testing and keeping kids safe. Thanks to Jacob's effort, last month, [48:03] the Oklahoma State House of Representatives passed Leo's Law in honor of young Leo. This bill requires the [48:08] Oklahoma Department of Human Services to include fentanyl testing and all-child welfare drug screenings [48:13] where fentanyl use is suspected. This is not an issue that is unique to Oklahoma. Other states, [48:18] such as California, have followed suit and introduced similar legislation. I'm proud of my home state for [48:24] leading this charge and even prouder of this young man from Kellyville, Oklahoma, who has turned his [48:29] unthinkable tragedy in successful advocacy efforts. I commend Jacob, but I know he cannot do this alone. [48:35] We must do our part and help him ensure that no other child is harmed from fentanyl like his son Leo was. [48:41] Secretary Kennedy, two things. Will you work with Congress to educate states about this ongoing [48:48] issue and hopefully get them to introduce laws and figure out how we can work together at the [48:52] federal level to ensure all states are testing for fentanyl and child welfare drug screenings when [48:57] necessary? I will work with your office on that. I think it's a wonderful objective. As you say, [49:04] it's normally regulated by state law, but we can look at other options. It would be great to get [49:09] everybody to do this. I'm sure children are dying across the country. Like I said, [49:12] even California saw the need to do this and pass their own laws. One other question before I go. [49:19] Substance abuse is one of the leading factors for kids entering foster care. In fiscal year 2024, [49:24] more than 30 percent of children entered foster care due to substance abuse by their parents. [49:30] Under your leadership, ACF has expanded access to drug treatment under the Title 4e Child Welfare [49:37] program for parents as part of the Great American Recovery Initiative. What steps can Congress take [49:42] to build on this on this administrative's emphasis on prevention services? We've now [49:55] funded as part of the Great American Recovery Program as a stomp program. We're working with states [50:01] with law enforcement, with detoxes, with rehabs, and sober housing to bring together [50:07] other treatment that has been fragmented and atomized in the past. Also, you know, one of the primary [50:15] problems with drug treatment is it has the same reverse incentives as we see in the main, you know, [50:22] in a physical health medical system, which is that people get paid more by keeping the addict [50:29] addicted. If you go to a rehab and you relapse, that's the best thing that'll happen to that rehab [50:38] because then you're coming back for a second bite. And we're now working on implementing a model. [50:44] And I actually visited a place in Arizona called Camelback this week. [50:50] It guarantees where the rehab after you go there for 30 days or 60 days will guarantee if you relapse [50:58] within the next 12 months, you come back for free. And that gives the rehab the incentive to make sure [51:04] you're going through IOP, that you're getting drug tested, that you're getting psychiatric care, [51:11] that you're going to 12-step meetings or whatever they need to do. Maximize because they're now, [51:17] their financial incentives are now aligned with the incentive of getting you healthy. And I think [51:23] ultimately that's where we need to move toward value-based care rather than essentially what's a fee-for-service [51:31] model. Thank you, Mr. Secretary. Mr. Chairman, I will not yield back time because I don't have [51:36] any to yield back, just to point that out. Thank you. Thank you, Mr. Hearn. Ms. DelBene. [51:42] Thank you, Mr. Chairman. Mr. Secretary, I'm glad you're appearing before us today. Under your leadership, [51:48] CMS recently added new layers of red tape that Medicare patients need to navigate to get the care [51:55] that they're entitled to. Mr. Secretary, I hope you understand the harm that delaying and denying [52:01] necessary care can have. Do you remember saying this, quote, Americans shouldn't have to negotiate [52:09] with their insurer to get the care they need. Pitting patients and their doctors against massive companies [52:16] was not good for anyone, end quote. Do you remember? I don't remember, but I would align with that. [52:23] And I'll submit for the record, actually, a press release from CMS with your quote in that [52:30] from June 23rd of 2025. Without objection. In this case, I agree. Pitting patients and their doctors [52:38] against massive companies isn't good for anyone. And yet, less than a week after you said that, CMS [52:44] announced the WISER model. The program allows private companies to use AI to review traditional [52:51] Medicare claims and pays them based on the amount of care they deny. This program went into place in [52:57] six states across the country, including my home state of Washington. President Trump said multiple [53:03] times on the campaign trail that he would not cut Medicare, but this program does exactly that. [53:09] For example, Joanne is a senior from Washington on Medicare. She has a herniated disc that is pinching [53:15] her sciatic nerve, causing immense pain down the right side of her body. Her doctor prescribed an [53:22] injection that would help relieve her pain. If it had been prescribed last year, she would have received [53:28] the treatment, no problem. But because of the WISER model that has been implemented, she's been in [53:34] intense pain for over six weeks while she waits for approval. She has been using crutches or a wheelchair for [53:41] over a month now, which is making her arthritis worse, adding to her chronic pain. Since using crutches, [53:47] she's fallen multiple times, including earlier this week. Instead of simply approving the procedure, [53:53] Joanne's conditions are getting worse. And Secretary Kennedy, the W in the WISER model stands for wasteful. [54:00] Do you think that Joanne's treatment, which would allow her to walk and live with less pain that her [54:05] doctor has prescribed, do you think that's wasteful? Do you want me to actually answer that question? [54:10] Yeah. I think that that's a terrible outcome. It's one that was not intended for the system, [54:19] obviously. The problem is there's tremendous ways. In Medicaid, there's only 5% of the cases [54:25] are given prior authorization. In private industry, 30%. This is traditional Medicare now, where it's now, [54:34] this has only been put under prior authorization under your leadership. Now, President Trump promised [54:41] multiple times that he quote, will not lay a finger on Medicare. Given President Trump's promise, did you [54:48] or the President approve this model, which is now delaying and denying care for people in states like [54:54] the state of Washington? Can I answer the question? Yeah. People are being denied care across our state right now. [55:02] Very quickly. And as an example, five years ago, we were paying $250,000 a year for $250 million for [55:12] skin substitutes. This year, $23 billion. Why? Because there was no prior authorization in the Medicare [55:20] program. And now someone like Joanne is not getting her care. It's more expensive for us because Joanne is [55:25] not getting her care. We have story after story. I can also submit for the record stories of all the [55:31] people who are being delayed and denied care. It is more expensive for us. It is more expensive for them [55:38] when they are not getting the care they need. Last year, I sent CMS a letter detailing my concerns about [55:43] the WISER model. I still have not gotten a response. That was last August. Can you publicly commit to responding to [55:51] that letter and addressing the concerns of this harmful model? Yeah, absolutely. We will. And I [55:57] apologize for not getting back to you sooner. We have an unprecedented number of communications from [56:06] Congress. Well, we don't have you here very often. We have people in my state who are being denied care, [56:14] who are being hurt based on this policy. And there's an indifference to the challenges that [56:20] they are facing all because of a model put in place for no reason and doing exactly what you said [56:26] shouldn't happen, which is, and I quote, pitting patients and their doctors against massive companies. [56:31] These are private companies doing this prior authorization was not good for anyone. Thank you. [56:36] I yield back, Mr. Chairman. As I said, discovering $23 billion with the fraud is not for no reason. And [56:44] that... You are hurting patients in our state and other states across the country for no reason. Right. [56:49] And I appreciate you finally responding to the letter. Thank you. I yield back. Ms. Miller. [56:53] Thank you, Chairman Smith. Secretary Kennedy, thank you so much for coming in front of our committee today [57:00] and for your leadership in improving the health and well-being of the American people. I have two things [57:08] I'd like to discuss. In my home state of West Virginia, we see some of the highest rates of [57:14] chronic disease in the country. Coupled with our rural nature and limited access to care, [57:20] many of these patients are especially vulnerable and face significant barriers to managing their [57:26] conditions. The first chronic disease that I want to speak about is our patient population that I am [57:36] focusing on, which is people who are living with chronic kidney disease and the end-stage renal disease. [57:44] I commend the administration's effort to promote affordability and fiscal responsibility in health [57:51] care. I am concerned, however, that in the case of kidney disease, the current ESRD bundle may [57:57] inadvertently discourage the development of adoption of new therapies and technologies that could improve [58:05] outcomes and reduce long-term costs for patients who do rely on life-saving dialysis. The complicated [58:13] post-Tadapa policy has resulted in promising innovative drugs being pulled from the market entirely or only [58:22] being accessible by a tiny fraction of the patients. I have a bill called the Kidney Care [58:27] Access Protection Act, and it is a piece of legislation that could expand access to the new treatment [58:34] options in a way that both encourages innovation and ensures costs remain well managed for Medicare and [58:41] taxpayers. As we work together toward better outcomes and cost containment, how is CMS evaluating ways to [58:49] strengthen incentives for innovation within the ERSD bundle while still maintaining fiscal responsibility? [58:57] I mean, I would say that that's the balance that we're all trying to achieve. [59:04] We are doing everything in our power to maintain the United States as the innovation center for the world, [59:13] and we want to make it easier to get quick approvals for drugs that actually work. [59:18] We need to do science on them, and we're doing gold standard science, and we have depoliticized science [59:27] at the agencies. I don't know enough about the renal disease aspect in the bundle, but I'm happy to work with you. [59:37] Also get somebody from Oz's team to come over and talk to you directly because [59:43] I know that that's not an outcome that they would like. [59:45] That would be wonderful. The second issue that I wanted to talk to you about is that it is clear [59:53] that what we eat plays a direct role in our health, and quite frankly, many Americans don't eat right, [1:00:00] and these poor nutrition choices are a major driver of chronic disease. I believe there's a strong case of [1:00:06] expanding access to MNT therapy for targeted and specific groups in Medicare beneficiaries who [1:00:14] outcome could actually measurably improve as a result. With that in mind, can you share your [1:00:19] perspective on the role medical nutrition therapy should play in improving health outcomes for [1:00:25] Medicare beneficiaries and how we can most effectively and responsibly expand to those who would benefit [1:00:32] from the most particularly in the rural and underserved areas? Yeah, I think and I've worked [1:00:38] with Governor Morrissey about that on this issue and I think there's nobody at this agency who is not [1:00:45] committed to the idea that food is medicine on that it is and if we want to do prevention in this country [1:00:55] we've got to end the chronic disease epidemic, we've got to start with food. That's one of the reasons [1:01:02] we're pushing nutrition into the colleges, we're pushing it into the hospitals, we're pushing it into [1:01:08] the community health centers to make it the central focus of healing and prevention. I want to work with [1:01:16] you in any way that I can to achieve the goals that you're talking about. Thank you so much. I yield back. [1:01:24] Dr. Murphy. I think your mic is working. Nope. All right. Is it now? It's now. It's working now. [1:01:44] Thank you for coming. I want my 12 seconds back. Thank you for coming. You know, we're talking about [1:01:49] a little bit about vaccination. I think we ought to talk a little bit about the arrogance of a fellow [1:01:54] named Anthony Fauci who came and lied to Congress, lied to the American people and in my opinion destroyed [1:02:00] the confidence of the American public in the health care system. So I think that when we're talking [1:02:05] about vaccination, that's number one. Number two is your predecessor who was not a physician either [1:02:10] led the greatest invasion in this country of 13 to 20 million illegal people coming in this country [1:02:14] who were not vaccinated and brought in disease into this country. So let's actually bring facts into [1:02:19] that conversation. Second of all, I share I share some of the concern now about what's happening with [1:02:25] our drug delivery system going to China. They are developing a burgeoning industry that is [1:02:31] threatening what we do as a as primal confidence, at least in the American pharmaceutical industry. [1:02:37] And I think we really, really have to be concerned about that. I think the greatest thing that your [1:02:42] administration has done is bring highlighting to the fact that food is medicine. I saw a child in [1:02:47] my clinic about six weeks ago that was eight years old that weighed 262 pounds. This is what we're [1:02:53] dealing with. This is what the obesity epidemic and it is sad that the number one drug that is selling [1:02:59] now in the country are weight loss drugs. This is endemic. This speaks to the terrible, terrible [1:03:04] tragedy that has become the American food industry. So thank you for highlighting that. I want to get [1:03:10] back to one thing that is my passion and that is the cost of care in this country. The cost of care in [1:03:15] this country has risen tremendously, in my opinion, primarily because of vertical integration that has [1:03:23] happened in this country, primarily which has been caused by the ACA. That is the number one driver of [1:03:28] health care costs. We can talk about the pharmaceutical industry. We can talk about the other things. [1:03:31] But we, a few weeks ago, had the arrogance and the vanity of our health insurance industries come [1:03:36] in front of this committee and just sit to point fingers otherwise. You convened last summer, in July, [1:03:42] the 70 percent of those who insured in this country. And they said they were going to do better. [1:03:46] And I know they gave a report saying they've cut down prior authorizations by 11 percent. But frankly, [1:03:52] after 35 years in the health care industry, I don't believe a damn word that they say. [1:03:56] And until we get the middlemen under control in this country, the number one driver of health [1:04:01] care costs in the pharmaceutical space is not the pharmaceutical industry. It is the pharmacy benefit [1:04:07] managers. It is the middlemen. And until we get rid of this thing that is only present in the United [1:04:13] States, we will not drive down health care costs. And so I urge you, I urge you to be the hallmark of [1:04:19] your administration is to go after what we have created, is the vertical integration that is destroying [1:04:25] the doctor-patient relationship and bankrupting America. Second of all, I want to talk about the [1:04:30] No Surprises Act. To your point, absolutely, a great bipartisan, bicameral bill. Your predecessor, [1:04:37] of course, went straight and gave all the authority to the insurance companies. I have a bill, H.R. 4710, [1:04:43] which puts meaningful enforcement back into this. Right now, our vain and arrogant insurance companies [1:04:48] are keeping hundreds of millions of dollars just in their little kitty, which has been appropriated [1:04:54] to people who provided the care, but they're keeping it. And so enforcement mechanism, and I [1:04:59] understand your administration is working on that, so I thank you with this. And then lastly, excuse me, [1:05:05] I applaud the Trump Rx. We had Mark Cuban come in. We're working with the administration and trying to [1:05:17] do this with Cost Plus. I saw a patient, again, about six weeks ago. He changed insurance companies. [1:05:22] The pill he had been on for 15-plus years was now close to $1,500. I literally pulled out my phone [1:05:28] and went to Cost Plus, and it was $15. So I applaud the administration for getting the middlemen out. [1:05:34] These are the problems that the American public is facing. You know, we can talk about all the other [1:05:39] extraneous issues, but if people can't afford healthcare, that's not access to healthcare. [1:05:44] When you allow 20 million people in the country and you overload hospitals and you overload [1:05:48] health care systems, we can't provide care to the American public. That is our primal and first duty. [1:05:54] So I want to say thank you for what you're doing. You have a tough job. We're here to support you, [1:06:00] and thank you for your efforts. With that, I'll yield back. Ms. Chu. Secretary Kennedy, [1:06:05] we have a child care affordability crisis in this country. Working families are having to pay skyrocketing [1:06:12] prices in some cases as much as 40% of their income, and too many working parents are having [1:06:17] to leave the workforce or turn down job opportunities because they can't afford child care. This is [1:06:23] hurting American families, our workforce, and our economy. During your 2024 presidential campaign, [1:06:30] you did a commendable thing. You proposed that the federal government should subsidize 100% of child [1:06:37] care costs for families below the poverty line and cap expenses at 10% of income for all other families. [1:06:45] It's right here in this article from the National Catholic Register. And yet, just two weeks ago, [1:06:52] President Trump said, we can't take care of child care. We're fighting wars. We can't take care of day [1:07:02] care. Now, earlier, you were asked about this and whether you agree with it, and you then, [1:07:07] you actually didn't answer it. You said, well, I fully funded Head Start. But your agency is illegally [1:07:16] withholding child care funding from every single state unless they submit a bunch of extra data not [1:07:24] required by law. And also, the President's budget request for 2027 proposes eliminating $350 million [1:07:34] for preschool development grants. Do you agree with eliminating $315 million from preschool development [1:07:42] grants? Those funds are going out. They're not being withheld. You're mistaken about that. No, this [1:07:50] this proposal, actually, what I said was the elimination of $315 million for preschool development [1:07:56] grants. I'm just wondering because it's completely contradictory to what your presidential campaign [1:08:02] was. Well, anyway, let me say this. Child care is one of the top expenses for American families [1:08:08] and is becoming increasingly unaffordable. President Trump campaigned on the promise that he would lower [1:08:14] costs. But his record, while in office, has been the exact opposite. He keeps on withholding federal [1:08:21] funding for child care. His reckless tariffs have raised prices on food and everyday goods. Gas prices are [1:08:29] also up thanks to his unpopular war of choice in Iran. So remember, Mr. Secretary, you once said, [1:08:37] for the cost of the Ukraine war, we could make child care affordable for every family. It's ironic that [1:08:44] Trump is doing the exact opposite, not funding child care because we have wars to fund. It's a slap in the [1:08:51] face to every American. And now I'd like to switch to another topic, hepatitis B. Today, I'm thinking [1:09:01] about my friend, Chi Moi, who was a city council member in my district, San Gabriel, California. Chi did [1:09:08] not know that he had hepatitis B until he donated blood. Eventually, there was a liver tumor that spread [1:09:14] to his pelvic bone. He was on the city council by then, and we watched as he grew weaker and weaker, [1:09:21] and then he became the first Asian American mayor. But he died of liver cancer just one month after his [1:09:29] installation. And we think he hung on long enough to reach that milestone only to die at the age of 53. [1:09:38] It was beyond tragic. But to think his life could have been saved had he been vaccinated [1:09:44] from hepatitis B as a newborn. Secretary, you've done an incredibly harmful thing to our community. [1:09:51] You eliminated the mandatory hepatitis B vaccine for newborns, and it disproportionately threatens [1:09:59] Asian Americans because while we make up 7% of the population, we account for 60% of all hepatitis [1:10:07] B cases. It's clear that this administration has no regard for the health, safety, and well-being [1:10:15] of Asian American communities, as well as communities across the United States. [1:10:21] Do you want me to reply? Well, if that's it. Hepatitis B is a terrible disease, [1:10:33] but babies are not at risk unless they essentially have zero risk, unless their mother is infected. [1:10:42] Mothers are tested when they go into the hospital to have a baby, and for all those people who are [1:10:48] infected, the vaccine is still a recommended vaccine. Everybody else, it's available. Parents can [1:10:57] assess the risks themselves through informed consent. Insurance will pay for it. We did not remove the [1:11:04] vaccine from being insured. And we just believe that Americans should have that choice, that the state [1:11:11] should not make that choice for them. Hepatitis B vaccine was not safety tested. It had a four-day [1:11:20] test with no placebo. We don't know what the risk profile is, and parents are allowed to ask that [1:11:26] question. The science is that it's not simply about choice. It's about whether infants are protected during [1:11:33] the most vulnerable period. Infants are protected. Okay, Mr. Kustoff is recognized. Thank you, [1:11:39] Chairman Smith, and thank you, Secretary Kennedy, for appearing today. If I could, Secretary Kennedy, [1:11:46] I represent parts of Memphis, Jackson, Tennessee. You and I have talked about Jackson, Tennessee before, [1:11:52] and rural West Tennessee. I wanted to talk to you about hospitals, particularly in those rural [1:11:58] communities. I know that because of the CMS Area Wage Index, we have hospitals that are in primarily rural [1:12:07] areas that are being paid less than those in urban areas. During the president's first term, CMS did [1:12:17] introduce the low-wage index hospital policy, and that did help to reduce that discrepancy. Back on [1:12:27] March 26, a few weeks ago, I introduced with Congresswoman Terri Sewell a bill called the Save Struggling [1:12:35] Hospitals Act. So it is bipartisan legislation. It aims to keep rural hospitals open by codifying an [1:12:44] adjustment to the Area Wage Index to ensure that hospitals in rural and low-wage areas receive a [1:12:53] fair Medicare reimbursement for the essential services that they provide. I know that you have publicly [1:13:01] said before that you support codification of the low-wage index hospital policy. I guess I just wanted to [1:13:07] ask you, that is something that you you still support and you would support being codified? [1:13:14] Absolutely. I wish that we could fix it within the agency. But as you know, the Social Security Act [1:13:24] requires any adjustment has to be revenue neutral. And that means if you take from one area, you have to [1:13:32] give to another. If you give to one area, you have to reduce payments to the other. It's a broken system. [1:13:39] It needs to be fixed, but only Congress can fix it. And I and my agency will work with you for that goal. [1:13:47] Thank you, Mr. Secretary. I could, if I could ask you about peptides. A lot of attention with peptides. [1:13:54] We know that about three years ago, the FDA removed 19 peptides from the list that compounding pharmacies [1:14:04] could routinely make in that limited access. Can I get your general opinion on peptides and your agency, [1:14:13] your department's plans, if there are any for maybe mainstreaming peptides? Well, we [1:14:21] um, returned 12 of those peptides yesterday. The class, um, to the category one, uh, categories of [1:14:31] that formulators will now be able to formulate them. Peptides are like supplements. Uh, the, uh, [1:14:39] the FDA is only FDA has authority to require pre-licensing safety studies, pre-marketing safety studies, [1:14:49] in any, uh, any drug that, uh, that claims a specific indication and that's mass marketed. [1:15:00] If you don't make those claims, if you're not mass marketed and you, then FDA does not require that. [1:15:06] Oh, so like supplements are not regulated in that way by FDA. Peptides are not supposed to be regulated. [1:15:13] It's been upheld again and again by the courts. The Biden administration improperly moved them to [1:15:20] category three without any evidence of safety. The only, the only justification they have is if [1:15:27] there's a safety concern and there was no science that indicated a safety concern. So it was improper. [1:15:32] We have now remediated that by moving them back. Thank you very much, Mr. Secretary. And I'll yield back, [1:15:38] Mr. Chairman. Thank you, Mr. Fitzpatrick. Secretary Kennedy, in a long overdue move, [1:15:44] uh, the FDA is finally taking steps to remove petroleum-based food dyes, including red 40, [1:15:50] yellow five, yellow six, blue one, blue two, and green three from our food and our medicine, [1:15:57] starting immediately. These dyes have been unequivocally linked to cancer, to hyperactivity, [1:16:03] and to so many, uh, other serious health risks. And yet they have been left unchecked and unlabeled for [1:16:09] absurdly too long. Secretary, beyond commitments from industry and beyond regulation, uh, from the FDA, [1:16:16] what steps can this legislative body take to make sure that we preserve over the long term, [1:16:22] um, cleaner ingredients in our food and our medicine as we look to address the link between [1:16:27] these chemicals and chronic, the chronic disease epidemic? The most important thing that you could [1:16:33] do, Congressman, is to close the grass loophole. We have, uh, regulations now that do everything in our [1:16:43] power, my agency's power to close that loophole. And those are now in the interagency process. So [1:16:50] we've completed it within my agency. There are now other agencies of equities in them and are looking at [1:16:56] them. Um, but we, it doesn't go far enough and we need to go farther. We need to really make sure that [1:17:04] any ingredient in our food is safety tested first. That's what they do in Europe. That's what they do in [1:17:10] other nations. That's why they only have 400 ingredients in their food in Europe compared to [1:17:15] 10,000 here. And so that we would love to work with you on that legislation. I think it's absolutely [1:17:23] critical if we're going to make America healthy again. Uh, second, I want to address something that [1:17:27] is of critical importance to my constituents in Bucks and Montgomery counties in Pennsylvania, [1:17:32] uh, pertaining to the chronic disease epidemic, pertaining to the impacts of PFAS and microplastics in our [1:17:38] food and our water supply. There is more that can be done at the federal level to address chemicals and [1:17:43] toxins in our food and water and elevate how these issues are connected to deteriorating health across our nation. [1:17:51] Specifically, the recent joint announcement that HHS and the EPA will be including microplastics in the EPA's [1:17:58] contaminant candidate list and launch the ARPA-H program to detect and remove plastics from the human body. [1:18:04] I believe to be a positive development in addressing the intersection of toxins in our food and water [1:18:10] and the chronic disease epidemic. Um, Secretary Kennedy, could you expand on the agency's efforts to [1:18:16] further address microplastics and PFAS contaminants, uh, in our food and water supply and how these actions [1:18:22] will, uh, impact overall health and fighting the chronic disease epidemic? We're putting 140 million dollars [1:18:28] into the, uh, into the STOMP program at ARPA-H to look at, to track, you know, right now microplastic, the average [1:18:38] American has a teaspoonful of microplastics in his brain. Almost one percent of brain volume is now [1:18:44] microplastics. That couldn't be a good thing. We don't, we know very little about the pathways by which it goes [1:18:51] into the brain. There are hundreds of components of microplastics, hundreds of different kinds. [1:18:58] Some of them may be benign. Other ones we know are hideously toxic. We are going to identify those. We're going to [1:19:04] trace the pathways so that we can better regulate them. The other thing that we're doing is moving them [1:19:12] to the MCL to the maximum contaminant list in the Safe Drinking Water Act so that we can now start regulating [1:19:19] and establish maximum contaminant levels for both PFAS and microplastics and start regulating them effectively [1:19:28] and drinking water. Um, I want to add this. The amount in our brains has doubled over the past five years. [1:19:37] So this is rising exponentially and it is an existential crisis. Thank you, sir. You're back, Mr. Chairman. [1:19:44] Thank you. Ms. Moore, ranking member Moore. Thank you so much, Secretary Kennedy. And I just want to join [1:19:55] in with the committee and sort of, you know, remembering the Kennedy family. I remember being nine years old, [1:20:01] begging my Republican mother to vote for John Kennedy. I don't think he won in Wisconsin, but [1:20:10] I do think that your family has made a great impact on this country. I promise to give you easy, [1:20:16] comfortable questions if you don't yell at me and hurt my feelings. [1:20:19] I promise. I promise you. Um, I just want to thank you for pointing out stuff like the dyes and stuff [1:20:28] in food and, and maybe even the looking at the food pyramid. I think that that's been a very helpful [1:20:35] discussion, uh, in terms of your making America healthy again. And I'm just going to ask you a [1:20:42] question and I hope it isn't, it's sort of outside of the scope of your service. But how does the cut, [1:20:48] the $1.4 billion cut in WIC and the $900 billion cut in SNAP interfere with your Make America [1:20:58] healthy initiative? I know that departments are told they have to cut. Do you think that that will [1:21:04] interfere? I, I, well, am I happy about the cuts? No, I'm not happy about the cuts. Don't you think it will? [1:21:13] I mean, fruit loops are a lot cheaper than good healthy food. Yeah, I mean, nobody wants to make the cuts [1:21:19] for us vote doesn't want to make the cuts. President Trump doesn't, but we got a $39 trillion debt. [1:21:25] That's costing every American child $6,600 a year. Yeah, I, I get this. Oh, okay. So it is my time. [1:21:33] Thank you. All right. Thanks. And I am, you know, I'm focusing on children here. You know, you, [1:21:37] you've made a beautiful quote that I was not aware of in your testimony. You said, although children [1:21:44] may be the victims of fate, they will not be the victims of our neglect. You claim your uncle said [1:21:51] that. What uncle were you talking about? Uh, John F. Kennedy Jr. President Kennedy. President Kennedy. [1:21:58] Although I just thought it was just classic. And so I just, you know, when we start putting things on [1:22:03] the chopping block and cutting stuff, I would have hoped that we would not have started with our children. [1:22:09] And I just want to know how that statement, um, that attribution to President Kennedy fits in [1:22:17] with, you know, cutting, um, uh, completely healthy start, which is a proven program, uh, that has [1:22:26] decreased infant and maternal mortality. I don't get it. It just contradicts that whole notion of not [1:22:35] neglecting our children or, um, or firing 20,000 people in your department with consolidations that [1:22:44] give technical support and help develop state plans around TANF, the social service block grant. [1:22:50] These are the most vulnerable people and kids. I mean, even cutting 43 million dollars out of the free [1:22:59] diaper care sort of program. And I just, I'm just making a statement. I'm not asking a question, [1:23:06] not confronting you, but I took all these notes while you were talking to other people. So I just [1:23:12] had to kind of address them. Um, I am wondering, um, how your Make America Healthy Again program fits in [1:23:23] with, um, the national database for new hires. It's a federal database maintained by, uh, your office for [1:23:31] the purposes of assisting child support agencies. Very sensitive information and section 453 says that [1:23:39] you will only use the data. Um, how does giving that data to ICE support your mission at HS, HHS? [1:23:50] Well, all the things that we do in terms of data sharing comply with the law. [1:23:54] No, this doesn't comply with the law, specifically section 453. I would love to see the general counsel's [1:24:01] memo on this if you wouldn't mind submitting that because it- I'm happy, happy to submit it. [1:24:07] Please. And let the record reflect that he will give us that letter because it is definitely in [1:24:13] contravention of our laws. I want to thank you for your indulgence and, and thank you for appearing here. [1:24:19] Well, thank you for the respect and, uh, the kindness of your presentation. [1:24:25] Thank you, sir. Mr. Stubbe. Thank you, Mr. Chairman. [1:24:29] Mr. Secretary, the contrast between the Trump administration and the last administration [1:24:33] cannot be more striking. On issue after issue, when your predecessor came before this committee, [1:24:37] he was defiant and claimed ignorance. In March 2024, I questioned then HHS Secretary Becerra about [1:24:45] the Office of Refugee Resettlement's process for finding replacements, placements and shelter for [1:24:50] unaccompanied migrant children. Of the more than 100 questions submitted by this committee, [1:24:54] my question to him about missing children was one of only two questions that your predecessor declined [1:24:59] to answer. The Biden administration's open border policies were nothing short of a lethal disaster [1:25:04] for our country. Let's be clear about the facts. The Biden DOJ received thousands of allegations of [1:25:10] sexual abuse related to unaccompanied minors processed through ORR. Under the Biden administration, [1:25:15] ORR permitted individuals with criminal records, no citizenship, and who refused a background check, [1:25:21] received custody of unaccompanied children. Over the course of 10 months alone, the agency lost [1:25:25] contact with neither 20,000 unaccompanied children. Under the Biden ORR, case managers failed to perform [1:25:32] home studies on more than 95 percent of placements of unaccompanied children. And finally, grand jury [1:25:38] testimony in my home state of Florida revealed unaccompanied children were placed in the custody of [1:25:42] convicted felons in homes with multiple unknown male occupants. This is unacceptable. Becerra's refusal to [1:25:49] even acknowledge the issue when I brought it up to him as disqualifying. That is why I introduced the [1:25:54] Stop Gaps Act with Senator Moody that builds up upon the Trump administration's success on securing the [1:25:59] border by requiring the ORR to work with state and local authorities to guarantee safe and proper vetting [1:26:05] of all individuals and entities before granting them custody of an unaccompanied child. Under the Trump [1:26:10] administration, the border is secure, crimes from illegals are being stopped, and there are rigorous [1:26:15] standards in place to better protect children. Mr. Secretary, can you speak to the work that [1:26:20] your agency is doing to combat our social services being taken advantage of by bad actors and the [1:26:25] increased safety of our children? Yeah, I mean, it was a humanitarian crisis. What my predecessor [1:26:34] engineered with the Biden administration, they lost 425,000 children. They lost them because they ended [1:26:44] verification of sponsors. People were just showing up with fake IDs. There was no genetic testing. There [1:26:52] was no income inquiries. There was no ID verified validation. And we are now in the process of trying [1:27:02] to find those children. We've been able to locate 138,000 of them. They're very, very difficult to find. Many of them, as you say, have been trafficked. They've [1:27:13] undergone slavery, sexual abuse. We found one sponsor who picked up 42 children, and their address was [1:27:28] an empty container in a parking lot. And there was no effort. And in fact, the administration, Mr. Pesera, [1:27:37] specifically ordered people in my agency to end the verification process. They were more interested. [1:27:45] They explained that the objective was to move kids out of custody as quickly as possible. They made a lot [1:27:56] of mistakes. And now, thanks to President Trump, the amount of unaccompanied minors has dropped by 97%. [1:28:04] We have beds now for 7,600 unaccompanied minors, and only 2,000 of those are filled. We hold them until, [1:28:15] only until, but until we can completely verify the people who picked them up are actually family members. [1:28:24] And that has never happened during the last four years. Well, thank you for your service to our [1:28:30] children and to the unaccompanied minors and the changes that you have made from the previous [1:28:35] administration. I yield back. Ms. Tinney. Thank you, Mr. Secretary. I really appreciate your service [1:28:42] and your great responses today. I just wanted to commend you first for your very sensible position [1:28:48] on vaccines. I am, too, I'm a fan of the greatest tennis player in the world, Novak Djokovic. I see you [1:28:54] got to play tennis with him. When Javier Becerra, who you- I lost, by the way. Yeah, not surprised. [1:29:00] When Javier Becerra was here, I asked him, I was trying to get a waiver for Mr. Djokovic to be able [1:29:08] to play in the U.S. Open at the time, the number one tennis player in the world, and still, I would [1:29:11] argue, the greatest ever. And he described to me that they would not give him a waiver for the vaccine, [1:29:16] because he did not take the vaccine, because it was science. Although all, a lot of other American [1:29:21] tennis players were allowed to be there who were not vaccinated. So thank you for your common sense [1:29:25] approach to choice and pro-safety, as opposed to being anti-vaccine. I'm glad you clarified that [1:29:30] today. But I wanted to jump to a really important issue in my district, and especially in the state [1:29:36] of New York. During the COVID crisis in upstate New York, nursing home residents were isolated from [1:29:43] their families for months, sometimes years, and Governor Cuomo disgracefully called it protecting them. [1:29:49] But the reality is that people declined rapidly in isolation, and in most cases died without a loved [1:29:53] one present. That wasn't protection. It was a policy failure of enormous consequence [1:29:59] by Governor Cuomo and his administration that cost lives to thousands of seniors, not to mention [1:30:04] the deadly nursing home order that he required nursing homes to take COVID-positive patients, [1:30:09] where they didn't have the ability to handle these patients. Sadly, many of those same [1:30:15] bureaucrats responsible for carrying out this disastrous policy are still working in Governor Hochul's [1:30:20] administration. That's why I, along with my co-sponsor, Representative Larson, Fitzpatrick, [1:30:26] Panetta on this committee, and numerous others, have reintroduced what's called the Essential Caregivers Act, [1:30:32] a bipartisan bicameral legislation that guarantees nursing home and long-term care residents the right [1:30:38] to in-person access to a designated family caregiver even during a public emergency. It also directs CMS to [1:30:45] establish clear uniform safety protocols so visits can continue safely. Families and friends are [1:30:52] visitors. They are loving caregivers, and they advocate, they catch things maybe that a nurse or [1:30:58] staff would not, and cutting them out of the facilities didn't protect the seniors. It actually [1:31:03] accelerated their decline. I was wondering, because of this situation and the isolation of so many nursing [1:31:09] home residents, which contributed to serious physical and cognitive decline, independent of the virus, [1:31:16] by the way, given the department's guidance and generous access for designated caregivers in nursing [1:31:22] homes, do you share the view that maintaining family access during emergencies is a patient safety issue [1:31:29] and not just a quality of life issue? Absolutely, and we made a lot of mistakes during the [1:31:35] with the countermeasures during the COVID pandemic, including shutting down the schools, shutting down [1:31:40] businesses. Those things kill people, and that's one of the reasons, in my opinion, that we had the highest [1:31:46] death rate of any nation in the world. We lost 3,000 Americans to COVID for every million population. There were other [1:31:55] countries. Haiti, for example, had 14 per million population. So Nigeria, 14 per million population. We had [1:32:05] 200 times the death rate of other countries. We had 10 times the death rate of Europe, and a lot of it was [1:32:14] just because of bad policies that were that were not science-based, and we are not going to do that under [1:32:21] my watch. And one of the reasons that I think blacks were more much more likely than most likely to die [1:32:32] is because depriving them of access to a family member, their hospitals and their neighbors already [1:32:38] closed. Priving them of access to a family member meant that there was a reduced incentive within [1:32:46] the hospital to provide them with the kind of good care that they needed. My time has expired, but can [1:32:53] I just ask you, would HHS support codifying a federal right for essential caregivers and giving them access? [1:33:00] I personally would support that. My agency will work with your staff. [1:33:04] Thank you. We appreciate it. Thanks so much for your testimony. I yield back. Mr. Boyle. [1:33:11] Thank you, Mr. Secretary. I'm over here. Thank you. I'm hoping this can be constructive and have a [1:33:19] conversation with you. I have the honor of representing an incredibly brave constituent and proud fellow [1:33:25] Philadelphian, LaTanya Morrison. Her grandson, Ahmad Butler, tragically died of a rare form of brain cancer [1:33:33] at just six years old. Last year, she and her family marched 179 miles on foot from Philadelphia to [1:33:42] Washington, D.C. to bring attention to the critical need for childhood cancer research funding. I met her right [1:33:50] outside here on the Capitol steps and had a wonderful but also heartbreaking conversation with her and [1:34:00] had been working with her and her family since then, specifically working with her on a proposal [1:34:06] called the Ahmad Butler Childhood Cancer Hope for a Cure Act to make sure that no grandparent, parent, [1:34:14] or loved one has to go through what she and her family experienced and continue to experience [1:34:22] this day. That hole in her heart will never go away. So my concern is, and I have no doubt that [1:34:30] that you have concern for this constituent I just described and all those who particularly have [1:34:35] lost a child to this horrible form of cancer, but at the same time, your administration or you as [1:34:46] secretary in this administration are carrying out hundreds of millions of dollars in cuts to cancer [1:34:53] research funding. So I was wondering if you could explain why you're doing that and does that really [1:35:00] get us anywhere closer to getting a cure that we all want to cure this horrible disease? [1:35:08] First of all, thank you for sharing that heartbreaking story and you know the worst thing that can happen [1:35:15] to a human being is to lose a child or a grandchild and it's something that I hope that I never have to [1:35:22] experience. And my heart goes out to that family. The one agency that within my agency and the only agency [1:35:33] within NIH that actually got a budget boost from our proposal was NCI and we, you know, were absolutely [1:35:42] committed to cancer research and particularly pediatric cancer research. I invite you congressmen to call me [1:35:52] to tell me if you're, if there are programs, some of our programs were duplicative so we've moved them [1:36:00] around and it looks like there was a cut but I don't know of any major cancer studies. I'm happy to talk to [1:36:09] you about it. You reach out to me. If you could, after this, sorry, just because you know we're time [1:36:14] limited and I have under a minute now. So I appreciate that and if if our staffs could follow up or you and I [1:36:20] directly with one another after this and I would just ask if I could get your pledge, not for me, [1:36:27] but for my constituent, if I could get your pledge that you will work with me, my staff, the White House, [1:36:35] to get the president to declare childhood cancer a national emergency which would, as you know, help [1:36:43] unleash additional resources and really focus the attention that we need on childhood cancer. [1:36:50] Yeah, in, in theory I like the idea. Let's talk about the details. We've already done, [1:36:58] the president already signed an executive order on pediatric cancers. I was there at the time. I, [1:37:04] I, so I need the devils in the details but in, in the theory, I, I absolutely support [1:37:12] that proposal and I'm happy to work with you and your staff on it. Thank you and I, I yield zero time [1:37:19] back. Mr. Chairman, I seek recognition to ask unanimous consent to enter into the record, [1:37:24] the exact transcript of Secretary Kennedy's remarks that we discussed regarding the reparenting of black [1:37:30] children. Without objection. Thank you. Um, Ms. Fischbach is recognized. Thank you, Mr. Chair. [1:37:36] And, um, Secretary Kennedy, I just, I'm over here. I know it gets confused. There's lots of us and we're [1:37:41] running around a lot and I just want to tell you, thank you so much for being here and thank you so [1:37:45] much for your willingness to answer questions. I, it always amazes me that people even agree to come [1:37:52] to these committees because we have you sit there on the hot seat for hours on end. Um, we all get a run [1:37:58] around, get coffee, whatever it is. Um, and, and, uh, the witness is sitting there. So I genuinely [1:38:03] appreciate that you're here and that you're answering questions very honestly. And, and Frank, [1:38:08] I just have to not tell me that I had a choice. Okay. Well then, fair enough. I am happy to be here. [1:38:16] Thank you very much. And, and just so you know, I'm from Minnesota. I represent a rural district and [1:38:21] I think, you know, rural Americans face heightened healthcare challenges. Um, while nationally, [1:38:27] healthcare is seeing increasing staffing, uh, costs, staffing shortages, shortages and increasing [1:38:32] wait times. All of these problems are amplified in rural areas, um, where care is already more limited. [1:38:38] And, uh, I know that we, um, counteracted that with the rural trend health transformation program [1:38:44] in the working families tax cut bill last year. Um, and, and significant funding was to strengthen [1:38:50] the healthcare in small towns across, uh, across the country. Um, I know in my office and another [1:38:56] Minnesota offices, uh, we sent letters of support to CMS in favor of the application and the funding. [1:39:02] Um, but the rural healthcare transformation program alone is not enough to solve, uh, those rural healthcare [1:39:09] issues. And so I am wondering if you could just, uh, talk a little bit about what's the administration's [1:39:14] plan to reduce health disparities in rural areas and what specific actions are you taking to ensure [1:39:21] quality and affordable rural healthcare remains a priority within HHS? I mean, we've already finalized [1:39:28] rules for site neutrality. I think that will help. Um, the administration would love to work with [1:39:35] Congress on the wage, um, area index, which I think also will help. And then, you know, we are continuing, [1:39:44] we, we made the biggest investment ever in history on rural healthcare. We're continuing to make [1:39:50] additional investments. I mentioned the, I think 135 million, uh, that I, uh, allocated for community, [1:40:01] uh, health centers, uh, last week. And so this is, uh, this is a priority for the president. It's a [1:40:10] personal priority for me. And, you know, if you have ideas of other things we ought to be doing, [1:40:15] we'd like to hear them. Well, and, and Mr. Secretary, I appreciate that because it is such a critical part of [1:40:23] and like I said, representing a rural area healthcare, having the access to that healthcare. [1:40:28] And I know that Mr. Estes had talked a little bit about specialty care in rural areas, but [1:40:32] it is absolutely critical for the survival of our small towns and, and the health of our individuals [1:40:38] who live there, um, that we have that, that we have healthcare available. And, um, I think some of our [1:40:44] provisions for telehealth and things like that have really moved things forward. But, um, I, I just [1:40:49] sincerely appreciate, um, the ability that your offer and, um, and the, we have worked with, [1:40:54] uh, um, worked with the department. And so I appreciate that. And I'm actually going to yield [1:41:00] back 35 seconds. Thank you. Um, Mr. Moore. I'll take that 35 seconds if I can. [1:41:06] I didn't give it to you. Yeah, I understand. Sarah, the most important thing you said today [1:41:10] in Congress, that Congress has allowed 39 trillion dollars of debt. And so that's forced you and your [1:41:14] agency and your amazing team. Um, some of which I know are very debt focused, Mr. Mr. Andres. Um, [1:41:22] you had to tighten your belt. I just want to say as a, as an American and as a member of the [1:41:26] bipartisan fiscal forum, I can't thank you enough for doing your part, uh, doing the hard part to be [1:41:31] able to find redundancies. You'll get criticized for it, but, but it matters and, and every agency [1:41:35] needs to be doing it. So thank you for that. Um, I've mentioned to you in, in, um, private how much [1:41:41] I appreciate the administration's focus on autism. You may recall my, my 10 year old, [1:41:46] my 10 year old Winnie is neurodivergent on the autism spectrum. He's the joy of my life. He's um, [1:41:52] but that's tenfold, uh, for my wife and for his younger, older and twin brothers. Um, and I, I want to [1:42:01] just highlight that I'd never had a ton of expectation on what we could uncover from scanning the existing [1:42:09] research. And, and Lucas, I've always appreciated the administration's focus on this though. Uh, [1:42:14] but I was, I was underwhelmed with what we ultimately put out. My wife was hurt and she felt [1:42:21] for a split second until we, she came to her senses and we talked about this, that there was any way she [1:42:26] was responsible. Um, we don't even know if she took Tylenol during her pregnancy, but that, that, that was a [1:42:32] hurtful moment for her. And I just want to encourage the administration and your team to keep at it. [1:42:37] And I think there's, there's more we can do here with low expectations. I don't expect much to be [1:42:41] able to figure out what the ultimate causes are. That's not an easy thing to do, but I do think [1:42:45] there's, there's more that we can do and, and, and, um, we can, we can build past what, what I was [1:42:49] ultimately underwhelmed with. So again, thank you for the administration's focus and I think we can do [1:42:54] more. Um, regarding something that's very important legislatively, I introduced HR 5343, um, the [1:43:02] insurance, ensuring patient access to critical breakthroughs product act, which builds on one of the biggest [1:43:07] wins from the Trump administration. We didn't fully get it implemented, but the, um, MSIT was, uh, [1:43:13] a significant policy for Medicare coverage for breakthrough medical devices. This bill requires [1:43:18] CMS to provide temporary medical coverage for treatments or devices that receive breakthrough [1:43:23] designation from the FDA. If a treatment can meet the FDA's burden of proof of safe and effective [1:43:28] and other requirements for breakthrough designation, there's no reason Medicare shouldn't be able to [1:43:32] provide temporary medical coverage while CMS completes its review for permanent coverage. [1:43:37] Um, and this is a brainchild of the Trump's first administration. We've talked about this. We all agree [1:43:42] in principle about this. It's, it's difficult to, to, to, to move in some cases, but can you update this [1:43:48] committee on your efforts to implement a policy like this through any type of executive rulemaking? [1:43:53] Um, I think, are we in, uh, we, we will have an announcement soon and we're happy to work with you on it. [1:44:11] This is, this is really important and builds on the success from the Trump first administration. [1:44:15] Uh, there is, as I'm learning too, FDA and CMS, they operate in parallel, they operate in tandem, [1:44:25] and sometimes there's different regulatory, um, constraints that they're going with. We've got to be able [1:44:30] to, to, to work through those. And, and if that's all this ultimately is, is just a, a difference between those two, [1:44:36] those, those two structures. I mean, this is a good policy that will, will help improve people's lives [1:44:43] and it will keep safe and effective technology, um, from, it'll, it'll enhance safe and effective [1:44:48] technology and get that into the, into the healthcare system. [1:44:51] Yeah, and I agree with you. And, uh, you know, particularly if it's a temporary, uh, if it's a temporary, [1:45:01] uh, payment, uh, payment that can be revoked, that is intended to be temporary, it's not permanent. [1:45:10] As you know, it's very, with a lot of medical devices, it's, uh, we find problems with them later. [1:45:17] We had tons of bipartisan support on this committee. Some that even didn't support it last time are now [1:45:22] on board. It's a, it's a great initiative and I look forward to working more with you. Thank you. [1:45:25] You too. Mr. Byer. Thank you, Mr. Chairman. Mr. Chairman, I'd like to yield such time as he may [1:45:31] require to the ranking member, Mr. Neal. Thank you, Mr. Byer. Mr. Chairman, I want to make, uh, [1:45:36] this moment an opportunity to correct the record on the No Surprises Act, which was passed out of [1:45:40] this committee with bipartisan support. I wrote that legislation. I know what was in it. And every [1:45:46] Republican on this committee at the time sided with me and we passed it out of the committee [1:45:50] unanimously and had a big victory on the House floor. Like any new program, it needs some help for sure. [1:45:56] But the notion that the suggestion we heard from the secretary that somehow that it languished [1:46:01] under Biden is simply not true. The national, uh, issue here before us, it's still the regulations [1:46:07] that were implemented. It created new protections against surprise medical bills for 200 million [1:46:12] Americans. Millions of families benefited from what we've done here every single year. This is a [1:46:17] victory that Democrats and Republicans on this committee should take credit for. And I yield my time [1:46:21] back to Mr. Byer. Thank you very much, ranking member. Uh, Mr. Secretary, the Agency for Healthcare [1:46:29] and Research and Quality, AHRQ, has been given an essential task by Congress. It's the only federal [1:46:34] agency specifically dedicated to improving healthcare delivery for Americans. It was actually a Ronald Reagan [1:46:39] creation. Making people's experience with healthcare easier and ensuring that taxpayer dollars [1:46:43] are spent on effective, affordable, and safe care. But Mr. Secretary, your department's budget [1:46:49] justification included 106 million dollars in cuts to AHRQ. The White House budget request was 129 [1:46:55] million in cuts. The budget appendix listed 116 million in cuts. The budget also lists more than 250 [1:47:00] staff at AHRQ, but widely available reports fewer than 100 people remain at the agency. Mr. Secretary, [1:47:07] these discrepancies read either as deliberate misrepresentation or basic accounting errors. [1:47:12] Can you clarify how many millions of dollars you intend to take away from research designed to give [1:47:17] American access to the best, most affordable healthcare? Uh, thank you for that question, [1:47:26] Congressman. Uh, Dr. Klein, who is running it, who is a Yale-educated physician, who is running AHRQ, [1:47:35] is still has hundreds of staff and the agency is operating. Thank you. Well, let me shift to United [1:47:43] States facing a mental health crisis. As you know, nearly a quarter of U.S. adults had a mental illness [1:47:48] in the last year, reported 30 percent of high school students. You recently led an agency reorganization. [1:47:54] There was a big scare in January where $2 billion was cut from SAMHSA for substance abuse and [1:48:00] prevention and mental health. There was a bipartisan outcry and it was restored. Um, but there's also [1:48:05] this real concern that there's a gutting of SAMHSA. I co-chair bipartisan the House Mental Health Caucus. [1:48:12] We'd love to have a bipartisan briefing on the reorganization. We request that back in December, [1:48:17] and I'd love for you to commit to briefing from members in Congress of the bipartisan Mental Health Caucus on the [1:48:23] current state's status of the mental health programs at SAMHSA, CDC, and NIMH. [1:48:28] Uh, I, I strongly support SAMHSA. It's a private mental health and [1:48:35] particularly addiction are, uh, are, uh, priorities for me, strong personal interests, [1:48:42] and, but also their, um, their national catastrophes. Uh, there were termination letters that went out [1:48:51] under SAMHSA. That was a mistake. We immediately, uh, recalled them within 24 hours, and I'm committed [1:48:59] to the continuing, uh, continuing operations in SAMHSA. I'm happy to meet with you about it. [1:49:06] Very great. Thank you very much, Mr. Secretary. Mr. Chairman, I yield back. [1:49:12] Ms. Van Dyne. How are you doing today? I'm great. [1:49:17] I appreciate you being here, and I know a lot of questions have been asked, [1:49:20] and some of the, uh, the accusations have been just outrageous. I have a bunch of stuff I wanted [1:49:25] to ask you about, but clarify. Your qualifications have been called into question because you [1:49:31] did not father a black child. How many different, um, um, HHS secretaries have had that privilege? [1:49:39] Have I had a privilege? Ridiculous question, isn't it? You know the answer? Zero. Um, [1:49:44] do you know how many, um, Democrat appointed, um, HHS secretaries have had a medical degree? [1:49:49] I think there may have been of the 26. No. Zero. Zero. Not a one. In the history. Yeah. Yeah. [1:49:58] Not a one. I think there may have been two with medical degrees. Yeah. It, it, there's a lot going [1:50:05] on that, that your office is handling and doing so well, and we're so proud of. On, you know, we, [1:50:12] we had, and I'm looking for, uh, for this photo, we had a previous secretary who I asked questions [1:50:18] about what was going on with the waste, fraud, and abuse. And I don't know if you recognize this. [1:50:22] I asked secretary Becerra the same question. What's going on at one, four, five, four, five [1:50:27] Friar streets in Van Nuys, California. Does that recommend, does that ring a bell to you at all? [1:50:33] No, I could guess. Why didn't you tell me? We had over a hundred different licenses for [1:50:40] hospices. Yep. Right at this address. And we asked him what he was doing about it. Basically nothing. [1:50:46] Can you walk through what your office is actually doing on the waste, [1:50:49] fraud, and abuse to make sure that we don't see this happening again? We've already shut down [1:50:52] 500 hospices in Los Angeles. Um, and, uh, and incidentally we haven't had one call from [1:51:03] Congress or anybody else about complaining because clearly these were fraudulent. A lot of these places [1:51:11] you'd say we, they'd have, um, they were just invented addresses. They would obtain patient [1:51:18] identification or they would pay people. They were going and giving people in poor neighborhoods, [1:51:24] flat screen televisions, 600 bucks. And then they would enlist them and enroll them in the hospice. [1:51:31] And we were paying them $6,000. And, um, and the, and the interesting thing is almost none of them ever [1:51:42] died. Oh, typically they stay in a hospice is about 18 days. These people stayed forever. Nothing ever [1:51:50] happened because they weren't actually there. They were just invented. And it was operated by certain, [1:51:56] uh, foreign communities, a lot of Estonians and a lot of Armenians. And there's an incredibly great [1:52:04] Armenian community in, uh, in Los Angeles. And very few of them were involved in this, but the ones that [1:52:12] were, were making hundreds of millions of dollars out of fraud and just stealing money from us. I think [1:52:19] the cost has been about $5 billion. And it's ridiculous. And I don't think a week goes by where [1:52:24] you're not, your office is not uncovering further fraud. And what we're finding in California is now [1:52:29] they're going after the people who are uncovering the fraud. They're actually trying to make it [1:52:32] illegal for some of these, uh, these, these journalists to even do their job and uncover it. They're, [1:52:37] they're not upset about the fraud. They're upset that it's being uncovered and your office is helping [1:52:41] to do that. I had a ton of questions I wanted to ask you about affordability. You know how expensive [1:52:46] health care is, not health insurance, but health care. There's a big difference. But like an association [1:52:51] health plans, what's, what's your thoughts on that? And I know not everything is going to be within your [1:52:55] purview, but what are your thoughts on making more competition? That's what we need. And we need [1:53:01] outcome-based care. You need more HSAs. President Trump wants to take the money away from the [1:53:07] insurance company. And so Obamacare was passed after, in the years after Obamacare was passed, [1:53:14] the share price of the insurance companies, the share value went up a thousand percent. [1:53:18] It's still up 300% compared to about 150% for the S and P 500. And so they are making money hand over [1:53:28] fist and the American people who were supposed to benefit their premiums have not gone down. They [1:53:34] had the illusion that they went down slightly. President Trump is actually taking steps that [1:53:40] will drive the premiums down and give better quality care to Americans. [1:53:44] I appreciate that very much. I yield back. Thank you. Now the chair recognizes Mr. Arrington for four [1:53:51] minutes. Thank you, Mr. Chairman. Mr. Secretary, good to see you. Thank you for your leadership and your [1:53:56] service to our country. Good to see you again. [1:53:58] We have the best system and the worst system. I mean, the best docks in mid-levels, the best [1:54:03] facilities and technology, and yet we have the worst, most inefficient system relative to the rest of the [1:54:11] developed world. When you get to the cost and quality intersection and it just it drives me crazy. [1:54:18] I think at the heart of that for me personally, it's market dysfunctions and distortions, right? [1:54:26] I think transparency, choice, competition, that's the best way to deliver value for taxpayers and for [1:54:33] patients. And taxpayers and patients aren't getting their best bang for the buck here. And it's bankrupting the [1:54:40] country. And it's putting people, families, working families further and further from access to good [1:54:48] care for their for their families and the people that they love. So the current incentive structure [1:54:55] is distortionary and it inhibits these forces, creating sort of monopoly dynamics, anti-competitive [1:55:04] behavior. So so I spend most of my time thinking about health care reform with respect to that [1:55:10] framing. Some examples in the in the world of drug innovation, there's patent abuse where [1:55:23] biotech companies are extending the life of their patent without making novel contributions using patent [1:55:29] thickets and essentially having these exclusive rights extended and gouging all of us and we're allowing [1:55:36] it to happen. I mean, I'm quite frankly, not putting the incumbent market participants at fault. [1:55:42] It's the perverse incentives that we've allowed to persist. One simple one for me is this disparity [1:55:50] between what we pay hospitals and physician groups for the same outpatient service. And the effects of [1:55:58] that are not just higher premiums on seniors in Medicare, higher costs for all of us as taxpayers, [1:56:05] but there's a giant sucking sound of independent physician groups and docs into hospital systems, [1:56:12] leaving us with less choice. So those are just top of mind examples. You are a breath of fresh air. [1:56:22] We may have disagreements on on on how to attack some of these problems, but you have a rare curiosity [1:56:30] and objectivity and objectivity and independence that you bring to the to this leadership, this [1:56:38] incredibly important leadership post for our country. And I think the problem with all these [1:56:44] distortions is that we have too much special interest, too much incumbent resistance, too much parochial [1:56:54] politics. And everyone in this town seems to be captured by it to to some extent or to one extent [1:57:04] or another. You just seem to have been able to, through the fiery furnace of public scrutiny over [1:57:11] the years. I don't know what it is, but I love that you can come to this. I believe with all my heart that [1:57:17] you just want to do the right thing for the country and for for all participants and for especially [1:57:23] our patients. Give me in the last 25 seconds your best shot on the monopoly forces and anti-competitive [1:57:32] behavior. What are one or two things that you think this body could do to address that and go a long [1:57:38] way to make things more affordable for working people in this country? Thank you very much for those very, [1:57:43] very kind and undeserved words. 10 years or 15 years ago, 80 percent of the doctors in our country were [1:57:51] independent, and 20 percent were corporate. Today, 20 percent are independent, 80 percent are corporate, [1:57:59] and the number that are independent are dropping precipitously because the economic forces that [1:58:05] are that are a result of these perverse incentives. Site neutrality, which we're fixing, is key to that. [1:58:13] The wage area index, reforming the PBMs, that is one of the most anti-competitive forces [1:58:21] out there, and we're doing that. You've given me legislation, which I'm now looking forward to [1:58:27] implementing through the regulatory process, and then we need the FTC to file some cases, [1:58:34] and it's already doing that in the PBM space. So those are just a few of the things that we ought [1:58:41] to be doing, and thank you for raising all those important issues. God bless you. Thank you. Thank you. [1:58:47] I remind members that votes have already been called, but we're going to try to work as deep as we can [1:58:52] into the hearing while votes are going on. So now I recognize Mr. Panetta from California for four minutes. [1:58:58] Thank you. Thank you, Mr. Chairman. Thank you, Mr. Secretary. Thank you to your staff for being here. [1:59:02] As we've heard today, there unfortunately are a number of issues that I believe are causing people [1:59:07] to get a little exhausted because they are scared of your agenda and with your leadership. An agenda that [1:59:14] is threatening to the health and safety of our nation and the lack of leadership that has led to two [1:59:19] major vacancies in your department. At the CDC, Dr. Menares was fired after only 28 days, [1:59:26] reportedly for not going along with your anti-vaccine agenda. But since then, August of last year, [1:59:32] the CDC has been without either a director or even an acting director. Now, I know you have [1:59:37] Jay Bhattacharya overseeing the CDC, but he's also overseeing NIH, managing over 27,000 employees and two [1:59:45] campuses that sit hundreds of miles apart. Furthermore, at CDC, Doge slashed whole offices, [1:59:53] resulting in almost 20 percent of its staff either being fired or quitting, and there's even been [1:59:58] hiring freezes there as well. For most of the past year, you've had people close to you act as proxies, [2:00:05] and in some cases, you've even taken unilateral actions like you did last May when you rolled back [2:00:10] COVID-19 vaccine guidance for pregnant women. Additionally, people should be aware that now, [2:00:15] that after passing the 210-day statutory limit for temporary leadership at CDC, Bhattacharya can no [2:00:23] longer legally perform the full range of director duties. That means that without an acting permanent [2:00:28] chief, tasks that congressional statutes explicitly reserved for the CDC director can only be performed [2:00:35] by you, the HHS secretary. That includes policy decisions, like adopting vaccine recommendations [2:00:41] for the CDC's Immunization Advisory Committee. The Surgeon General's post is also vacant. Now, [2:00:47] I know that Casey Means, a MAHA devotee with no active medical license and not a practicing [2:00:53] physician, had her confirmation hearing two months ago, but she performed so poorly, including her [2:00:58] unwillingness to commit to recommending vaccines, that the Senate has not scheduled a vote. That fact, [2:01:04] and the fact that there's 1,500 cases of measles that have occurred this year throughout the nation, [2:01:09] the fact that a recent E. coli outbreak has sickened people, it seems that the Senate is having a hard [2:01:15] time with your agenda. I know that the literal holdups of these positions are from the Senate, [2:01:21] but it's clear that you and the Senate are having a hard time agreeing on people. The issue is, [2:01:26] Mr. Secretary, that without leadership at DHS, if there is a crisis, if there is an outbreak, [2:01:31] we lose surveillance. There's delayed recognition of problems, there's low response times, [2:01:36] there's mixed messaging, and a loss of real-time guidance. These vacancies hurt America's health, [2:01:42] and they make Americans less safe. There's some disagreement with you in the White House as well. [2:01:47] You've heard of gliophosphate, the herbicide, correct, Mr. Secretary? Yes. [2:01:51] And you called it one of the likely culprits in America's chronic disease epidemic, yet the [2:01:56] president ignored your advice, and he signed an executive order that bolstered the production [2:02:01] of that weed killer. We all know what happens when it comes to your vaccine policy, but according to [2:02:06] a recent YouGov poll, nearly three-quarters of Americans believe that vaccines are somewhat safe [2:02:12] or very safe. And now the courts seem to be getting tired of your agenda. In March of this year, [2:02:16] a federal court paused some new vaccine policies from HHS, including reducing the number of jabs recommended [2:02:22] for children and reconstituted a vaccine advisory committee. Mr. Secretary, your stance on vaccines [2:02:28] and the vacancies in the public health leadership coincide with a continuing decline of public trust [2:02:34] in federal health authorities, something that's only gotten worse with the current administration. [2:02:39] We need credible voices when it comes to the health and safety of our nation. We need a CDC [2:02:44] director that we can trust. We need a surgeon general that we can trust, because right now, Mr. [2:02:48] Secretary, many, many people in my district and all across the country are having a hard time trusting [2:02:54] your agenda. I yield back. Mr. Feenstra. Thank you, Mr. Chair and Ranking Member Neal. Thank you, [2:03:02] Mr. Secretary, for taking the time to be here today. Greatly appreciate it. Last year, we Republicans passed [2:03:08] a working family tax cuts bill, the largest tax cut in American history. And working alongside with your [2:03:14] department, we included $50 billion in rural health care transformation programming to create high [2:03:20] quality and affordable health care for rural communities. I'm so proud of our state, Iowa, [2:03:25] that's one of the four front runners and leaders in advanced care and delivering some of this dollars [2:03:30] to our farmers, our families, and our seniors. One of the biggest problems we're having in rural [2:03:36] America, rural Iowa, and I'm the leading voice on this, is the diminishing access to maternal health [2:03:43] care. We have women traveling 50 to 75 miles or more for maternal care. And I understand historically [2:03:51] low patient volumes make it feasibly burdensome for small rural hospitals to provide delivery services, [2:03:58] but currently less than half of our rural hospitals in the U.S. have labor and delivery services, [2:04:03] and they continue to recede every year. Maintaining access to maternal health care is incredibly [2:04:09] important and vital for rural communities. Can you expand on what we can do and how [2:04:14] I can work with your department to change the tide in this area? Well, first of all, thank you for [2:04:23] raising that issue. President Trump is absolutely committed more than any president we've ever seen [2:04:32] in preserving rural health care. It's in crisis right now. As I pointed out earlier, we've lost 120 [2:04:41] hospitals since 2010, and his investment in the rural health transformation fund, which you voted for and approved, [2:04:51] is the biggest investment in history in rural health care. And it's a five-year investment. It increased the influx of federal dollars [2:05:01] into rural health care by about 50 percent every year for the next five years. [2:05:07] We're also doing other things in my agency to funnel additional dollars to rural health care, and [2:05:16] that includes the $135 million that I signed approved last week for community development health centers, [2:05:25] which are primary in rural areas. So with that, we also have a shortage of specialty doctors, whether it be [2:05:32] OBGYNs, whether it be oncologists and stuff like that. Again, come from a rural state of Iowa. Is there anything [2:05:38] that we can do to try to keep these specialty care doctors and even family docs in rural America? I mean, [2:05:46] it just seems like they're all gravitating to the urban centers, and we're having a hard time recruiting [2:05:54] family doctors, oncologists, OBGYNs. Anything that you can offer, any suggestions you can offer to help [2:06:00] rural America, rural Iowa in that area? Well, we've just finalized and promulgated the site [2:06:06] neutrality rule, which should help. The biggest thing that needs to be done is fixing the wage [2:06:14] area index, and that's something that has to come from Congress. We'd love to work with you on that. [2:06:20] Well, thank you. I appreciate all your department is doing, and Secretary, thank you so much for being [2:06:25] here, and I yield back. Thank you. Ms. Smelly-Takas. Thank you, Mr. Secretary. I want to begin by [2:06:34] thanking you for your leadership on an issue that is very important to me and so many Americans, [2:06:38] and that is ending the inhumane and outdated animal testing in this country. Hundreds of thousands of [2:06:45] dogs, cats, monkeys, rabbits, and other animals remain in captivity for painful and unnecessary [2:06:50] procedures, even though studies have shown that animal testing in medicine frequently fails to [2:06:56] accurately predict human conditions. We are seeing real progress by this administration. The NIH is [2:07:01] investing 87 million in a new center to develop standardized lab-grown 3D tissue models and has [2:07:07] announced that grant funding may be used to support finding homes for retired lab animals, and you've [2:07:13] also asked agencies to prioritize non-animal methods, and you've also ordered a review to end the importation [2:07:20] of monkeys from Asia for testing. I just want to urge you to stay the course. I'm very happy to work with [2:07:26] you to continue to make progress here to end this cruel, costly, and antiquated practice. I also want [2:07:32] to thank you and the President for working with our New York delegation to fully fund and staff the World [2:07:38] Trade Center 9-11 Healthcare Program. My district is home to many first responders, and unfortunately, [2:07:44] sadly, they're still suffering from 9-11-related illnesses, so I appreciate your efforts. Also, [2:07:51] Secretary Kennedy, as you know, one in five adult Americans are currently living with mental health [2:07:58] condition, including over 3.2 million New Yorkers. Timely and convenient access to mental health [2:08:04] professionals is essential for individuals to receive the care that they need. We must do more to [2:08:10] integrate mental health services in primary care settings, and that is why I've introduced the Complete [2:08:14] Care Act, which incentivizes primary care providers to integrate mental health specialists such as [2:08:20] psychiatrists, psychologists, and substance abuse counseling into their practices and provide [2:08:25] a temporary increase in reimbursement to help cover the costs. So my question is, is that a piece of [2:08:30] legislation? I know this is a priority for you in the administration. Is that a piece of legislation that [2:08:34] you could potentially support? Yeah, and we will work with your office on that, and on animal testing, there's [2:08:42] 25 million dollars to NIH in the proposed budget that we've proposed to, again, find other alternatives to [2:08:52] animal testing. We're already doing a lot of work on organoids, on tissue chips, on AI, which actually are [2:09:01] more accurate and faster and cheaper than animal testing. So it's part of our larger effort to speed drug approval. [2:09:11] Well, thank you very much, and again, I lend my support to you and however I can help with those efforts. [2:09:16] One last issue I do want to bring up is women's health. Recently, the HHS hosted its first ever [2:09:21] national conference on women's health. It's an important step in elevating the conversation around [2:09:26] women's health care access and research that has been chronically underfunded in both the private [2:09:31] and the public sector for decades. My question is, how does the administration plan to advance its goals [2:09:36] of improving health outcomes for women, particularly in underserved areas that have historically faced [2:09:41] limited investment and resource constraints? You know, part of that for rural areas, [2:09:51] the Rural Health Transformation Program hopefully will expand those abilities to treat maternal health. [2:09:59] We are putting enormous investments into maternal health, and I could go through those with you in [2:10:05] detail, but we're spending literally hundreds of millions of dollars on it. We've got multiple programs, [2:10:15] programs, and I just would mention again our Paranoidal Pilot Program, which has reduced, [2:10:24] it has 220 hospitals that are involved. We provide them protocols reducing maternal [2:10:31] mortalities, and we have succeeded in those hospitals in reducing maternal mortalities by 41 percent. [2:10:38] Well, I appreciate that, and I don't have a rural area. I do represent New York City, Staten Island, [2:10:43] and Brooklyn, but we do have a lot of safety net facilities, and we'd love for your administration's [2:10:48] attention to that as well. Thank you so much. Thank you. Thank you, Mr. Schneider. Thank you. [2:10:53] Mr. Stracheter, do you know who Alexander Fleming is? He invented penicillin. How about Gerhard Domach? [2:11:00] I guess you're not going to answer. He invented sulfuminid drugs. How about Salmon Waxman? Still nothing. Okay. [2:11:09] Well, he invented streptomycin, drugs that we use on tuberculosis. Would you agree that these three people [2:11:15] helped make people healthier, the medicines they discovered? I would say yes. All right. Thank you. [2:11:21] What's interesting is all the— Did you say thalidomide? Did you say thalidomide? I did not. I said [2:11:26] streptomycin. Okay. So, European—all of them were born in Europe. Now, Salmon Waxman moved to the United States [2:11:33] in 1910. He actually left Ukraine because of anti-Semitism, same time my grandmother did. [2:11:39] What unites them is all three won the Nobel Prize. Salmon Waxman won it as an American citizen. [2:11:47] Fleming was Scottish. Domach was German. The UK has 29 Nobel Prizes in medicine and physiology. [2:11:55] Germany has 16. The United States has 93. But if you expand it beyond just medicine, [2:12:00] and now I'm going to focus on the National Institutes of Health. From the National Institutes of Health [2:12:06] website, they've identified 174 scientists who have either worked at NIH or done research funded by [2:12:14] NIH that have earned them a sole or shared part of 104 Nobel Prizes. NIH has led the world in scientific [2:12:23] research, leading to extraordinary breakthroughs, changing the lives—not just American lives, [2:12:28] but lives around the world for the better—making Americans healthier and people around the world [2:12:34] healthier. NIH is the crown jewel of American research. Mr. Secretary, are you familiar with SMA? [2:12:40] SMA? SMA. SMA is Spinal Muscular Atrophy. [2:12:48] Yeah. So it is a disease. It's a progressive rare genetic disease that affects the motor neuron cells [2:12:54] of the spinal cord. Children with SMA don't walk. They can't sit up. If they're not treated, 90% will die [2:13:02] before the age of two. Are you familiar with gene therapies? Of course. Okay. Well, gene therapies, [2:13:09] do you think it's worth exploring the possibilities for gene therapies like we did in other things at NIH? [2:13:15] We are doing that aggressively. We're putting tens of millions of dollars into it, and we are [2:13:21] accelerating the approval of new— Okay. Well, thank you. I appreciate that. Because SMA, [2:13:25] which is a death sentence for children age two, now has a treatment developed in my district with [2:13:31] research support from NIH, now a drug called Zolgenza, that instead of dying at two with this [2:13:39] gene therapy, these children are achieving the milestones parents want for their children of [2:13:44] sitting up, feeding themselves, even walking. We believe it is a cure that these children will now, [2:13:50] instead of dying at the age of two, live out their full lives. And this is the development that is [2:13:55] happening because of research in places around the world, in this country, all supported by NIH. [2:14:02] And we're here today to discuss a budget that you brought before Congress, where you're proposing [2:14:08] to shrink NIH funding, the world's premier funder of medical research, shrink it by $5.7 billion. [2:14:16] The CBO predicts that this reduction could lead to 50 fewer drugs coming to the market over the next 30 [2:14:23] years. Drugs that can cure diseases, save lives, make America healthier again, and you're cutting that [2:14:31] funding. You're diminishing science. You're making it harder for Americans to lead. I picked those three [2:14:38] people—Fleming, Dommach, and Waxman—because at the turn of the last century, scientists from around the [2:14:46] world came to the United States because they were chased out of their countries in Europe. [2:14:51] The actions you and this administration are taking are chasing American scientists away from this [2:14:56] country and fueling the research and development and drug commercialization in places like China. [2:15:03] You are not making Americans healthier. You're making Americans sicker, hurting our economy, [2:15:08] and making our children's future less prosperous, less secure. You should be ashamed of yourself. I yield back. [2:15:14] As votes have been called, the committee will stand in recess until immediately following the vote series. [2:15:21] The hearing will come to order. We'll recognize Mr. Bean. [2:59:12] Thank you very much, Mr. Chairman. Good afternoon to you. Good afternoon, Ways and Means, and good [2:59:16] afternoon, Mr. Secretary. Thank you so much for your patience in being here today. For the record, [2:59:21] everybody needs to hear this. For the record, the previous administration didn't have an advanced degree [2:59:27] or wasn't a physician, but I'm going to tell you what you did under your leadership. Great things are [2:59:33] happening. You've elevated the talk about let's get healthy so much that just last year, I went to [2:59:40] a food production facility in Jacksonville, Florida, Danone, which makes Activia yogurt and Oinkos Greek [2:59:48] yogurt, silk, international coffees. We did a little tour, but before that, their leadership says, [2:59:54] we're changing all our ingredients. We're going to go ahead and voluntarily remove red dyes. We're matching [3:00:01] what our production facility does in Europe to make healthy. We're doing that voluntarily, which is [3:00:07] exciting. I went last month. You did, and this is voluntarily, all of the medical schools have [3:00:14] voluntarily said, let's change our curriculum and let's add nutrition and let physicians say that food [3:00:21] is medicine. You did that. That was just what happens. You've also made the bean family change our diet, [3:00:30] too, and we're having a new focus on salads and whole foods. What's next? How can we continue the focus [3:00:38] of making America healthy again, Mr. Secretary? Thank you. Thank you, Congressman Bean, for pointing that [3:00:49] out, and I will say this. In the history of HHS, there have been three medical doctors. One of them [3:00:57] appointed by Tom Price out of 26 total, and none of them ever appointed by a Democrat. There's never [3:01:06] been a Democrat. They didn't have the conversation or leadership. You're out there doing it. I don't [3:01:11] think we saw them doing push-ups anywhere either, so thank you so much for doing that. How about, I know [3:01:16] you're leading the efforts on fraud. We'd love to get our money back. What's next on fraud? What can we do [3:01:21] to assist you and your department on making sure that every dollar goes to its intended recipient? [3:01:26] Yeah. I mean, we're driving the use of AI across all the federal agents of government. We're leading. [3:01:32] We now have over 90 percent of reviewers at FDA using AI. We're using it to detect fraud. We've changed [3:01:43] the system under the Biden administration. We were paying claims that we knew were fraudulent before we [3:01:51] paid them. It was called the pay and chase system, and we've ended that now. So now we look at every [3:01:58] claim and make sure that it is not fraudulent. We have a bill, the bean bill. It's the doge and spending [3:02:04] bill. It says, let's check. Let's check to make sure that it's done first. So put a good word in me [3:02:09] with Secretary Besant on that bill, and we'll do the same here. And then I also want to say, wouldn't it [3:02:17] be better if Americans took more control of their health? I've got a bill that lets everybody, or at [3:02:23] least a lot more Americans, have their own health savings account so they can start putting dollars [3:02:29] in to save for an emergency or a deductible. How important is it that Americans take control of [3:02:37] their own health, Mr. Secretary? It's the only thing that's going to actually get us healthy again. We have [3:02:42] to make, as Vern said, every American the CEO of their own health. We have to give them control. [3:02:51] We now have these wearables that can actually tell them that as they eat what it's doing to their, [3:02:58] what the food they're chewing is doing to their glucose levels. We have ended information blocking [3:03:05] for the first time in history, so every American is going to have access to their own health records [3:03:10] on their cell phone. Mr. Secretary, thank you. You don't have to do this, [3:03:14] yet you're in the line of fire because you believe America needs to get healthy. Thank you so much for [3:03:20] your leadership. I yield back, Mr. Chairman. Mr. Miller. Thank you, Mr. Chairman. I appreciate it. [3:03:28] And thank you, Mr. Secretary, for being here today. I know it's been a long morning, and hopefully it'll be [3:03:33] almost over soon for you, and you've taken a lot of heat on both sides. There's a lot that I could talk [3:03:39] about, but every time I go back home, I hear the same thing from our constituents about health care, [3:03:44] prices, and costs. And earlier this Congress, I was one of 17 Republicans who decided to vote for the [3:03:50] ACA extension because of the situation that I'm just a fundamental believer that I can't personally [3:03:56] pull the rug out from underneath our constituents, at least 22,000 of mine, without providing a solution [3:04:02] to the problem. And look, I think when it comes to longevity of life and everything you've done [3:04:07] to get this country in better shape and health has been absolutely phenomenal. I, myself, [3:04:12] care a lot about my health and what I put into my body and work out and truly believe that what I put [3:04:17] into my body in terms of eating food is medicine, and you are spot on about that. But I would just [3:04:23] love to hear from you, you know, and you've been working with us. Will you commit to working more with [3:04:28] us in Congress, you know, in a bipartisan way to make sure that we can find an amicable solution [3:04:34] for the health care issue that we face in our country? And I just want to go back home and be [3:04:39] able to look at, you know, my constituents of the 7th District, which is Cuyahoga, Medina, Wayne, [3:04:44] and Holmes, and soon to be Ashland, and just say, you know, this is what we're doing. Here's the plan. [3:04:48] We can, you know, bring in more revenues, we can lower the cost, and we can actually make this work for [3:04:53] you. Something that, you know, the other party and Speaker Pelosi said, we have to know what's in this [3:04:59] legislation, you know, after we pass it. And that is unacceptable. And so I really just want to hear [3:05:04] from you, you know, path forward and working with you. I'd be very grateful. I mean, in terms of fixing [3:05:10] the system, I really think that we need to go to more individual choice and competition. And we need [3:05:19] to take the money, and this is what President Trump wants to do, away from the insurance companies and [3:05:24] give it to individual Americans to do more direct primary care. If you look at how competitive direct [3:05:31] primary care and how convenient it is, there are companies that are offering direct primary care, [3:05:38] a hundred dollars or less a month, and you get 24 hours service and all your medical costs taken [3:05:45] care of, you know, absent catastrophic care. And I think we have to, President Trump wants to go to [3:05:54] a model like that through HSA, through catastrophic plan, through expanding primary care. I have to [3:06:01] say this, under, even after the repeal of the Obamacare extended tax credits, 87% of people on Obamacare [3:06:15] are paying less than $90 a month, and 50% of them are paying $50 a month, approximately $50 a month. [3:06:24] But there was huge amounts of money being pumped into it, and it was not lowering premiums. It was [3:06:32] simply expanding the costs of a system that was going bankrupt. And President Trump has pledged to [3:06:40] save Medicaid and Medicare, and Medicaid was going to go bankrupt. And there is no way that we can let [3:06:47] that happen. And we had to, we have to figure out a way, a plan that actually incentivizes good [3:06:54] behavior rather than bad behavior. I'm with you, and I agree with everything you just said. [3:07:00] But that's what I would like to start working on with you and HHS, and this Congress is a plan, [3:07:05] is a framework for the future. I believe that this country is very reactionary, and we used to take [3:07:10] more action to prevent things from taking place, even though we know it's coming our way. I believe that we [3:07:15] can work in a bipartisan way to lay out a framework for this country when it comes to health care. [3:07:20] And Mr. Secretary, you could lead that charge, and you'll find, you know, this body and this [3:07:24] committee to work with you in any way possible. Thank you, Mr. Chairman. I yield back. [3:07:28] Mr. Horsford. Thank you. I want to bring this conversation back to where I think it belongs, [3:07:36] and that's with the people that we are all here to represent. Secretary Kennedy, while you're here, [3:07:43] your boss is en route to my district in Las Vegas trying to rebrand the one big, beautiful bill. [3:07:50] But back home, my constituents aren't buying what President Trump is trying to sell because they're [3:07:56] living the real-life consequences of higher cost, less certainty, and real fear about losing [3:08:04] their coverage and their access to care. During the majority's field hearing in Las Vegas last year, [3:08:10] they shut out the public and brought in a paid actor. I took a different approach. I invited my [3:08:17] constituents to share their real stories about what these health care cuts would actually mean for them. [3:08:24] And what I heard wasn't a matter of politics, but rather of survival. One of those constituents is [3:08:31] Deja, a mother of a medically complex child, Shay. Shay was born at 30 weeks. He spent three months in the [3:08:39] NICU and came home on an oxygen and feeding tube, one he still depends on to survive today. He needs in-home nursing, [3:08:49] specialist, and ongoing care, all made possible by Medicaid. Without it, his family would face [3:08:56] inaccessible costs and co-pays, leaving Shay at risk of failing to thrive. I've also heard from another [3:09:04] constituent, Richard, who told me that at the beginning of this year, his marketplace premiums [3:09:09] went up $1,700 a month. He said he and his wife are effectively out of the economy. They don't go out. [3:09:18] They don't get to go to restaurants. There's no discretionary spending because they're just trying [3:09:25] to make sure that he has access to care. So families like Deja's and Richard's, to them, [3:09:31] the health care affordability crisis is real and it's urgent. So let me bring it back to the basics, [3:09:40] cost and coverage. What are you doing right now, Mr. Secretary, to lower premiums and to protect [3:09:47] coverage for families like Deja's and Richard's? Well, first of all, first of all, I would say, [3:09:54] Congressman, there are no cuts to Medicaid. You look at the congressional- What are you doing, [3:09:59] Mr. Secretary? My question is, what are you doing right now? What are your priorities to reduce cost [3:10:09] and ensure coverage for the American people? Well, we negotiated the lowest drug prices in history [3:10:17] and we're implementing those now with the MFN. This is one of many things. And how does that address [3:10:23] coverage? Well, in terms of insurance coverage, we're doing many, many things within the agency. [3:10:32] We are- President Trump is right now- What are you doing? You're the Secretary of Health and Human [3:10:42] Services, reclaiming my time. I'm asking about tangible actions and results. To me, the fact that [3:10:50] you can't answer a basic question, like bringing down cost and coverage, which should be your top [3:10:56] priority, not some podcast, but actually addressing the needs of people. Now, like others, I want to [3:11:05] make America healthy. I agree with the goal of moving from a sick care system to a true health care system [3:11:12] focused on prevention. And prevention starts with the basics- clean air, clean water, and reducing exposures [3:11:19] to toxins. So I'm struggling to reconcile the reports that some at EPA are working to roll back protections [3:11:28] that would increase exposure to heavy metals in drinking water, arsenic, lead, mercury, and chromium. [3:11:35] These are toxins linked to cancer, to heart disease, to stroke, and permanent brain damage in children. [3:11:42] So just one question. Were you consulted on those efforts to roll back those EPA protections? Yes or no? [3:11:51] No, I haven't been. But I'm happy to talk to you right now about a long list of things that we're [3:11:57] doing to roll back insurance premiums. And I would begin now with skin substitutes. Our reform on that [3:12:04] is reducing premiums in Medicare by 6 percent this year. So have you aligned your goals dealing with [3:12:13] the reforms to the EPA protections and how that is making people sicker, not healthier? That was my [3:12:22] question. Yeah, I could not answer those questions because it's not in my- You can't answer the [3:12:28] question as the Secretary- On my agency. You don't coordinate with the EPA, Mr. Secretary? Your [3:12:33] department is not involved with rolling back protections that would increase exposure to heavy [3:12:39] metals, materials, even though it affects people's health? Is that what you're telling me? You don't [3:12:45] coordinate? I'd say calm down, Congressman. Don't tell me- Look, health care is personal to my [3:12:51] constituents like Deja and Richard. Your time is over. Do not tell me to calm down. Health care [3:12:58] is real. And if you can't answer basic questions, then maybe come prepared next time. I'm answering [3:13:04] the question. You don't give me the chance to answer. You haven't given me a chance to answer. I'm happy to [3:13:09] answer your question. You said you weren't- You cut me off when I started to answer. You said you- [3:13:13] You started screaming at me. You did not consult- Okay, the time has expired. We're going to move on, Mr. [3:13:18] Yacom. People scream when they don't have much to say. You obviously don't have anything to say because [3:13:23] you can't even uphold what it is you're doing to- Mr. Horsford, you have two minutes over. [3:13:28] Give me a chance to answer the question. We're moving on to Mr. Yacom. It's getting hot in here, [3:13:34] Mr. Chairman. Thank you, Mr. Chairman, for holding this hearing today. And thank you, Senator Kennedy, [3:13:40] for being here today to highlight the important work that HHS is doing under your leadership. [3:13:44] Health care is top of mind for Hoosiers, and I regularly hear their concerns about cost, [3:13:49] quality, and access to health care. During your tenure, HHS has taken significant steps [3:13:55] to alleviate these concerns by reducing administrative burden on providers, protecting [3:13:59] patients from unapproved compound drugs, and increasing patient access to innovative treatments. [3:14:05] Mr. Secretary, under your leadership, HHS has focused on combating fraud and improper payments. [3:14:11] That frees up resources for those who need it most. Can you share how you're reducing fraud and [3:14:16] protecting taxpayer dollars? I mean, we've implemented across the department all kinds of- we're now [3:14:26] we're laser focused on ending fraud. We're doing investigations in Florida on DRE under durable medical [3:14:36] equipment. There are now more durable medical equipment companies in south of Florida than there are [3:14:43] McDonald's. And most of those are almost certainly fraudulent. And in fact, we found a hotel with half [3:14:51] a dozen different companies registered to different rooms, all of them selling durable medical equipment [3:14:57] that they didn't have. They had no inventories. And as soon as we close in on them, they go back to Cuba. [3:15:03] This is money from my agency that has been stolen by a federal government. The same thing with the hospices [3:15:10] in Los Angeles. The same thing with with ABA treatments in Minnesota, where we put on hold 349 million [3:15:21] dollars because it was because that money we suspect was stolen. And a lot of that money is ending up in [3:15:28] Somalia, some of it apparently with Al Shabbat. We are we are being victimized in our country because of the [3:15:36] laxity of vigilance by the Biden administration, the deliberate, purposeful suspension of program [3:15:45] integrity by the Biden administration, fraud has become rife without our system across our system. [3:15:52] We estimate the cost of it to the American taxpayers about 100 billion dollars a year. If we stop fraud [3:15:59] just in Medicare, you can extend that program for another five years. That's incredible, Mr. Secretary. [3:16:05] And thank you for your efforts to combat fraud. And I want to continue to work with you on those efforts. [3:16:10] Unfortunately, my Democrat colleagues constantly talk about, as it relates to your efforts to combat [3:16:15] fraud, they say that you're taking resources away from people that need them. I don't believe that [3:16:20] that is the case at all. And I would love to hear just briefly from you what efforts you are undertaking to [3:16:26] ensure that you're not taking resources away from people who need them, but that you are indeed taking [3:16:30] it away from people like Somalia. I mean, you know, one of the things that Democrats keep saying is that [3:16:37] we're cutting Medicaid. The president promised to preserve Medicaid and he's doing that for the people [3:16:43] who need it. If you look at last week's congressional budget analysis, the increase in Medicaid under the [3:16:51] Trump plan is 47 percent over the next 10 years. We're increasing Medicaid, not decreasing it. What we [3:17:00] did with Medicaid is we're kicking people off it who were illegally taking it. There was almost 3 million [3:17:07] people who were registered for Medicaid in two states or registered for Medicaid and Obamacare. That's illegal. [3:17:15] There were a million illegal aliens who were on it. That's illegal. Thank you. And finally, I just want [3:17:22] to talk about just thank you for your quick implementation of the Republican enacted Rural [3:17:27] Health Transformation Initiative. Indiana proudly received $209 million of that money. And also, [3:17:34] I'd like to just simply fully associate my remarks today with my colleague, Representative Blake Moore, [3:17:40] as he and I are co-leads on HR 5343 dealing with breakthrough medical devices. We are leading a [3:17:47] very broad bipartisan letter from multiple committees of jurisdiction to you and to your agency and to [3:17:54] Dr. Oz dealing with breakthrough medical device coverage for seniors. This is essential to ensure [3:18:01] that our seniors have the best access to treatments and diagnostic devices because we need to ensure that [3:18:07] our seniors get results that they deserve. And so you can expect that letter from me, from my office, [3:18:13] and from a number of my colleagues here very soon. I look forward to working with you on that. I look [3:18:18] forward to your response. Thank you, Mr. Secretary. I look forward to replying and to working with you. [3:18:22] Thank you, sir. Mr. Chairman, I yield back. Thank you. I now recognize myself for questions. [3:18:27] 60 million Americans, 20 percent of the U.S. population, live in rural communities and suffer from a lack of [3:18:35] access to quality, affordable health care as part of the working families tax cuts. Republicans invested [3:18:43] a historic 50 billion dollars in in rural health care through the rural health transfer transformation [3:18:49] program. But for years, we've seen urban hospitals game the system to qualify for benefits Congress has [3:18:57] intended for rural facilities. This is absolutely unacceptable. Secretary Kennedy, will you commit to putting [3:19:05] in guardrails into actively engaging with states to prevent the gaming of RHTP to ensure this money goes [3:19:15] to truly rural facilities? Yes, I will. And, you know, originally for 340B, for example, there were 90 [3:19:25] facilities that was intended to lower drug prices in poor communities and rural communities. And there were 90 [3:19:33] facilities who were approved. Today there are 12,000 and there are 50,000 different offices. And now it's [3:19:43] being because of those lower prices, they're using the lower prices. Sometimes, for example, in Virginia, [3:19:50] we found a rural hospital that was where the company that owned it was taking their 340B money, the [3:19:58] discounts they were supposed to be giving patients, spending, selling the drug price at full cost, [3:20:06] and then using that money to build a hospital in an affluent area. Those kind of thefts we're seeing [3:20:13] all the time. And that's one of the ways that there's this systematic and prefers transfer of wealth from [3:20:19] rural America to more affluent areas is happening every day. So geographically, urban hospitals are abusing [3:20:28] a Medicare loophole to reclassify as rural to get higher reimbursements, growing from three [3:20:36] reclassified hospitals in 2017 to 435 in 2023. Can I get your commitment to help reverse this practice, [3:20:47] prevent these abuses of the Medicare trust fund, and protect truly rural communities moving forward? [3:20:54] Yeah, I wish we could do it within my agency, but we need congressional help. It's a complex, [3:21:01] it's a complex formula, but it's costing us $81 billion a year. It's now about 7% of drug prices, [3:21:09] and it's, you know, it's unsustainable. Thank you. With the epidemic of rural hospital closures, [3:21:18] it should be easier for struggling hospitals to serve their rural communities through innovative [3:21:23] options like the rural emergency hospital model. To date, only 44 rural communities have converted to [3:21:31] this model. I'm fortunate to have two REHs in my district, but the only two in the entire state [3:21:41] of Missouri. Unfortunately, it took one hospital in my district months working with your office to [3:21:48] finally gain approval. Other hospitals may not have time to wait on bureaucratic processes. Senator [3:21:55] Kennedy, will you commit to improving the approval process for requests for rural emergency hospitals [3:22:01] so the designations can proceed in a timely manner? Yes, I will, and I and Dr. Oz will work with your [3:22:08] office to make that happen. Thank you. There are stark discrepancies in the way Medicare reimburses [3:22:15] rural healthcare compared to their urban counterparts. As we know, it is an unfortunate reality that [3:22:23] healthcare often follows the dollar, making reimbursement policies not just a financial [3:22:29] question, but a life and death concern for growing access to care. I had a medical technology company tell [3:22:36] me about a remote monitoring device that they were paid twice as much for in San Francisco than in Missouri. [3:22:45] With this discrepancy, it's not a matter of if, it's a question of when rural areas will be left behind. [3:22:56] Because they're going to spend all their resources going to San Francisco, make 80 bucks a month rather [3:23:01] than 40 in southeast Missouri. Will you and the administration commit to working to bring [3:23:07] rural reimbursements more in line with the same treatments done in urban settings? [3:23:12] Yes, we will. And, you know, we've already addressed some of that discrepancy through our promulgation, [3:23:20] the site neutrality rule. We need your help on the wage area index to really correct those disparities. [3:23:28] Earlier, as you noted, the implementation of the No Surprises Act, it was a disaster under the Biden [3:23:36] administration losing four lawsuits and harming patient access to care. One of the things that [3:23:42] frustrates me the most about government agencies is a tendency to ignore the written statutes of [3:23:48] Congress. The ranking member raised this a little bit earlier in regards to the No Surprises Act. [3:23:54] But the Ways and Means Republicans have requested your department urgently finalize a needed rule that [3:24:01] is in line with what we passed out of this committee and what was signed into law. Just last night, [3:24:08] months later, I received a response to the letter, but I'd like to ask for a clarification. So will you [3:24:15] commit to me now to finalize this rule as it was written by Congress as a top priority for your department? [3:24:22] We're working as fast as we can to finalize that rule now. [3:24:25] That's good. Large consolidated hospitals and health systems have a history [3:24:32] of abusing federal health programs to prioritize payments over providing quality care and lower [3:24:38] costs for patients. How is HHS championing site neutral reforms, including policies this committee [3:24:46] has passed to ensure that large hospitals aren't overcharging patients and taxpayers? [3:24:52] We've just finished promulgating that rule, and I hope that it corrects some of those inequalities. [3:25:01] Thank you. Mr. Suozzi. Oh, Mr. Neal. [3:25:07] Mr. Suozzi, do you want to? [3:25:08] Go ahead. Let him give you the time. [3:25:10] No, Mr. Suozzi. [3:25:12] No, no. I'm going to yield to Mr. Neal. [3:25:14] Look, so let me agree with something you said, Mr. Secretary. Wage index issues based on reimbursement [3:25:22] and teaching hospital reimbursements are, as you have stated correctly, very complicated [3:25:28] undertakings, but generally for a pretty good ascribed purpose. I yield back my time to Mr. Suozzi. [3:25:36] Thank you, Mr. Reckie Member. Mr. Chairman, thank you. Mr. Secretary, thank you so much. It's good to see you. [3:25:42] Like many of my colleagues, I have a long history with the Kennedys. I've got a picture in my office [3:25:47] of my father campaigning with John F. Kennedy in 1960. It's been a big inspiration to me throughout [3:25:52] my entire life. And as you and I have discussed before, when your dad ran for a senator from New [3:25:57] York State, he lived in Glen Cove, my hometown, where I was the young mayor. And you lived at home [3:26:04] for a little while. And when I was the mayor of Glen Cove in 2007, I invited you to come and speak [3:26:09] because you had founded the Riverkeeper about the environmental quality of the Long Island Sound. [3:26:13] And you really did a fantastic job and made a tremendous impression on people back in those days. [3:26:18] And I applaud some of the things that you're doing. I like the idea of going after the food dies. [3:26:24] I like going after microplastics. I like the idea of doing prevention instead of just treatment and [3:26:29] going after chronic disease. But I want to just try and find out how you feel about a quote that you [3:26:35] made versus a quote that the president recently said. We've heard it a couple of times here today. [3:26:39] In June of 2024, you said we've poured our we're talking about America, we've poured our wealth [3:26:45] into one military operation after another. As a result, our nation has decayed from within an [3:26:52] epidemic of chronic disease, a plague of addiction and a historic economic inequality. Now, how does that [3:26:58] compare? That's your statement running for president in 2024 to what the president just recently said [3:27:03] last week? It's not possible for us to take care of daycare, Medicaid, Medicare, all these individual [3:27:11] things. They can do it on a state basis. You can't do it on a federal. We have to take care of one thing, [3:27:18] military protecting. We have to guard our country. Now, how do you square that about your beliefs versus [3:27:23] the president's belief? Do you agree with what the president said? As I said before earlier, the [3:27:29] president's budget reflects his commitment to daycare. There was no it's one of the head start [3:27:35] program is one of the few programs that was spared a cut across the agency of five percent. [3:27:43] He said we can't do daycare. We can't do Medicaid. We can't put it this way in practical terms. [3:27:47] The president's budget increases the defense budget by 500 billion dollars and it cuts your agencies by 10 [3:27:55] billion dollars or more. Now, how does that square, especially given your philosophy that you've [3:28:00] promoted for decades that we've got to focus more on taking care of the health of the people of the [3:28:05] United States of America and not squander it on foreign military campaigns? How does that how does that [3:28:10] jive? Well, you know, the president is making a lot of tough decisions and he's making tough decisions [3:28:18] because of problems that he inherited. He didn't make up the glyphosate dependence in 98. [3:28:24] No, I'm talking about. No, I understand. He didn't make up the he didn't create the problem in Iran. [3:28:31] That was created. I understand that. But he's increasing the budget by 500 billion and cutting [3:28:35] the health care of the people of the United States of America. You say he's not cutting Medicaid. [3:28:39] Nobody buys that. Okay. You say he's not cutting it. We say he is cutting it. He got rid of the [3:28:44] premium tax credits. We say that's a major problem for the people of the United States of America. [3:28:48] The Democrats had two chances to extend the premium tax credits and make them permanent. [3:28:53] We just and they did it neither time. And now you're blaming him for doing it. [3:28:57] We just we just passed it out of the House at the beginning of the year. [3:29:02] The Democrats were in power contained control. Let's not think about Democrats versus Republicans, [3:29:07] Mr. Kennedy. I don't want to do that. I want to be bipartisan. I want to work together. I've [3:29:11] applauded you on some of the things that you're doing that are good. But how does it square that [3:29:14] he's increasing the defense budget by 500 billion and cutting money for NIH and CDC? The budget, [3:29:22] some of the, you talk about the budget and the things he's inherited. He's increased the deficit [3:29:27] by more than any administration in the history of America as part of the big beautiful bill. [3:29:32] That's not something he inherited. This president has done more to protect public health than any [3:29:38] president in history. He's the first one. You guys are the ones that gave us the chronic disease [3:29:43] epidemic. We're the unhealthiest population on the face of the earth. [3:29:47] Did that all happen in the past four years of the Biden administration? It's the you guys? [3:29:51] It happened. It happened. It was the Kennedy administration. It was the Clinton administration. [3:29:54] You've been a politician your entire life. Yes. And you've been involved in public life [3:29:58] your whole life as well. Right. Well, I'm not in elected office. [3:30:02] You've tried to run for elected office. You've decided not to do it on many occasions. I followed [3:30:06] you very closely, Bobby. I've never ran for anything until I ran for president. I know you decided not to [3:30:09] at the last minute every time. I followed you very... What does that have to do with it? I'm saying... [3:30:13] You're bringing up the politics, not me. All right. Time is over, Mr. Swazi. [3:30:20] Thank you, Mr. Chairman. Thank you. Mr. Secretary. Thank you, Mr. Secretary. [3:30:24] Mr. Secretary, thank you for appearing before us today. I learned one thing. I always wondered why [3:30:29] my mother, my grandmother, always had a picture of JFK and the Pope side by side. And apparently [3:30:37] everyone in Connecticut did that as well in Massachusetts. But it showed how much my family [3:30:42] appreciated the Kennedy family. We're glad you're here. And that please be advised that members [3:30:48] have two weeks to submit written questions to be answered later in writing. Those questions [3:30:52] and your answers will be made part of the formal hearing record. With that, the committee stands adjourned. [3:30:56] Thank you very much. Thank you. [3:31:48] Thank you.