RFK Jr. testifies on Capitol Hill on HHS priorities

[16:06] Trump administration and the Make America Healthy Again movement, you've given a voice [16:12] to the reality that Americans do not believe that the healthcare status quo works for them. [16:20] Despite spending $5.3 trillion annually on healthcare, more than six in ten Americans [16:27] have at least one, one chronic disease. [16:31] That has cost us dearly in terms of our health, quality of life, as well as taxpayer dollars. [16:40] On behalf of the millions of Americans who are demanding better from our health and food [16:45] systems and for using HHS as a platform to make America healthy again, our health system [16:53] is full of misaligned incentives, the most glaring being that reimbursement is concentrated [16:59] to patients who are already sick and does too little to help Americans stay healthy. [17:06] Just this week, we held a field hearing in Florida on preventive care where we heard from local [17:13] medical professionals who, because they are at the forefront of modern medicine, help their [17:18] patients get back to the basics of a healthy life – nutrition, wellness, exercise, and [17:25] preventative medicine. [17:27] It was clear from witness testimony that the movement that you help lead has begun putting [17:34] lots of thought into how we realign health incentives in support of this goal. [17:40] It is not just lifestyle choices undermining the health of the American people. [17:45] Industry consolidation, with huge companies swallowing up various parts of the healthcare [17:51] system, has helped pad the bottom line of big corporations while doing little to support [17:57] the health or well-being of working-class Americans. [18:01] Sixteen years after Democrats promised Obamacare would be the silver bullet for lowering prices, [18:07] healthcare costs and insurance company profits have never been higher. [18:12] That's why the Ways and Means Committee is focused on addressing consolidation and vertical [18:16] integration in the healthcare industry to expand access and lower costs. [18:22] Earlier this year, we questioned the CEOs of major health insurance empires about how it could [18:28] be that they are focused on lowering costs for patients and not expanding revenue for themselves [18:36] when each insurer owns pharmacies, medical providers, and PBM middlemen. [18:41] It would not surprise you to know they did not have good answers. [18:46] Soon, we will have the same conversation with large hospital systems that have driven up prices [18:53] without expanding access to care. [18:57] That lack of access is especially important for the 60 million rural Americans who have higher [19:03] rates of chronic diseases and have 43 percent higher mortality rates than urban Americans. [19:10] We also need to do more to protect access to rural healthcare. [19:13] I want to thank you for distributing the first installment of funds to states from the $50 billion [19:19] Rural Health Transformation Program that Republicans enacted and the Working Families Tax Cuts. [19:26] Rural communities in my home state of Missouri are thrilled to have this program to protect [19:31] access to care and expand the quality of services offered to patients. [19:37] I'd ask that you and your department work with Congress to continue stewardship and oversight [19:43] of those critical funds to transform how healthcare services are delivered to rural Americans. [19:49] And I hope we can find ways to work together to meaningfully reverse the incentives in healthcare [19:55] that make it profitable to consolidate access at the expense of rural communities. [20:01] Another critical priority of your administration is the First Ladies Fostering the Future program. [20:08] Mrs. Trump joined the Ways and Means Committee yesterday in this very room for a special roundtable [20:14] featuring two foster youth who shared their stories and highlighted the importance of this initiative [20:21] to help more foster youth live a life of their own choosing. [20:25] Members of this committee have introduced bipartisan legislation that complements the First Ladies [20:30] Initiative and represents the most significant reforms to the Chafee Foster Youth Program since 1999. [20:39] We look forward to your partnership in turning these policies into law and then implementing them. [20:45] We also need to work together to address fraud in our healthcare system. [20:49] Every dollar stolen by fraudsters, illegal immigrants, and criminals is one less dollar that benefits [20:57] the American people, including the $60 billion lost in waste, fraud, and abuse in Medicare alone. [21:03] We must hold the criminals who steal billions from the American people accountable. [21:09] One has to look no further than the alleged $3.5 billion of Medicare hospice fraud in LA County alone [21:19] to know that this is a massive scandal that is waiting to be uncovered. [21:23] I applaud your work and to help uncover numerous outrageous examples of fraud and look forward [21:29] to providing you and the department the tools you need to root it out. [21:34] I'm glad that the Trump administration is taking proactive steps to lower healthcare costs [21:39] and expand access to rural communities. [21:41] And the president's new anti-fraud task force is so important for identifying and prosecuting criminals. [21:49] I look forward to discussing these issues and others today, [21:52] and I'm pleased to recognize the Ranking Member Neal for his opening statement. [21:55] Thank you, Mr. Chairman. [21:56] Mr. Secretary, welcome. [21:58] We share a heritage as sons of the Commonwealth. [22:02] I was in that audience the day before the presidential election in 1960 [22:07] as Senator Jack Kennedy finished his campaign in Waterbury, Connecticut, [22:13] in Springfield, Massachusetts, and that night in Boston, Massachusetts. [22:17] Twenty-four hours later, he was the president-elect. [22:22] The joy in our home can hardly be calculated in just comments like this. [22:27] Stayed up all night for that result. [22:29] We watched him declare victory the next day, and we were delighted. [22:35] I passed out pamphlets for your dad when he ran for president in 1968. [22:39] I was a delegate for Teddy in 1980 when he ran, and I ran his campaigns in Western Massachusetts. [22:46] Great friends with your brother Joe, your nephew Joe, and your cousin Patrick. [22:53] Together, with witness two days ago, when five governors of Massachusetts, [23:00] Maura Healy, Mitt Romney, Bill Weld, Mike Dukakis, and Deval Patrick, [23:07] all gathered to celebrate the signing of what we believe to be the antecedents of the Affordable Care Act. [23:14] All very capable people, regardless of party. [23:19] We built in Massachusetts a mecca of healthcare for the world. [23:24] We're proud of it. [23:25] It's the gold standard. [23:27] It has drawn investment. [23:29] Two days ago, Spain announced another $200 million that they would invest in our hospitals [23:34] because they are destinations for the world. [23:38] Our success has been beyond our wildest hope. [23:41] Boston is the center of healthcare innovation in the world. [23:48] CDC, NIH, Kindle Square, a fact, the highest concentration of research and development [23:56] in the world in about an eight-block area. [23:59] Our colleges, our hospitals, our nurses, our professionals, our advocates, all are extremely [24:07] proud of what we did, regardless of political party, and we don't want to see it dismantled. [24:13] And by the way, as a footnote, Mr. Secretary, we also like Dunkin' Donuts coffee. [24:20] We watch daily as the threats to this healthcare system that we have constructed, whether it's [24:25] talking about measles and vaccinations. [24:29] We remember what it was like before Dr. Salk's polio vaccine. [24:34] My mom, who was a devotee of the Kennedy family, she said the way we prevented polio in the fifties [24:40] was to stay out of fresh water in August. [24:44] Let me say this, nothing has changed about the science of vaccines. [24:49] We need people not to be preyed upon by demagoguery, and there should not be a politicization [24:57] of these very issues. [25:00] Let me go to some of the contradictions that the administration has made as we talk about [25:05] budgeting. [25:07] One trillion dollar cuts from our healthcare system, putting 440 hospitals at risk so that [25:13] we can have a tax cut for the wealthiest among us, and that's based on tax distribution [25:18] tables. [25:19] The administration's agenda includes obstacles to better healthcare. [25:33] Costs are sky high, but that has much to do right now with a lot of issues, including tariffs [25:36] in Iran. [25:38] We want to push healthy eating for everybody, and I've not met any candidate anywhere who [25:43] ever said vote for me, I'm for more fraud. [25:46] That doesn't happen. [25:47] We want a fair and balanced approach to looking at it. [25:50] A proposed cut of 12.5% to HHS? [25:56] Let me remind all in this room, and you're going to be familiar with this name, Mr. Secretary, [26:02] Silvio Conti. [26:04] He was the Republican member of Congress in the district next to mine. [26:07] He was the author of the LIHEAP program, and it has worked beyond any objective measurement [26:15] that we believed at the time. [26:17] He wanted to make sure that people had an opportunity in the climate of New England to heat their [26:21] homes during the winter. [26:24] 159,000 families in Massachusetts relied upon LIHEAP last year. [26:31] Attacking childcare providers and delaying their payments means more parents will choose [26:35] between the childcare and their paycheck. [26:40] Families see through podcasts and campaigns. [26:43] 60% of the American family worries right now about affording healthcare. [26:48] We should be fixing and repairing the parts of the healthcare system that we want to improve [26:53] for all members of the American family. [26:56] We should not be offering just to deflect blame. [27:00] We should be pointing out this achievement. [27:03] People should not have to choose between medicine and childcare. [27:08] We delivered historic relief with Medicare negotiations. [27:11] We capped out-of-pocket costs and we lowered premiums. [27:15] We need to come to the aid of the American family at this very difficult time. [27:20] Republicans need to understand that Americans deserve a fair shake. [27:25] I'm going to close on the note that I opened with, and Mr. Secretary, I think you're well [27:29] aware of it. [27:30] What we built in Massachusetts over these years since Senator Kennedy became president, it [27:36] was done with Republicans and Democrats, but together we're immensely proud of what it [27:41] was that we achieved, and we don't want to see it dismantled. [27:44] Thank you, Mr. Chairman. [27:45] Thank you, Ranking Member Neal. [27:50] Today's sole witness is the Secretary of Health and Human Services, Robert F. Kennedy, Jr. [27:56] The committee has received your written testimony, and it will be made part of the formal hearing [28:00] record. [28:01] Secretary Kennedy, you have five minutes to deliver your remarks, and you may begin when you're [28:04] ready. [28:14] Thank you, Mr. Chairman, Ranking Member Neal. [28:20] Members of the committee, thank you for the opportunity to appear before you today to discuss [28:25] the president's fiscal year 2027 budget request. [28:30] We stand at a generational turning point. [28:32] Our children of the sickest generation in modern history and decades of failed policy, captured [28:38] agencies, and profit-driven systems have caused it. [28:42] Parents across the country demanded change, and we are delivering it. [28:45] We are ending the era of federal policies that fueled the chronic disease epidemic and replacing [28:52] them with policies that put the health of Americans first. [28:56] President Trump and I are challenging the status quo and the institutions that defend it as we [29:02] work to make America healthy again. [29:04] In just 15 months, HHS has delivered historic wins. [29:09] We negotiated most favored nation drug prices with 16 of the largest pharmaceutical companies [29:15] so Americans no longer pay more than other people in wealthy countries for the same medication. [29:21] We're bringing real transparency to healthcare pricing so patients know the cost of care before [29:27] they receive it. [29:28] I use the full convening power of the federal government to bring health insurance CEOs to [29:34] the table to reform prior authorization. [29:36] We are cutting red tape, speeding decisions, and demanding transparency. [29:41] We are also cracking down on waste, fraud, and abuse. [29:46] This year, HHS and USDA issued new dietary guidelines that put real, whole food at the center of the [29:52] American plate. [29:54] We flipped the food pyramid upside down and sent a clear message to the American people, eat [29:59] real food. [30:01] The HHS has also opened the door to partnerships with industry, trade associations, non-profits, [30:07] and advocacy organizations. [30:08] More than 50 medical schools have committed to expand nutrition education from an average [30:14] of just two hours to 40 hours. [30:18] Food manufacturers are stepping up to more than 40 percent of the food industry is committed [30:22] to phase out petroleum-based dyes by year-end, and many have already eliminated them. [30:29] In conjunction with these efforts, FDA approved six natural food colorings derived from fruits [30:34] and vegetables. [30:35] Though President Trump's Great American Recovery Initiative, HHS, is matching compassion [30:42] with action to help Americans break the cycle of addiction. [30:47] At HHS, we are prioritizing patients with ultra-rare diseases and their families and driving faster [30:53] access to life-saving treatments. [30:56] We are restoring gold standard science and integrity across the agency. [31:01] We are protecting children from sex-rejecting procedures that expose them to irreversible harm. [31:07] We are eliminating outdated and misleading warning labels on hormone therapies used to treat [31:13] women during menopause. [31:14] We are strengthening oversight of organ procurement. [31:18] We are implementing Operation Stork Speed to ensure the safety and quality of infant formula. [31:23] We are applying the same focus and urgency, as you mentioned, to rural America. [31:29] The Rural Health Transformation Fund delivers the largest investment in rural health in our [31:34] nation's history, $50 billion over five years, to strengthen hospitals and ensure Americans [31:40] can access the care they need no matter where they live. [31:45] Members of Congress on both sides of the aisle have made rural health a clear priority in their [31:49] conversations with me because every state is feeling the strain of hospital closures, workforce [31:56] shortages, and gaps in access. [31:59] HHS announced more than a $135 million investment this month to expand rural residency programs [32:06] and nutrition services. [32:07] The data is clear. [32:09] When physicians train in rural communities, they are more likely to practice there. [32:14] The President's budget puts all these priorities in action. [32:18] It invests in prevention because preventing disease costs less and delivers better outcomes [32:23] than treating it. [32:25] As my uncle President John F. Kennedy said, progress is a nice word, but change is its motivator [32:31] and change has its enemies. [32:34] We see those forces clearly, entrenched interests, defenders of a failing status quo, and institutions [32:42] that put profits ahead of the American people. [32:46] Health resistance underscores the urgency of this moment. [32:50] We can reverse the chronic disease, improve public health, and lower costs. [32:55] I stand ready to work with this committee and Congress to seize this opportunity to implement [33:01] and codify lasting generational reform in American healthcare. [33:05] For our country, for our children, and for the healthy American people, together we can make [33:11] America healthy again. [33:13] Thank you very much. [33:14] Thank you. [33:15] Thank you. [33:16] Thank you. [33:17] Thank you. [33:18] Thank you. [33:19] Thank you. [33:20] As always, we want to ensure that all members have an opportunity to ask questions of the [33:25] Secretary. We'll now proceed to the question and answer session. Start with Mr. Buchanan. [33:30] Thank you, Mr. Chairman. And I want to thank Secretary Kennedy and your leadership. It's been [33:37] incredible in my mindset. The U.S. is spending $5.3 trillion on health care and getting sicker [33:44] as a nation. Six out of ten, six in ten Americans, 95 percent in terms of Medicare beneficiaries, [33:51] have at least one chronic disease. Roughly half of the adult population is projected to be obese [33:57] by the end of this decade. I believe this problem stems from unhealthy and ultra-processed foods, [34:05] and I applaud HHS and its continued support and leadership on this issue. We must prioritize [34:12] prevention as the key to reversing trends in heart disease, obesity, and diabetics. I believe the [34:19] best way to do that has been the cost curve is by making sure that people don't get sick in the [34:25] first place. I like to say to people who are, you need to be the CEO, I read it, of your own health, [34:32] and I think that's critical. Mr. Secretary, I appreciate our strong partnership in advancing the [34:37] health of this country. I look forward to continuing to work together to support a [34:42] health care system that values prevention, not reaction. My one couple of questions I've got, [34:49] together we've had, we've accomplished so many things to support health and prevention. [34:54] For example, we've worked on new food pyramid, is real food cutting the ultra-processed foods. [35:00] We're also brought back the presidential fitness guides, which I'm excited about. And I guess [35:06] in terms of what some of the things that we've done, what do you think we could be doing more of in [35:11] that space in terms of diet and exercise? Sorry, flipping the food pyramid and issuing new dietary [35:24] guidelines was the beginning. When I came into office, I was handed the dietary guidelines that [35:30] have been developed by the Biden administration. They were 453 pages long, they were incomprehensible, [35:39] they were written by food industry lobbyists, and they reflected the mercantile impulses that had driven [35:47] Fruit Loops to the top of the food pyramid. Fruit Loops isn't even a food, it's just poison. And we brought [35:55] together the best nutritionists in this country, from the best universities all over this country, [36:00] a dozen of them who worked 11 months to reform the dietary guidelines, and offered for the first time [36:07] not dogma-based guidelines, but science-based guidelines. Every recommendation is cited and sourced [36:14] some multiple peer-reviewed publications. That's the beginning. The next part, we have to drive those [36:20] changes into dietary culture in our country. We are aggressively using the food subsidies program [36:29] with Brooke Rollins, my partner in this. Let me mention, I've got another question with one minute [36:33] left, but I'm deeply passionate about promoting access to screening as a way to prevent diseases. [36:39] Through my personal experience with Alzheimer's and lung cancer, I've become a strong believer in the power [36:44] of detection and prevention, and I'd like to get just your thoughts and ideas on that in terms of [36:49] screening, like lung screening for cancer and stuff like that. Screening for prevention is absolutely [36:56] critical. We are forming now the USPST, which is the committee that decides on new procedures [37:08] and interventions that need to be, that need to get CMS compensation. And that committee has been [37:17] lackadaisical and negligent for 20 years. We're now bringing new members on who have a clear mission. We're [37:25] going to have much more frequent meetings. We're going to have, for the first time, transparency. [37:29] We're going to, and we're making huge investments at NIH and elsewhere, and doing the kind of science [37:40] that we need to do better screening for Alzheimer's. Thank you, and I yield back. Thank you, Mr. Neal. [37:45] Thank you, Chairman. Mr. Secretary, fighting fraud is bipartisan here. As I noted earlier in my remarks, [37:53] that nobody ever campaigned with a bumper sticker that said, vote for me, I'm for more fraud. So fighting fraud certainly has [38:02] considerable support across this Congress, and nothing makes me or you or others in this room matter than those who might rip off Medicare. [38:10] So I think those who commit fraud ought to be held accountable. So let's talk about Lawrence Duran. He perpetrated what at the time was the largest [38:21] therapy issue related Medicare fraud in history, hundreds of thousands of false claims. He was sentenced to 50 years in prison, [38:29] and he and other collaborators were ordered to pay back 87 million dollars in restitution. [38:37] His sentence was commuted by the president. Did the president consult you as we pursue this fraud? [38:44] I don't know anything about that case. [38:47] Fair enough. [38:48] Congressman, I can say this. This has not been, although it's a bipartisan issue, and there's bipartisan passion for this issue, [38:58] the application, the implementation of anti-fraud has not been bipartisan. [39:02] Okay, so let me let me go to the next one, Mr. Secretary. How about Joseph Schwartz? He pled guilty last year to bilking taxpayers out of more than 38 million dollars, [39:11] paid himself millions of dollars along the way. His negligence as it related to nursing homes is well known to all of us. [39:19] President Trump pardoned Mr. Schwartz. I'm assuming he didn't consult you on that either. [39:25] If we're going to talk about fraud, it's not the people just at the lower end of the economic scale. [39:33] If we're going to pursue fraudsters, it's not just the people who might make simple, honest mistakes that could be corrected. [39:40] It's the people at the top that helped to perpetuate this fraud. [39:42] And the administration's position seems to be that it's only the recipients and not the providers that commit fraud. [39:50] We are not defending fraud. We're not cheering for it. We're not excusing it. But there needs to be an even-handed approach, [39:56] including not passing out pardons to people that might be supporters of the administration. [40:02] So let me on a nice note thank your staff here in front of all for helping me out recently or helping my constituents out [40:09] on an issue that related to daycare. Your staff came to the aid of a Head Start provider in my district [40:18] and really helped out 100 families. The problem is that we don't want that to be something that can be [40:25] completed by senior members of the Ways and Means Committee coupled with a group of administrators [40:31] who know the problem and have come to the assistance of those who need it. But it shouldn't be that way. [40:37] It needs to be more universal and the cuts that are being proposed to these initiatives are not helpful [40:42] to the American family. I look at these decisions and if we're going to pursue fraud, [40:48] Mr. Secretary, it has to be across the board. And we want an even-handed approach to these fraud [40:55] investigations, including those whose schemes have cost the American taxpayers hundreds of millions [41:01] of dollars. I yield back my time. Mr. Smith. Thank you, Mr. Chairman. Thank you, [41:07] Secretary, for being here this morning and entertaining our questions. I represent one of the largest land area [41:14] districts in the country and most of my constituents live in rural and even remote areas. Agriculture [41:20] is the engine of our economy in my district and we're proud of our role in feeding not just America [41:26] but the world. Now, before I get to my questions, I would like to stress the importance of modern [41:31] agriculture practices in producing a healthy, affordable, and sustainable food supply. The [41:36] agriculture industry depends on our standards and regulations being science-driven and risk-based. [41:42] I do want to say that threatening the availability of technologies could inadvertently lower yields [41:48] and actually increase the price of food at a time when many Americans are already struggling to make [41:52] ends meet. So I encourage you to continue to bring farmers and ranchers to the table as you consider [41:58] matters relating to agriculture. Moving on, I do want to talk about rural health. You mentioned the [42:04] Rural Health Transformation Program. I think that means a lot to so many of our constituents, [42:10] our communities, our states. The RHT programs notice a funding opportunity recognize the important role [42:17] of pharmacists in meeting rural communities' health needs. I believe that pharmacists are an underutilized [42:23] part of our health system. Nearly nine in ten Americans live within five miles of a pharmacy, [42:28] making pharmacists among the most accessible health professionals. Because of the broad accessibility, [42:34] I think there is more we should do to empower pharmacists to help meet rural health needs. That's why I [42:39] introduced a bill we call E-CAPS that would improve access to care for seniors across America by [42:46] providing Medicare coverage of pharmacist-administered tests and treatment for common illnesses like COVID, [42:52] flu, and strep. By allowing pharmacists to test and treat seniors for common illnesses, we can make [42:58] these services more accessible and reduce pressure on emergency departments. I do want to ask what is your [43:04] approach to improving access to health care services for Americans who live in rural and remote areas, [43:11] and what can we do to ensure Americans in rural areas aren't left behind in our health care system? [43:15] I mean, as last week, I went to Arizona to announce an unprecedented $125 million investment [43:27] in community health centers, which are serving 39 million Americans, mainly in rural areas around the [43:35] country, will improve nutrition and also retention of their workforce, which is one of the reasons that [43:43] so many of our rural health programs, so many parts of it, are failing today. We've seen closures of 120 [43:51] rural hospitals since 2010. It is a crisis when these hospitals close. It doesn't just deny access to health care. [44:01] Those hospitals are economic drivers for their community. They're the highest paid jobs. They're oftentimes the biggest employer. [44:07] That reason, President Trump made the biggest investment in rural health care in American history, [44:13] the $50 billion rural health transformation fund. Right now, Medicaid gives about 7% of its money to [44:24] rural hospitals, and it's about $20 million a year. Well, we're increasing the flow of federal dollars to [44:31] rural community health care, an extra $10 million a year. So that's a 50% rise over the next five years, [44:39] and it's going to give those hospitals the ability to upgrade their infrastructure, to install telehealth, [44:47] to move to AI, and to retain workers, and do all the other things they need to achieve permanent stability. [44:54] I appreciate that. And just in closing, and I just want to note, moving to CMMI, the Center for Innovation, [45:00] I appreciate its intent. I do believe it lacks some transparency, and especially when CBO found [45:06] CMMI's activities increased direct spending by $5.4 billion. So my time has expired, but I would [45:14] encourage you to take a look at that so that we can make sure that innovation drives cost savings and [45:20] better outcomes, rather than just driving more spending and not positive results. Thank you. [45:26] CMMI has been disastrously mismanaged in the past. We are changing that. We're making it a [45:33] center for innovation that Congress intended it to be. Thank you. Mr. Doggett. [45:38] Mr. Secretary, since waste fraud and abuse has been something of a watchword in this administration, [45:45] I'm sure that you're familiar with the December 3rd Government Accountability Office response to a [45:51] request by Chairman Smith, which reported significant agent and broker fraud with the Affordable Care Act, [45:58] including brokers signing up people who didn't even know they were signed up. As you're aware, last May, [46:06] under your authority, CMS fully reinstated all 850 brokers and agents who had been suspended back in 2024 [46:17] because of suspected ACA fraud. Can you guarantee to our committee today that every one of those [46:23] suspected brokers and agents was thoroughly investigated and found to be innocent of any fraud, [46:29] any wrongdoing or criminal activity? I can tell you. Can you, sir? Yes or no? You can't answer that. [46:43] That is very troubling, I must say. 850 people accused of fraud, suddenly reinstated all at once. [46:51] Do you know whether any of these suspected fraudsters who were reinstated so swiftly were subject to any [46:58] additional oversight under your authority? Have there been guardrails that have been put in place [47:03] to ensure those 850 agents don't continue to commit fraud? Congressman, I'm a lifelong Democrat, [47:10] so I was shocked. I don't care your party affiliation, we're all against frauds. I was shocked when I came [47:17] into this agency. Were you shocked to see that 850 people who were suspended for fraud had been reinstated [47:24] all at once? I was shocked to learn that President Biden had directed my agency to stop all program [47:33] integrity activities and focus on enrollment. Thinking back my time, sir. And that's what caused the [47:38] problem that you're talking about. President Biden's administration was the one that suspended 850 [47:42] suspected fraudsters. Your administration was the one that let them all go back to work. [47:48] President Biden fired everybody in my agency except for six people who were involved in program [47:53] integrity. In fact, under your leadership, you have suspended the very people at CMS who are [47:59] responsible for overseeing any fraud in the program. We've got more to combat fraud than any [48:06] administration issue. If you want to filibuster, go to the Senate, but would you please try to answer [48:09] my question, sir? Have there been any new complaints against these 850 brokers? As I said, I am happy to [48:16] talk to get my staff to contact yourself. I'm not asking if you're happy to talk. I just want to know the [48:21] answer to my question. Have there been any new complaints of fraud against these people? I don't [48:26] know why those people reinstated it. As far as I'm concerned, it may be because of a lawsuit. [48:32] I have to check on that. I can guarantee you there is no administration in the history. [48:37] Reclaiming my time, sir, as it runs out, it is very troubling that the only fraud that Chairman Smith [48:45] referred to as a smoking gun to deny affordable health care credits put the blame on the mother that [48:51] was trying to protect the sick child, that nothing was done about that and the Secretary still [48:56] doesn't know much of anything about it. As far as fraud, Paul Wozak is one who had 10 million dollars [49:04] of wages that he kept some of to buy a 2 million dollar yacht. His mother contributed to the Trump [49:11] campaign and he no longer has to pay 4.4 million dollars or stay in prison. Mr. Secretary, I want to [49:19] know what role you play in the soft on crime approach to health care fraudsters. Have you recommended [49:25] that any of these health care fraudsters should get pardons or commutations or did the campaign [49:30] contributions speak for themselves? I don't think there is anybody in this country, I don't think [49:38] there's anybody in this country who believes that this administration is soft on fraud. We're the [49:45] first administration. It's just the fraudsters who have the money in the cottage industry to get themselves [49:50] pardoned and not even have to restitute what they've taken from those they've defrauded. It's [49:55] really a disgrace. I'm surprised you would defend it. It's not a credible story. It's a fact, sir. It's [50:02] not a story. It's a fact. Mr. Kelly. More fraudsters pardoned by any president in American history. Your time [50:08] has expired. Thank you. Mr. Kelly. Thank you, Chairman. Mr. Secretary, thanks for being with us today and [50:15] as usual, the beatings will continue until our morale improves. I did want to just talk about [50:23] one thing real quickly. I'm really wishing you success in the rollouts of the bridge and balance [50:27] models, expanding seniors access to weight loss drugs and as Mr. Buchanan talked about this, this is [50:33] really critical. But at this point in today's hearing, I'm going to turn my time over to Mr. Zweigert from [50:38] Arizona. I think he has some, would take more than four minutes for him to go through all the things he wants to ask you. [50:44] But again, thank you for walking out of where you were into this. I appreciate what you're doing [50:49] and your family has always been a hallmark of American service. So thank you so much, [50:52] Mr. Secretary. Mr. Zweigert. Thank you, Mr. Kelly. I appreciate him doing this. [51:00] Let's actually do some waste and fraud where we have real money. I actually want to talk about what's [51:05] often referred to as CPAP, the CDPAP, New York Health. Let's actually use New York because that's [51:13] actually what Oversight has been looking at. Something is wrong when the biggest job creator [51:21] in New York City over the last few years turns out to be a home visitation program that you all manage. [51:29] We have some data here that basically says for every thousand residents 65 and up in New York State, [51:35] the whole state, 171 are receiving these stipends, these payments. In New York, if New York itself [51:46] was actually at the Medicaid population average, it would save 43 billion dollars a year. [51:55] When we start to actually examine and dive into the numbers, the disproportionate, yes, we have frauds [52:04] here, frauds there, but we have entire states that seem to be helping this fraud along. What do I do to [52:10] help a program like this that substantially expanded during COVID that we now have not only New York, [52:17] but a handful of other states that seem to be using it as a jobs program and not a health program? [52:22] Senator, that is a huge problem. New York State pays on average 80% more per capita on Medicaid than [52:36] any other state. 80% over the average. And part of the reason for that, as you point out, [52:43] are these waiver programs that many of the states have now applied for and received. In the old days, [52:51] Medicaid paid for medical procedures. So if you got a hernia operation, we could figure that out at CMS. [52:58] We could see you had a scar. It was done by a licensed doctor, by a licensed nurse, [53:04] and we could track to make sure it actually happened. The waivers allow people, family members, [53:13] who are taking care of an elderly parent to get paid for balancing the checkbook, [53:19] for picking up the groceries, for driving somebody to a doctor's appointment. Today, the biggest job [53:25] in New York, 650,000 people, the biggest employment niche is home care. These are family members who are [53:34] getting paid to do things that they used to do as family members for free. And this is rife with fraud, [53:43] because we have no way at CMS to determine whether they actually perform that duty or not. [53:50] We don't know whether you drove your grandmother to a doctor's office. So it's an opportunity for fraud, [53:56] and states corrupt people, fraudsters are taking that opportunity all over the country. [54:03] And it's one of the reasons that Medicaid doubled during the Biden administration, [54:10] because we are paying for fraud now as much as for medicine. [54:14] Thank you, Mr. Secretary. And we get a round two. I yield back. [54:18] Mr. Thompson. [54:20] Thank you, Mr. Chairman, and thank you for your persistence in getting this [54:24] hearing scheduled. And Mr. Secretary, thank you for finally appearing before our committee. [54:30] Mr. Secretary, let's start with an easy one. Do you have a medical or public health degree? [54:35] No. [54:36] No? [54:37] No. [54:38] Yet you're overruling doctors, scientists, and public health experts across our country. [54:45] Your dangerous conspiracy theories are undermining safe and effective vaccines. [54:51] Mr. Secretary, I want to echo my friend the ranking member's comments about polio. [54:56] I remember as a kid, kids older than me, in school with me, who got polio. [55:03] They lived with the lasting impacts of that infection for the rest of their lives. [55:08] I was fortunate to get the polio vaccine. And I was fortunate to never get polio because of that [55:16] vaccine. And because we're about the same age, I'm sure you have similar experiences. But now you [55:24] undermine vaccines and are helping make diseases deadly again. Mr. Chairman, I ask unanimous consent to [55:31] submit for the record this article from the Sacramento Bee about the rising measles cases in California. [55:37] With that objection. [55:38] Thank you. In 2000, measles were declared eliminated in the United States. And I've got a graph behind me [55:47] that shows that. Under four years of President Biden, there were 514 measles cases in the U.S. [55:57] Under just one year of President Trump, there are nearly 2300 cases. Mr. Secretary, kids have died because [56:06] measles is running rampant under your watch. In large part because President Trump allowed your conspiracy [56:15] theories to run our public health. Americans need serious leadership grounded in evidence and science. [56:23] Instead, we have you and this President elevating misinformation and undermining basic public health. [56:32] HHS should be led by professionals who respect science and data, listen to doctors, and put patients first. [56:41] Not by rhetoric, not by conspiracy, and not by ignoring established medical facts. So today, Mr. Secretary, [56:49] this is not just about policy differences. It's about whether this department is going to protect [56:55] the health of the American people or put them at greater risk. Right now, it looks like the latter. [57:02] Let's not sugarcoat this. Americans are paying more for health care, not less. Families are being squeezed [57:09] at every turn, and instead of relief, they're being handed policies that will make things much worse. [57:17] You and this administration promised to lower costs. Instead, costs are rising. And you and this [57:24] administration ripped health care away from millions of people. H.R. 1, the big, ugly, big, beautiful bill, [57:33] whatever it's being called these days, cut a trillion dollars from Medicaid. That means fewer doctor visits, [57:40] delayed care, and more people showing up in already overcrowded emergency rooms. Let's be honest where [57:49] this leads. People will get sicker, preventable conditions will go untreated, and people will die. [57:56] Mr. Secretary, you shouldn't be in this office. I yield back the balance of my time. [58:02] Mr. Schweikert. [58:05] Mr. Secretary, you are actually the first person I've had in my 16 years who's actually willing to have [58:13] conversations with me on how to have the revolution of lowering the cost of health care and help our [58:18] brothers and sisters be healthy. But I want to go to one that makes the lobbyist community pucker up, [58:25] because every other lobbyist seems to be working on this. These are just some of the MedPAC reports. [58:30] Um, you pay for them. They basically say Medicare Advantage, Medicare Part C, has a misalignment on [58:41] the math. We need to come to a final conclusion. Are these accurate? Or the stories I get from the [58:49] lobbyists accurate? Are the insurance companies accurate? Because the latest report says Medicare [58:55] Advantage comes in at 114 percent of fee-for-service. In 2005, when we set up Medicare Advantage, [59:03] which I'm a big supporter of a capitated model where you make your profit by helping your brothers [59:08] and sisters be healthier, instead of a model where you make your money by constantly risk scoring them [59:15] as sicker. And you saw last year's Wall Street Journal series showing how many people had been [59:21] scored as being sick, and they didn't have that disease. They had never been tested for that disease. [59:27] 114 percent compared to 95 percent fee-for-service is about $1.75 trillion over 10 years, making it the [59:39] single biggest misalignment in the federal government. Can I beg of you, um, and I know you're going to, [59:48] Dr. Oz and others, we need to put everyone in a room, maybe our actuaries, maybe my economists from [59:53] the Joint Economic Committee who have been working on this for three years. It's a stunning amount of money. [59:58] How do we use Medicare Advantage, a managed care model, to have your vision of they make a profit [1:00:04] because you helped people be healthier? It may require a multiple year enrollment, so there's a [1:00:11] payoff for the investment. 31 percent of Medicare spending is diabetes. What can I do to work with [1:00:21] you? What can I do to move CMS and HHS to a vision here of health care for seniors? [1:00:27] Thank you, uh, Congressman. I'd love, I'd love to have those discussions with you. I'll say the, [1:00:35] the, the fraud, a part of it is perverse incentives, as you pointed out, and part of it is fraud. Medicaid, [1:00:41] Medicare Advantage was created as a, to end perverse incentives to give us value-based care, [1:00:48] as opposed to traditional Medicare, and in some ways it's doing that. In every metric that we look at, [1:00:56] people who have Medicare Advantage are better off, are healthier, they're getting treated better, [1:01:01] they're more compliant, and people who are getting costs are fee-for, uh, fee-for-cost programs. [1:01:08] Um, one of the other problems is that, one of the major problems is upcoding, and it's just rampant [1:01:16] fraud throughout the system, as you point out, and we are fixing that now for the first time. [1:01:21] And I can tell you that we're already seeing, uh, some change in the discrepancy. This year we raised [1:01:30] the premiums for, or we're proposing to raise the premiums for, um, Medicare Advantage by 2 percent, [1:01:36] whereas Medicaid and Medicare are going up by 5 percent. Mr. Secretary, um, I want to propose a more [1:01:43] radical solution of alignment of incentives. Get rid of the risk scoring, I would get rid of the star [1:01:49] rating, and do those scoring at the beginning, and then design a system where, as you help the enrollee [1:01:58] get healthier, they benefit. We're almost out of time. I want to thank you and the agency for also [1:02:04] starting the things of wearables, the, the thing you can wear on your wrist, the thing you wear, [1:02:08] the thing you, and the ability to allow Americans to sort of have their own medical lab attached to [1:02:15] them. Now we have to figure out how to allow it to prescribe. And with that, I yield back to Mr. [1:02:19] Chairman. Mr. Larson. Well, thank you, uh, Mr. Chairman and, uh, Mr. Secretary, [1:02:26] welcome to the Ways and Means Committee. I want to first, uh, associate myself with the remarks of, uh, [1:02:33] Leader Neil, uh, especially as it relates to the great legacy, uh, of your family. Thank you. There [1:02:43] wasn't, uh, on my paper route, there wasn't a house that was door I didn't knock on where there was a [1:02:49] picture of Pope John the 23rd and John F. Kennedy. Uh, that's how deep, uh, and incredible influence [1:03:01] that the president of the United States, the first Catholic elected, uh, had on generations of people [1:03:13] and still every bit as much relevant today as he was in the 1960s. Your family and its legacy of [1:03:24] public service deserves always to be acknowledged, uh, for the enormous sacrifice and their willing, [1:03:32] willingness to serve and to serve in the public interest. Well, Mr. Neil also pointed out as my [1:03:40] other colleagues, I think you can understand and appreciate the incredible frustration. President [1:03:48] Kennedy said that science is the quiet power and whether it comes to sending a man to the moon or [1:04:00] vaccinations, uh, president Kennedy was out front in terms of his belief in government and his belief [1:04:12] in making sure that vaccines were provided for the health and wellbeing of the American people [1:04:22] and the children were all sworn to serve and protect. I would like, uh, Mr. Chairman, if you would, [1:04:30] to submit for the record, the, uh, Connecticut Department of Public Health testimony on the [1:04:37] establishment of, uh, vaccine standards. Without objection. Thank you, Mr. Chairman. I would also, uh, [1:04:44] Mr. Chairman, like to submit before the record, uh, a stark divide, uh, Americans more confident in [1:04:54] career scientists at the U.S. health agencies than leaders. Without objection. And I guess that's what [1:05:02] it all comes down to, uh, when we look at the vaccination process and I think everybody's entitled [1:05:14] to their opinions and views, but we're not entitled to our own facts and the facts I think speak clearly [1:05:23] on this. When I confront doctors in my community, they say they're spending more time counseling people [1:05:32] about taking their vaccination shots. We know what we were able to do just, uh, four years ago, [1:05:42] the state of Connecticut braced for what they thought might be an outbreak of measles because [1:05:49] the case was reported. But as it turns out, that was the only case and it was attributed to the fact [1:05:58] that people were vaccinated and that's what prevented that. Uh, and as Mr. Neal and others have meant to [1:06:05] mentioned, whether it's polio, whether it's measles, whatever the case may be, I think you can [1:06:10] appreciate how deeply concerned people are about this and how the contrast between what your uncle [1:06:24] and the president of the United States said in his beliefs and yours with respect to vaccinations. [1:06:30] And with that, I see my time has run back out. I'll yield back my time. Thank you. Mr. LaHood. [1:06:36] Thank you, Mr. Chairman. Uh, Mr. Secretary, um, welcome. Um, I want to get your opinion on the FDA. [1:06:44] There's been broad reporting, um, in the press on concerns that, and mismanagement and bungled drug [1:06:52] reviews at the FDA have chilled investments, uh, in life-saving innovative cures, uh, and that China is [1:07:00] rapidly becoming the recipient of those investment dollars. I also serve on the Select Committee on China. [1:07:06] And as we look at how do we win the strategic competition, uh, when it comes to investment [1:07:10] and innovation, it's very important that we have a vibrant, efficient FDA. And I understand that you [1:07:17] aren't involved in those drug review decisions, and I intend to take that up with Dr. Markery, [1:07:22] but it seems like a squandered opportunity, uh, to maintain America's position as the premier, [1:07:28] uh, destination for investment in medicine and modern technology. Can you comment on that, Secretary? [1:07:33] Uh, what I would comment is, I acknowledge that Congress is eating our lunch, and that happened [1:07:40] during the Biden administration. We are redressing that. Um, we have broken every record for drug [1:07:46] approvals. We approved 67 drugs. This year, new drugs. We approved, which is a record. We approved 39 new [1:07:55] devices, which is a record. We approved 91 new generic drugs, which is a record. We, um, we are 100% [1:08:07] online to get it, make all of our Pitufa deadlines, which does not usually happen. [1:08:12] happen. We have dramatically shortened a period of, from approval, from, from conception to commerce. [1:08:22] We just approved two new drugs, two new oncology drugs in record time, one in 45 days. The closest [1:08:30] before that was 310 days. The other in 55 days. These are two drugs that are so effective [1:08:37] that they can bring people out of hospice. Oh, we are doing, we are, we, we've moved to two to one, [1:08:47] from two to one trials to one to one trials with where it's appropriate. We're, we're using AI to [1:08:54] dramatically shorten, uh, the, the times to approval. We're doing things that no other agency has with [1:09:01] greater competence, greater efficiency than any other agency in history. You hear these stories about [1:09:08] a drug that's been refused. You read about them in the Wall Street Journal. This week, they were talking [1:09:13] about a melanoma drug. Every, every panel within FDA, all the career panels, the career scientists who [1:09:21] looked at that drug said it was not effective. The drug maker was told to do a two-arm trial. He did a [1:09:29] one-arm trial and all the people who were tested also received a chemotherapy drug. So we don't [1:09:35] know what the effect was. And what Marty made the correct decision to not approve that drug, [1:09:42] but everybody goes after him because the industry is so powerful. They own Congress. They own the media [1:09:48] and they can beat up Marty McCary because he's trying to do change over there. Gotcha. I want to switch [1:09:54] subjects. I'm also the chair of the work and welfare subcommittee, which has jurisdiction over [1:09:58] foster care and the Shafee programs. Yesterday, we had the First Lady here to talk about Fostering [1:10:03] the Future, her initiative when it comes to foster care. Can you comment on the role HHS is playing [1:10:11] in implementing the Fostering the Future Executive Order to help improve outcomes for foster youth? [1:10:17] President Trump and the First Lady, who's been extraordinary for us to work with, [1:10:21] have said their vision is one family per one for one child. Right now, we have a two-to-one ratio. [1:10:30] And part of the reason for that is that the Biden administration was excluding an entire class of [1:10:38] people because of their religious beliefs. We are told the states to actually pass laws, instructed them [1:10:45] to pass laws, refusing families who had certain religious beliefs, mainly Christian religious [1:10:52] beliefs, to not be allowed to have children. And that dramatically constricted the pool of available [1:10:59] parents. We are changing that. We're also addressing one of the big issues, which is to allow children to [1:11:08] stay with their families of origin. One of the biggest drivers of those separations is drug abuse. [1:11:15] And we are aggressively going after these issues. And partially as a result of our work, the number [1:11:22] of foster children has dropped from 425,000 to 325,000 because there's more kids who are doing [1:11:31] our early preventative services on and intervening early with parents who have drug addiction problems. [1:11:37] Thank you, Mr. Secretary. I yield back. Mr. Davis. Thank you, Mr. Chairman. [1:11:42] Secretary Kennedy, thank you. And I, too, share the admiration of your family's legacy and contributions [1:11:52] to the development of this nation. In my district in Chicago, child care can be hard to find. And when [1:12:02] parents can't find child care, they can't go to work. Last week, President Trump said, and I quote, [1:12:10] the United States can't take care of day care because we're fighting wars and need to spend our [1:12:19] money on those. Do you agree with President Trump that we should cut child care to pay for his war in [1:12:28] Iran? I don't think that that's what President Trump meant, Congressman. And I appreciate you very much [1:12:37] for actually giving me an opportunity to answer your question, which none of your colleagues have done. [1:12:42] They've all shut me up, and they've talked about science, but science is about debate. [1:12:47] They give a little speech that they can go and market, you know, for fundraising, and then they [1:12:52] don't allow me to answer the question. And I deeply appreciate the respect that you've shown. [1:12:58] In this budget, we were told to make a 12 percent cut across our department because we, [1:13:05] Congress wrote a $39 trillion debt. We're now having to tighten our belt. The two programs that I [1:13:13] protected, I protected, and that Russ Flood protected were the Head Start program. [1:13:17] Okay. Oh, it is getting no cuts. And incidentally, [1:13:21] there have been no cuts to Medicaid. Look at the CBO. I've got another question [1:13:26] that I need to ask. Black women are nearly three times as likely to die from pregnancy-related causes [1:13:34] as white women. Yet the Trump administration is undermining black maternal health from all sides. [1:13:42] The GOP slashed over a trillion dollars from Medicaid, which pays for over 40 percent of births [1:13:50] in the United States. President Trump just proposed cutting maternal and child health programs by over [1:13:59] $800 million. Doge canceled funds for several research projects that could save countless black [1:14:08] mothers like the Morehouse School of Medicine research on improving the health of black pregnant and [1:14:15] postpartum women. How can we lower black maternal health experiences if we're cutting funds for these [1:14:23] critical programs? And the administration says that you can't consider race or ethnicity in healthcare. [1:14:32] We are, this administration, under my leadership and President Trump's leadership, is doing more to [1:14:42] advance maternal health than any other administration in history. It was tremendous duplication of [1:14:48] departments. We had 42 different maternal health services in our department, and we cut some of those [1:14:55] and consolidated them. Right now, we are investing huge amounts of money in maternal health. We serve 59 million [1:15:03] American mothers. Our perinatal program, which is a groundbreaking program, we're now in 220 hospitals, [1:15:11] has reduced maternal mortality in those hospitals by 42 percent. Nobody's done that in history. [1:15:20] My time is going to expire, but let me ask you, the community health centers are excellent stewards for [1:15:28] the 340B program, and they've done a great job with them. Now they're burdened with a new model and reporting [1:15:36] requirements. Would you consider exempting the health centers from that model of rebate, all of the reporting [1:15:45] things that are making it difficult? I'm happy to talk to you about that. I can say that we are giving, we are [1:15:52] increasing the budget, our community health services centers in this country, in this budget, where [1:16:00] everything else is getting cut, because we understand that they do a better job at treating their patients, [1:16:06] and particularly patients, for community than any other system in our country, and we strand. I just gave [1:16:12] another 143 million dollars to them last week, in addition to the proposed increase in their budget that [1:16:19] are in this budget, proposed budget. Thank you, Mr. Chairman. Now you're back. Thank you. Mr. Estes. [1:16:26] Thank you, Mr. Chairman, and thank you, Secretary Kennedy, for being here today. You know, I want to start [1:16:31] by commending the Department of Health and Human Services for establishing the Maha Commission and [1:16:37] Administration for a Healthy America to fight chronic disease and promote healthy living for all Americans. [1:16:42] As mentioned earlier, the statistics are staggering that six in ten Americans have at least one chronic [1:16:48] disease and that 90 percent of our health care spending is dedicated to fighting these conditions. [1:16:53] We've got to look at ways to reverse this trend and focus on how do we improve wellness. We're strongly [1:17:00] supportive of a pivot away from this reactionary sick care towards the preventive maintenance and [1:17:06] strategic alignments for particularly rural health. We also need to recognize the importance of [1:17:11] patients' access to quality care and availability of providers. A bold vision for a healthy America [1:17:18] doesn't work if we can't succeed to support our rural communities with the essential medical [1:17:24] workforce and emergency transportation required. In my district in South Central Kansas, institutions [1:17:31] like the Kansas College of Osteopathic Medicine and the future Wichita Biomedical Campus are working [1:17:36] hard to generate the next generation of doctors that will be supportive for us. You know, Mr. Secretary, [1:17:43] air ambulances are an essential lifeline in rural America, and when emergency happens, [1:17:48] sometimes those helicopters are often the only way a patient gets to a medical treatment in time. [1:17:54] Many of our bases are at risk of closing because of the Medicare reimbursement rates haven't been [1:18:00] meaningfully updated for a couple of decades, and part of that's because the federal government [1:18:05] hasn't been doing its job. Five years ago, the No Surprises Act required the Department of HHS and [1:18:12] Department of Transportation to collect those costs and operational data, and to date those rules haven't [1:18:18] been finalized. And I wanted to just ask, you know, how can we work together? How can we get HHS and [1:18:24] Department of Transportation to work to update that? I am happy to work with you on that. I can tell you that [1:18:29] the No Surprises Act was passed with the best intentions and it was a great law, but it was not implemented [1:18:38] by the Biden Administration. And those proposed regulations on the No Surprises Act were left to [1:18:46] languish. We are now in the final process of finalizing them. And I'm happy to work with your office to talk [1:18:53] about the air ambulance problem. You know, this is a huge issue, particularly in Alaska. So I hear from [1:19:02] them all the time about the same issue. But we've also found a lot of fraud in that area, so we need [1:19:09] the kind of audits that you're talking about and the kind of information that you're talking about. We're [1:19:14] really interested in that and I look forward to working with you on it. Great. Well, thank you. [1:19:18] And, you know, one of the things we're also concerned about is the real threat of retirement of so many [1:19:23] providers in the physician workforce. And, you know, as we look particularly of how that's going to [1:19:29] impact patients, particularly in rural communities, many of the communities lack specialists and [1:19:36] particularly with the number of physicians at an older age in our rural communities. And we're seeing [1:19:43] now more patients are approximately seen 50 percent more specialists than in year 2000. And so I want to [1:19:52] see if there's things that you're doing in the administration to help ensure that our rural [1:19:56] patients can get access to some of these specialty care. I think one of the most important things [1:20:01] that we've done to address that very, very grave problem is the site neutrality rules, which we have [1:20:09] recently finalized. And that will end the disparity between what's paid to rural providers and what's paid [1:20:16] to urban providers and hopefully dampen the appetite for consolidations, which are destroying rural [1:20:26] economies and rural health care and allow them to get a living wage, which they don't have right now. [1:20:34] Right. Well, thank you. Thank you for all your hard work. I yield back. [1:20:38] Ms. Sam Chess. Thank you, Secretary Kennedy. We appreciate your appearance here today. [1:20:43] To win the support of skeptical senators during your confirmation hearings, you claimed and I'm quoting [1:20:49] here, I support vaccines. I support the childhood vaccine schedule. I was skeptical about those [1:20:56] comments because prior to your nomination, you espoused numerous disproven theories that childhood [1:21:02] vaccines, including the measles vaccines, were linked to autism, death and other adverse effects. [1:21:07] Not surprisingly, we were right to be skeptical of your promise to support the childhood vaccine [1:21:13] schedule because at your direction, the CDC removed its universal vaccine recommendations for children [1:21:19] covering seven immunizations, including things like flu, COVID, hepatitis A, hepatitis V and rotavirus. [1:21:26] On Fox News last year, you stated, and I'm quoting you again here, there are adverse effects from the [1:21:32] vaccine. It does cause deaths every year. It causes all the illnesses that measles itself causes. [1:21:39] A deadly measles outbreak in Texas killed an unvaccinated six-year-old, the first such death [1:21:45] in a decade. So simple yes or no question. It's not that we don't want to let you answer. It's that we [1:21:51] all have limited time and you have plenty of time to answer questions and you have plenty of time to give [1:21:56] testimony at the beginning. So simple yes or no answer will do here. Do you agree with the majority [1:22:02] of doctors that the measles vaccine could have saved that child's life in Texas? It's possible, certainly. [1:22:10] Okay, thank you. I want to look at some very important data. In 2024, under the Biden administration, [1:22:17] which apparently seems to be responsible for every ill in the world, in 2024, under the Biden [1:22:23] administration, there were 258 cases of measles. And in 2025, under your leadership at HHS, it ballooned to [1:22:33] over 2,000. That's a 675% increase. And we are now on track to surpass that this year with over 1,600 [1:22:44] confirmed cases in just three and a half months. If we project those numbers out for all of 2026, [1:22:51] we can expect a whopping 6,400 cases of measles. That's a 2,380% increase in a preventable disease. [1:23:00] CDC data also shows that about 80% of children who died from flu this season were not vaccinated. The [1:23:09] anti-vaccine rhetoric you ran on and the anti-vaccine actions you have taken over the last year [1:23:16] clearly correlates with the dramatic increases, again, in preventable diseases. As a mother, [1:23:22] this horrifies me. Stopping the spread of communicable diseases is one of HHS's primary [1:23:28] responsibilities. And a strong public health messaging campaign on the importance of vaccines [1:23:34] could have stopped this surge of measles cases as it had in past outbreaks. But I was appalled to learn [1:23:41] that the CDC suspended public health messaging on vaccines last February. It ended a successful flu [1:23:49] vaccine campaign as well. My question is, did President Trump approve your decision to end CDC's [1:23:56] pro-vaccine public messaging campaign campaign? You've got a lot of misinformation there, first of [1:24:01] all. No, I'm asking you a question. I appreciate a response to the question. Let me respond to the [1:24:05] misstatements that you've made. No, you have other opportunities. I have limited time. Please answer [1:24:11] my question. You're the only opportunity I have to respond. Did President Trump approve your decision to [1:24:16] end CDC's pro-vaccine public messaging campaign? Allow me to answer, to respond to a lot of the [1:24:22] misinformation. No, answer my question please, sir. I have limited time. There's a global measles [1:24:28] epidemic. We've done better in preventing it than any country in the world. There is no country that [1:24:33] has seen a bigger percentage increase. That's not true. Mexico has three times our measles and they have [1:24:38] one-eighth of our population. And who, did President Trump approve your decision to end the CDC's pro-vaccine [1:24:43] public messaging campaign? Canada has doubled the measles and they have one-eighth of our population. [1:24:49] He approved that. We've done better at preventing measles than any country in the world. Did President [1:24:54] Trump approve your decision to end the CDC's pro-vaccine public messaging campaign? We've [1:25:00] done better at preventing measles and ending the epidemic than any country in the world. That's not [1:25:05] answering my question. And I think you don't want to answer the question, because I think you know [1:25:10] I want to respond to your misinformation. Terrible, terrible decisions that impact very, [1:25:15] very, very real lives, especially the lives of children. Now, one thing that I find incredible [1:25:22] is that you suspended this pro-vaccine messaging campaign, but somehow you're spending taxpayer [1:25:28] dollars to drink milk shirtless in a hot tub with Kid Rock, and somehow you think that's a better public [1:25:35] health message than informing the public about the importance of vaccines? [1:25:40] General Lady's time has expired. Really? Really? I yield back. [1:25:43] You don't have anything to yield. Mr. Smucker. [1:25:47] Thank you, Mr. Chairman. Thank you, Secretary, for being here today. I'd like to first thank you for your [1:25:57] work. Thank you for your willingness to do this. Thank you for your courage, because taking on [1:26:03] entrenched systems does take real courage, and I think future generations will thank you for the work [1:26:10] that you're doing today. I want to talk just two quick things. You've spoken extensively about the [1:26:17] role of diet in preventing chronic disease, and I have two specific policies, bills that I'm working on [1:26:24] that we've talked with the department about, but I'd love to get your public comments about them today. The [1:26:31] first is food is medicine interventions, like produce prescriptions, medically tailored meals, [1:26:40] which there's growing evidence that they can really improve outcomes for patients with chronic disease. So [1:26:48] I think there's a role for these approaches in federal health programs, and of course, you know, CMMI [1:26:56] is created specifically to test new health care delivery models that improve outcomes of lower [1:27:01] costs. And I appreciate that under your leadership, CMMI has started to prioritize prevention-focused [1:27:09] models. So I've been working on and plan to introduce actually this afternoon a bipartisan bill that would [1:27:15] test a bundled payment that provides certain chronically ill patients with a comprehensive package, access to [1:27:22] healthy produce, nutrition counseling, remote monitoring, with the goal of preventing disease progression and [1:27:29] reducing avoidable health care costs. I'd just like to get your reaction to that and love to have the [1:27:34] continued support of the department for a policy like this. I mean, we have the highest chronic disease [1:27:39] burden in the world. Congressman was talking about the deaths from infectious disease, which are a couple of [1:27:46] thousand a year. Ninety percent of the people who die and the three million people who die in this country die of chronic [1:27:53] disease, and nobody's paying attention to this. And all of these members have ignored this for as long as they've been [1:27:59] in office. This is the real threat to American health. In fact, during COVID, we have the highest death rate of any [1:28:07] country in the world. And when you ask CDC, why is that true? They say, well, it's because we're the sickest population. [1:28:16] The average American who died from COVID had 3.8 chronic disease. What was killing them? COVID or the chronic disease? We have to [1:28:25] understand chronic disease. Infectious disease has a very hard time killing healthy person. It kills people [1:28:32] with chronic disease. And we are, I'm looking forward to you, you know, up to 70 percent of type 2 diabetes [1:28:42] can be reversed and people can even lose the diagnosis simply by changing their diet. [1:28:48] Well, thank you. I do want to bring up [1:28:50] one additional piece of legislation that we're working on. You know, food manufacturers are moving [1:28:57] in the right direction due to your leadership on reducing additives, reformulating products, [1:29:02] responding to consumer demand for healthier options. There's still a gap, though, in what's [1:29:10] in the generally recognized as safe or grass pathway where companies can self-determine a substance is [1:29:16] safe. They determine that themselves, often relying on their own expert panels with limited transparency [1:29:23] into potential conflicts of interest or underlying data. So that's another piece of legislation I'm [1:29:29] working on. I think we should establish clear standards for self-crast panels, strengthen public [1:29:35] confidence in our food supply. Just wanted to get your thoughts. Do you believe reforms like that are [1:29:41] Yeah, that's absolutely critical. We have finalized in my agency a closing the grass loophole and that [1:29:50] regulation is now going through the interagency process. We're a little bit hobbled in what we can [1:29:56] do and Congress can do much more. So my office would love to work with your office on getting a much [1:30:02] stronger bill, much stronger regulations. The grass loophole has been hijacked by the food industry [1:30:11] and because of that we have 10,000 ingredients in our food. In Europe they only have 400 and most of [1:30:18] those have never been safety tested. We don't even have a list of them. We have no idea what they are. [1:30:23] It essentially allows the industry to put in any chemical they want, any chemical they devise in [1:30:31] lab into our food without even the slightest regulations. And that needs to be changed if we're [1:30:39] going to make America healthy again. I appreciate your help and your leadership, Congressman. Thank [1:30:43] you. Look forward to working with you on that. Ms. Sewell. Mr. Secretary, you've made a number of [1:30:49] outlandish and frankly disturbing comments both before and during your tenure as Secretary of Health and [1:30:56] Human Services. I want to draw your attention to one of those times. In a 2024 podcast interview, [1:31:05] you suggested that black children on ADHD medication should be reparented. You said every black kid is now [1:31:15] just standardly put on Adderall, SSRI benzos, which are known to induce violence, and that those children [1:31:25] are going to have to go somewhere to get reparented. There is a lot to unpack in that comment. [1:31:32] I know that you've already answered several of the questions I was going to ask and so I'm just going [1:31:36] to rephrase them. Mr. Secretary, you've already admitted that you are not board certified physician, [1:31:42] and you've already admitted that you did not go to medical school. Have you ever reparented, [1:31:49] or parented, I should say, a black child? I don't even know what that phrase means, [1:31:55] and I doubt that I said it. A yes or no answer. I doubt that I said that phrase? No, I'm not going to [1:31:59] answer something that I didn't say. You absolutely said it. Oh, I'd like to hear the recording. [1:32:06] So to be clear. It doesn't make any sense. I don't even know what it means. I don't either. [1:32:11] That's why I'm asking. And by the way. So to be clear, you're not a doctor, you have no medical [1:32:16] degree, and you have no formal medical training. And you have never parented a black child. [1:32:21] As of 24 of the 26 HHS secretaries have not had medical degrees. This is my time, [1:32:28] and I say to the chairman, I want to reclaim my time. So you are not a doctor, have no formal medical [1:32:36] training, and you've never parented a black child. And yet you are suggesting that the federal [1:32:40] government should take black children away from their families and re-parent them and send them [1:32:46] off to some wellness farm instead of providing them with evidence-based. You're just making stuff up. [1:32:51] I am absolutely not making this up. Mr. Secretary, in your opinion, what factors should the federal [1:32:57] government consider when re-parenting a black child who has been on ADHD or ADD? That's rhetorical. [1:33:04] I don't even know what you're talking about, Congressman. [1:33:08] I don't know what you're talking about. I don't know what re-parenting either means. [1:33:12] I don't either, but you said that. I did not say that. [1:33:15] Mr. Secretary, for black families of the United States, the issue of family separation is not new. [1:33:21] Our nation has a long and painful history of separating black children from their families. [1:33:26] During slavery, black children were taken from their parents and sold with no regard for their [1:33:31] humanity. And after slavery, black families continued to face forced separations through [1:33:36] Jim Crow laws, discriminatory policing, and child welfare systems that too often assumed that black [1:33:43] parents were unfit. Even today, black children are removed from their homes at higher rates than white [1:33:48] children, not because of their greater harm, but because of longstanding bias and built-in institutionalism. [1:33:56] For you to suggest that black families are not capable of raising their own children is deeply offensive. [1:34:03] Sir, you are the Secretary of Health and Human Services for the world's most powerful country, [1:34:10] and your words matter. When you suggest that re-parenting black children, when you so doubt [1:34:17] about the safety of vaccines, and when you promote unproven statements that have no basis in science, [1:34:24] you endanger the lives of everyone across this nation. Those children have parents, [1:34:33] and to suggest that they have to be re-parented is offensive. [1:34:38] I never suggested that. [1:34:40] Your words matter. When those words are careless, communities pay the price. When your words are [1:34:46] imprecise, they create confusion. And when your words are dismissive, they cause real harm. [1:34:53] So you don't have the pleasure, because of your position, to speak first and think later. Not in [1:35:02] this job and not because of your responsibility. I expect, and the American people expect, that you [1:35:09] choose your words with sincereness and with seriousness. The seriousness that your position demands. [1:35:17] American lives are at stake, and it's time that you start acting like it, sir. [1:35:21] Thank you. Ms. Hearn. Mr. Hearn. Mr. Hearn. [1:35:27] Mr. Hearn. Thank you, Mr. Chairman. It's good to be with you today. Mr. Secretary, thank you so much. [1:35:39] It's good to have you here today. I really appreciate it. I want to use my time to bring an issue [1:35:45] to your attention. Last month, a young man from Oklahoma, Jacob Toe, came to meet me in my office. [1:35:52] He told me a story that stuck with me and one that can make a huge difference for children in our [1:35:56] country. In 2024, Jacob was in the midst of a custody dispute for his three-year-old son, [1:36:01] Leonardo, or Leo, as they called him. One day, Jacob got the call no parent ever wanted to receive. [1:36:08] While Leo was in his mother's care, the young boy passed away. Jacob learned that Leo died from an [1:36:13] accidental ingestion of fentanyl that was left within the reach of his mother's home. Jacob fought to [1:36:18] figure out how this could possibly happen. In doing so, he learned that the drug screening panels used in [1:36:23] the child welfare process did not test for fentanyl, which is not detected by standard drug panels. [1:36:28] While talking to lawmakers back home, they, like me, were shocked that fentanyl was not already [1:36:34] included in the child welfare drug screenings. I believe other states across the country do not [1:36:39] realize this gap in care and safety exists. While grieving the death of his son, Jacob decided to [1:36:44] get involved. He told his story all around the state of Oklahoma, urging lawmakers to correct this [1:36:49] deadly gap in testing and keeping kids safe. Thanks to Jacob's effort, last month the Oklahoma [1:36:55] State House of Representatives passed Leo's Law in honor of young Leo. This bill requires the [1:37:00] Oklahoma Department of Human Services to include fentanyl testing and all-child welfare drug screenings [1:37:05] where fentanyl use is suspected. This is not an issue that is unique to Oklahoma. Other states, [1:37:10] such as California, have followed suit and introduced similar legislation. I'm proud of my home state for [1:37:16] leading this charge and even prouder of this young man from Kellyville, Oklahoma, who has turned his [1:37:21] unthinkable tragedy in successful advocacy efforts. I commend Jacob, but I know he cannot do this alone. [1:37:27] We must do our part and help him ensure that no other child is harmed from fentanyl like his son Leo [1:37:32] was. Secretary Kennedy, two things. Will you work with Congress to educate states about this ongoing [1:37:39] issue and hopefully get them to introduce laws and figure out how we can work together at the federal level [1:37:44] to ensure all states are testing for fentanyl and child welfare drug screenings when necessary? [1:37:50] I will work with your office on that. I think it's a wonderful objective. As you say, it's normally [1:37:57] regulated by state law, but we can look at other options. It would be great to get everybody to do [1:38:01] this. I'm sure children are dying across the country. Like I said, even California saw the need to do this and [1:38:06] pass their own laws. One other question before I go. Substance abuse is one of the leading factors for kids [1:38:13] entering foster care, and in fiscal year 2024, more than 30 percent of children entered foster care [1:38:19] due to substance abuse by their parents. Under your leadership, ACF has expanded access to drug [1:38:26] treatment under the Title IVe Child Welfare Program for Parents as part of the Great American Recovery [1:38:31] Initiative. What steps can Congress take to build on this administrative's emphasis on prevention services? [1:38:39] Well, we've now funded as part of the Great American Recovery Program as a STOMP program. We're working [1:38:51] with states, with law enforcement, with detoxes, with rehabs, and sober housing to bring together [1:38:59] a treatment that has been fragmented and atomized in the past. We also, you know, one of the primary [1:39:07] problems with drug treatment is it has the same reverse incentives as we see in the main, you know, [1:39:14] in the physical health medical system, which is that people get paid more by keeping the addict [1:39:20] addicted. If you go to a rehab and you relapse, that's the best thing that'll happen to that rehab [1:39:29] because then you're coming back for a second bite. And we're now working on implementing a model, and I [1:39:36] actually visited a place in Arizona called Camelback this week. It guarantees where the rehab after you [1:39:45] go there for 30 days or 60 days will guarantee if you relapse within the next 12 months, you come back [1:39:52] for free. And that gives the rehab the incentive to make sure you're going through IOP, that you're [1:39:58] getting drug tested, that you're getting psychiatric care, that you're going to 12-step meetings or [1:40:04] whatever they need to do. Maximize because they're now, their financial incentives are now aligned with the [1:40:12] incentive of getting you healthy. And I think ultimately that's where we need to move toward [1:40:18] value-based care rather than essentially what's a fee-for-service model. Great. Thank you, Mr. Secretary. [1:40:25] Mr. Chairman, I will not yield back time because I don't have any to yield back, just to point that out. [1:40:30] Thank you. Thank you, Mr. Hearn. Ms. DelBene. Thank you, Mr. Chairman. Mr. Secretary, I'm glad you're [1:40:36] here. Thank you, Mr. Secretary. Thank you, Mr. Secretary. Thank you, Mr. Secretary. Thank you, Mr. Secretary. [1:40:50] I hope you understand the harm that delaying and denying necessary care can have. Do you remember [1:40:57] saying this, quote, Americans shouldn't have to negotiate with their insurer to get the care they [1:41:03] need? Pitting patients and their doctors against massive companies was not good for anyone, end [1:41:10] quote. Do you remember? I don't remember, but I would align with that. And I'll submit for the record [1:41:17] actually a press release from CMS with your quote in that from June 23rd of 2025. Without objection. [1:41:26] In this case, I agree. Pitting patients and their doctors against massive companies isn't good for [1:41:31] anyone. And yet less than a week after you said that, CMS announced the WISER model. The program [1:41:39] allows private companies to use AI to review traditional Medicare claims and pays them based [1:41:45] on the amount of care they deny. This program went into place in six states across the country, [1:41:51] including my home state of Washington. President Trump said multiple times on the campaign trail that [1:41:56] he would not cut Medicare, but this program does exactly that. For example, Joanne is a senior from [1:42:03] Washington on Medicare. She has a herniated disc that is pinching her sciatic nerve, causing immense [1:42:10] pain down the right side of her body. Her doctor prescribed an injection that would help relieve her pain. [1:42:16] If it had been prescribed last year, she would have received the treatment, no problem. But because of the [1:42:22] WISER model that has been implemented, she's been in intense pain for over six weeks while she waits [1:42:29] for approval. She has been using crutches or a wheelchair for over a month now, which is making [1:42:35] her arthritis worse, adding to her chronic pain. Since using crutches, she's fallen multiple times, [1:42:41] including earlier this week. Instead of simply approving the procedure, Joanne's conditions are getting [1:42:46] worse. Secretary Kennedy, the W in the WISER model stands for wasteful. Do you think that Joanne's [1:42:53] treatment, which would allow her to walk and live with less pain that her doctor has prescribed, [1:42:58] do you think that's wasteful? Do you want me to actually answer that question? Yeah. I think that [1:43:05] that's a terrible outcome. It's one that was not intended for the system, obviously. The problem is [1:43:13] because there's tremendous ways. In Medicaid, there's only 5% of the cases are given prior [1:43:18] authorization. In private industry, 30%. This is traditional Medicare now, where it's now, [1:43:26] this has only been put under prior authorization under your leadership. Now, President Trump promised [1:43:33] multiple times that he, quote, will not lay a finger on Medicare. Given President Trump's promise, [1:43:39] did you or the President approve this model, which is now delaying and denying care for people in states [1:43:46] like the state of Washington? Can I answer the question? Yeah. People are being denied care across [1:43:53] our state right now. I'll say very quickly, and this is an example. Five years ago, we were paying $250,000 [1:44:01] a year for $250 million for skin substitutes. This year, $23 billion. Why? Because there was no [1:44:10] prior authorization in the Medicare program. And now someone like Joanne is not getting her care. [1:44:15] It's more expensive for us because Joanne is not getting her care. We have story after story. I can [1:44:21] also submit for the record stories of all the people who are being delayed and denied care. It is more [1:44:26] expensive for us. It is more expensive for them when they are not getting the care they need. Last year, [1:44:33] I sent CMS a letter detailing my concerns about the WISER model. I still have not gotten a response. That was [1:44:38] last August. Can you publicly commit to responding to that letter and addressing the concerns of this harmful [1:44:45] model? Yeah, absolutely. We will. And I apologize for not getting back to you sooner. We have an [1:44:53] unprecedented number of communications from Congress. Well, we don't have you here very often. We have people in [1:45:03] in my state who are being denied care, who are being hurt based on this policy, and there's an [1:45:10] indifference to the challenges that they are facing all because of a model put in place for no reason [1:45:15] and doing exactly what you said shouldn't happen, which is, and I quote, pitting patients and their [1:45:21] doctors against massive companies. These are private companies doing this prior authorization. It was not [1:45:27] good for anyone. Thank you. I yield back, Mr. Chairman. As I said, discovering 23 billion dollars [1:45:32] with the fraud is not for no reason, and that... You are hurting patients in our state and other [1:45:39] states across the country for no reason, and I appreciate you finally responding to the letter. [1:45:43] Thank you. I yield back. Ms. Miller. Thank you, Chairman Smith. Secretary Kennedy, [1:45:48] thank you so much for coming in front of our committee today and for your leadership in improving [1:45:55] the health and well-being of the American people. I have two things I'd like to discuss. In my home [1:46:02] state of West Virginia, we see some of the highest rates of chronic disease in the country. Coupled with [1:46:09] our rural nature and limited access to care, many of these patients are especially vulnerable and face [1:46:16] significant barriers to managing their conditions. The first chronic disease that I want to speak about [1:46:23] is our patient population that I am focusing on, which is people who are living with chronic kidney disease [1:46:33] and the end-stage renal disease. I commend the administration's effort to promote affordability [1:46:40] and fiscal responsibility in health care. I am concerned, however, that in the case of kidney disease, [1:46:47] the current ESRD bundle may inadvertently discourage the development of adoption of new therapies and [1:46:54] technologies that could improve outcomes and reduce long-term costs for patients who do rely on [1:47:02] life-saving dialysis. The complicated post-Tadapa policy has resulted in promising innovative drugs [1:47:10] being pulled from the market entirely or only being accessible by a tiny fraction of the patients. [1:47:17] I have a bill called the Kidney Care Access Protection Act, and it is a piece of legislation that [1:47:23] could expand access to the new treatment options in a way that both encourages innovation and ensures [1:47:30] costs remain well managed for Medicare and taxpayers. As we work together toward better outcomes and [1:47:37] cost containment, how is CMS evaluating ways to strengthen incentives for innovation within the [1:47:44] ERSD bundle while still maintaining fiscal responsibility? I mean, I would say that that's the balance that [1:47:53] we're all trying to achieve. We are doing everything in our power to maintain the United States as the [1:48:02] innovation center for the world, and we want to make it easier to get quick approvals for drugs that [1:48:09] actually work. We need to do science on them, and we're doing gold standard science, and we're we have [1:48:17] depoliticized science at the agencies. I don't know enough about the renal disease aspect in the bundle, but [1:48:26] I'm happy to work with you. Also get somebody from Oz's team to come over and talk to you directly because [1:48:34] I know that that's not an outcome that they would like. That would be wonderful. The second issue that [1:48:41] I wanted to talk to you about is that it is clear that what we eat plays a direct role in our health, [1:48:48] and quite frankly, many Americans don't eat right. And these poor nutrition choices are a major driver of [1:48:55] chronic disease. I believe there's a strong case of expanding access to MNT therapy for targeted and specific [1:49:03] groups in Medicare beneficiaries who outcome could actually measurably improve as a result. [1:49:10] With that in mind, can you share your perspective on the role medical nutrition therapy should play in [1:49:15] improving health outcomes for Medicare beneficiaries and how we can most effectively and responsibly [1:49:22] expand to those who would benefit from the most, particularly in the rural and underserved areas? [1:49:27] Yeah, I think, and I've worked with Governor Morrissey about that on this issue. And I think [1:49:35] there's nobody at this agency who is not committed to the idea that food is medicine, that it is, [1:49:44] and if we want to do prevention in this country, we've got to, and end the chronic disease epidemic, [1:49:51] we've got to start with food. That's one of the reasons we're pushing nutrition into the colleges, [1:49:56] we're pushing it into the hospitals, we're pushing it into the community health centers, [1:50:03] make it the central focus of healing and prevention. I want to work with you in any way that I can [1:50:11] to achieve the goals that you're talking about. Thank you so much. I yield back. Dr. Murphy, [1:50:23] I don't think your mic is working. Oh, nope. All right. Is it now? It's now, it's working now. [1:50:35] Thank you for coming. I want my 12 seconds back. Thank you for coming. You know, we're talking about [1:50:41] a little bit about vaccination. I think we ought to talk a little bit about the arrogance of a [1:50:45] fellow named Anthony Fauci, who came and lied to Congress, lied to the American people, and in my [1:50:50] opinion, destroyed the confidence of the American public in the healthcare system. So I think that when [1:50:56] we're talking about vaccination, that's number one. Number two is your predecessor, who was not a [1:51:00] physician either, led the greatest invasion in this country of 13 to 20 million illegal people [1:51:05] coming in this country who were not vaccinated and brought in disease into this country. So let's [1:51:10] actually bring facts into that conversation. Second of all, I share some of the concern now [1:51:16] about what's happening with our drug delivery system going to China. They are developing a burgeoning [1:51:22] industry that is threatening what we do as primal confidence, at least in the American pharmaceutical [1:51:28] industry. And I think we really, really have to be concerned about that. I think the greatest thing [1:51:33] that your administration has done is bring highlighting to the fact that food is medicine. [1:51:38] I saw a child in my clinic about six weeks ago that was eight years old that weighed 262 pounds. This is [1:51:45] what we're dealing with. This is what the obesity epidemic, and it is sad that the number one drug that [1:51:50] is selling now in the country are weight loss drugs. This is endemic. This speaks to the terrible, [1:51:56] terrible tragedy that has become the American food industry. So thank you for highlighting that. [1:52:01] I want to get back to one thing that is my passion, and that is the cost of care in this country. [1:52:06] The cost of care in this country has risen tremendously, in my opinion, primarily because [1:52:13] of vertical integration that has happened in this country, primarily which has been caused by the ACA. [1:52:18] That is the number one driver of health care costs. We can talk about the pharmaceutical industry. [1:52:22] We can talk about the other things. But we, a few weeks ago, had the arrogance and the vanity [1:52:27] of our health insurance industries come in front of this committee and just sit to point fingers [1:52:31] otherwise. You convened last summer, in July, the 70 percent of those who insured in this country, [1:52:37] and they said they were going to do better. And I know they gave a report saying they've cut down [1:52:40] prior authorizations by 11 percent. But frankly, after 35 years in the health care industry, I don't believe a [1:52:46] damn word that they say. And until we get the middlemen under control in this country, the number [1:52:52] one driver of health care costs in the pharmaceutical space is not the pharmaceutical industry. It is the [1:52:58] pharmacy benefit managers. It is the middlemen. And until we get rid of this thing that is only present [1:53:04] in the United States, we will not drive down health care costs. And so I urge you, I urge you to be the [1:53:10] hallmark of your administration is to go after what we have created is the vertical integration that is [1:53:16] destroying the doctor-patient relationship and bankrupting America. Second of all, I want to talk [1:53:22] about the No Surprises Act. To your point, absolutely a great bipartisan bicameral bill. Your predecessor, [1:53:29] of course, went straight and gave all the authority to the insurance companies. I have a bill, HR 4710, [1:53:34] which puts meaningful enforcement back into this. Right now, our vain and arrogant insurance companies [1:53:40] are keeping hundreds of millions of dollars just in their little kitty, which has been appropriated [1:53:46] to people who provided the care, but they're keeping it. And so enforcement mechanism, and I [1:53:51] understand your administration is working on that. So I thank you with this. And then lastly, [1:53:56] excuse me, I applaud the Trump RX. We had Mark Cuban come in. We're working with the administration and [1:54:09] trying to do this with Cost Plus. I saw a patient, again, about six weeks ago. He changed insurance [1:54:13] companies. The pill he had been on for 15 plus years was now close to $1,500. I literally pulled [1:54:19] out my phone and went to Cost Plus and it was $15. So I applaud the administration for getting the [1:54:25] middlemen out. These are the problems that the American public is facing. You know, we can talk [1:54:30] about all the other extraneous issues, but if people can't afford health care, that's not access to [1:54:35] health care. When you allow 20 million people in the country and you overload hospitals and [1:54:39] the overload of health care systems, we can't provide care to the American public. That is our [1:54:45] primal and first duty. So I want to say thank you for what you're doing. You have a tough job. [1:54:51] We're here to support you and thank you for your efforts. With that, I'll yield back. [1:54:54] Ms. Chu. Secretary Kennedy, we have a child care affordability crisis in this country. Working [1:55:01] families are having to pay skyrocketing prices, in some cases as much as 40 percent of their income, [1:55:07] and too many working parents are having to leave the workforce or turn down job opportunities because [1:55:13] they can't afford child care. This is hurting American families, our workforce, and our economy. [1:55:19] During your 2024 presidential campaign, you did a commendable thing. You proposed that the federal [1:55:25] government should subsidize 100 percent of child care costs for families below the poverty line and cap [1:55:32] expenses at 10 percent of income for all other families. It's right here in this article from [1:55:38] the National Catholic Register. And yet, just two weeks ago, President Trump said, we can't take care of [1:55:47] child care. We're fighting wars. We can't take care of day care. Now, earlier, you were asked about this [1:55:57] and whether you agree with it. And you then, you actually didn't answer it. You said, well, I fully [1:56:02] funded Head Start. But your agency is illegally withholding child care funding from every single [1:56:11] state unless they submit a bunch of extra data not required by law. And also, the President's budget [1:56:20] request for 2027 proposes eliminating $350 million for preschool development grants. Do you agree with [1:56:30] eliminating $315 million from preschool development grants? Those funds are going out. They're not [1:56:37] being withheld. You know, you're mistaken about that. No, this proposal, actually what I said was [1:56:43] the elimination of $315 million for preschool development grants. I'm just wondering because it's [1:56:50] completely contradictory to what your presidential campaign was. Well, anyway, let me say this. [1:56:56] Child care is one of the top expenses for American families and is becoming increasingly unaffordable. [1:57:03] President Trump campaigned on the promise that he would lower costs, but his record while in office [1:57:08] has been the exact opposite. He keeps on withholding federal funding for child care. His reckless tariffs [1:57:16] have raised prices on food and everyday goods. Gas prices are also up thanks to his unpopular war of [1:57:24] choice in Iran. So remember, Mr. Secretary, you once said for the cost of the Ukraine war, we could make [1:57:32] child care affordable for every family. It's ironic that Trump is doing the exact opposite, not funding [1:57:40] child care because we have wars to fund. It's a slap in the face to every American. And now I'd like to [1:57:49] switch to another topic, hepatitis B. Today, I'm thinking about my friend Chi Moi, who was a city [1:57:56] council member in my district, San Gabriel, California. Chi did not know that he had hepatitis B until he [1:58:02] donated blood. Eventually, there was a liver tumor that spread to his pelvic bone. He was on the city council [1:58:09] by then. And we watched as he grew weaker and weaker. And then he became the first Asian American [1:58:16] mayor. But he died of liver cancer just one month after his installation. And we think he hung on long [1:58:25] enough to reach that milestone, only to die at the age of 53. It was beyond tragic. But to think his life [1:58:33] could have been saved had he been vaccinated from hepatitis B as a newborn. Secretary, you've done an [1:58:40] incredibly harmful thing to our community. You eliminated the mandatory hepatitis B vaccine for [1:58:48] newborns. And it disproportionately threatens Asian Americans because while we make up 7% of the [1:58:54] population, we account for 60% of all hepatitis B cases. It's clear that this administration has no [1:59:03] regard for the health, safety, and well-being of Asian American communities, as well as communities [1:59:11] across the United States. You want me to reply? Well, if that's it. Hepatitis B is a terrible disease. [1:59:25] But babies are not at risk unless they essentially have zero risk, unless their mother is infected. For all [1:59:33] mothers are tested when they go into the hospital to have a baby. And for all those people who are [1:59:40] infected, the vaccine is still a recommended vaccine. For everybody else, it's available. Parents can [1:59:49] assess the risks themselves through informed consent. Insurance will pay for it. We did not remove the [1:59:56] vaccine from being insured. And we just believe that Americans should have that choice, that the state [2:00:03] should not make that choice for them. Hepatitis B vaccine was not safety tested. It had a four-day [2:00:12] test with no placebo. We don't know what the risk profile is. And parents are allowed to ask that [2:00:18] question. Mr. Kustoff. The science is that it's not simply about choice. It's about whether infants [2:00:24] are protected during the most vulnerable period. Infants are protected. Okay, Mr. Kustoff is recognized. [2:00:31] Thank you, Chairman Smith. And thank you, Secretary Kennedy, for appearing today. If I could, Secretary [2:00:36] Kennedy, I represent parts of Memphis, Jackson, Tennessee. You and I have talked about Jackson, [2:00:43] Tennessee before, and rural West Tennessee. I wanted to talk to you about hospitals, [2:00:49] particularly in those rural communities. I know that because of the CMS Area Wage Index, we have [2:00:57] hospitals that are in primarily rural areas that are being paid less than those in urban areas. [2:01:05] During the President's first term, CMS did introduce the low-wage index hospital policy, [2:01:13] and that did help to reduce that discrepancy. Back on March 26, a few weeks ago, I introduced with [2:01:22] Congresswoman Terri Sewell a bill called the Save Struggling Hospitals Act. So it is bipartisan legislation. [2:01:31] It aims to keep rural hospitals open by codifying an adjustment to the Area Wage Index to ensure that [2:01:40] hospitals in rural and low-wage areas receive a fair Medicare reimbursement for the essential services [2:01:48] that they provide. I know that you have publicly said before that you support codification of the low-wage [2:01:56] index hospital policy. I guess I just wanted to ask you, that is something that you you still support [2:02:03] and you would support being codified? Absolutely. I wish that we could fix it within the agency, but as [2:02:09] you know, the Social Security Act requires any adjustment has to be revenue neutral, and that [2:02:22] means if you take from one area, you have to give to another. If you give to one area, you have to [2:02:28] reduce payments to the other. It's a broken system. It needs to be fixed, but only Congress can fix it, [2:02:34] and I and my agency will work with you toward that goal. Thank you, Mr. Secretary. If I could, [2:02:41] if I could ask you about peptides. A lot of attention with peptides. We know that about three years ago, [2:02:49] the FDA removed 19 peptides from the list that compounding pharmacies could routinely make in [2:02:57] that limited access. Can I get your general opinion on peptides and your agency, your department's [2:03:07] plans if there are any for maybe mainstreaming peptides? Well, we returned 12 of those peptides [2:03:16] yesterday. The class to the category one categories that formulators will now be able to formulate them. [2:03:26] Eptides are like supplements. The FDA has authority to require pre-licensing safety studies, pre-marketing [2:03:39] safety studies, and any drug that claims a specific indication and that's mass marketed. If you don't make [2:03:52] those claims, if you're not mass marketed and you then FDA does not require that. Oh, so like supplements [2:04:00] are not regulated in that way by FDA. Peptides are not supposed to be regulated. It's been upheld again [2:04:06] and again by the courts. The Biden administration improperly moved them to category three without [2:04:13] any evidence of safety. The only the only justification they have is if there's a safety concern and there [2:04:20] was no science that indicated a safety concern. So it was improper. We have now remediated that by moving [2:04:26] them back. Thank you very much, Mr. Secretary. Now yield back, Mr. Chairman. Thank you, Mr. Fitzpatrick. [2:04:33] Secretary Kennedy, in a long overdue move, the FDA is finally taking steps to remove petroleum-based food [2:04:40] dyes, including red 40, yellow 5, yellow 6, blue 1, blue 2, and green 3 from our food and our medicine [2:04:49] starting immediately. These dyes have been unequivocally linked to cancer, to hyperactivity, [2:04:55] and to so many other serious health risks, and yet they have been left unchecked and unlabeled for [2:05:01] absurdly too long. Secretary, beyond commitments from industry and beyond regulation from the FDA, [2:05:08] what steps can this legislative body take to make sure that we preserve over the long term [2:05:15] cleaner ingredients in our food and our medicine as we look to address the link between these chemicals [2:05:20] and the chronic disease epidemic? The most important thing that you could do, Congressman, [2:05:26] is to close the grass loophole. We have regulations now that do everything in our power, [2:05:35] the my agency's power to close that loophole, and those are now in the interagency process, [2:05:42] so we've completed it within my agency. There are now other agencies of equities in them and are looking [2:05:48] at them, but it doesn't go far enough, and we need to go farther. We need to really make sure that any [2:05:56] ingredient in our food is safety tested first. That's what they do in Europe. That's what they do in other [2:06:02] nations. That's why they only have 400 ingredients in their food in Europe compared to 10,000 here, [2:06:08] and so that we would love to work with you on that legislation. I think it's absolutely critical if [2:06:15] we're going to make America healthy again. Second, I want to address something that is of critical [2:06:20] importance to my constituents in Bucks and Montgomery counties in Pennsylvania pertaining to the chronic [2:06:25] disease epidemic, pertaining to the impacts of PFAS and microplastics in our food and our water supply. [2:06:32] There is more that can be done at the federal level to address chemicals and toxins in our food and [2:06:37] water and elevate how these issues are connected to deteriorating health across our nation. Specifically, [2:06:43] the recent joint announcement that HHS and the EPA will be including microplastics in the EPA's [2:06:49] contaminant candidate list and launch the ARPA-H program to detect and remove plastics from the human body, [2:06:56] I believe to be a positive development in addressing the intersection of toxins in our food and water [2:07:01] and the chronic disease epidemic. Secretary Kennedy, could you expand on the agency's efforts to further [2:07:08] address microplastics and PFAS contaminants in our food and water supply and how these actions will [2:07:14] impact overall health and fighting the chronic disease epidemic? We're putting 140 million dollars [2:07:20] into the STOMP program at ARPA-H to look at, to track, you know, right now microplast, the average American [2:07:30] has a teaspoonful of microplastics in his brain. Almost one percent of brain volume is now microplastics. [2:07:37] That couldn't be a good thing. We know very little about the pathways by which it goes into the brain. [2:07:46] Hundreds of components of microplastics, hundreds of different kinds. Some of them may be benign. [2:07:52] Other ones we know are hideously toxic. We are going to identify those. We're going to trace the [2:07:57] pathways so that we can better regulate them. The other thing that we're doing is moving them to the [2:08:04] MCL to the maximum contaminant list in the Safe Drinking Water Act so that we can now start [2:08:11] regulating and establish maximum contaminant levels for both PFAS and microplastics and start [2:08:18] regulating them effectively in drinking water. I want to add this. The amount in our brains has doubled [2:08:27] over the past five years. So this is rising exponentially and it is an existential crisis. [2:08:34] Thank you sir. I yield back Mr. Chairman. Thank you. Ms. Moore. Ranking Member Moore. [2:08:41] Thank you so much Secretary Kennedy and I just want to join in with the committee and sort of [2:08:49] you know remembering the Kennedy family. I remember being nine years old begging my [2:08:55] Republican mother to vote for John Kennedy. I don't think he won in Wisconsin but I do think that [2:09:03] your family has made a great impact on this country. I promise to give you [2:09:08] easy comfortable questions if you don't yell at me and hurt my feelings. I promise you. I just want to [2:09:16] thank you for pointing out stuff like the dyes and stuff in food and and maybe even the looking at the [2:09:23] food pyramid. I think that that's been a very helpful discussion in terms of your making America healthy [2:09:32] again. And I'm just going to ask you a question and I hope it doesn't it's sort of outside of the scope of your [2:09:37] service. But how does the cut the 1.4 billion dollar cut in WIC and the 900 billion dollar cut in SNAP [2:09:47] interfere with your make America healthy initiative? I know that departments are told they have to cut. [2:09:55] Do you think that that will interfere? I well am I happy about the cuts? No I'm not happy about the cuts. [2:10:03] Don't you think it will mean Fruit Loops are a lot cheaper than good healthy food. Yeah I mean nobody [2:10:10] wants to make the cuts. Russ doesn't want to make the cuts. President Trump doesn't but we got a 39 [2:10:15] trillion dollar debt and that's costing every American child 6,600 dollars a year. Yeah I get this. [2:10:22] Oh okay so it is my time thank you. All right thanks. And I am you know I'm focusing on children here you [2:10:28] know you you made a beautiful quote that I was not aware of in your testimony. You said although [2:10:35] children may be the victims of fate they will not be the victims of our neglect. You claim your uncle [2:10:42] said that. What uncle were you talking about? John F. Kennedy Jr. President Kennedy. President Kennedy. [2:10:50] Although I just thought it was just classic. And so I just you know when we start putting things on the [2:10:55] chopping block and cutting stuff I would have hoped that we would not have started with our children. [2:11:00] And I just want to know how that statement that attribution to President Kennedy fits in with you [2:11:10] know cutting um completely healthy start which is a proven program that has decreased infant and maternal [2:11:20] mortality. I don't get it. It just contradicts that whole notion of not neglecting our children or um or [2:11:31] firing 20,000 people in your department with consolidations that give technical support and [2:11:37] help develop state plans around TANF the social service block grant. These are the most vulnerable [2:11:44] people and people and kids. I mean even cutting 43 million dollars out of the free diaper care sort of [2:11:53] program and I just I'm just making a statement I'm not asking a question not confronting you but I took all [2:12:00] these notes while you were talking to other people so I just had to kind of address them. Um I am wondering [2:12:08] um how your make America healthy again program fits in with um the national database for new hires. It's a federal [2:12:20] database maintained by uh your office for the purposes of assisting child support agencies. Very sensitive [2:12:28] information and section 453 says that you will only use the data. Um how does giving that data to ICE [2:12:36] support your mission at HS? HHS? Well all the things that we do in terms of data sharing comply with the law. [2:12:46] No it this doesn't comply with the law specifically section 453. I would love to see the general counsel's [2:12:53] memo on this if you wouldn't mind submitting that because it I'm happy happy to submit it. Please then let [2:13:00] the record reflect that he will give us that letter because it is definitely in contravention of [2:13:07] our laws. I want to thank you for your indulgence and and thank you for appearing here. Well thank [2:13:12] you for the respect and uh the kindness of your presentation. Thank you sir. Mr. Stubbe. Thank you [2:13:19] Mr. Chairman. Mr. Secretary the contrast between the Trump administration and the last administration [2:13:24] cannot be more striking. On issue after issue when your predecessor came before this committee he was [2:13:29] defiant and claimed ignorance. In March 2024 I questioned then HHS Secretary Becerra about the Office of [2:13:37] Refugee Resettlement's process for finding replacements placements and shelter for unaccompanied [2:13:42] migrant children. Of the more than 100 questions submitted by this committee my question to him [2:13:47] about missing children was one of only two questions that your predecessor declined to answer. The Biden [2:13:52] administration's open border policies were nothing short of a lethal disaster for our country. Let's be [2:13:58] clear about the facts. The Biden DOJ received thousands of allegations of sexual abuse related to [2:14:03] unaccompanied minors processed through ORR. Under the Biden administration ORR permitted individuals with [2:14:09] criminal records, no citizenship and who refused a background check received custody of unaccompanied [2:14:14] children. Over the course of 10 months alone the agency lost contact with neither 20,000 unaccompanied [2:14:20] children. Under the Biden ORR case managers failed to perform home studies on more than 95 percent [2:14:26] of placements of unaccompanied children. And finally grand jury testimony in my home state of Florida [2:14:31] revealed unaccompanied children were placed in the custody of convicted felons in homes with [2:14:36] multiple unknown male occupants. This is unacceptable. Becerra's refusal to even acknowledge the issue [2:14:42] when I brought it up to him is disqualifying. That is why I introduced the Stop Gaps Act with Senator [2:14:47] Moody that builds up upon the Trump administration's success on securing the border by requiring the ORR [2:14:53] to work with state and local authorities to guarantee safe and proper vetting of all individuals and [2:14:58] entities before granting them custody of an unaccompanied child. Under the Trump administration [2:15:03] the border is secure, crimes from illegals are being stopped, and there are rigorous standards [2:15:07] in place to better protect children. Mr. Secretary, can you speak to the work that your agency is doing [2:15:13] to combat our social services being taken advantage of by bad actors and the increased safety of our [2:15:18] children? Yeah, I mean, it was a humanitarian crisis. What my predecessor engineered with the Biden [2:15:29] administration, they lost 425,000 children. They lost them because they ended verification of sponsors. [2:15:38] Oh, people were just showing up with fake IDs. There was no genetic testing. There was no income [2:15:45] inquiries. There was no ID verified validation. And we are now in the process of trying to find those [2:15:54] children. We've been able to locate 138,000 of them. They're very, very difficult to find. Many of them, [2:16:02] as you say, have been trafficked. They've undergone slavery, sexual abuse. We found [2:16:11] one sponsor who picked up 42 children, and their address was an empty container in a parking lot. [2:16:24] And there was no effort. And in fact, the administration, Mr. Becerra, specifically ordered [2:16:32] people in my agency to end the verification process. They were more interested. They explained that [2:16:40] the objective was to move kids out of custody as quickly as possible. Well, they made a lot of [2:16:48] mistakes. And now, thanks to President Trump, the amount of unaccompanied minors has dropped by 97%. [2:16:57] We have beds now for 7,600 unaccompanied minors, and only 2,000 of those are filled. We hold them until, [2:17:07] only until we can completely verify the people who picked them up are actually family members. And [2:17:15] that has never happened during the last four years. Well, thank you for your service to our children [2:17:23] and to the unaccompanied minors and the changes that you have made from the previous administration. [2:17:27] I yield back. Ms. Tinney. Thank you, Mr. Secretary. I really appreciate your service and your great [2:17:34] responses today. I just wanted to commend you first for your very sensible position on vaccines. I am, [2:17:42] too, I'm a fan of the greatest tennis player in the world, Novak Djokovic. I see you got to play [2:17:46] tennis with him. When Javier Becerra, who... I lost, by the way. Yeah, not surprised. [2:17:54] When Javier Becerra was here, I asked him, I was trying to get a waiver for Mr. Djokovic to be able to [2:18:00] play in the U.S. Open at the time, the number one tennis player in the world. And still, I would argue, [2:18:04] the greatest ever. And he described to me that they would not give him a waiver because he did [2:18:09] not take the vaccine because it was science. Although a lot of other American tennis players [2:18:13] were allowed to be there who were not vaccinated. So thank you for your common sense approach to choice [2:18:19] and pro-safety as opposed to being anti-vaccine. I'm glad you clarified that today. [2:18:23] But I wanted to jump to a really important issue in my district and especially in the state of New York. [2:18:29] During the COVID crisis in upstate New York, nursing home residents were isolated from their [2:18:35] families for months, sometimes years. And Governor Cuomo disgracefully called it [2:18:39] protecting them. But the reality is that people declined rapidly in isolation and in most cases [2:18:45] died without a loved one present. That wasn't protection. It was a policy failure of enormous [2:18:49] consequence by Governor Cuomo and his administration that cost lives to thousands of seniors, not to [2:18:55] mention the deadly nursing home order that he required nursing homes to take COVID-positive [2:19:01] patients where they didn't have the ability to handle these patients. Sadly, many of those same [2:19:06] bureaucrats responsible for carrying out this disastrous policy are still working in Governor Hochul's [2:19:12] administration. That's why I, along with my co-sponsor, Representative Larson, Fitzpatrick, [2:19:19] Panetta on this committee and numerous others, have reintroduced what's called the Essential Caregivers Act, [2:19:24] a bipartisan, bicameral legislation that guarantees nursing home and long-term care residents the [2:19:29] right to in-person access to a designated family caregiver even during a public emergency. It also [2:19:36] directs CMS to establish clear uniform safety protocols so visits can continue safely. Families [2:19:43] and friends are visitors. They are loving caregivers and they advocate, they catch things maybe that a [2:19:49] nurse or staff would not and cutting them out of the facilities didn't protect the seniors, it actually [2:19:55] accelerated their decline. I was wondering because of this situation and the isolation of so many nursing [2:20:01] home residents which contributed to serious physical and cognitive decline, independent of the virus by the [2:20:08] way. Given the department's guidance and generous access for designated caregivers in nursing homes, [2:20:15] do you share the view that maintaining family access during emergencies is a patient safety issue [2:20:21] and not just a quality of life issue? Absolutely and we made a lot of mistakes during the [2:20:27] with the countermeasures during the COVID pandemic including shutting down the schools, shutting down [2:20:32] businesses, those things kill people and that's one of the reasons, in my opinion, that we had the highest death [2:20:39] of any nation in the world. We lost 3,000 Americans to COVID for every million population or other [2:20:47] countries. Haiti for example had 14 per million population so Nigeria 14 per million population we had 200 [2:20:57] times the death rate of other countries we had 10 times the death rate of Europe and a lot of it was just [2:21:06] because of bad policies that were that were not science-based and we are not going to do that under [2:21:13] my watch um and one of the reasons that I think blacks were more much more likely the most likely to die [2:21:24] was because depriving them of access to a family member their hospitals and their neighbors already [2:21:30] closed depriving them of access to a family member meant that there was um a reduced incentive within the [2:21:38] hospital to provide them with the kind of good care that they needed. I just my time has expired but [2:21:44] can I just ask you would HHS support codifying a federal right in uh for essential caregivers and [2:21:51] giving them access? I personally would support that my agency will work with your staff. [2:21:56] Thank you. We appreciate it. Thanks so much for your testimony I yield back. Mr. Boyle. [2:22:03] Thank you uh Mr. Secretary uh I'm over here thank you I'm hoping this can be uh constructive uh and have a [2:22:11] conversation with you. I have the honor of representing an incredibly brave uh constituent and proud [2:22:16] fellow Philadelphian Latonya Morrison. Her grandson Ahmad Butler tragically died of a rare form of brain [2:22:24] cancer at just six years old. Last year she and her family marched 179 miles on foot from Philadelphia to [2:22:34] Washington DC to bring attention to the critical need for childhood cancer research funding. I met her [2:22:42] right outside here on the Capitol steps and had uh a wonderful but also heartbreaking conversation with [2:22:50] her and had been working with her and her family since then uh specifically working with her on a [2:22:57] proposal called the Ahmad Butler childhood cancer hope for cure act to make sure that no grandparent parent [2:23:06] or loved one has to go through what she and her family experienced and continue to experience [2:23:13] this day. That hole in her heart will never go away. So my concern is and I have no doubt that that you [2:23:22] have concern for this constituent I just described and all those who particularly have lost a child [2:23:29] to uh to this horrible form of cancer but at the same time your administration or you as secretary in [2:23:38] this administration are carrying out hundreds of millions of dollars in cuts to cancer research funding [2:23:46] so I was wondering if you could explain why you're doing that and does that really get us anywhere [2:23:53] closer to getting a cure that we all want to cure this horrible disease? First of all thank you for [2:24:01] sharing that heartbreaking story and uh you know the worst thing that could happen to a human being is to [2:24:08] to lose a child or a grandchild and it's something that I hope that I never have to experience [2:24:14] and my heart goes out to that family the one agency that within my agency and the only agency within NIH that [2:24:26] actually got a budget boost from our proposal was NCI and we you know we're absolutely committed to cancer [2:24:35] research and particularly pediatric cancer research. I invite you congressmen to call me [2:24:44] to tell me if you're if there are programs some of our programs were duplicative so we've moved them [2:24:52] around and it looks like there was a cut but I don't know of any major cancer studies that I'm happy to [2:25:00] talk to you about it you reach out to me if you could after this sorry just because you know we're time [2:25:05] limited and I've under a minute now so uh I appreciate that and if if our staffs could follow up or you and I [2:25:12] directly uh with one another after this and I would just ask if I could get your pledge not for me but [2:25:19] for my constituent if I could get your pledge that you will work with me my staff the white house to get [2:25:27] the president to declare childhood cancer a national emergency which would as you know help unleash [2:25:36] additional resources and really focus the attention that we need on childhood cancer yeah in in theory I [2:25:44] like the idea let's talk about the details you know we've already done uh the president already [2:25:51] signed an executive order on pediatric cancers I was there at the time I so I need the devils in the [2:25:59] details but in in the theory I absolutely support that proposal and I'm happy to work with you and your [2:26:07] staff on it thank you and I yield uh zero time uh back Mr. Chairman I seek recognition to ask unanimous [2:26:14] consent to enter into the record uh the exact transcript of Secretary Kennedy's uh remarks um that [2:26:20] we discussed regarding the reparenting of black children without objection thank you um Miss Fischbach [2:26:25] is recognized thank you Mr. Chair and um Secretary Kennedy I just I'm over here I know it gets confused [2:26:32] there's lots of us and we're running around a lot and I just want to tell you thank you so much for being [2:26:36] here and thank you so much for your willingness to answer questions I it always amazes me that people [2:26:43] even agree to come to these committees because we have you sit there on the hot seat for hours on end [2:26:48] um we all get a run around get coffee whatever it is um and and the witness is sitting there so I [2:26:54] genuinely appreciate that you're here and that you're answering questions very honestly and and [2:26:59] Frank I just have to not tell me that I had a choice okay well then fair enough I am happy to be here [2:27:08] well thank you very much and and just so you know I'm from Minnesota I represent a rural district and [2:27:13] I think you know rural Americans face heightened health care challenges um while nationally health [2:27:19] care is seeing increasing staffing uh cost staffing shortages shortages and increasing wait times [2:27:25] all of these problems are amplified in rural areas um where care is already more limited and [2:27:31] I know that we um counteracted that with the rural tr health transformation program in the working [2:27:37] families tax cut bill last year um and and significant funding was to strengthen the health care in [2:27:43] small towns across across the country um I know in my office and in other Minnesotan offices uh we sent letters of [2:27:50] support to CMS in favor of the application and the funding um but the rural health care transformation [2:27:57] program alone is not enough to solve uh those rural health care issues and so I am wondering if you [2:28:02] could just uh talk a little bit about what's the administration's plan to reduce health disparities in [2:28:09] rural areas and what specific actions are you taking to ensure quality and affordable rural health care [2:28:15] remains a priority within HHS I mean we've already finalized rules for site neutrality I think that [2:28:22] will help um the administration would love to work with congress on the wage um area index which I think [2:28:31] also will help and then you know we are continuing we we made the biggest investment ever in history on rural [2:28:40] health care we're continuing to make additional investments I mentioned the I think 135 million that I [2:28:51] allocated for community uh health centers uh last week and so this is a this is a priority for the [2:29:01] president it's a personal priority for me and you know if you have ideas of other things we ought to [2:29:07] be doing we'd like to hear them well and and Mr. Secretary I appreciate that because it is such a [2:29:13] critical part of and like I said representing a rural area health care having the access to that health [2:29:19] care and I know that Mr. Estes had talked a little bit about specialty care in rural areas but it is [2:29:25] absolutely critical for the survival of our small towns and and the health of our individuals who live [2:29:30] there um that we have that that we have health care available and I think some of our provisions for [2:29:36] telehealth and things like that have really moved things forward but um I I just sincerely appreciate [2:29:42] um the ability that your offer and um and the we have worked with uh worked with the department and [2:29:49] so I appreciate that and I'm actually going to yield back 35 seconds thank you um Mr. Moore I'll take that [2:29:56] 35 seconds if I can I didn't give it to you yeah I understand sir the most important thing you said today in [2:30:02] Congress that the Congress has allowed 39 trillion dollars of debt and so that's forced you and your [2:30:06] agency and your amazing team um some of which I know are very debt focused Mr. Mr. Andres um you had to [2:30:14] tighten your belt I just want to say as a as an American and as a member of the bipartisan fiscal forum [2:30:19] I can't thank you enough for doing your part uh doing the hard part to be able to find redundancies [2:30:24] you'll get criticized for it but but it matters and every agency needs to be doing it so thank you for that [2:30:28] um I've mentioned to you in in private how much I appreciate the administration's focus on autism [2:30:35] and you may recall my my 10 year old my 10 year old Winnie is neurodivergent on the autism spectrum [2:30:41] he's the joy of my life he's um but that's tenfold uh for my wife and for his younger older and twin [2:30:50] brothers um and I I want to just highlight that I'd never had a ton of expectation on what we could [2:30:59] uncover from scanning the pre-existing research and and I've always appreciated the administration's [2:31:04] focus on this though uh but I was I was underwhelmed with what we ultimately put out my wife was hurt [2:31:12] and she felt for a split second until we she came to her senses and we talked about this that there [2:31:17] was any way she was responsible um we don't even know if she took Tylenol during her pregnancy but that [2:31:23] that that was a hurtful moment for her and I just want to encourage the administration and your team [2:31:28] to keep at it and I think there's there's more we can do here with low expectations I don't expect [2:31:32] much to be able to figure out what the ultimate causes are that's not an easy thing to do but I [2:31:36] do think there's there's more that we can do and and and um we can we can build past what what I was [2:31:41] ultimately underwhelmed with so again thank you for the administration's focus and I think we can do [2:31:46] more um regarding something that's very important legislatively I introduced hr 5343 [2:31:53] um the insurance ensuring patient access to critical breakthroughs product act which builds [2:31:58] on one of the biggest wins from the trump administration we didn't fully get it implemented [2:32:02] but the msit was a significant policy for medicare coverage for breakthrough medical devices this bill [2:32:10] requires cms to provide temporary medical coverage for treatments or devices that receive breakthrough [2:32:15] designation from the fda if a treatment can meet the fda's burden of proof of safe and effective [2:32:20] and other requirements for breakthrough designation there's no reason medicare [2:32:24] shouldn't be able to provide temporary medical coverage while cms completes its review for permanent [2:32:28] coverage um and this is a brainchild of the trump's first administration we've talked about this [2:32:34] we all agree in principle about this it's it's difficult to to to move in some cases but can you [2:32:39] update this committee on your efforts to implement a policy like this through any type of executive rule [2:32:44] making um i think are we enrolled uh we we will have an announcement soon and we're happy to work [2:33:02] with you on it this is this is really important and builds on the success from the trump first administration [2:33:07] uh there is as i'm learning too the fda and cms they operate in parallel they operate in tandem and [2:33:17] sometimes there's different regulatory constraints that they're going with we've got to be able to to [2:33:23] work through those and and if that's all this ultimately is is just a difference between those two [2:33:29] those those two structures i mean this is a good policy that will will help improve people's lives [2:33:34] and it will keep safe and effective technology um from it will enhance safe and effective technology [2:33:41] and get that into the into the healthcare system yeah and i agree with you and uh you know particularly [2:33:47] if it's a temporary uh if it's a temporary uh payment payment that can be revoked that is intended to [2:33:59] be temporary it's not permanent as you know it's very with a lot of medical devices it's uh we find [2:34:07] problems with them later we had tons of bipartisan support on this committee some that even didn't [2:34:12] support it last time are now on board it's a it's a great initiative and look forward to working more [2:34:17] with you thank you you too mr buyer thank you mr chairman mr chairman i'd like to yield such time [2:34:22] as he may require to the ranking member mr neil thank you mr buyer mr chairman i want to make uh [2:34:28] this moment an opportunity to correct the record on the no surprises act which was passed out of this [2:34:32] committee with bipartisan support i wrote that legislation i know what was in it and every republican [2:34:38] on this committee at the time sided with me and we passed it out of the committee unanimously and had a [2:34:43] big victory on the house floor like any new program it needs some help for sure but the notion that the [2:34:50] suggestion we heard from the secretary that somehow that it languished under biden is simply not true [2:34:56] the national uh issue here before is it's still the regulations that were implemented it created new [2:35:01] protections against surprise medical bills for 200 million americans millions of families benefited from [2:35:06] what we've done here every single year this is a victory that democrats and republicans on this committee [2:35:11] should take credit for it and i yield my time back to mr buyer thank you very much ranking member [2:35:18] mr secretary the agency for health care and research and quality arc has been given an essential [2:35:24] task by congress it's the only federal agency specifically dedicated to improving health care [2:35:28] delivery for americans it was actually a ronald reagan creation making people's experience with [2:35:33] health care easier and ensuring that taxpayer dollars are spent on effective affordable and safe [2:35:38] care but mr secretary your department's budget justification included 106 million dollars in [2:35:43] cuts to arc the white house budget request was 129 million in cuts the budget appendix listed 116 million [2:35:50] cuts the budget also lists more than 250 staff at arc but widely available reports fewer than 100 people [2:35:56] remain at the agency mr secretary these discrepancies read either as deliberate misrepresentation or basic [2:36:03] accounting errors you clarify how many millions of dollars you intend to take away from research [2:36:08] standards designed to give american access to the best most affordable health care uh thank you for [2:36:17] that question congressman uh dr klein who is running it who is a yale educated physician who's running [2:36:25] a hrq is still has hundreds of staff and the agency is operating thank you well let me shift to united [2:36:35] states facing a mental health crisis as you know nearly a quarter of u.s adults had a mental illness in [2:36:40] the last year reported 30 of high school students you recently led an agency reorganization there was [2:36:46] a big scare in january where two billion dollars was cut from samsa for substance abuse and prevention [2:36:52] mental health there was a bipartisan outcry and it was restored but there's also this real concern that [2:36:58] there's a gutting of samsa i co-chair bipartisan the house mental health caucus we'd love to have a [2:37:04] bipartisan briefing on the reorganization we request that back in december and i'd love for you to commit to [2:37:10] a briefing for members in congress of the bipartisan mental health caucus on the current state's status [2:37:17] of the mental health programs at samsa cdc and nimh yeah i i strongly support samsa it's a private mental [2:37:25] health and particularly addiction are uh our uh priorities for me strong personal interests and but also [2:37:35] their um their national catastrophes uh there were termination letters that went out under samsa that [2:37:43] was a mistake we immediately uh recalled them within 24 hours and i'm committed to the continuing uh [2:37:53] continuing operations in samsa happy to meet with you about it thank you very much mr secretary mr jeremy [2:38:00] i yield back miss van dyne how are you doing today i'm great i appreciate you being here and i know a [2:38:11] lot of questions have been asked and some of the uh the accusations have been just outrageous i have a [2:38:16] bunch of stuff i want to ask you about but clarify your qualifications have been called into question [2:38:22] because you did not father a black child how many different um um hhs secretaries have had that [2:38:30] privilege i've had a pretty ridiculous question isn't it you know the answer zero um do you know [2:38:36] how many um democrat appointed um hhs secretaries have had a medical degree i think there may have [2:38:44] been of the 26th zero zero not a one any history yeah yeah not a one i think there may have been two [2:38:52] with medical degrees yeah it there's a lot going on that that your office is handling and doing so well [2:39:00] and we're so proud of on you know we we had and i'm looking for uh for this photo we had a previous [2:39:08] secretary who i asked questions about what was going on with the waste fraud and abuse and i don't [2:39:13] know if you recognize this i asked secretary becerra the same question what's going on at 14545 fryer [2:39:19] streets in van nuys california does that reckon does that ring a bell to you at all no i i could guess [2:39:26] uh why don't you tell me we had over a hundred different licenses for for hospices yep right at [2:39:34] this address and we asked him what he was doing about it basically nothing can you walk through [2:39:39] what your office is actually doing on the waste fraud and abuse to make sure we've already shut down 500 [2:39:45] hospices in los angeles um and uh and incidentally we haven't had one call from congress or anybody else [2:39:57] about complaining because clearly these were fraudulent a lot of these places i could say we [2:40:05] they'd have um they were just invented addresses they would obtain patient identification or they [2:40:12] would pay people they were going and giving people in poor neighborhoods flat screen televisions [2:40:18] 600 bucks and then they would enlist them and enroll them in the hospice and we were paying them six [2:40:26] thousand dollars and um and the and the interesting thing is almost none of them ever died oh typically [2:40:35] they stay in a hospice is about 18 days these people stayed forever nothing ever happened because they [2:40:42] weren't actually there they were just invented and it was operated by certain uh foreign communities [2:40:52] a lot of estonians and a lot of armenians and there's an incredibly great armenian community [2:40:58] in uh in los angeles and very few of them were involved in this but the ones that were were making [2:41:06] hundreds of millions of dollars out of fraud and just stealing money from us i think the cost [2:41:11] has been about five billion dollars and it's ridiculous and i don't think a week goes by where [2:41:16] you're not your office is not uncovering further fraud and what we're finding in california is now [2:41:21] they're going after the people who are uncovering the fraud they're actually trying to make it illegal for [2:41:25] some of these uh these these journalists to even do their job and uncover it they're they're not [2:41:30] upset about the fraud they're upset that it's being uncovered in your office is helping to do [2:41:34] that i had a ton of questions i wanted to ask you about affordability you know how expensive health [2:41:38] care is not health insurance but health care there's a big difference but like an association health [2:41:43] plans what's what's your thoughts on that and i know not everything is going to be within your purview [2:41:47] but what are your thoughts on making more competition than we're in the in that's what we need and we need [2:41:51] output outcome based care you need more hsas president trump wants to take the money away from [2:41:59] the insurance company and so obamacare was passed after in the years after obamacare was passed the [2:42:06] share price of the insurance companies the share value went up a thousand percent it's still up 300 [2:42:13] compared to about 150 for the s p 500 and so they are making money hand over fist and the american [2:42:23] people who are supposed to benefit their premiums have not gone down they had the illusion that they [2:42:27] went down slightly president trump is actually taking steps that will drive the premiums down and [2:42:34] give better quality care to americans i appreciate that very much i yield back thank you now the chair [2:42:41] recognizes mr errington for four minutes thank you mr chairman mr secretary good to see you um thank you [2:42:47] for your leadership and your service to our country um we have the best system and the worst system i mean [2:42:53] the best docks in mid-levels the best facilities and technology and yet we have the worst most [2:42:59] inefficient system relative to the rest of the developed world uh when you get to the cost and [2:43:06] quality intersection and it just it drives me crazy i think at the heart of that for me personally [2:43:13] it's a it's the dis it's market dysfunctions and distortions right i think transparency choice competition [2:43:22] that's the best way to deliver value for taxpayers and for patients and taxpayers and patients aren't [2:43:28] getting their best bang for the buck here and it's bankrupting the country uh and it's putting [2:43:35] people families working families further and further uh from access to good care for their for their [2:43:42] families and the people that they love so the the current incentive structure is distortionary [2:43:49] and it inhibits these forces creating sort of monopoly dynamics anti-competitive behavior so so i spend most [2:43:58] of my time thinking about health care reform with respect to that framing um some examples in the in the [2:44:09] world of drug innovation there's patent abuse where biotech companies are extending the life of their [2:44:17] patent without making novel contributions using patent thickets and essentially having these exclusive [2:44:24] rights extended and gouging all of us and we're allowing it to happen i mean i'm quite frankly not [2:44:30] putting the incumbent market participants at fault it's the perverse incentives we've allowed to persist [2:44:38] one simple one for me is this disparity between what we pay hospitals and physician groups [2:44:45] for the same outpatient service and the effects of that are not just higher premiums on seniors in [2:44:53] medicare higher costs for all of us as taxpayers but there's a giant sucking sound of independent [2:45:00] physician groups and docs into hospital systems leaving us with less choice so those are just uh top of [2:45:07] mind examples um you are a breath of fresh air we may have disagreements on on on how to attack some of [2:45:17] these problems but you have a rare curiosity and object and objectivity um and independence that you [2:45:26] bring to the to this leadership this incredibly important leadership post for our country and i think [2:45:34] the problem with all these distortions is that we have too much special interest too much incumbent [2:45:43] resistance too much parochial politics and everyone in this town seems to be captured by it to what to [2:45:52] some extent uh or to one extent or another you just seem to have been able to through the fiery furnace of [2:46:02] public scrutiny over the years i don't know what it is but i love that you can come to this i believe with [2:46:08] all my heart that you just want to do the right thing for the country and for for all participants and for [2:46:14] especially our patients give me in the last 25 seconds your best shot on the monopoly forces and [2:46:23] anti-competitive behavior what are one or two things that you think this body could do to address that [2:46:29] and go a long way to make things more affordable for working people in this country thank you very much [2:46:34] for those very very kind and undeserved words um 10 years or 15 years ago 80 of the doctors in our [2:46:42] country were independent uh and 20 were corporate today 20 are independent 80 are corporate and and [2:46:51] the number that independent are dropping precipitously because the economic forces that are uh that are [2:46:58] a result of these perverse incentives site neutrality which we're fixing is uh key key to that the wage area [2:47:06] index reforming the pbms um that is one of the most anti-competitive forces out there and we're doing [2:47:15] that you've given me legislation which i'm now looking forward to implementing through the regulatory [2:47:21] process and then we need the ftc to file some cases and it's already doing that in the pbm space [2:47:30] so those are just a few of the things that we ought to be doing and thank you for raising all those [2:47:35] important issues god bless you thank you thank you uh remind members that uh votes have already been [2:47:41] called but we're going to try to work as deep as we can into the hearing uh while all votes are going [2:47:46] on so now i recognize mr panetta from california for four minutes thank you thank you mr chairman thank [2:47:51] you mr secretary thank you to your staff for being here as we've heard today there unfortunately are a [2:47:56] number of issues that i believe are causing people to get a little exhausted because they are scared of your [2:48:02] agenda and with your leadership an agenda that is threatening to the health and safety of our nation [2:48:08] nation and the lack of leadership that has led to two major vacancies in your department at the cdc [2:48:15] dr maneras was fired after only 28 days reportedly for not going along with your anti-vaccine agenda [2:48:21] but since then august of last year the cdc has been without either a director or even an acting [2:48:27] director now i know you have jay batacharya overseeing the cdc but he's also seeing overseeing nih managing [2:48:34] over 27 000 employees and two campus that's two campuses that sit hundreds of miles apart furthermore [2:48:42] at cdc doge slashed whole offices resulting in almost 20 percent of its staff either being fired or [2:48:49] quitting and there's even been hiring freezes there as well for most of the past year you've had people [2:48:55] close to you act as proxies and in some cases you've even taken unilateral actions like you did last [2:49:01] may when you rolled back cova 19 vaccine guidance for pregnant women additionally people should be [2:49:06] aware that now that after passing the 200 days 210 day statutory limit for temporary leadership at cdc [2:49:13] batacharya can no longer legally perform the full range of director duties that means that without an [2:49:19] acting permanent chief tasks that congressional statutes explicitly reserve for the cdc [2:49:25] director can only be performed by you the hhs secretary that includes policy decisions like [2:49:32] adopting vaccine recommendations for the cdc's immunization advisory committee the surgeon [2:49:37] general is post is also vacant now i know that casey means a maha devotee with no active medical [2:49:43] license and not a practicing physician had her confirmation hearing two months ago but she performed [2:49:49] so poorly including her unwillingness to commit to recommending vaccines that the senate has not [2:49:54] scheduled to vote that fact and the fact that there's 1500 cases of measles that have occurred [2:49:59] this year throughout the nation the fact that a recent e coli outbreak has sickened people it seems [2:50:05] that the senate is having a hard time with your agenda i know that the literal holdups in the of these [2:50:11] positions are from the senate but it's clear that you in the senate are having a hard time agreeing on [2:50:16] people the issue is mr secretary that without leadership at dhs if there is a crisis if there is an [2:50:22] outbreak we lose surveillance there's delayed recognition of problems there's low response [2:50:27] times there's mixed messaging and a loss of real-time guidance these vacancies hurt america's health and [2:50:34] they make americans less safe there's some disagreement with you in the white house as well [2:50:39] you've heard of gliophosphate the herbicide correct mr secretary yes and you called it one of the likely [2:50:45] culprits in america's chronic disease epidemic yet the president ignored your advice and he signed an [2:50:50] executive order that bolstered the production of that weed killer we all know what happens when [2:50:56] it comes to your vaccine policy but according to a recent you gov poll nearly three quarters of [2:51:01] americans believe that vaccines are somewhat safe are very safe and now the courts seem to be getting [2:51:06] tired of your agenda in march of this year a federal court paused some new vaccine policies from hhs [2:51:12] including reducing the number of jabs recommended for children and reconstituted a vaccine advisory [2:51:17] committee mr secretary your stance on vaccines and the vacancies in the public health leadership [2:51:22] coincide with a continuing decline of public trust in federal health authorities something that's only [2:51:28] gotten worse with the current administration we need credible voices when it comes to the health and [2:51:33] safety of our nation we need a cdc director that we can trust we need a surgeon general that we can trust [2:51:39] because right now mr secretary many many people in my district and all across the country are having a [2:51:45] hard time trusting your agenda i yield back mr feenstra thank you uh mr chair and ranking member neil [2:51:53] thank you mr secretary for taking the time to be here today greatly appreciate it uh last year uh we [2:51:59] republicans passed a working family tax cuts bill the largest tax cut in american history and working [2:52:05] alongside with your department we included 50 billion in rural health care transformation programming [2:52:11] to create high quality and affordable health care for rural communities i'm so proud of our state iowa [2:52:17] that's one of the four front runners and leaders in advanced care and delivering some of this dollars to [2:52:22] our farmers our families and our seniors one of the biggest problems we're having in rural america rural [2:52:28] iowa and i'm the leading voice on this is the diminishing access to maternal health care we have women [2:52:37] traveling 50 to 75 miles or more uh for maternal care and i understand historically low patient volumes [2:52:44] make it feasibly burdensome for small rural hospitals to provide delivery services but currently less than [2:52:50] half of our rural hospitals in the u.s have labor and delivery services and they continue to recede every [2:52:57] year maintaining access to maternal health care is incredibly important and vital for rural communities [2:53:03] can you expand on what we can do and how i can work with your department to to change the tide in this [2:53:10] area well first of all thank you for raising that issue president trump is absolutely committed more than [2:53:20] any president we've ever seen in uh in preserving rural health care it is a it's in crisis right now as i [2:53:30] pointed out earlier we've lost 120 hospitals since 2010 and the his investment in the rural health [2:53:39] transformation fund which you voted for and approved is the biggest investment in history in rural health [2:53:47] care and it's a five-year investment it increased the influx of federal dollars into rural health care by [2:53:54] about 50 percent every year for the next five years we're also doing other things in my agency [2:54:03] to funnel additional dollars to rural health care and that includes the 135 million dollars [2:54:12] i signed approved last week for community development health centers which are primary in rural areas [2:54:20] so so with that we also have a shortage of of specialty doctors whether it be ob-gyns whether it be [2:54:26] oncologists and stuff like that again come from rural state of iowa is there anything that we can do [2:54:31] to try to keep uh these specialty care doctors and even family docs in rural america i mean it just [2:54:38] seems like they're all gravitating to the urban centers and we're we're having a hard time recruiting [2:54:45] uh family doctors oncologists ob-gyns any anything that you can offer any suggestions you can offer [2:54:51] to help uh rural america rural iowa in that area well we've just final finalized and promulgated the [2:54:58] site neutrality rule which should help the biggest thing that needs to be done is fixing the wage um area [2:55:06] index and that's something that has to come from congress yep we'd love to work with you on that well [2:55:12] thank you i i appreciate all your your department is doing and secretary thank you so much for being [2:55:17] here and i yield back thank you miss melley takas thank you mr secretary i want to begin by thanking [2:55:26] you for your leadership on an issue that is very important to me and so many americans that is ending [2:55:31] the inhumane and outdated animal testing in this country um hundreds of thousands of dogs cats monkeys [2:55:38] rabbits and other animals remain in captivity for painful and unnecessary procedures even though studies have [2:55:44] shown that animal testing in in medicine frequently fails to accurately predict human conditions we are [2:55:50] seeing real progress by this administration the nih is investing 87 million in a new center to develop [2:55:56] standardized lab-grown 3d tissue models and has announced that grant funding may be used to [2:56:01] support finding homes for retired lab animals and you've also asked agencies to prioritize non-animal methods [2:56:08] and you've also ordered a review to end the importation of monkeys from asia for testing i just want to [2:56:15] urge you to stay the course i'm very happy to work with you to continue to make progress here to end this [2:56:20] cruel costly and antiquated practice i also want to thank you and the president for working with our new [2:56:27] york delegation to fully fund and staff the world trade center 9 11 healthcare program my district is home to [2:56:34] many first responders and unfortunately sadly uh they're still suffering from 9 11 related illnesses [2:56:40] uh so i appreciate your efforts also secretary kennedy in in um as you know one in five adult americans [2:56:49] are currently living with mental health condition including over 3.2 million new yorkers timely and [2:56:54] convenient access to mental health professionals is essential for individuals to receive the care that [2:57:00] they need we must do more to integrate mental health services in primary care settings and that [2:57:05] is why i've introduced the complete care act which incentivizes primary care providers to integrate [2:57:10] mental health specialists such as psychiatrists psychologists and substance abuse counseling [2:57:15] into their practices and provide a temporary increase in reimbursement to help cover the costs [2:57:19] so my question is is that a piece of legislation i know this is a priority for you in the administration [2:57:24] is that a piece of legislation that you could potentially support yeah and we will work with your [2:57:30] office on that and on uh animal testing there's uh 25 million dollars nih in the proposed budget [2:57:38] that we've proposed uh to again find other alternatives to animal testing we're already doing a lot of work [2:57:47] on organoids on tissue chips on ai which actually are more accurate and faster and cheaper than animal [2:57:58] testing so it's part of our larger effort to speed drug approval well thank you very much and again [2:58:04] i lend my support to you and however i can help with those efforts um one last issue i do want to bring [2:58:09] up is women's health recently the hhs hosted its first ever national conference on women's health [2:58:15] it's important step in elevating the conversation around women women's health care access and research [2:58:20] that has been chronically underfunded in both the private and the public sector for decades [2:58:25] my question is how does the administration plan to advance its goals of improving health outcomes [2:58:29] for women particularly in underserved areas that have historically faced limited investment [2:58:34] and resource constraints i i but you know part of that for rural areas um the rural health [2:58:43] transformation program hopefully will expand those abilities uh to treat maternal health we are putting [2:58:51] enormous investments into into maternal health and i could go through those with you in detail um but [2:58:59] uh there but we're spending a hundred literally hundreds of millions of dollars on it we've got multiple [2:59:06] programs and i just would mention again our paranoidal uh pilot program which has reduced it has 220 hospitals [2:59:17] that are involved we provide them protocols reducing maternal maternal mortalities and we have succeeded [2:59:26] in those hospitals in reducing maternal mortalities by 41 percent well i appreciate that and i don't have [2:59:32] a rural area i do represent new york city staten island and brooklyn but we do have a lot of safety net [2:59:37] facilities and we'd love for your administration's attention to that as well thank you so much thank you [2:59:42] thank you mr smiter uh thank you um mr starker do you know who alexander fleming is he invented penicillin [2:59:51] how about gerhard domach i guess you're not going to answer he invented sulfaminoid drugs how about [2:59:57] salmon waxman still nothing okay well he invented streptomycin uh drugs that uh we use on tuberculosis [3:00:05] would you agree that these three people help make people healthier the medicines they discovered i would [3:00:11] say yes all right thank you um what's interesting did you say thalidomide did you say thalidomide i did [3:00:17] not i said streptomycin okay so um european all of them were born in europe now someone waxman moved [3:00:24] to the united states in 1910 he actually left ukraine uh because of anti-semitism same time my grandmother did [3:00:31] what unites them is all three won the nobel prize salmon waxman wanted as as an american citizen [3:00:37] um fleming was scottish domach was german uk has 29 nobel prizes in um in medicine and physiology [3:00:47] germany has 16 the united states has 93 but if you expand it beyond just medicine and now i'm going [3:00:53] to focus on the national institutes of health from the national institute of health website they've [3:00:59] identified 174 scientists who have either worked at nih or done research funded by nih that have earned them [3:01:08] a sole or shared part of 104 nobel prizes nih has led the world in scientific research leading to [3:01:16] extraordinary breakthroughs changing the lives not just american lives but lives around the world for [3:01:21] the better making americans healthier and people around the world healthier nih is the crown jewel of [3:01:28] american research uh mr secretary are you familiar with sma sms sma sma is spinal muscular atrophy [3:01:41] so it is a disease it's a progressive rare genetic disease that affects the motor neuron cells of [3:01:46] spinal cord children with sma don't walk they can't sit up if they're not treated 90 will die before [3:01:54] the age of two are you familiar with gene therapies of course okay well gene therapies uh do you think [3:02:01] it's worth exploring the possibilities for gene therapies like we did in other things at nih we are [3:02:07] doing that aggressively we're putting on tens of millions of dollars into it and we are [3:02:13] accelerating i appreciate that because sma which is a death sentence for children age two now has a [3:02:20] treatment developed in my district with research support from nih now a drug called zolgenza that [3:02:28] instead of dying at two with this gene therapy these children are achieving the milestones parents want [3:02:35] for their children of sitting up feeding themselves even walking we believe it is a cure that these [3:02:41] children will now instead of dying at the age of two live out their full lives and this is the [3:02:46] development that is happening because of research to places around the world in this country all [3:02:53] supported by nh nh nh and we're here today to discuss a budget that you brought before congress [3:02:59] where you're proposing to shrink nih funding the world's premier funder of medical research [3:03:05] shrink it by 5.7 billion dollars the cbo predicts that this reduction could lead to 50 fewer drugs [3:03:13] coming to the market over the next 30 years drugs that can cure diseases save lives make america healthier [3:03:21] again and you're cutting that funding you're diminishing science you're making it harder for americans to [3:03:28] lead i picked those three people people fleming domach and waxman because at the turn of the last [3:03:35] century scientists from around the world came to the united states because they were chased out of [3:03:41] their countries in europe the actions you in this administration are taking are chasing american [3:03:47] scientists away from this country and fueling the research and development and drug commercialization [3:03:54] in places like china you are not making americans healthier you're making americans sicker hurting our [3:03:59] economy and making our children's future less prosperous less secure you should be ashamed of yourself i yield back [3:04:07] as votes have been called the committee will stand in recess until immediately following the vote series