RFK Jr. testifies on HHS budget before House committee

[0:00] commanding better from our health and food systems and for using HHS as a platform to [0:07] make America healthy again, our health system is full of misaligned incentives. [0:13] The most glaring being that reimbursement is concentrated to patients who are already [0:18] sick and does too little to help Americans stay healthy. [0:23] Just this week, we held a field hearing in Florida on preventive care where we heard [0:29] from local medical professionals who because they are at the forefront of modern medicine [0:34] help their patients get back to the basics of a healthy life, nutrition, wellness, exercise [0:42] and preventative medicine. [0:44] It was clear from witness testimony that the movement movement that you help lead has begun [0:50] putting lots of thought into how we realign health incentives and support of this goal. [0:57] It is not just lifestyle choices undermining the health of the American people. [1:02] Industry consolidation with huge companies swallowing up various parts of the health care system [1:08] has helped pad the bottom line of big corporations while doing little to support the health or [1:15] well-being of working class Americans. [1:18] 16 years after Democrats promised Obamacare would be the silver bullet for lowering prices, [1:24] health care costs and insurance company profits have never been higher. [1:29] That's why the Ways and Means Committee is focused on addressing consolidation and vertical [1:33] integration in the health care industry to expand access and lower costs. [1:39] Earlier this year, we questioned the CEOs of major health insurance empires about how it [1:45] could be that they are focused on lowering costs for patients and not expanding revenue for themselves. [1:53] And each insurer owns pharmacies, medical providers and PBM middlemen. [1:59] It would not surprise you to know they did not have good answers. [2:03] Soon, we will have the same conversation with large hospital systems that have driven up prices [2:10] without expanding access to care. [2:14] That lack of access is especially important for the 60 million rural Americans who have higher [2:19] rates of chronic diseases and have 43% higher mortality rates than urban Americans. [2:26] We also need to do more to protect access to rural health care. [2:30] I want to thank you for distributing the first installment of funds to states from the $50 billion [2:36] Rural Health Transformation Program that Republicans enacted in the Working Families Tax Cuts. [2:42] Rural communities in my home state of Missouri are thrilled to have this program to protect access [2:48] to care and expand the quality of services offered to patients. [2:53] I'd ask that you and your department work with Congress to continue stewardship and oversight [2:59] of those critical funds to transform how health care services are delivered to rural Americans. [3:05] And I hope we can find ways to work together to meaningfully reverse the incentives in health care [3:12] that make it profitable to consolidate access at the expense of rural communities. [3:17] Another critical priority of your administration is the First Lady's Fostering the Future program. [3:25] Mrs. Trump joined the Ways and Means Committee yesterday in this very room for a special roundtable [3:30] featuring two foster youth who shared their stories and highlighted the importance of this initiative [3:37] to help more foster youth live a life of their own choosing. [3:42] Members of this committee have introduced bipartisan legislation that complements the First Lady's Initiative [3:48] and represents the most significant reforms to the Chafee Foster Youth Program since 1999. [3:56] We look forward to your partnership in turning these policies into law and then implementing them. [4:01] We also need to work together to address fraud in our health care system. [4:06] Every dollar stolen by fraudsters, illegal immigrants, and criminals is one less dollar [4:13] that benefits the American people, including the $60 billion lost in waste, [4:17] fraud and abuse in Medicare alone. [4:20] We must hold the criminals who steal billions from the American people accountable. [4:26] One has to look no further than the alleged $3.5 billion of Medicare [4:32] hospice fraud in L.A. County alone to know that this is a massive scandal that is waiting to be uncovered. [4:40] I applaud your work and to help uncover numerous outrageous examples of fraud [4:45] and look forward to providing you and the department the tools you need to root it out. [4:50] I'm glad that the Trump administration is taking proactive steps to lower health care costs [4:55] and expand access to rural communities. [4:58] And the president's new anti-fraud task force is so important for identifying and prosecuting criminals. [5:06] I look forward to discussing these issues and others today, [5:08] and I'm pleased to recognize the ranking member, Neil, for his opening statement. [5:11] Thank you, Mr. Chairman. [5:13] Mr. Secretary, welcome. [5:15] We share a heritage as sons of the Commonwealth. [5:18] I was in that audience the day before the presidential election in 1960, [5:24] as Senator Jack Kennedy finished his campaign in Waterbury, Connecticut, [5:30] in Springfield, Massachusetts, and that night in Boston, Massachusetts. [5:34] 24 hours later, he was the president-elect. [5:38] The joy in our home can hardly be calculated in just comments like this. [5:44] Stayed up all night for that result. [5:46] We watched him declare victory the next day, and we were delighted. [5:50] I passed out pamphlets for your dad when he ran for president in 1968. [5:55] I was a delegate for Teddy in 1980 when he ran, and I ran his campaigns in western Massachusetts. [6:03] Great friends with your brother Joe, your nephew Joe, and your cousin Patrick. [6:10] Together, with witness two days ago, when five governors of Massachusetts, Maura Healy, [6:19] Mitt Romney, Bill Weld, Mike Dukakis, and Deval Patrick, all gathered to celebrate the signing [6:26] of what we believe to be the antecedents of the Affordable Care Act. [6:30] All very capable people, regardless of party. [6:36] We built in Massachusetts a mecca of healthcare for the world. [6:40] We're proud of it. It's the gold standard. [6:43] It has drawn investment. [6:45] Two days ago, Spain announced another $200 million [6:49] that they would invest in our hospitals because they are destinations for the world. [6:54] Our success has been beyond our wildest hope. [6:58] Boston is the center of healthcare innovation in the world. [7:05] CDC, NIH, Kindle Square, a fact, the highest concentration of research and development [7:12] in the world in about an eight-block area. [7:16] Our colleges, our hospitals, our nurses, our professionals, our advocates, [7:23] all are extremely proud of what we did, regardless of political party. [7:27] And we don't want to see it dismantled. [7:29] And by the way, as a footnote, Mr. Secretary, we also like Dunkin' Donuts coffee. [7:37] We watch daily as the threats to this healthcare system that we have constructed, [7:42] whether it's talking about measles and vaccinations, [7:45] we remember what it was like before Dr. Salk's polio vaccine. [7:51] My mom, who was a devotee of the Kennedy family, [7:55] she said the way we prevented polio in the 50s was to stay out of fresh water in August. [8:01] Let me say this. [8:02] Nothing has changed about the science of vaccines. [8:06] We need people not to be preyed upon by demagoguery, [8:11] and there should not be a politicization of these very issues. [8:16] Let me go to some of the contradictions that the administration has made [8:20] as we talk about budgeting. [8:24] One trillion dollar cuts from our healthcare system, [8:28] putting 440 hospitals at risk so that we can have a tax cut for the wealthiest among us. [8:33] And that's based on tax distribution tables. [8:35] That's not made up at this moment. [8:38] Baseless claims about Tylenol and autism. [8:41] This damage could be catastrophic. [8:44] The administration's agenda includes obstacles to better healthcare. [8:49] Costs are sky high, but that has much to do right now with a lot of issues, including tariffs in Iran. [8:55] We want to push healthy eating for everybody. [8:58] And I've not met any candidate anywhere who ever said, [9:00] vote for me, I'm for more fraud. [9:03] That doesn't happen. [9:04] We want a fair and balanced approach to looking at it. [9:07] A proposed cut of 12.5% to HHS? [9:13] Let me remind all in this room, and you're going to be familiar with this name, Mr. Secretary, [9:19] Silvio Conti. [9:20] He was the Republican member of Congress in the district next to mine. [9:24] He was the author of the LIHEAP program, and it has worked beyond any objective measurement [9:32] that we believed at the time. [9:34] He wanted to make sure that people had an opportunity in the climate of New England [9:38] to heat their homes during the winter. [9:41] 159,000 families in Massachusetts relied upon LIHEAP last year. [9:47] Attacking childcare providers and delaying their payments means more parents [9:51] will choose between the childcare and their paycheck. [9:56] Family see-through podcasts and campaigns. [10:00] 60% of the American family worries right now about affording healthcare. [10:04] We should be fixing and repairing the parts of the healthcare system [10:09] that we want to improve for all members of the American family. [10:12] We should not be offering just to deflect blame. [10:16] We should be pointing out this achievement. [10:20] People should not have to choose between medicine and childcare. [10:25] We delivered historic relief with Medicare negotiations. [10:28] We capped out-of-pocket costs, and we lowered premiums. [10:32] We need to come to the aid of the American family at this very difficult time. [10:37] Republicans need to understand that Americans deserve a fair shake. [10:42] I'm going to close on the note that I opened with, and Mr. Secretary, I think you're well aware of it. [10:47] What we built in Massachusetts over these years since Senator Kennedy became president, [10:53] it was done with Republicans and Democrats. [10:55] But together, we're immensely proud of what it was that we achieved, [10:59] and we don't want to see it dismantled. [11:01] Thank you, Mr. Chairman. [11:05] Thank you, Ranking Member Neal. [11:07] Today's sole witness is the Secretary of Health and Human Services, Robert F. Kennedy, Jr. [11:13] The committee has received your written testimony, and it will be made part of the formal hearing record. [11:17] Secretary Kennedy, you have five minutes to deliver your remarks, and you may begin when you're ready. [11:22] Thank you, Mr. Chairman, Ranking Member Neal. [11:37] Members of the committee, thank you for the opportunity to appear before you today [11:41] to discuss the president's fiscal year 2027 budget request. [11:46] We stand at a generational turning point. [11:49] Our children of the sickest generation in modern history and decades of failed policy, [11:54] captured agencies, and profit-driven systems have caused it. [11:59] Parents across the country demanded change, and we are delivering it. [12:02] We are ending the era of federal policies that fueled the chronic disease epidemic [12:08] and replacing them with policies that put the health of Americans first. [12:13] President Trump and I are challenging the status quo and the institutions that defend it [12:18] as we work to make America healthy again. [12:21] In just 15 months, HHS has delivered historic wins. [12:25] We negotiated most favored nation drug prices with 16 of the largest pharmaceutical companies, [12:32] so Americans no longer pay more than other people in wealthy countries for the same medications. [12:38] We're bringing real transparency to healthcare pricing so patients know the cost of care before they receive it. [12:45] I use the full convening power of the federal government to bring health insurance CEOs to the table to reform prior authorization. [12:52] We are cutting red tape to speeding decisions and demanding transparency. [12:58] We are also cracking down on waste, fraud, and abuse. [13:02] This year, HHS and USDA issued new dietary guidelines that put real whole food at the center of the American plate. [13:10] We flipped the food pyramid upside down and sent a clear message to the American people, eat real food. [13:16] HHS has also opened the door to partnerships with industry, trade associations, non-profits, and advocacy organizations. [13:25] More than 50 medical schools have committed to expand nutrition education from an average of just two hours to 40 hours. [13:34] Food manufacturers are stepping up too. [13:36] More than 40 percent of the food industry is committed to phase out petroleum-based dyes by year-end, [13:42] and many have already eliminated them. [13:46] In conjunction with these efforts, FDA approved six natural food colorings derived from fruits and vegetables. [13:53] Though President Trump's Great American Recovery Initiative, HHS, is matching compassion [13:59] with action to help Americans break the cycle of addiction. [14:03] At HHS, we are prioritizing patients with ultra-rare diseases and their families, [14:09] and driving faster access to life-saving treatments. [14:12] We're restoring gold standard science and integrity across the agency. [14:17] We're protecting children from sex-rejecting procedures that expose them to irreversible harm. [14:24] We're eliminating outdated and misleading warning labels on hormone therapies used to treat women during menopause. [14:32] We're strengthening oversight of organ procurement. [14:35] We're implementing Operation Stork Speed to ensure the safety and quality of infant formula. [14:41] We're applying the same focus and urgency as you mentioned to rural America, the Rural Health [14:47] Transformation Fund delivers the largest investment in rural health in our nation's history, [14:52] $50 billion over five years to strengthen hospitals and ensure Americans can access the care they need no matter where they live. [15:00] Members of Congress on both sides of the aisle have made rural health a clear priority in their conversations with me, [15:08] because every state is feeling the strain of hospital closures, workforce shortages, and gaps in access. [15:16] HHS announced more than a $135 million investment this month to expand rural residency programs and nutrition services. [15:24] The data is clear. When physicians train in rural communities, they're more likely to practice there. [15:31] The President's budget puts all these priorities in action. [15:35] It invests in prevention because preventing disease costs less and delivers better outcomes than treating it. [15:42] As my uncle President John F. Kennedy said, progress is a nice word, but change is its motivator and change has its enemies. [15:50] We see those forces clearly, entrenched interests, defenders of a failing status quo, [15:58] and institutions that put profits ahead of the American people. [16:02] That resistance underscores the urgency of this moment. [16:06] We can reverse the chronic disease, improve public health and lower costs. [16:11] I stand ready to work with this committee and Congress to seize this opportunity. [16:16] We implement and codify lasting generational reform in American health care. [16:22] For our country, for our children, and for the healthy American people, together we can make America healthy again. [16:29] Thank you very much. [16:30] Thank you. Without objection, each member will be recognized for four minutes to accommodate the Secretary's time. [16:37] As always, we want to ensure that all members have an opportunity to ask questions of the Secretary. [16:42] We'll now proceed to the question and answer session. Start with Mr. Buchanan. [16:48] Thank you, Mr. Chairman, and I want to thank Secretary Kennedy and your leadership. [16:53] It's been incredible in my mindset. [16:55] The U.S. is spending $5.3 trillion on health care and getting sicker as a nation. [17:02] Six out of ten, six in ten Americans, 95 percent, in terms of Medicare beneficiaries, have at least one chronic disease. [17:10] Roughly half of the adult population is projected to be obese by the end of this decade. [17:16] I believe this problem stems from unhealthy and ultra-processed foods. [17:22] And I applaud HHS and its continued support and leadership on this issue. [17:27] We must prioritize prevention as the key to reversing trends in heart disease, obesity, and diabetics. [17:35] I believe the best way to do that has been the cost curve is by making sure that people get – don't get sick in the first place. [17:43] I like to say to people who are – you need to be the CEO – I read it – of your own health, and I think that's critical. [17:50] Mr. Secretary, I appreciate our strong partnership in advancing the health of this country. [17:56] I look forward to continuing to work together to support a health care system that values prevention, not reaction. [18:03] My one – couple of questions I've got – together, we've had – we've accomplished so many things to support health and prevention. [18:10] For example, we've worked on new – the food pyramid is real food, cutting the ultra-processed foods. [18:17] We're also brought back the presidential fitness guides, which I'm excited about. [18:22] And I guess, in terms of what – some of the things that we've done, what do you think we could be doing more of in that space, in terms of diet and exercise? [18:30] Sorry, flipping the food pyramid and issuing new dietary guidelines was the beginning. [18:43] When I came into office, I was handed the dietary guidelines that have been developed by the Biden administration. [18:50] They were 453 pages long. They were incomprehensible. They reflected – they were written by food industry lobbyists, [18:59] and they reflected the mercantile impulses that had driven Fruit Loops to the top of the food pyramid. [19:06] Fruit Loops isn't even a food. It's just poison. [19:10] And we brought together the best nutritionists in this country, from the best universities all over this country, [19:17] a dozen of them, who worked 11 months to reform the dietary guidelines and offered, for the first time, [19:24] not dogma-based guidelines, but science-based guidelines. [19:27] Every recommendation is cited and sourced to multiple peer-reviewed publications. [19:34] That's the beginning. The next part, we have to drive those changes into dietary culture in our country. [19:42] We are aggressively using the food subsidies program with Brooke Rollins, my partner in this. [19:48] Let me mention I've got another question with one minute left, but I'm deeply passionate [19:52] about promoting access to screening as a way to prevent diseases. Through my personal experience [19:57] with Alzheimer's and lung cancer, I've become a strong believer in the power of detection and [20:02] prevention, and I'd like to get just your thoughts and ideas on that in terms of screening, [20:07] like lung screening for cancer and stuff like that. [20:10] The screening for prevention is absolutely critical. We are forming now the USPST, which is the [20:19] committee that decides on new procedures and interventions that need to get CMS compensation. [20:32] And that committee has been lackadaisical and negligent for 20 years. [20:38] We're now bringing new members on who have a clear mission. We're going to have much more frequent [20:43] meetings. We're going to have, for the first time, transparency. We're going to – and we're making huge [20:50] investments at NIH and elsewhere in doing the kind of science that we need to do better screening for [20:59] Alzheimer's. [21:01] Thank you, and I yield back. [21:02] Thank you. Mr. Neal. [21:03] Thank you, Chairman. [21:06] Mr. Secretary, fighting fraud is bipartisan here. As I noted earlier in my remarks, [21:10] that nobody ever campaigned with a bumper sticker that said, [21:14] vote for me. I'm for more fraud. So, fighting fraud certainly has considerable support across [21:20] this Congress. And nothing makes me or you or others in this room matter than those who might rip [21:26] off Medicare. So, I think those who commit fraud ought to be held accountable. So, let's talk about [21:33] Lawrence Duran. He perpetrated what at the time was the largest therapy issue-related Medicare fraud [21:40] in history, hundreds of thousands of false claims. He was sentenced to 50 years in prison, [21:46] and he and other collaborators were ordered to pay back $87 million in restitution. His sentence was [21:55] commuted by the President. Did the President consult you as we pursue this fraud? [22:01] I don't know anything about that case. [22:04] Fair enough. [22:05] Congressman, I can say this. This has not been, although it's a bipartisan issue and there's [22:12] bipartisan passion for this issue, the application, the implementation of anti-fraud has not been [22:18] bipartisan. [22:19] Okay. So, let me go to the next one, Mr. Secretary. How about Joseph Swartz? He pled guilty last year to [22:26] bilking taxpayers out of more than $38 million, paid himself millions of dollars along the way, [22:32] his negligence as it related to nursing homes is well known to all of us. President Trump [22:37] pardoned Mr. Schwartz. I'm assuming he didn't consult you on that either. If we're going to talk [22:44] about fraud, it's not the people just at the lower end of the economic scale. If we're going to pursue [22:51] fraudsters, it's not just the people who might make simple, honest mistakes that could be corrected. [22:56] It's the people at the top that helped to perpetuate this fraud. And the administration's [23:00] position seems to be that it's only the recipients and not the providers that can commit fraud. We [23:07] are not defending fraud. We're not cheering for it. We're not excusing it. But there needs to be an [23:11] even-handed approach, including not passing out pardons to people that might be supporters of the [23:17] administration. So, let me on a nice note thank your staff here in front of all for helping me out [23:23] recently or helping my constituents out on an issue that related to daycare. Your staff came to the aid [23:32] of a Head Start provider in my district and really helped out a hundred families. The problem is that [23:39] we don't want that to be something that can be completed by senior members of the Ways and Means [23:44] Committee coupled with a group of administrators who know the problem and have come to the assistance of [23:50] those who need it. But it shouldn't be that way. It needs to be more universal and the cuts that are [23:56] being proposed to these initiatives are not helpful to the American family. I look at these decisions [24:03] and if we're going to pursue fraud, Mr. Secretary, it has to be across the board. And we want an even-handed [24:10] approach to these fraud investigations, including those whose schemes have cost the American taxpayers [24:17] hundreds of millions of dollars. I yield back my time. Mr. Smith. Thank you, Mr. Chairman. Thank you, [24:24] Secretary, for being here this morning and entertaining our questions. I represent one of the largest land [24:30] area districts in the country, and most of my constituents live in rural and even remote areas. [24:36] Agriculture is the engine of our economy in my district, and we're proud of our role in feeding [24:42] not just America but the world. Now, before I get to my questions, I would like to stress the importance [24:47] of modern agriculture practices in producing a healthy, affordable, and sustainable food supply. [24:53] The agriculture industry depends on our standards and regulations being science-driven [24:57] and risk-based. I do want to say that threatening the availability of technologies could inadvertently [25:03] lower yields and actually increase the price of food at a time when many Americans are already [25:08] struggling to make ends meet. So I encourage you to continue to bring farmers and ranchers to the [25:14] table as you consider matters relating to agriculture. Moving on, I do want to talk about rural health. [25:20] You mentioned rural health transformation program. I think that means a lot to so many of our [25:27] constituents, our communities, our states. The RHT programs notice a funding opportunity recognize the [25:33] important role of pharmacists in meeting rural communities' health needs. I believe that pharmacists [25:38] are an underutilized part of our health system. Nearly nine in ten Americans live within five miles of a pharmacy, [25:45] making pharmacists among the most accessible health professionals. Because of the broad accessibility, [25:50] I think there is more we should do to empower pharmacists to help meet rural health needs. [25:55] That's why I introduced a bill we call E-CAPS that would improve access to care for seniors across [26:02] America by providing Medicare coverage of pharmacists administered tests and treatment for common [26:08] illnesses like COVID, flu, and strep. By allowing pharmacists to test and treat seniors for common [26:14] illnesses, we can make these services more accessible and reduce pressure on emergency departments. [26:20] I do want to ask, what is your approach to improving access to health care services for [26:24] Americans who live in rural and remote areas? And what can we do to ensure Americans in rural areas [26:30] aren't left behind in our health care system? I mean, as last week, I went to Arizona to announce [26:38] an unprecedented $125 million investment in community health centers, which are serving 39 million Americans, [26:50] mainly in rural areas around the country, will improve nutrition and also retention of their workforce, [26:58] which is one of the reasons that so many of our rural health program, so many parts of it are failing today. [27:06] We've seen closures of 120 rural hospitals since 2010. It is a crisis. When these hospitals close, [27:14] it doesn't just deny access to health care. Those hospitals are economic drivers for their community. [27:20] They're the highest paid jobs. They're oftentimes the biggest employer. For that reason, President Trump [27:26] made the biggest investment in rural health care in American history, a $50 billion rural health [27:33] transformation fund. Right now, Medicaid gives about 7% of its money to rural hospitals. And it's about [27:43] $20 million a year. Well, we're increasing the flow of federal dollars to rural community health care [27:50] an extra $10 million a year. So that's a 50% rise over the next five years. And it's going to give those [27:57] hospitals the ability to upgrade their infrastructure to install telehealth, to move to AI, and to retain [28:06] workers and do all the other things they need to achieve permanent stability. I appreciate that. And just [28:12] in closing, and I just want to note, moving to CMMI, the Center for Innovation, I appreciate its intent. I do [28:20] believe it lacks some transparency. And especially when CBO found CMMI's activities increased direct spending [28:26] by $5.4 billion. So my time has expired. But I would encourage you to take a look at that so that we [28:34] can make sure that innovation drives cost savings and better outcomes rather than just driving more [28:40] spending and not positive results. Thank you. CMMI has been disastrously mismanaged in the past. [28:48] We are changing that. We're making it a center for innovation that Congress intended it to be. Thank you. [28:53] Mr. Doggett. Mr. Secretary, since waste fraud and abuse has been something of a watchword in this [29:00] administration, I'm sure that you're familiar with the December 3rd Government Accountability Office [29:06] response to a request by Chairman Smith, which reported significant agent and broker fraud with the [29:14] Affordable Care Act, including brokers signing up people who didn't even know they were signed up. [29:20] As you're aware, last May, under your authority, CMS fully reinstated all 850 brokers and agents who had [29:31] been suspended back in 2024 because of suspected ACA fraud. Can you guarantee to our committee today [29:39] that every one of those suspected brokers and agents was thoroughly investigated and found to be innocent [29:45] of any fraud, any wrongdoing or criminal activity? I can tell you. Can you, sir? Yes or no? You can't [29:59] answer that. That is very troubling, I must say. 850 people accused of fraud, suddenly reinstated all at [30:07] once. Do you know whether any of these suspected fraudsters who were reinstated so swiftly were subject [30:14] to any additional oversight under your authority? Have there been guard rails that have been put in [30:19] place to ensure those 850 agents don't continue to commit fraud? Congressman, I'm a lifelong Democrat, [30:27] so I was shocked. I don't care your party affiliation, we're all against fraud. I was shocked when I came [30:34] into this agency. Were you shocked to see that 850 people who were suspended for fraud had been reinstated [30:41] all at once? I was shocked to learn that President Biden had directed my agency to stop all program [30:49] integrity activities and focus on enrollment. Thinking back my time, sir. And that's what caused the [30:55] problem that you're talking about. President Biden's administration was the one that suspended 850 [30:59] suspected fraudsters. Your administration was the one that let them all go back to work. [31:05] President Biden fired everybody in my agency except for six people who were involved in program [31:10] integrity. In fact, under your leadership, you have suspended the very people at CMS who are [31:16] responsible for overseeing any fraud in the program. We've got more to combat fraud than any [31:22] administration issue. If you want to filibuster, go to the Senate. But would you please try to answer [31:26] my question, sir? Have there been any new complaints against these 850 brokers? As I said, I am happy to [31:33] talk to get my staff to contact your staff. I'm not asking if you're happy to talk. I just want to know the [31:38] answer to my question. Have there been any new complaints of fraud against these people? I don't [31:43] know why those people reinstated it. As far as I'm concerned, it may be because of a lawsuit. [31:49] I have to check on that. I can guarantee you there is no administration in history. Reclaiming my time, [31:55] sir, as it runs out, it is very troubling that the only fraud that Chairman Smith referred to as a [32:03] smoking gun to deny affordable health care credits, put the blame on the mother that was trying to [32:09] protect the sick child, that nothing was done about that. And the secretary still doesn't know much of [32:14] anything about it. As far as fraud, Paul Wozak is one who had $10 million of wages that he kept some of [32:23] to buy a $2 million yacht. His mother contributed to the Trump campaign, and he no longer has to pay [32:31] $4.4 million or stay in prison. Mr. Secretary, I want to know what role you play in the soft-on-crime [32:38] approach to health care fraudsters. Have you recommended that any of these health care fraudsters [32:44] should get pardons or commutations, or did the campaign contributions speak for themselves? [32:48] I don't think there is anybody in this country, I don't think there's anybody in this country who [32:58] believes that this administration is soft on fraud. We're the first administration in history. [33:03] The fraudsters who have the money in the cottage industry to get themselves pardoned and not even [33:08] have to restitute what they've taken from those they've defrauded. It's really a disgrace. I'm [33:13] surprised you would defend it. It's not a credible story. It's a fact, sir. It's not a story. It's a fact. [33:21] Mr. Kelly. More fraudsters pardoned by any president in American history. Your time has expired, [33:26] Mr. Kelly. Thank you, Chairman. Mr. Secretary, thanks for being with us today. And as usual, [33:33] the beatings will continue until morale improves. I did want to just talk about one thing real [33:40] quickly. I'm really wishing you success in the rollouts of the bridge and balance models, [33:44] expanding seniors' access to weight loss drugs. And as Mr. Buchanan talked about, this is really [33:50] critical. But at this point in today's hearing, I'm going to turn my time over to Mr. Zweigert from [33:55] Arizona. I think he has some, would take more than four minutes for him to go through all the things he [34:00] wants to ask you. But again, thank you for walking out of where you were into this. I appreciate what [34:05] you're doing. And your family has always been a hallmark of American service. So thank you so much, [34:09] Mr. Secretary. Mr. Zweigert. Thank you, Mr. Kelly. And I appreciate him doing this. And [34:17] let's actually do some waste and fraud where we have real money. I actually want to talk about what's [34:22] often referred to as CPAP, the CDPAP, New York Health. Let's actually use New York because that's [34:30] actually what Oversight has been looking at. Something is wrong when the biggest job creator [34:38] in New York City over the last few years turns out to be a home visitation program that you all manage. [34:46] We have some data here that basically says for every thousand residents 65 and up in New York State, [34:52] the whole state, 171 are receiving these stipends, these payments. In New York, if New York itself [35:02] was actually at the Medicaid population average, it would save 43 billion dollars a year. When we start [35:15] to actually examine and dive into the numbers, the disproportionate, yes, we have frauds here, [35:21] frauds there. But we have entire states that seem to be helping this fraud along. What do I do to help [35:28] a program like this that substantially expanded during COVID that we now have not only New York, [35:33] but a handful of other states that seem to be using it as a jobs program and not a health program? [35:40] Senator, that is a huge problem. New York's state pays, on average, [35:47] 80 percent more per capita on Medicaid than any other state. 80 percent over the average. [35:57] And part of the reason for that, as you point out, are these waiver programs that the states, [36:03] many of the states have now applied for and received. In the old days, Medicaid paid for medical [36:10] procedures. So if you got a hernia operation, we could figure that out at CMS. We could see you had a [36:17] scar. It was done by a licensed doctor, by a licensed nurse, and we could track to make sure it actually [36:23] happened. The waivers allow people, family members, who are taking care of an elderly parent to get paid [36:34] for balancing the checkbook, for picking up the groceries, for driving somebody to a doctor's [36:39] appointment. Today, the biggest job in New York, 650,000 people. The biggest employment niche is home [36:48] care. These are family members who are getting paid to do things that they used to do as family members [36:54] for free. And this is rife with fraud because we have no way at CMS to determine whether they actually [37:05] perform that duty or not. We don't know whether you drove your grandmother to a doctor's office. [37:11] So it's an opportunity for fraud. And states are state corrupt people. Fraudsters are taking that [37:18] opportunity all over the country. And it's one of the reasons that Medicaid doubled during the Biden [37:25] administration, because we are paying for fraud now as much as for medicine. Thank you, Mr. Secretary. [37:32] And we get a round two. I yield back. Mr. Thompson. Thank you, Mr. Chairman. And thank you for your [37:39] persistence in getting this hearing scheduled. And Mr. Secretary, thank you for finally appearing [37:45] before our committee. Mr. Secretary, let's start with an easy one. Do you have a medical or public [37:51] health degree? No. No? No. Yet you're overruling doctors, scientists and public health experts across [38:01] our country. Your dangerous conspiracy theories are undermining safe and effective vaccines. [38:08] Mr. Secretary, I want to echo my friend the ranking members comments about polio. [38:13] I remember as a kid, kids older than me in school with me who got polio. They live with the lasting [38:22] impacts of that infection for the rest of their lives. I was fortunate to get the polio vaccine. [38:29] And I was fortunate to never get polio because of that vaccine. And because we're about the same age, [38:37] I'm sure you have similar experiences. But now you undermine vaccines and are helping make diseases [38:44] deadly again. Mr. Chairman, I ask unanimous consent to submit for the record this article from the [38:50] Sacramento Bee about the rising measles cases in California. Without objection. Thank you. [38:56] In 2000, measles were declared eliminated in the United States. And I've got a graph behind me that [39:04] shows that. Under four years of President Biden, there were 514 measles cases in the U.S. Under just one [39:15] year of President Trump, there are nearly 2,300 cases. Mr. Secretary, kids have died because measles is [39:24] running rampant under your watch. In large part because President Trump allowed your conspiracy [39:32] theories to run our public health. Americans need serious leadership grounded in evidence and science. [39:40] Instead, we have you and this President elevating misinformation and undermining basic public health. [39:50] HHS should be led by professionals who respect science and data, listen to doctors, and put patients first. [39:58] Not by rhetoric, not by conspiracy, and not by ignoring established medical facts. So today, Mr. Secretary, [40:06] this is not just about policy differences. It's about whether this department is going to protect the health [40:13] of the American people or put them at greater risk. Right now, it looks like the latter. [40:19] Let's not sugarcoat this. Americans are paying more for health care, not less. Families are being squeezed [40:26] at every turn. And instead of relief, they're being handed policies that will make things much worse. [40:34] You and this administration promised to lower costs. Instead, costs are rising. And you and this [40:41] administration ripped health care away from millions of people. H.R. 1, the big, ugly, big, beautiful bill, [40:50] whatever it's being called these days, cut a trillion dollars from Medicaid. That means fewer doctor visits, [40:58] delayed care, and more people showing up in already overcrowded emergency rooms. Let's be honest where this [41:06] leads. People will get sicker, preventable conditions will go untreated, and people will die. [41:13] Mr. Secretary, you shouldn't be in this office. I yield back the balance of my time. [41:21] Mr. Schweikert. Mr. Secretary, you are actually the first person I've had in my 16 years who's actually [41:29] willing to have conversations with me on how to have the revolution of lowering the costs of health care and [41:34] help our brothers and sisters be healthy. But I want to go to one that makes the lobbyist community [41:41] pucker up because every other lobbyist seems to be working on this. These are just some of the MedPAC [41:47] reports. You pay for them. They basically say Medicare Advantage, Medicare Part C, has a misalignment [41:57] on the math. We need to come to a final conclusion. Are these accurate? Or the stories I get from the [42:05] lobbyists accurate? Are the insurance companies accurate? Because the latest report says Medicare [42:12] Advantage comes in at 114 percent of fee-for-service. In 2005, when we set up Medicare Advantage, which I'm [42:21] a big supporter of a capitated model where you make your profit by helping your brothers and sisters be [42:26] healthier, instead of a model where you make your money by constantly risk-scoring them as sicker. [42:33] And you saw last year's Wall Street Journal series showing how many people had been scored as being [42:39] sick, and they didn't have that disease. They had never been tested for that disease. 114 percent [42:45] compared to 95 percent fee-for-service is about 1.75 trillion dollars over 10 years, making it the single [42:56] biggest misalignment in the federal government. Can I beg of you, and I know you're going to, [43:05] Dr. Oz and others, we need to put everyone in a room, maybe our actuaries, maybe my economists from [43:10] the Joint Economic Committee who have been working on this for three years. It's a stunning amount of [43:15] money. How do we use Medicare Advantage, a managed care model, to have your vision of they make a profit [43:21] because you helped people be healthier? It may require a multiple year enrollment, so there's a [43:28] payoff for the investment. 31 percent of Medicare spending is diabetes. What can I do to work with [43:38] you? What can I do to move CMS and HHS to a vision here of health care for seniors? Thank you, [43:46] Congressman. I'd love to have those discussions with you. I'll say the fraud, part of it is perverse [43:55] incentives, as you pointed out, and part of it is fraud. Medicaid, Medicare Advantage was created [44:01] as a, to end perverse incentives, to give us value-based care, as opposed to traditional Medicare, [44:08] and in some ways it's doing that. In every metric that we look at, people have Medicare Advantage are [44:15] better off, are healthier, they're getting treated better, they're more compliant, and people who [44:21] are getting costs are fee-for-cost programs. One of the other problems is that, one of the major [44:30] problems is upcoding, and it's just rampant fraud throughout the system, as you point out, [44:35] and we are fixing that now for the first time. And I can tell you that we're already seeing [44:40] some change in the discrepancy this year. We raise the premiums for, or we're proposing to raise the [44:49] premiums for Medicare Advantage by 2 percent, whereas Medicaid and Medicare are going up by 5 percent. [44:56] Mr. Secretary, I want to propose a more radical solution of alignment of incentives. Get rid of the [45:04] risk scoring, I would get rid of the star rating, and do those scoring at the beginning, [45:11] and then design a system where, as you help the enrollee get healthier, they benefit. [45:17] We're almost out of time. I want to thank you and the agency for also starting [45:21] the things of wearables, the thing you can wear on your wrist, the thing you can wear, [45:25] the thing you – and the ability to allow Americans to sort of have their own medical lab [45:31] attached to them. Now we have to figure out how to allow it to prescribe. And with that, [45:35] I yield back to Mr. Chairman. Mr. Larson. Well, thank you, [45:40] Mr. Chairman and Mr. Secretary. Welcome to the Ways and Means Committee. I want to [45:46] first associate myself with the remarks of Leader Neil, especially as it relates to the great legacy [45:58] of your family. Thank you. There wasn't – on my paper route, there wasn't a house whose door I didn't [46:05] knock on, where there was a picture of Pope John XXIII and John F. Kennedy. That's how deep [46:15] and incredible influence that the President of the United States, the first Catholic elected, [46:25] had on generations of people, and still every bit as much relevant today as he was in the 1960s. [46:38] Your family and its legacy of public service deserves always to be acknowledged for the enormous [46:47] sacrifice and their willingness to serve and to serve in the public interest. What Mr. Neil also [46:56] pointed out, as my other colleagues, I think you can understand and appreciate the incredible [47:02] frustration. President Kennedy said that science is the quiet power. And whether it comes to sending a man [47:13] to the moon or vaccinations, President Kennedy was out front in terms of his belief in government and his [47:28] belief in making sure that vaccines were provided for the health and well-being of the American people [47:38] and the children were all sworn to serve and protect. I would like, Mr. Chairman, if you would, to submit for the [47:48] record the Connecticut Department of Public Health testimony on the establishment of vaccine standards. [47:57] Without objection. Thank you, Mr. Chairman. I would also, Mr. Chairman, like to submit for the record [48:04] a stark divide, Americans more confident in career scientists at the U.S. health agencies than leaders. [48:17] Without objection. And I guess that's what it all comes down to. [48:22] When we look at the vaccination process, and I think everybody's entitled to their opinions and views, [48:32] but we're not entitled to our own facts. And the facts, I think, speak clearly on this. When I confront [48:42] doctors in my community, they say they're spending more time counseling people about taking their [48:52] vaccination shots. We know what we were able to do. Just four years ago, the state of Connecticut braced [49:02] for what they thought might be an outbreak of measles because a case was reported. But as it turns out, [49:10] that was the only case. And it was attributed to the fact that people were vaccinated. And that's what [49:18] prevented that. And as Mr. Neal and others have meant to mention, whether it's polio, whether it's [49:24] measles, whatever the case may be, I think you can appreciate how deeply concerned people are about this [49:33] and how the contrast between what your uncle and the president of the United States said in his [49:43] beliefs and yours with respect to vaccinations. And with that, I see my time has run back out. I'll [49:51] yield back my time. Thank you. Mr. LaHood. Thank you, Mr. Chairman. Mr. Secretary, welcome. I want to get your [49:59] opinion on the FDA. There's been broad reporting in the press on concerns that and mismanagement and bungled drug [50:09] reviews at the FDA have chilled investments in lifesaving innovative cures and that China is rapidly [50:17] becoming the recipient of those investment dollars. I also serve on the Select Committee on China. And as we look at how do we [50:24] win the strategic competition when it comes to investment and innovation, it's very important that we [50:30] have a vibrant, efficient FDA. And I understand that you aren't involved in those drug review decisions, [50:36] and I intend to take that up with Dr. Markry. But it seems like a squandered opportunity to maintain [50:42] America's position as the premier destination for investment in medicine and modern technology. Can you [50:49] comment on that, Secretary? What I would comment is I acknowledge that Congress is eating our lunch and [50:55] that happened during the Biden administration. We are redressing that. We have broken every record for drug [51:03] approvals. We approved 67 drugs. This year, new drugs. We approved, which is a record. We approved 39 new devices, which is [51:13] a record. We approved 91 new generic drugs, which is a record. We are 100% online to make all of our pitufa deadlines, [51:28] which does not usually happen. We have dramatically shortened a period from approval from conception to [51:38] commerce. We just approved two new drugs, two new oncology drugs in record time, one in 45 [51:45] days. The closest before that was 310 days. The other in 55 days. These are two drugs that are so effective [51:54] that they can bring people out of hospice. Oh, we are doing we are we we've moved to two to one from two [52:04] to one trials to one to one trials with where it's appropriate. We're using AI to dramatically shorten [52:13] the times to approval. We're doing things that no other agency has with greater competence, greater [52:20] efficiency than any other agency in history. You hear these stories about a drug that's been refused. [52:26] You read about them in the Wall Street Journal. This week they were talking about a melanoma drug. [52:32] Every every panel within FDA, all the career panels, the career scientists who looked at that drug [52:39] said it was not effective. The drug maker was told to do a two arm trial. He did a one arm trial. [52:47] And all the people who were tested also received a chemotherapy drug. So we don't know what the [52:52] effect was. And what Marty made the correct decision to not approve that drug. But everybody goes after [53:00] him because the industry is so powerful. They own Congress, they own the media, and they can beat up [53:06] Marty McCary because he's trying to do change over there. [53:10] Gotcha. I want to switch subjects. I'm also the chair of the Work and Welfare Subcommittee, [53:14] which has jurisdiction over foster care and the Shafee programs. Yesterday, we had the First Lady here [53:19] to talk about Fostering the Future, her initiative when it comes to foster care. Can you comment on the [53:26] role HHS is playing in implementing the Fostering the Future executive order to help improve [53:32] outcomes for foster youth? President Trump and the First Lady, who's been extraordinary for us to work [53:38] with, have said their vision is one family, her one for one child. Right now, we have a two to one ratio. [53:47] And part of the reason for that is that the Biden administration was excluding an entire class of [53:55] people because of their religious beliefs. We are told the states to actually pass laws, instructed them [54:02] to pass laws, refusing families who had certain religious beliefs, mainly Christian religious [54:09] beliefs, to not be allowed to have children. And that dramatically constricted the pool of available [54:16] parents. We are changing that. We're also addressing one of the big issues, which is to allow children to [54:25] stay with their families of origin. One of the biggest drivers of those separations is drug abuse. [54:32] And we are aggressively going after these issues. And partially as a result of our work, [54:39] number of foster children has dropped from 425,000 to 325,000 because there's more kids who are doing [54:48] our early preventative services on and intervening early with parents who have drug addiction problems. [54:54] Thank you, Mr. Secretary. I yield back. Mr. Davis. Thank you, Mr. Chairman. [54:59] Secretary Kennedy, thank you. And I, too, share the admiration of your family's legacy [55:07] and contributions to the development of this nation. In my district in Chicago, child care can be hard [55:17] to find. And when parents can't find child care, they can't go to work. Last week, President Trump said, [55:26] and I quote, the United States can't take care of daycare because we're fighting wars and need to [55:35] spend our money on those. Do you agree with President Trump that we should cut child care to pay for his [55:45] war in Iran? I don't think that that's what President Trump meant. Congressman, I appreciate you very much. [55:53] You're actually giving me an opportunity to answer your question, which none of your colleagues have done. [55:59] They've all shut me up and they've talked about science, but science is about debate. [56:04] They give a little speech that they can go and market, you know, for fundraising, [56:09] and then they don't allow me to answer the question. And I deeply appreciate the respect [56:14] that you've shown. In this budget, we were told to make a 12 percent got across our department because [56:22] Congress wrote a $39 trillion debt. We're now having to tighten our belt. The two programs that I [56:30] protected, I protected, and that Russell had protected were the Head Start program. [56:34] Okay. Oh, it is getting no cuts. And incidentally, there have been no cuts to Medicaid. [56:41] Look at the CBO. I've got another question that I need to ask. [56:45] Black women are nearly three times as likely to die from pregnancy-related causes as white women. [56:53] Yet the Trump administration is undermining black maternal health from all sides. The GOP slashed over a [57:01] trillion dollars from Medicaid, which pays for over 40 percent of births in the United States. [57:09] President Trump just proposed cutting maternal and child health programs by over $800 million. [57:18] Doge canceled funds for several research projects that could save countless black mothers, [57:26] like the Morehouse School of Medicine research on improving the health of black pregnant and [57:32] postpartum women. How can we lower black maternal health experiences if we're cutting funds for these [57:40] critical programs? And the administration says that you can't consider race or ethnicity in healthcare. [57:52] We are, this administration, under my leadership and President Trump's leadership, [57:58] is doing more to advance maternal health than any other administration in history. [58:03] It was tremendous duplication of departments. We had 42 different maternal health services in our [58:09] department. And we cut some of those and consolidated them. Right now, we are investing huge amounts of [58:17] money in maternal health. We serve 59 million American mothers. Our perinatal program, which is a [58:24] groundbreaking program, we're now in 220 hospitals, has reduced maternal mortality in those hospitals by [58:33] 42 percent. Nobody's done that in history. My time is going to expire, but let me ask you, [58:41] the community health centers are excellent stewards for the 340B program and they've done a great job with [58:49] them. Now they're burdened with a new model and reporting requirements. Would you consider exempting [58:57] the health centers from that model of rebate, all of the reporting things that are making it difficult? [59:04] I'm happy to talk to you about that. I can say that we are giving, we are increasing the budget, [59:12] our community health services centers in this country, in this budget, where everything else is getting cut, [59:19] because we understand that they do a better job at treating their patients and particularly patients [59:24] in the poor community than any other system in our country. And we strand, I just gave another 143 [59:30] million dollars to them last week, in addition to the proposed increase in their budget that are in [59:37] this budget, proposed budget. Thank you, Mr. Chairman. Now you're back. Thank you. Mr. Estes. [59:43] Thank you, Mr. Chairman. And thank you, Secretary Kennedy, for being here today. You know, [59:48] I want to start by commending the Department of Health and Human Services for establishing the [59:52] Maha Commission and Administration for a Healthy America to fight chronic disease and promote healthy [59:58] living for all Americans. As mentioned earlier, the statistics are staggering that 6 in 10 Americans [1:00:03] have at least one chronic disease and that 90 percent of our health care spending is dedicated to [1:00:09] fighting these conditions. We've got to look at ways to reverse this trend and focus on how do we [1:00:14] improve wellness. We're strongly supportive of a pivot away from this reactionary sick care towards [1:00:22] the preventive maintenance and strategic alignments for particularly rural health. [1:00:26] We also need to recognize the importance of patients' access to quality care and availability of [1:00:31] providers. A bold vision for a healthy America doesn't work if we can't succeed to support our rural [1:00:38] communities with the essential medical workforce and emergency transportation required. In my district [1:00:45] in South Central Kansas, institutions like the Kansas College of Osteopathic Medicine and the future [1:00:51] Wichita Biomedical Campus are working hard to generate the next generation of doctors that will be [1:00:57] supportive for us. You know, Mr. Secretary, air ambulances are an essential lifeline in rural America, [1:01:03] and when an emergency happens, sometimes those helicopters are often the only way a patient gets [1:01:08] to a medical treatment in time. Many of our bases are at risk of closing because of the Medicare [1:01:16] reimbursement rates haven't been meaningfully updated for a couple of decades, and part of that's [1:01:21] because the federal government hasn't been doing its job. Five years ago, the No Surprises Act [1:01:26] was required to the Department of HHS and the Department of Transportation to collect those costs and [1:01:32] operational data. And to date, those rules haven't been finalized. And I wanted to just ask, you know, [1:01:38] how can we work together? How can we get HHS and Department of Transportation to work to update that? [1:01:43] I am happy to work with you on that. I can tell you that the No Surprises Act was passed with the [1:01:51] best intentions, and it was a great law, but it was not implemented by the Biden administration. [1:01:57] And those proposed regulations on the No Surprises Act were left to languish. We are now in the final [1:02:05] process of finalizing them. And I'm happy to work with your office to talk about the air ambulance [1:02:11] problem. And, you know, these are huge. This is a huge issue, particularly in Alaska. So I hear from [1:02:19] them all the time about the same issue. And we've also found a lot of fraud in that area. So we need the [1:02:27] kind of audits that you're talking about and the kind of information that you're talking about. We're [1:02:31] really interested in that. And I look forward to working with you on it. [1:02:34] Great. Well, thank you. And, you know, one of the things we're also concerned about is the real threat [1:02:38] of retirement of so many providers in the physician workforce. And, you know, as we look particularly [1:02:45] of how that's going to impact patients, particularly in rural communities, many of the communities [1:02:51] lack specialists, and particularly with the number of physicians at an older age in our rural communities. [1:02:58] And we're seeing now more patients are approximately seeing 50 percent more specialists than in the [1:03:06] year 2000. And so I want to see if there's things that you're doing in the administration to help [1:03:11] ensure that our rural patients can get access to some of these specialty care. [1:03:16] I think one of the most important things that we've done to address that very, very grave problem [1:03:23] is the site neutrality rules, which we have recently finalized. And that will [1:03:29] end the disparity between what's paid to rural providers and what's paid to urban providers, [1:03:34] and hopefully dampen the appetite for consolidations, which are destroying [1:03:41] rural economies and rural health care, and allow them to get a living wage, which they don't have [1:03:51] right now. Right. Well, thank you. Thank you for all your hard work. I yield back. [1:03:55] Ms. Sam Chess. Thank you. Secretary Kennedy, we appreciate your appearance here today. [1:04:00] To win the support of skeptical senators during your confirmation hearings, you claimed, and I'm quoting [1:04:06] here, I support vaccines. I support the childhood vaccine schedule. I was skeptical about those [1:04:13] comments because prior to your nomination, you espoused numerous disproven theories that childhood [1:04:19] vaccines, including the measles vaccines, were linked to autism, death, and other adverse effects. [1:04:24] Not surprisingly, we were right to be skeptical of your promise to support the childhood vaccine [1:04:30] schedule because at your direction, the CDC removed its universal vaccine recommendations for [1:04:35] children covering seven immunizations, including things like flu, COVID, hepatitis A, hepatitis V, [1:04:42] and rotavirus. On Fox News last year, you stated, and I'm quoting you again here, [1:04:47] there are adverse effects from the vaccine. It does cause deaths every year. It causes all the illnesses [1:04:54] that measles itself causes. A deadly measles outbreak in Texas killed an unvaccinated six-year-old, [1:05:00] the first such death in a decade. So simple yes or no question. It's not that we don't want to let you [1:05:07] answer. It's that we all have limited time, and you have plenty of time to answer questions, and you [1:05:12] have plenty of time to give testimony at the beginning. So simple yes or no answer will do here. Do you agree [1:05:18] with the majority of doctors that the measles vaccine could have saved that child's life in Texas? [1:05:25] It's possible, certainly. Okay, thank you. I want to look at some very important data. In 2024, [1:05:33] under the Biden administration, which apparently seems to be responsible for every ill in the world, [1:05:38] in 2024, under the Biden administration, there were 258 cases of measles. And in 2025, under your [1:05:47] leadership, at HHS, it ballooned to over 2,000. That's a 675 percent increase. And we are now on [1:05:56] track to surpass that this year, with over 1,600 confirmed cases in just three and a half months. [1:06:04] If we project those numbers out for all of 2026, we can expect a whopping 6,400 cases of measles. [1:06:12] That's a 2,380 percent increase in a preventable disease. CDC data also shows that about 80 percent [1:06:21] of children who died from flu this season were not vaccinated. The anti-vaccine rhetoric you ran on, [1:06:28] and the anti-vaccine actions you have taken over the last year, clearly correlates with the dramatic [1:06:35] increases, again, in preventable diseases. As a mother, this horrifies me. Stopping the spread of [1:06:41] communicable diseases as one of HHS's primary responsibilities. And a strong public health [1:06:48] messaging campaign on the importance of vaccines could have stopped this surge of measles cases [1:06:54] as it had in past outbreaks. But I was appalled to learn that the CDC suspended public health messaging [1:07:01] on vaccines last February. It ended a successful flu vaccine campaign as well. My question is, [1:07:09] did President Trump approve your decision to end CDC's pro-vaccine public messaging campaign? [1:07:16] You've got a lot of misinformation there, first of all. No, I'm asking you a question. [1:07:19] I appreciate a response to the question. Let me respond to the misstatements that you've made. [1:07:23] No, you have other opportunities. I have limited time. Please answer my question. [1:07:29] I have to respond. Did President Trump approve your decision to end CDC's pro-vaccine [1:07:35] public messaging campaign? Allow me to answer, to respond to a lot of the misinformation. No, [1:07:40] answer my question, please, sir. I have limited time. There's a global measles epidemic. We've done [1:07:46] better in preventing it than any country in the world. There is no country that has seen a bigger [1:07:51] percentage increase. That's not true. Mexico has three times our measles and they have one-eighth of [1:07:56] our population. And do you, did President Trump approve your decision to end the CDC's pro-vaccine [1:08:00] public messaging campaign? Canada has doubled the measles and they have one-eighth of our population? [1:08:06] Did he approve that? We've done better at preventing measles than any country in the world. [1:08:11] Did President Trump approve your decision to end the CDC's pro-vaccine public messaging campaign? [1:08:17] We've done better at preventing measles. That's not answering my question, sir. That is not [1:08:22] answering my question. And I think you don't want to answer the question because I think you know [1:08:27] I want to respond to your misinformation. Terrible, terrible decisions that impact very, [1:08:33] very real lives, especially the lives of children. Now, one thing that I find incredible is that you [1:08:40] suspended this pro-vaccine messaging campaign, but somehow you're spending taxpayer dollars to drink [1:08:47] milk shirtless in a hot tub with Kid Rock and somehow you think that's a better public health [1:08:53] message than informing the public about the importance of vaccines? General Lady's time is [1:08:58] expired. Really? I yield back. You don't have anything to yield. Mr. Smucker. Thank you, Mr. Chairman. Thank [1:09:10] you, Secretary, for being here today. I'd like to first thank you for your work. Thank you for your [1:09:15] willingness to do this. Thank you for your courage, because taking on entrenched systems does take [1:09:23] real courage, and I think future generations will thank you for the work that you're doing today. [1:09:28] I want to talk just two quick things. You've spoken extensively about the role of diet in preventing [1:09:36] chronic disease, and I have two specific policies, bills that I'm working on that we've talked with the [1:09:43] department about, but I'd love to get your public comments about them today. The first is food is [1:09:50] medicine interventions, like produce prescriptions, medically tailored meals, which there's growing [1:09:59] evidence that they can really improve outcomes for patients with chronic disease, so I think there's a [1:10:05] role for these approaches in federal health programs. And, of course, you know, CMMI is created specifically [1:10:14] to test new healthcare delivery models that improve outcomes at lower costs, and I appreciate that [1:10:20] under your leadership, CMMI has started to prioritize prevention-focused models. So I've been working on [1:10:28] and planning to introduce actually this afternoon a bipartisan bill that would test a bundled payment [1:10:34] that provides certain chronically ill patients with a comprehensive package, access to healthy produce, [1:10:40] nutrition counseling, remote monitoring, with the goal of preventing disease progression and reducing [1:10:46] avoidable healthcare costs. I'd just like to get your reaction to that and love to have the continued [1:10:51] support of the department for a policy like this. [1:10:53] Yeah, I mean, we have the highest chronic disease burden in the world. Congressman was talking about [1:11:00] the deaths from infectious disease, which are a couple of thousand a year. 90 percent of the people [1:11:07] who die, the three million people who die in this country, die of chronic disease, and nobody's paying [1:11:11] attention to this. And all of these members have ignored this for as long as they've been in office. [1:11:18] This is the real threat to American health. In fact, during COVID, we have the highest death rate of any [1:11:24] country in the world. And when you ask CDC, why is that true? They say, well, it's because we're the [1:11:32] sickest population. The average American who died from COVID had 3.8 chronic disease. What was killing [1:11:38] them? COVID or the chronic disease? You have to understand chronic disease, infectious disease has a [1:11:46] very hard time killing healthy person. It kills people with chronic disease. And we are, I'm looking forward [1:11:54] to, you know, up to 70 percent of type 2 diabetes can be reversed and people can even lose the diagnosis [1:12:03] simply by changing their diet. Well, thank you. I do want to bring up one additional piece of [1:12:10] legislation that we're working on. You know, food manufacturers are moving in the right direction [1:12:16] due to your leadership on reducing additives, reformulating products, responding to consumer [1:12:20] demand for healthier options. There's still a gap, though, in what's in the generally recognized as [1:12:28] safe or grasp pathway where companies can self-determine a substance is safe. They determine that [1:12:35] themselves, often relying on their own expert panels with limited transparency into potential conflicts [1:12:41] of interest or underlying data. So that's another piece of legislation I'm working on. I think we should [1:12:48] establish clear standards for self-grasp panels, strengthen public confidence in our food supply. [1:12:55] Just wanted to get your thoughts. Do you believe reforms like that are? Yeah, that's absolutely [1:13:00] critical. We have finalized in my agency a closing the grass loophole and that regulation is now going [1:13:08] through the interagency process. We're a little bit hobbled in what we can do and Congress can do much more. [1:13:15] So my office would love to work with your office on getting a much stronger bill, [1:13:21] much stronger regulations. The grass loophole has been hijacked by the food industry. [1:13:28] And because of that, we have 10,000 ingredients in our food. In Europe, they only have 400. And most of [1:13:34] those have never been safety tested. We don't even have a list of them. We have no idea what they are. [1:13:39] It essentially allows the industry to put in any chemical they want, any chemical they devise and [1:13:48] lab into our food without even the slightest regulations. And that needs to be changed if [1:13:55] we're going to make America healthy again. I appreciate your help and your leadership, Congressman. [1:14:00] Thank you. Look forward to working with you on that. Ms. Sewell. [1:14:03] Mr. Secretary, you've made a number of outlandish and frankly disturbing comments both before and [1:14:11] during your tenure as Secretary of Health and Human Services. I want to draw your attention to one of [1:14:17] those times. In a 2024 podcast interview, you suggested that black children on ADHD medication should be [1:14:27] reparented. You said every black kid is now just standardly put on Adderall, SSRI benzos, which are [1:14:37] known to induce violence and that those children are going to have to go somewhere to get reparented. [1:14:46] There is a lot to unpack in that comment. I know that you've already answered several of the questions [1:14:51] I was going to ask. And so I'm just going to rephrase them. Mr. Secretary, you've already admitted [1:14:57] that you are not board certified physician and you've already admitted that you did not go [1:15:02] to medical school. Have you ever reparented or parented, I should say, a black child? [1:15:09] I don't even know what that phrase means and I doubt that I said it. [1:15:13] Yes or no answer. I doubt that I said that phrase? No, I'm not going to answer something that I didn't [1:15:18] say. You absolutely said it. Oh, I'd like to hear the recording. [1:15:22] So to be clear. It doesn't make any sense. I don't even know what it means. I don't either. [1:15:27] That's why I'm asking. By the way. So to be clear, you're not a doctor. You have no medical degree [1:15:33] and you have no formal medical training. You have never parented a black child. [1:15:38] As have 24 of the 26 HHS secretaries have not had medical degrees. This is my time. And I say to the [1:15:47] chairman, I want to reclaim my time. Um, so you are not a doctor, have no formal medical training, [1:15:54] and you've never parented a black child. And yet you are suggesting that the federal government [1:15:58] should take black children away from their families and reparent them and send them off to some wellness [1:16:04] farm instead of providing them with evidence based. You're just making stuff up. I am absolutely not [1:16:09] making this up. Mr. Secretary, in your opinion, what factors should the federal government consider [1:16:15] when reparenting a black child who has been on ADHD or ADD? I don't even know what you're talking about, [1:16:23] Congressman. I don't know what you're talking about. I don't know what reparenting either means. [1:16:29] I don't either. But you said that. I did not say that. Mr. Secretary, for black families of the United [1:16:34] States, the issue of family separation is not new. Our nation has a long and painful history of [1:16:40] separating black children from their families. During slavery, black children were taken from their [1:16:45] parents and sold with no regard for their humanity. And after slavery, black families continued to face [1:16:51] forced separations through Jim Crow laws, discriminatory policing and child welfare [1:16:57] systems that too often assume that black parents were unfit. Even today, black children are removed [1:17:03] from their homes at higher rates than white children, not because of their greater harm, but because of [1:17:09] longstanding bias and built in institutionalism. For you to suggest that black families are not capable [1:17:16] of raising their own children is deeply offensive. Sir, you are the Secretary of Health and Human Services [1:17:24] for the world's most powerful country, and your words matter. When you suggest that reparenting black [1:17:31] children, when you so doubt about the safety of vaccines, and when you promote unproven statements [1:17:39] that have no basis in science, you endanger the lives of everyone across this nation. Those children have [1:17:49] parents. And to suggest that they have to be reparented is offensive. I never suggested that. Your words matter. [1:17:58] When those words are careless, communities pay the price. When your words are imprecise, they create [1:18:05] confusion. And when your words are dismissive, they cause real harm. So you do, you don't have the pleasure [1:18:13] because of your position to speak first and think later. Not in this job and not because of your [1:18:21] responsibility. I expect and the American people expect that you choose your words with sincereness [1:18:29] and with seriousness. The seriousness that your position demands. American lives are at stake and [1:18:35] it's time that you start acting like it, sir. Thank you. Miss Hearn. Mr. Hearn. Mr. Hearn. [1:18:48] Thank you, Mr. Chairman. It's good to be with you today. Mr. Secretary, thank you so much for [1:18:55] sorry. It's good to have you here today. I really appreciate it. I want to use my time to bring an [1:19:02] issue to your attention. Last month, a young man from Oklahoma, Jacob Toe, came to meet me in my office. [1:19:09] He told me a story that stuck with me, one that can make a huge difference for children in our country. [1:19:14] In 2024, Jacob was in the midst of a custody dispute for his three year old son, Leonardo [1:19:19] or Leo, as they called him. One day, Jacob got the call no parent ever wanted to receive. While Leo [1:19:25] was in his mother's care, the young boy passed away. Jacob learned that Leo died from an accidental [1:19:30] ingestion of fentanyl that was left within the reach of his mother's home. Jacob fought to figure [1:19:35] out how this could possibly happen. In doing so, he learned that the drug screening panels used in the [1:19:40] child welfare process did not test for fentanyl, which is not detected by standard drug panels. [1:19:45] While talking to lawmakers back home, they, like me, were shocked that fentanyl was not already [1:19:51] included in the child welfare drug screenings. I believe other states across the country do not [1:19:56] realize this gap in care and safety exists. While grieving the death of his son, Jacob decided to [1:20:01] get involved. He told his story all around the state of Oklahoma, urging lawmakers to correct [1:20:06] this deadly gap in testing and keeping kids safe. Thanks to Jacob's effort, last month, [1:20:11] the Oklahoma State House of Representatives passed Leo's Law in honor of young Leo. This bill requires [1:20:17] the Oklahoma Department of Human Services to include fentanyl testing and all child welfare drug [1:20:21] screenings where fentanyl use is suspected. This is not an issue that is unique to Oklahoma. Other states, [1:20:27] such as California, have followed suit and introduced similar legislation. I'm proud of my home state for [1:20:33] leading this charge and even prouder of this young man from Kellyville, Oklahoma, who has turned his [1:20:38] unthinkable tragedy and successful advocacy efforts. I commend Jacob, but I know he cannot do this alone. [1:20:44] We must do our part and help him ensure that no other child is harmed from fentanyl like his son Leo [1:20:49] was. Secretary Kennedy, two things. Will you work with Congress to educate states about this ongoing issue [1:20:57] and hopefully get them to introduce laws and figure out how we can work together at the federal level to [1:21:02] ensure all states are testing for fentanyl and child welfare drug screenings when necessary? [1:21:07] I will work with your office on that. I think it's a wonderful objective. As you say, [1:21:13] it's normally regulated by state law, but we can look at other options. It would be great to get [1:21:18] everybody to do this. I'm sure children are dying across the country. Like I said, even California saw [1:21:22] the need to do this and pass their own laws. One other question before I go. Substance abuse is one of the [1:21:29] leading factors for kids entering foster care, and in fiscal year 2024, more than 30 percent of [1:21:34] children entered foster care due to substance abuse by their parents. Under your leadership, [1:21:40] ACF has expanded access to drug treatment under the Title IVe Child Welfare Program for Parents as [1:21:47] part of the Great American Recovery Initiative. What steps can Congress take to build on this [1:21:52] administration on this on this administrative's emphasis on prevention services? We've now [1:22:03] funded as part of the Great American Recovery Plan as a stomp program. We're working with states [1:22:09] with law enforcement, with detoxes, with rehabs, and sober housing to bring together [1:22:16] a treatment that has been fragmented and atomized in the past. We also, you know, one of the primary [1:22:24] problems with drug treatment is it has the same reverse incentives as we see in the main, you know, [1:22:31] in a physical health medical system, which is that people get paid more by keeping the addict [1:22:37] addicted. If you go to a rehab and you relapse, that's the best thing that'll happen to that rehab, [1:22:46] because then you're coming back for a second bite. And we're now working on implementing a model, [1:22:53] and I actually visited a place in Arizona called Camelback this week. That guarantees where they, [1:23:01] the rehab after you go there for 30 days or 60 days will guarantee if you relapse within the next 12 [1:23:07] months, you come back for free. And that gives the rehab the incentive to make sure you're going through [1:23:14] IOP, that you're getting drug tested, that you're getting psychiatric care, that you're going to 12-step [1:23:21] meetings or whatever they need to do maximize because they're now, their financial incentives [1:23:27] are now aligned with the incentive of getting you healthy. And I think ultimately that's where we [1:23:33] need to move toward value-based care rather than essentially what's a fee-for-service model. [1:23:41] Great. Thank you, Mr. Secretary. Mr. Chairman, I will not yield back time because I don't have any to yield [1:23:46] back, just to point that out. Thank you. Thank you, Mr. Hearn. Ms. DelBene. [1:23:50] Thank you, Mr. Chairman. Mr. Secretary, I'm glad you're appearing before us today. Under your [1:23:57] leadership, CMS recently added new layers of red tape that Medicare patients need to navigate [1:24:03] to get the care that they're entitled to. Mr. Secretary, I hope you understand the harm that [1:24:08] delaying and denying necessary care can have. Do you remember saying this, quote, Americans shouldn't [1:24:17] have to negotiate with their insurer to get the care they need. Pitting patients and their doctors [1:24:23] against massive companies was not good for anyone, end quote. Do you remember? I don't remember, but I [1:24:31] would align with that. And I'll submit for the record actually a press release from CMS with your quote [1:24:37] in that from June 23rd of 2025. Without objection. In this case, I agree. Pitting patients and their doctors [1:24:46] against massive companies isn't good for anyone. And yet less than a week after you said that, CMS [1:24:53] announced the WISER model. The program allows private companies to use AI to review traditional [1:25:00] Medicare claims and pays them based on the amount of care they deny. This program went into place in [1:25:06] six states across the country, including my home state of Washington. President Trump said multiple times [1:25:12] on the campaign trail that he would not cut Medicare, but this program does exactly that. [1:25:17] For example, Joanne is a senior from Washington on Medicare. She has a herniated disc that is pinching [1:25:24] her sciatic nerve, causing immense pain down the right side of her body. Her doctor prescribed an [1:25:30] injection that would help relieve her pain. If it had been prescribed last year, she would have received [1:25:36] the treatment no problem. But because of the WISER model that has been implemented, she's been in [1:25:43] intense pain for over six weeks while she waits for approval. She has been using crutches or a wheelchair [1:25:49] for over a month now, which is making her arthritis worse, adding to her chronic pain. Since using crutches, [1:25:56] she's fallen multiple times, including earlier this week. Instead of simply approving the procedure, [1:26:02] Joanne's conditions are getting worse. And Secretary Kennedy, the W in the WISER model stands for [1:26:08] wasteful. Do you think that Joanne's treatment, which would allow her to walk and live with less pain [1:26:13] that her doctor has prescribed, do you think that's wasteful? Do you want me to actually answer that [1:26:19] question? Yeah. I think that that's a terrible outcome. It's one that was not intended for the system, [1:26:27] obviously. The problem is there's tremendous ways. In Medicaid, there's only 5% of the cases [1:26:34] are given prior authorization. In private industry, 30%. This is traditional Medicare now where it's now [1:26:42] this is only been put under prior authorization under your leadership. Now President Trump promised [1:26:50] multiple times that he, quote, will not lay a finger on Medicare. Given President Trump's promise, [1:26:56] did you or the president approve this model, which is now delaying and denying care for people in states [1:27:03] like the state of Washington? Can I answer the question? Yeah. People are being denied care across [1:27:10] our state right now. Very quickly. And this is an example. Five years ago, we were paying $250,000 a [1:27:19] year for $250 million for skin substitutes. This year, $23 billion. Why? Because there was no prior [1:27:27] authorization, the Medicare program. And now someone like Joanne is not getting her care. It's more [1:27:32] expensive for us because Joanne is not getting her care. We have story after story. I can also submit [1:27:38] for the record stories of all the people who are being delayed and denied care. It is more expensive for [1:27:44] us. It is more expensive for them when they are not getting the care they need. Last year, I sent CMS a [1:27:50] letter detailing my concerns about the WISER model. I still have not gotten a response. That was last [1:27:56] August. Can you publicly commit to responding to that letter and addressing the concerns of this [1:28:02] harmful model? Yeah, absolutely. We will. And I apologize for not getting back to you sooner. [1:28:09] We have an unprecedented number of communications from Congress. [1:28:16] Well, we don't have you here very often. We have people in my state who are being denied care, [1:28:23] who are being hurt based on this policy. And there's an indifference to the challenges that they [1:28:29] are facing, all because of a model put in place for no reason and doing exactly what you said [1:28:34] shouldn't happen, which is, and I quote, pitting patients and their doctors against massive companies. [1:28:40] These are private companies doing this prior authorization. It was not good for anyone. Thank you. [1:28:45] I yield back, Mr. Chairman. As I said, discovering $23 billion with the fraud is not for no reason. [1:28:52] And that- You are hurting patients in our state and other states across the country for no reason, [1:28:58] and I appreciate you finally responding to the letter. Thank you. I yield back. [1:29:01] Ms. Miller. Thank you, Chairman Smith. Secretary Kennedy, thank you so much for coming in front of [1:29:08] our committee today and for your leadership in improving the health and well-being of the American [1:29:15] people. I have two things I'd like to discuss. In my home state of West Virginia, we see some of the [1:29:21] highest rates of chronic disease in the country. Coupled with our rural nature and limited access to [1:29:28] care, many of these patients are especially vulnerable and face significant barriers to managing their [1:29:35] conditions. The first chronic disease that I want to speak about is our patient population that I am [1:29:45] focusing on, which is people who are living with chronic kidney disease and the end-stage renal disease. [1:29:53] I commend the administration's effort to promote affordability and fiscal responsibility in health [1:29:59] care. I am concerned, however, that in the case of kidney disease, the current ESRD bundle may [1:30:06] inadvertently discourage the development of adoption of new therapies and technologies that could improve [1:30:14] outcomes and reduce long-term costs for patients who do rely on life-saving dialysis. The complicated [1:30:22] post-Tadapa policy has resulted in promising innovative drugs being pulled from the market entirely [1:30:30] or only being accessible by a tiny fraction of the patients. I have a bill called the Kidney Care Access [1:30:37] Protection Act, and it is a piece of legislation that could expand access to the new treatment options in a [1:30:43] way that both encourages innovation and ensures costs remain well managed for Medicare and taxpayers. [1:30:52] As we work together toward better outcomes and cost containment, how is CMS evaluating ways to [1:30:58] strengthen incentives for innovation within the ERSD bundle while still maintaining fiscal responsibility? [1:31:05] I mean, I would say that that's the balance that we're all trying to achieve. [1:31:11] I believe we are doing everything in our power to maintain the United States as the innovation [1:31:20] center for the world, and we want to make it easier to get quick approvals for drugs that actually work. [1:31:27] We need to do science on them, and we're doing gold standard science, and we have depoliticized science [1:31:35] science at the agencies. I don't know enough about the renal disease aspect in the bundle, but I'm happy to work with you. [1:31:46] Also get somebody from Oz's team to come over and talk to you directly, because I know that that's not an outcome that they would like. [1:31:54] That would be wonderful. [1:31:55] The second issue that I wanted to talk to you about is that it is clear that what we eat plays a direct [1:32:04] role in our health, and quite frankly, many Americans don't eat right. And these poor nutrition choices are a [1:32:11] major driver of chronic disease. I believe there's a strong case of expanding access to MNT therapy for [1:32:18] targeted and specific groups in Medicare beneficiaries who outcome could actually measurably improve as a result. [1:32:27] With that in mind, can you share your perspective on the role medical nutrition therapy should play in [1:32:32] improving health outcomes for Medicare beneficiaries and how we can most effectively and responsibly [1:32:38] expand to those who would benefit from the most, particularly in the rural and underserved areas? [1:32:44] Yeah, I think, and I've worked with Governor Morrissey about that on this issue, and I think there's nobody at [1:32:52] this agency who is not committed to the idea that food is medicine, that it is, and if we want to do [1:33:02] prevention in this country, we've got to, and end the chronic disease epidemic, we've got to start with food. [1:33:10] That's one of the reasons we're pushing nutrition into the colleges, we're pushing it into the [1:33:14] hospitals, we're pushing it into the community health centers to make it the central focus of [1:33:22] healing and prevention. I want to work with you in any way that I can to achieve the goals that you're [1:33:30] talking about. Thank you so much. I yield back. Dr. Murphy, I don't think your mic is working. [1:33:48] Nope. All right. Is it now? It's now. It's working now. Thank you for coming. I want my 12 seconds back. [1:33:56] Thank you for coming. You know, we're talking about a little bit about vaccination. I think we ought to [1:34:01] talk a little bit about the arrogance of a fellow named Anthony Fauci who came and lied to Congress, [1:34:05] lied to the American people, and in my opinion, destroyed the confidence of the American public in [1:34:11] the health care system. So I think that when we're talking about vaccination, that's number one. Number two is, [1:34:16] your predecessor, who was not a physician either, led the greatest invasion in this country of 13 [1:34:20] to 20 million illegal people coming in this country who were not vaccinated and brought [1:34:25] in disease into this country. So let's actually bring facts into that conversation. Second of all, [1:34:30] I share some of the concern now about what's happening with our drug delivery system going to [1:34:36] China. They are developing a burgeoning industry that is threatening what we do as primal confidence, [1:34:43] at least in the American pharmaceutical industry, and I think we really, really have to be concerned [1:34:48] about that. I think the greatest thing that your administration has done is bring highlighting to [1:34:53] the fact that food is medicine. I saw a child in my clinic about six weeks ago that was eight years old [1:34:59] that weighed 262 pounds. This is what we're dealing with. This is what the obesity epidemic, [1:35:05] and it is sad that the number one drug that is selling now in the country are weight loss drugs. [1:35:10] This is endemic. This speaks to the terrible, terrible tragedy that has become the American [1:35:15] food industry. So thank you for highlighting that. I want to get back to one thing that is my passion, [1:35:21] and that is the cost of care in this country. The cost of care in this country has risen tremendously, [1:35:27] in my opinion, primarily because of vertical integration that has happened in this country, [1:35:32] primarily which has been caused by the ACA. That is the number one driver of healthcare costs. We can [1:35:37] talk about the pharmaceutical industry. We can talk about the other things. But we, a few weeks ago, [1:35:42] had the arrogance and the vanity of our health insurance industries come in front of this [1:35:46] committee and just sit to point fingers otherwise. You convened last summer in July the 70 percent of [1:35:52] those who insured in this country, and they said they were going to do better. And I know they gave a [1:35:56] report saying they've cut down prior authorizations by 11 percent. But frankly, after 35 years in the healthcare industry, [1:36:03] I don't believe a damn word that they say. And until we get the middlemen under control in this country, [1:36:09] the number one driver of healthcare costs in the pharmaceutical space is not the pharmaceutical [1:36:14] industry. It is the pharmacy benefit managers. It is the middlemen. And until we get rid of this [1:36:19] thing that is only present in the United States, we will not drive down healthcare costs. And so I urge you, [1:36:26] I urge you to be the hallmark of your administration, is to go after what we have created, [1:36:31] is the vertical integration that is destroying the doctor-patient relationship and bankrupting [1:36:36] America. Second of all, I want to talk about the No Surprises Act. To your point, absolutely, [1:36:42] a great bipartisan bicameral bill. Your predecessor, of course, went straight and gave all the authority [1:36:48] to the insurance companies. I have a bill, HR 4710, which puts meaningful enforcement back into this. [1:36:54] Right now, our vain and arrogant insurance companies are keeping hundreds of millions of dollars, [1:37:00] just in their little kitty, which has been appropriated to people who provided the care, [1:37:05] but they're keeping it. And so enforcement mechanism, and I understand your administration [1:37:09] is working on that, so I thank you with this. And then lastly, excuse me, I applaud the Trump Rx. [1:37:17] We had Mark Cuban come in. We're working with the administration and trying to do this with Cost Plus. [1:37:27] I saw a patient, again, about six weeks ago. He changed insurance companies. The pill he had been on for [1:37:32] 15-plus years was now close to $1,500. I literally pulled out my phone and went to Cost Plus, and it [1:37:38] was $15. So I applaud the administration for getting the middlemen out. These are the problems [1:37:44] that the American public is facing. You know, we can talk about all the other extraneous issues, [1:37:49] but if people can't afford health care, that's not access to health care. When you allow 20 million [1:37:54] people in the country and you overload hospitals and you overload health care systems, we can't provide [1:38:00] care to the American public. That is our primal and first duty. So I want to say thank you for [1:38:04] what you're doing. You have a tough job. We're here to support you and thank you for your efforts. [1:38:10] With that, I'll yield back. Ms. Chu. Secretary Kennedy, [1:38:14] we have a child care affordability crisis in this country. Working families are having to pay [1:38:20] skyrocketing prices, in some cases as much as 40 percent of their income, and too many working [1:38:25] parents are having to leave the workforce or turn down job opportunities because they can't afford [1:38:31] child care. This is hurting American families, our workforce, and our economy. During your 2024 [1:38:37] presidential campaign, you did a commendable thing. You proposed that the federal government [1:38:43] should subsidize 100 percent of child care costs for families below the poverty line and cap expenses at [1:38:50] 10 percent of income for all other families. It's right here in this article from the National [1:38:55] Catholic Register. And yet, just two weeks ago, President Trump said, we can't take care of [1:39:04] child care. We're fighting wars. We can't take care of day care. Now earlier, you were asked about this [1:39:14] and whether you agree with it, and you then, you actually didn't answer it. You said, well, I fully [1:39:19] funded Head Start. But your agency is illegally withholding child care funding from every [1:39:27] single state unless they submit a bunch of extra data not required by law. And also, the president's [1:39:36] budget request for 2027 proposes eliminating 350 million for preschool development grants. Do you agree [1:39:46] with eliminating 315 million from preschool development grants? Those funds are going out. They're not being [1:39:54] withheld. You know, you're mistaken about that. No, this, this proposal, actually, what I said was [1:40:00] the elimination of 315 million for preschool development grants. I'm just wondering because it's [1:40:07] completely contradictory to what your presidential campaign was. Well, anyway, let me say this. [1:40:13] Child care is one of the top expenses for American families and is becoming increasingly unaffordable. [1:40:20] President Trump campaigned on the promise that he would lower costs. But his record while in office [1:40:25] has been the exact opposite. He keeps on withholding federal funding for child care. [1:40:32] His reckless tariffs have raised prices on food and everyday goods. Gas prices are also up thanks to [1:40:40] his unpopular war of choice in Iran. So remember, Mr. Secretary, you once said for the cost of the Ukraine [1:40:47] war, we could make child care affordable for every family. It's ironic that Trump is doing the exact [1:40:55] opposite, not funding child care because we have wars to fund. It's a slap in the face to every American. [1:41:03] And now I'd like to switch to another topic, hepatitis B. Today, I'm thinking about my friend, [1:41:11] Chi Moi, who was a city council member in my district, San Gabriel, California. [1:41:15] Chi did not know that he had hepatitis B until he donated blood. Eventually, there was a liver tumor [1:41:23] that spread to his pelvic bone. He was on the city council by then, and we watched as he grew [1:41:28] weaker and weaker. And then he became the first Asian American mayor. But he died of liver cancer [1:41:36] just one month after his installation. And we think he hung on long enough to reach that milestone, [1:41:43] only to die at the age of 53. It was beyond tragic. But to think his life could have been saved had he [1:41:51] been vaccinated from hepatitis B as a newborn. Secretary, you've done an incredibly harmful thing [1:41:59] to our community. You eliminated the mandatory hepatitis B vaccine for newborns. And it disproportionately [1:42:07] threatens Asian Americans, because while we make up 7% of the population, we account for 60% of all [1:42:15] hepatitis B cases. It's clear that this administration has no regard for the health, safety, and well-being [1:42:24] of Asian American communities, as well as communities across the United States. [1:42:29] Do you want me to reply? Well, if that's it. Hepatitis B is a terrible disease. [1:42:41] But babies are not at risk unless they essentially have zero risk, unless their mother is infected. For [1:42:49] all mothers are tested when they go into the hospital to have a baby. And for all those people who are [1:42:56] infected, the vaccine is still a recommended vaccine. Everybody else, it's available. Parents can [1:43:06] assess the risks themselves through informed consent. Insurance will pay for it. We did not remove the [1:43:13] vaccine from being insured. And we just believe that Americans should have that choice, that the [1:43:20] state should not make that choice for them. Hepatitis B vaccine was not safety tested. It had a four-day [1:43:29] test with no placebo. We don't know what the risk profile is. And parents are allowed to ask that question. [1:43:35] The science is that it's not simply about choice. It's about whether infants are protected during [1:43:41] the most vulnerable period. Infants are protected. Okay. Mr. Kustoff is recognized. Thank you, [1:43:48] Chairman Smith. And thank you, Secretary Kennedy, for appearing today. If I could, Secretary Kennedy, [1:43:55] I represent parts of Memphis, Jackson, Tennessee. You and I have talked about Jackson, Tennessee before, [1:44:01] and rural West Tennessee. I wanted to talk to you about hospitals, particularly in those rural communities. [1:44:09] I know that because of the CMS area wage index, we have hospitals that are in primarily rural areas [1:44:16] that are being paid less than those in urban areas. During the president's first term, CMS did introduce [1:44:26] the low-wage index hospital policy, and that did help to reduce that discrepancy. Back on March 26, [1:44:36] a few weeks ago, I introduced with Congresswoman Terri Sewell a bill called the Save Struggling Hospitals Act. [1:44:45] So it is bipartisan legislation. It aims to keep rural hospitals open by codifying an adjustment to the [1:44:54] area wage index to ensure that hospitals in rural and low-wage areas receive a fair Medicare reimbursement [1:45:04] for the essential services that they provide. I know that you have publicly said before that you support [1:45:11] codification of the low-wage index hospital policy. I guess I just wanted to ask you, [1:45:17] that is something that you still support and you would support being codified? [1:45:21] Absolutely. I wish that we could fix it within the agency. But as you know, the Social Security Act [1:45:32] requires any adjustment has to be revenue neutral. And that means if you take from one area, [1:45:41] you have to give to another, or if you give to one area, you have to reduce payments to the other. [1:45:46] It's a broken system. It needs to be fixed, but only Congress can fix it. And I and my agency will [1:45:53] work with you toward that goal. Thank you, Mr. Secretary. I could, if I could ask you about peptides. [1:46:00] A lot of attention with peptides. We know that about three years ago, the FDA removed 19 peptides from the [1:46:09] list that compounding pharmacies could routinely make in that limited access. Can I get your general [1:46:17] opinion on peptides and your agency, your department's plans, if there are any for maybe mainstreaming peptides? [1:46:28] Well, we returned 12 of those peptides yesterday. The class to the category one [1:46:39] categories of that formulators will now be able to formulate them. [1:46:44] Eptides are like supplements. The FDA is only, the FDA has authority to require pre-licensing safety [1:46:54] studies, pre-marketing safety studies in any drug that claims a specific indication and that's mass [1:47:07] marketed. If you don't make those claims, if you're not mass marketed and you then FDA does not require [1:47:14] that. Oh, so like supplements are not regulated in that way by FDA. Peptides are not supposed to be [1:47:21] regulated. It's been upheld again and again by the courts. The Biden administration improperly moved [1:47:28] them to category three without any evidence of safety. The only, the only justification they [1:47:35] have is if there's a safety concern and there was no science that indicated a safety concern, [1:47:39] so it was improper. We have now remediated that by moving them back. Thank you very much, Mr. [1:47:46] Secretary. And I'll yield back, Mr. Chairman. Thank you, Mr. Fitzpatrick. Secretary Kennedy, [1:47:51] in a long overdue move, the FDA is finally taking steps to remove petroleum-based food dyes, including [1:47:58] red 40, yellow 5, yellow 6, blue 1, blue 2 and green 3 from our food and our medicine starting [1:48:06] immediately. These dyes have been unequivocally linked to cancer, to hyperactivity and to so many [1:48:13] other serious health risks and yet they have been left unchecked and unlabeled for absurdly too long. [1:48:19] Secretary, beyond commitments from industry and beyond regulation from the FDA, what steps can this [1:48:26] legislative body take to make sure that we preserve over the long term cleaner ingredients in our [1:48:33] food and our medicine as we look to address the link between these chemicals and chronic, [1:48:37] the chronic disease epidemic? The most important thing that you could do, Congressman, is to close [1:48:43] the grass loophole. We have regulations now that do everything in our power, my agency's power, [1:48:53] to close that loophole and those are now in the interagency process. So we've completed it within [1:49:00] my agency. There are now other agencies of equities in them and are looking at them. But it doesn't go [1:49:08] far enough and we need to go farther. We need to really make sure that any ingredient in our food is [1:49:14] safety tested first. That's what they do in Europe. That's what they do in other nations. That's why they only [1:49:20] have 400 ingredients in their food in Europe compared to 10,000 here. And so that we would [1:49:27] love to work with you on that legislation. I think it's absolutely critical if we're going to make [1:49:32] America healthy again. Second, I want to address something that is of critical importance to my [1:49:38] constituents in Bucks and Montgomery counties in Pennsylvania pertaining to the chronic disease [1:49:42] epidemic, pertaining to the impacts of PFAS and microplastics in our food and our water supply. [1:49:48] There is more that can be done at the federal level to address chemicals and toxins in our food [1:49:53] and water and elevate how these issues are connected to deteriorating health across our nation. [1:49:59] Specifically, the recent joint announcement that HHS and the EPA will be including microplastics in the [1:50:05] EPA's contaminant candidate list and launch the ARPA-H program to detect and remove plastics from the human [1:50:12] body. I believe to be a positive development in addressing the intersection of toxins in our food [1:50:17] and water and the chronic disease epidemic. Secretary Kennedy, could you expand on the agency's efforts to [1:50:24] further address microplastics and PFAS contaminants in our food and water supply and how these actions will [1:50:31] impact overall health and fight the chronic disease epidemic? We're putting 140 million dollars into the [1:50:40] STOMP program at ARPA-H to look at, to track, you know, right now microplastics, the average American [1:50:47] has a teaspoonful of microplastics in his brain. Almost one percent of brain volume is now microplastics. [1:50:53] That couldn't be a good thing. We know very little about the pathways by which it goes [1:51:00] into the brain. There are hundreds of components in microplastics, hundreds of different kinds. [1:51:07] Some of them may be benign. Other ones we know are hideously toxic. We are going to identify those. [1:51:13] We're going to trace the pathways so that we can better regulate them. The other thing that we're doing [1:51:19] is moving them to the MCL to the maximum contaminant list in the Safe Drinking Water Act so that we can [1:51:26] now start regulating, establish maximum contaminant levels for both PFAS and microplastics and start [1:51:35] regulating them effectively in drinking water. I want to add this. The amount in our brains has doubled [1:51:44] over the past five years. So this is rising exponentially and it is an existential crisis. [1:51:51] Thank you sir. You're back Mr. Chairman. Thank you. Ms. Moore. Ranking Member Moore. Thank you so much [1:52:00] Secretary Kennedy and I just want to join in with the committee and sort of, you know, remembering the [1:52:07] Kennedy family. I remember being nine years old begging my Republican mother to vote for John Kennedy. [1:52:15] I don't think he won in Wisconsin, but I do think that your family has made a great impact on this [1:52:22] country. I promise to give you easy, comfortable questions if you don't yell at me and hurt my [1:52:28] feelings. I promise. I promise you. I just want to thank you for pointing out stuff like the dyes and [1:52:36] stuff in food and maybe even the looking at the food pyramid. I think that that's been a very helpful [1:52:44] discussion in terms of your making America healthy again. And I'm just going to ask you a question [1:52:51] and I hope it doesn't, it's sort of outside of the scope of your service. But how does the cut, [1:52:57] the $1.4 billion cut in WIC and the $900 billion cut in SNAP interfere with your Make America [1:53:07] Healthy initiative? I know that departments are told they have to cut. Do you think that that will interfere? [1:53:13] Well, am I happy about the cuts? No, I'm not happy about the cuts. Don't you think it will mean [1:53:22] Fruit Loops are a lot cheaper than good healthy food. Yeah, nobody wants to make the cuts. [1:53:28] Russ Vogt doesn't want to make the cuts. President Trump doesn't, but we got a $39 trillion debt [1:53:33] and that's costing every American child $6,600 a year. Yeah, I get this. [1:53:39] Oh, okay, so it is my time. Thank you. All right, thanks. And I am, you know, I'm focusing on children here. [1:53:45] You know, you made a beautiful quote that I was not aware of in your testimony. You said, [1:53:51] although children may be the victims of fate, they will not be the victims of our neglect. You claim your uncle [1:53:59] said that. What uncle were you talking about? John F. Kennedy Jr.? President Kennedy. President [1:54:06] Kennedy, although I just thought it was just classic. And so I just, you know, when we start putting [1:54:12] things on the chopping block and cutting stuff, I would have hoped that we would not have started [1:54:16] with our children. And I just want to know how that statement, that attribution to President Kennedy [1:54:25] fits in with, you know, cutting a completely healthy start, which is a proven program that has decreased [1:54:36] infant and maternal mortality. I don't get it. It just contradicts that whole notion of not neglecting [1:54:44] our children or firing 20,000 people in your department with consolidations that give technical [1:54:53] support and help develop state plans around TANF, the social service block grant. These are the most [1:55:00] vulnerable people and kids. I mean, even cutting 43 million dollars out of the free diaper care [1:55:10] sort of program. And I just, I'm just making a statement. I'm not asking a question, not confronting you, [1:55:16] but I took all these notes while you were talking to other people. So I just had to kind of address them. [1:55:22] I am wondering how your Make America Healthy Again program fits in with the national database for [1:55:35] new hires. It's a federal database maintained by your office for the purposes of assisting child support [1:55:43] agencies. Very sensitive information. And Section 453 says that you will only use the data. How does [1:55:51] given that data to ICE support your mission at HS, HHS? Well, all the things that we do in terms of data [1:56:01] sharing comply with the law. No, this doesn't comply with the law, specifically Section 453. I would love [1:56:09] to see the general counsel's memo on this, if you wouldn't mind submitting that, because it... I'm happy, [1:56:14] happy to submit it. Please, then let the record reflect that he will give us that letter, because it is [1:56:20] definitely in contravention of our laws. And I want to thank you for your indulgence, and thank you for [1:56:28] appearing here. Well, thank you for the respect and the kindness of your presentation. Thank you, sir. [1:56:34] Mr. Stubbe. Thank you, Mr. Chairman. Mr. Secretary, the contrast between the Trump administration and the [1:56:40] last administration could not be more striking. On issue after issue, when your predecessor came before [1:56:45] this committee, he was defiant and claimed ignorance. In March 2024, I questioned then HHS [1:56:51] Secretary Becerra about the Office of Refugee Resettlement's process for finding replacements, [1:56:57] placements, and shelter for unaccompanied migrant children. Of the more than 100 questions submitted [1:57:02] by this committee, my question to him about missing children was one of only two questions that your [1:57:07] predecessor declined to answer. The Biden administration's open border policies were nothing [1:57:11] short of a lethal disaster for our country. Let's be clear about the facts. The Biden DOJ received [1:57:17] thousands of allegations of sexual abuse related to unaccompanied minors processed through ORR. Under [1:57:23] the Biden administration, ORR permitted individuals with criminal records, no citizenship, and who refused [1:57:28] a background check received custody of unaccompanied children. Over the course of 10 months alone, [1:57:33] the agency lost contact with neither 20,000 unaccompanied children. Under the Biden ORR, [1:57:39] case managers failed to perform home studies on more than 95 percent of placements of unaccompanied [1:57:44] children. And finally, grand jury testimony in my home state of Florida revealed unaccompanied [1:57:49] children were placed in the custody of convicted felons in homes with multiple unknown male occupants. [1:57:55] This is unacceptable. Becerra's refusal to even acknowledge the issue when I brought it up to him [1:58:00] is disqualifying. That is why I introduced the Stop Gaps Act with Senator Moody that builds up upon the [1:58:06] Trump administration's success on securing the border by requiring the ORR to work with state [1:58:11] and local authorities to guarantee safe and proper vetting of all individuals and entities before [1:58:16] granting them custody of an unaccompanied child. Under the Trump administration, the border is secure, [1:58:21] crimes from illegals are being stopped, and there are rigorous standards in place to better protect [1:58:25] children. Mr. Secretary, can you speak to the work that your agency is doing to combat our social [1:58:31] services being taken advantage of by bad actors and the increased safety of our children? [1:58:35] Yeah, I mean, it was a humanitarian crisis. What my predecessor engineered [1:58:45] with the Biden administration, they lost 425,000 children. They lost them because they ended [1:58:53] verification of sponsors. People were just showing up with fake IDs. There was no genetic testing. [1:59:00] There was no income inquiries. There was no ID verified validation. And we are now in the process of [1:59:10] trying to find those children. We've been able to locate 138,000 of them. They're very, [1:59:17] very difficult to find. Many of them, as you say, have been trafficked. They've undergone slavery, [1:59:26] sexual abuse. We found one sponsor who picked up 42 children, and their address was an empty container [1:59:39] in a parking lot. And there was no effort. And in fact, the administration, Mr. Becerra, [1:59:46] specifically ordered people in my agency to end the verification process. They were more interested. [1:59:54] They explained that the objective was to move kids out of custody as quickly as possible. [2:00:04] They made a lot of mistakes. And now, thanks to President Trump, the amount of unaccompanied [2:00:11] minors has dropped by 97 percent. We have beds now for 7,600 unaccompanied minors, and only 2,000 of those [2:00:20] are filled. We hold them until, only until, but until we can completely verify the people who picked [2:00:30] them up are actually family members. And that has never happened during the last four years. [2:00:36] Well, thank you for your service to our children and to the unaccompanied minors and the changes [2:00:42] that you have made from the previous administration. I yield back. [2:00:45] Ms. Tinney. [2:00:46] Thank you, Mr. Secretary. I really appreciate your service and your great responses today. [2:00:52] I just wanted to commend you first for your very sensible position on vaccines. I am, [2:00:59] too, I'm a fan of the greatest tennis player in the world, Novak Djokovic. I see you got to play [2:01:03] tennis with him. When Javier Becerra, who you- [2:01:06] I lost, by the way. [2:01:07] Yeah. Not surprised. [2:01:11] When Javier Becerra was here, I asked him, I was trying to get a waiver for Mr. Djokovic to be able to [2:01:16] play in the U.S. Open at the time, the number one tennis player in the world, and still, I would argue, [2:01:20] the greatest ever. And he described to me that they would not give him a waiver because he did [2:01:25] not take the vaccine because it was science, although a lot of other American tennis players [2:01:30] were allowed to be there who were not vaccinated. So thank you for your common sense approach to [2:01:35] choice and pro-safety as opposed to being anti-vaccine. I'm glad you clarified that today. [2:01:40] But I wanted to jump to a really important issue in my district and especially in the state of New York. [2:01:45] During the COVID crisis in upstate New York, nursing home residents were isolated from their families [2:01:52] for months, sometimes years, and Governor Cuomo disgracefully called it protecting them. But the [2:01:58] reality is that people declined rapidly in isolation and in most cases died without a loved one present. [2:02:03] That wasn't protection. It was a policy failure of enormous consequence by Governor Cuomo and his [2:02:08] administration that cost lives to thousands of seniors, not to mention the deadly nursing home order [2:02:14] that he required nursing homes to take COVID positive patients where they didn't have the [2:02:19] ability to handle these patients. Sadly, one of those, many of those same bureaucrats responsible [2:02:24] for carrying out this disastrous policy are still working in Governor Hochul's administration. [2:02:30] That's why I, along with my co-sponsor, Representative Larson, Fitzpatrick, Panetta on this committee, [2:02:37] and numerous others have reintroduced what's called the Essential Caregivers Act, [2:02:41] a bipartisan, bicameral legislation that guarantees nursing home and long-term care residents [2:02:46] the right to in-person access to a designated family caregiver even during a public emergency. [2:02:52] It also directs CMS to establish clear uniform safety protocols so visits can continue safely. [2:02:59] Families and friends are visitors. They are loving caregivers and they advocate, they catch things [2:03:06] maybe that a nurse or staff would not, and cutting them out of the facilities didn't protect the seniors [2:03:11] that actually accelerated their decline. I was wondering, because of this situation and the isolation [2:03:17] of so many nursing home residents, which contributed to serious physical and cognitive decline, [2:03:24] independent of the virus, by the way, given the department's guidance and generous access for [2:03:29] designated caregivers in nursing homes, do you share the view that maintaining family access during [2:03:35] emergencies is a patient safety issue and not just a quality of life issue? [2:03:40] Absolutely, and we made a lot of mistakes during the, with the countermeasures during the COVID pandemic, [2:03:46] including shutting down the schools, shutting down businesses, those things kill people, and that's [2:03:51] one of the reasons, in my opinion, that we had the highest death rate of any nation in the world. [2:03:57] We lost 3,000 Americans to COVID for every million population. There were other countries, [2:04:05] Haiti, for example, had 14 per million population, so Nigeria 14 per million population. We had 200 times [2:04:16] the death rate of other countries, we had 10 times the death rate of Europe, and a lot of it was just because [2:04:23] of bad policies that were, that were not science-based, and we are not going to do that under my watch. [2:04:31] And one of the reasons that I think blacks were more, much more likely, the most likely to die, [2:04:41] was because depriving them of access to a family member, their hospitals and their neighbors already [2:04:47] closed, depriving them of access to a family member meant that there was a reduced incentive within the [2:04:55] hospital to provide them with the kind of good care that they needed. [2:04:59] And I just, my time has expired, but can I just ask you, would HHS support codifying a federal right [2:05:06] for essential caregivers and giving them access? [2:05:08] I personally would support that. My agency will work with your staff. [2:05:13] Thank you. We appreciate it. [2:05:15] Look at your legislation. [2:05:15] Thanks so much for your testimony. I yield back. [2:05:17] Mr. Boyle. [2:05:20] Thank you, Mr. Secretary. I'm over here. Thank you. I'm hoping this can be constructive [2:05:26] and have a conversation with you. I have the honor of representing an incredibly brave [2:05:32] constituent and proud fellow Philadelphian, LaTanya Morrison. Her grandson, Ahmaud Butler, tragically [2:05:39] died of a rare form of brain cancer at just six years old. Last year, she and her family marched 179 miles [2:05:49] on foot from Philadelphia to Washington, D.C. to bring attention to the critical need for childhood cancer [2:05:57] research funding. I met her right outside here on the Capitol steps and had a wonderful but also [2:06:05] heartbreaking conversation with her and had been working with her and her family since then, [2:06:12] specifically working with her on a proposal called the Ahmaud Butler Childhood Cancer Hope for Cure Act [2:06:20] to make sure that no grandparent, parent, or loved one has to go through what she and her [2:06:27] family experienced and continue to experience this day. That hole in her heart will never go away. [2:06:35] So my concern is, and I have no doubt that you have concern for this constituent I just described [2:06:42] and all those who particularly have lost a child to this horrible form of cancer, but at the same time, [2:06:51] your administration or you as secretary in this administration are carrying out hundreds of [2:06:58] millions of dollars in cuts to cancer research funding. So I was wondering if you could explain [2:07:05] why you're doing that and does that really get us anywhere closer to getting a cure that we all want [2:07:13] to cure this horrible disease? First of all, thank you for sharing that heartbreaking story. And [2:07:22] you know, the worst thing that can happen to a human being is to lose a child or a grandchild. [2:07:28] And it's something that I hope that I never have to experience. And my heart goes out to that family. [2:07:34] The one agency that within my agency and the only agency within NIH that actually got a budget boost [2:07:45] from our proposal was NCI. And we, you know, we're absolutely committed to cancer research [2:07:53] and particularly pediatric cancer research. I invite you, congressmen, to call me, [2:08:00] to tell me if you're, if there are programs, some of our programs were duplicative. So we've moved them [2:08:09] around and it looks like there was a cut, but I don't know of any major cancer studies. I'm happy to [2:08:17] talk to you about it. You reach out to me. If you could, after this, sorry, just because you know, [2:08:22] we're time limited and I've under a minute now. So I appreciate that. And if our staffs could follow [2:08:28] up or you and I directly with one another after this, and I would just ask if I could get your pledge, [2:08:35] not for me, but for my constituent, if I could get your pledge that you will work with me, my staff, [2:08:42] the White House, to get the president to declare childhood cancer a national emergency, which would, [2:08:50] as you know, help unleash additional resources and really focus the attention that we need on childhood [2:08:58] cancer. Yeah, in, in theory, I like the idea. Let's talk about the details. We've already done, [2:09:07] the president already signed an executive order on pediatric cancers. I was there at the time. I, [2:09:14] so I need the devils in the details, but in, in the theory, I absolutely support that proposal, [2:09:22] and I'm happy to work with you and your staff on it. Thank you. And I, I yield, uh, zero time, uh, back. [2:09:28] Mr. Chairman, I seek recognition to ask unanimous consent to enter into the record, uh, the exact [2:09:33] transcript of Secretary Kennedy's, uh, remarks, um, that we discussed regarding the reparenting of [2:09:38] black children. Without objection. Thank you. Um, Ms. Fischbach is recognized. Thank you, [2:09:44] Mr. Chair. And, um, Secretary Kennedy, I just, I'm over here. I know it gets confused. There's lots of us, [2:09:50] and we're running around a lot. And I just want to tell you, thank you so much for being here. And [2:09:53] thank you so much for your willingness to answer questions. I, it always amazes me that people even [2:10:00] agree to come to these committees because we have you sit there on the hot seat for hours on end. Um, [2:10:06] we all get to run around, get coffee, whatever it is. Um, and, and, uh, the witness is sitting there. [2:10:11] So I genuinely appreciate that you're here and that you're answering questions very honestly. And, [2:10:15] and, and Frank. My staff did not tell me that I had a choice. Okay. Well then, fair enough. [2:10:23] I am happy to be here. Well, thank you very much. And, and just so you know from Minnesota, [2:10:28] I represent a rural district and, uh, I think, you know, rural Americans face heightened healthcare [2:10:33] challenges. Um, while nationally healthcare is seeing increasing staffing, uh, costs, staffing [2:10:39] shortages, and increasing wait times, all of these problems are amplified in rural areas. Um, [2:10:45] where care is already more limited. And, uh, I know that we, um, counteracted that with the rural [2:10:51] health transformation program in the working families tax cut bill last year. Um, and, and [2:10:57] significant funding was to strengthen the healthcare in small towns across, uh, across the country. Um, [2:11:03] I know in my office and in other Minnesotan offices, uh, we sent letters of support to CMS in favor of [2:11:09] the application and the funding. Um, but the rural healthcare transformation program alone is not [2:11:15] enough to solve, uh, those rural healthcare issues. And so I am wondering if you could just, uh, [2:11:21] talk a little bit about what's the administration's plan to reduce health disparities in rural areas, [2:11:26] and what specific actions are you taking to ensure quality and affordable rural healthcare remains a [2:11:32] priority within HHS? I mean, we've already finalized rules for site neutrality. I think that will help. [2:11:39] Um, the administration would love to work with Congress on the wage, um, area index, which I think [2:11:47] also will help. And then, you know, we are continuing, we, we, we made the biggest investment ever in history [2:11:56] on rural healthcare. Uh, we're continuing to make additional investments. I mentioned the, I think, [2:12:03] 135 million, uh, that I, uh, allocated for community, uh, health centers, uh, last week. And so this is, [2:12:15] uh, this is a priority for the president. It's a personal priority for me. And, you know, if you [2:12:21] have ideas of other things we ought to be doing, we'd like to hear them. Well, and, and Mr. Secretary, [2:12:27] I appreciate that because it is such a critical part of, and like I said, representing a rural area, [2:12:34] health care, having the access to that health care. And I know that Mr. Estes had talked a little [2:12:38] bit about specialty care in rural areas, but it is absolutely critical for the survival of our small [2:12:44] towns and, and the health of our individuals who live there, um, that we have that, that we have [2:12:50] health care available. And, um, I think some of our provisions for telehealth and things like that [2:12:55] have really moved things forward. But, um, I, I just sincerely appreciate, um, the ability that [2:13:00] your offer and, um, and the, we have worked with, uh, um, worked with the department. And so I [2:13:06] appreciate that. And I'm actually going to yield back 35 seconds. Thank you. Um, Mr. Moore. I'll take [2:13:13] that 35 seconds if I can. I didn't give it to you. Yeah, I understand. Sir, the most important thing [2:13:18] you said today in Congress that Congress has allowed $39 trillion of debt. And so that's forced [2:13:23] you and your agency and your amazing team. Um, some of which I know are very debt focused. Mr. [2:13:29] Andres, um, you had to tighten your belt. I just want to say as a, as an American and as a member [2:13:34] of the bipartisan fiscal forum, I can't thank you enough for doing your part, uh, doing the hard [2:13:39] part to be able to find redundancies. You'll get criticized for it, but, but it matters and, and [2:13:43] every agency needs to be doing it. So thank you for that. Um, I've mentioned to you in, in, um, private [2:13:48] how much I appreciate the administration's focus on autism. You may recall my, my 10 year old, [2:13:54] my 10 year old Winnie is neurodivergent on the autism spectrum. He's the joy of my life. He's the, [2:14:00] um, but that's tenfold, uh, for my wife and for his younger, older and twin brothers. Um, and I, [2:14:10] I want to just highlight that I'd never had a ton of expectation on what we could uncover from [2:14:17] scanning the existing research. And, and I've always appreciated the administration's focus on [2:14:22] this though. Uh, but I was, I was underwhelmed with what we ultimately put out. My wife was hurt [2:14:29] and she felt for a split second until we, she came to her senses and we, we talked about this, [2:14:34] that there was any way she was responsible. Um, we don't even know if she took Tylenol [2:14:38] during her pregnancy, but that, that, that was a hurtful moment for her. And I just want to [2:14:43] encourage the administration and your team to keep at it. And I think there's, there's more we can do [2:14:47] here with low expectations. I don't expect much to be able to figure out what the ultimate causes are. [2:14:51] That's not an easy thing to do, but I do think there's, there's more that we can do. And, and, [2:14:55] and, um, we can, we can build past what, what I was ultimately underwhelmed with. So again, [2:15:00] thank you for the administration's focus. And I think we can do more. Um, regarding something [2:15:05] that's very important legislatively, I introduced HR 5343, um, the insurance, ensuring patient access [2:15:13] to critical breakthroughs product act, which builds on one of the biggest wins from the Trump [2:15:16] administration. We didn't fully get it implemented, but the, um, MSIT was, uh, a significant policy [2:15:23] for Medicare coverage for breakthrough medical devices. This bill requires CMS to provide temporary [2:15:29] medical coverage for treatments or devices that receive breakthrough designation from the FDA. If a [2:15:34] treatment can meet the FDA's burden of proof of safe and effective and other requirements for [2:15:38] breakthrough designation, there's no reason Medicare shouldn't be able to provide temporary medical [2:15:42] coverage while CMS completes its review for permanent coverage. Um, and this is a brainchild of the [2:15:48] Trump's first administration. We've talked about this. We all agree in principle about this. It's, [2:15:52] it's difficult to, to, to, to move in some cases, but can you update this committee on your efforts to [2:15:57] implement a policy like this through any type of executive rulemaking? Um, I think, are we, uh, we, [2:16:16] we will have an announcement soon and we're happy to work with you on it. This is, this is really [2:16:21] important and builds on the success from the Trump first administration. Uh, there is, as I'm learning [2:16:28] too, FDA and CMS, they operate in parallel, they operate in tandem. And sometimes there's different [2:16:34] regulatory constraints that they're going with. We've got to be able to, to, to work through those. [2:16:41] And, and if that's all this ultimately is, is just a difference between those two, those, [2:16:46] those two structures. I mean, this is a good policy that will, will help improve people's lives [2:16:51] and it will keep safe and effective technology, um, from, it'll, it'll enhance safe and effective [2:16:57] technology and get that into the, into the healthcare system. Yeah. And I agree with you. And, [2:17:02] uh, you know, particularly if it's a temporary, uh, if it's a temporary, uh, payment, uh, payment that [2:17:14] can be revoked, that is intended to be tender and temporary. It's not permanent. As you know, it's very, [2:17:20] with a lot of medical devices, it's, uh, we find problems with them later. We had tons of bipartisan [2:17:27] support on this committee. Some that even didn't support it last time are now on board. It's a, [2:17:31] it's a great initiative and I look forward to working more with you. Thank you. You too. [2:17:36] Mr. Beyer. Thank you, Mr. Chairman. Mr. Chairman, I'd like to yield such time as he may require to [2:17:40] the ranking member, Mr. Neal. Thank you, Mr. Beyer. Mr. Chairman, I want to make, uh, [2:17:44] this moment an opportunity to correct the record on the No Surprises Act, which was passed out of this [2:17:49] committee with bipartisan support. I wrote that legislation. I know what was in it. [2:17:54] And every Republican on this committee at the time sided with me and we passed it out of the [2:17:58] committee unanimously and had a big victory on the House floor. Like any new program, [2:18:03] it needs some help for sure. But the notion that the suggestion we heard from the secretary that [2:18:09] somehow that it languished under Biden is simply not true. The national, uh, issue here before us, [2:18:15] it's still the regulations that were implemented. It created new protections against surprise medical bills [2:18:19] for 200 million Americans. Millions of families benefited from what we've done here [2:18:24] every single year. This is a victory that Democrats and Republicans on this committee [2:18:28] should take credit for. And I yield my time back to Mr. Beyer. [2:18:32] Thank you very much, ranking member. Uh, Mr. Secretary, [2:18:36] the Agency for Healthcare and Research and Quality, ARC, has been given an essential task by Congress. [2:18:42] It's the only federal agency specifically dedicated to improving health care delivery for Americans, [2:18:46] it was actually a Ronald Reagan creation, making people's experience with health care easier and [2:18:51] ensuring that taxpayer dollars are spent on effective, affordable and safe care. [2:18:55] But Mr. Secretary, your department's budget justification included 106 million dollars [2:19:00] in cuts to ARC. The White House budget request was 129 million in cuts. [2:19:04] The budget appendix listed 116 million in cuts. The budget also lists more than 250 staff at ARC, [2:19:10] but widely available reports fewer than 100 people remain at the agency. Mr. Secretary, [2:19:16] these discrepancies read either as deliberate misrepresentation or basic accounting errors. [2:19:21] Can you clarify how many millions of dollars you intend to take away from research [2:19:25] designed to give American access to the best, most affordable health care? [2:19:29] Thank you for that question, Congressman. Dr. Klein, who is running it, who is a Yale-educated [2:19:41] physician, who is running AHRQ, is still has hundreds of staff and the agency is operating. [2:19:48] Thank you. Well, let me shift to the United States facing a mental health crisis. As you know, [2:19:54] nearly a quarter of U.S. adults had a mental illness in the last year, reported 30 percent of [2:19:58] high school students. You recently led an agency reorganization. There was a big scare in January [2:20:04] where two billion dollars was cut from SAMHSA for substance abuse and prevention and mental health. [2:20:10] There was a bipartisan outcry and it was restored. But there's also this real concern that there's a [2:20:15] gutting of SAMHSA. I co-chair bipartisan the House Mental Health Caucus. We'd love to have a bipartisan [2:20:22] briefing on the reorganization. We request that back in December. And I'd love for you to commit to [2:20:28] briefing for members in Congress of the bipartisan Mental Health Caucus on the current status of the [2:20:34] mental health programs at SAMHSA, CDC, and NIMH. I strongly support SAMHSA. It's a private mental health and [2:20:44] particularly addiction. Our priorities for me, strong personal interests, but also their national [2:20:55] catastrophes. There were termination letters that went out under SAMHSA. That was a mistake. We [2:21:02] immediately recalled them within 24 hours. And I'm committed to continuing operations in SAMHSA. I'm [2:21:13] happy to meet with you about it. Thank you very much, Mr. Secretary. Mr. Chairman, I yield back. [2:21:18] Ms. Van Dyne. How are you doing today? I'm great. I appreciate you being here. And I know a lot [2:21:27] of questions have been asked. And some of the accusations have been just outrageous. I have [2:21:33] a bunch of stuff I wanted to ask you about. But clarify, your qualifications have been called into [2:21:38] question because you did not father a black child. How many different HHS secretaries have had that [2:21:47] privilege? I've had a privilege. It's a ridiculous question, isn't it? You know the answer? Zero. [2:21:53] Do you know how many Democrat appointed HHS secretaries have had a medical degree? [2:21:58] I think there may have been of the 26th. No. Zero. Zero. Not a one. In the history. Yeah. [2:22:06] Yeah. Not a one. I think there may have been two with medical degrees. Yeah. There's a lot going on [2:22:14] that your office is handling and doing so well and we're so proud of. You know, we had, and I'm [2:22:21] looking for this photo, we had a previous secretary who I asked questions about what was going on with [2:22:28] the waste, fraud, and abuse. And I don't know if you recognize this. I asked Secretary Becerra the same [2:22:33] question. What's going on at 14545 Friar Street in Van Nuys, California? Does that ring a bell to you at all? [2:22:40] No. I could guess. Why didn't you tell me? We had over a hundred different licenses for hospices. [2:22:49] For hospices? Yep. Right at this address. And we asked him what he was doing about it. Basically [2:22:54] nothing. Can you walk through what your office is actually doing on the waste, fraud, and abuse to [2:22:59] make sure that we don't see this happening again? We've already shut down 500 hospices in Los Angeles. [2:23:05] And incidentally, we haven't had one call from Congress or anybody else about complaining because [2:23:16] clearly these were fraudulent. A lot of these places, you'd say they'd have, they were just invented [2:23:24] addresses. They would obtain patient identification or they would pay people. They were going and giving [2:23:31] people in poor neighborhoods, flat screen televisions, 600 bucks. And then they would enlist them and [2:23:38] enroll them in the hospice. And we were paying them $6,000. And, um, and the, and the interesting [2:23:49] thing is almost none of them ever died. Oh, typically they stay in a hospice is about 18 days. These people [2:23:57] stayed forever. Nothing ever happened because they weren't actually there. They were just invented. [2:24:02] And it was operated by certain, uh, foreign communities, a lot of Estonians and a lot of [2:24:11] Armenians. And there's an incredibly great Armenian community in, uh, in Los Angeles. And very few of [2:24:18] them were involved in this, but the ones that were, were making hundreds of millions of dollars out of [2:24:25] fraud and just stealing money from us. I think the cost has been about $5 billion. And it's ridiculous. [2:24:31] And I don't think a week goes by where you're not, your office is not uncovering further fraud. [2:24:36] And what we're finding in California is now they're going after the people who are uncovering the [2:24:39] fraud. They're actually trying to make it illegal for some of these, uh, these, these journalists to [2:24:44] even do their job and uncover it. They're, they're not upset about the fraud. They're upset that it's [2:24:48] being uncovered and your office is helping to do that. I had a ton of questions I wanted to ask you about [2:24:52] affordability. You know how expensive health care is, not health insurance, but health care. There's [2:24:57] a big difference, but like an association health plans, what's, what's your thoughts on that? And I [2:25:02] know not everything is going to be within your purview, but what are your thoughts on making more [2:25:05] competition in the, in the, in the, that's what we need. And we need out, outcome based care. You need [2:25:11] more HSAs. President Trump wants to take the money away from the insurance company. And so Obamacare was [2:25:18] passed after, in the years after Obamacare was passed, the share price of the insurance companies, [2:25:25] the share value went up a thousand percent. It's still up 300 percent compared to about 150 percent [2:25:31] for the S and P 500. And so they are making money hand over fist and the American people who were [2:25:40] supposed to benefit their premiums have not gone down. They had the illusion that they went down slightly. [2:25:46] President Trump is actually taking steps that will drive the premiums down and give better quality [2:25:52] care to Americans. I appreciate that very much. I go back. Thank you. Now the chair recognizes Mr. [2:25:58] Arrington for four minutes. Thank you, Mr. Chairman. Mr. Secretary, good to see you. Thank you for your [2:26:04] leadership and your service to our country. Good to see you again. We have the best system and the worst [2:26:08] system. I mean, the best docks in mid-levels, the best facilities and technology, and yet we have the worst, [2:26:16] most inefficient system relative to the rest of the developed world. When you get to the cost and [2:26:23] quality intersection, and it just drives me crazy. I think at the heart of that, for me personally, [2:26:30] it's market dysfunctions and distortions, right? I think transparency, choice, competition, [2:26:38] that's the best way to deliver value for taxpayers and for patients. And taxpayers and patients aren't [2:26:45] getting their best bang for the buck here. And it's bankrupting the country and it's putting people, [2:26:52] families, working families, further and further from access to good care for their families and the [2:26:59] people that they love. So the current incentive structure is distortionary and it inhibits these [2:27:07] forces, creating sort of monopoly dynamics, anti-competitive behavior. So I spend most of my [2:27:15] time thinking about healthcare reform with respect to that framing. Some examples. In the world of drug [2:27:27] innovation, there's patent abuse where biotech companies are extending the life of their patent [2:27:34] without making novel contributions using patent thickets and essentially having these exclusive [2:27:41] rights extended and gouging all of us and we're allowing it to happen. I mean, I'm quite frankly not [2:27:47] putting the incumbent market participants at fault. It's the perverse incentives that we've allowed to [2:27:53] persist. One simple one for me is this disparity between what we pay hospitals and physician groups [2:28:02] for the same outpatient service. And the effects of that are not just higher premiums on seniors in [2:28:10] Medicare, higher costs for all of us as taxpayers, but there's a giant sucking sound of independent [2:28:16] physician groups and docs into hospital systems, leaving us with less choice. So those are just top of [2:28:23] mind examples. You are a breath of fresh air. We may have disagreements on how to attack some of these [2:28:34] problems, but you have a rare curiosity and objectivity and independence that you bring to this leadership, [2:28:46] this incredibly important leadership post for our country. And I think the problem with all these [2:28:53] distortions is that we have too much special interest, too much incumbent resistance, too much [2:29:02] parochial politics, and everyone in this town seems to be captured by it to some extent [2:29:09] or to one extent or another. You just seem to have been able to, through the fiery furnace of public [2:29:19] scrutiny over the years, I don't know what it is, but I love that you can come to this. I believe with all [2:29:25] my heart that you just want to do the right thing for the country and for all participants and for [2:29:31] especially our patients. Give me in the last 25 seconds your best shot on the monopoly forces and [2:29:39] anti-competitive behavior. What are one or two things that you think this body could do to address [2:29:45] that and go a long way to make things more affordable for working people in this country? [2:29:50] Thank you very much for those very, very kind and undeserved words. [2:29:55] 10 years or 15 years ago, 80 percent of the doctors in our country were independent [2:30:01] and 20 percent were corporate. Today, 20 percent are independent, 80 percent are corporate, [2:30:08] and the number that are independent are dropping precipitously because of the economic forces [2:30:13] that are a result of these perverse incentives. Site neutrality, which we're fixing, is key to that. [2:30:22] The wage area index, reforming the BBMs, that is one of the most anti-competitive forces [2:30:31] out there, and we're doing that. You've given me legislation, which I'm now looking forward to [2:30:36] implementing through the regulatory process. And then we need the FTC to file some cases, [2:30:43] and it's already doing that in the BBM space. So those are just a few of the things that we ought [2:30:50] to be doing, and thank you for raising all those important issues. God bless you. Thank you. [2:30:54] Thank you. Remind members that votes have already been called, but we're going to try to work as deep [2:31:00] as we can into the hearing while votes are going on. So now I recognize Mr. Panetta from California for four [2:31:06] minutes. Thank you. Thank you, Mr. Chairman. Thank you, Mr. Secretary. Thank you to your staff for being [2:31:10] here. As we've heard today, there unfortunately are a number of issues that I believe are causing [2:31:15] people to get a little exhausted because they are scared of your agenda and with your leadership, [2:31:21] an agenda that is threatening to the health and safety of our nation and the lack of leadership [2:31:27] that has led to two major vacancies in your department. At the CDC, Dr. Moneris was fired after [2:31:34] only 28 days, reportedly for not going along with your anti-vaccine agenda. But since then, [2:31:39] August of last year, the CDC has been without either a director or even an acting director. Now, [2:31:44] I know you have Jay Bhattacharya overseeing the CDC, but he's also overseeing NIH, managing over 27,000 [2:31:52] employees and two campuses that sit hundreds of miles apart. Furthermore, at CDC, Doge slashed whole [2:32:01] offices, resulting in almost 20% of its staff either being fired or quitting, and there's even been [2:32:07] hiring freezes there as well. For most of the past year, you've had people close to you act as proxies, [2:32:14] and in some cases, you've even taken unilateral actions like you did last May when you rolled back [2:32:19] COVID-19 vaccine guidance for pregnant women. Additionally, people should be aware that now that [2:32:24] after passing the 210-day statutory limit for temporary leadership at CDC, Bhattacharya can no [2:32:31] longer legally perform the full range of director duties. That means that without an acting permanent [2:32:37] chief, tasks that congressional statutes explicitly reserve for the CDC director can only be performed [2:32:44] by you, the HHS secretary. That includes policy decisions like adopting vaccine recommendations for the [2:32:50] CDC's Immunization Advisory Committee. The Surgeon General's post is also vacant. Now, I know that Casey [2:32:57] Means, a Maha devotee with no active medical license and not a practicing physician, had her confirmation [2:33:03] hearing two months ago, but she performed so poorly, including her unwillingness to commit to recommending [2:33:09] vaccines, that the Senate has not scheduled a vote. That fact, and the fact that there's 1,500 cases of [2:33:15] measles that have occurred this year throughout the nation, the fact that a recent E. coli outbreak [2:33:20] has sickened people, it seems that the Senate is having a hard time with your agenda. I know that the [2:33:26] literal holdups of these positions are from the Senate, but it's clear that you and the Senate are [2:33:31] having a hard time agreeing on people. The issue is, Mr. Secretary, that without leadership at DHS, [2:33:38] if there is a crisis, if there is an outbreak, we lose surveillance. There's delayed recognition of [2:33:42] problems, there's low response times, there's mixed messaging, and a loss of real-time guidance. These [2:33:48] vacancies hurt America's health, and they make Americans less safe. There's some disagreement with [2:33:54] you in the White House as well. You've heard of gliophosphate, the herbicide, correct, Mr. Secretary? [2:34:00] Yes. And you called it one of the likely culprits in America's chronic disease epidemic, [2:34:05] yet the President ignored your advice, and he signed an executive order that bolstered the production [2:34:10] of that weed killer. We all know what happens when it comes to your vaccine policy, but according to [2:34:15] a recent YouGov poll, nearly three-quarters of Americans believe that vaccines are somewhat safe [2:34:21] or very safe. And now the courts seem to be getting tired of your agenda. In March of this year, [2:34:25] a federal court paused some new vaccine policies from HHS, including reducing the number of jabs [2:34:30] recommended for children and reconstituted a vaccine advisory committee. Mr. Secretary, [2:34:35] your stance on vaccines and the vacancies in the public health leadership coincide with a continuing [2:34:41] decline of public trust in federal health authorities, something that's only gotten worse [2:34:46] with the current administration. We need credible voices when it comes to the health and safety of [2:34:51] our nation. We need a CDC director that we can trust. We need a surgeon general that we can trust, [2:34:56] because right now, Mr. Secretary, many, many people in my district and all across the country are having [2:35:01] a hard time trusting your agenda. I yield back. Mr. Feenstra. Thank you, Mr. Chair and Ranking Member [2:35:10] Neal. Thank you, Mr. Secretary, for taking the time to be here today. Greatly appreciate it. Last year, [2:35:16] we Republicans passed a working family tax cuts bill, the largest tax cut in American history. [2:35:21] And working alongside with your department, we included $50 billion in rural health care transformation [2:35:27] programming to create high quality and affordable health care for rural communities. I'm so proud of [2:35:32] our state, Iowa, that's one of the four front runners and leaders in advanced care and delivering [2:35:38] some of this dollars to our farmers, our families and our seniors. One of the biggest problems we're [2:35:44] having in rural America, rural Iowa, and I'm the leading voice on this, is the diminishing access to [2:35:51] maternal health care. We have women traveling 50 to 75 miles or more for maternal care. And I understand [2:35:59] historically low patient volumes make it feasibly burdensome for small rural hospitals to provide [2:36:05] delivery services. But currently, less than half of our rural hospitals in the U.S. have labor and [2:36:10] delivery services. And they continue to recede every year. Maintaining access to maternal health care is [2:36:17] incredibly important and vital for rural communities. Can you expand on what we can do and how I can work with [2:36:23] your department to change the tide in this area? Well, first of all, thank you for raising that [2:36:32] issue. President Trump is absolutely committed more than any president we've ever seen in preserving rural [2:36:43] health care. It's in crisis right now. As I pointed out earlier, we've lost 120 hospitals since 2010. And his [2:36:55] investment in the Rural Health Transformation Fund, which you voted for and approved, is the biggest [2:37:01] investment in history in rural health care. And it's a five-year investment. It increased the influx of [2:37:08] federal dollars into rural health care by about 50 percent every year for the next five years. We're also [2:37:16] doing other things in my agency to funnel additional dollars to rural health care. And that includes the [2:37:25] $135 million. I signed and approved last week for community development health centers, which are [2:37:34] primary in rural areas. So with that, we also have a shortage of specialty doctors, whether it be OBGYNs, [2:37:42] whether it be oncologists and stuff like that. Again, come from rural state of Iowa. Is there anything [2:37:47] that we can do to try to keep these specialty care doctors and even family docs in rural America? I mean, [2:37:55] it just seems like they're all gravitating to the urban centers. And we're having a hard time [2:38:01] recruiting family doctors, oncologists, OBGYNs. Anything that you can offer, any suggestions you can [2:38:08] offer to help rural America, rural Iowa in that area? Well, we've just finalized and promulgated the [2:38:15] site neutrality rule, which should help. The biggest thing that needs to be done is fixing the wage [2:38:22] area index. And that's something that has to come from Congress. Yep. We'd love to work with you on [2:38:28] that. Well, thank you. I appreciate all your department is doing. And Secretary, thank you so [2:38:33] much for being here. And I yield back. Thank you. Ms. Smelly Takas. Thank you, Mr. Secretary. I want to [2:38:42] begin by thanking you for your leadership on an issue that is very important to me and so many Americans, [2:38:47] that is ending the inhumane and outdated animal testing in this country. Hundreds of thousands of [2:38:53] dogs, cats, monkeys, rabbits, and other animals remain in captivity for painful and unnecessary [2:38:59] procedures, even though studies have shown that animal testing in medicine frequently fails to [2:39:04] accurately predict human conditions. We are seeing real progress by this administration. The NIH is [2:39:10] investing $87 million in a new center to develop standardized lab-grown 3D tissue models and has announced [2:39:16] that grant funding may be used to support finding homes for retired lab animals. And you've also asked [2:39:22] agencies to prioritize non-animal methods. And you've also ordered a review to end the importation of [2:39:29] monkeys from Asia for testing. I just want to urge you to stay the course. I'm very happy to work with [2:39:34] you to continue to make progress here to end this cruel, costly, and antiquated practice. I also want to [2:39:41] thank you and the President for working with our New York delegation to fully fund and staff the [2:39:46] World Trade Center 9-11 healthcare program. My district is home to many first responders. Unfortunately, [2:39:53] sadly, they're still suffering from 9-11 related illnesses. So I appreciate your efforts. Also, [2:40:00] Secretary Kennedy, as you know, one in five adult Americans are currently living with mental health [2:40:07] condition, including over 3.2 million New Yorkers. Timely and convenient access to mental health [2:40:13] professionals is essential for individuals to receive the care that they need. We must do more [2:40:18] to integrate mental health services in primary care settings. And that is why I've introduced the [2:40:22] Complete Care Act, which incentivizes primary care providers to integrate mental health specialists, [2:40:28] such as psychiatrists, psychologists, and substance abuse counseling into their practices and provide a [2:40:33] temporary increase in reimbursement to help cover the costs. So my question is, is that a piece of [2:40:38] legislation? I know this is a priority for you in the administration. Is that a piece of legislation [2:40:42] that you could potentially support? Yeah, and we will work with your office on that. And on [2:40:49] animal testing, there's 25 million dollars to NIH in the proposed budget that we've proposed [2:40:57] to, again, find other alternatives to animal testing. We're already doing a lot of work on organoids, [2:41:05] on tissue chips, on AI, which actually are more accurate and faster and cheaper than animal testing. So [2:41:15] it's part of our larger effort to speed drug approval. Well, thank you very much. And again, [2:41:21] I lend my support to you and however I can help with those efforts. One last issue I do want to bring [2:41:26] up is women's health. Recently, the HHS hosted its first ever national conference on women's health. [2:41:32] It's an important step in elevating the conversation around women's healthcare access and research that [2:41:37] has been chronically underfunded in both the private and the public sector for decades. My question is, [2:41:42] how does the administration plan to advance its goals of improving health outcomes for women, [2:41:46] particularly in underserved areas that have historically faced limited investment and resource [2:41:51] constraints? I, you know, part of that for rural areas, the Rural Health Transformation Program [2:42:02] hopefully will expand those abilities to treat maternal health. We are putting enormous investments [2:42:10] into, into maternal health and I could go through those with you in detail. But there, but we're spending [2:42:20] a hundred, literally hundreds of millions of dollars on it. We've got multiple programs. And I just would [2:42:26] mention again, our Paranoidal Pilot Program, which has reduced, it has 220 hospitals that are involved. We [2:42:35] provide them protocols, reducing maternal, maternal mortalities. And we have succeeded in those hospitals [2:42:44] in reducing maternal mortalities by 41%. Well, I appreciate that. And I don't have a rural area. I do [2:42:50] represent New York City, Staten Island and Brooklyn. But we do have a lot of safety net facilities. We'd love [2:42:55] for your administration's attention to that as well. Thank you so much. Thank you. [2:42:59] Thank you, Mr. Snyder. Thank you. Mr. Strackrateri, do you know who Alexander Fleming is? He invented penicillin. [2:43:08] How about Gerhard Domach? I guess you're not going to answer. He invented sulfiminoid drugs. How about [2:43:14] Salmon Waxman? Still nothing. Okay. Well, he invented streptomycin, drugs that we use on tuberculosis. [2:43:22] Would you agree that these three people help make people healthier, the medicines they discovered? [2:43:26] I would say yes. All right. Thank you. What's interesting is all the – Did you say [2:43:31] thalidomide? Did you say thalidomide? I did not. I said streptomycin. Okay. [2:43:36] So European – all of them were born in Europe. Now, Salmon Waxman moved to the United States in 1910. [2:43:42] He actually left Ukraine because of anti-Semitism, same time my grandmother did. What unites them is all [2:43:49] three won the Nobel Prize. Salmon Waxman won it as an American citizen. Fleming was Scottish, [2:43:56] Stomach was German. The UK has 29 Nobel Prizes in medicine and physiology. Germany has 16. The United [2:44:05] States has 93. But if you expand it beyond just medicine, and now I'm going to focus on the National [2:44:11] Institutes of Health. From the National Institutes of Health website, they've identified 174 scientists [2:44:18] who have either worked at NIH or done research funded by NIH that have earned them a sole or shared [2:44:26] part of 104 Nobel Prizes. NIH has led the world in scientific research, leading to extraordinary [2:44:33] breakthroughs, changing the lives, not just American lives, but lives around the world for the better, [2:44:39] making Americans healthier and people around the world healthier. NIH is the crown jewel of American [2:44:45] research. Mr. Secretary, are you familiar with SMA? [2:44:51] SMA. SMA is spinal muscular atrophy. So it is a disease, it's a progressive rare genetic disease [2:45:01] that affects the motor neuron cells of the spinal cord. Children with SMA don't walk, they can't sit [2:45:07] up. If they're not treated, 90 percent will die before the age of two. Are you familiar with gene [2:45:14] therapies? Of course. Okay, well gene therapies, do you think it's worth exploring the possibilities for [2:45:20] gene therapies like we did in other things at NIH? We are doing that aggressively. We're putting tens of [2:45:27] millions of dollars into it and we are accelerating approval. Okay, well thank you, I appreciate that, [2:45:32] because SMA, which is a death sentence for children age two, now has a treatment developed in my district [2:45:39] with research support from NIH, now a drug called Zolgenza, that instead of dying at two with this gene [2:45:47] therapy, these children are achieving the milestones parents want for their children of sitting up, [2:45:54] feeding themselves, even walking. We believe it is a cure that these children will now, instead of [2:46:00] dying at the age of two, live out their full lives. And this is the development that is happening [2:46:05] because of research at places around the world, in this country, all supported by NIH. And we're here [2:46:12] today to discuss a budget that you brought before Congress, where you're proposing to shrink NIH [2:46:18] funding. The world's premier funder of medical research, shrink it by 5.7 billion dollars. The CBO [2:46:26] predicts that this reduction could lead to 50 fewer drugs coming to the market over the next 30 years. [2:46:32] Drugs that can cure diseases, save lives, make America healthier again, and you're cutting that funding. [2:46:40] You're diminishing science. You're making it harder for Americans to lead. [2:46:46] I picked those three people, Fleming, Dolmetsch, and Waxman, because at the turn of the last century, [2:46:53] scientists from around the world came to the United States because they were chased out of their [2:46:58] countries in Europe. The actions you and this administration are taking are chasing American [2:47:04] scientists away from this country and fueling the research and development and drug commercialization [2:47:10] in places like China. You are not making Americans healthier. You're making Americans sicker, [2:47:15] hurting our economy, and making our children's future less prosperous, less secure. You should [2:47:20] be ashamed of yourself. I yield back. As votes have been called, the committee will stand in recess [2:47:27] until immediately following the vote series. The hearing will come to order. We'll now recognize Mr. [2:47:41] Bean. Thank you very much, Mr. Chairman. Good afternoon to you. Good afternoon, [2:47:45] Ways and Means, and good afternoon, Mr. Secretary. Thank you so much for your patience in being here [2:47:49] today. For the record, everybody needs to hear this. For the record, the previous administration [2:47:55] didn't have an advanced degree or wasn't a physician, but I'm going to tell you what you did [2:48:00] under your leadership. Great things are happening. You've elevated the talk about let's get healthy so [2:48:07] much that just last year I went to a food production facility in Jacksonville, Florida, Denone, which [2:48:15] makes Activia yogurt and Oinkos Greek yogurt, silk, international coffees. We did a little tour, but [2:48:22] before that their leadership says we're changing all our ingredients. We're going to go ahead and [2:48:27] voluntarily remove red dyes. We're matching what our production facility does in Europe to make healthy. [2:48:35] We're doing that voluntarily, which is exciting. I went last month. You did, and this is voluntarily, [2:48:42] all of the medical schools have voluntarily said let's change our curriculum and let's add nutrition [2:48:49] and let physicians say that food is medicine. You did that. That was just what happens. And so you've [2:48:57] also made the bean family change our diet too, and we're having a new focus on salads and whole foods. [2:49:04] What's next? How can we continue the focus of making America healthy again, Mr. Secretary? [2:49:14] And thank you. Thank you, Congressman Bean, for pointing that out. And I will say this. [2:49:21] In the history of HHS, there have been three medical doctors. One of them appointed by Tom Price. [2:49:28] Out of 26 total, and none of them ever appointed by a Democrat. There's never been a Democrat. [2:49:37] They didn't have the conversation or leadership. You're out there doing it. I don't think we saw [2:49:41] them doing pushups anywhere either. So thank you so much for doing that. I know you're leading the [2:49:46] efforts on fraud. We'd love to get our money back. What's next on fraud? What can we do to assist you [2:49:51] and your department on making sure that every dollar goes to its intended recipient? [2:49:56] Yeah, I mean, we're driving the use of AI across all the federal agents of government. We're leading. [2:50:01] We now have over 90 percent of reviewers at FDA using AI. We're using it to detect fraud. [2:50:12] We've changed the system under the Biden administration. We were paying claims that we [2:50:18] knew were fraudulent before we paid them. It was called the pay and chase system. [2:50:23] Yeah, nuts. And we've ended that now. So now we look at every claim and make sure that it is not [2:50:30] fraudulent. We have a bill, the bean bill. It's the doge and spending bill. It says, let's check. [2:50:35] Let's check it to make sure that it's done first. So put a good word in me with Secretary Besant on [2:50:41] on that bill and we'll do the same here. And then I also want to say, wouldn't it be better if [2:50:48] Americans took more control of their health? I've got a bill that lets everybody, or at least a lot [2:50:53] more Americans, have their own health savings account so they can start putting dollars in [2:50:58] to save for an emergency or a deductible. How important is it that Americans take control of [2:51:06] their own health, Mr. Secretary? It's the only thing that's going to actually get us healthy again. We [2:51:11] have to make, as Vern said, every American the CEO of their own health. We have to give them control. [2:51:20] We now have these wearables that can actually tell them that as they eat what it's doing to their, [2:51:27] what the food they're chewing is doing to their glucose levels. We have ended information blocking [2:51:34] for the first time in history. So every American is going to have access to their own health records [2:51:39] on their cell phone. Mr. Secretary, thank you. You don't have to do this yet. You're in the line [2:51:45] of fire because you believe America needs to get healthy. Thank you so much for your leadership. [2:51:50] I yield back, Mr. Chairman. Mr. Miller. Thank you, Mr. Chairman. I appreciate it. [2:51:58] And thank you, Mr. Secretary, for being here today. I know it's been a long morning and hopefully it'll be [2:52:03] almost over soon for you. And you've taken a lot of heat on both sides. There's a lot that I could talk [2:52:08] about. But you know, every time I go back home, I hear the same thing from our constituents about [2:52:13] health care, prices and costs. And earlier this Congress, I was one of 17 Republicans who decided to [2:52:19] vote for the ACA extension because of the situation that I'm just a fundamental believer that I can't [2:52:26] personally pull the rug out from underneath our constituents, at least 22,000 of mine, without [2:52:31] providing a solution to the problem. And look, I think when it comes to longevity of life and everything [2:52:36] you've done to get this country in better shape and health has been absolutely phenomenal. I, myself, [2:52:41] I care a lot about my health and what I put into my body and work out and truly believe that what [2:52:46] I put into my body in terms of eating food is medicine. And you are spot on about that. [2:52:52] But I would just love to hear from you, you know, and you've been working with us. Will you commit to [2:52:57] working more with us in Congress, you know, in a bipartisan way to make sure that we can find an [2:53:02] amicable, amicable solution for the health care issue that we face in our country? And I just [2:53:07] want to go back home and be able to look at, you know, my constituents of the seventh district, [2:53:12] which is Cuyahoga, Medina, Wayne and Holmes and soon to be Ashland and just say, you know, [2:53:16] this is what we're doing. Here's the plan. We can, you know, bring in more revenues. We can lower the cost [2:53:21] and we can actually make this work for you. Something that, you know, the other party and Speaker Pelosi [2:53:27] said, we have to know what's in this legislation, uh, you know, after we pass it. And that is [2:53:32] unacceptable. And so I really just want to hear from you, you know, path forward and working with [2:53:36] you. And I'd be very grateful. I mean, in terms of fixing the system, I really think that we need [2:53:42] to go to more individual choice and competition and, um, and we need to take the money. And this is what [2:53:51] President Trump wants to do away from the insurance companies and give it to individual Americans to do [2:53:56] more direct primary care. If you look at how competitive direct primary care and how convenient [2:54:03] it is, there are companies that are offering direct primary care, a hundred dollars or less a month, [2:54:10] and you get 24 hours service and all your medical costs taken care of, you know, absent catastrophic [2:54:18] care. And I think we have to, President Trump wants to go to a model like that through HSA, [2:54:26] through catastrophic plan, expanding primary care. I have to say this under, uh, even after the [2:54:34] repeal of the Obamacare, uh, extended, extended, um, tax credits, 87% of people on Obamacare are paying [2:54:45] less than $90 a month and 50% of them are paying $50 a month, approximately $50 a month. Um, but there was [2:54:55] huge amounts of money being pumped into it and it was not lowering premiums. It was simply expanding [2:55:03] the costs of a system that was going bankrupt. And it was, President Trump has pledged to save Medicaid [2:55:11] and Medicare and Medicaid was going to go bankrupt. And when there is no way that we can let that happen. And we had to, we have to figure out a way, a plan, and actually incentivize good behavior rather than bad behavior. [2:55:24] I'm, I'm with you and I, I agree with everything you just said, but that's what I would like to [2:55:31] start working on with you and HHS and this Congress is a plan, is a framework for the future. I believe [2:55:37] that this country is very reactionary and we used to take more action to prevent things from taking place, [2:55:42] even though we know it's coming our way. I believe that we can work in a bipartisan way to lay out a [2:55:46] framework for this country when it comes to healthcare. And Mr. Secretary, you could lead that charge and you'll find, [2:55:52] you know, this body and this committee to work with you in any way possible. Thank you, [2:55:56] Mr. Chairman. I yield back. Mr. Horsford. Thank you. I want to bring this conversation back [2:56:04] to where I think it belongs. And that's what the people that we are all here to represent. [2:56:09] Secretary Kennedy, while you're here, your boss is en route to my district in Las Vegas, [2:56:16] trying to rebrand the one big, beautiful bill. But back home, my constituents aren't buying [2:56:22] what President Trump is trying to sell because they're living the real-life consequences of higher [2:56:28] cost, less certainty, and real fear about losing their coverage and their access to care. [2:56:36] During the majority's field hearing in Las Vegas last year, they shut out the public and brought in [2:56:42] a paid actor. I took a different approach. I invited my constituents to share their real stories [2:56:49] about what these healthcare cuts would actually mean for them. And what I heard wasn't a matter [2:56:56] of politics, but rather of survival. One of those constituents is Deja, a mother of a medically [2:57:02] complex child, Shea. Shea was born at 30 weeks. He spent three months in the NICU and came home on an [2:57:11] oxygen and feeding tube, one he still depends on to survive today. He needs in-home nursing, [2:57:18] specialist, and ongoing care, all made possible by Medicaid. Without it, his family would face [2:57:26] inaccessible costs and co-pays, leaving Shea at risk of failing to thrive. I've also heard from another [2:57:34] constituent, Richard, who told me that at the beginning of this year, his marketplace premiums [2:57:39] went up $1,700 a month. He said he and his wife are effectively out of the economy. They don't go out. [2:57:47] They don't get to go to restaurants. There's no discretionary spending because they're just [2:57:53] trying to make sure that he has access to care. So families like Deja's and Richard's, to them, [2:58:01] the healthcare affordability crisis is real and it's urgent. So let me bring it back to the basics, [2:58:10] cost and coverage. What are you doing right now, Mr. Secretary, to lower premiums and to protect [2:58:16] coverage for families like Deja's and Richard's? Well, first of all, first of all, I would say, [2:58:24] Congressman, there are no cuts to Medicaid. You look at the... What are you doing, Mr. Secretary, [2:58:29] that's my question is, what are you doing right now? What are, what are, what are your priorities to [2:58:37] reduce costs and ensure coverage for the American people? Well, we have, we negotiated the lowest drug [2:58:45] prices in history and we're implementing those now with the MFN. This is one of many things. [2:58:50] And how does that address coverage? Well, in terms of insurance coverage, we're doing [2:58:58] many, many things within the agency. We are, we're, President Trump is right now... What are you doing? [2:59:10] You're the Secretary of Health and Human Services, reclaiming my time. I'm asking about tangible actions [2:59:16] and results. To me, the fact that you can't answer a basic question, like bringing down cost and [2:59:23] coverage, which should be your top priority, not some podcast, but actually addressing the needs of [2:59:30] people. Now, like others, I want to make America healthy. I agree with the goal of moving from a sick [2:59:39] care system to a true health care system focused on prevention. And prevention starts with the [2:59:45] basics, clean air, clean water, and reducing exposures to toxins. So I'm struggling to reconcile [2:59:52] the reports that some at EPA are working to roll back protections that would increase exposure to [2:59:59] heavy metals in drinking water, arsenic, lead, mercury, and chromium. These are toxins linked to cancer, [3:00:07] to heart disease, to stroke, and permanent brain damage in children. So just one question. Were you [3:00:15] consulted on those efforts to roll back those EPA protections? Yes or no? No, I haven't been, [3:00:22] but I'm happy to talk to you right now about a long list of things that we're doing to roll back [3:00:27] insurance premiums. And I would begin now with the skin substitutes. Our reform on that is reducing [3:00:34] premiums and Medicare by 6% this year. So have you aligned your goals dealing with the reforms to [3:00:45] the EPA protections and how that is making people sicker, not healthier? That was my question. [3:00:52] Yeah, I could not answer those questions because it's not in my... You can't answer the question as the [3:00:58] Secretary... It's on my agency. You don't coordinate with the EPA, Mr. Secretary? Your department is not [3:01:04] involved with rolling back protections that would increase exposure to heavy metals, materials, [3:01:11] even though it affects people's health? Is that what you're telling me? You don't coordinate? [3:01:16] I'd say calm down, Congressman. Don't tell me when... Look, healthcare is personal to my constituents, [3:01:21] like Deja and Richard. Your time is over. Do not tell me to calm down. Healthcare is real. [3:01:29] And if you can't answer basic questions, then maybe come prepared next time. I'm answering the question. [3:01:34] You don't give me the chance to answer. You haven't given me a chance to answer. I'm happy to answer your [3:01:39] question. You said you weren't... And you cut me off when I started to answer. [3:01:42] You said you... You started screaming at me. Did not consult with EPA. Okay, the time has expired. [3:01:47] We're going to move on, Mr. Yacom. People scream when they don't have much to say. [3:01:51] You obviously don't have anything to say because you can't even uphold what it is you're doing to [3:01:56] reduce cost and coverage. Mr. Horsford... Give me a chance to answer the question. [3:02:00] We're moving on to Mr. Yacom. It's getting hot in here, Mr. Chairman. Thank you, Mr. Chairman, [3:02:06] for holding this hearing today. And thank you, Senator Kennedy, for being here today to highlight [3:02:10] the important work that HHS is doing under your leadership. Healthcare is top of mind for Hoosiers, [3:02:16] and I regularly hear their concerns about cost, quality, and access to healthcare. During your [3:02:22] tenure, HHS has taken significant steps to alleviate these concerns by reducing administrative burden on [3:02:28] providers, protecting patients from unapproved compound drugs, and increasing patient access to [3:02:33] innovative treatments. Mr. Secretary, under your leadership, HHS has focused on combating fraud [3:02:40] and improper payments. That frees up resources for those who need it most. Can you share how you're [3:02:45] reducing fraud and protecting taxpayer dollars? I mean, we've implemented across the department [3:02:54] all kinds of... We're laser-focused on ending fraud. We're doing investigations in Florida on DRE, [3:03:04] under durable medical equipment. There are now more durable medical equipment companies in South Florida [3:03:12] than there are McDonald's. And most of those are almost certainly fraudulent. And in fact, we found a hotel [3:03:20] with half a dozen different companies registered to different rooms, all of them selling durable medical [3:03:26] equipment that they didn't have. They had no inventories. And as soon as we close in on them, [3:03:31] they go back to Cuba. This is money from my agency that has been stolen by a federal government. The same [3:03:38] thing with the hospices in Los Angeles. The same thing with ABA treatments. In Minnesota, where we put on hold, [3:03:49] $349 million because that money, we suspect, was stolen. And a lot of that money is ending up in Somalia, [3:03:59] some of it apparently with Al Shabbat. We are being victimized in our country because of the laxity [3:04:07] of vigilance by the Biden administration, the deliberate, purposeful suspension of program integrity [3:04:15] by the Biden administration. Fraud has become rife across our system. We estimate the cost of it to [3:04:24] the American taxpayers is about $100 billion a year. If we stop fraud just in Medicare, [3:04:30] we can extend that program for another five years. That's incredible, Mr. Secretary. And thank you for [3:04:35] your efforts to combat fraud. And I want to continue to work with you on those efforts. [3:04:40] Unfortunately, my Democrat colleagues constantly talk about, as it relates to your efforts to combat [3:04:45] fraud, they say that you're taking resources away from people that need them. I don't believe that [3:04:50] that is the case at all. And I would love to hear just briefly from you what efforts you are undertaking [3:04:55] to ensure that you're not taking resources away from people who need them, but that you are indeed [3:04:59] taking it away from people like Somalia. Yeah, I mean, you know, one of the things that Democrats keep [3:05:06] saying is that we're cutting Medicaid. The president promised to preserve Medicaid and he's doing that [3:05:11] for the people who need it. If you look at last week's congressional budget analysis, the increase [3:05:20] in Medicaid under the Trump plan is 47 percent over the next 10 years. We're increasing Medicaid, [3:05:28] not decreasing it. What we did with Medicaid is we're kicking people off it who were illegally taking it. [3:05:35] There was almost three million people who were registered for Medicaid in two states or registered [3:05:42] for Medicaid and Obamacare. That's illegal. There were a million illegal aliens who were on it. [3:05:49] Thank you. That's illegal. Thank you. And finally, I just want to talk [3:05:52] about just thank you for your quick implementation of the Republican enacted rural health transformation [3:05:58] initiative. Indiana proudly received 209 million dollars of that money. And also, I'd like to just simply [3:06:05] fully associate my remarks today with my colleague, Representative Blake Moore, as he and I are [3:06:10] co-leads on H.R. 5343 dealing with breakthrough medical devices. We are leading a very broad bipartisan [3:06:18] letter from multiple committees of jurisdiction to you and to your agency and to Dr. Oz dealing with [3:06:25] breakthrough medical device coverage for seniors. This is essential to ensure that our seniors have the [3:06:32] best access to treatments and diagnostic devices because we need to ensure that our seniors get [3:06:38] results that they deserve. And so you can expect that letter from me, from my office, and from a [3:06:43] number of my colleagues here very soon. I look forward to working with you on that. I look forward to your [3:06:48] response. Thank you, Mr. Secretary. I look forward to replying and to working with you. Thank you, [3:06:52] sir. Mr. Chairman, I yield back. Thank you. I now recognize myself for questions. [3:06:56] Um, 60 million Americans, 20% of the U.S. population live in rural communities and suffer from a lack, [3:07:04] a lack of access to quality, affordable health care. As part of the working families tax cuts, [3:07:11] Republicans invested a historic $50 billion in, in rural health care through the rural health transfer, [3:07:17] transformation program. But for years, we've seen urban hospitals game the system to qualify for [3:07:25] benefits Congress has intended for rural facilities. This is absolutely unacceptable. Secretary Kennedy, [3:07:33] will you commit to putting in guardrails and to actively engaging with states to prevent [3:07:40] the gaming of our HTP to ensure this money goes to truly rural facilities? Yes, I will. And they, [3:07:49] you know, originally for 340B, for example, there were 90 facilities. It was intended to lower drug prices [3:07:58] in poor communities and rural communities. And there were 90 facilities who were approved. Today, [3:08:04] there are 12,000. And there are 50,000 different offices. And now it's being because of those lower [3:08:14] prices. They're using the lower prices. Sometimes, for example, in Virginia, we found a rural hospital [3:08:22] that was where the company that owned it was taking their 340B money, the discounts they were supposed to [3:08:29] be giving patients, spending, selling the drug price at full cost, and then using that money to build [3:08:38] a hospital in an affluent area. Those kind of thefts we're seeing all the time. And that's one of the [3:08:44] ways that there's this systematic and prefers transfer of wealth from rural America to more affluent areas [3:08:53] is happening every day. So geographically, urban hospitals are abusing a Medicare loophole to [3:08:59] reclassify as a rule to get higher reimbursements, growing from three reclassified hospitals in 2017 [3:09:08] to 435 in 2023. Can I get your commitment to help reverse this practice, prevent these abuses of the [3:09:18] Medicare trust fund, and protect truly rural communities moving forward? [3:09:23] Yeah, I wish we could do it within my agency, but we need congressional help. It's a complex [3:09:29] formula, but it's costing us $81 billion a year. It's now about 7% of drug prices, and it's, you know, [3:09:42] it's unsustainable. Thank you. With the epidemic of rural hospital closures, it should be easier for [3:09:49] struggling hospitals to serve their rural communities through innovative options like the rural emergency [3:09:55] hospital model. To date, only 44 rural communities have converted to this model. I'm fortunate to have [3:10:03] two REHs in my district, but the only two in the entire state of Missouri. Unfortunately, it took one [3:10:13] hospital in my district months working with your office to finally gain approval. Other hospitals may [3:10:20] not have time to wait on bureaucratic processes. Senator Kennedy, will you commit to improving [3:10:26] the approval process for requests for rural emergency hospitals so the designations can proceed in a timely [3:10:32] manner? Yes, I will. And I and Dr. Oz will work with your office to make that happen. Thank you. There are [3:10:41] stark discrepancies in the way Medicare reimburses rural health care compared to their urban counterparts. [3:10:48] As we know, it is an unfortunate reality that health care often follows the dollar, making reimbursement [3:10:57] policies not just a financial question, but a life and death concern for growing access to care. [3:11:03] I had a medical technology company tell me about a remote monitoring device that they were paid twice as [3:11:10] much for in San Francisco than in Missouri. With this discrepancy, it's not a matter of of if, it's a question [3:11:21] of when rural areas will will be left behind because they're going to spend all their resources going to [3:11:28] San Francisco, make 80 bucks a month rather than 40 in southeast Missouri. Will you and the administration [3:11:34] commit to working to bring rural disperse reimbursements more in line with the same treatments done in urban [3:11:41] settings? Yes, we will. And, you know, we've already addressed some of that discrepancy through our [3:11:49] promulgation, the site neutrality rule. We need your help on the wage area index to really correct those [3:11:57] disparities. Earlier, as you noted, the implementation of the No Surprises Act, [3:12:02] it was a disaster under the Biden administration, losing four lawsuits and harming patient access to [3:12:09] care. One of the things that frustrates me the most about government agencies is a tendency to ignore [3:12:17] the written statutes of Congress. The ranking member raised this a little bit earlier in regards to [3:12:23] the No Surprises Act. But the Ways and Means Republicans have requested your department urgently [3:12:28] finalize a needed rule that is in line with what we passed out of this committee and what was signed into [3:12:36] law. Just last night, months later, I received a response to the letter, but I'd like to ask for a [3:12:43] clarification. So will you commit to me now to finalize this rule as it was written by Congress as a top priority for [3:12:51] your department? We're working as fast as we can to finalize that rule now. That's good. Large consolidated [3:12:59] hospitals and health systems have a history of abusing federal health programs to prioritize payments [3:13:05] over providing quality care and lower costs for patients. How is HHS championing site neutral reforms, [3:13:14] including policies this committee has passed to ensure that large hospitals aren't overcharging patients [3:13:21] and taxpayers? We've just finished promulgating that rule and I hope that it corrects some of those [3:13:30] inequalities. Thank you. Mr. Swazi. Oh, Mr. Neal. Mr. Swazi, let him give you the time. No, Mr. Swazi. [3:13:42] I'm going to yield to Mr. Neal. So let me agree with something you said, Mr. Secretary. Wage index [3:13:49] issues based on reimbursement and teaching hospital reimbursements are, as you have stated correctly, [3:13:57] very complicated undertakings, but generally for a pretty good ascribed purpose. I yield back my time [3:14:05] to Mr. Swazi. Thank you, Mr. Reckie Member. Mr. Chairman, thank you. Mr. Secretary, thank you so much. [3:14:10] It's good to see you. Like many of my colleagues, I have a long history with the Kennedys. I've got a picture [3:14:16] in my office of my father campaigning with John F. Kennedy in 1960. It's been a big inspiration to [3:14:22] me throughout my entire life. And as you and I have discussed before, when your dad ran for [3:14:26] a senator from New York State, he lived in Glen Cove, my hometown, where I was the young mayor. And [3:14:32] you lived in that at home for a little while. And when I was the mayor of Glen Cove in 2007, [3:14:37] I invited you to come and speak because you had founded the Riverkeeper about the environmental [3:14:42] quality of the Long Island Sound. And you really did a fantastic job and made a tremendous impression [3:14:46] on people back in those days. And I applaud some of the things that you're doing. I like the idea [3:14:52] of going after the food dies. I like going after microplastics. I like the idea of doing prevention [3:14:57] instead of just treatment and going after chronic disease. But I want to just try and find out how [3:15:03] you feel about a quote that you made versus a quote that the president recently said. We've heard [3:15:07] it a couple of times here today. In June of 2024, he said, we've poured our we're talking about [3:15:13] America. We've poured our wealth into one military operation after another. As a result, our nation [3:15:19] has decayed from within an epidemic of chronic disease, a plague of addiction and a historic [3:15:26] economic inequality. Now, how does that compare? That's your statement running for president in 2024 [3:15:31] to what the president just recently said last week. It's not possible for us to take care of daycare [3:15:37] Medicaid, Medicare, all these individual things. They can do it on a state basis. You can't do it [3:15:44] on a federal. We have to take care of one thing, military protecting. We have to guard our country. [3:15:51] Now, how do you square that about your beliefs versus the president's belief? Do you agree with what [3:15:54] the president said? As I said before earlier, the president's budget reflects his commitment to take [3:16:01] care. There was no it's one of the head start program is one of the few programs that was spared. [3:16:09] A cut across the agency of 25 percent. He said we can't do daycare. We can't do Medicaid. We can't put [3:16:15] it this way in practical terms. The president's budget increases the defense budget by 500 billion [3:16:21] dollars and it cuts your agencies by 10 billion dollars or more. Now, how does that square, especially [3:16:28] given your philosophy that you've promoted for decades, that we've got to focus more on taking [3:16:34] care of the health of the people of the United States of America and not squander it on foreign [3:16:38] military campaigns? How does that how does that jive? Well, you know, the president is making a lot [3:16:44] of tough decisions and he's making tough decisions because of problems that he inherited. He didn't make [3:16:51] up the glyphosate dependence in 98. No, I'm talking about the increase. No, I understand. He didn't make [3:16:57] up the he didn't create the problem that it ran. That was created by. I understand that, but he's [3:17:02] increasing the budget by 500 billion and cutting the health care of the people of the United States [3:17:07] of America. You know, you say he's not cutting Medicaid. Nobody buys that. Okay. You say he's not [3:17:11] cutting it. We say he is cutting it. He got rid of the premium tax credits. We say that's a major [3:17:16] problem for the people of the United States of America. The Democrats had two chances to extend the premium [3:17:21] tax credits and make them permanent. We just and they did it in either time. And now you're blaming him for [3:17:26] doing it. We just we just passed it out of the House at the beginning of the year. Democrats were in power [3:17:33] contain control. Let's not think about Democrats versus Republicans, Mr. Kennedy. I don't want to do [3:17:38] that. I want to be bipartisan. I want to work together. I've applauded you on some of the things that you're doing [3:17:42] that are good. But how does it swear that he's increasing the defense budget by 500 billion and cutting [3:17:48] money for NIH and CDC? The budget. Some of the you talk about the budget and the the things he's [3:17:54] inherited. He's increased the deficit by more than any administration in the history of America [3:18:00] as part of the big beautiful bill. That's not something he inherited. This president has done [3:18:05] more to protect public health than any president in history is the first one. You guys are the ones [3:18:12] that gave us the chronic disease epidemic. We're the unhealthiest population on the face of the earth. [3:18:16] Yeah, that all happened in the past four years of the Biden administration. It's the you guys. [3:18:20] It happened. It happened. It was the Kennedy administration. It was the Clinton administration. [3:18:24] You've been a politician your entire life. Yes. And you've been involved in public life [3:18:28] your whole life as well. Right. Well, I'm not an elected office. You've tried to run for an elected [3:18:33] office. You decided not to do it on many occasions. I followed you very closely, Bobby. I've never ran for [3:18:37] anything until I ran for president. I know you decided not to at the last minute every time. I followed you. [3:18:41] What does that have to do with it? You're bringing up the politics, not me. [3:18:44] Time is over, Mr. Swazi. Thank you, Mr. Chairman. Thank you. [3:18:51] Thank you, Mr. Secretary. Thank you for appearing before us today. I learned one thing. [3:18:58] I always wondered why my mother, my grandmother, always had a picture of JFK and the Pope side by [3:19:04] side. And apparently everyone in Connecticut did that as well in Massachusetts. But it showed how much [3:19:11] my family appreciated the Kennedy family. We're glad you're here. And that please be advised that [3:19:17] members have two weeks to submit written questions to be answered later in writing. Those questions and [3:19:22] your answers will be made part of the formal hearing record. With that, the committee stands adjourned.