Senate grills RFK Jr on Trump’s 2027 HHS budget request

[0:00] The committee will come to order. [0:03] Today, we meet to discuss the President's fiscal year 2027 budget for the U.S. Department [0:08] of Health and Human Services. [0:10] And thank you, Secretary Kennedy, for joining us. [0:13] Mr. Secretary, last year during your nomination hearing, I noted our health care system was [0:19] on an unsustainable, dysfunctional path. [0:23] As costs for patients and taxpayers soared, outcomes and access continued to decline. [0:31] These challenges presented an opportunity to chart a better way, a better way forward. [0:38] Although much work remains, we have made significant progress. [0:42] For too long, Medicaid's financing and pragmatic oversight was on autopilot. [0:48] Coupled with pandemic-related increases and costly regulations under the previous administration, [0:53] Medicaid spending, and hear this, doubled between 2019 and 2025. [1:00] The working families' tax cuts took significant steps to realign our health care system, strengthening [1:06] access for those in need, putting patients back in charge of their care, and providing [1:12] overdue reforms to curb waste, fraud, and abuse. [1:17] The law prohibits coverage of certain non-citizens under federal health care programs. [1:23] It removes Medicaid beneficiaries who are deceased, enrolled in multiple states, or own a home worth [1:31] over a million dollars. [1:33] It also requires individuals who are able to work, or volunteer, or go to school, to do [1:40] so, to be able to be eligible for Medicaid. [1:44] A requirement that mirrors similarly intended safety net programs. [1:49] These commonsense reforms, along with policies to prevent financing gimmicks, will save taxpayers [1:56] hundreds of billions of dollars, and ensure Medicaid's long-term sustainability, ensuring [2:02] the program's dollars reach those for whom it was intended. [2:07] Under the working families' tax cuts, Americans will keep more of their hard-earned money and [2:12] have greater control over their health care. [2:16] The law expands access to health savings accounts so that patients do not, patients, not insurance [2:22] companies, can choose the health care that is right for them. [2:27] Individuals with high-deductible health plans can also rely on telehealth services without [2:32] meeting minimum out-of-pocket payments. [2:36] Republicans also made a historic $50 billion investment in rural health care through the Rural [2:42] Health Transformation Program. [2:46] Beginning this year, all 50 states are receiving funds from the program, which will be used to [2:51] bolster workforces, invest in connected technology, and promote preventive health interventions. [2:59] Working in partnership with Ranking Member Wyden, the Finance Committee delivered on our commitment [3:04] to bring transparency and accountability to the prescription drug supply chain through pharmacy [3:10] benefit manager reforms. [3:13] The bipartisan law will end perverse incentives for PBMs to steer patients toward higher-cost drugs [3:19] and vertically integrate pharmacies. [3:23] Our work to address anti-competitive consolidation is just beginning, and I look forward to continuing [3:28] these efforts with Ranking Member Wyden and all members of this committee. [3:34] On a bipartisan basis, we also extended Medicare coverage of telehealth and hospital at-home services, [3:41] insured Medicare Advantage plans, maintain accurate provider directories, and removed Medicaid [3:47] barriers to high-quality, specialized health care for children. [3:52] These extraordinary accomplishments will expand choice and lower costs for all Americans. [3:59] Mr. Secretary, under your leadership, HHS has also taken sizable steps to fix the failures [4:05] in our health care system that frustrate both patients and providers. [4:10] Together with the private sector, the administration is breaking down the bureaucratic obstacles that, [4:15] for too long, have been accepted as the norm. [4:18] HHS is reducing health insurers' cumbersome overuse of prior authorization, which routinely delays [4:25] care delivery. [4:27] Through TrumpRx, patients can shop for lower-priced versions of their drugs, covered especially by [4:33] those that are not covered by many insurance plans. [4:37] I appreciate your commitment to making America healthy again by empowering patients with the [4:43] tools and information they need to create a healthier future. [4:48] Under your leadership, the department has focused on addressing root causes and prevention of illnesses. [4:55] Now, Medicare is becoming a system that invests in the whole person, in lifestyle interventions, [5:02] and our medical schools are equipping providers with the education to deploy these services. [5:10] Thank you for that. [5:11] Mr. Secretary, I look forward to learning more about how we can work together to build on [5:15] the progress we've made in the last year to put patients at the center of our health care [5:20] system. [5:22] And now I recognize Ranking Member Wyden for his opening remarks. [5:25] Thank you very much, Mr. Chairman. [5:27] Today we gather to discuss Donald Trump's health care blueprint for the coming year. [5:34] Robert Kennedy came into the Office of Health Secretary with sweeping promises of restoring [5:39] the public's trust in government and making Americans healthy again. [5:45] Now as the Trump campaign pollsters flail about trying to cover up Robert Kennedy's devastatingly [5:54] unpopular anti-vaccine policies, I believe the witness will try to have it both ways. [6:02] He'll serve up enough fakery this morning to help Senate Republicans ignore the real harm [6:08] that's being caused while twisting the truth enough so he can go back to pushing anti-vax policies [6:15] that make kids sick when he's out of the hearing room. [6:19] The rank hypocrisy of the Trump administration on health can be summed up in a sentence. [6:26] It's good news for those at the top, while American families get sicker and poorer. [6:32] While Donald Trump and the secretary are cozying up the insurance executive by handing over [6:38] more than $20 billion and throwing consumer protections in the trash, Oregonians now play [6:45] Russian roulette with their health care, actually trying to figure out how they can go without [6:51] insurance until they qualify for Medicare because they can't afford higher ACA premiums. [7:00] When Donald Trump cuts the sweetheart deals with the big pharma executives, rural America continues [7:06] to struggle, often because Republicans have made the largest cut to health care in American history. [7:15] What these communities are seeing now, I believe, is only a beginning of how things are going [7:21] to get worse when the cuts Republicans have hidden. [7:26] And I've never seen this in all my time in public service, hiding the details until after [7:31] the election. [7:33] Time and again, when Republicans are put in charge of Americans' health care, there's a never-ending [7:37] flood of benefits for special interests while American families get left further behind. [7:42] Nothing illustrates the Trump-Kennedy hypocrisy on health more than their approach to prescription [7:48] drugs. [7:50] Donald Trump spent the last year hosting executives from the big pharma companies in the Oval Office. [7:57] He boasted of so-called deals to bring down the price of medicine. [8:01] The details, the important facts about these deals are totally secret. [8:08] My staff spoke with each company involved in these deals. [8:12] The only thing that's clear is the list of goodies that the company's got in exchange. [8:17] Robert Kennedy is here this morning, and he's going to ask Congress to codify these sweetheart [8:23] deals sight unseen. [8:27] Let me repeat that. [8:29] People in Congress aren't going to see the details about these deals. [8:34] So while the American people wait for their cost of the pharmacy to go down, the administration [8:39] touts Trump-Rx, which actually offers higher prices for drugs than what most people can [8:44] get through their insurance. [8:46] There is no bigger fraud on the planet when it comes to drug costs than Donald Trump. [8:53] Meanwhile, Robert Kennedy has presided over the biggest cut to Americans' health care in [8:57] history, a choice that's already kicked Americans off their care, forced hospitals to close, and [9:03] caused health care workers to lose their jobs. [9:06] Since Republicans passed that law, my staff has been thoroughly cataloging every hospital, [9:12] every clinic, and every health care provider that has shut their doors, reduced services, [9:17] or laid off staff. [9:19] So we have the receipts. [9:21] There have been over 170 closures and service reductions across 34 states. [9:28] Only 7,500 health care workers have lost their jobs across 24 states. [9:33] These health care providers cited the impossible financial challenges caused by the Republican [9:38] Medicaid cuts. [9:39] Mr. Chairman, I'd like to enter into the record our analysis. [9:44] Without objection. [9:45] Now, I recently held a forum with health care workers at home in rural Oregon in a place where [9:50] Donald Trump got better than 70 percent of the vote. [9:54] What I heard there underscores the reports that are coming in from around the nation. [9:59] Health care providers are walking an economic tightrope, and these communities can't afford [10:04] to lose the services they're providing. [10:05] So, Mr. Chairman, I'd like to enter into the record submissions from five states, including [10:10] Oregon, as well as news articles from around the country that confirm the catastrophe that [10:16] is playing out on the ground as states contend with the impossible task of implementing more [10:21] than a trillion dollars in cuts. [10:23] Without objection. [10:26] Mr. Kennedy is the most senior and influential health care official in the country. [10:30] When it comes to vaccines, Robert Kennedy has used this once-in-a-lifetime platform to [10:37] make parents doubt themselves and doubt their doctors. [10:42] Ninety percent of Americans infected with measles during this unprecedented outbreak, mostly kids, [10:47] have not been vaccinated. [10:49] It is no coincidence that it comes as the person in charge of our country's health care lays [10:55] out propaganda about vaccines all on the taxpayer dime. [11:00] The secretary has ducked, bobbed, and weaved without taking responsibility of saying what [11:05] needs to be said. [11:07] Vaccines save lives in America. [11:09] They keep kids from getting sick. [11:12] And yet the secretary won't say it in plain straightforward terms. [11:18] He's repeatedly lied before the Congress. [11:21] First, he lied to me about his trip to Samoa. [11:23] As chairman, I'd like to enter into the record a report by The Guardian and the Associated Press [11:28] disclosing emails between State Department officials that make it clear that the secretary [11:34] was traveling to the island nation to promote his anti-vax views. [11:38] Without objection. [11:39] Second, he lied to Congresswoman Terry Sewell by denying that he said black children should [11:43] be reparented if they receive treatment for ADD and ADHD. [11:49] And he's continued to lie about the Republican cuts to Medicaid, claiming that there have been [11:54] no cuts. [11:56] That is an absurd claim that would get him laughed out of any room in rural America where public [12:01] officials and health care providers gather to make agonizing choices about payment cuts [12:07] at this moment. [12:09] These lies and misrepresentations underscore why, as you know, Mr. Chairman, I asked Robert [12:14] Kennedy to testify under oath the last time he came before the committee. [12:19] Regardless of whether or not he's taken the oath, you ought to remember that you can't [12:22] lie to Congress. [12:23] It's a crime. [12:25] Our witness is going to tell the committee this morning that Democrats are interested in [12:29] protecting the status quo. [12:31] Nothing could be further from the truth. [12:33] The nation's health care system is broken. [12:36] That's only going to get worse with the Republican cuts that the secretary has been cheerleading [12:40] for from the sidelines. [12:43] Right now, Democrats on this side to a person are leading an effort to reimagine health care [12:49] for American families so it is more affordable, more simple and less beholden to the corporate [12:55] interests that Republicans empower at every single opportunity. [13:00] My own take is if the secretary was serious about making America healthier again, he'd be [13:05] working with us and dealing with these issues rather than going to the side of big insurance [13:10] and big pharma with sweetheart deals. [13:13] It's an important hearing and I look forward to the questions. [13:15] Thank you. [13:17] And with that, Mr. Secretary, we turn it over to you for your opening statement. [13:20] Thank you, Ranking Member Wyden and members of the committee, thank you for the opportunity [13:29] to appear before you today to discuss President Trump's proposed 2027 budget for HHS. [13:36] First, I'd like to take a moment to express my deepest condolences to your colleague, Senator [13:42] Mark Warner, over the recent loss of his daughter, Madison. [13:46] My thoughts and prayers with him and his family. [13:50] We stand at a generational turning point. [13:53] Our children are the sickest generation in modern history. [13:56] In decades, the failed policies, captured agencies and profit-driven systems caused it. [14:03] Us across this country demanded change and we are delivering it. [14:07] We're ending the era of federal policies that fueled the chronic disease epidemic and replacing [14:12] them with policies that put the health of the American people first. [14:18] President Trump and I are challenging the status quo and the institutions that defended [14:23] as we work to make America healthy again. [14:26] In just 15 months, HHS has delivered historic wins. [14:31] We negotiated the most favored nation drug prices with 16 of the largest pharmaceutical [14:36] companies so that Americans no longer pay more than other people in wealthy countries [14:41] for the exact same medications. [14:44] We're bringing real transparency to healthcare pricing so that patients know the cost of care [14:49] before they receive it. [14:51] I used the full convening power of the federal government to bring health insurance CEOs to [14:58] the table to reform prior authorization and I brought the 400 largest tech companies together [15:04] to end information blocking so that for the first time Americans will be able to get their [15:10] own health records which they own on their cell phones. [15:15] We are cutting red tape, speeding decisions and abandoning transparency. [15:19] We're also cracking down on waste fraud and abuse. [15:24] This year, HHS and USDA issued new dietary guidelines that put real whole food at the center of the [15:30] American plate. [15:32] We flipped the food pyramid upside down and sent a clear message to the American people, eat real food. [15:38] HHS has opened the door to partnerships with industry, trade associations, non-profits and advocacy groups. [15:47] More than 50 medical schools have committed to expand nutrition education from an average of two hours to 40 hours. [15:56] Food manufacturers are stepping up too. [15:59] More than 40% of the food industry has committed to phase out petroleum-based dyes by the end of the year and many have [16:05] already eliminated them. [16:10] In conjunction with these efforts, FDA approved six natural food colorings derived from fruits and vegetables. [16:14] Through President Trump's Great American Recovery Initiative, HHS is matching compassion with action to help Americans break the cycle of addiction. [16:25] At HHS, we are prioritizing patients with ultra-rare diseases and their families driving faster access to life-saving treatments. [16:34] We are restoring gold standard science and integrity across the agency. [16:39] We are protecting children from sex, rejecting procedures that expose them to irreversible harms. [16:45] We are eliminating outdated and misleading warning labels on hormone therapies used by women during menopause. [16:53] We are strengthening oversight of organ procurement. [16:57] We are regulating television advertisements for pharmaceutical industries, something the Democrats have been asking for for generations. [17:06] We are implementing Operation Stork Speed to ensure the safety and quality of infant formula. [17:12] We are applying that same focus and urgency to rural America. [17:16] The Rural Health Transformation Fund delivers the largest investment in rural health in our nation's history, $50 billion over five years to strengthen rural hospitals and ensure Americans can access the care they need no matter where they live. [17:32] HHS has also, last week, announced more than $135 million investment this month to expand rural residency programs and nutrition services. [17:45] The data is clear. When physicians train in rural communities, they are far more likely to stay and serve there. [17:51] The President's budget puts all these priorities in action. [17:55] It invests in prevention because preventing disease costs less than treating it. [18:06] As my uncle President John F. Kennedy said, progress is a nice word. [18:11] Change has its – change is its motivator, and change has its enemies. [18:18] We see those forces clearly entrenched interests, defenders of a failing status quo, [18:24] and institutions that put profits ahead of the American people. [18:29] The resistance underscores the urgency of this moment. [18:34] We can reverse chronic disease, improve public health, and lower costs. [18:38] I stand ready to work with this committee and Congress to seize this opportunity to implement and codify lasting generational reform in American health care for our country, [18:49] for our children, and for the health of the American people. [18:52] Together, we can make America healthy again. Thank you, Mr. Chairman. [18:57] Thank you, Mr. Secretary. [18:59] And I believe that your effort and focus on making America healthy again and helping us to focus on nutrition and prevention and healthy lifestyles is one of the most significant things that you have done, [19:13] among the many that you've described in your testimony. [19:17] In that context, in your testimony, you identified nutrition as a bedrock of health, [19:24] and one of the primary levers for treating and preventing chronic disease. [19:29] You also emphasized that it's imperative for our nation's healthcare providers to be equipped to incorporate nutrition into patient care, [19:37] securing commitments from more than 50 medical schools to provide at least 40 hours of nutrition education is an incredible start. [19:49] I don't think it was very long ago that there was probably very little nutrition taught in medical school. [19:54] And now we are encouraging that to be a focal point. [19:58] How does HHS plan to build on this progress by securing additional commitments from medical schools and expanding nutrition education into other key areas, [20:07] such as residency training, medical licensing, and continuing medical education? [20:12] Thank you very much, Chairman. [20:15] We are expanding the number of medical schools. [20:19] There's already many, many others that have signed on since the original 54. [20:26] We are working with the states, more than half the states, on a MAHA legislative plan, [20:31] more than half the states have already passed legislation requiring nutrition education and continuing medical education. [20:41] We have now issued notices to all the hospitals in America that they must start serving nutritious foods in the hospitals. [20:58] Something that, you know, the food before that has been appalling. [21:03] They're giving diabetic patients Jell-O and custard and a soda drink. [21:09] And if they want to continue to get Medicaid, Medicare dollars, they need to change that now. [21:16] And then we're driving good nutrition through the WIC program, through SNAP, through school lunches, [21:26] through the Indian tribal services, and other federal subsidies programs as well. [21:33] Thank you very much. [21:34] I will just tell you that I, for one, deeply appreciate that strong focus on helping us get focused on nutrition. [21:41] It was a sad thing that our society had not focused on it as well as it should have until now. [21:50] Republicans established the rural health transformation program in the Working Families Tax Cut Act [21:59] to strengthen and modernize our nation's rural health care delivery system. [22:03] We do have a problem in the rural health care system. [22:08] And with this funding, we are hoping that states will be able to implement comprehensive strategies [22:13] that not only expand preventive, primary, maternal, and behavioral health services, [22:18] but also create new access points that bring care closer to home and stabilize our challenged rural hospitals. [22:25] All 50 states received their first year awards, ranging from $147 million to $281 million. [22:33] What do you think are some of the most innovative ways that states are now going to be able to work [22:37] to transform their rural health care networks? [22:40] The states, the applications from the states were really extraordinary. [22:46] We were astonished how resourceful and imaginative they are. [22:51] Among, I think, the most common applications were to improve or to maximize the use of AI in diagnostics, [23:05] in health delivery, and also just in billing and management of the systems. [23:13] A lot of the money is being spent on telehealth, which is going to bring, deliver rural health care to many areas [23:24] that are particularly remote in this country, places like Wyoming, Alaska, and many others, [23:30] where health care just simply is not accessible. [23:35] A lot of the applications were for residency programs and for worker recruitment and retention, [23:42] and then just allow for badly needed infrastructure repairs. [23:47] We've lost more than 120 hospitals in rural areas since 2010. [23:53] And it's a crisis when they lose that hospital. [23:56] They're not just losing access to approximate health care. [24:02] They're also losing the greatest economic driver in many of these communities. [24:07] These are, in many cases, the greatest employer. [24:11] They have the highest pay for their workers. [24:14] And when they close, businesses stop moving to the area. [24:20] So it's absolutely critical that we keep those hospitals open. [24:24] And that's why this plan raised by 50 percent the amount of the infusion of federal dollars [24:31] that is flowing to rural areas in this country. [24:34] Thank you very much. [24:35] My time's expired, and I want to try to stay at these five minutes, [24:38] so I'm trying to set a pattern here for the rest of the committee. [24:41] And I had questions on telehealth and innovation and AI, as well as waste, fraud, and abuse. [24:47] You anticipated many of those in your answers. [24:49] Thank you very much. [24:50] Senator Wyden. [24:51] Thank you, Mr. Chairman. [24:52] Mr. Secretary, it sure looks to me like the president is working very hard to muzzle you on the issue of the vaccine question. [25:04] It is very clear you weren't mentioned at the State of the Union address. [25:09] The pollsters that the president has have found that 80 percent of all voters support the childhood vaccine for measles and hepatitis B. [25:17] But at the same time, your handpicked people at HHS voted to end the universal recommendation of a hepatitis B vaccine for every newborn. [25:26] So my question to you is we are seeing with measles, we are seeing with vaccines a problem all over the country. [25:35] And putting infants at risk like this is so dangerous that a court even blocked your new policy from taking effect. [25:43] Why would you be doing something that is so awful for kids on this vaccine issue? [25:50] I know it's been your life work, but you promised that you'd do differently when you came for your confirmation hearing. [25:56] Senator, we, under my leadership, handle the measles outbreak better than any country in the world. [26:04] This is a global outbreak. [26:06] Mexico has three times the amount of measles and they have one third of our population. [26:12] Canada has twice the number of measles and has one eighth of our population. [26:17] We had about, we have 1,700 cases this year, 2,200 last year. [26:25] Europe had 33,000 last year and 127,000 the year before. [26:31] There are populations that don't want to vaccinate. [26:35] Mennonites do not want to vaccinate. [26:37] They have not vaccinated since 1797. [26:40] It has nothing to do with me. [26:42] I have not visited Mexico or Europe. [26:46] I had nothing to do with the measles outbreak here. [26:49] We have limited our outbreak better than any country in the world because I've talked to Dr. Abbott or Governor Abbott regularly. [26:56] I talked to Governor McMaster. [26:59] We send the epidemic intelligence services into their regions when they need it immediately, [27:06] and we give them the help we can to end the pandemic. [27:10] There are going to be people who don't vaccinate. [27:13] The vaccination levels dropped during COVID because people stopped trusting the American government. [27:20] I am here to restore that trust. [27:22] All I can tell you is that in America today when a baby is born, doctors give the baby a hepatitis B vaccination on day one. [27:32] With hepatitis B, we're talking about a serious lifelong illness that leads to liver failure and liver transplants. [27:39] There is no cure. [27:40] And as of December, you're still appointing people who are trying to undermine that policy. [27:46] That's not in the interest of families, and that's why the president's pollsters are telling them to isolate you and keep you from talking about it. [27:53] But I'm telling you, we're going to make sure that the truth gets out. [27:56] I'm going to move on now to this drug price. [27:58] That's a mischaracterization of the president. [28:00] I'm going to move on. [28:01] I'm asking the questions, Mr. Secretary. [28:03] I'm moving on now to the drug pricing question and the disclosure of these deals. [28:07] These secret deals with pharmaceutical companies set up a never-ending flood of goodies for big pharma. [28:12] You take Pfizer, for example, the day after Pfizer's CEO stood in the Oval Office with Trump, the company's stock prices soared through the roof. [28:21] Pfizer is going to get a blanket exemption from Trump's drug tariffs, and all of Pfizer's drugs are exempt from Trump's latest fake scheme to align Medicare prices with those in other countries. [28:33] So it doesn't seem to me that the American people get a whole lot from this, and every Democratic member of our committee is demanding that you disclose the deals, the specifics. [28:47] The public's got a right to know about something of this kind of consequence, and every single Democrat up here wants to see this as a transparency issue. [28:56] Now, yesterday, you indicated to my colleague, Senator Merkley, that you would give out some information about the deals, but not the real information that would indicate if the deals are so good, why is the Trump administration trying to hide them? [29:13] So my question to you is, yes or no, this is a yes or no question, reflecting the interest of our colleagues up here. [29:21] Will you commit to releasing your written agreements with the pharmaceutical companies tomorrow? [29:27] No, I will not, and I can explain why. Those agreements contain proprietary information and trade secrets. [29:37] When you pass the Inflation Reduction Act and ordered me to negotiate with the pharmaceutical companies, you put in a provision that required NDAs, because nobody's going to come to the table with me if I start releasing proprietary information. [29:55] You seem to be saying we were paying the highest prices for drugs in the world. [30:00] You seem to be arguing that now we're paying the lowest. [30:04] We've dropped IVF by 83 percent. [30:08] We've dropped GLPs by 89 percent. [30:11] Insulin, COPD drugs, asthma drugs, and the American people, now they're paying the lowest costs in the world rather than the highest. [30:20] And you want to go back on that? You can do this better than us. [30:24] We did it because you wouldn't act. [30:27] You have a lot more power to negotiate than we do. [30:30] Why don't you just go do it? [30:32] You've been promising to do it for 20 years and you've never done it. [30:35] We are going to do it, Mr. Secretary. [30:37] We are going to do it. [30:38] But when you try to hide the information on consequential issues as you're doing on these Trump Rx things, it makes it harder for us to make marketplace forces. [30:47] You're in bed with big pharma. [30:48] You're telling me you don't have secret agreements here and secret meetings here in Congress all the time, every day? [30:57] Senator Scott. [30:58] Thank you. [30:59] Good morning. [31:00] Good morning. [31:01] Secretary Kennedy, I want to start off by thanking you for everything that you, HHS, CDC, did truly an incredible job helping South Carolina, my home state, throughout our measles outbreak. [31:17] South Carolina has experienced the largest outbreak in U.S. history since measles was declared eliminated more than two decades ago. [31:26] From the calls you made to our governor to the countless weekly calls between CDC and South Carolina's Department of Public Health staff to the CDC staff being deployed to the upstate. [31:39] I know without a question, we would not be on the right side of this outbreak without your leadership and without your help. [31:48] And South Carolina is indebted to your leadership. [31:51] And we really appreciate that. [31:52] Thank you, Senator. [31:53] I'm very hopeful that in just a few days on April 26th, we can declare the outbreak long and gone as long as there are no new cases. [32:05] That is a big deal for a state that has been suffering for months and months through this challenge. [32:13] Thank you. [32:16] It is thanks to your leadership and the leaderships of the folks that I mentioned from CDC to the HHS to our folks on the ground that this day has finally come. [32:25] While it is hard to find positives, it's really hard to find a silver lining through this process. [32:32] If we did, it is early detection matters a lot. [32:38] The more time we spend on figuring out how to get ahead of it, the better off we will all be in the future. [32:45] That is why last month I, along with several of my Senate colleagues, introduced the PREDICT Act to strengthen and expand wastewater surveillance. [32:54] When someone is infected with a virus like measles or the flu, they shed viral material, often before they even are aware that they are sick. [33:05] CDC helped work through the sequencing of positive wastewater samples from 20 wastewater sites testing for measles in South Carolina. [33:14] This critical work highlights the best kind of government, one that works in the background on prevention and saving lives using smart science. [33:26] It is an idea that should reach every single community across the country, not just a handful of communities who have the resources to deploy. [33:35] By utilizing these tools and monitoring the spread of disease early, public health officials can see an outbreak coming days or weeks before hospital admissions begin to rise and take steps to intervene in moments when time is truly of the essence. [33:54] Americans deserve a public health system that sees threats coming before they become emergencies and the PREDICT Act brings us one step closer to that reality. [34:06] Secretary, as we look forward to lessons learned from this outbreak, can you please commit to working with me on wastewater surveillance such as the PREDICT Act? [34:18] Absolutely. [34:19] Absolutely. [34:22] Absolutely. [34:23] Absolutely, Senator. [34:25] Thank you for your kind words about the management of the measles. [34:30] I just had a wonderful interchange of series with Governor McMaster and I want to thank all the health department in South Carolina for the hard work they did with CDC to end the outbreak. [34:47] I absolutely will work with you on the PREDICT Act. [34:51] It's something that's very personally important to me to have more wastewater surveillance. [34:57] And we are also putting $325 million in this budget into a new biothreat radar system that we'll integrate with the microbial surveillance at wastewater treatment plan. [35:13] To detect pathogens as soon as they emerge in our country and elsewhere in the world. [35:19] That's really important because your new system, the biothreat radar system, it strengthens outbreak detection and I think it would be a perfect fit for us to take this PREDICT Act and put it under that umbrella, so to speak. [35:33] I look forward to working with you, Senator. [35:35] Thank you very much. [35:36] For those unaware of South Carolina's the negative impact of measles, it was the largest outbreak, hundreds of hundreds, nearly a thousand cases. [35:46] And it was a response, all of the government response, where we saw HHS, CDC, the secretary working together. [35:53] I know we have disagreements around this dais. [35:56] But when you need help and they show up and it's effective, you should take the time to say thank you. [36:04] Thank you very much, Senator. [36:06] Thank you. [36:07] Senator Bennett. [36:08] Thank you, Mr. Chairman. [36:09] Thank you, Mr. Kenney, for being here again. [36:11] For decades, parents in this country were able to send their kids to school without worrying about whether they could come home with a dangerous case of the flu or a dangerous case of the measles, as my colleague from South Carolina is saying. [36:25] Last year, we saw the largest number of children die from the flu in modern history. [36:33] Are you familiar with that, Mr. Secretary? [36:36] Yes, I am. [36:38] And have you told President Trump about that, that last year was the largest childhood death of flu in modern America? [36:48] Well, that's one of the reasons that FDA just approved two new vaccines for influenza A and influenza B. [36:56] Because you would agree that last year was the worst year on record in terms of flu deaths in modern history, not in the old days. [37:05] Right. [37:06] In the old days, we were having hundreds of thousands. [37:09] You're right. [37:10] Of course. [37:11] And do you agree that 89 percent of the children who died from flu were unvaccinated? [37:20] I don't know the exact number. [37:22] That is the exact number, Mr. Kennedy. [37:25] And it was, you know, I think of interest to a lot of people in America that you took down the communications from HHS on the flu, the importance of getting a vaccine when you first became the secretary. [37:42] And I just wondered whether you regret having done that. [37:46] You're now saying that you're approving vaccines for the flu. [37:50] I approve lots of vaccines. [37:52] I've spent a billion dollars, authorized a billion dollars, developing new vaccines, including a universal flu vaccine. [38:01] So are you, you know. [38:02] The flu vaccine, I think the last year, the flu vaccine had a something like a 20 percent efficacy. [38:09] So having these things, having these single antigen vaccines is not serving the public interest. [38:16] The Cochrane Collaboration said they simply don't work. [38:19] For the record, Mr. Secretary, that I assume you no longer believe that the flu vaccine is destroying children's brains, [38:27] that there's zero evidence that the flu vaccine prevents any hospitalizations or any deaths, [38:33] because today you're here agreeing that the vast majority of kids that died from the flu were people without vaccines. [38:42] And you're saying that you're now approving vaccines. [38:45] We're making sure that we follow the science, Senator. [38:48] Well, I hope you'll follow the science because that's what put us in the position 30 years ago of essentially having measles declared at an end in the United States of America. [39:01] Well, many nations have lost their elimination status, including Canada, the U.K., a lot of Europe this year, [39:09] because of the outbreak, and the outbreak has nothing to do. [39:12] I mean, I would hope that the, well, I know you said the outbreak has nothing to do with you. [39:17] That was your answer to Ron Wyden. [39:21] You're the chair, you're the head of the agency. [39:23] You're the head of the agency. [39:24] My agency has no jurisdiction over Canada, Mexico, the U.K., Australia. [39:28] I would agree with that. [39:29] I would agree with that. [39:30] We are. [39:31] I think everybody on this dais believes that the United States of America ought to be leading in these matters. [39:36] That's why we're so discouraged by your cuts to NIH, because that's going to make it harder for us to lead. [39:43] That's why we are so discouraged by your cuts to Medicaid that are making it impossible to invest in rural America. [39:50] That's why we should. [39:51] There are no cuts to Medicaid, Senator, as you know. [39:53] No, I don't. [39:54] There's no cuts to Medicaid. [39:55] The congressional budget. [39:56] That is absolutely, Mr. Kennedy. [39:59] Look at the Congressional Budget Office this week. [40:02] They say we are increasing Medicaid spending by 47 percent over 10 years. [40:08] That's not a cut, except in Washington. [40:11] Okay, it is a cut when it comes to the rural hospitals all over America that are having to close because of the Medicaid cuts. [40:20] And those are real dollars. [40:22] They were closing before I came in here. [40:24] Now they're not closing. [40:25] Let me just ask you, do you realize that last year the United States had the highest number of measles cases in 30 years? [40:35] That the last time we had more than that was before? [40:38] The whole world did. [40:39] The whole world did. [40:40] Yeah, we were the leader, Mr. Kennedy. [40:42] We still are. [40:43] We have a 92 percent vaccination rate. [40:46] We have one of the highest vaccination rates for measles on Earth. [40:50] So are you taking the position, let me ask you, are you taking the position, as your CDC director has taken, [40:58] that the measles vaccine is vital to keeping American children healthy in this country? [41:05] Are you taking that position today? [41:07] That has not been your position. [41:09] That's my position. [41:10] We promote the measles vaccine. [41:12] Thank you, Mr. Chairman. [41:13] That is, that will be, I hope, I hope you will go out to America and promote this. [41:17] The idea that you have nothing to do with this is dead wrong. [41:20] The measles vaccine prevents measles in 97 percent of the people who take it. [41:24] I've always said that. [41:25] That's what the science says. [41:27] I would ask you to please underscore it because there's a reason that we are having these outbreaks, [41:33] Mr. Chairman, and that is the misinformation that's been propagated. [41:36] If you would have a change of view, that's excellent. [41:39] Let's get it out there to the American. [41:41] Senator Langford. [41:42] Hey, Mr. Chairman. [41:45] Mr. Kennedy, good to see you again. [41:47] Thanks for your work on this. [41:49] You have been one that has spoken out often on vaccine issues and to be able to provide clarity in this area. [41:55] And so I appreciate your engagement on this so much lately. [41:58] I want to talk to you about a little bit about pharmacy benefit managers. [42:01] This has been an issue that we've talked about before, you and I, and that we talk about often around this dais. [42:06] We have now passed a piece of legislation that delinks the compensation between the price for pharmacy benefit managers and the price of the drug, which I think is exceptionally helpful to be able to work towards the consumer. [42:17] The any willing pharmacy, which PBMs have been fighting to destroy our independent pharmacies around my state and around the country. [42:26] We're losing more than one pharmacy a day now around the country, often because of what PBMs are actually doing to them in the compensation structure and the way they do the scoring on this. [42:36] So I appreciate that. That law has now been passed. Y'all are in the process of implementing that. [42:40] We want to continue to be able to work with your team on the implementation. [42:43] Any questions that your team may have or that any way that we can actually help in the process, we want to be able to stay engaged on this because this has been a passion area for us for quite a while. [42:51] I know it's been a real interest for you as well. Senator Maggie Hassan and I, we have a piece of legislation that takes another step on this dealing with the pharmacy benefit managers, and that is this issue of tearing that has been out there. [43:05] Now, your team has put out a clear statement to say there's an expectation that when a drug is released in the biosimilar, the generic level, it's actually put on that tier to be sold. [43:14] But you and I both know that's not happening. You have said it. We're trying to make it clear in law as well to be able to give you the reinforcements that you need on that to be able to say when a generic or biosimilar is put out there, it needs to be put on that lower tier cost and not put up on the more expensive brand cost because that will ultimately drive the generic out of business. [43:35] The brands know that we want to be able to push back against that. So I would ask only for your help and your team's help on technical assistance to make sure that we get this language right so that whenever we can get this passed on the tiering issue, we can actually get that enforced as quickly as possible. [43:51] Yeah, and thank you, Senator Lanford, for your leadership on this issue. It's been a long time coming. It's a bipartisan issue. Everybody knows it's a problem. I think the biggest fix, as you pointed out, was delinking the compensation to the PBMs from the list price of the pharmaceutical, which created the perverse incentive of having them choose. [44:14] They're supposed to be looking out for our interest, but the higher cost, the highest cost pharmaceutical would net them the most profits. So they were giving us a higher cost rather than lower cost. [44:27] There's a couple of the PBMs that have now, well, Sigma, David Cordani has, I think, taken the lead in expanding transparency. So the industry has a template for doing this. [44:42] But we need to keep working on this to make sure that they're actually, to the extent they're working in the system, that they're doing what they were meant to do, which is to lower cost for consumers rather than raise it. [44:58] Yeah, that's our target as well. I've told the PBM companies, I'm not opposed to your company. I'm just opposed to you trying to shut down my independent pharmacies and raising the prices of consumers. [45:07] That's the biggest issue that's out there on that. We want to get lower price and greater access on this, not less and less on it. [45:14] I want to switch this up to you and I have not spent a lot of time talking about, but it's continuing to be able to rise. And that's the issue of assisted suicide. [45:21] We now have three states, California, Colorado and Vermont, that disability groups are filing charges against some of the assisted suicide laws because it seems to target those with disabilities. [45:33] And the Americans with disabilities and the Americans with Disabilities Act passed in 1990, that act has worked to be able to protect those with disabilities, not incentivize them to take their own life. [45:44] And so this is an ongoing conversation on this. And I think my question for you today is, is HHS engaging? Some of these lawsuits are out there among states right now. [45:53] And I know you're not engaging in the lawsuits. What is HHS doing to be able to protect those with disabilities that may be targeted by these assisted suicide laws? [46:04] To me, I think those laws are abhorrent. And we see in Canada today, I think it's the number one cause of death is assisted suicide. [46:14] And as you say, it targets people with disabilities and people who are struggling in their lives. And I don't think we can be a moral society. We can't be a moral authority around the globe if that becomes institutionalized throughout our society. [46:35] So I'm happy to work with you in whatever way we can be great. Love to have the help on that. We've now seen a rise of people with eating disorders that are giving access to assisted suicide. [46:45] And this is just wrong in a multitude of ways. One quick statement. We'll follow up on this in writing on it. Oklahoma is still pursuing the title $10 that the Biden administration took away from my state of Oklahoma because we would not promote abortion in the state. [46:59] So they removed title 10 funding from us. It's about $9 billion on that. We'll follow up with your team on that one as well. But we're still trying to be able to get access to those dollars. The Biden administration tried to punish my state. [47:10] We will work with you to try to fix that. Thank you. Thank you. Senator Hassan. [47:15] Thank you, Mr. Chair and Senator Wyden for holding this hearing. Thank you, Secretary Kennedy, for being here this morning. [47:23] Look, I have noticed that while HHS has done relatively little promotion of the lifesaving measles vaccine that we were all just discussing, you have been doing a lot of your own self promotion using official government channels and resources. [47:40] HHS produced a video of you and Kid Rock exercising and drinking milk in a hot tub, I think at his pretend White House. Another official video features a dramatic sequence of you as a shirtless WWE fighter. [47:55] You also posted a video on government accounts that depicts you as a video game hero. And you've even posted multiple photos of your younger self over time, your face, to say that you alone are the leader taking on big pharma in this administration. [48:12] Does the president know about this self promotion campaign that you're carrying out? [48:17] Is it official HHS resources? I didn't know about a number of those videos. We have a... [48:24] They've all come out like in the last six weeks, a couple of months. [48:27] I just happen to not see them. I have no idea if the president... [48:31] So you don't know how your own team is managing official U.S. resources and promoting you in the process. [48:39] So the president hasn't authorized you to use HHS resources for these vanity projects? [48:45] You know, I was asked the other day by one of the senators about the Kid Rock video, how much it cost the U.S. government. And I asked my team how much it cost and they said zero. [48:55] Well, so interesting. I mean, you were at Kid Rock's home. Did the president authorize you to use official HHS resources for these vanity projects? That's my question. Have you discussed them with the president? Did he authorize the use of them? [49:10] I've never discussed it with the president. [49:13] Right. So as far as you know, he hasn't authorized it. Now, let me move on to a couple of other decisions that you've made. Did the president approve your decision to fire all 17 members of the CDC's vaccine committee in June of 2025? [49:28] You mean, did I talk to him directly? We talked to the White House DPC. [49:36] So again, my question is about the decision process in this administration about firing 17 members of the CDC's vaccine committee that is established under law. Did the president approve that decision to fire the CDC's vaccine committee members in June of 2025? [49:57] Yes, he did. Yes, he did. OK, so now you also made changes to the vaccine committee charter just two weeks ago. [50:06] It appears to get around the federal court decision that said you had improperly disbanded the vaccine committee. So did President Trump authorize you to do that? [50:15] DPC did, which is the Domestic Policy Council, which is in the White House. [50:23] So the Domestic Policy Council did, but have you discussed with the president? [50:27] I don't know if it made it was elevated to the presidential level, but it was. [50:32] So you're making you're making extraordinary changes to the vaccine charter so that you will be able to bring on quacks and conspiracy theorists to guide vaccine policy in this country. [50:47] And you haven't discussed it with the president. Look, I am asking these questions because it appears to me. [50:53] that you're focused on promoting yourself over everyone else, promoting your own theories over actual scientific inquiry, promoting your own unqualified lackeys over doctors and scientists, [51:11] and promoting images where you think you look cool rather than messages that will help people live healthier lives. [51:18] It is always about you and building a platform for yourself, which means it's never about the American people. [51:25] Is that a question? [51:26] Or their public health and safety. [51:27] Is that a question? [51:28] Because I'd like to answer it. [51:29] Let me go on to my next question. [51:30] How was the question if I'm not allowed to answer it? [51:33] You answered questions, and I drew those conclusions from your answers, and that's why I have this time on the dais and you do not. [51:41] Now, I agree with you that all Americans should have access to healthy food. [51:46] However, President Trump has made it far harder for families to afford their groceries. [51:51] As I am looking at my time, so I'm going to hold this question for the next hearing where I will see you this afternoon. [51:59] Thank you. [52:02] Thank you. [52:03] Senator Cortez Mastel. [52:04] Thank you. [52:06] Let me keep in the line of the conversations about whether the president understands what you're doing here. [52:12] Just yesterday, there is an article in the Wall Street Journal, Oncologists vs. the FDA and RFK Jr. [52:19] I can't hear you, Senator. [52:21] There are many concerns from oncologists in this country because under your administration, the life-saving drug for metastatic melanoma has not been approved. [52:38] And in fact, you've been asked about this in hearings. [52:43] And according to the article in the Review Journal, so I want to give you an opportunity to correct some of this. [52:50] You said every panel within FDA, all the career panels, the career scientists who looked at the drug said it was not effective. [52:57] According to the Wall Street Journal, that isn't true. [52:59] The initial panel that reviewed Replimun's RP1 recommended approval. [53:05] Secondly, when you sent a rejection letter, you parroted that Replim, not only was it a one-armed trial, and all the people who were testing it. [53:15] I can't hear you. [53:16] Also received a chemotherapy drug, so we don't know what the effect was. [53:21] And again, the fact check, no patients in the trial received chemotherapy. [53:25] Let me also reiterate, oncologists in this country, oncologists who treat patients with cancer, life-saving drugs, are asking and anticipated that this drug would be approved. [53:39] There is no concern. [53:41] And my question to you is, based on the misinformation that you have said in previous hearings about this drug, are you prepared to change your position and actually move forward? [53:52] And does the President understand that your decision that you're making is preventing oncologists in this country from treating cancer patients with a life-saving drug? [54:03] Yeah, I mean, first of all, I had nothing to do with this decision. [54:06] This decision comes out of FDA, and we trust the process there. [54:11] And I've been told by Marty McCary that every panel that looked at that drug unanimously voted against it. [54:19] And they voted against it because it does not appear to work, because the trial was a one-armed trial when the company was asked to do a two-armed trial. [54:28] But clearly that's misinformation. [54:29] I would ask yourself, Mr. Kennedy, no, I'm going to ask you. [54:32] Why would I ever reject a drug that works? [54:35] Why would you prevent the opportunity for life-saving drugs to an individual? [54:39] That's a great question. [54:40] Why would you take a second look at this? [54:41] Why would you take a second look at this? [54:42] Why would I? [54:43] That's exactly right. [54:44] So I'm going to ask you to take a second look at it. [54:46] What kind of perverse motive are you describing to me? [54:49] My next question for you, Mr. Kennedy, is this. [54:51] If the drug works, we're going to approve it. [54:53] Let me just say, I appreciate your comments earlier in this administration going after waste, fraud, and abuse. [55:00] I think the healthcare fraud and abuse control program is important. [55:04] I've been calling for more funding for it. [55:06] I think it's essential that HICFAC has the dollars that it needs to go after in healthcare fraud. [55:14] But let me ask you this. [55:16] As we are fighting for funding for it to go after healthcare fraud, this president has actually pardoned at least two people convicted of healthcare fraud in just the first year of this administration. [55:30] Mr. President Trump commuted the sentence of Lawrence Durand, who filed more than $205 million in false claims to Medicare by taking advantage of people seeking treatment for severe mental illness. [55:41] Someone who defrauded Medicare for hundreds of millions of dollars. [55:45] He no longer faces consequences and wiped out 87 million obligation in restitutions and fines. [55:52] Have you talked to the president about the fact that he is actively undermining your agency's work to combat fraud? [55:59] The president doesn't consult me on his pardons. [56:02] I don't know anything about that case. [56:04] What I do know is that during the Biden administration, they purposely opened the door for hundreds of billions of dollars. [56:12] I'm not talking about the past I'm talking about now, so that answers no. [56:15] Yeah, but you're talking about one case I don't know anything about. [56:18] Why would I know anything about that case? [56:20] In my state, Mr. Secretary, with respect to the Medicaid cuts, effective May 1st, Boulder City Hospital in my state will no longer be able to support inpatient stays longer than 24 hours and will transform into a rural emergency hospital rather than retain the current designation as a critical access hospital. [56:41] According to the CEO, it is because of the financial constraints exacerbated by the upcoming Medicaid provider tax cuts due to H.R. 1. [56:52] Seventy-one people will lose their jobs because of H.R. 1 and those Medicaid cuts. [56:57] This is one of my rural communities. [56:59] This is going to be devastating for so many, and this is the first that we're seeing in my state. [57:04] My question to you is what are you going to do to make sure that our rural communities aren't left in a health care desert without a reasonable way to access those services? [57:15] We're putting largest investment in the history into rural hospitals. [57:19] There's never been anything like it. [57:21] Prior to the rural health transformation— [57:23] Apparently that's not true for my rural hospital in Boulder City and many other are concerned, so you don't have an answer for that either. [57:28] There's rural hospitals are closing at an alarming rate around the country long before President Trump got in here. [57:34] Thank you, Senator Daines. [57:37] Chairman, thank you. [57:39] Secretary Kennedy, welcome. [57:42] It's good to see you here again. [57:45] Good to see you, Senator Daines. [57:47] Since you were first nominated this role, it's been your goal in the president's to make HHS the gold standard of science. [57:54] I appreciate your sincere commitment to that goal and the role you're playing in restoring America's leadership in scientific rigor, transparency, and public health. [58:08] And before I get into a more specific public health question, I just want to follow up on the exchange you just had about the rural health care in our country. [58:17] And Montana—I think when you think Montana, you think rural. We love that about our state. [58:22] But I want to build on what you just said, Mr. Secretary, because there was a transformative $50 billion investment that Senate Republicans made in working with the Trump administration to strengthen health care across rural America in our working family tax cut bill. [58:43] This has been $50 billion. Following a competitive application process, Montana is receiving a $233 million investment from the Trump administration, the fourth highest funding award of all 50 states, to stabilize and modernize rural health care delivery throughout the state. [59:08] Mr. Secretary, could you touch for a moment on the real change this investment will have on rural health care access delivery and outcomes in places like Montana as well as across America? [59:21] Yeah, I mean, I would—and I would—I would refer in my answer to the senator's criticism—the senator's hypothesis that some future cut Medicaid is closing hospitals in her state. [59:38] Right now, Medicaid pays about 7 percent in total to rural hospitals. It's about $20 billion a year to all the rural areas in our country. We have now increased the influx of federal dollars by an extra $10 billion a year. It's astronomical. It's a 50 percent rise in the money that rural hospitals are getting traditionally from Medicaid. [1:00:07] So any—first of all, we're not cutting Medicaid. And they keep saying we are, but the Congressional Budget Office says we're raising it by 47 percent. And in addition to that, this fund is putting an unmatched flow of federal dollars into those hospitals. And, you know, President Trump cares. [1:00:27] And all these hospitals are closing. We've got to keep rural America alive. And you cannot do that without local health care. [1:00:34] Mr. Secretary, I met yesterday with our hospital administrators from across our state. They came in—CEOs came into my office, and we were talking about enthusiasm, excitement they had about what's happening right now, as you just articulated. And the fact you're also going after the fraud that's occurring right now in these programs. The American people want—want the right people—want the right people—want the right people—want to [1:00:57] help. They want the fraudsters removed. And I appreciate your leadership on that. And that's delivering real results and outcomes for the American people. Back on the issue of safety, I want to go back to my earlier comment. [1:01:04] people. Back on the issue of safety, I want to go back to my earlier comment, and I want to continue [1:01:11] the conversation we had around what HHS is doing to apply the principles of safety for the American [1:01:19] people as it relates to the federal regulations on mefapristone. You've stated the FDA is conducting [1:01:26] a comprehensive safety review, which they are, and I encourage you to see that review through [1:01:33] completion guided by the best available data. Some of the evidence we already have today points to [1:01:40] some serious real-world consequence as it relates to safety for women. We know about the outcomes to [1:01:47] the baby. I'm talking about the outcomes now to women. In fact, there was analysis of over 865,000 [1:01:55] mefapristone prescriptions compiled from insurance claims found that 11 percent of women experienced [1:02:03] a serious adverse event. That typically means going to the ER, serious medical care required within 45 [1:02:11] days of taking mefapristone. That's 22 times higher than the FDA's long-standing estimate of less than [1:02:20] 0.5 percent. In the first half of 2025, over 27 percent, in fact, of all abortions in the U.S. [1:02:28] or chemical abortions provided by online clinics. And that number continues to grow. Given the fact [1:02:36] there's a lot of disturbing data that already exists, will you implement interim safeguards as well as look [1:02:43] at reinstating the in-person dispensing requirement until the full safety review is completed? [1:02:52] Regrettably, Senator Daines, I cannot comment on that because of the litigation. I've been advised [1:02:59] by the Office of General Counsel not to talk about it. Well, I think I can use this. But I have read [1:03:06] that study. Right. And the actual adverse effects are 22 times what the FDA had in there on the label. [1:03:16] And so we are we want to see action taken because women are being harmed by mefapristone. Thank you, Senator Warren. [1:03:25] Thank you, Mr. Chairman. So after President Trump and the Republicans slashed health care for millions of families, [1:03:33] the president pitched his Trump Rx website as the answer for Americans who are worried about health care costs. [1:03:41] He claims that Trump Rx has reduced prices by as much as 600 percent. [1:03:48] 600 percent, which I think means companies should be paying you to take their drugs. [1:03:54] But let's do some real math here. Take one drug, Protonix. A 30-day supply of this heartburn medication [1:04:03] cost $200 on Trump Rx. But there is an identical generic version of this pill [1:04:10] called Pantoprizol. Secretary Kennedy, do you know how much it costs for a 30-day supply [1:04:18] of that drug at Costco? But I would say this, Senator. [1:04:24] Do you know what it costs for a little drug? President Trump has a different way of calculating. [1:04:29] There's two ways of calculating percentage. If you have a $600 drug and you reduce it to 10, [1:04:34] that's a 600 percent reduction. I understand that you know I only have five minutes. [1:04:38] Do you know what the drug costs at Costco? [1:04:44] I do not. [1:04:45] The drug is $16 at Costco. Trump Rx charges $200 for Protonix and Costco charges $16. [1:04:56] Let's do another one. T-Cosin is a treatment for heart arrhythmia. It costs $336 on Trump Rx. [1:05:06] Or you can get the generic cost plus drugs for $12. So you tell me, Mr. Secretary, are patients [1:05:16] better off paying $336 on Trump Rx or $12 at cost plus drugs? [1:05:23] You're comparing apples to oranges because you're comparing the brand drug to the generic drug. [1:05:30] Yeah, to the exact same drug. [1:05:34] Well, people should be buying the generic and we will be directing them to the generic. [1:05:38] To the exact same drug. [1:05:38] Yeah, we'll be directing them to the generic. [1:05:40] Sir, tell me. Tell me, Mr. Secretary, you think people ought to be paying $336 instead of $12? [1:05:47] Well, a lot of people, a lot of doctors prescribe the brand. So we're giving them 600 percent reductions [1:05:54] on the brand. We will be directing them to the generic whenever it's available. [1:05:59] So here's the thing. We know about brand names versus generic. It's a big pharma talking point [1:06:06] in order to fool people into buying a more expensive drug. The generic is chemically the same. [1:06:13] And here's the thing. If you're buying a drug on Trump Rx, there is a more than one in four chance [1:06:21] that Trump's discount is actually a price hike. And for an anti-big pharma guy, you sure don't seem [1:06:30] worried about steering patients to more expensive drugs that are going to pad big pharma's profits. [1:06:35] But there's more in this deal. In exchange for these scam discounts, President Trump has exempted [1:06:44] these drug companies from his 100 percent tariffs. So think about that. Big pharma makes billions of [1:06:51] dollars in tariff relief by listing their drugs on Trump Rx. And then they don't even lower the costs [1:07:00] on many of these drugs. That is a great deal for big pharma. So Secretary Kennedy, [1:07:05] here's my question. Did you sign off on these sweetheart deals for big pharma? Or was this [1:07:12] all President Trump's idea? The tariff relief is only applicable. If the company has agreed to produce [1:07:22] the drug in America, they have one year to do so. And then they don't get the tariff relief, [1:07:28] and then it is going to bankrupt them. So you're the one who negotiated these? [1:07:33] Did I negotiate the deal? You negotiated these deals. Will you make those deals [1:07:37] available to us so we can see them? I didn't personally negotiate them. [1:07:41] All right. Did your team negotiate these deals? Yes. [1:07:44] Will you make those deals available to us so we can see them? A little transparency? [1:07:48] We will make the deal. I've already said this. I'm happy to make the deals available except for [1:07:54] proprietary information and trade secrets, which when you pass the IRA. I will hold you to that, [1:08:00] Mr. Secretary, because if these deals with big pharma are so great for Americans, [1:08:05] then we should be able to see what promises have been made. You have the power to make this deal [1:08:10] yourself. Why don't you do that? Why did you? We did this because you refused to do it. [1:08:15] What we've got is Trump. You have a lot more power to negotiate than we do. [1:08:20] We've got the lowest prices in history. [1:08:23] By health care costs, and you and Donald Trump are actually making the problem worse. [1:08:27] The American public deserves better. [1:08:30] Millions of people who are using Trump Rx disagree with you. [1:08:34] They've got a better than one out of four chance of paying more at Trump Rx than they would if they [1:08:47] went to Costco. That's not much of a deal for the American people. [1:08:50] Not on branded drugs. [1:08:53] Oh, so your answer is Americans should just not take prescription drugs. [1:08:56] We are directing people. We will be directing people to the generics, the cheapest available, [1:09:01] but a lot of doctors prescribe the brands, and we're giving them massive reductions in the brands. [1:09:08] So those mass, mass discounts are that people can pay- [1:09:13] Massive. 600 percent. [1:09:14] 600 percent. They can pay hundreds of dollars- [1:09:17] Or more. On Trump Rx, or they can get it for 12 bucks. [1:09:21] This is the second instance of the secretary denying the public's right to know. [1:09:27] That's all that the members on this committee have asked for. [1:09:29] All right. Thank you, Senator Wyden and Senator Warren. [1:09:36] At this point, to the rest of the members of the committee, [1:09:38] we're going to take a five- or ten-minute break, and then we will come back and resume the questioning. [1:09:45] The Senate will- I mean, the committee will recess. [1:09:49] The committee will come to order. [1:15:56] And the next senator for her questions is Senator Cantwell. [1:16:00] Thank you, Mr. Chairman. Thank you, Secretary Kennedy. [1:16:02] Thank you for your very long statement that's in the book. [1:16:07] You covered a lot. I think it was 10 or 11 pages. I don't think secretaries usually show up covering [1:16:14] 11 pages of material in their written testimony. So I wanted to ask a couple- I have three subjects [1:16:20] that I want to go over if I could. One- no. No, no, no, no. Ernie Moniz once said, [1:16:30] I read the four-year quadrennial energy report for our nation, and he thought that was crazy. [1:16:35] But, you know, when somebody spends that- I think it probably took him two years to write what was our [1:16:42] four-year energy outlook. Somebody needs to read it. So I actually think you covered a lot of subjects [1:16:47] there. So I wanted to ask about that, because I have priorities that I wanted to cover and see if we [1:16:53] could get your commitments on them. One, you talked a lot about Indian health care, which I appreciated. [1:16:58] I've met with several of my tribes. One issue is that we don't have for urban- you know, IHS does their thing [1:17:06] you've addressed trying to fix that, but Indian urban health needs the full FMAP funding. We got a fix, [1:17:13] myself and Senator Murkowski, but it only lasted for two years. And so we would like to see urban [1:17:21] Indian health get the full federal Medicaid- medical assistance for- for the Indian health care [1:17:26] programs. And would you work with us on that? Absolutely and enthusiastically. Okay, great. [1:17:33] Second issue- And you can call me directly on that and- Great. So appreciate that. This is a really [1:17:38] big issue. People don't understand, but we have 150,000 American Indians and Alaska Natives that live in [1:17:43] urban areas like Seattle. And so when they only get half the money for the care that everybody else gets, [1:17:50] it creates a disparity in actually being able to deliver that care. Okay. Second issue is in the cuts [1:17:56] to Head Start, in the cuts to the administrative issues and Head Starts and not putting out the new RFP for [1:18:04] proposals, Walla Walla, which is, yes, a real place, has- they may have to shut down their whole Head Start program. [1:18:13] So are you going to put out requests for proposals for funding for Head Start? [1:18:22] Request for proposal for, I mean, I mean, Head Start, we have, you know- There's been some [1:18:30] administrative cuts. And so one of the things they haven't put out are these RFPs that allow programs in [1:18:37] small communities to actually apply for those federal dollars and then be able to keep their program open. [1:18:43] I think what I should do is send you a letter on this. I mean, you know, I'm very committed to Head Start. [1:18:48] My family started a Head Start. I just, we protected it in the budget. I just put 62 million extra into [1:18:56] it so that they can do good nutrition. I'm happy to work with you to make sure. I think this is an area [1:19:02] where we might say, yes, Secretary, would you call the administrator in Walla Walla, Washington? Okay. [1:19:06] So the big question- I'm happy to do that. Thank you. The big question I wanted to ask about is [1:19:12] this issue of Wiser. I don't know if you've heard about this. And you mentioned briefly in your [1:19:17] testimony the coverage of modernization of CMS in technology. And the concern that I wanted to try [1:19:28] to address today is something that's been raised in our newspaper in Seattle. We obviously know a lot [1:19:33] about AI because we have a big AI community, but what's happening is AI is being used as a denial [1:19:40] device for the CMS system. And it's apparently had some problems where it's not taking a few days to [1:19:49] find out whether you're going to get covered or not. It's basically taking weeks to find out that you're [1:19:55] getting a few days to find out that you're going to get the same. And so what I'm worried about is this is a [1:20:03] gentleman who had some back issues and wanted to get what would have been under Medicare, an approved [1:20:13] system by his doctor, whether he could have that steroid or whatever care he could get. Now he's under this Wiser [1:20:20] application process, which can just turn down and deny. So we have hospitals calling me about this. I [1:20:28] have doctors calling me about this. I have patients calling me about this. So I appreciate if you take a [1:20:34] look at it. Yeah, go ahead. Okay. First of all, that kind of delay is unacceptable and we will work with you on [1:20:42] it. The Wiser model, you know, we're doing, we do only 5% prior authorization across Medicare and Medicaid. [1:20:54] And, but we found we were being ripped off by certain categories of procedures that are not good for [1:21:04] the patient. And a lot of time they're unnecessary and they're very lucrative for the doctor's skin [1:21:09] substitutes. And in three years from being 250 million to 23 billion, the spinal surgeries, certain [1:21:19] kind of spinal surgeries, which is from maybe the one that he's in and then knee arthroscopic surgeries. [1:21:25] So the AI targets those. And I don't know what happens then, but anyway, it shouldn't be delayed. [1:21:32] And we will try to work with you to fix it. I just want to bring my last point, [1:21:34] because I know my times have started, but this is exactly the point. Somebody might have had a bright idea. [1:21:39] I think AI should be used for advancing research and finding things that might take us years to [1:21:43] figure out and find them out in months instead. But to use AI as an app or a tool that might deny [1:21:50] people and then cut them off of Medicare, when this part of Medicare was never a referral, [1:21:57] is making me anxious that somebody really does think that AI should be used to judge our Medicare [1:22:03] services. And so it makes me anxious. So I appreciate you. [1:22:07] It's supposed to allow us to detect fraud early. There's probably kinks in the system. I will work [1:22:13] with you to try to straighten that out. But as I said, we were getting ripped off for 23 billion dollars [1:22:20] just by one category of procedure. I don't want Mr. Magnuson, who I showed to be ripped off though. [1:22:26] And I think that's the scary thing about AI is that if we really think we're going to put AI in charge [1:22:31] of deciding on instead of doctors, I think we're going to have some real problems. And also, [1:22:36] would you think about the transparency on this? Because if you created that model or that app, [1:22:40] or I think here's a third party, what is the transparency that we all have about how that app works? [1:22:47] Yeah, it's supposed to have a human supervisor so that a human and prior authorization is denied that [1:22:54] there's supposed to be a human being who checks that off and that the AI just identifies at the outset. [1:23:00] We want to know before so that we're not, I hear what you're saying. So thank you, Mr. Chairman. [1:23:05] Senator Barrasso. Thank you, Mr. Chairman. Mr. Secretary, thanks for being here today. [1:23:12] I really applaud what the administration's doing in terms of focusing on making America healthy again. [1:23:17] And we can agree that addressing chronic diseases is not a simple task. At its core, [1:23:22] making America healthy depends on prevention. I believe that as a doctor who practiced a long time, [1:23:26] was involved with the Wyoming health fairs, all focused on prevention. There is something called [1:23:31] the U.S. Preventative Services Task Force. It has a 40-year history of providing independent, [1:23:37] evidence-based recommendations on preventive care. It's part of HHS. And as a doctor, I've relied on [1:23:43] these recommendations over the years. They've helped shape the standard of care across the country from [1:23:48] cancer screening to heart health. And I believe, actually, if more people follow the recommendations, [1:23:53] our country would be a lot healthier. Last week before the House Ways and Means Committee, [1:23:58] you said you thought the task force had been lackadaisical and negligent for 20 years. I mean, [1:24:04] they did a lot of good work on breast cancer prevention, cervical cancer, alcohol in pregnancy. [1:24:09] And then you said you'd plan to bring on new members with a clear mission. So over the last [1:24:14] last year, they've canceled and not rescheduled multiple meetings of the task force that the [1:24:19] department has. One of them was just on three days notice. And I'm concerned that these actions show [1:24:24] that we're not really prioritizing this important task force. So how are you demonstrating that you [1:24:30] have a serious and consistent plan to reform the task force on prevention? And what exactly do you [1:24:35] believe the preventive services task force has been getting wrong? The task force is critically [1:24:43] important. It plays a critical role in getting compensation, CMS compensation for important approved [1:24:54] interventions. We consider that critical. The meetings were intermittent. I know I have not done a good [1:25:02] job at getting the meetings out there. We are going to change that. And then we are going to we're posting [1:25:11] a applications that a number of the of the members are rotating out. And I think there's only five [1:25:19] left. We're going to we're posting applications. We're going to get resumes on this week. We encourage [1:25:25] people to send in resumes who are in all these different specialties. The number of specialties were not [1:25:31] well represented on the committee. And we want to increase that to make sure that everybody is represented [1:25:37] there and to increase the number of meetings and also increase the transparency of the meetings. [1:25:43] In January of 2026, the addition of the American family physicians, a lot of physicians at practice [1:25:50] all across the country read. They follow this. Dr. Doug Campos-Altcult raised some concerns about the future of the [1:25:57] task force that we're talking about here, particularly talked about the risk of undermining its independence [1:26:02] and evidence-based methodology. And Mr. Chairman, I ask unanimous consent that this article I could submit [1:26:09] to the record without objection. Thank you, Mr. Chairman. And I share his concerns because what we've just seen [1:26:16] for the last year, the task force's methodology is grounded in an independent review of the evidence, [1:26:22] careful evaluation of the benefits and the harms. And among so many health providers, [1:26:27] it is widely even considered the gold standard for preventive care. So I hear what you're saying [1:26:31] in terms of the different specialties of people rotating on. I can promise you, Senator, [1:26:35] we're not going to undermine any of those functions. And I don't think we'll get any [1:26:39] criticism for doing so. We just want to get the best people and have a more representative group of [1:26:46] specialties. Okay. So you believe it's still the current methodology? The way they do it is still the gold [1:26:51] standard? I think there are some limitations that we are trying to address. [1:26:58] And I'm happy to meet with you or consult with you to make sure we're doing it right. [1:27:02] Well, no, I'd be very happy about that. And then, you know, on vaccines and a number of people have [1:27:07] asked vaccines, you committed when we visited in September to increasing transparency, to rebuild [1:27:13] trust in the public health guidance. And since then, there have been some changes to the vaccines, [1:27:18] vaccination schedule, specifically with children. There have been some disruptions to the advisory [1:27:22] committee on immunization practices. And I think that there's been more confusion for families [1:27:28] and for providers. And I think sometimes it's very hard to keep up with some of the [1:27:32] recommendations. So I'll ask you again, are you taking steps now to ensure vaccine guidance [1:27:37] is clear, evidence-based and trustworthy and when what those steps? [1:27:41] Yeah, absolutely. That's what we're doing for the first time we're going to be doing [1:27:46] for new vaccines that are not yet on the schedule [1:27:50] to make sure that they have safety studies placebo controlled trials first. [1:27:54] And for the vaccines on the schedule, they're being reviewed. There's a limitation. I can't really [1:28:03] talk about it because it's under litigation. Thank you. Thank you, Mr. Chairman. Thank you, [1:28:09] Senator Cassidy. Hey, Mr. Secretary. Thanks for coming in. First, just a statement. CMS is working with [1:28:17] Louisiana to approve Medicaid provider tax preprints after passing the Working Families Tax Cut Act. [1:28:26] We have one more to be approved. The Physician 2026 preprint. Louisiana's fiscal year starts in two [1:28:34] months. And we just need to get this done ASAP as well as congressional intent. Please prioritize [1:28:40] getting it resolved. And I'll follow up with you and Dr. Oz, but critical to my state's providers and to [1:28:46] my state's fiscal health, if you will, that this be complied with. I'm happy to meet with or, you know, [1:28:53] I'm happy to put my staff in touch. You can call me any time to make sure it's happening. Thank you, [1:28:58] sir. Next, affordable health care. My gosh, when I'm on the campaign trail, for example, [1:29:05] or just speaking to folks back home, it's all about that. We have expanded access to health savings account. [1:29:14] Now, I'm not clear, though, particularly on the exchanges. So a bronze plan is now eligible for [1:29:23] an HSA as an example. How is the department alerting folks, enrollees, that this HSA [1:29:31] opportunity exists? I'm aware of the opportunity. I do not know whether there's an advertising campaign [1:29:40] or what. I will check on that for you, Senator. Thank you. The Biden administration. [1:29:45] I mean, the Trump administration is absolutely committed to increasing access to HSAs and to [1:29:54] direct primary care and to the catastrophic plans. And so we, you know, I will do everything in our [1:30:01] power to make sure that that is is known. Sounds great. [1:30:06] That's great. Staying on the exchanges, there was a lot of fraud with zero premium policies in the ACA, [1:30:18] people paying hundreds of millions of dollars in fines for doing this. I'm not seeing additional [1:30:23] funding to address that fraud in your 2027 budget. And yet I recently had an insurance broker told me [1:30:31] she is still seeing folks fraudulently enrolled in the ACA marketplace. So the problem continues [1:30:38] even though there's now a greater awareness. Going back to your budget, there was not dollars that [1:30:43] I saw to address ACA fraud. Any comment on that? Well, the president's marketplace integrity rule [1:30:54] eliminates the zero premium plans. Those plans were particularly subject to fraud. We think there [1:31:01] were 4.4 million people on them who, many of them who didn't even know they were registered [1:31:08] because there was broker fraud. People were getting names, signing people up and collecting the [1:31:14] commission for signing people up. Who didn't know they were signed up? There were, um, I think only [1:31:22] 40 percent of the people on it ever made a claim, which indicates. So, so you accept all that. [1:31:29] Yeah. So, but it appears that the problem persists. And so I'm being told by folks involved, [1:31:35] but the budget as we see it does not have money to go after that. Uh, and so, uh, how is the, uh, [1:31:42] knowing that we've already done good work, what are we doing prospectively to attempt to address the, [1:31:48] um, continued threat and perhaps reality of fraud in the marketplace? I mean, we're using now AI [1:31:55] throughout the department to detect fraud and we're using it very aggressively. We have the best people [1:32:01] in Silicon Valley who are now designing the systems. Now, is that on the Medicare, Medicaid program? [1:32:06] Is that for Medicaid? Medicare to let out the door. But I think, you know, we're relying on the [1:32:10] marketplace integrity role to eliminate a lot of the opportunities for fraud in the ACA. [1:32:17] Okay. Uh, we may follow up with you on that just for clarity. Okay. Um, then, uh, next, um, [1:32:24] on Medicare Advantage, we know Medicare is going insolvent soon. [1:32:28] We want to protect the 72 year old retiree in Jefferson Parish, for example. Um, your department [1:32:35] has banned the use of unlinked chart reviews, a little technical, but you and I know what we're [1:32:39] talking about. But in the latest MA rate notice, HHS is continuing to use 2018 diagnoses and 2019 [1:32:49] expenditure data, not 2023 diagnoses and 2024 expenditure data. Why would CMS not use the more [1:32:58] recent numbers, which gives more precision as regards what the expenditure, what the payment [1:33:03] should actually be? Well, I can't answer that question. The guy who can is behind me, Chris Klump. [1:33:10] But we're happy to talk to you about it. It's a, I mean, we know we went through a lot of, uh, effort [1:33:17] to delink to end the delinking of chart reviews with the, um, with, with payments to end the upcoding [1:33:24] fraud, which was the biggest, uh, uh, uh, uh, opportunity for fraud throughout the system. [1:33:31] So I don't know why we got the year, why we're not doing it, you know, back to it, doing it to 2023 [1:33:38] and 2024, but I will find out for you. Sounds great. Without a yield. Thank you, sir. Thank you, [1:33:43] Senator Johnson. Thank you, Mr. Chairman. Uh, Mr. Secretary, welcome. Uh, thanks for your service. [1:33:51] Thanks for putting up with all this abuse. Uh, but in particular, thank you for your commitment [1:33:55] to radical transparency. Um, I think you're aware of the fact that I, I, on many fronts, [1:34:00] think our response to the pandemic was a miserable failure. Uh, I'm also well aware that, uh, because the [1:34:06] pandemic's over, so many people just want to put it behind us. Let's not, let's not examine all the [1:34:13] things that went wrong. Uh, one group of people who do not want to move on, one group of people that [1:34:20] insist on a reckoning are those who were injured by the COVID mRNA injection. I think you're aware of the [1:34:28] fact that I'm there's today, uh, worldwide, we have almost 1.7 million reports of adverse events, [1:34:35] almost 39,000 deaths. By the way, of those deaths, 24% occurred either on the day of injection [1:34:44] or within one or two days. I know VAERS doesn't prove causation, but man, that's a correlation. [1:34:49] The, the injection injured, I refuse to call it a vaccine. It's not a traditional vaccine. [1:34:54] The injection injured at a minimum would like to have their injuries acknowledged so they can get [1:34:59] treatment. I saw a horribly sad video of a man in Japan, the central line being effectively treated [1:35:07] for his vaccine, for his injection injury, couldn't get treatment here in the US. One of the things [1:35:12] preventing is we have no ICD code for those. So I, I know this is, uh, you're running through HHS. I [1:35:18] think, uh, uh, NHA director of Bhattacharya is looking for an ICD code. I'm, I'm just asking you if [1:35:26] you're willing to look at that and prioritize that to get, get the injection injured at least in IDC code [1:35:32] and acknowledge these, these injuries. Would you make that commitment? [1:35:34] We are working on it and, uh, we, we are working on it. [1:35:39] Okay. We're trying to make that happen as quickly as possible. And we're also [1:35:45] doing the studies that now need to be done at NIH. Um, the coroner's reports on the blood, [1:35:52] you know, clots and all of these. I'm glad you talked about coroner. So my, my next question is [1:35:58] a memo that is apparently from a CBER director, Dr. Prasad in December, 2015, where apparently within [1:36:06] FDA you're reviewing, I think it was 96 autopsies of child death following the COVID mRNA injection. [1:36:14] In that memo, Dr. Prasad writes, this is a profound revelation. For the first time, [1:36:18] the U.S. FDA will acknowledge that COVID-19 vaccines killed, killed American children. [1:36:24] Healthy young children who face tremendously low risk of death were coerced at behest of the Biden [1:36:29] administration via school and work mandates to receive a vaccine that could result in death. [1:36:33] In many cases, such mandates were harmful is difficult. It is difficult to read cases where [1:36:39] kids seven to 16 may be dead as a result of COVID vaccines. Putting these facts together, [1:36:45] it is horrifying to consider the U.S. vaccine regulation, including our actions may have harmed [1:36:50] more children than we saved. This requires humility and introspection. It requires oversight. And so I [1:36:57] wrote a letter to you and your agency back in December 15th. Of the 10 responses, I got three out of 10. [1:37:08] No responses, no response in terms of the documents I requested. So I'm asking you, please, [1:37:13] will you commit to responding fully to my December oversight letter? [1:37:17] A hundred? You have my 100 percent commitment. [1:37:19] In the letter, we also mentioned the fact that I was requesting the deliverer process on the Biden [1:37:26] administration last minute requesting or granting a four year extension of the liability shield for [1:37:32] these COVID injections. So please, would you also commit to providing me that deliberate of those [1:37:37] documents? If we have them, I will hand them over to you. Finally, let's just put up this graph. [1:37:46] Because of your radical transparency, I've got close to 11 million pages. You know, [1:37:50] we uncovered, they hid the signal on myocarditis. We also just recently uncovered that they also hit a [1:37:56] signal on ischemic stroke for people over 65, the tail in 2022, 2023. They hid both signals. [1:38:02] They downplayed them. But what is most alarming, and we'll be holding a hearing on this next week, [1:38:08] I've got a draft report. They were made aware, Peter Marks was made aware on March 26th of 2021, [1:38:17] that the inventors of the algorithm that analyzes the various data was going to mask adverse events. [1:38:25] They were, he was told that by using a different system, they had uncovered 49 examples of extreme [1:38:33] masking, 25 significant adverse events, including cardiac, sudden cardiac death, Bell's palsy, [1:38:41] pulmonary infarction. So this report will be issued in conjunction with that hearing. Again, [1:38:48] I didn't need a sophisticated mathematical model to tell me that we had safety signals screaming at us. [1:38:55] This chart shows the deaths associated with vaccines all the way going back to 1990, [1:39:01] when Bayer started, you know, a couple hundred a year, anaphylactic shock, that type of thing. [1:39:07] 2021, over 20,000 deaths. And for five years, FDA has been saying, uh, we don't see a signal. [1:39:15] This was a signal screaming at us that to date to this very day, we are covering up. So my, [1:39:22] there are a bunch of people involved in this coverup that still continue to work within the HHS, [1:39:27] CDC, FDA. I want your commitment that those people be made available for interviews. [1:39:32] I'll have to subpoena others. I'm going to dig into this massive government. [1:39:37] You have my commitment. [1:39:39] Thank you. [1:39:39] Thank you, Senator Smith. [1:39:42] Thank you, Mr. Chair. [1:39:43] Mr. Chair, a few rounds ago, there was a back and forth between Senator Daines and [1:39:49] Secretary Kennedy about Mifepristone. So Mifepristone's safety profile is well established, [1:39:55] 25 years of data, 100 peer-reviewed studies. It's a safety profile that is better established than many [1:40:02] everyday medications. And so I'd like to submit for the record, Mr. Chair, 40 peer-reviewed, [1:40:10] statistically significant studies on Mifepristone's safety profile. These are the same that [1:40:16] Senator Hasson submitted during Secretary Kennedy's confirmation hearings. [1:40:22] Mr. Chairman, just very quickly, I'd like to associate myself with your important remarks. [1:40:26] Without objection. [1:40:27] Thank you very much. Good morning, Mr. Kennedy. I'd like to talk about [1:40:31] prevention and where we should be able to agree not only to how prevention can help to keep [1:40:37] Americans healthier, but also save healthcare dollars. And I'd like to start by associating [1:40:42] myself with Senator Barrasso's questions and concerns about what's happening with the [1:40:47] Preventative Services Task Force. But let's get into it. Last week, you said that screening for [1:40:53] prevention is absolutely critical. So I want to dig into that. I agree with that. Let's start with [1:40:59] mammograms. Would you agree that mammograms are important preventative health care? [1:41:03] Yes. Absolutely. I agree with that, too. So it makes me wonder why your agency cut the programs [1:41:11] that fund breast cancer screenings. Hospitals in my neighboring states of South Dakota and North Dakota [1:41:16] actually had to pause breast cancer screenings because your agency announced cuts to the national [1:41:23] breast and cervical cancer early detection programs. Doesn't make any sense to me. [1:41:28] Let's try another one. Is depression screening preventative care in your mind? [1:41:34] Depression? Yes. Yes. Yes. Okay. I agree with that, too. However, the Trump administration [1:41:41] and congressional Republicans pushed through the biggest cuts to Medicaid in the history of that [1:41:48] program. And Medicaid is the largest payer of behavioral health care. So that's cutting access to [1:41:54] care for millions of Americans to get mental health care. How about smoking? Is smoking cessation, [1:42:01] cessation, pardon me, preventative care? Yes. Okay. So again, your latest budget eliminates the CDC's [1:42:10] office for smoking on smoking and health. And 200 CDC employees who were working on smoking cessation [1:42:18] cessation are gone now. The flu shot. Is the flu shot preventative care? [1:42:23] Yes. Okay. So you said that it would be better if fewer kids got the flu shot. You've rescinded [1:42:30] recommendations for scientifically and, you know, medically sound flu vaccines. You canceled public [1:42:37] awareness campaigns about the importance of getting the flu vaccine. I mean, this is not a record that [1:42:43] matches with saying that preventative care is important. I do not understand the contrast here [1:42:53] between what you say you want to do and what is actually happening in this administration. [1:42:58] Now, let me go to this. Are you familiar with Title X? Yes. Okay. Great. Title X is a highly successful [1:43:08] comprehensive strategy to provide birth control and preventative care to low-income women. And we know [1:43:13] that every dollar that's invested in Title X, Mr. Chair, saves somewhere between $3 and $7 in Medicaid [1:43:20] costs, preventing unintended pregnancies. So, Secretary Kennedy, can you explain why you were recommending [1:43:27] zeroing out funding for Title X, which would eliminate screenings for cervical cancer and would almost [1:43:35] certainly result in higher unintended pregnancies? Can I respond to some of your earlier statements? [1:43:42] Please. First of all, there are no cuts in Medicaid. I keep saying this. Here's what the CBO said. [1:43:49] The fiscal year 2025, $668 billion. Fiscal year 2036, $981 billion. That's not a cut. [1:43:59] Mr. Secretary Kennedy, a trillion dollars in cuts, according to the CBO, [1:44:04] seven million people losing their health insurance because of the Trump administration actions. That's [1:44:10] not debatable. There's nobody who is legally enrolled in Medicaid who is losing coverage. [1:44:16] That is just not true. Nobody. That is just not true. [1:44:18] It is so. It's true. How can this be cut? [1:44:22] What else would you like to respond to my questions about why the administration is cutting preventative care? [1:44:27] We're putting, a lot of it is being returned to the states. We're doing a $667 billion block grant to [1:44:38] the states for mental health. My counties are asking why the cost shift to their taxpayers is [1:44:43] happening at the same time that rural hospitals are going out of business. The states administer the [1:44:50] programs better than we do. So we're giving the same money to the states to administer the program. [1:44:56] That is not the way it is working. Thank you, Mr. Chair. Thank you. Senator Liu Han. [1:45:01] Thank you, Mr. Chairman. Mr. Chairman, I'd like to ask unanimous consent to submit into the record [1:45:08] CBO report from July 2025 on HR1. Unanimous consent to that report. [1:45:19] Appreciate that. Mr. Kennedy, that report found that there was a $990 billion cut to Medicaid CBO [1:45:28] report. That's not my question. How can there be a cut? [1:45:33] Mr. Secretary, it's in the record. I'd be happy to share it with you. Your team has it as well. CBO [1:45:37] report July 2025. It's a cut from the growth rate. Only in Washington is that considered a cut. [1:45:41] There you go, Mr. Secretary. In the same way the gas prices are not high today. [1:45:44] It doubled in the last four years. Mr. Secretary, let's talk about vaccines. [1:45:50] You've been asked quite a few questions today about vaccines. Your hearings this last week in the [1:45:56] House as well. You've been asked a lot of questions about vaccines. You've been responding quite a bit [1:46:02] about vaccines. I went back to look at statements you've made, I don't know, over the last 10 years or so [1:46:09] on vaccines as well. I appreciate that you say today that you support people getting vaccine. [1:46:19] Is that accurate? Yes. [1:46:21] Mr. Secretary, I was reminded, though, that July 6, 2023, Samoa 2019, August 2018, [1:46:31] February 23, 2021, and the dates go on and I have a list of them where there was a lot of misinformation. [1:46:37] Tell me a piece of information that I ever promoted about vaccines. Tell me one piece of information. [1:46:46] Mr. Secretary, again, if I could continue. Tell me one piece of misinformation. You said I promoted [1:46:52] misinformation. Thank you, Mr. Secretary. I'll get there. So, Mr. Secretary, the history shows that [1:47:01] you were pushing vaccine misinformation, predating your tenure. Tell me one instance. [1:47:06] Mr. Secretary. Tell me one statement that I made. [1:47:08] Mr. Secretary. One statement. So, now, during your leadership at HHS, [1:47:12] measles, a disease once eliminated in the United States, is on the rise in over 1,700 Americans, [1:47:20] as you're aware. You've been asked by colleagues as well where, you know, kids died last year. [1:47:27] Mr. Secretary. Can I answer the question? I don't have a question yet, Mr. Secretary. [1:47:34] You're making misstatements. At a previous hearing, you seemed to almost brag about how [1:47:38] well the United States has fared in response to measles outbreaks compared to Mexico and Canada, [1:47:42] I think, here again today. And Europe and all the other countries. [1:47:45] Mr. Secretary. The United States has always been a leader and we demand that it's a leader. That [1:47:48] should not be a question. We're still the leader. [1:47:50] Mr. Secretary. Can you please tell us here today what you're going to do to reduce the number of [1:47:55] measles cases and improve the MMR vaccine vaccination rate? [1:47:59] Mr. Improve the MMR. We promote the MMR. We advise every child to get the MMR. That's what we do. [1:48:08] Mr. Secretary, I'd be happy to just ask for that to be in the record and I'd be happy to get a [1:48:12] question in the record. You can respond to it. I'm real curious if you're going to include funding [1:48:17] coordinated vaccine education and distribution campaign, for example, countering misinformation [1:48:22] about measles and the MMR vaccine. Tell me one piece of misinformation I've ever said. [1:48:26] One statement. Just one. If I could continue. You say you have a list of them. Read one. [1:48:31] Tailoring outreach to communities with declining vaccination rates as well. [1:48:35] Measuring whether those campaigns are working. You're just making things up, Senator. [1:48:39] You're just inventing stuff. Tell me one piece. You say you have a whole list there. Read me one [1:48:44] thing I've ever said. Mr. Secretary, if you want to run for the United States Senate and get on the [1:48:49] diocese here, you're happy to do it. You should resign from the HHS today and run for office. [1:48:53] And you can be in here. You can ask anyone all the questions you want, Mr. Secretary. [1:48:56] I'm asking you some questions. What I just gave you wasn't even... [1:48:59] You're not asking questions. You're just making statements that are incorrect. [1:49:02] Let me ask you a question about someone that you know very well. David Geyer. [1:49:08] So, Mr. Secretary, does David Geyer work for you? [1:49:10] He is a contract. [1:49:14] So, Mr. Secretary, last time you were here, I asked you, [1:49:20] why was it that David Geyer was listed on the HHS director as a senior data analyst? He still is. [1:49:26] Is he a contractor or is he a contractor? [1:49:29] He's a contract employee. [1:49:31] Mr. Secretary, you were asked by one of my colleagues about [1:49:34] getting their hands on some documents that you may have. Do you have Mr. Geyer's contract? [1:49:41] I imagine we do. [1:49:43] Would you share that with the committee by Friday? [1:49:46] I don't think there's any legal problem with it. [1:49:48] It's not a legal problem. It's subject to Information of Public Records Act, which we could go [1:49:53] about as well. [1:49:54] Well, then, yeah, I'm happy to. [1:49:55] I appreciate that. And including in the contract, would you share, [1:49:59] can we expect you to share with the committee by Friday the scope of David Geyer's contract? [1:50:05] I don't see any reason why not. [1:50:07] I appreciate that. Does David Geyer report to the HHS office here in DC? [1:50:11] He reports to CDC. [1:50:16] So what I asked for in the last time we had a conversation, Mr. Secretary, was about the protocols [1:50:23] that go into David Geyer's work. You responded to me by saying that those protocols are public. [1:50:28] They are not. I asked the committee chair. [1:50:31] I said they will be public when he does the work, when he develops the protocols. [1:50:35] Will you commit to share the protocols to David Geyer's work with this committee by Friday? [1:50:40] No, I won't because they don't exist. [1:50:43] Okay. So, Mr. Secretary, I appreciate that honest response. Mr. Chairman, [1:50:48] Ranking Member Wyden, you'll remember, and I can get you the information from this. [1:50:53] Last time I asked this question to the Secretary, he said it was all public. It was all available. [1:50:58] He just said it's not. So I don't know if it's going to take us to sit down on IPRA. [1:51:01] I said it's going. I said we will make it available when it's done. [1:51:04] I certainly hope that we can get our hands on the protocol information and David Geyer's work. [1:51:08] Thank you, Mr. Chairman. Thank you. Senator Blackburn. [1:51:12] Thank you, Mr. Chairman, and Mr. Secretary, thank you for being with us today. We appreciate it. [1:51:18] I really want to applaud your leadership on the CMS strategy to crush fraud. [1:51:25] This is getting longer and longer. [1:51:26] This is something that Tennesseans are welcoming, seeing, and the fact that you have already found, [1:51:34] I think it's 5.7 billion in fraudulent Medicare payments. And when you look at that as a recurring [1:51:42] expense, you see how much that's costing the taxpayer. Pardon me. I also want to highlight the [1:51:53] remarkable success we have seen with the rural health care transformation program. And Republicans [1:52:00] on this committee really worked hard to make that happen. We're looking forward to good results. [1:52:07] I do want to go to your question, your comments about fraud and fighting fraud. And you mentioned [1:52:17] the work that was being done to beef up your systems. Pardon me. Too much pollen in the air. [1:52:28] Talk for a minute about what you're doing there with the data transfer, with aggregating data from the [1:52:36] states and what you plan to do to make certain that the audit is now a mandatory component to weed out [1:52:50] some of this fraud like we've seen in Minneapolis and in L.A. [1:52:53] I mean, let me just talk about what happened in the Biden administration that opened the door to [1:53:01] all this fraud. The Biden administration took many steps, but three major steps. One implemented [1:53:07] what they call a pay and chase system where when we get invoices that we know to be fraudulent, [1:53:15] we have to pay them. And then they had a clawback strategy that then you would go after them. And of [1:53:21] course, nothing ever got clawed back. And it opened the door wide. Two, they stopped. They told the [1:53:30] states that they could not, that they could only check for valid, for enrollment validity once a year. [1:53:39] They can find them. They told people in my, they got, in my agency, we had 80 people assigned [1:53:48] to do program integrity and fraud detection over 50 states and six territories. It wasn't enough. [1:53:54] The Biden administration came in and fired all but six of them. So now I, when I came in, [1:54:01] I have six people in my office, my predecessor, Mr. Becerra, told his staff, we don't do program [1:54:10] integrity. We should focus on enrollments. And that's what happens. And so now you've got all [1:54:16] of these problems. And I'll give you one example. Hospices in Los Angeles, we've shut down 500 of them. [1:54:24] We have not gotten one call from a congressperson or one call from a patient. Why? Because those [1:54:31] hospices did not exist. Right. They were signing up patients. They were getting patient IDs, [1:54:37] signing them up and charging us $6,000 a month for that patient. How did we detect them all? Because [1:54:45] the patients never died. And then you are, I would assume that you all are sharing this information with [1:54:53] the states and working with the states when it comes to Medicaid fraud. Some of them refuse to [1:55:00] work with us. Minnesota refused to work. Florida, where there was terrible, terrible fraud in the [1:55:07] durable medical equipment space, is working very aggressively side by side with us, with the governor [1:55:13] DeSantis and with the attorney general. Certain states have refused to produce an audit. All right. [1:55:19] In those states, we are withholding their reimbursements. I want to move to the area wage [1:55:25] index. This is something Senator Warner and I are working on because you've got hospitals [1:55:32] in urban areas and they are receiving higher payments than the hospitals in the rural [1:55:39] or the low wage communities. But of course, we know that so much health care now is technology [1:55:45] and technology cost the same regardless of where you are. And last week, I know that at the Ways and [1:55:54] Means hearing, they discussed this issue with you. And I would like to know that you are confirming your [1:56:02] support for the approach of bringing into parity this area wage index so that we can level the playing [1:56:11] field with these rural and disadvantaged hospitals with hospitals in urban areas. [1:56:18] Yeah, absolutely. And I've worked on it with Senator Whitehouse because he has the same problem with [1:56:26] Rhode Island. Unfortunately, there is no way that we can fix it in HHS. We need congressional help and [1:56:32] we will work with you on it. We have the bill and we are pushing it forward. Thank you. Thank you, [1:56:37] Mr. Chairman. Thank you. Senator Young. Welcome, Mr. Secretary. It's good to have you here. [1:56:45] Thank you to you and your team for your hard work and for your focus on preventative measures. I think [1:56:50] that point of emphasis of the Make American Healthy Again movement is important while focusing more [1:56:58] broadly on wellness as opposed to just health care and health delivery is important. I also appreciate [1:57:04] the attention and interest you've shown in with respect to long COVID, this collection of symptoms [1:57:13] that remain after people get COVID and has an economic cost globally of conservatively at a trillion dollars [1:57:22] per year. It's adversely impacting millions of Americans. No doubt is having some impact on our long-term [1:57:31] unemployment rate and people need some hope. I think you offered some hope for starters during your [1:57:40] confirmation hearings when you told me you were going to prioritize this issue. Secondarily, when you held [1:57:46] a roundtable session bringing in some of our nationally renowned doctors who have expertise in this area. [1:57:53] I'd like an update, sir. How are you working with your FDA commissioner, McCary, and our NIH director, [1:58:04] Bhattachary, to advance treatment for long COVID? Yes, we are, Senator, and a lot of the reforms came out of [1:58:12] that long table. I want to, I mean, that roundtable, I want to thank you for your leadership. And we're working with [1:58:19] many of the doctors that we brought in with Bruce Patterson from California with Jordan Vaughan from [1:58:25] Florida and the leading doctors who are, who become experts in this area, who are under, and we are [1:58:32] working to develop biomarkers. As you know, there are many, many different presentations of this disease. [1:58:39] They have to be identified and diagnosed differently. They have to be treated differently. [1:58:45] We are identifying the biomarkers for those. We're putting everything up on a website [1:58:51] so that patients will have access to the best care and the best doctors who have had the most success [1:58:57] in treating their particular form of the illness. Well, there's urgency to this. Thank you for [1:59:02] prioritizing this. I will ask again for your commitment to continue to work together on this. [1:59:09] Yes. Do I have it? Oh, yes. Okay. And I'll see Dr. I'll see Dr. Alicia Jackson later today, [1:59:18] of course, our director of ARPA-H. This seems to lend itself to the ARPA-H model in light of the fact [1:59:25] that once we come up with treatments, diagnostics, et cetera, it typically takes two decades to find their [1:59:32] way out in the clinical practice. We can't wait for that. So, moving on to biotechnology more [1:59:38] generally. For the last couple of years, I've chaired a National Security Commission on Emerging [1:59:42] Biotechnology. Bottom line up front, we have assessed that unless we optimize our nation's biotech [1:59:52] research, development, production, and innovation ecosystem, we are at risk of falling behind the [2:00:00] Chinese Communist Party, our primary adversaries by my lights in biotechnology, which has direct [2:00:09] national security, economic security implications. In 2022, Chinese pharmaceutical companies accounted [2:00:17] for just 5% of licensing deals. By 2025, that figure jumped to 42%. I've been encouraged to see the FDA, [2:00:27] under your leadership, speed up approval times for drugs. But I think more needs to be done. We [2:00:33] outlined some of this in our report, which can be found at biotech.senate.gov. How, Mr. Secretary, [2:00:39] can we work together to spur further domestic development and investment in the U.S. biotech industry? [2:00:47] Yeah. And, you know, last year, 50% of the new drugs approved were, came out of China. And they, [2:00:57] and that's, that rate is increasing exponentially. And they're stealing our IP. They're stealing our [2:01:03] researchers. They're stealing our best scientists. They're operating duplicate labs in other countries. [2:01:09] And it's a crisis. They're, they're, they're, they're threatening our biosecurity [2:01:14] and our public health. Yeah. And our dominance in the area. As you pointed out, we have speeded the, [2:01:20] the length of time from concept to commercialization dramatically. We, we just approved in record time [2:01:33] two oncology drugs, one in 54 days, one in 45 days. The average for that part of the, [2:01:39] of the process was before that was 310 days. Yes. And both of those are drugs that bring people out of [2:01:47] hospice. Literally, they're so effective. Um, we are now doing inspections in China. So we're dramatically, [2:01:56] uh, ramping up our inspection of Chinese sites. A lot of them are violating ethics, [2:02:02] the clinical trial sites. They're using minorities against their will and doing all these kind of, [2:02:08] um, mischief, uh, that needs to be exposed. Uh, we are investing hundreds of billions, [2:02:18] hundreds of billions of dollars in reassuring, uh, KSMs and APIs in this country so that we can end that, [2:02:26] that chain. And we have a pre-check program that encourages pharmaceutical companies to build in this [2:02:33] country. The ones that produce the drugs here, if they research them here, they will be given [2:02:39] preference and, and be able to move up in the line. Thank you so much for your leadership as it relates [2:02:45] to this issue. Mr. Chairman. Thank you. Senator Tillis. Thank you, Mr. Chairman. Uh, Secretary Kennedy, [2:02:51] thank you for being here. You mentioned China. I was just chairing a committee for the last two [2:02:55] hours on China's rampant theft of intellectual property and all the other Milan activities they're [2:03:00] involved in. Um, which actually, uh, takes me back to a statement I think you made a while back about [2:03:09] China is eating our lunch on pharmaceutical innovation. Uh, I think, uh, there's an argument [2:03:15] to be made that we're handing China our lunch. Um, I, and I've, and I've talked about this in the [2:03:22] committee for several years. By simultaneously cutting NIH funding for basic research and imposing MFN [2:03:31] price controls that slash private R and D by 30 to 50%. HHS is squeezing both sides of a balloon and [2:03:40] expecting it not to pop. Um, and I'm not just, I'm not picking on this administration. It's exactly [2:03:47] what the Biden administration did with the build back better bill within six months of passing that [2:03:51] bill, trying to impose price controls. We saw a 40 to 60% drop in small molecule research. It's [2:03:58] in, inescapable, the connection between the two. Um, so I think that these steps that this [2:04:05] administration's taking, similar to the steps of the Biden administration, China gets the IP, [2:04:11] China gets the manufacturing, America gets the lower prices on drugs, lower prices on drugs we didn't [2:04:17] invent, produced in facilities that we don't own. And you've already alluded to the, uh, the, uh, [2:04:23] unacceptable circumstances in China for the workers and those there were aiding and abetting that I [2:04:28] think through this policy. So MFN tells the world that America will no longer invent in the future, [2:04:34] in my opinion. Um, now I want to get to a question, give you a chance to answer that for years. I've been [2:04:42] saying that we've got to drive down healthcare prices. We've got to drive down the cost of [2:04:48] pharmaceutical drugs, but we have a simplistic approach that we use here. We never have everybody in [2:04:53] the barbershop at the same time. We just try to scalp whoever we can as a matter of public policy. [2:04:58] MFN is the most recent example of that. MFN is the most aggressive single link intervention in [2:05:06] a complex value chain attempted at the federal level. It doesn't address supply chain concentration [2:05:11] or IP theft. It just hammers the end price in hopes that the rest of the system magically adjust. [2:05:18] So well intentioned single link interventions have failed for a decade. What other than political [2:05:26] branding makes this one different? In other words, the Democrats had embraced this for years, [2:05:32] this sort of socialized approach or socialized approach to controlling prices. What's different [2:05:38] about now the Republican approach to do almost fundamentally the same thing? [2:05:42] Senator Tillis, when President Trump charged us with lowering prices to the same as Europe, [2:05:52] he also made two separate provisos. He said he did not want to end the research domination in U.S. [2:06:01] companies. And he said he wanted them to reassure pharmaceuticals, which seemed like an impossible task. [2:06:08] We managed to do all three things. And the truth of that, our success of that is reflected [2:06:17] in the share prices of those pharmaceutical companies that went up about $1.3 trillion [2:06:22] dollars after we signed the agreement. And the way the magic, you know, part of the magic- [2:06:28] And are you certain that we will see an equal or greater amount of R&D coming out of these [2:06:33] companies that have taken price cuts? Because we've seen the empirical data from Build Back [2:06:38] Better. It didn't prove to be true. Look at the investments they're making in our country. [2:06:42] I think Eli Lilly is building six new plans. Pfizer is building plans. Merck is building plans. [2:06:49] Everybody is building plans here in this country. And so why not, if the policy is working so well, [2:06:56] why not apply to MFN to everything versus the select number that you've chosen to negotiate [2:07:01] agreements with? And I think have recommended that we codify those agreements? [2:07:05] We chose the first, the top 17 companies that produce 99% of our drugs, our brand drugs. [2:07:12] And we have agreements with- But if it's working well, [2:07:14] why not this just be a universal, if it's working well and sustainable, [2:07:17] why not this just be a universal program for any, any, any drug that makes it through FDA approval? [2:07:23] Each one of those companies had separate needs and separate circumstances. And there's [2:07:27] separate agreements with each one of them. A lot of, you know, the magic behind it was that we use [2:07:32] tariffs to force the Europeans to raise their prices. With that in mind, how could you possibly codify [2:07:37] that if it represents a different- I know that there's a discussion about codifying it. How do you [2:07:42] codify something that is unique to each one of those entities? Yeah, you know what, that's, [2:07:47] that is a long discussion. And I agree it's complicated, but I think that we can do it. [2:07:52] On the man who, who is a genius behind this is Chris Klomp and he's working on legislative language [2:07:59] now. But you're happy, I mean, I'm happy to make him available to you. Thank you. We'll submit [2:08:05] other related questions for the record. Appreciate you being here today. Thank you. Senator Whitehouse. [2:08:13] Thanks very much. Secretary Kennedy, I'm going to talk about some Rhode Island stuff with you. [2:08:18] I think as you know, and as CMS has long agreed, New England is a regional healthcare market. [2:08:27] And there is literally zero justification for having Rhode Island suffer a 20 percent payment [2:08:36] hold compared to its neighboring states of Connecticut and Massachusetts. You have said that [2:08:42] that requires legislation to change. And that is what CMS constantly says. But as somebody who has [2:08:51] tried to work this problem for well over a decade, what I have seen has been CMS has not even tried. [2:09:00] They give no indication that they could care less about the disruption to healthcare services that this [2:09:07] causes in Rhode Island. In the past, they have even gone out of their way to make the problem worse [2:09:13] for Rhode Island. And I had to fight back and fix that worsening. But the underlying problem remains. [2:09:21] And I just want to flag for you again that Rhode Island has been a leader in the move to value-based care. [2:09:33] When accountable care organizations were set up, there were times when the two best in the country [2:09:39] were coastal medical and primary care physicians of Rhode Island. So we've got a record of doing [2:09:46] value-based care right. The move to value-based care could be the vehicle for correcting the payment [2:09:54] hole. And I just want to flag that for you because I want to make darn sure we get there. [2:09:59] We cannot be in a situation where Rhode Island's costs have been depressed because CMS kept Rhode Island's [2:10:06] revenues down. And now we're supposed to compare with Connecticut and Massachusetts, which had higher [2:10:12] spend because they had higher revenues. It's obvious mathematics. I appreciate that you've taken an [2:10:18] interest in this. I'm raising it again because I ain't going away on this subject. It is likely to cause [2:10:24] real damage to healthcare services in Rhode Island if it is not fixed. The second irritation that I've had with [2:10:32] CMS for a long time has been a similar disinterest with respect to how families with a loved one facing the [2:10:46] end of their life get dealt with. It is not uncommon for someone to wish to die at home. It is not uncommon [2:10:55] for the family to wish that they stay at home through this very delicate period. And yet there are times when the [2:11:03] family just can't take it any longer and they're frightened and they would like to get their loved one to a [2:11:08] nursing home. And what CMS has required is that that dying mom has to go and spend three days and two [2:11:16] nights in a hospital, check in, go through all that rigmarole, all that nonsense, all that expense [2:11:22] before Medicare would let them into a nursing home. We are fixing that with your help. I'm looking forward to [2:11:29] getting that actually landed. But I just have to point out how long CMS was willing to stand idly by [2:11:37] and look at that kind of effective cruelty in the system. Thank you for changing that. Similarly, [2:11:43] if your loved one is dying at home and you want them to stay at home, you're not ready to go to a [2:11:49] nursing home, but you need some help. Respite care for years was sending your loved one to the hospital. [2:12:01] Again, all the anxiety, all the nervousness, the whole neighbourhood worried about the ambulance in the yard, [2:12:07] all of that completely unnecessary when you could send respite care to the home where the patient was [2:12:12] less expensively. CMS was just obstinate about that. Ditto home care. If you're a dying patient, [2:12:20] you still can get outside. You should still be able to get home care to support the family through that [2:12:25] period. You shouldn't have to wait until you're homebound. So we're fixing those three things and others, [2:12:32] but it's really important that we get this right. And I think Rhode Island, when we get this right, [2:12:38] can provide a model for the rest of the country. And I just want to flag the vast bureaucratic [2:12:43] disinterest of CMS over decades about these problems. And we just need to change the culture [2:12:51] there so that they listen and think a little bit about the actual human harm that some of their [2:12:57] policies are causing. Last thing I'll mention to you is prior authorizations. I'd love to get rid of [2:13:03] even more of them. Prior authorizations make some sense in a fee-for-service model, [2:13:09] but they've been abused by the insurance industry for cash flow advantage. [2:13:14] In a value-based care model, the logical underpinnings for a prior authorization evaporate, evaporate. [2:13:27] So I would urge that you continue to work with us to get rid of prior authorizations for doctors [2:13:33] who are working in a value-based care model. Thank you, Chairman. Thank you. [2:13:38] Thank you for your leadership, Senator. And I agree with you. [2:13:43] Thank you. Senator Welch. Thank you. [2:13:47] My view, Mr. Secretary, is the health care system is absolutely broken. It's too expensive. And one of the [2:13:55] areas that your administration is focused on, the president specifically, is the cost of pharmaceuticals, [2:14:01] Trump-Rx. And I just want to go through that to determine what actually has happened. [2:14:08] The front page of Trump-Rx says it has, quote, the world's lowest prices on prescription drugs. [2:14:16] So I want to do a comparison about our prices versus prices, say, in Germany. And we have a chart here. [2:14:24] This one drug, this is for infertility, $10 cheaper in Germany than here. Another one for diabetes and heart [2:14:33] problems, $88 cheaper in Germany. Diabetes, $116. Another diabetes drug, $122. Autoimmune conditions, [2:14:47] $1,653 cheaper in Germany. $1,653 cheaper in Germany. Another drug, really important for stunted growth in [2:14:56] children, $2,723 cheaper. I mean, do you dispute any of these figures? [2:15:02] We currency adjust the prices. So we currency adjust the prices. So we're getting the lowest prices in [2:15:14] the world. So you're saying my chart is wrong? Yeah. I'm saying it's apples and oranges. Yeah. [2:15:21] It's I really don't get that. We check what the price is. I mean, it's $2,700 in apples [2:15:29] more if you buy that autoimmune that that prescription drug here than there. I mean, the point here is Trump Rx [2:15:38] was sold as the cheapest prices. Our research shows challenges that, unfortunately. [2:15:45] Another thing, Trump Rx isn't even the cheapest prices in the United States. [2:15:51] It's only a small fraction of available drugs are included. You know, there's 24,000 FDA approved drugs, [2:16:03] 80 drugs are on Trump Rx, literally 80 drugs. And that obviously means that for the vast majority of [2:16:12] drugs, they're not even in Trump Rx. The other thing that is important is that the everyday Americans [2:16:20] cannot access Trump Rx. The fine you get a coupon if you go on the website and it tells a very different [2:16:30] story. A patient is not eligible if he or she is enrolled in any federal or state health care program [2:16:37] with prescription drug coverage such as Medicaid or Medicare or any similar federal health program, [2:16:43] TRICARE. Do you dispute that? This is the terms of Trump Rx. The vast majority of people aren't even [2:16:55] eligible. You know, the other point is that who's really benefiting? You know, you mentioned that there [2:17:02] was $1.3 trillion in market increase for the drug companies. But I'm not seeing any reduction in cost to [2:17:11] everyday Americans who want to get prescription drugs. You know, drug companies who made these deals [2:17:17] were given exemption from Trump tariffs, right? They got a quick quote. Only if they move their [2:17:24] production to this country. Well, so they got a tariff reduction. They got a tariff reduction [2:17:29] only if they produce here. And they get it for if they make a commitment to produce here, [2:17:35] they can get it a year in advance. All right. Thank you for that clarification. But what I understand [2:17:40] is that all but one of the 16 Trump Rx companies have increased prescription drug prices since making [2:17:50] their deals. The prices are going up. Companies that signed deals made even more money. You mentioned [2:17:56] $1.3 trillion in market value increase. But they made those companies have made $177 billion in profits [2:18:05] up from $107 billion. You know, here's my concern. I met with President Trump in his first term. He said very [2:18:15] directly and he has on the campaign that people are getting ripped off with pharma pricing. He gets it, [2:18:21] but he's not solving it. Trump Rx doesn't work. So I have a bill co-sponsored by Senator Hawley, [2:18:31] the Fair Prescription Drug Prices for Americans Act, which would prohibit pharmaceutical companies [2:18:37] from selling drugs in the United States at higher prices than at the international average, [2:18:43] which is something I thought the president said he supported. Does your administration support [2:18:48] that legislation? Senator, we would love to work with you on the codification. [2:18:54] You know, we, this does not, Trump Rx does not yet cover every drug. It covers the most common [2:19:01] drugs. It's dropped the price of GLPs by 89 percent. Let's just level out. It's 80 drugs out of 24,000. [2:19:10] It's the most common drugs. You can't be eligible if you're in any other health care. It's the most commonly [2:19:15] used drugs. The companies that have agreed to this have had an increase in profits by $170 billion. [2:19:20] It's GLPs. It's all the most. Trump Rx is a fraud. [2:19:27] We need to move on. Senator Sanders. Secretary Kennedy, how are you? [2:19:34] Um, you know, in public life, [2:19:39] we all make misstatements. All right. A couple of hours ago, I think you said to Senator Wyden that we [2:19:47] now pay the lowest prices in the world for prescription drugs. That is an absurd statement. [2:19:53] Nobody in the world believes that. Do you want to correct that statement? [2:19:57] It's for the drugs that are on Trump Rx. I'm not talking about drugs. You said we pay the lowest [2:20:02] prices in the world for prescription drugs. For those drugs, we do. [2:20:04] I'm sorry? For those drugs, we do, Senator. [2:20:07] Well, for certain drugs. But in general, would you agree with the Rand Corporation and every other [2:20:12] independent survey that we continue to pay the highest prices in the world? And many, [2:20:17] you agree with that? Many drugs are not covered by the agreements yet. [2:20:21] On average, do we pay the highest prices in the world? As we always have, except for the most common [2:20:27] drugs. I'm not saying this is a new development, but you said a moment ago that we pay the lowest [2:20:32] prices in the world. The most common drugs we do, or GLPs, or IVF drugs, or COPD drugs, [2:20:39] or asthma drugs for insulin. Well, let me give you an example. For the cancer drug Opdivo, it costs [2:20:48] $260,000 in the United States, costs $56,000 in Japan. We pay on the lowest prices, et cetera, [2:20:56] et cetera. Senator Welch made the same point. All right, the bottom line is, look, there are [2:21:02] thousands of drugs out there. There may be a drug here or a drug there. We pay lower prices. [2:21:06] In general, according to the RAND Corporation, we now pay nearly three times as much for prescription [2:21:12] drugs than 33 other countries in the OECD. You agree with that? For the most common drugs, [2:21:20] we have the lowest prices. All right. I am working on legislation which is not inconsistent with what [2:21:27] Trump has talked about, and that is we should not be paying higher prices for prescription drugs [2:21:34] than people in Europe or in Canada. Is that something, is that a concept that you can support? [2:21:40] Yes, President Trump wants this codified, and you have a lot more power than we do. [2:21:46] You're right. You're exactly right, and that is why I am going to be offering [2:21:51] an amendment to the budget process right now, which would, in fact, codify what Trump is talking about, [2:21:58] that the United States should not be paying higher prices than other countries around the world. [2:22:02] Is that an amendment that you can support and get Republicans to come on board? [2:22:07] We will work with you, but in theory, that's exactly what we want. [2:22:11] All right. Let me ask you another question. We're on the help committee. Casey Means, who is the [2:22:17] Trump nominee for surgeon general, was before us a while back. She agreed with me that TV ads, [2:22:26] prescription drug TV ads in America should be banned. As you may know, [2:22:31] we're one of two countries in the world. Do you agree with that? [2:22:34] Yes. I agree with it in theory. Constitutionally, you can't ban it. But we are now regulating it for the [2:22:47] first time. And you'll see that the ads have changed on TV recently, because we've sent out [2:22:53] a thousand disciplinary letters. You may be right. But I think, [2:22:56] you know, the people who determine the constitutionality of laws of the Supreme Court. [2:23:00] We worked a lot on it because I wanted to regulate it. [2:23:04] Okay. But bottom line is, am I hearing you correctly to say that you would like to see a ban [2:23:09] on prescription drug TV ads? Yes. [2:23:12] Okay. Good. There are a lot of seniors in this country who right now cannot afford dental care. [2:23:26] Many seniors have no teeth in their own in their mouths, can't afford hearing aids. I am introducing [2:23:36] an amendment to the budget process, which would expand Medicare to cover dental, hearing and vision. [2:23:44] Is that something you can support? I'm happy to talk to you about it. I'm happy to work with you on it. [2:23:54] Other question. Right now, we have a diabetes epidemic in this country, an obesity epidemic. [2:24:07] Many parents who would like to buy healthy food for their kids really can't make sense of the [2:24:12] labeling on food products. All right. Other countries in the world are quite clear in their labeling about [2:24:20] the amount of sugar, et cetera, that's in a product. Are you guys making any product, any progress in [2:24:26] coming up with simple, strong labeling on food products? Yes, we are. When will we see something? [2:24:33] Well, the delay in it has been that one of the big enemies, as you point out, obesity is costing 80% [2:24:41] of Medicaid and Medicare dollars. One of the big problems is ultra processed food, and there has been [2:24:47] no federal definition or any useful definition. We've now worked on a definition. There are other, [2:24:54] and here at HHS, we are now, we're in the process of going through the interagency process. There's other [2:25:02] agencies that are equity, USDA, Department of Commerce, OMB, and they are reviewing our regulations. [2:25:09] As soon as we promulgate those, we already have the labeling ready to go. Do you have any sense when that [2:25:14] will be? Excuse me? Any sense when that you'll be promulgating? It has to go, [2:25:19] Senator, through the other agencies that I don't have any control, but we want it to happen quickly. [2:25:25] Thank you. Mr. Chairman, before he leaves, let me agree with Senator Sanders and ask unanimous [2:25:33] consent that an article in the New York Times which shows that there's a higher price for Wegove [2:25:38] on Trump Rx. This is the fact in terms of America, and Senator Sanders has been correct. [2:25:45] Without objection. Senator Warnock. Thank you, [2:25:49] brother chair. Secretary Kennedy, you're here today to defend the president's budget request. In September, [2:25:56] you said that the CDC, quote, will again become the world authority on infectious disease policy. [2:26:05] Do you still stand by that statement? Yes or no? We already are. Secretary Kennedy, [2:26:11] do you know what rabies is? Rabies? Yeah. Do you know what it is? I know what it is. Okay. So [2:26:17] rabies, people contract rabies, as we know, through bites from infected animals like skunks, [2:26:27] foxes, like raccoons. Yeah. And it can devastate a family. When a pet is infected, it is very serious. [2:26:37] It's 100% fatal in humans. Yes. If left untreated. And generally, it's a horrific experience. Staff at the [2:26:48] CDC rabies division in Atlanta, Georgia have historically been able to field emergency calls [2:26:55] 24-7 from providers about complex rabies cases using CDC expertise to determine appropriate care. [2:27:06] Secretary Kennedy, since you and President Trump took office, do you know how many people are left to [2:27:12] staff this 24-7 line? I do not know, Senator. Okay. So the answer is one. So I want you to know that. [2:27:25] There's one person left to staff a 24-7 line to respond to rabies, a disease which left untreated. [2:27:37] You know how many rabies cases there are every year in the United States? [2:27:41] So I'm asking the question. The CDC's infectious disease work has been so decimated under your [2:27:48] leadership that there's only one person left to staff to line and respond to families about this [2:27:52] very deadly and terrifying infectious disease. Let me ask about another disease. Secretary Kennedy, [2:27:59] do you know what prion diseases are? Yes. Yes, I do. Okay. Thanks. And when you think of prion [2:28:06] diseases, one of them would be mad cow disease. Mad cow disease. So and diseases like mad cow disease can [2:28:12] be transmitted from animal meat to humans and it can cause a rapid onset of dementia, challenges with [2:28:22] walking, personality changes and severe insomnia. It's also 100% fatal and there is no cure with people's [2:28:35] brain tissue essentially turning into a sponge before death. Do you know which office at CDC monitors prion [2:28:44] disease? So I do not know. It's the it's the prion and public health office. Do you know what population [2:28:54] is most at risk of contracting the disease? I would say it's people who eat meat from CAFOs. [2:29:04] So so hunters, hunters, prion and public health office is critical in a state like Georgia. [2:29:11] In Georgia, we have a lot of hunters. There are more than 600,000 hunters in my state, [2:29:18] but your budget proposes to eliminate this office. Respectfully, you seem distracted by the secretary. [2:29:27] Why does your budget propose to eliminate the CDC office that focuses on monitoring this deadly infectious [2:29:36] disease? That's especially a risk to rural communities. Why are you proposing to eliminate [2:29:41] the office? You know, there's a lot of cuts at the agency that nobody wants. We have a 39 trillion [2:29:48] dollar debt. We've been asked to cut across the agency 12 percent. I assure you that the 600,000 hunters [2:29:56] in Georgia would want this office. They would want the protection. I assure you that families [2:30:02] that are dealing with rabies or the prospects of that would want to know that somebody is going to [2:30:08] answer the phone when they call. You've come to Congress and justified destroying the CDC [2:30:14] by saying you want to just restore the CDC's mission to focusing on infectious diseases. Yet you're also [2:30:24] gutting the very offices that keep American families safe from disturbing and deadly infectious diseases. [2:30:33] Senator, there's one to three rabies cases a year in the United States. Oh, I think one person [2:30:42] manning that office full time probably can handle that traffic. In terms of prion disease, it's very, [2:30:49] very rare. I beg to differ. Here is the issue, and we see this across the board with CDC. The incredible [2:30:57] folks at the CDC in Atlanta, Georgia, they protect us every day from the threats that we don't see. [2:31:08] And they don't get much credit for it because of the stuff that does not happen. And it's okay for the [2:31:13] general public not to wake up thinking about that. But we expect you to keep Americans alive. And the [2:31:22] cutting that we're seeing, these draconian cuts, for an agency that you said you wanted to restore to be [2:31:28] the leader in infectious disease. Yet you're cutting the coverage of infectious disease. [2:31:33] Personally, sir, even as you seem distracted while I talk to you about deadly diseases, [2:31:38] I think you're dangerous to the American public. And you ought to be fired. And if you're not fired, [2:31:44] you ought to have the decency to resign. You're way above, way in over your head. Thank you. [2:31:50] Senator Marshall. Thanks, Mr. Chairman, and welcome Secretary Kennedy. [2:31:56] Mr. Chairman, it breaks my heart. I want to cry when I see the weaponization of healthcare [2:32:05] used by my colleagues across the aisle. I've never seen so many disingenuous statements, [2:32:13] misleading statements, the outright manipulation of data to meet their political narrative. I've never [2:32:20] seen this before. And again, at stake is people's health, Mr. Secretary. Measles. Two-thirds of the [2:32:32] people that had measles last year were over the age of five. Were you secretary of HHS for people that [2:32:39] over the age of five that decided not to get a vaccine years ago? That decision by those people [2:32:45] predated my appointment. And I think it's 80 percent or over five. And the epidemic or the outbreak [2:32:57] started before I came into office. Yeah. Yeah. So thank you for helping clean up that mess. And [2:33:02] I think about the flu vaccine. Again, the total mismanipulation of data, probably the biggest [2:33:08] challenge with flu vaccines is it's not very efficacious. And I don't know whether it's 20 or 40 [2:33:13] percent good. You get a shot. There's so many different brands and flavors of flu. Are you working [2:33:20] on trying to make a more efficacious flu vaccination? Yes, we are. We're trying to make a universal flu [2:33:26] vaccine that can protect against all strains of flu. In many years, the vaccine is 20 percent effective [2:33:35] or in that range. So we need something that actually works. And that doesn't have to be given [2:33:42] every year. Yeah. And I'm so glad, though, today that my colleagues across the aisle recognized the [2:33:48] failure of Obamacare, pointed out both sides of your hundreds of hospitals closing. But there's no [2:33:56] policies that this Congress has passed that are implemented yet. Our Medicaid policies, which will [2:34:01] increase spending by 50 percent over the next five years or so, have not even taken effect till 20, [2:34:09] 27 for the for the most part. So I think it's an admission that the ACA didn't work, that Medicaid [2:34:15] expansion didn't work. Why do we have failing hospitals now? Well, number one is overregulation, [2:34:23] especially in smaller hospitals. The ACA led to so much overregulation, which leads to consolidation [2:34:28] of industry. The next issue is the depopulation of rural America. We built hospitals with 50, [2:34:34] 100 beds. And now the average census in these rural critical access hospitals is 1.6 patients per night. [2:34:42] So it's just really hard to make a business plan that works like that. But I want to point out and say [2:34:49] thanks to President Trump that our Medicaid provider tax, because that Medicaid provider tax, Kansas is [2:34:57] going to get an extra billion dollars this year, an extra billion with the B dollars. Rural Health [2:35:03] Transformation Fund, 222 million dollars. Doc pay is increased by 2.5 percent as well. So I think that [2:35:13] you have done some great things. I would assume that you have done as much financially for rural [2:35:19] hospitals as any president in American history, any HHS has done. I would agree with that. I think the [2:35:27] Rural Health Transformation Fund is an inflection of money that increases the annual federal dollars to [2:35:38] rural hospitals by 50 percent for the next five years. Yeah. I mean, significant funding out of that [2:35:44] billion dollars I was talking about from the Medicaid provider tax, increased new dollars to [2:35:48] Kansas, of course, will be going to the critical access hospitals, making them eligible for it as [2:35:52] well. And I want to talk about the rural emergency hospital model for a second. This is something that [2:35:59] we worked on really hard in Kansas, saying, what is the alternative? Here's three hospitals in the same [2:36:04] county, two hospitals in the same county, three or four hospitals within a 20 mile radius. [2:36:10] They're each seeing 1.6 inpatients per day. There's just no model that works. So what does work? What [2:36:16] type of healthcare model works in rural America? What's really important to our rural American [2:36:20] healthcare? Well, it's access to primary care, addressing our chronic diseases, but a darn good [2:36:25] emergency room connected with telemedicine to a tertiary care center. That's what's important. [2:36:31] And Mr. Secretary, I want to submit for the record some suggestions that would make it easier for [2:36:37] hospitals to make those transitions to a rural emergency hospital model. And there's some that [2:36:43] you can do. But there's also things that guess what Congress needs to do. Can you just briefly speak [2:36:47] about rural emergency hospitals for a second? Yeah, I mean, submit this for the record, please. [2:36:53] Without objection. And please be brief in your response, Mr. Secretary. I think you're right. [2:36:59] If you can't, if there's one or two patients a day, you can't sustain that, that are going to [2:37:06] stay overnight. But what those hospitals do need is really top rate emergency care. And as you say, [2:37:13] you can now use telehealth to talk to specialists at a centralized hospital who can make sure that [2:37:21] you're getting the best procedures possible. Thank you, Mr. Chairman. Thank you. [2:37:26] And that concludes the senator's questions, except Senator Wyden has asked to make one more brief [2:37:33] question, and then we will wrap it up. Yeah, I saw in the news a little bit ago, [2:37:40] Secretary Kennedy, that a three-year-old girl was sexually abused in a foster home at an agency that [2:37:48] you oversee. Are you familiar with this? No, I am not. You're the secretary of health and human [2:37:57] services, and it's in a national publication. And you didn't know that a three-year-old girl [2:38:03] was being sexually abused on your watch? I can tell you there were tens of thousands of [2:38:10] girls and boys who were sexually abused. The Biden administration lost 425,000 children, [2:38:17] and you never complained. Whose job is it to inform you of something like this? Because this, [2:38:22] to me, is an unconscionable case. Yeah, but why weren't you worried when he lost 425,000 children? [2:38:29] I read this. Why are you suddenly worried? I read this in the newspaper. [2:38:32] Why are you suddenly worried about sexual abuse of children now and trafficking [2:38:37] when it was mass promoted under the Biden administration, where they gave 425,000 children [2:38:44] to adults without identification? Mr. Secretary, I'm asking the questions here, [2:38:48] and this was in a national publication seen by millions of people, an unconscionable example [2:38:55] of mistreatment of a three-year-old, and you don't know anything about it. This is a selective [2:38:59] indignation. I'm just going to say. It's very dishonest, Senator. We have been working on this [2:39:04] for years. Why don't you help us find those children who are lost, still lost? We found 138,000. [2:39:09] We're working on this right now, and we'll have additional opportunities to talk to you. The reality is [2:39:15] that this has been a long hearing, but a particularly important one because the view on so many of these [2:39:23] issues where you basically bob weave and deny, for example, your views on vaccines are toxic. You know, [2:39:31] people are suffering as a result of your discouraging vaccination and American families suffer. And I've [2:39:38] asked you repeatedly to give specifics. We had all these members who are on our legislation, all these [2:39:46] members say that they're concerned about Trump Rx and people not getting fair prices. You could settle [2:39:52] this by giving me tomorrow all the details. Now, if you want to talk about redactions or things like [2:39:59] that, you can do it. But hand it over now so we can get going. And I think- [2:40:04] Why don't you do an agreement yourself? You've had power to do that for 20 years [2:40:08] and haven't done it. And that's why I was forced to do it. [2:40:11] For years, I put big pharma- [2:40:13] Why are you complaining about what I did instead of doing it yourself? [2:40:16] I'm speaking out today- [2:40:18] It's ridiculous. [2:40:19] Because I think this is a sweetheart deal for big pharma. [2:40:22] And the last exchange proves it when you kept saying the drugs were cheaper. [2:40:26] It is selective indignation, Senator. It's all tribalism that's just destroying our country. [2:40:34] It's about public service. [2:40:35] It's not honest. It is not honest. [2:40:38] I yield the floor. [2:40:39] Thank you, Senator Wyden. And Mr. Secretary, thank you for coming. You've spent nearly [2:40:46] three hours here with us. And we appreciate you coming to have this discussion with us. [2:40:51] Obviously, we have disagreements up here on the dais. And I think that you have handled yourself very [2:40:58] well and you've answered the questions very well. I also think you're doing an outstanding job as the [2:41:04] Secretary of Health and Human Services. And I commend you for the results that we are seeing, [2:41:10] as I said in my opening remarks. Before we conclude, I ask unanimous consent that Senator [2:41:17] Grassley's questions be entered into the record without objection to be so ordered. Again, Mr. Secretary, [2:41:24] thank you for coming before the committee today. Members are informed that the questions for the [2:41:29] record should be submitted by next Wednesday, April 29th at 5 p.m. And before I adjourn the committee, [2:41:36] I would like to ask the public to remain seated while the secretary departs. And with that, [2:41:43] the committee is adjourned.