▶ 0:18:45Chair Crapo: The committee will come to order. Today we meet to discuss the president's fiscal year 2020 seven budget for the U.S. department of health and human services. Thank you, secretary kennedy, for joining us. Mr. secretary, last year during your nomination hearing, I noted our health care system was on and in sustainable dysfunctional path. As costs for patients and taxpayers sword, outcomes and access continue to decline.
▶ 0:19:18Chair Crapo: I suggested these challenges presented an opportunity to chart a better way forward. Although much work remains, we have made significant progress. For too long medicaid's financing and programmatic oversight was on autopilot. Coupled with pandemic related increases and costly regulations under the previous administration, medicaid spending -- hear this -- doubled between 2019 and 2025.
▶ 0:19:48Chair Crapo: The working families tax cuts took significant steps to realign our health care system, strengthening access for those in need, putting patients back in charge of their care, and providing overdue reforms to curb waste, fraud, and abuse. The law prohibits coverage of certain noncitizens under federal health care programs. It removes medicaid beneficiaries who are deceased. Enrolled in multiple states or own a home worth over a million dollars.
▶ 0:20:21Chair Crapo: It also requires individuals who are able to work or volunteer or go to school to do so to be able to be eligible for medicaid. A requirement that mirrors similarly intended safety net programs. These commonsense reforms along with policies to prevent financing gimmicks will save taxpayers hundreds of billions of dollars and ensure medicaid's long-term sustainability.
▶ 0:20:51Chair Crapo: Ensuring the programs dollars reach to those for whom it was intended. Under the working families tax cuts, americans will keep more of their hard earned money and have greater control over their health care. The lot expands access to health savings accounts so that patients, not insurance companies cannot can choose the insurance right for them.
▶ 0:21:15Chair Crapo: Individuals with high deductible health plans can also rely on telehealth services without meeting minimum out-of-pocket payments. Republicans also made an historic $50 billion investment in rural health care through the rural health transformation program. Beginning this year, all 50 states are receiving funds from the program which will be used to bolster workforces, invest in connected technology, and promote preventative health interventions.
▶ 0:21:47Chair Crapo: Working in partnership with ranking member wyden, the finance committee delivered on our commitment to bring transparency and accountability to the prescription drug supply chain through pharmacy benefit manager reforms. The bipartisan law will end perverse incentives for pbm's to steer patients toward higher cost drugs and vertically integrate pharmacies. Our work to address anticompetitive consolidation is just beginning.
▶ 0:22:14Chair Crapo: I look forward to continuing these efforts with ranking member wyden and all members of this committee. On a bipartisan basis, we also extended medicare coverage of telehealth and hospital at home services, ensured medicare advantage plans maintain accurate provider directories, and removed medicaid beer is too high quality specialized health care for children. These extraordinary accomplishments will expand choice and lower cost for all americans.
▶ 0:22:45Chair Crapo: Mr. secretary, under your leadership, hhs has also taken sizable steps to fix the failures in our health care system that frustrate both patients and providers. Together with the private sector, the administration is breaking down the bureaucratic obstacles that for too long have been accepted as the norm. Hhs is reducing health insurers cumbersome overuse of prior authorization which routinely delays care delivery.
▶ 0:23:14Chair Crapo: Through trumprx, patients can shop for lower priced drugs of their drugs covered especially by those not covered by those insurance plans. I appreciate your commitment to making america healthy again by empowering patients with the tools and information they need to create a healthier future. Under your leadership, the department has focused on addressing root causes and prevention of illnesses.
▶ 0:23:44Chair Crapo: Now medicare is becoming a system that invests in the whole person, and lifestyle interventions, and in our medical schools are equipping providers with the education to deploy the services. Thank you for that. Mr. secretary, I look forward to learning more about how we can work together to build on the progress we have made in the last year to put patients at the center of our health care system. Now I recognize ranking member wyden for his opening remarks.
▶ 0:24:11Sen. Wyden: Thank you very much, Mr. chairman. Today, we gather to discuss donald trump's health care blueprint for the coming year. Robert kennedy came into the office as health secretary with sweeping promises of restoring the public's trust in government and making americans healthy again.
▶ 0:24:33Sen. Wyden: Now, as the trump campaign pollsters flail about, trying to cover up robert kennedy's devastatingly unpopular anti-vaccine policies, I believe the witness will try to have it both ways.
▶ 0:24:49Sen. Wyden: He will serve enough fakery so that senate republicans ignore the real harm being caused about listing the truth enough so that he can go back to pushing anti-vax policies that make kids sick when he is out of the hearing room. The rank hypocrisy of the trump administration on health can be summed up in a sentence. Goodies for those at the top while american families get sick or in poor.
▶ 0:25:22Sen. Wyden: Donald trump and the secretary are closing up to insurance executives by handing over $20 billion and growing consumer protections in the trash, oregonians now play russian roulette with their health care, actually trying to figure out how they can go without insurance until they qualify for medicare because they cannot afford higher aca premiums.
▶ 0:25:48Sen. Wyden: When donald trump because the sweetheart deals with the big pharma executives, rural america continues to struggle, often because republicans made the largest cut to health care in american history. What these communities are seeing now I believe is only the beginning of how things are going to get worse when the cuts republicans have hidden -- and I have never seen this in all my time in public service. Hiding the details until after the election.
▶ 0:26:20Sen. Wyden: Time and again when republicans are put in charge of america's health care, it's a never ending flood of benefits for special interests while american families get left further behind. Nothing illustrates the trump-kennedy hypocrisy on help more than their approach to prescription drugs. Donald trump spent the last year hosting executives from the big pharma companies in the oval office. He boasted of so-called deals to bring down the price of medicine.
▶ 0:26:50Sen. Wyden: The details, the important facts about these deals are totally secret. My staff spoke with each company involved in these deals. The only thing that is clear is the list of goodies the companies got in exchange. Robert kennedy is here this morning, and he's going to as congress to codify these sweetheart deals site unseen. Let me repeat that. People in congress are not going to see the details about these deals.
▶ 0:27:21Sen. Wyden: So while the american people wait for the cost at the pharmacy to go down, the administration touts trump rx which actually offers higher prices for drugs than what most people to get through their insurance. There is no bigger fraud on the planet when it comes to drug costs and donald trump. Meanwhile, robert kennedy has presided over the biggest cut to americans health care in history. The choice that has already kicked americans off their care, forced hospitals to close, and caused health care workers to lose their jobs.
▶ 0:27:54Sen. Wyden: Since republicans pass that lock on my staff have been thoroughly cataloguing every hospital, every clinic and every health care provider that has shut their doors, reduced services, or laid off staff. So we have the receipts. There have been over 170 closures and service reductions across 34 states. Nearly 7500 health-care workers have lost their jobs across 24 states.
▶ 0:28:20Sen. Wyden: These health-care providers cited the impossible financial challenges caused by the republican medicaid cuts. Mr. chairman, I like to enter into the record our analysis.
▶ 0:28:30Chair Crapo: Without objection.
▶ 0:28:32Sen. Wyden: I recently held a form with health-care workers in rural oregon in a place where donald trump got better than 70% of the vote. What I heard there underscores the reports coming in from around the nation. Health care providers are mocking an economic tight rope and these communities cannot afford to lose the services they are providing. Mr.
▶ 0:28:53Sen. Wyden: Chairman, I like to enter into the record submissions from five states including oregon as well as news articles from around the country that confirm the catastrophe that is playing out on the ground as states contend with the possible task of implementing more than a trillion dollars in cuts.
▶ 0:29:10Chair Crapo: Without objection.
▶ 0:29:11Sen. Wyden: Mr. kennedy is the most senior and influential health care they are in the country. When it comes to vaccines, robert kennedy has used this once-in-a-lifetime platform to make parents doubt themselves and doubt their doctors. 90% of americans infected with measles during this unprecedented outbreak, mostly kids, have not been vaccinated.
▶ 0:29:37Sen. Wyden: It is no coincidence it comes as the person in charge of our country's health care lays out propaganda about vaccines all on the taxpayer dime. The secretary has ducked, bob, and weaved without taking responsibility and saying what needs to be said. Vaccines save lives in america. They keep kids from getting sick. Yet, the secretary will not say it in plain, straightforward terms. He has repeatedly lied before the congress.
▶ 0:30:07Sen. Wyden: First, he lied to me about his trip to samoa. Mr. chairman, I like to enter a report by the guardian and associated press disclosing email between state department officials that make it clear that the secretary was traveling to the island nation to promote his anti-vaccine views.
▶ 0:30:23Chair Crapo: Without objection.
▶ 0:30:25Sen. Wyden: Second, he lied to congresswoman terri sewell by denying that he said that black children should be re-parented if they received treatment for add and adhd. He has continued to lie about the republican cuts to medicaid, claiming there have been no cuts. That is an absurd claim that would get him laughed out of any room in rural america where public officials and health care providers gather to make agonizing choices about payment cuts at this moment.
▶ 0:30:56Sen. Wyden: These lies and misrepresentations underscore why I asked robert kennedy to testify under oath last time he came before the committee. Regardless of whether or not he has taken the oath, you ought to remember that you cannot lie to congress. It is a crime. Our witness will tell the committee this morning that democrats are interested in protecting the status quo. Nothing could be further from the truth. The nation's health care system is broken.
▶ 0:31:23Sen. Wyden: It would only get worse with the republican cuts that the secretary has been cheerleading from the sidelines. Right now, democrats on this side, to a person, are leading an effort to reimagine health care for american families so it is more affordable, more simple, and less beholden to the corporate interests that republicans in power at every single opportunity.
▶ 0:31:47Sen. Wyden: My own take is that if the secretary was serious about making america healthy again, he would work with us on dealing with these issues rather than going to the side of big insurance and big pharma, sweetheart deals. This is an important hearing. I look forward to questions.
▶ 0:32:03Chair Crapo: Thank you. Mr. secretary, we will turn it over to you for your opening statement.
▶ 0:32:09Sec. Kennedy: Chairman crapo, thank you, ranking member wyden, members of the committee, thank you for the opportunity to appear before you today to discuss president trump's proposed 2027 budget for hhs. First, I like to take a moment to express my deepest condolences to your colleague, senator mark warner, over the recent loss of his daughter madison. My thoughts and prayers are with him and his family. We stand at a generational turning point.
▶ 0:32:41Sec. Kennedy: Our children are the sickest generation in modern history and decades of failed policies captured agencies and profit driven systems caused it. Parents across this country demand change and we are delivering it. We are ending the era of federal policies that fueled the chronic disease epidemic and replacing them with policies that put the health of the american people first.
▶ 0:33:05Sec. Kennedy: President trump and I are challenging the status quo and the institutions that defend it as we work to make america healthy again. In just 15 months, hhs has delivered historic wins. We negotiate most favored drug prices with 16 of the largest pharmaceutical companies so that americans no longer pay more than other people in wealthy countries for the exact same medications.
▶ 0:33:31Sec. Kennedy: We are bringing real transparency to health care pricing so that patients know the cost of care before they receive it. I use the full convening power of the federal government to bring health insurance ceo's to the table to reform prior authorization. I brought the 400 largest tech companies together in information blocking so that for the first time americans can get their own health records which they own on their cell phones.
▶ 0:34:01Sec. Kennedy: We are cutting red tape, speeding decisions and demanding transparency. We are also cracking down on waste, fraud, and abuse. This year, hhs and usda issued new dietary guidelines that put real, whole food at the center of the american plate. We flipped and the food pyramid upside down and sent a clear message to the american people, eat real food.
▶ 0:34:26Sec. Kennedy: Hhs has opened the door to partnerships with industry, trade associations, nonprofits, and advocacy groups. More than 50 medical schools have committed to expand nutrition education from an average of two hours to 40 hours. Food manufacturers are stepping up too. More than 40% of the food industry has committed to phase out petroleum-based dyes by the end of the year and many have eliminated them.
▶ 0:34:55Sec. Kennedy: In conjunction with these efforts, fda approved six natural food colorings derive from fruits and vegetables. Through president trump's great american recovery initiative, hhs is matching compassion with action to help americans break the cycle of addiction. At hhs, we are prioritizing patients with ultra rare diseases, their families driving faster access to life-saving treatment. We are restoring gold standard science and integrity across the agency.
▶ 0:35:25Sec. Kennedy: We are protecting children from sex addict and procedures that expose them to irreversible harms. We are eliminating outdated and misleading warning labels on hormone therapies used by women during menopause. We are strengthening organ site procurement. We are regulating television advertisements for pharmaceutical industries, something the democrats have been asking for four generations.
▶ 0:35:54Sec. Kennedy: We are implementing operation warp speed to ensure the quality of infant formula. We are applying that same focus and urgency to rural america. The rural health information fund delivers the largest investment of rural health in our nations history, $50 billion over five years. The strength in rural hospitals ensure americans can access the care they need no matter where they live.
▶ 0:36:19Sec. Kennedy: Hhs is also announcing more than 135 millionth dollars of investment this month to expand rural residency programs and nutrition services. The data is clear, when physicians trained in rural communities, they are far more likely to stay and serve their. The president's budget puts all of these priorities in action. It invests in prevention because preventing disease cost less than treating it.
▶ 0:36:47Sec. Kennedy: As my uncle president said, progress is a nice word, change is his motivator. Change has its enemies. We see those forces clearly entrenched interests, the vendors of a failing status quo, and institutions that put profits ahead of the american people. The resistance underscores the urgency of this moment.
▶ 0:37:15Sec. Kennedy: We can reverse chronic disease, improve public health, and lower cost. 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, our children, and for the health of the american people. Today, we can make america healthy again. Thank you, Mr. chairman.
▶ 0:37:39Chair Crapo: Thank you, Mr. secretary. I believe 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 you have done among the many that you described in your testimony. In that context, in your testimony, you identified nutrition as a bedrock of help.
▶ 0:38:07Chair Crapo: One of the primary levers for treating and preventing chronic disease, you also emphasize that it is imperative for our nations health care providers to be equipped to incorporate nutrition into patient care. Securing commitments from more than 50 medical school to provide at least 40 hours of nutrition education is an incredible start. I don't think it was very long ago that there was probably very little nutrition taught in medical school.
▶ 0:38:36Chair Crapo: Now we are encouraging that to be a focal point. How does hhs plan to build on this progress by securing additional commitments from medical schools and expanding nutrition education into other key areas such as residency training, medical licensing, and continuing medical education?
▶ 0:38:53Sec. Kennedy: Thank, chairman. We are expanding the number of medical schools. There are already many others that have signed on since the original 54. We are working with the states, more than half the states on a maha legislative plan, where more than half of the states have required -- passed legislation requiring nutrition education and continuing medical education.
▶ 0:39:28Sec. Kennedy: We have issued notices to all the hospitals in america that they must start serving nutritious foods in the hospitals. The food before that has been appalling. They are giving diabetic patients j. Lo, custard, and a soda drink. If they want to continue to get medicaid dollars, they need to change that now.
▶ 0:40:00Sec. Kennedy: We are driving good nutrition through the wic program, through snap, through school lunches, through the indian tribal services and other federal subsidies programs as well.
▶ 0:40:13Chair Crapo: Thank you very much. I will tell you that I, for one, deeply appreciate that strong focus on helping us get focused on nutrition. It was a sad thing that our society had not focused on it as well as it should have until now. Republicans established the rural health transformation program in the working families tax cut act to strengthen and modernize our nations rural health care delivery system.
▶ 0:40:45Chair Crapo: We do have a problem in the rural health care system. With this funding, we are hoping that state will be able to implement comprehensive strategies that not only expand preventative primary, maternal, and behavioral health services but also create new access points that bring chair closer to home and stabilize our challenged rural hospitals. All 50 states received their first year awards ranging from 147 million dollars to 280 $1 million.
▶ 0:41:15Chair Crapo: What do you think are some of the most innovative ways that states will not be able to work to transform their rural health care networks?
▶ 0:41:21Sec. Kennedy: The applications from the states were really extraordinary. We were astonished how resourceful and imaginative they are. Among the most common applications were to maximize the use of ai in diagnostics, health delivery, and also in
▶ 0:41:53Sec. Kennedy: Billing, management of the systems. A lot of the money is being spent on telehealth which is going to bring deliverable health care too many areas that are particularly remote in this country, places like wyoming, alaska, others, where health care is sadly not accessible.
▶ 0:42:18Sec. Kennedy: A lot of the application for residency programs and worker recruitment, retention, and badly needed infrastructure repairs. We have lost more than 120 hospitals in rural areas since 2010. It's a crisis. When they lose that hospital, they are not just losing access to proximate health care, they are also losing the greatest economic driver in many of these communities.
▶ 0:42:49Sec. Kennedy: In many cases, the greatest employer, the highest pay for their workers, and when they close, businesses stop moving to the area. It's absolutely critical that we keep those hospitals open. That is why this plan raises by 50% the infusion of federal dollars flowing into rural areas in this country.
▶ 0:43:15Chair Crapo: Thank you very much be my time has expired. I want to stay at these five minutes, trying to set a pattern for the rest of the committee. I had questions on telehealth and innovation and ai as well as waste, fraud, and abuse. You anticipated many of those in your answer. Senator wyden.
▶ 0:43:34Sen. Wyden: Thank you. Mr. secretary, it sure looks to me that the president is working very hard to muzzle you on the issue of the vaccine question. It is very clear. You were mentioned at the state of the union address.
▶ 0:43:51Sen. Wyden: The pollsters that the president has found that 87% of all voters support the childhood vaccine for measles and hepatitis b, but at the same time, your hand pick people at hhs voted to end the universal recommendation of hepatitis b vaccine for every newborn. My question to you is, we are seeing with measles, vaccine problems all over the country, putting infants at risk like this.
▶ 0:44:20Sen. Wyden: It is so dangerous that a court even blocked your new policy from taking effect. Why would you be doing something that is so awful for kids on this vexing issue? I know it's been your life work, but you promised you would do differently when you came for your confirmation hearing.
▶ 0:44:37Sec. Kennedy: Senator, under my leadership, we handled the measles outbreak better than any country in the world. It's a global outbreak. Mexico has three times the amount of measles. They have one third of our population. Canada has twice the number of measles, 1/8 of our population. We have about 1700 cases this year. 2200 last year.
▶ 0:45:07Sec. Kennedy: Europe had 33,000 last year, 127,000 the year before. There are populations I don't want to vaccinate. Mennonites do not want to vaccinate. They have not vaccinated since 1797. It has nothing to do with me. I have not visited mexico or europe. I had nothing to do with the measles outbreak here.
▶ 0:45:31Sec. Kennedy: We have limited our outbreak better than any country in the world because I have talked to governor abbott, governor mcmaster. We send the epidemic intelligence services into their region when they need it immediately and we give them the help we can to end the pandemic. There will be people who do not vaccinate. Vaccination levels dropped during covid because people stopped trusting the american government.
▶ 0:46:01Sec. Kennedy: I am here to restore that trust.
▶ 0:46:03Sen. Wyden: 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. Hepatitis b is a serious lifelong illness that leads to liver failure, liver transplants. There is no cure. As of december, you are still appointing people who are trying to undermine that policy. That is not in the interest of families.
▶ 0:46:30Sen. Wyden: That is why the president's pollsters are telling him to isolate you and keep you from talking about it. We are going to make sure the truth gets out. I am going to move on now. I'm asking the questions, Mr. secretary. Moving on to the drug pricing question and disclosure of these deals. These secret deals with pharmaceutical companies set up a never ending flood of goodies for big pharma to for big pharma .
▶ 0:46:58Sen. Wyden: The ceo of pfizer stood in the oval office with president trump and the stock price soared through the roof. Pfizer will get a blanket exemption and all of their drugs are exempt from trump's latest scheme to align medicare prices with those with other countries. It doesn't seem to me that the american people get a whole lot from this. Every democratic member of our committee is demanding that you disclose the deals, the specifics.
▶ 0:47:29Sen. Wyden: The public has the right to know about something of this consequence. Every single democrat up here wants to see this. This is a transparency issue. 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 that the deals were so good, why is the trump administration trying to hide them?
▶ 0:47:56Sen. Wyden: My question to you is, yes or no -- this is a yes or no question reflecting the interest of our colleagues here. Will you commit to releasing your written agreements with pharmaceutical companies tomorrow?
▶ 0:48:08Sec. Kennedy: No, I will not. I can explain why. Those agreements contain proprietary information and trade secrets. When you passed the inflation reduction act and ordered me to negotiate with the pharmaceutical companies, you put in a provision that required nda's because nobody is going to come to the table with me if I start releasing proprietary information.
▶ 0:48:36Sec. Kennedy: You seem to be saying that we were paying the highest prices for drugs in the world. You seem to be arguing that. Now we are the lowest. We have dropped by 83%. We have dropped glp's by 89%. Insulin, copd drugs, asthma drugs. Now they are paying the lowest cost in the world rather than the highest. You want to go back on that? You can do this better than us.
▶ 0:49:06Sec. Kennedy: We did it because you didn't act. You have a lot more power to negotiate than we do. Why don't you just do it? You have been promising to do it for 20 years.
▶ 0:49:15Sec. Kennedy: Mr. secretary, we are going to do it, but when you try to hide the information on consequential issues that you are doing on these trump rx things, it makes it harder for us to make marketplace forces. You are in bed with big pharma.
▶ 0:49:31Sec. Kennedy: You don't have secret meetings here in congress all the time every day?
▶ 0:49:37Chair Crapo: Senator scott.
▶ 0:49:41Sen. Scott: Good morning. Secretary kennedy, I want to start out by thanking you for everything that you, hhs, cdc did, truly an incredible job helping south carolina throughout our measles outbreak. South carolina has experienced the largest outbreak in U.S. history since measles was declared eliminated more than two decades ago.
▶ 0:50:08Sen. Scott: 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, I know without a question we would not be on the right side of this outbreak without your leadership and without your help. South carolina is indebted to your leadership. We really appreciate that.
▶ 0:50:33Sec. Kennedy: Thank you, senator.
▶ 0:50:36Sen. Scott: I'm hopeful that in a few days on april 26 we can declare the outbreak long and gone as long as there are no new cases. That is a big deal for a state that has been suffering for months, months through this challenge. Thank you. It is thanks to your leadership and leadership of the folks I mention from cdc to hhs to our folks on the ground that this day is finally come.
▶ 0:51:08Sen. Scott: While it is hard to find positives, really hard to find a silver lining through this process, if we did, it is early detection matters a lot. The more time we spend on figuring out how to get ahead of it, the better off we will all be in the future.
▶ 0:51:28Sen. Scott: That is why last month, I along with several of my senate colleagues, introduce the predict act, to strengthen and expand wastewater surveillance. When someone is infected with the flu, they shed viral material often before they even aware they are sick. Cdc work through the sequencing of positive wastewater samples from 20 wastewater sites, testing for measles in south carolina.
▶ 0:51:56Sen. Scott: This critical work highlights the best kind of government, one that works in the background on prevention, saving lives using smart science. 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.
▶ 0:52:18Sen. Scott: By utilizing these tools and monitoring the spread of disease early, public health officials can see and outbreak coming days or weeks before hospital admissions begin to rise, and take steps to intervene when time is truly of the essence. 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.
▶ 0:52:49Sen. Scott: 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?
▶ 0:52:58Sec. Kennedy: Absolutely. Thank you for your kind words on the management of the measles. I just had a wonderful interchange with governor mcmaster.
▶ 0:53:21Sec. Kennedy: I want to thank all of the health department in south carolina for the hard work they did with cdc to end the outbreak. I will absolutely work with you on the predict act. It is something that is personally important to me, having more wastewater surveillance.
▶ 0:53:40Sec. Kennedy: We are also putting $325 million in this budget into a new bio threat radar system that will integrate with the microbial surveillance and wastewater treatment plants to detect pathogens as soon as they emerge in our country and elsewhere in the world.
▶ 0:54:01Sen. Scott: Your new system, the bio threat radar system, strengthens outbreak protection. I think it would be a perfect fit for us to take this predict act and put it under that umbrella so to speak.
▶ 0:54:14Sec. Kennedy: I look forward to working with you, senator.
▶ 0:54:17Sen. Scott: For those unaware of south carolina's negative impact on measles, it was the largest outbreak, thousands of cases. It was a response, all of government response, where we saw hhs, cdc, the secretary working together. I know we have disagreements on this dais, but when you need help and they show up and is effective, you should take the time to say thank you.
▶ 0:54:45Sec. Kennedy: Thank you very much, senator.
▶ 0:54:47Chair Crapo: Senator bennet.
▶ 0:54:51Sen. Bennet: Thank you, Mr. kennedy, for being here again. For decades, parents in this country could send their kids to school without worrying about whether they might come home with a dangerous case of the flu or a dangerous case of the measles, as my colleague from south carolina is saying. Last year, we saw the largest number of children die from the flu in modern history. Are you familiar with that, Mr. secretary?
▶ 0:55:17Sec. Kennedy: Yes, I am.
▶ 0:55:20Sen. Bennet: Have you told president trump about that, that last year was the largest childhood debt of flu in american -- modern american history?
▶ 0:55:29Sec. Kennedy: That is one of the reasons that fda just approved two new vaccines for influenza a and influenza b.
▶ 0:55:37Sen. Bennet: 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?
▶ 0:55:46Sec. Kennedy: In the old days, we have hundreds of thousands.
▶ 0:55:50Sen. Bennet: Of course. Do you agree that 89% of the children who died from flu were unvaccinated?
▶ 0:56:01Sec. Kennedy: I don't know the exact number.
▶ 0:56:04Sen. Bennet: That is the exact number, Mr. kennedy. I think it interests a lot of people in america that you took down the communications from hhs on the importance of getting a flu vaccine when you first became a secretary. I just wondered whether you regret having done that? You are now saying that you are approving vaccines for the flu.
▶ 0:56:32Sec. Kennedy: I have approved lots of vaccines. I have spent a billion dollars approving, developing new vaccines including a universal flu vaccine. Last year, the flu vaccine had something like a 20% efficacy. Having these single antigen vaccines is not serving the public interest. They simply don't work.
▶ 0:57:00Sen. Bennet: For the record, Mr. secretary, I assume you number u no longer believe that the flu vaccine is destroying children's brains. There is no evidence that it causes any hospitalizations or deaths. Today you are agreeing that the vast majority of kids that died from the flu were people without vaccines, and you are saying that you are now approving vaccines.
▶ 0:57:26Sec. Kennedy: We are making sure we follow the science.
▶ 0:57:29Sen. Bennet: I hope you follow the science because that is what put us in the position 30 years ago of essentially having measles declared at an end in the united states of america.
▶ 0:57:43Sec. Kennedy: Many nations have lost their elimination status including the u.k., canada, a lot of europe this year because of the outbreak.
▶ 0:57:53Sen. Bennet: I know you said the outbreak has nothing to do with you, that was your answer to ron wyden. You are the head of the agency.
▶ 0:58:05Sec. Kennedy: My agency has no jurisdiction over canada, mexico.
▶ 0:58:09Sen. Bennet: I would agree with that. I think everyone on this dais believes that the united states of america ought to be leading in these matters. That is why we are so discouraged by your cuts to nih. That is going to make it harder for us to lead. That is why we are so discouraged by your cuts to medicaid that are making it impossible to invest in rural america.
▶ 0:58:32Sec. Kennedy: There are no cuts to medicaid, senator, as you know.
▶ 0:58:37Sen. Bennet: That is absolutely --
▶ 0:58:41Sec. Kennedy: Look at the congressional budget office. They say we are increasing medicare by 40% over 10 years. That is not a cut except in washington.
▶ 0:58:52Sen. Bennet: It is a cut when it comes to rural hospitals all over america that are having to close because of the medicaid cuts, and those are real dollars. Let me just ask you. Do you realize, last year, the united states had the highest number of measles cases in 30 years? The last time we had more than that was before the measles.
▶ 0:59:23Sen. Bennet: We were the leader, Mr. kennedy.
▶ 0:59:24Sec. Kennedy: We still are. We have a 92% vaccination rate. We have one of the highest vaccination rates were measles on earth.
▶ 0:59:32Sen. Bennet: Let me ask you, are you taking the position, as your cdc director has taken, that the measles vaccine is vital to keeping american children healthy in this country? Are you taking that position today? That has not been your position.
▶ 0:59:51Sec. Kennedy: That is my position. We promote the measles vaccine.
▶ 0:59:55Sen. Bennet: Thank you. I hope you will go out to america and promote this. The idea that you have nothing to do with this is dead wrong.
▶ 1:00:03Sec. Kennedy: 97% of the people who take it. That is always what I've said the science says.
▶ 1:00:09Sen. Bennet: I would ask you to underscore it because there is a reason we are having these outbreaks from Mr. chairman, and that is the misinformation that has been propagated. That is excellent, let's get it out there to the american people.
▶ 1:00:22Chair Crapo: Senator lankford.
▶ 1:00:26Sen. Lankford: Mr. kennedy, good to see you again. Thanks for your work on this. You have been one has spoken out often on vaccine issues, providing clarity in this area. Appreciate your engagement on this lately. I want to talk about pharmacy benefit managers. This has been an issue that we have talked about before, we talked about often around this dais.
▶ 1:00:49Sen. Lankford: We have passed a piece of legislation that de-links the price between firms a benefit managers and the price of the drug. Exceptionally helpful to work toward the consumer, anyone pharmacy. Pbm's have been fighting to destroy our independent pharmacies around my state and around the country. We are losing more than one pharmacy a day now around the country, because of what pbm's are doing to them in the compensation structure, the way they do the scoring on this.
▶ 1:01:19Sen. Lankford: I appreciate that. That law has been passed. We want to continue to work with your team on the limitation and any question that your team may have, anyway that we can help in the process. We want to stay engaged on this because this is been a passion for us for a while, I know it interest for you as well.
▶ 1:01:38Sen. Lankford: Senator maggie hassan and I have a piece of legislation that takes another step on this dealing with the pharmacy benefit managers, and that is this issue of tearing -- tiering that has been out there. When a drug is released at the generic level, it is actually put on that tear to be sold. You and I know that that is not happening.
▶ 1:01:59Sen. Lankford: We are 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 bio similar is put out there, he needs to be put on the lower tier cost and not put up on the more expensive brand cost because that will drive the generic out of business. The brands know that. We want to push back against that.
▶ 1:02:20Sen. Lankford: I would ask for your help and your teams help on technical assistance so we make sure we get the language right so whenever we can get this passed and the tiering issue, we can get that in force as quickly as possible.
▶ 1:02:32Sec. Kennedy: Thank you, senator lankford, for your leadership on this issue. It's been a long time coming. It's a bipartisan issue. I think the biggest fix as you point out was delinking the compensation to the pbm's, the list price of the pharmaceutical which created a perverse incentive of having them choose.
▶ 1:02:57Sec. Kennedy: They are supposed be looking out for our interests but the highest cost pharmaceutical would net them the most profits, so they were giving us a higher cost rather than lower cost. There are couple pbm's that are now -- david has taken the lead in expanding transparency so the industry has a template for doing this, but we need to keep working on this.
▶ 1:03:30Sec. Kennedy: To ensure that to the extent that they are working in a system, that they are doing what they were meant to do which is to lower costs for consumers rather than raise it.
▶ 1:03:39Sec. Kennedy: That is our target, as well. I have told pbm companies, I'm not opposed to your company's, I'm just opposed to you shutting down independent pharmacies and raising prices for consumers. That is the biggest issue that is out there. We want greater access, not less. I want to sweep to something that you and I have spent time talking about, continuing to rise, the rise of assisted suicide.
▶ 1:04:05Sec. Kennedy: Three states, colorado, california, vermont, where disability groups are filing charges against some of the assisted suicide laws. It seems to target those with disabilities. The americans with disability act passed in 1990. That act has worked to protect those with disabilities, not incentivize them to take their own lives. This is an ongoing conversation. My question for you today is, is hhs engaging -- some of these losses are with the states.
▶ 1:04:37Sec. Kennedy: What is hhs doing to be able to protect those with disabilities that may be targeted by these assisted suicide laws?
▶ 1:04:44Sec. Kennedy: To me, I think those laws are abhorrent. We see it in canada today, the number one cause of death is assisted suicide. As you say, it targets people with disabilities and people who are struggling in their lives.
▶ 1:05:08Sec. Kennedy: I don't think we can be a moral society if we could be a moral authority. That becomes institutionalized around our societies. I'm happy to work with you in whatever way we can.
▶ 1:05:21Sec. Kennedy: We have now seen a rise of people with eating disorders that are given access to assisted suicide. It is wrong. One quick statement. We will follow up I'm writing. Oklahoma is to pursuant to title $10 the lighted adventures and took away from my state because we would not promote abortion in the state, so they removed title x funding for us, about $9 billion.
▶ 1:05:46Sec. Kennedy: We will follow up on that as well that we are trying to get access to those dollars the biden administration tried to punish my state.
▶ 1:05:52Sec. Kennedy: We will work with you to fix that.
▶ 1:05:54Chair Crapo: Senator hassan.
▶ 1:05:58Sen. Hassan: Take you come Mr. chair, senator wyden for holding this hearing. Secretary kennedy, thank you for being here this morning. 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 soul promotion using official government channels and resources. Hhs produced a video of you and kid rock exercising and drinking milk in a hot tub.
▶ 1:06:27Sen. Hassan: I think at his pretend white house. Another official video features a dramatic sequence of you as a shirtless wwe fighter. You also posted a video on government accounts that the pix you as a video game hero. You 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.
▶ 1:06:54Sen. Hassan: Does the president know about this cell promotion campaign you are carrying out? Using resources?
▶ 1:07:01Sec. Kennedy: I didn't know about a number of those videos.
▶ 1:07:05Sen. Hassan: They have all come out in the last six weeks, couple months.
▶ 1:07:09Sec. Kennedy: I happen to not see them.
▶ 1:07:12Sen. Hassan: So you don't know how your own team is managing official U.S. resources and promoting you in the process. So the president has not authorize you to use hhs resources for these vanity projects.
▶ 1:07:26Sec. Kennedy: I was asked the other day about one of the senators, the kid rock video, how much it cost the U.S. government. I asked my team. They said zero.
▶ 1:07:37Sen. Hassan: Interesting. You were at kid rock's home. Did the president authorize you to use official hhs resources for these vanity projects? Have you discussed with the president, did he authorize them?
▶ 1:07:52Sec. Kennedy: Never discussed with the president.
▶ 1:07:55Sen. Hassan: 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 vaccine committee in june of 2025?
▶ 1:08:08Sec. Kennedy: Did I talk to him directly? We talked to the white house dpc.
▶ 1:08:18Sen. Hassan: 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 commission members?
▶ 1:08:39Sec. Kennedy: Yes, he did.
▶ 1:08:41Sen. Hassan: You also made changes to the vaccine committee charter just two weeks ago. It appears to get around the federal court decision that said you had improperly disbanded the vaccine committee. Did president trump authorize you to do that?
▶ 1:08:56Sec. Kennedy: Dpc did. Domestic policy council, which is in the white house.
▶ 1:09:06Sen. Hassan: You discussed with the president --
▶ 1:09:09Sec. Kennedy: I don't know if it was elevated to the presidential level.
▶ 1:09:13Sen. Hassan: You are 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 and you haven't not discussed it with the president? I'm asking these questions because it appears to me, you are focused on promoting -- this is my time, sir.
▶ 1:09:40Sen. Hassan: I'm asking these questions because it appears to be that you are focused on promoting yourself over everyone else, promoting your own theories over actual scientific inquiry, promoting your own unqualified lackeys over doctors and scientists, and promoting images where you think you look cool rather than messages that will help people live healthier lives. It is always about you and building a platform for yourself, which means it is never about the american people or public health and safety.
▶ 1:10:10Sen. Hassan: I will move onto my next question. Do you believe -- you answered questions and I drew those conclusions from your answers. That is why I have time on the dais and you do not. I agree with you that all americans should have access to healthy food. However, president trump has made it far harder for families to afford their groceries. As I'm looking at my time, so I will hold this question for the next hearing where I will see you this afternoon.
▶ 1:10:40Sen. Hassan: Thank you.
▶ 1:10:41Chair Crapo: Senator cortez masto.
▶ 1:10:46Sen. Cortez Masto: Thank you. Let me keep in the line about the conversation about whether the president understand what you're doing here. Just yesterday there is an article in the wall street journal, colleges versus the fda.
▶ 1:11:02Sec. Kennedy: I cannot hear you, senator. Sen. h>> under your administrat, the lifesaving drug for metastatic melanoma has not been approved. In fact, you have been asked about this in hearings. According to the article in the review journal -- I want to give you an opportunity to correct some of this.
▶ 1:11:32Sec. Kennedy: You said every panel within the fda, all the career panels, career scientists who looked at the drug said it was not effective. According to the wall street journal, that wasn't true. The initial panel recommended approval. Secondly, when you sent a rejection letter, you said it was a one armed trial. Also received chemotherapy drugs, so we don't know what the effect was.
▶ 1:12:03Sec. Kennedy: Again, the fact-check, no patients in the trial received chemotherapy. Let me also reiterate, oncologists in this country who treat patients with cancer, lifesaving drugs, are asking and anticipating that this drug would be approved. 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?
▶ 1:12:34Sec. Kennedy: Does the president understand that your decision that you are making is preventing oncologists in this country from treating cancer patients with lifesaving drugs?
▶ 1:12:44Sec. Kennedy: First of all, I had nothing to do with the decision. The decision comes out of the fda. We trust the process there. I have been told by marty mcgarry that every panel looked at that drug, unanimously voted against it. They voted against it because it does not appear to work because the trial was a one armed trial.
▶ 1:13:08Sen. Cortez Masto: Clearly, that is misinformation. Mr., why would you prevent the opportunity for lifesaving drugs for individuals?
▶ 1:13:20Sec. Kennedy: That is a great question. Why would I?
▶ 1:13:24Sen. Cortez Masto: I will ask you to take a second look at it. My next question for you, Mr. kennedy is this. Let me just say -- I appreciate your comments earlier and this demonstration going after waste, fraud, and abuse. The health care fraud and abuse program is important. I've been calling for more funding for it. I think it's essential that it has the dollars that it needs to go after health care fraud.
▶ 1:13:55Sen. Cortez Masto: But let me ask you this, as we are fighting for funding to go after health care fraud, this president has actually hardened at least -- parted at least two people convicted of health care fraud in the first year of this administration. 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.
▶ 1:14:24Sen. Cortez Masto: Someone who defrauded medicare for hundreds of millions of dollars, he no longer faces consequences and wiped out 87 one million obligation in restitution and fines. Have you talked to the president about the fact he is actively undermining your agency's work to combat fraud?
▶ 1:14:40Sec. Kennedy: The president doesn't consult me on his pardons. I don't know anything about that case. What I do know is during the biden administration, they purposefully opened the door for hundreds of billions of dollars --
▶ 1:14:56Sen. Cortez Masto: I am talking about -- let me move on. I will tell you the reality of my state, Mr. secretary, respected the medicaid cuts. Effective may 1, 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 their current designation as a critical access hospital.
▶ 1:15:23Sen. Cortez Masto: According to the ceo, it is because of the financial constraints exacerbated by the upcoming medicaid provider tax cuts due to hr one. 71 people will lose their jobs because of hr 1 and this medicaid cuts. This is going to be devastating for so many and this is the first we are seeing in my state.
▶ 1:15:46Sen. Cortez Masto: My question to you is, what are you going to do to make sure our rural communities are not left in a health care desert without a reasonable way to access those services?
▶ 1:15:56Sec. Kennedy: We are putting the largest investment and history into rural hospitals. There is never been anything like it.
▶ 1:16:06Sen. Cortez Masto: That is not true for many. So you don't have an answer.
▶ 1:16:09Sec. Kennedy: Rural hospitals are closing pray to Sen. cortez
▶ 1:16:13Masto: I know my time is up.
▶ 1:16:14Sec. Kennedy: Long before president trump got in here.
▶ 1:16:17Chair Crapo: Senator daines.
▶ 1:16:19Sen. Daines: Thank you. Secretary kennedy, welcome. It is good to see you here. Since you were first nominated, it is been your goal and the president's to make hhs the gold standard of science. I appreciate your sincere commitment to that goal and the role you are playing in restoring america's leadership in scientific rigor, transparency, and public health.
▶ 1:16:49Sen. Daines: Before I get into more specific public health question I want to follow up on the exchange you just had about rural health care in our country. In montana, we think of montana you think rural. We love that about our state. I want to build on what you just said, Mr. secretary.
▶ 1:17:07Sen. Daines: There was a transformative $50 billion investment that senate republicans made in working with the trump administration to strengthen health care across rural america and are working family tax cut bill. $50 billion following a competitive application process.
▶ 1:17:31Sen. Daines: Montana has received 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. Mr.
▶ 1:17:51Sen. Daines: 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?
▶ 1:18:02Sec. Kennedy: And I would refer in my answer to this editor's visit -- senator's criticism, hypothesis that some future medicaid is closing hospitals. Right now medicaid pays about 7% of the end total to rural hospitals. About $20 billion a year to all the rural areas in our country.
▶ 1:18:34Sec. Kennedy: We have increased influx of federal dollars by an extra $10 billion a year. It is astronomical. 50% rise in the money rural hospitals are getting traditionally from medicaid. First of all, we are not cutting medicaid and they keep saying we are but the congressional budget office says we are raising at by 47%.
▶ 1:18:59Sec. Kennedy: In addition to that, this find is putting an unmatched low a federal dollars into those hospitals. President trump cares. We have got to keep rural america alive and you cannot do that without local health care.
▶ 1:19:20Sen. Daines: I met with hospital administration or's ceos came into my office and we were talking about enthusiasm, excitement they had about what is happening right now is you just articulated. The fact you're are also going after the fraud that is occurring right now in these programs -- we want the right people come the fraudsters removed. I appreciate your leadership on that. That is delivering real results.
▶ 1:19:50Sen. Daines: I want to go back to my earlier comment and I want to continue the conversation we had around what hhs is doing to apply the principles of safety for the american people and relates to the federal regulations on mifep ristone. You said there is a comprehensive safety review and encourage you do see that review through completion guided by the best available data.
▶ 1:20:19Sen. Daines: Some events we already have today points to some serious real-world consequence as it relates to safety for women. We know about the outcomes the baby, I'm talking about the outcomes to women. There was an analysis of over 865,000 mifesteprone prescriptions compiled from insurance claims found 11% of women experienced a serious adverse event.
▶ 1:20:46Sen. Daines: It typically means going to the er, serious medical care required. Within 45 days of taking mifesteprone. That is 22 times higher than the fda's long-standing estimate of less than .5%. In the first half of 2025, over 27% of all abortions in the U.S. were chemical abortions, provided by online clinics. That number continues to grow.
▶ 1:21:17Sen. Daines: Giving the fact there is a lot of disturbing data that already exists, will you implement interim safeguards as well as look at reinstating the in person dispensing requirement until the full safety review is completed?
▶ 1:21:33Sec. Kennedy: Regrettably, senator daines, I cannot comment on that because of the litigation I have been advised by the office of general counsel not to talk about it.
▶ 1:21:43Sen. Daines: I can --
▶ 1:21:47Sec. Kennedy: I have read the study.
▶ 1:21:50Sen. Daines: The adverse effects are 22 times what the fda had on the label. We want to see action taken because women are being harmed by mifesteprone.
▶ 1:22:03Chair Crapo: Senator warren.
▶ 1:22:06Sen. Warren: After president trump and the republicans slashed health care for millions of families, the president pitched his trump rx website as the answer for americans are worried about health care costs. It claims that trump rx has reduced prices by as much as 600%. Which I think means companies should be paying you to take their drugs.
▶ 1:22:35Sen. Warren: But let's do some real math here. Take one drug, a 30 day supply of this harper medication costs $200 on trump rx but there is an identical generic version of this bill -- pill. Do you know how much it costs for a 30 day supply of the generic drug at costco?
▶ 1:23:02Sec. Kennedy: No, but I would say at -- president trump has a different way of calculating their two of calculating percentage. If it was a $600 drug and you reduce it to --.
▶ 1:23:19Sen. Warren: I only have five minutes. You know it it costs at costco?
▶ 1:23:23Sec. Kennedy: I do not.
▶ 1:23:26Sen. Warren: $16 at costco. Trump rx charges $200 for the drug and costco charges $16. Let's do another one. A treatment for heart arrhythmia costs $336 on trump rx or you can get the generic at cost plus drugs for $12. So you tell me, Mr.
▶ 1:23:54Sen. Warren: Secretary, our patients better off paying $336 on trump rx or $12 at cost plus drugs?
▶ 1:24:03Sec. Kennedy: You are comparing apples to oranges. You're comparing the brand drug to the generic drug.
▶ 1:24:11Sen. Warren: To the exact same drug.
▶ 1:24:14Sec. Kennedy: Will people should be buying the generic.
▶ 1:24:18Sen. Warren: The exact same. Tell me, Mr. secretary, think people ought to be paying $336 instead of $12?
▶ 1:24:27Sec. Kennedy: A lot of doctors prescribe the brand. We are giving them 600% reductions on the brand. We will be directing them to the generic whenever it is available.
▶ 1:24:40Sen. Warren: Here's the thing. We know about brand names versus generic. It is a big pharma talking point in order to fool people into buying more expensive drugs. Generic is chemically the same. Here's the thing, if you are buying a drug on trump rx, there is a more than one in four chance that trump's discount is actually a price hike.
▶ 1:25:09Sen. Warren: And for an anti-big pharma guy, you don't seem worried about steering patients to more expensive drugs that are going to pad big pharma's profits. But there is more in this deal. In exchange for these scam discounts, president trump has exempted these drug companies from his 100% tariffs. Big pharma makes billions of dollars in tariff relief by listing their drugs on trump rx.
▶ 1:25:39Sen. Warren: And then they don't even lower the costs on many of these drugs. That is a great deal for big pharma. Secretary kennedy, here's my question. Did you sign off on these sweetheart deals for big pharma or was this all president trump's idea?
▶ 1:25:55Sec. Kennedy: The tariff is only applicable if the company has agreed to produce the drug in america. They have won your to do so. And they don't get the tariff relief and then it is going to bankrupt them.
▶ 1:26:13Sen. Warren: You're the one that negotiated these? You negotiated these deals? We make these deals available to us so we can see them?
▶ 1:26:19Sec. Kennedy: I did not personally negotiate them.
▶ 1:26:25Sen. Warren: Did your team?
▶ 1:26:25Sec. Kennedy: Yes.
▶ 1:26:28Sen. Warren: We make them available? A little transparency?
▶ 1:26:32Sec. Kennedy: I am happy to make the deals available except for proprietary and trade secrets.
▶ 1:26:40Sen. Warren: I will hold you to that, Mr. secretary, because of these deals with big pharma are so great for americans, that we should be able to see what promises have been made.
▶ 1:26:48Sec. Kennedy: You have the power to make this deal yourself. We did this because you refused to do it.
▶ 1:26:56Sen. Warren: What we have is trump --.
▶ 1:26:58Sec. Kennedy: You have a lot more power to negotiate than we do. The lowest prices in history.
▶ 1:27:06Sen. Warren: You and donald trump are actually making the problem worse. The american public deserves better.
▶ 1:27:10Sec. Kennedy: Millions of people are using trump rx disagree with you. I said they millions of people using trump rx disagree with you.
▶ 1:27:25Sen. Warren: One out of four chance at paying more at trump rx that if they went to cosco. That is not much of a deal for the american people.
▶ 1:27:30Sec. Kennedy: Not branded drugs.
▶ 1:27:35Sen. Warren: So your answer is americans should just not take prescription drugs?
▶ 1:27:38Sec. Kennedy: We will be directing people to generics, the cheapest available but a lot of doctors prescribe their brands and we are giving them massive reductions.
▶ 1:27:49Sen. Warren: So those mass, mass discounts people can pay --.
▶ 1:27:54Sec. Kennedy: 600%.
▶ 1:27:56Sen. Warren: They can pay hundreds of dollars on trump rx or get it for $12 at costco.
▶ 1:28:02Chair Crapo: The second instance of the secretary denying the public's right to know. That's all the members on this committee have asked for. Thank you, senator wyden. Senator warren. At this point to the rest of the members of the committee, we're going to take a 10 minute break and then we will come back and resume the questioning. The committee will recess.
▶ 1:34:34Chair Crapo: The next senator for questions senator cantwell.
▶ 1:34:42Sen. Cantwell: Thank you for your very long statement in the book. If you covered a lot. I think it was 10 or 11 pages. I don't think secretaries usually show up covering 11 pages of material in the written testimony. I wanted to ask -- I have three subjects I want to go over if I could. One --
▶ 1:35:05Sec. Kennedy: Are you being sarcastic?
▶ 1:35:09Sen. Cantwell: No, no. When somebody spends -- I think it probably took him two years to write our four-year energy outlook, somebody needs to read it. I think you covered a lot of subject so I wanted to ask about that. I have priorities I wanted to cover it see if we could get your commitments on them. One, you talked about indian health care, which I appreciated.
▶ 1:35:40Sen. Cantwell: I met with several of my tribes. One issue is that we don't have for urban -- ihs does their thing, addressed trying to fix that but indian urban health needs the full funding. We got a fix, myself and senator murkowski, but it only lasted for two years. We would like to see urban indian health get the full federal medicaid, medical assistance for the indian health care programs and would you work with us on that?
▶ 1:36:09Sec. Kennedy: Absolutely and enthusiastically.
▶ 1:36:12Sen. Cantwell: Great.
▶ 1:36:14Sec. Kennedy: You can call me directly on that.
▶ 1:36:18Sen. Cantwell: This is a really big issue prepare you -- this is a really big issue. When the only get half the money for the care everybody else gets, it creates a disparity in being able to deliver the care.
▶ 1:36:35Sen. Cantwell: Second issue, in the guts to headstart, the administration of issues of headstart and not putting out the new rfp for proposals walla walla, they may have to shut down the whole headstart program. Are you going to put out requests for proposals for funding for headstart?
▶ 1:37:00Sec. Kennedy: A request for proposal -- headstart, you know.
▶ 1:37:11Sen. Wcantwell: They put out to apply for federal dollars and the be able to keep their program open. I think what I should do is send you a letter on this.
▶ 1:37:27Sec. Kennedy: I am very committed to headstart. My family started headstart. We protected it in the budget. I just put $62 million extra into it so they can do good nutrition. I'm happy to work with you.
▶ 1:37:41Sen. Cantwell: This is an area we might say, secretary, would you call the administrator in walla, walla walla come to washington. I would ask you about weiser. I don't know if you have heard about this. You mentioned briefly in your testimony the coverage of modernization at the cms in technology.
▶ 1:38:08Sen. Cantwell: And the concern I wanted to try to address today something that has been raised in our newspaper in seattle. We honestly know a lot about ai because we have a big ai community, but ai is being used as a denial device for the cms system.
▶ 1:38:26Sen. Cantwell: It apparently has had some problems where it is not taking a few days to find out whether you're going to get covered or not, it is basically taking weeks to find out you are denied on things that never were our prior denial before.
▶ 1:38:42Sen. Cantwell: What -- this is a gentleman who had some back issues and wanted to get what would have been under medicare and approved system by his doctor whether he could have that steroid or whatever care he could get. Now he is under this weiser application process which could -- can turn down and deny. We have hospitals calling me about this.
▶ 1:39:10Sen. Cantwell: I have doctors calling me about this, patients calling me about this. I appreciate you to take a look at it.
▶ 1:39:17Sec. Kennedy: First of all, that delay is unacceptable and we will work with you on it. The weiser model, we do only 5% prior authorization across medicare and medicaid.
▶ 1:39:38Sec. Kennedy: We found we were being ripped off by certain categories of procedures that are not good for the patient and a lot of time there unnecessary and very lucrative for the doctors. Went from being 3 million to 23 billion.
▶ 1:39:59Sec. Kennedy: Spinal surgeries, certain kind of spinal surgeries, which is maybe the one -- and knee surgeries. They are a target sows and I don't know what happens in print anyway, it should not be delayed. We will try to work with you.
▶ 1:40:15Sen. Cantwell: This is exactly the point. Someone might've had a bright idea. I think idea should be used for -- ai should be used for taking care of things that might have taken years but now take months. But use it as an app or tool that might deny people and then cut them off from medicare when this part of medicare was never a referral is making me anxious that somebody really does think that ai should be used to judge our medicare services.
▶ 1:40:45Sen. Cantwell: It makes me anxious.
▶ 1:40:46Sec. Kennedy: It is supposed to allow us to detect fraud early. I will work with you to try to straighten that out. As I said, we were getting ripped off for $23 billion just by one category a procedure.
▶ 1:41:03Sen. Cantwell: I don't want this man I showed to be rubbed off. The scary thing about ai is, if we think we are going to put ai in charge of deciding instead of doctors, we are going to have real problems. Would you think about the transparency on this? If you created that model or that app is a third party, what is the transparency that we all have about how that app works?
▶ 1:41:27Sec. Kennedy: It is supposed to have a human supervisor. When prior authorization is denied, they're supposed to be a human being that checks it off and then the ai just identifies --.
▶ 1:41:41Sen. Cantwell: I hear what you're saying. Thank you.
▶ 1:41:46Chair Crapo: Senator barrasso.
▶ 1:41:49Sen. Barrasso: Thank you for being here today. I applaud what the administration is doing in terms of focus on making america healthy again. We can agree addressing conic diseases is not a simple task. At its core, making america healthy involves prevention. There's something called the U.S. preventative services task force.
▶ 1:42:15Sen. Barrasso: It has a 40 year history of providing independent evidence-based recommendations on preventive care as part of hhs and as a doctor of her life of these recommendations over the years. They have helped shape the standard of care across the country from the cancer screening to heart health. I believe we have our people following the recommendations, our country would be healthier.
▶ 1:42:37Sen. Barrasso: Last week before the house ways and means committee, you said you thought the task force had been lackadaisical and negligent for 20 years. They did a lot of good work on breast cancer server and -- breast cancer prevention, alcohol invention. Over the last year, they have and rescheduled multiple meetings the task force the department has. One with just three days notice.
▶ 1:43:04Sen. Barrasso: I'm concerned these actions showed not really prioritizing this important task force. How are you demonstrating give a serious and consistent plan to reform the task force on prevention and what exactly do you believe preventative services task force has been getting wrong?
▶ 1:43:20Sec. Kennedy: The task force is greatly important and plays a critical role in getting compensation for important approved interventions. We consider that critical. The meetings were intermittent. I know have not done a good job of getting the meetings out there. We are going to change that.
▶ 1:43:49Sec. Kennedy: We are posting applications -- a number of the members are rotating out. I think their only five left. We are posting applications. We are going to get resumes. We encourage people to send in resumes these different specialties. A number of specialties were not well represented on the committee and we want to increase that to make sure everybody is represented.
▶ 1:44:20Sec. Kennedy: And to increase the number of meetings and also increase the transparency of the meetings.
▶ 1:44:28Sen. Barrasso: In 2026, a lot of physicians that practice all across the country follow this. One doctor raised concerns about the future of the task force we are talking about, particularly talked about the risk of undermining its independence and evidence-based methodology. I ask unanimous consent this article I can submit to the record.
▶ 1:44:50Chair Crapo: Without objection.
▶ 1:44:54Sen. Barrasso: I share his concerns because what we have seen for the last year the task force methodology is grounded in an independent review of the evidence, careful evaluation of the benefits and harms, and among seven health providers it is widely considered the gold standard for preventative care. I hear what you're saying in terms of the different specialties.
▶ 1:45:14Sec. Kennedy: I promise you we are not going undermine dysfunctions. We just want to get the best people, more representative group of specialties.
▶ 1:45:31Sen. Barrasso: You think of what they do it is the gold standard?
▶ 1:45:33Sec. Kennedy: There are some limitations we are trying to address. I am happy to meet with you or consult with you to make sure we are doing it right.
▶ 1:45:44Sen. Barrasso: On vaccines and a number of people have asked about vaccines, committed when we visited in september to increasing transparency to rebuild trust in the public health guidance. Since then there have been some changes to the vaccination schedules, specifically with children. Some disruptions to the advisory committee. I think there been more confusion for families and providers. I think sometimes very hard to keep up with some of the recommendations.
▶ 1:46:14Sen. Barrasso: I will ask, are you taking steps now to ensure vaccine guidance is clear, evidence-based, and trustworthy?
▶ 1:46:21Sec. Kennedy: Absolutely, that is what we are doing. For the first time we're going to be doing for new vaccines that are not yet on the schedule to make sure they have safety studies, placebo-controlled trials first. For the vaccines on the schedule that are being reviewed, there is a limitation, can't really talk about it because it is under litigation.
▶ 1:46:47Chair Crapo: Senator cassidy.
▶ 1:46:50Sen. Cassidy: Thank you for coming in. First statement, cms is working on louisiana to improve medicaid provider tax preprints after passing the working families tax cut act. We have one more to be approved. The physician 2026 preprint. Louisiana's fiscal year starts in two months and we just need to get this done asap.
▶ 1:47:20Sen. Cassidy: Please prioritize getting it resolved and I will follow up with you and Dr. oz. Article to my states providers and my state's fiscal health if you will, this would comply with.
▶ 1:47:30Sec. Kennedy: I am happy to meet with or happy to put my stuff in touch. You can call me anytime to make sure it is happening.
▶ 1:47:40Sen. Cassidy: Thank you. Next, affordable health care. My gosh, on the campaign trail and speaking to folks back home, it is all about that. We have expanded access to health savings account, now, I'm not clear, though, particularly on the exchanges. So a bronze plan estelle eligible for hsa as an example.
▶ 1:48:07Sen. Cassidy: How is the department alerting folks from enrollees, that this hsa opportunity exists?
▶ 1:48:14Sec. Kennedy: I'm aware of the opportunity. I do not know whether there is an advertising campaign. I will check on that for you, senator. The trump administration is committed to increasing access to hsa, direct primary care and the catastrophic plans.
▶ 1:48:41Sec. Kennedy: We will do everything in our power to make sure that is known.
▶ 1:48:48Sen. Cassidy: Staying on the exchanges, there is a lot of fraud with zero premium policies in the aca. People paying hundreds of millions of dollars in fines for doing this. I am not seeing additional funding to address that fraud in your 2027 budget and yet I recently had an insurance broker tell me she is still seeing folks fraudulently enroll in the aca marketplace.
▶ 1:49:17Sen. Cassidy: The problem continues even though there now a greater awareness. Gladback your budget, there are not dollars I sought to address aca fraud. Any comment on that?
▶ 1:49:29Sec. Kennedy: Welcoming the president's markup integrity role eliminates zero premium plans. Those plans were particularly subject to fraud. We think 4.4 million people on them, many of them who did not even know they were registered because it was broker fraud. They were signing people up and collecting the commission for signing people up who did not know they were signed up.
▶ 1:50:01Sec. Kennedy: I think there were only 40% of the people on it ever made a claim, which indicates --
▶ 1:50:10Sen. Cassidy: But it appears the problem persists. I am being told by folks involve the budget as we see it does not have money to go after that. Knowing we have already done good work, what are we doing prospectively to attempt to address the continued threat and perhaps reality of fraud in the marketplace?
▶ 1:50:33Sec. Kennedy: We are using now ai throughout the department to detect fraud and we are using it very aggressively. We have the best people in silicon valley for designing the systems.
▶ 1:50:46Sen. Cassidy: Is that the medicare/medicaid?
▶ 1:50:48Sec. Kennedy: We are relying on the marketplace integrity rule to eliminate a lot of the opportunities for fraud in the aca.
▶ 1:50:58Sen. Cassidy: We may follow up with you on that just for clarity. Next, a medicare advantage. Medicare is going insolvent soon. We want to protect the 72-year-old retiree in jefferson parish, for example.
▶ 1:51:15Sen. Cassidy: Your department has banned the use of unlinked chart reviews, little technical but we know what were talking about, but in the latest notice, hhs is continuing to use 2018 diagnoses and 2019 expenditure data not 2023 diagnoses and 2024 expenditure data. Why would cms not use the more recent numbers which gives more precision as regard to the expenditure what the payment should actually be?
▶ 1:51:45Sec. Kennedy: I can't answer that question. The guy behind me can, chris klumpp. We are happy to talk to you about it. We went through a lot of effort to end the delinking of chart reviews with payments to end the up coating fraud which was the biggest opportunity for fraud throughout the system.
▶ 1:52:13Sec. Kennedy: I don't know why we got the year, while we are not doing -- 2023 and 2024, but I will find out for you.
▶ 1:52:22Sen. Cassidy: Thank you.
▶ 1:52:23Chair Crapo: Senator johnson.
▶ 1:52:26Sen. Johnson: Welcome. Thank you for your service. Thank you for putting up with all of this abuse. Thank you for your commitment of transparency. I think you're aware of of the fact on many fronts I think our response -- our response to the pandemic was a miserable failure. I'm aware because the pandemic is over, so many people want to just put it behind us. Let's not examine all the things that went wrong.
▶ 1:52:58Sen. Johnson: People who do not want to move on, people who insist on reckoning are those who were injured by the covid mrna injection. I think you are aware of the fact today, worldwide, we have almost 1.7 million reports of adverse events. Almost 39,000 deaths. By the way, of those deaths, 24% occurred either on the day of injection or within one or two days.
▶ 1:53:27Sen. Johnson: It does not prove causation about that is correlation. The injection injured -- or refuse to call it a vaccine -- at minimum would like to have their injuries acknowledged so they can get treatment. I saw horridly sad video of a man in japan, central line being effectively treated for his injection injury. One of the things preventing is we have no icd code for those.
▶ 1:53:56Sen. Johnson: I know this is running through hhs, the director is looking for an icd code. I'm asking you if you're willing to look and prioritize it, get the injection injury at least an icd code and acknowledge these injuries but would you make that?
▶ 1:54:17Sec. Kennedy: We are working on it. We are working on it and try to make it happen as quickly as possible. We are also doing the studies that now need to be done at nih. The corners' reports on blood clots.
▶ 1:54:36Sen. Johnson: My next question is a memo apparently from Dr. brassard in 2015 were apparently within fda reviewing it, I think it was 96 autopsies or child at following the covid mrna injection, in that memo, he writes, "profound revelation for the first time U.S. fda will acknowledge covid-19 vaccines killed american children.
▶ 1:55:06Sen. Johnson: Healthy young children who face tremendously low risk of death or coerced at the behest of the biden administration via schoolwork mandates to receive the vaccine that could result in death. In many cases such mandates were harmful. It is difficult to read cases were kids seven-16 may be dead as a result of covid vaccines, putting these facts together it is horrifying to consider the U.S. vaccine regulation including our actions may have harmed more children than we saved.
▶ 1:55:34Sen. Johnson: This requires humility and introspection." it requires oversight. I wrote a letter to you and your agency back in december 15. Of the 10 responses, I got three out of 10. No responses in terms of the documents I've requested. I'm asking you, please, will you commit to responding fully to my december oversight letter?
▶ 1:55:58Sec. Kennedy: You have by 100% commitment.
▶ 1:56:01Sen. Johnson: I was requesting the process on the biden administration last-minute request or granting an extension liability shield for covid injections. Please, you commit to providing me that delivery of those documents?
▶ 1:56:18Sec. Kennedy: If we have them, I will hand them over to you.
▶ 1:56:23Sen. Johnson: Let's put up this graph. Because of your radical transparency, close to 11 million pages, we uncovered -- they hid the signal on myocarditis. We uncovered they also hid a signal on ischemic stroke for people over 65. They hid both signals. They downplayed them. What is most alarming, and we will be holding a hearing on this next week, I've got a draft report.
▶ 1:56:52Sen. Johnson: They were made aware on march 26, 2021 the inventors of the algorithm that analyzed the data was going to mask adverse events. He was told that by using a different system, they had uncovered 49 examples of extreme masking.
▶ 1:57:16Sen. Johnson: 25 significant adverse events, including cardiac -- sudden cardiac death, bell's palsy, cardiac infarction. This report will be in conjunction with that hearing. I did not need a sophisticated mathematical model to tell me we had safety signals screaming at us. This chart shows deaths associated with vaccines all the way back to 1990. Couple hundred a year.
▶ 1:57:45Sen. Johnson: An eclectic shock, that type of thing. 2021, over 20,000 deaths. For five years, the fbi's been saying, we don't see a signal. This was a signal screaming at us to this very day we are covering up. They're a bunch of people involved in this that still continue to work within the hhs, cdc, fda. I want your commitment those people will be made available for interviews. I will have to subpoena others.
▶ 1:58:16Sen. Johnson: I'm going to dig into this massive cover-up.
▶ 1:58:17Sec. Kennedy: You have my commitment.
▶ 1:58:20Chair Crapo: Senator smith.
▶ 1:58:22Sen. Smith: A few rounds ago there was a back and forth between senator daines and secretary kennedy about mifesteprone. Mifesteprone's safety profile is well-established, 25 years of data, 100 peer-reviewed studies. It is a safety profile better establish the many every day medications. I would like to submit for the record, Mr.
▶ 1:58:48Sen. Smith: Chair, 40 peer-reviewed statistically significant studies on mifesteprone's safety profile. These are the same senator hassan submitted during secretary kennedy's confirmation hearings.
▶ 1:59:02Sen. Wyden: I would like to associate myself with your important remarks.
▶ 1:59:06Chair Crapo: Without objection.
▶ 1:59:10Sen. Smith: Good morning. I would like to talk about prevention and where we should be able to agree not only how prevention can help to keep americans healthier but also save health care dollars. I would like to start by associating myself a senator barrasso's questions and concerns about what is happening with preventative services task force. Let's get into it. Last week you said screening for prevention is absolutely critical. I want to dig into that. Let's start with mammograms.
▶ 1:59:41Sen. Smith: Would you agree mammograms are important preventative health care?
▶ 1:59:44Sec. Kennedy: Yes.
▶ 1:59:47Sen. Smith: I agree. It makes me wonder why your agency cuts to programs that fund breast cancer screenings. Hospitals in north dakota and south dakota had to pause breast cancer screenings because your agency announced cuts to the national breast and cervical cancer early detection programs. Doesn't make sense to me. His depression screening preventative care in your mind?
▶ 2:00:14Sec. Kennedy: Depression? Yes.
▶ 2:00:19Sen. Smith: I agree. However, the trump administration and congressional republicans pushed through the biggest because to medicaid in the history of that program. Medicaid is the largest payer of behavioral health care, so that is cutting access to care. For millions of americans to get mental health care. How about smoking? Is smoking cessation preventative care?
▶ 2:00:45Sec. Kennedy: Yes.
▶ 2:00:47Sen. Smith: Again, her latest budget eliminates the cdc office on smoking and health. 200 cdc employees who were working on smoking secession -- cessation are gone now. The flu shot. As that preventative care?
▶ 2:01:04Sec. Kennedy: Yes.
▶ 2:01:07Sen. Smith: You said it would be better if you are kid got the flu shot. Your rescinded recommendations for scientifically and medically sound flu vaccines, canceled public awareness campaigns about the importance of getting the flu vaccine. This is not a record that matches with saying preventative care is important.
▶ 2:01:28Sen. Smith: I do not understand the contrast here between what you say you want to do and what is actually happening in this administration. Let me go to this. Are you familiar with title x?
▶ 2:01:43Sec. Kennedy: Yes.
▶ 2:01:45Sen. Smith: Great. It is a highly successful comprehensive study to provide birth control and preventative care to low income women. We know every dollar that is invested in title x saves somewhere between three dollars and seven dollars in medicaid costs, preventing unintended pregnancies.
▶ 2:02:05Sen. Smith: Can you explain why you are recommending zeroing out funding for title x which would eliminate screenings for cervical cancer and would almost certainly result in higher unintended pregnancies?
▶ 2:02:19Sec. Kennedy: Cannot respond to some of your earlier statements?
▶ 2:02:23Sen. Smith: Please.
▶ 2:02:24Sec. Kennedy: First of all, there are no cuts in medicaid's. Here's what the cbo said. Fiscal 2025, $668 billion. Fiscal 2036, $981 billion.
▶ 2:02:43Sen. Smith: $120 and because according to the cbo, 7 million people losing their health insurance because of the trump administration actions. That is not debatable.
▶ 2:02:51Sec. Kennedy: There is nobody who is legally enrolled in medicaid.
▶ 2:02:57Sen. Smith: That is not true. That is not true. How else would you like to respond to my questions about why the administration is cutting preventative care?
▶ 2:03:09Sec. Kennedy: A lot of it is being returned to the states. We are doing a $667 billion block grant to the states.
▶ 2:03:21Sen. Smith: My counties are asking why the cost shift to their taxpayers is happening at the same time the hospitals are going out of business.
▶ 2:03:29Sec. Kennedy: Administer the program is better than we do. We are giving the same money to the program.
▶ 2:03:36Sen. Smith: That is not the way it is working. Thank you, Mr. chair.
▶ 2:03:40Chair Crapo: Sen. lujan:.
▶ 2:03:43Sen. Lujan: I would like to ask unanimous consent to submit into the record a cbo report from july 2025. Hr 1.
▶ 2:03:56Chair Crapo: Unanimous consent without objection.
▶ 2:04:02Sen. Lujan: That report found $990 billion cut to medicaid cbo report.
▶ 2:04:09Sec. Kennedy: How can that be a cut?
▶ 2:04:14Sen. Lujan: It is in the record. I would be happy to share it. Her team has it as well.
▶ 2:04:18Sec. Kennedy: Only in washington is that considered a cut.
▶ 2:04:24Sen. Lujan: In the same way gas prices are not higher.
▶ 2:04:26Sec. Kennedy: It doubled in the last four years.
▶ 2:04:30Sen. Lujan: This talk about vaccines. You've been asked quite a few questions about vaccines, or hearings in the last week, asked a lot of questions about vaccines. Given respondent quite a bit about vaccines. I went back to look at statements you made, I don't know, the last 10 years or so on vaccines as well. I appreciate that you say today you support people getting vaccines. Is that accurate?
▶ 2:05:01Sec. Kennedy: Yes.
▶ 2:05:04Sen. Lujan: I was reminded july 6, 2023, august 2018, favor 23rd, the dates go on and on. I have a list of them. There was a lot of misinformation.
▶ 2:05:19Sec. Kennedy: Information that I ever promoted vaccines, tell me one piece of information.
▶ 2:05:28Sen. Lujan: If I could continue.
▶ 2:05:29Sec. Kennedy: 71 -- tell me one piece of misinformation.
▶ 2:05:36Sen. Lujan: I will get there. Mr. secretary, the history shows you are pushing --
▶ 2:05:46Sec. Kennedy: Tell me one statement.
▶ 2:05:50Sen. Lujan: During her leadership at hhs, measles, disease once eliminated in the united states, is on the rise and over 1700 americans come as you are aware. You have been asked by colleagues as well where kids died last year as a result.
▶ 2:06:11Sec. Kennedy: To answer the question.
▶ 2:06:15Sen. Lujan: I don't have a question.
▶ 2:06:16Sec. Kennedy: You are making the statements.
▶ 2:06:20Sen. Lujan: Almost bragged about measles -- united states has always been a leader and we demand it is a leader. That should not be a question. Can you please tell us here today what you're going to do to reduce the number of measles cases and improve the mmr vaccine rate?
▶ 2:06:39Sec. Kennedy: Improve the mmr? We promote the mmr. We advise every child to get the mmr. That is what we do.
▶ 2:06:49Sen. Lujan: I would be happy to ask for that to be in the record and happy to get a question in the record if you can respond to it. I'm curious if you're going to include funding according to vaccine education and distribution, countering this information about measles and the mmr?
▶ 2:07:05Sec. Kennedy: Tell me one piece of information -- misinformation or just one.
▶ 2:07:12Sen. Lujan: Tailoring outreach with declining vaccination rates as well, measuring one of those campaigns --
▶ 2:07:18Sec. Kennedy: You're just making things up. Tell me one thing you say you have a list. Read me one thing I've ever said .
▶ 2:07:28Sen. Lujan: If you want to run for the senate and get on the dais, you should resign from hhs and run for office and you can be here and ask all the questions you want. I'm asking you some questions. What I gave you --.
▶ 2:07:40Sec. Kennedy: You're just making statements that are incorrect.
▶ 2:07:44Sen. Lujan: Let me ask a question about someone you know well rated david geyer. Does he work for you?
▶ 2:07:50Sec. Kennedy: He is a contract -- contract employee.
▶ 2:08:00Sen. Lujan: The last time you're here I asked why was it david geyer was listed on the hhs directory as a senior data analyst. He still is.
▶ 2:08:08Sec. Kennedy: Is a contract employee.
▶ 2:08:11Sen. Lujan: You are asked by one of my colleagues about getting their hands on some documents you may have. Do you have his contract?
▶ 2:08:20Sec. Kennedy: I imagine we do.
▶ 2:08:24Sen. Lujan: Would you share it with the committee by friday?
▶ 2:08:26Sec. Kennedy: I don't think there's any legal problem with it.
▶ 2:08:31Sen. Lujan: Subject to the information a public records act which we could go about.
▶ 2:08:35Sec. Kennedy: Then I am happy to.
▶ 2:08:38Sen. Lujan: Including the contract can we expect you to share with the committee by friday the scope of david geyer's contract?
▶ 2:08:45Sec. Kennedy: I don't see any reason why not.
▶ 2:08:48Sen. Lujan: Does he report to the hhs office here in D.C.?
▶ 2:08:53Sec. Kennedy: He reports to cdc.
▶ 2:08:58Sen. Lujan: What I asked for the last time that a conversation was about the protocols that go to david geyer's work. You responded to me by saying this protocols are public. They are not. I asked the committee chair --
▶ 2:09:12Sec. Kennedy: I said they will be public when he develops the protocols.
▶ 2:09:18Sen. Lujan: Will you commit to sharing the protocols of david geyer's work by friday?
▶ 2:09:21Sec. Kennedy: No, because they don't exist.
▶ 2:09:27Sen. Lujan: Mr. secretary, I appreciate the honest response. You will remember, and I can get to the information from this, the last time I asked this question of the secretary, he said it was all public, all available. He just said it is not. I don't know if it is going to take --.
▶ 2:09:42Sec. Kennedy: I said we will make it available when it is done.
▶ 2:09:47Sen. Lujan: I hope we can get our hands on david geyer's work.
▶ 2:09:51Chair Crapo: Senator blackburn. Thank you for being with us today. We appreciate it. I really want to applaud your leadership on the cms strategy. This is something that tennesseans are welcoming saying and the fact you have already found I think it is 5.7 billion in fraudulent medicare payments.
▶ 2:10:21Chair Crapo: When you look at that as a recurring expense, you see how much that is costing the taxpayer. I also want to highlight the remarkable success we have seen with the rural health care transformation program. And republicans on this committee really worked hard to make that happen. We are looking forward to good results.
▶ 2:10:48Chair Crapo: I do want to go to your question , your comments about fraud and fighting fraud. You mentioned the work that was being done to beef up your systems. Pardon me. Too much pollen in the air.
▶ 2:11:09Chair Crapo: Talk for a minute about what you are doing with the data transfer, with aggregating data from the states, and what you plan to do to make certain that the audit is now mandatory component to weed out some of this fraud, like we have seen in minneapolis and l.a.
▶ 2:11:36Sec. Kennedy: Let me just talk about what happened in the biden administration that opened the door to all of this fraud read the biden administration took many steps but three major steps. One, implemented what they called a pay and chase system where when we had invoices that we know to be fraudulent, we have to pay them. And then they had a clawback strategy that you would then go after and then of course, nothing ever got claude back. Opened the door wide.
▶ 2:12:11Sec. Kennedy: They stopped, told the states that they could only check for enrollment validity once a year. They told people in my agency we had 80 people assigned to program integrity and fraud detection over 50 states and six territories. It wasn't enough. The biden administration came in and fired all but six of them.
▶ 2:12:41Sec. Kennedy: When I came from I had six people in my office. My predecessor told his staff, we don't to program integrity. We should focus on enrollments. And that's what happens. So now you have all of these problems, and I will give you one example, hospices in los angeles, we have shut down 500. We have not gotten one call from a congressperson or one call from a patient.
▶ 2:13:12Sec. Kennedy: Why? Because those hospices did not exist. They were getting patient ids, signing them up, and charging us $6,000 a month for that patient. How do we detect them all? Because the patients never died.
▶ 2:13:29Sen. Blackburn: You are, I would assume, you are all sharing this information with the states and working with the states when it comes to medicaid fraud.
▶ 2:13:39Sec. Kennedy: Some of them refuse to work with us and some refused to work -- florida, where there was terrible, terrible fraud, working very aggressively and side-by-side with us. Certain states have refused to produce an audit.
▶ 2:14:04Sen. Blackburn: I want to move to the area wage index. You have got hospitals in urban areas and they are receiving higher payments than the hospitals then rural or low-wage communities. Of course we know so much health care now is technology and technology costs the same regardless of where you are.
▶ 2:14:30Sen. Blackburn: Last week, I know at the ways and means hearing, they discussed this issue with you. I would like to know you are confirming your support for the approach for bringing into parity this area wage index so we can level the playing field with these rural and disadvantaged hospitals and with hospitals in urban areas.
▶ 2:14:57Sec. Kennedy: Absolutely. I worked with senator whitehouse because he has the same problem with rhode island. Unfortunately, there is no way we can fix it -- we need congressional outlet and we will work with you.
▶ 2:15:16Sen. Blackburn: We have the bill and we are pushing it forward.
▶ 2:15:17Chair Crapo: Thank you. Senator young.
▶ 2:15:22Sen. Young: Welcome, Mr. secretary. It is good to have you here. Thank you to you and your team for your hard work and for your focus on preventative measures. I think that point of emphasis of the make american healthy again movement is important. Focusing more broadly on wellness as opposed to just health care and help delivery is important. I also appreciate the attention and interest you have shown with respect to long covid.
▶ 2:15:53Sen. Young: This collection of symptoms that remain after people get covid and has an economic cost globally of conservatively $1 trillion per year. It is adversely impacting millions of americans. No doubt it is having some impact on our long-term employment rate. And people need some hope.
▶ 2:16:17Sen. Young: I think you offered some hope, for starters, during her confirmation hearings when you told me you're going to prioritize this issue. Secondarily, when you held a roundtable session when bringing in some of our nationally renowned doctors who have expertise in this area, I would like an update, sir, are you working with your fda commissioner and nih director to advance treatment for a covid?
▶ 2:16:49Sec. Kennedy: Yes, we are. A lot of the reforms came out of that -- came out of that roundtable and I want to thank you for your leadership and we are working with many of the doctors that we brought in light breeze patterson from california , jordan vaughn from florida and leading doctors who are we to become experts in this area. We are working to develop markers. There are many, many different presentations of this disease.
▶ 2:17:21Sec. Kennedy: They have to be identified and diagnosed differently. They had to be treated differently. We are identifying the markers. We are putting everything up on a website so patients will have access to the best care and best doctors who have had the most success in treating a particular form of illness.
▶ 2:17:42Sen. Young: There is urgency. Thank you for prioritizing this. I will ask again for your commitment to continue to work together on this. Do I have it?
▶ 2:17:51Sec. Kennedy: Oh, yes. Sen. yes. >> I will see Dr. alicia jackson later today. Of course, our director of arpa h. This seems to lend itself to the model, in the fact that when we come up with diagnostics it typically takes two decades to find a way out in the clinical practice.
▶ 2:18:16Sec. Kennedy: We can't wait for that, so moving onto biotechnology more generally, for the last couple of years I have cheered a national security commission on emerging biotechnology. Bottom-line, upfront, we have assessed that if we optimize our nation biotech research development production and innovation ecosystem we are at risk of falling behind the chinese communist party.
▶ 2:18:45Sec. Kennedy: Our primary adversaries, by my lights. In biotechnology, which has direct security implications. In 2022 chinese pharmaceutical companies accounted for just 5% of licensing deals. By 2025 that figure jumped to 42%. I have been encouraged to see -- to see the fda speed up approval times for drugs, but I think one needs to be done.
▶ 2:19:15Sec. Kennedy: We outlined some of this in our report, which can be found at biotech. Senate.gov. How can we work together to spur further domestic development and investment in the U.S. biotech industry?
▶ 2:19:28Sec. Kennedy: And last year 50% of new drugs approved more of -- came out of china and they -- that rate is increasing exponentially and they are stealing our ip, they are stealing our researchers, they are stealing our best scientists, they are operating duplicate labs in other countries, and it is a crisis. They are threatening our bio security and our public health and our dominance in the area.
▶ 2:20:00Sec. Kennedy: As you pointed out, we have speeded the length of time from concept to commercialization dramatically. We just approved in record time two oncology drugs. One at 54 days, wanted 45 days. The average for that part of the process was before that was 310 days.
▶ 2:20:25Sec. Kennedy: In both of those are drugs that bring people out of hospice, literally, they are so effective. We are now doing inspections in china, so we are dramatically ramping up our inspection of chinese lakes -- a lot of them are violating efforts. A lot of them are using minorities against their will and using this mischief that needs to be exposed.
▶ 2:20:56Sec. Kennedy: We are investing hundreds of billions -- hundreds of millions of dollars in reassuring ksn's and api's in this country so we can end that change and we have a pre-program that encourages pharmaceutical companies to build in this country, the ones that produce the drugs here, if they research them here they will be given preference and be able to move up in the line.
▶ 2:21:23Sen. Young: Thank you so much for your leadership as it relates to this issue. Mr. chairman.
▶ 2:21:28Chair Crapo: Thank you. Senator tillis.
▶ 2:21:31Sen. Tillis: Thank you for being here. You mentioned china. I was just chairing a committee on china's theft of intellectual property and all of the other malign activities they are involved in. Which actually takes me back to a statement I think you made a while back about china is eating our lunch on pharmaceutical innovation. I think there is an argument to be made that we are handing china our lunch.
▶ 2:22:02Sen. Tillis: And I talked about this in the committee for several years. By simultaneously cutting nih funding for basic research and imposing price controls that slash private r&d hhs is squeezing both sides of the balloon and expecting it not to pop. And I'm not picking on this administration.
▶ 2:22:29Sen. Tillis: It is exactly what the biden administration did with the build back better bill within six months of passing that bill, trying to impose price controls. We saw a 40% to 60% drop in small molecule research. It is inescapable, the connection between the two.
▶ 2:22:46Sen. Tillis: So, I think this steps this administration is taking, similar to the steps of the biden administration gets the ip, china gets the manufacturing, america gets the lower prices on drugs we didn't invent, produced in facilities that we don't own, and you have already alluded to the unacceptable circumstances in china for the workers and those there.
▶ 2:23:10Sen. Tillis: We are aiding and abetting that, so [indiscernible] tells the world america will no longer invent in the future, in my opinion. Never want to get to a question. If you a chance to answer that. For years I have been saying that we have got to drive down health care prices. You got to drive down the cost of pharmaceutical drugs. But we have a simplistic approach we use here. We never have everybody in the barbershop at the same time. We just try to scalp whoever we can as a matter of public policy.
▶ 2:23:44Sen. Tillis: Mfn is the most aggressive single link intervention in a complex value chain attempted at the federal level. It does not address supply chain concentration or ip theft. It hammers the end price in hopes that the rest of the system magically adjusts. So, well-intentioned, single-link interventions have failed for a decade. What, other than political branding, makes this one different?
▶ 2:24:11Sen. Tillis: In other words, the democrats have raised this for years, this sort of socialized approach, their socialized approach to controlling prices. What is different about the republican approach to do the same thing?
▶ 2:24:23Sec. Kennedy: Senator tillis, when president trump charged us with lowering prices to the same as europe he also made two separate provisos. He said he did not want to end the research domination of U.S. companies. And he said he wanted them to three shore pharmaceuticals, which seemed like an impossible task. He managed to do all three things.
▶ 2:24:52Sec. Kennedy: And the truth of that, our success at that is reflected in the share prices of those pharmaceutical companies that went up $1.3 trillion. After we sign the agreement. The way the magic -- part of the math --
▶ 2:25:10Sen. Tillis: Will we see a greater or equal amount of r&d coming out of these companies that have taken price cuts? From build back better it didn't prove to be true.
▶ 2:25:21Sec. Kennedy: Look at the investments they are making in our country. Eli lilly is building plans. Pfizer is building plants. Merck is building plans. Everybody is building plants here in this country.
▶ 2:25:34Sen. Tillis: If the policy is working so well why not apply mfn to everything? This is the select number you have chosen to negotiate agreements with? And I think have recommended we codify those agreements?
▶ 2:25:47Sec. Kennedy: We chose the top 17 companies that produce our brand drugs and we have agreements.
▶ 2:25:54Sen. Tillis: If it is working well why not be universal? If it is working well and sustainable why not be a universal program for any drug that makes it through fda approval?
▶ 2:26:04Sec. Kennedy: Each one of those companies had separate needs and there are separate agreements with each one of them. You know, the magic behind it was that we used tariffs.
▶ 2:26:14Sen. Tillis: With that in mind, how could you possibly codify that if it represents -- I know there is a discussion about codifying it. How do you codify something that is unique to each one of those entities?
▶ 2:26:26Sec. Kennedy: You know what, that is a long discussion, and I agree it is complicated but I think we can do it. I am the man who is a genius behind this is chris klumpp, and he is working on legislative language now, but you are happy -- I'm happy to make them available to you.
▶ 2:26:44Sen. Tillis: Thank you. We will sum other related questions. Appreciate you being here today.
▶ 2:26:51Chair Crapo: Thank you. Senator whitehouse.
▶ 2:26:55Sen. Whitehouse: Thanks very much. Secretary kennedy, I'm going to talk about some rhode island stuff with you. I think, as you know, and as cms has long agreed, new england is a regional health care market. And there is literally zero justification for having rhode island suffer a 20% payment whole compared to its neighboring states of connecticut and massachusetts.
▶ 2:27:22Sen. Whitehouse: You have said that that requires legislation to change, and that is what cms constantly says. But as somebody who has tried to work this problem for well over a decade but I have seen has been cms has not even tried. They give no indication that they could care less about the disruption to health care services. That this causes in rhode island.
▶ 2:27:51Sen. Whitehouse: In the past they have even gone out of their way to make the problem worse for rhode island, and I had to fight back and fix that worsening. But the underlying problem remains. And I just want to flag for you, again, that rhode island has been a leader in the move to value-based care.
▶ 2:28:16Sen. Whitehouse: When accountable care organizations were set up there were times when the two best in the country were coastal medical and primary care physicians of rhode island. So, we've got a record of doing value-based care the move to value-based care could be the vehicle for correcting the payment whole. And I just want to flag debt for you, because I want to make sure we get there.
▶ 2:28:41Sen. Whitehouse: We cannot be in the situation where rhode island's costs have been depressed because cms kept rhode island's revenues down, and how we are supposed to can air with -- compare with connecticut and massachusetts, which higher spin because they had higher revenues. It is obvious mathematics. I appreciate that you have taken an interest in this. I'm raising it again because I ain't going away on the subject. It is likely to cause real damage to health care services in rhode island if it is not fixed.
▶ 2:29:12Sen. Whitehouse: The second irritation I have had with cms for a long time has been a similar disinterest with respect to how families with a loved one facing the end of their life get help with. It is not uncommon for someone who wished to die at home. It is not uncommon for the family to wish that they stay at home through this very delicate period.
▶ 2:29:43Sen. Whitehouse: And yet, there are times when the family just cannot take it any longer and they are frightened, and they would like to get their loved one to a nursing home and what cms has required is that that dying mom has to go and spend three days and two nights in a hospital. Check in, go through that rigmarole, all of that expense before medicare would let them into a nursing home. We are fixing that, with your help. I'm looking forward to getting that landed.
▶ 2:30:12Sen. Whitehouse: But, I just have to point out how long cms was willing to stand idly by and look at that kind of effective cruelty in the system. Thank you for changing that. Similarly, if your loved one is dying at home and you want them to stay at home, you're not ready to go to a nursing home but you need some help, respite care for years was sending your loved one to the hospital.
▶ 2:30:42Sen. Whitehouse: Again, all of the anxiety, all of the nervousness, the whole neighborhood worried about the ambulance in the yard. All that completely unnecessary when you could send respite care to the home where the payson -- patient was less expensively. Cms was obstinate about that. Ditto, home care. If you are a dying patient you still can get outside. Should still be able to get home care to support the family through that period. You should not have to wait until you are homebound.
▶ 2:31:09Sen. Whitehouse: So, we are fixing those three things and others, but it is really important that we get this right. I think rhode island, when we get this right, can provide a model for the rest of the country, and I want to flag vast bureaucratic disinterest of the cms over decades about these problems, and we just need to change the culture there so that they listen and think a little bit about the actual human harm that some of their policies are
▶ 2:31:40Sen. Whitehouse: Causing. Last thing I will mention to you is prior authorizations. I would love to get rid of even more of them. Prior authorizations make some sense in a fee-for-service model, but they had been abused -- have been abused by the insurance industry. In a value-based model theological underpinnings for a prior authorization evaporate. Evaporate.
▶ 2:32:07Sen. Whitehouse: So, I would urge that you continue to work with us to get rid of prior authorizations for doctors who are working in a value-based care model. Thank you, chairman.
▶ 2:32:20Chair Crapo: Thank you.
▶ 2:32:21Sec. Kennedy: Thank you for your leadership senator, and I agree with you.
▶ 2:32:25Chair Crapo: Senator welch.
▶ 2:32:27Sen. Welch: My view, Mr. secretary, is the system is broken. It is too expensive, and one of the areas your administration is focused on, the president specifically, is the cost of pharmaceuticals. Trump rx. I want to go through that to determine what has happened. The front page on trump rx says, it has the world's lowest prices on prescription drugs.
▶ 2:32:59Sen. Welch: I want to do a comparison about our prices versus prices, say, in germany. We have a chart here. One drug, this is for infertility, $10 cheaper in germany than here. Another one for diabetes and heart problems. $88 cheaper in germany. Diabetes, $116. Another diabetes drug, $122.
▶ 2:33:27Sen. Welch: Autoimmune conditions, $1652 cheaper in germany. Another drug, really important for stunted growth in children, $2723 cheaper. Do you dispute any of these figures?
▶ 2:33:43Sec. Kennedy: Weak currency and adjust the prices, so --
▶ 2:33:48Sen. Welch: What?
▶ 2:33:50Sec. Kennedy: We currency adjust the prices, so we are getting the lowest prices in the world.
▶ 2:33:57Sen. Welch: So you are saying my chart is wrong?
▶ 2:34:00Sec. Kennedy: I'm saying it is apples and oranges.
▶ 2:34:03Sen. Welch: I really don't get that. We checked what the price is. It is 2700 dollars in apple more if you buy that prescription drug here than they are. The point here is that trump rx was sold as the cheapest prices. Her research shows challenges that, unfortunately. Another thing, trump rx is not even the cheapest prices in the united states.
▶ 2:34:37Sen. Welch: Only a small fraction of available drugs are included. There is 24,000 fda-approved drugs, 80 drugs are on trump rx. Literally 80 drugs. That obviously means that for the vast majority of drugs they are not even in trump rx. The other thing that is important is that everyday americans cannot access trump rx.
▶ 2:35:06Sen. Welch: You get a coupon if you go on the website. And it tells a very different story. The patient is not eligible if he or she is enrolled in any federal or state health care program with prescription drug coverage, such as medicaid or medicare, or any similar federal health program. Try care. Do you dispute that? This is the terms of trump rx. The vast majority of people are not even eligible.
▶ 2:35:37Sen. Welch: You know, the other points is that, who is benefiting? There was one point $3 trillion in market increase from the drug companies. But I'm not seeing any reduction in cost to everyday americans who want to get prescription drugs. Drug companies that made these deals were given exemption from trump tariffs, right?
▶ 2:36:03Sec. Kennedy: Only if they move their production to this country.
▶ 2:36:07Sen. Welch: So, they got a tariff reduction arbitrarily?
▶ 2:36:10Sec. Kennedy: [indiscernible] and they get it if they make a commitment to produce here they can get it a year in advance.
▶ 2:36:18Sen. Welch: Thank you for that clarification. What I understand is that all but one of the 16 trump rx companies have increased prescription drug prices since making their deals. The prices are going up. Companies that signed deals made even more money. Mentioned in .3 trillion dollars in market value increase. But they made -- those companies have made 170 $7 billion in profits, up from $107 billion.
▶ 2:36:52Sen. Welch: Here is my concern. I met with president trump in his first term. He said very directly and he has on the campaign, that people are getting ripped off with farmer pricing. He gets it. He is not solving it. Trump rx does not work.
▶ 2:37:09Sen. Welch: So, I have a bill cosponsored by senator hawley, the fair prescription drug prices for americans act, which would prohibit pharmaceutical companies from selling drugs in the united states at higher prices than at the international average. Just something I thought the president said he supported. Does your administration support that legislation?
▶ 2:37:31Sec. Kennedy: Senator, we would love to work with you on the codification. This does not -- trump rx does not yet cover every drug. It covers the most common drugs [indiscernible] drop the price of glp's by 89%.
▶ 2:37:46Sen. Welch: Let's just level. It is 80 drugs out of 24,000.
▶ 2:37:51Sec. Kennedy: It is the most common drugs.
▶ 2:37:54Sen. Welch: If you are eligible for any other health care -- the companies have agreed to this have increased profits by $170 billion.
▶ 2:38:04Sec. Kennedy: It is glps.
▶ 2:38:07Sen. Welch: Trump rx is a fraud.
▶ 2:38:09Chair Crapo: We need to move on. Senator sanders.
▶ 2:38:15Sen. Sanders: Secretary kennedy, how are you? You know, in public life we all make misstatements, alright? The couple of hours ago I think you said to senator wyden that we now pay the lowest prices in the world for prescription drugs. That is an absurd statement. Nobody in the world believes that. Do want to correct that?
▶ 2:38:37Sec. Kennedy: It is for the drugs that are on trump rx.
▶ 2:38:40Sen. Sanders: You said we pay the lowest prices in the world for prescription drugs.
▶ 2:38:45Sec. Kennedy: For those drugs we do, senator.
▶ 2:38:48Sen. Sanders: For certain drugs, but in general would you agree with the rand corporation and every other independent survey that we continue to pay the highest prices in the world? Do you agree with that?
▶ 2:38:58Sec. Kennedy: There are many drugs not covered by the agreements yet.
▶ 2:39:03Sen. Sanders: On average do we pay the highest prices in the world?
▶ 2:39:06Sec. Kennedy: As we always have.
▶ 2:39:08Sen. Sanders: I'm not saying this is a new development, but you said a moment ago that we pay the lowest prices in the world.
▶ 2:39:14Sec. Kennedy: For the most common drugs we do. Glp is our ivf drugs were copd drugs or asthma drugs for insulin.
▶ 2:39:23Sen. Sanders: Let me give you an example. For the cancer drug optivo, it cost 56,000 dollars in japan. All repaying the lowest prices? Etc., etc., senator. Senator welch made import. There are thousands of drugs out there, and there may be a drug here or there we pay lower prices.
▶ 2:39:50Sen. Sanders: In general, according to the rand corporation we pay nearly three times as much for prescription drugs then 33 other countries in the oecd. Do you agree with that?
▶ 2:39:59Sec. Kennedy: For the most common drugs we have the lowest prices.
▶ 2:40:03Sen. Sanders: Alright, I'm working on legislation which is not inconsistent with what trump has talked about, and that is, we should not be paying higher prices for prescription drugs then people in europe or canada. Is that something -- is that a concept you can support?
▶ 2:40:20Sec. Kennedy: Yes. President trump wants this codified, and you have a lot more power than we do.
▶ 2:40:30Sen. Sanders: You are right. That is why I'm going to be offering an amendment to the budget process right now which would, in fact, codify what trump is talking about. That the united states should not be paying higher prices than other countries around the world. Is that an amendment that you can support and get republicans to come on board?
▶ 2:40:49Sec. Kennedy: We will work with you, but in theory that is exactly what we want.
▶ 2:40:54Sen. Sanders: Let me ask you another question. We are on the help committee. The nominee for surgeon general was with us a while back. She agreed with me that tv ads in america -- prescription drug tv ads should be banned. We are one of two countries in the world. Do you agree with that?
▶ 2:41:17Sec. Kennedy: Yes. I would -- I agree with in theory. Constitutionally you cannot and it. But we are now regulating it for the first time, and you will see that the ads have changed on tv recently because we have set out -- sent out 1000 disciplinary letters.
▶ 2:41:37Sen. Sanders: The people who determine the constitutionality of the laws are the supreme court.
▶ 2:41:43Sec. Kennedy: We worked a lot on her because I wanted to regulate it.
▶ 2:41:46Sen. Sanders: Am I hearing you correctly to say that you would like to see a ban on prescription drug tv ads?
▶ 2:41:53Sec. Kennedy: Yes.
▶ 2:41:54Sen. Sanders: Ok, good. There are a lot of seniors in this country who right now cannot afford dental care. Many seniors have no teeth in their mouths. Cannot afford hearing aids. I am introducing an amendment to the budget process which would expand medicare to cover dental, hearing, and vision.
▶ 2:42:26Sen. Sanders: Is that something you can support?
▶ 2:42:27Sec. Kennedy: I'm happy to talk to about it. I'm happy to work with you on it.
▶ 2:42:36Sen. Sanders: Other question. Right now we have a diabetes epidemic in this country. An obesity epidemic. Any parents would like to buy healthy food for their kids really cannot make sense of the labeling on food products. Right? Other countries in the world are quite clear in their labeling, about the amount the amount of sugar, etc., in a product.
▶ 2:43:06Sen. Sanders: Are you guys making any progress in coming up with simple, strong labeling on food products?
▶ 2:43:10Sec. Kennedy: Yes, we are.
▶ 2:43:12Sen. Sanders: When will we see something?
▶ 2:43:15Sec. Kennedy: Well, the delay in it has been one of the big enemies, as you pointed out, obesity is causing 80% of medicaid and medicare dollars. One of the big problems is also processed food, and there has been no federal definition or any usable definition. We have now worked on a definition. There are other -- here at hhs we are now -- we are in the process of going to the interagency process.
▶ 2:43:43Sec. Kennedy: There is other agencies that are equity. Usda, department of commerce, omb, and they are reviewing our regulations. As soon as we promulgate those, we already have the labeling to go.
▶ 2:43:54Sen. Sanders: You have any sense when that will be?
▶ 2:43:57Sec. Kennedy: Excuse me?
▶ 2:43:59Sen. Sanders: Any sense when you will be promulgating that?
▶ 2:44:03Sec. Kennedy: It has to go through the other agencies but we wanted to happen quickly. >> Mr. chairman, let me agree with senator sanders and ask unanimous consent in an article in the new york times shows there is a higher price for wegovy on trump rx. This is the fact in terms of america and senator sanders has been correct.
▶ 2:44:26Chair Crapo: Without objection. Senator warnock.
▶ 2:44:30Sen. Warnock: Thank you. Secretary kennedy, you are here today to defend the president's budget request. In september you said that the cdc "will again become the world authority on infectious disease policy." you still stand by that statement?
▶ 2:44:48Sec. Kennedy: We already are.
▶ 2:44:50Sen. Warnock: Secretary kennedy, dino what rabies is?
▶ 2:44:54Sec. Kennedy: Rabies?
▶ 2:44:56Sen. Warnock: Rabies, people contract rabies, as we know, through bites, from infected animals like skunks, foxes, raccoons. And it can devastate a family. It is very serious. It is 100% fatal in humans.
▶ 2:45:26Sen. Warnock: In general it is a horrific experience. Using cdc expertise to determine appropriate care. Secretary kennedy, since you and president trump took office do you people are left to staff this 24/7 line?
▶ 2:45:59Sec. Kennedy: I do not know, senator.
▶ 2:46:01Sen. Warnock: The answer is one. I want you to know that. There is one person left to staff a 24/7 line to respond to rabies. A disease, which left untreated --
▶ 2:46:19Sec. Kennedy: Do you know how many rabies cases there are every year in the united states?
▶ 2:46:24Sen. Warnock: I'm asking the questions. The cdc's infectious disease work has been so decimated under your leadership that there is one person to respond to families about this deadly and terrifying infectious disease. Let me ask about another disease. Do you know what prion diseases are?
▶ 2:46:43Sec. Kennedy: Yes, I do.
▶ 2:46:45Sen. Warnock: When you think of prion disease is one of them would be mad cow disease. Diseases like mad cow disease can be transmitted from animal meat to humans, and it can cause a rapid onset of dementia challenges with walking, personality, changes, and severe insomnia. It is also 100% fatal and there is no cure.
▶ 2:47:18Sen. Warnock: With people's brain tissue essentially turning into a sponge before death. You know which office at cdc monitors prion disease? It is the prion and public health office. Do you know which is most at risk of contract -- of contracting the disease?
▶ 2:47:40Sec. Kennedy: I would say it is people that eat meat from [indiscernible]
▶ 2:47:47Sen. Warnock: So, hunters. Plan and public health office is critical in a state like georgia. We have a lot of hunters. There are more than 600,000 hunters in my state but your budget proposes to eliminate this office. Respectfully, you seem distracted, brother secretary.
▶ 2:48:10Sen. Warnock: What is your budget proposed to eliminate the cdc office that focuses on monitoring this deadly infectious disease that is especially a risk to rural communities? Why are you proposing to eliminate the office?
▶ 2:48:23Sec. Kennedy: You know, there is a lot of cuts that the agency -- that nobody wants. Have a $39 trillion that. We have been asked to cut across the agency 12%.
▶ 2:48:34Sen. Warnock: I assure you that the 600,000 hunters in georgia would want this office. They would want the protection. I assure you that families that are dealing with rabies or the prospects of that would want to know that somebody is going to answer the phone when they call. You have come to congress and justified destroying the cdc. By saying you want to just restore the cdc's mission, to focusing on infectious diseases.
▶ 2:49:05Sen. Warnock: Yet you are also guarding the very offices that keep american families safe from disturbing and deadly infectious diseases.
▶ 2:49:14Sec. Kennedy: Senator --
▶ 2:49:16Sen. Warnock: Hold on.
▶ 2:49:18Sec. Kennedy: Senator, there is one to 12 rabies cases in the united states. I think one person manning that office full-time can probably handle that. In terms of prion disease, it is very rare.
▶ 2:49:30Sen. Warnock: I beg to differ. Here is the issue. And we see this across the board with cdc. The incredible fulks at the cdc in atlanta, georgia, they protect us every day. From the threats that we don't see. And they don't get much credit for because of the stuff that does not happen. And it is ok for the general public not to wake up thinking about that.
▶ 2:49:59Sen. Warnock: But we expect you to keep americans alive. And the cutting we are seeing, these draconian cuts for an agency you said you wanted to restore to be the leader in infectious disease, you are cutting the coverage of the infectious disease. Even as you seem distracted while I talk to about deadly diseases, I think you are dangerous to the american public and you want to be fired. And if you are not fired you want to have the decency to resign.
▶ 2:50:27Sen. Warnock: You are way above -- weigh in over your head. Thank you.
▶ 2:50:31Chair Crapo: Senator marshall.
▶ 2:50:35Sen. Marshall: Welcome, secretary kennedy. Mr. chairman, it breaks my heart. I want to cry when I see the weaponization of health care used by my colleagues across the aisle. I have never seen so many disingenuous statements. Misleading statements. The outright manipulation of data to meet their political narratives.
▶ 2:51:02Sen. Marshall: I have never seen this before, and, again, at stake is people's health, Mr. secretary. Measles. Two thirds of the people that had measles last year were over the age of five. Were you secretary of hhs for people over the age of five that decided not to get a vaccine years ago?
▶ 2:51:25Sec. Kennedy: That decision by those people predated my appointment. And I think it is 80% were over five, and the epidemic -- the outbreak -- started before I came into office.
▶ 2:51:39Sen. Marshall: Thank you for helping clean up that mess, and I think about the flu vaccine. Again, the total miss manipulation of data. Probably the biggest challenge with flu vaccines is it is not very efficacious. And I don't know whether it is 20% or 40%, good, you get a shot, there is so many different brands and flavors of flu. Are you working on trying to make a more efficacious flu vaccination?
▶ 2:52:05Sec. Kennedy: Yes. We are trying to make a universal vaccine that can protect against all strains of flu, in the years a vaccine is 20% effective or in that range, so we need something that actually works and does not have to be given every year.
▶ 2:52:24Sen. Marshall: And I'm so glad today that my colleagues across the aisle recognize the failure of obamacare, pointed out both sides here, hundreds of hospitals closing, but there is no policies that this congress has passed to better implement it yet. Our medicaid policies, which will increase spending by 50% over the next five years or so have not even taken effect until 2027 for the most part.
▶ 2:52:53Sen. Marshall: I think it is an admission that the aca didn't work, that medicaid expansion didn't work. Why do we have failing hospitals now? Number one is hope for regulation. Specially in smaller hospitals. The aca led to so much regulation which led to consolidation of ministry. The next is the depopulation of rural america. We build hospitals with 100 beds and the average census in these rural hospitals is 1.6 patients per night.
▶ 2:53:23Sen. Marshall: So, it is hard to make a business plan that works like that. But I want to point out and say, thanks to president trump. That our medicaid provider tax, because that medicaid provider tax kansas is going to get an extra billion dollars this year. An extra billion with a b dollars. Rural health transformation fund, 222 million dollars. Doc pay is increased by 2.5% as well.
▶ 2:53:54Sen. Marshall: I think that you have done some great things. I mean, I would assume you have done as much financially for rural hospitals as any president in american history in the hhs has done.
▶ 2:54:05Sec. Kennedy: I would agree with that. I think rural health transformation fund is an inflection of money -- or, of an -- and increases the annual federal dollars to rural hospitals by 50% for the next five years.
▶ 2:54:22Sen. Marshall: Yeah. I mean, significant funding on event telling dollars I was talking about from the medicaid provider and -- tax is going to hospitals making them eligible for an as well. I want to talk about the rule -- rural emergency hospital model. This is something we worked on really hard in kansas, saying, what is the alternative? Here is three hospitals in the same county. Two hospitals in the same county.
▶ 2:54:51Sen. Marshall: They are each seeing 1.6 inpatients per day. There is no model that works. What does work? What type of health care model works in rural america? What is important to rural american health care? It is access to primary care addressing chronic diseases, but a good emergency room connected to a tertiary care center. That is what is important. And that -- Mr.
▶ 2:55:14Sen. Marshall: Secretary, I want to submit for the record some suggestions that would make it easier for hospitals to make those transitions to a rural emergency hospital model. There are some you can do but also things that congress needs to do. Can you briefly speak about rural emergency hospitals? I will cement this for the record, please.
▶ 2:55:36Chair Crapo: Please be brief in your response, Mr. secretary.
▶ 2:55:40Sec. Kennedy: If there is one or two patients a day you can sustain that that are going to stay overnight. But with those hospitals do need is really top rated emergency care. As you say, you can now use telehealth. To talk to specialists at a centralized hospital who can make sure you are getting the best procedures possible.
▶ 2:56:04Sen. Marshall: Thank you, Mr. chairman.
▶ 2:56:06Chair Crapo: Thank you. That concludes the senators' questions, except senator wyden has asked to make one more brief question, and then we will wrap it up.
▶ 2:56:17Sen. Wyden: Yeah, I saw on the news little bit ago, secretary kennedy, that a three euro girl was sexually abused in a foster home at an agency you oversee. Are you familiar with this?
▶ 2:56:32Sec. Kennedy: No, I am not.
▶ 2:56:35Sen. Wyden: You're the secretary of health and human services and it is in a national publication, and you did not know that a three-year-old girl was being sexually abused on your watch?
▶ 2:56:46Sec. Kennedy: I can tell you there were tens of thousands of girls and boys who were sexually abused -- the biden administration lost 425,000 children, and you never complained.
▶ 2:56:59Sen. Wyden: Whose job is to inform you of something like that? Because this, to me, is an unconscionable case.
▶ 2:57:06Sec. Kennedy: Why were you worried when you lost 425,000 children?
▶ 2:57:11Sen. Wyden: I read this in the newspaper.
▶ 2:57:14Sec. Kennedy: Why you suddenly worried about sexual abuse of children now antitrafficking when it was mass-promoted under the biden? Are they gave 420 5000 children to adults without identification?
▶ 2:57:27Sen. Wyden: I'm asking the questions here, and this was in a national publication seen by millions of people. An unconscionable examine of ministry -- example of mistreatment of a three-year-old and you don't know anything about it.
▶ 2:57:41Sec. Kennedy: This is selective in the nation. It is very dishonest, senator. Why don't you help find those children who are lost? We found 138,000.
▶ 2:57:51Sen. Wyden: We will have additional opportunities to talk to you. The reality is that this has been a long hearing, but a particularly important one, because the view on so many of these issues, where you basically bob, we have, and to deny, for example, your views on vaccines are toxic. No, people are suffering as a result of your discouraging vaccination and american families suffer.
▶ 2:58:19Sen. Wyden: And I have asked you repeatedly to give specifics -- you had all of these members who were on our legislation, all of these members say that they are concerned about trump rx and people not getting fair prices. You could settle this by giving me, tomorrow, all of the details. Now, if you want to talk about redaction's you can do it, but handed over now so we can get going.
▶ 2:58:44Sec. Kennedy: Were you doing yourself? You have had the power to do that for 20 years and have not done it, and that is why I was forced to do it.
▶ 2:58:52Sen. Wyden: For years I put pharma --
▶ 2:58:55Sec. Kennedy: [indiscernible] when I did instead of doing it yourself.
▶ 2:58:59Sen. Wyden: I'm speaking out today. This is a sweetheart deal for big pharma and the last exchange proves it, when you kept saying the drugs were cheaper.
▶ 2:59:08Sec. Kennedy: It is selective indignation, senator. It is all tribalism that is just destroying our country.
▶ 2:59:15Sen. Wyden: It is about public service.
▶ 2:59:17Sec. Kennedy: It is not honest.
▶ 2:59:19Sen. Wyden: I yield to the floor. >> thank you, senator wyden. Mr. secretary, you spent nearly three hours here with us and we appreciate you coming to have this discussion with us. Obviously we have disagreements up here on the dais, and I think that you have handled yourself very well and you have answered the questions very well.
▶ 2:59:42Sen. Wyden: I also think you are doing an outstanding job as the secretary of health and human services and I commend you for the results we are seeing. As I said in my opening remarks. Before we conclude I ask unanimous consent that senator grassley's questions be entered into the record. Without objection, it will be so ordered. Sir secretary, thank you brooke coming before the committee today.
▶ 3:00:09Sen. Wyden: Numbers are informed that the questions for the record should be submitted by next wednesday, april 29, at 5:00 p.m. And before I adjourn the committee I would like to ask the public to remain seated while the secretary departs. And with that, the committee is adjourned.