Hearings to examine the President's proposed budget request for fiscal year 2026 for the Department of Health and Human Services.

1[Senate Hearing 119-90]2[From the U.S. Government Publishing Office]34                                                 S. Hrg. 119-9056                      HEARING ON FISCAL YEAR 20267                        DEPARTMENT OF HEALTH AND8                         HUMAN SERVICES BUDGET9=======================================================================1011                                HEARING1213                              [BEFORE THE]1415                    COMMITTEE ON HEALTH, EDUCATION,16                          LABOR, AND PENSIONS17                          UNITED STATES SENATE1819                    ONE HUNDRED NINETEENTH CONGRESS2021                             FIRST SESSION2223                               ----------2425                              MAY 14, 20252627                               ----------2829                       Printed for the use of the30          Committee on Health, Education, Labor, and Pensions3132[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]3334                               __________3536        Available via the World Wide Web: http://www.govinfo.gov'3738                     U.S. GOVERNMENT PUBLISHING OFFICE3960-601 PDF                   WASHINGTON : 202640=======================================================================4142          COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS4344                BILL CASSIDY, M.D., Louisiana, Chairman45RAND PAUL, M.D., Kentucky            BERNIE SANDERS (I), Vermont,46SUSAN M. COLLINS, Maine                  Ranking Member47LISA MURKOWSKI, Alaska               PATTY MURRAY, Washington48MARKWAYNE MULLIN, Oklahoma           TAMMY BALDWIN, Wisconsin49ROGER MARSHALL, M.D., Kansas         CHRISTOPHER MURPHY, Connecticut50TIM SCOTT, South Carolina            TIM KAINE, Virginia51JOSH HAWLEY, Missouri                MAGGIE HASSAN, New Hampshire52TOMMY TUBERVILLE, Alabama            JOHN HICKENLOOPER, Colorado53JIM BANKS, Indiana                   ED MARKEY, Massachusetts54JON HUSTED, Ohio                     ANDY KIM, New Jersey55ASHLEY MOODY, Florida                LISA BLUNT ROCHESTER, Delaware56                                     ANGELA ALSOBROOKS, Maryland5758               Matthew Gallivan, Majority Staff Director59           Danielle Janowski, Majority Deputy Staff Director60                Warren Gunnels, Minority Staff Director61               Zain Rizvi, Minority Deputy Staff Director6263                            C O N T E N T S6465                              ----------6667                               STATEMENTS6869                        WEDNESDAY, MAY 14, 20257071                                                                   Page7273                           Committee Members7475Cassidy, Hon. Bill, Chairman, Committee on Health, Education,76  Labor, and Pensions, Opening statement.........................     177Sanders, Hon. Bernie, Ranking Member, U.S. Senator from the State78  of Vermont, Opening statement..................................     27980                               Witnesses8182Kennedy, Hon. Robert F., Jr., Secretary of Health and Human83  Services, Washington, DC.......................................     584    Prepared statement...........................................     785    Summary statement............................................    118687                          ADDITIONAL MATERIAL8889Statements, articles, publications, letters, etc.90Murkowski, Hon. Lisa:91    National Task Force letter...................................    5592Hassan, Hon. Maggie:93    HHS Employee Directory Geier.................................    5894    Geier Charge.................................................    5995    Geier Order..................................................    7796Markey, Hon. Ed:97    Make America Sick Again......................................   11598Blunt Rochester, Hon. Lisa:99    CDC has no Acting Director...................................   135100Sanders, Hon. Bernie:101    HHS reorganization budget and RIFs letters...................   145102Murphy, Hon. Christopher:103    Two articles about Robert F. Kennedy Jrs. vaccine opinions...   225104105                      HEARING ON FISCAL YEAR 2026106                        DEPARTMENT OF HEALTH AND107                         HUMAN SERVICES BUDGET108109                              ----------110111                        Wednesday, May 14, 2025112113                                       U.S. Senate,114       Committee on Health, Education, Labor, and Pensions,115                                                    Washington, DC.116    The Committee met, pursuant to notice, at 1:31 p.m., in117room 430, Dirksen Senate Office Building, Hon. Bill Cassidy,118Chairman of the Committee, presiding.119120    Present: Senators Cassidy [presiding], Paul, Collins,121Murkowski, Mullin, Marshall, Scott, Hawley, Husted, Banks,122Moody, Sanders, Murray, Baldwin, Murphy, Kaine, Hassan,123Hickenlooper, Markey, Kim, Blunt Rochester, and Alsobrooks.124125                  OPENING STATEMENT OF SENATOR CASSIDY126127    The Chairman. I was waiting for the cameras to leave, and128they weren't, so decided to rein them in. The Senate Committee129on Health, Education, Labor, and Pensions will please come to130order.131132    Secretary Kennedy, thank you for coming before the133Committee. President Trump has taken on the mission to reform134the Federal Government, making healthcare more affordable and135making America healthy again. It is clear the status quo does136not work. Bureaucratic bloat, regulatory hurdles at the137Department of Health and Human Services have made it harder to138deliver critical services.139140    HHS needs to work better for the American people. This141means finding ways to speed up approvals for life-saving drugs,142improving delivery of health care services so Americans who143need these benefits can receive them, addressing the high144levels of chronic disease, and holding bad actors accountable145to lower health care costs for the American people.146147    I am encouraged that HHS is already working to address148these issues. I want to note that this is the first time in at149least two decades the HHS Secretary is testifying on the150Department's budget before the HELP Committee. And I appreciate151Secretary Kennedy for coming to answer our questions on the152fiscal year 2026 budget.153154    Now, people fear change, even when it is from worse to155better. But without a clearly defined plan or objective, people156assume the worst. Much of the conversation about HHS's agenda157has been set by anonymous sources in the media and individuals158with a bias against the President.159160    Americans need direct reassurance from the Administration,161and from you, Mr. Secretary, that these reforms will make their162lives easier, not harder, and that is why I have invited you.163No one can make that case better than you. These are the164questions about how HHS will be able to preserve its primary165functions and duties under this proposed budget.166167    Many offices and programs potentially seeing changes are168essential for implementing bipartisan laws, including laws169championed and signed into law by President Trump. Example, in1702018, Congress worked with President Trump to pass the Support171for Patients and Communities Act, provide--protecting172communities, saving lives through increased access to naloxone,173and prevention and treatment for fentanyl addiction.174175    The HELP Committee and President Trump also worked together176to pass laws to improve research into health disparities,177address the needs of Americans with traumatic brain injuries,178Alzheimer's, Lyme disease, support family caregivers, and help179moms and babies live healthier lives, programs essential to180achieving President Trump's goal of making America healthy181again.182183    The proposed budget offices that are responsible for184overseeing many of these initiatives, which were initiated by185President Trump, will be consolidated or repurposed. Now, I186agree with Secretary Kennedy that HHS needs reform. Over the187past several years, I have engaged stakeholders and worked with188colleagues to identify opportunities to modernize a wide array189of HHS agencies and programs.190191    The Department needs to have an effective plan to fulfill192statutory duties in tandem with efforts to increase193transparency, accountability, to streamline programs, and to194root out wasteful spending. Congress and the Administration195should work together to ensure reform strike the right balance196and deliver for all Americans.197198    Mr. Secretary, once more, no one can set the record199straight better than you to explain how the Department will200maintain its critical duties and implement change important to201Americans' health.202203    By providing this clarity, we in Congress will be able to204advocate for shared priorities in future legislation, and you205will gain the trust of the American people, putting their minds206at ease. I appreciate you being here.207208    I look forward to hearing how the proposed HHS budget will209advance President Trump's mission. And with that, I recognize210Senator Sanders for his opening statement.211212                  OPENING STATEMENT OF SENATOR SANDERS213214    Senator Sanders. Thank you, Mr. Chairman. Mr. Secretary,215thanks for being with us. Let me begin by quoting a sentence216that came from your prepared remarks.217218    You state, and I quote, ``The United States remains the219sickest developed nation, and we spend $4.5 trillion annually220on health care, two to three times more per capita than221comparable nations. Clearly something is structurally wrong222with our approach.'' You are right. The current healthcare223system is broken. It is wildly expensive. It is dysfunctional.224225    What do we do, Mr. Secretary, to address it? Maybe for a226start, we do what every other major country on earth does and227recognize that health care is a human right guaranteed to every228man, woman, and child.229230    Maybe we understand that the function of a rational health231care system is not to make hundreds of billions of dollars in232profit for insurance companies and drug companies who often233engage in stock buybacks, pay their CEOs outrageous234compensation packages. There was a guy from one of the major235drug companies sitting exactly where you are sitting last year.236The guy makes $50 million a year. Meanwhile, we don't have237enough doctors.238239    We don't have enough nurses. We don't have enough dentists,240we don't have enough pharmacists, we don't have enough health241care workers in general. You are right, the system is242structurally broken. We spend far more, we have a shorter life243expectancy than other countries.244245    This is an issue that I want to address with you. How in246fact do we guarantee health care to all people and do it in an247effective way? Let me say a word about prescription drugs. You248and President Trump had a press conference earlier this week249discussing an Executive Order that both of you claim would make250sure that the American people pay the lowest prices in the251world for prescription drugs, not the highest.252253    As you mentioned at your press conference, this is a254concept that I personally strongly support, and I think you are255aware of that. But as President Trump and you should know, this256Executive Order, like Trump's previous Executive Orders on the257subject, will likely be thrown out by the courts, and we will258be back to exactly where we are today, paying by far the259highest prices in the world for prescription drugs. In my view,260the way forward is through Legislative action.261262    If you and President Trump are serious about significantly263lowering the outrageous price of prescription drugs in this264country, as I hope you are, I would very much appreciate both265of you working with me and other people on this Committee and266in the Senate on legislation that I will soon be introducing267which accomplishes exactly the same goal as you and the268President talked about, making sure that we pay no more for269prescription drugs than people in other major countries.270271    If we are serious about that, let's work together and let's272make that happen. And in fact, if Republicans and Democrats273come together on this, if we prioritize it, we can pass that274legislation in a couple of weeks. Thirdly, Secretary Kennedy,275all of us want to make the Government more efficient and cost-276effective, none fewer than I--there is too much bureaucracy.277278    But let me tell you also what we want and what the American279people want. And that is we want the Federal Government to play280a major role in continuing its efforts to combat such terrible281diseases. There is cancer, Alzheimer's, diabetes, heart282disease, and others terrible illnesses that claim the lives of283millions of Americans.284285    In that regard, I must tell you that I have heard from286citizens, patients, and doctors in Vermont and all over this287country who are deeply concerned that under the leadership of288you and Mr. Musk, the Trump administration has terminated at289least $13.5 billion in health care funding, including more than2901,600 grants to conduct vital research into cancer prevention,291Alzheimer's, diabetes, and cardiovascular disease, among many292other medical research investments.293294    In the first 3 months of this year, the National Institute295of Health has been effectively cut by $2.7 billion, a 35296percent cut reversing over a decade of investment in medical297research. Under your leadership, cancer research has been298slashed by 31 percent.299300    Further, Secretary Kennedy, under your leadership, you have301undermined the vital role vaccines play in preventing disease302during the single largest measles outbreak in 25 years, which303has led to over 1,000 cases of measles, over 125304hospitalizations, and 3 deaths.305306    Let me say a word about USAID. Elon Musk, the richest man307on earth, who has led the effort to cut health and nutrition308programs for the poorest people on earth, has absurdly309suggested that no one, ``no one'' has died from the massive310cuts to USAID. Mr. Musk is 100 percent wrong.311312    According to independent researchers, nearly 200,000 people313have already died throughout the world as a result of the314massive cuts in funding to prevent malaria, tuberculosis, HIV,315malnutrition, and other serious diseases. Further, as a result316of the elimination of U.S. funding for a global vaccine317program, it has been estimated that over a million children318will die because of the cuts that will save taxpayers very,319very little money. So let me just conclude by saying this.320321    The United States of America is the wealthiest country on322earth. We should have the best healthcare system in the world,323not one of the worst. Given our purchasing power, we should be324paying the lowest prices on earth for prescription drugs, not325the highest.326327    Instead of giving hundreds of billions of dollars in tax328breaks to the richest people in this country, we should be329proudly investing in coming up with cures for cancer,330Alzheimer's disease, diabetes, and other terrible illnesses.331That is what we should be doing, but I am afraid that in too332many ways, we are doing exactly the opposite. Thank you, Mr.333Chairman.334335    The Chairman. Thank you, Senator Sanders. I will now336introduce the witness. We are joined today by the Hon. Robert337F. Kennedy, Jr., the 26th Secretary of the United States338Department of Health and Human Services.339340    In his role as Secretary, Mr. Kennedy is responsible for341overseeing the Nation's civilian Federal health agencies who342serve over 150 million Americans. We look forward to hearing343from you today, Secretary Kennedy. Again, thank you for joining344us.345346 STATEMENT OF HON. ROBERT F. KENNEDY JR., SECRETARY OF HEALTH347               AND HUMAN SERVICES, WASHINGTON, DC348349    Secretary Kennedy. Thank you, Senator Sanders. I just want350to begin by saying I know how determined President Trump is for351us to have the lowest drug prices in the world as between352Europe and the United States. And I also know that he doesn't353care how we get there, that is where he wants Americans to be.354355    He has said I don't know how many times since I have been356involved with him, about that. We shouldn't be paying or be357able to go to London and buy GLP for $88 that in this country358cost us $1,300. And I know it is something that you have been359talking about for many years, and I look forward to working360with you on legislation or----361362    Senator Sanders. Thank you.363364    Secretary Kennedy [continuing]. Any way that we can to get365there. Thank you, Chairman Cassidy and Senator Sanders. I am366honored to be before you today to present the Department of367Health and Human Services Fiscal Year 2026 budget. Debilitating368disease, contaminated food, toxic environments, addiction, and369mental illness affect Americans across every race, class, and370political belief.371372    When my team and I took the helm at HHS, we set out with373clear goals. First, we aim to make America healthy again with a374special focus on the chronic disease epidemic. Second, we375committed to delivering more efficient, responsive, and376effective service to over 100 million Americans who rely on377Medicare, Medicaid, and other programs.378379    Third, we focus on achieving these goals by cutting costs380for taxpayers. We intend to do more, a lot more, with less. The381budget I am presenting today supports these goals and382reflects----383384    [Public interruption.]385386    The Chairman. The witness will suspend. The Committee will387come to order. Capitol Police are asked to remove the388individuals from the hearing room. Members of the audience--are389reminded disruptions will not be tolerated. Members of the390audience are reminded disruptions will not be permitted while391the Committee conducts its business.392393    Capitol Police are asked to remove the individuals from the394hearing room. That was a made for C-SPAN moment. The Secretary395will resume. Just a second, Mr. Secretary. Let's get the doors396closed and the ruckus is totally clear. Got it. Okay. And we397thank the Capitol Police for working with due diligence. Thank398you very much. Mr. Secretary, please resume.399400    Secretary Kennedy. The budget, I am----401402    The Chairman. Excuse me, Mr. Secretary. Will you reset the403clock? The clock has been running. Whatever it would be. Okay,404please.405406    Secretary Kennedy. All right. The budget I am presenting407today supports those goals and reflects two enduring American408values, compassion and responsibility. I invite the Committee409to unite around these ideals with me.410411    The United States remains the sickest developed nation in412the world, and we spend $4.5 trillion annually on healthcare.413Two to three times more per capita than comparable nations.414Clearly, something is structurally and systemically wrong with415this system. Furthermore, healthcare costs are steadily416increasing at a rate of 2 percent greater than the economy.417418    If we don't staunch this unsustainable hemorrhage, we will419ransom our children to bankruptcy, servitude, and disastrous420health consequences. Yes, an exploding debt is a social421determinant of health. We won't solve this problem by throwing422more money at it. We must spend smarter. We will shift funding423away from bureaucracy and toward direct impact.424425    Some things at HHS will not change. We will preserve legacy426programs like Medicare, Medicaid, and Head Start, as the427foundation of the MAHA Agenda. Vulnerable populations, seniors,428and veterans deserve consistent access to care, and I will429ensure that they receive it.430431    Today, 83 million Americans, urban and rural, lack adequate432access to primary care physicians. We will prioritize these433families, especially Native American and Alaskan communities.434We will protect IHS funding, streamline its operations, and435give the tribes more autonomy in managing their resources.436437    Let me be clear, we intend to make the Trump HHS not just438the most effective, but also the most compassionate in U.S.439history. Our official budget statement outlines many440priorities, but I want to highlight a few. First, we will441consolidate programs to better tackle mental health and442addiction.443444    These issues now rival chronic disease and their impact.445HHS will aggressively combat the opioid crisis, especially the446spread of synthetic drugs like fentanyl. We will empower state,447local, and tribal leaders to create effective solutions.448Second, we will address nutrition, physical activity, and449healthy lifestyles.450451    The President's budget requests $94 billion in452discretionary funds to support these priorities, including the453Administration for a Healthy America. We will emphasize healthy454eating in Head Start, and ensure the program continues to serve455its 750,000 children and parents effectively.456457    Third, we will equip FDA to expand its food safety efforts458through research, regulation, inspection, and education, remove459harmful chemicals from food and packaging. Fourth, we will fund460cutting edge research at NIH while cutting risky or non-461essential studies. That includes ending gain-of-function462experiments and research based upon radical gender ideologies.463464    At the CDC, we will return to core missions, tracking465disease, investigating outbreaks, and sustaining public health466infrastructure while cutting waste. Fifth, we will eliminate467DEI funding and redirect resources toward real poverty468reduction. We will move beyond lip service to communities of469color and take meaningful action to meet their needs.470471    Six, we will strengthen cybersecurity and health IT. The AI472revolution has arrived, and we are already using new technology473to manage health data more efficiently and securely. Finally,474we will rebuild public trust, a trust that eroded through years475of industry capture, corruption, waste, and misplaced476priorities.477478    We will launch a new era of transparency in public service,479creating an honest science-driven HHS that answers to the480President, to Congress, and to the American people. I look481forward to working with Congress to pursue this mission482together as a bipartisan cause.483484    Let's work side by side to make America healthy again.485Thank you.486487    [The prepared statement of Secretary Kennedy follows.]488              prepared statement of robert f. kennedy, jr.489    The mission of the Department of Health and Human Services (HHS or490Department) is to enhance and protect the health and well-being of the491American people.492493    President Trump and all of us at HHS take that charge seriously.494So, when a program is not as effective as it can be, or costs more than495it ought to, or fails to deliver on its promise--change and reform are496necessary.497498    The President's Fiscal Year (FY) 2026 Budget applies this mindset499to the work of the Department, making thoughtful and strategic500decisions to transform HHS and better protect the health and well-being501of the American people. The budget invests in methods to address502chronic disease; protect American families from environmental toxins;503promote nutrition as well as food and drug safety; strengthen services504for American Indians and Alaska Natives; encourage innovation in505America's healthcare future; and focus resources toward proven and506effective initiatives. This budget, likewise, recognizes the fiscal507challenges our Country faces today, and the need to update and redirect508our investments to meet the needs of a rapidly changing world.509510    The Fiscal Year 2026 Budget request includes reforms to put511healthcare spending on a sustainable fiscal path. We must remake the512government to maximize efficiency and productivity in order to fulfill513the President's promise to Make America Healthy Again (MAHA). HHS has514made progress toward these goals, promoting the health of Americans515while instituting significant workforce reductions and identifying over516$13 billion anticipated in contract savings--and there is more to come.517Over the next few months, we will work together with Congress to518restructure the Department and improve how we deliver services to the519American people. HHS takes seriously our role as responsible stewards520of taxpayer dollars, and we look forward to working with you to521implement the President's agenda while continuing to cut government522bloat and rescope the Federal role. Protecting the health of Americans523has to be done hand in hand with protecting our Nation's fiscal524health--they rely on each other. The Fiscal Year 2026 Budget will525reduce duplication of programs and services, increase accountability,526and work with state and local governments to improve flexibility.527528    The Fiscal Year 2026 Budget protects key programs that Americans529rely on that keep us competitive with our enemies, and fulfill promises530made to Tribal Nations. This budget allows us to do our part to restore531fiscal responsibility to the Federal Government while optimizing HHS's532ability to improve and save American lives. The reductions made are533necessary to right-size the Department's budget, which has ballooned by534about 40 percent since the COVID-19 pandemic.535536    The Fiscal Year 2026 Budget focuses on restructuring efforts to537transform HHS to Make America Healthy Again. I look forward to working538with you on our vision to Make America Healthy Again. The President's539Budget for HHS also reflects proposals to meet the President's540comprehensive Government-wide Transformation Plan through a sweeping541restructuring that aims to identify opportunities to improve the work542HHS does for the American people, in terms of its efficacy, efficiency,543quality, and cost-effectiveness.544545    The HHS restructuring will serve multiple goals without impacting546critical services. First, beginning in fiscal year 2026 it could save547taxpayers an estimated $1.8 billion per year through a reduction in548workforce. Our reductions have focused on aligning HHS staffing levels549to reflect the size of HHS prior to the COVID-19 pandemic which saw550around a 15 percent increase in the number of employees.551552    Second, it will streamline the functions of the Department.553Currently, the 28 divisions of HHS contain many redundant units. The554restructuring plan will consolidate them into 15 new divisions,555including a new Administration for a Healthy America, or AHA, and will556centralize core functions such as Human Resources, Information557Technology, Procurement, External Affairs, and Policy. The558restructuring plan intends to reduce regional offices from 10 to 5 by559planning to close regional offices in high-cost cities. This560restructuring will reduce the number of full-time employees to561approximately 62,000, while preserving critical staff such as FDA food562safety inspectors.563564    Third, the overhaul will implement the new HHS priority of ending565America's epidemic of chronic illness by focusing on safe, wholesome566food, clean water, and the elimination of environmental toxins. These567priorities will be reflected in the reorganization of HHS.568569    Finally, the restructuring will improve Americans' experience with570HHS by making the agency more responsive and efficient, while ensuring571that Medicare, Medicaid, and other essential health services remain572intact.573574    In summary, these changes will allow us to act more nimbly and575focus on the core mission of improving the Nation's health. Without576duplication of resources, and reduced bureaucracy, HHS can use Federal577dollars to more directly impact the lives of those served by HHS578programs. HHS will be prepared to share additional information with579Congress in the coming weeks. We look forward to congressional580collaboration in this process.581                        Making Americans Healthy582    One of the Department's top priorities is fighting the scourge of583chronic disease facing our Country. Today, Americans' overall health is584in a grievous condition. Over 70 percent of adults and a third of585children are overweight or obese. Diabetes is ten times more prevalent586than in 1960. Cancer among people 50 and under is rising by one or 2587percent a year. Autoimmune diseases, neurodevelopmental disorders,588asthma, Alzheimer's, ADHD, depression, addiction, and a host of other589physical and mental health conditions are on the rise.590591    The United States has worse health than any other developed nation,592yet we spend far more on healthcare--at least double; in some cases,593triple. Last year we spent $4.9 trillion, not counting indirect costs594like missed work. That's almost 17.6 percent of our Nation's GDP. But595more than that, it's a human tragedy--today, over half of all Americans596are chronically ill.597598    The President's Budget requests $94 billion in discretionary599funding to combat these challenges. This budget includes strategic600investments in the new Administration for a Healthy America (AHA). It601is my vision for this new agency to better coordinate programs targeted602to improve chronic care, disease prevention, and other health603resources.604605    The Fiscal Year 2026 Budget provides resources to the Department of606Health and Human Services that would allow the Secretary to tackle607issues related to nutrition, physical activity, healthy lifestyles,608over-reliance on medication and treatments, the effects of new609technological habits, environmental impacts, and food and drug quality610and safety.611                                  CMS612    Medicare, Medicaid, and the Children's Health Insurance Program613remain a cornerstone of the MAHA agenda to improve outcomes for our614seniors and children. This budget continues CMS program funding to615maintain beneficiary service levels, streamline program administration,616and move toward improved health outcomes while eliminating non-617statutory and wasteful spending. The Trump administration remains618committed to protecting these programs by ensuring that Federal619taxpayer dollars are protected against waste, fraud, and abuse.620                    Mental Health and Substance Use621    It is estimated that one in five adults in the United States lives622with mental illness--that's nearly 20 percent of the adult population.623Approximately 16 million Americans with mental illness had serious624thoughts of suicide. As the number of deaths by suicide continues to625increase, it is more important than ever that HHS expand access to the626care people need when they need it. An estimated 49.5 percent of627adolescents have had a mental health disorder at some point in their628lives. As child and youth mental health declines, HHS is dedicated to629providing resources to children and youth in their communities.630631    The Fiscal Year 2026 Budget invests in behavioral health by632streamlining programs to avoid duplication and supporting block grant633funding for these critical services. The Administration is committed to634combating the scourge of deadly drugs, especially synthetic opioids635like fentanyl, that have ravaged American communities, as President636Trump did during his first term. The President has made reducing the637initiation of drug use, particularly among young people, and increasing638the number of individuals receiving evidence-based treatment, leading639to long-term recovery from substance use disorders, a top priority. The640Budget also proposes to refocus activities that were formerly part of641the Substance Abuse and Mental Health Services Administration, by642eliminating funding for programs that duplicate block grant funding, or643are too small to have a national impact.644                              Primary Care645    Under the President's Executive Order to establish the Make America646Healthy Again Commission, I am committed to investigating any potential647root causes of the chronic disease epidemic. As part of AHA, programs648related to primary care will be streamlined, and focused on needs of649all Americans no matter where they may live and at what income level.650The Budget and the transformation at HHS support these efforts and651ensures that primary care includes prevention and addresses the root652causes of chronic disease.653                               Head Start654    For Americans to be healthy, we must start when they are children.655The President's Budget recommends Head Start continue to receive656funding equal to the Fiscal Year 2025 Enacted level. In exchange, Head657Start needs to be consistent with Administration priorities. This658includes increasing parental choice; improving health, education, and659employment outcomes; increasing program delivery efficiency; and660promoting parental engagement. Head Start directly supports local-level661institutions, including faith-based centers, empowering them to oversee662care. Head Start also enables parents to find dignity in work when663their children are enrolled in a safe and secure Head Start program.664                          Make Americans Safe665    I am committed to making Americans safer. I am working to make sure666our tax dollars support healthy foods--and we are scrutinizing the667chemical additives in our food supply.668669    Wholesome food is a key component of the MAHA agenda and670maintaining FDA activities that enable the United States to identify671harmful ingredients, and overall make the food supply safer, will be a672key component to the Department's ability to realize a healthy future.673      Protecting Our National Security and Sustaining Scientific674                            Competitiveness675    This budget also supports the Nation's public health infrastructure676and capacity to respond to existing and emerging public health threats,677with a focus on infectious diseases, preparedness, and outbreak678response.679680    While we need to rescale our biomedical research budget, HHS will681continue to prioritize America's national security and competitiveness.682Biomedical research continues to be one of our Country's biggest683exports. NIH is the largest single public funder of biomedical and684behavioral research in the world. This budget includes $27.5 billion685for NIH, a rebalancing that will focus on essential research at a more686practical cost and invest in security infrastructure. We will focus687only on Gold Standard science at NIH and across HHS, increasing688transparency for research done there.689690    NIH has broken the trust of the American people with wasteful691spending, misleading information, risky research, and the promotion of692dangerous ideologies that undermine public health. The Administration693is committed to restoring accountability, public trust, and694transparency at the NIH.695696    Supporting and encouraging scientific research is a longstanding697Federal priority, one that results in both a growing economy and698Americans living longer lives. Executing this responsibility demands699that the Federal Government regularly considers how to organize this700support in the most efficient manner possible. HHS is committed to701safeguarding taxpayer resources so that institutions are adequately702supported at a sustainable level, and that we are only funding703essential costs, in line with private-sector standards. The budget704proposes to consolidate major HHS research institutions in NIH to705maximize the effectiveness of their research.706707    The proposed budget shifts NIH's focus away from foreign interests708and reforms its efforts on the core research activities that align with709the President's commitment to Make America Healthy Again. NIH will no710longer issue grants to promote radical gender ideology to the detriment711of America's youth, or fund dangerous gain-of-function research, though712related research will continue consistent with Administration policy713and oversight. Our Administration is committed to eliminating radical714gender ideologies that poison the minds of Americans.715                            Restoring Trust716    At HHS, we're committed to empowering states, localities, and717Tribal communities by supporting science-based policies, rebuilding718trust in public health, and protecting future generations from harmful719exposures. We are committed to restoring a tradition of gold-standard,720evidence-based science--not one driven by politicized DEI, gender721ideology, nor sexual identity. We are removing the financial conflicts722of interest in our agencies--to create an honest, unbiased, science-723driven HHS, accountable to the President, to Congress, and to the724American people.725726    Americans do not want their tax dollars going to initiatives that727espouse radical ideologies. We are proposing to eliminate programs like728the Community Services Block Grants that have been hijacked from true729poverty reduction to fund DEI initiatives, saving taxpayers $770730million. Americans need to trust that we are good stewards of the731dollars they entrust to us, and this budget shows our commitment to732pursuing pathways to gain back taxpayers' trust.733734    We have also ended HHS as the principal vector for child735trafficking. The Budget re-focuses the Unaccompanied Alien Children736(UAC) program on its core mission of sheltering unaccompanied alien737children while also protecting them from child trafficking and labor738exploitation. During the Biden administration, HHS became a739collaborator in child trafficking for sex and slavery. The Biden740administration operated the UAC program like an assembly line,741prioritizing the quick release of children to insufficiently vetted742sponsors over the children's safety. And we have ended that. We are743very aggressively going out and trying to find these children that were744lost by the Biden administration.745746    The Budget refocuses the Centers for Disease Control and Prevention747mission on core activities such as emerging and infectious disease748surveillance, outbreak investigations, and maintaining the Nation's749public health infrastructure, while streamlining programs and750eliminating waste. The Budget proposes merging multiple programs into751one grant program that will address Sexually Transmitted Diseases,752Viral Hepatitis, and Tuberculosis giving States more flexibility to753address local needs.754                Strengthening the Indian Health Service755    Through the Indian Health Service (IHS), HHS is responsible for756providing quality healthcare services to more than 2.2 million eligible757American Indians and Alaska Natives.758759    HHS has a unique trust responsibility to provide healthcare for760Tribes, including on remote reservations and other vulnerable761communities in Indian Country. Without this support, many of these762communities truly have no other options for care. The budget763prioritizes and preserves funding for this agency.764765    Looking forward, and consistent with our statutory authorities, we766recognize that our provision of quality healthcare in Indian Country767and beyond must change to achieve and ensure the high quality of these768services. As more Tribes have assumed the responsibilities of providing769healthcare for their members with support from the IHS, investments in770the budget reflect our support for the growth of Tribal self-governance771in the provision of healthcare.772773                                 * * *774775    The President's 2026 budget for HHS recognizes the importance of776focusing government spending on programs that work and reforming our777Nation's healthcare programs for a fast-changing world. This Budget778recognizes that securing America's future demands sound fiscal779management and responsible decisions about our priorities. If we are780serious about fulfilling HHS's mission of enhancing and protecting the781well-being of all Americans, we must adopt the bold innovation and782direction espoused by the President's Budget to Make America Healthy783Again.784                                 ______785786                [summary statement of secretary kennedy]787    Thank you, Mr. Chairman, Members of the Committee.788789    I'm honored to appear before you today to present the Department of790Health and Human Services' Fiscal Year 2026 budget.791792    Debilitating disease, contaminated food, toxic environments,793addiction, and mental illness affect families across every race, class,794and political belief. When my team and I took the helm at HHS, we set795out with clear goals. First, we aimed to make America healthy again,796with a special focus on the chronic disease epidemic. Second, we797committed to delivering more efficient, responsive, and effective798service to the over 100 million Americans who rely on Medicare,799Medicaid, and other programs. Third, we focused on achieving these800goals while cutting costs for taxpayers. We intend to do more--a lot801more--with less.802803    The budget I'm presenting today supports these goals and reflects804two enduring American values: compassion and responsibility. I invite805the Committee to unite around these ideals with me.806807    The United States remains the sickest developed nation, and we808spend $4.5 trillion annually on health care--two to three times more809per capita than comparable nations. Clearly, something is structurally810wrong with our approach.811812    Furthermore, health care costs are steadily increasing at a rate 2813percent greater than the economy. If we don't staunch this814unsustainable hemorrhage, we will ransom our children to bankruptcy,815servitude, and disastrous health consequences. Yes, an exploding debt816is a social determinant of health.817818    We won't solve this problem by throwing more money at it. We must819spend smarter. The 2026 budget cuts costs through restructuring--not by820eliminating essential services. We will reduce 28 divisions to 15,821eliminate redundant units, and centralize functions like HR,822procurement, and policy. These changes will return us to pre-COVID-19823staffing levels and yield immediate savings of $1.8 billion per year,824with more savings ahead.825826    We will shift funding away from bureaucracy and toward direct827impact.828829    Some things at HHS will not change. We will preserve legacy830programs like Medicare, Medicaid, and Head Start as the foundation of831the MAHA agenda. Vulnerable populations, seniors, and veterans deserve832consistent access to care, and I will ensure they receive it. Today, 83833million Americans--urban and rural--lack adequate access to primary834care physicians. We will prioritize these families, especially Native835American and Alaskan communities. We will protect IHS funding,836streamline its operations, and give tribes more autonomy in managing837resources.838839    Let me be clear: We intend to make the Trump HHS not just the most840effective, but also the most compassionate in U.S. history.841842    Our official budget statement outlines many priorities, but I want843to highlight a few:844845    First, we will consolidate programs to better tackle mental health846and addiction. These issues now rival chronic disease in their impact.847HHS will aggressively combat the opioid crisis, especially the spread848of synthetic drugs like fentanyl. We will empower state, local, and849Tribal leaders to create real solutions.850851    Second, we will address nutrition, physical activity, and healthy852lifestyles. The President's budget requests $94 billion in853discretionary funds to support these priorities, including the854Administration for a Healthy America (AHA). We will emphasize healthy855eating in Head Start and ensure the program continues to serve its856750,000 children and parents effectively.857858    Third, we will equip the FDA to expand its food safety efforts--859through research, regulation, inspection, and education--to remove860harmful chemicals from food and packaging.861862    Fourth, we will fund cutting-edge research at the NIH while cutting863risky or nonessential studies. That includes ending gain-of-function864experiments and research based on radical gender ideology. At the CDC,865we will return to core missions: tracking diseases, investigating866outbreaks, and sustaining public health infrastructure--while cutting867waste.868869    Fifth, we will eliminate DEI funding and redirect resources toward870real poverty reduction. We will move beyond lip service to communities871of color and take meaningful action to meet their needs.872873    Sixth, we will strengthen cybersecurity and health IT. The AI874revolution has arrived, and we must use new technology to manage health875data more efficiently and securely.876877    Finally, we will rebuild public trust--trust that eroded through878years of industry capture, waste, and misplaced priorities. We will879launch a new era of transparency and public service, creating an880honest, science-driven HHS that answers to the President, to Congress,881and to the American people.882883    I look forward to working with Congress to pursue this mission884together--as a bipartisan cause. Let's work side by side to make885America healthy again.886                                 ______887888    The Chairman. Thank you, Mr. Secretary. I will start with889questions. Mr. Secretary, I appreciate that NIH wants to890recalibrate its research portfolio to address conditions not891previously attended to sufficiently, nutrition, conditions such892as a rise after viral infection like myalgic encephalomyelitis893or chronic fatigue syndrome.894895    But this is happening in tandem with reports that HHS is896closing the office for long COVID research and practice. And I897talk to people for whom long COVID is seriously impacting their898life.899900    To what extent will HHS continue to support research, data901collection, and other programs focused on understanding ongoing902health impacts of long COVID?903904    Secretary Kennedy. Senator, I am 100 percent committed to905finding treatments for long COVID. I am deeply involved in that906personally. I have a son who is really dramatically affected by907long COVID.908909    I have many, many friends who are affected by that, and by910Lyme disease, incidentally, which we also--is also a priority.911The COVID office was cut by an Executive Order from the White912House, but we have--everybody at NIH and at CDC is committed to913these kind of studies. And I can tell you personally, I will914make sure that they happen.915916    The Chairman. Thank you. The NIH is the largest public917funder of biomedical research in the world, given us an edge918over countries like China with whom we are obviously a919geopolitical rival.920921    But it takes a long time to develop this. And the rising922prevalence of neurodegenerative disease is one area in which we923have an impending crisis if we don't support the research and924advanced cures. And my concern--and now I will speak as a guy925from Louisiana. If NIH funding is substantially reduced, they926have folks at my universities, at Tulane and LSU, who are doing927work on these sorts of things.928929    Knowing that the NIH budget is getting squeezed, and the930indirect cost likewise, how will the NIH successfully do more931with less? How will we build those new scientists to find these932cures and to compete with geopolitical rivals?933934    Secretary Kennedy. Well, for one thing, Senator Cassidy,935you are talking about neurodegenerative disease. Now----936937    The Chairman. For example, ALS or Alzheimer's.938939    Secretary Kennedy. ALS, right. The Chinese are not spending940a lot of money on DEI. And there are--and we are cutting those941studies.942943    We are cutting studies on gain-of-function studies, and we944are cutting grants to foreign scientists from adversarial945countries, and particularly the Chinese, which have the946Thousand Talents Program, which is openly trying to exploit947U.S. research and take our IP.948949    We spend more than any country in the world on biomedical950research. We spend--NIH controls about 70 percent of the global951funding for biomedical research. The cuts we have made today952are cuts--are administrative cuts.953954    As far as I know, we have not fired any working scientist.955Of the working scientists, the people who are actually doing956science, there are some people who were--scientists that were957doing IT or administration. But in terms of--who did lose their958jobs. But in terms of working scientists, our policy was to959make sure none of them were lost and that research continues.960961    The Chairman. Let me--thank you. Let me ask you, the budget962proposes to eliminate several large block grants for hospital963and health Department emergency preparedness, and other core964public health capabilities, explaining states are better965equipped. To fund these activities.966967    Now, I agree that frontline public health happens at the968local level, but what works well in say Louisiana may not work969well in a State like New York. But rural under-resourced states970especially rely upon Federal funding to support public health.971972    How do you propose we balance competing interests,973returning power to states because there is a difference in how974different states do it, but replace the funding necessary to975combat these public health problems?976977    Secretary Kennedy. Well, I think it is a balance, Mr.978Chairman. And we have a legal obligation, CDC has a legal979obligation, to do national pandemic response, and we will meet980that obligation.981982    In fact, we are going to improve it, and particularly if we983can get support from this body, to refund, reappropriate the984PAHPA, which is critical for a pandemic response. But there are985some functions that are local in nature. And in those cases, we986will be supporting local infrastructure to respond.987988    They know better than we know, and we saw this during some989of the hurricane response with Governor DeSantis's response,990which was really Florida localized. There was no deaths and991very little destruction to a hurricane that was as bad as the992one that followed that relied on Federal response and was993really a catastrophe for the state.994995    I think experience shows that the locality is going to996often do better with some functions, particularly with the997hospitals and infrastructure. But we are not relinquishing our998responsibility at CDC to manage national emergencies.9991000    The Chairman. Thank you.10011002    Senator Sanders.10031004    Senator Sanders. Thank you, Mr. Chairman. Let me start1005going back to prescription drugs. Mr. Secretary, did I hear you1006correctly to state that your goal is to have Americans pay the1007lowest prices in the world or equivalent to what is paid in1008other major countries? That is my goal. That you are prepared1009to work with us on legislation to achieve that goal?10101011    Secretary Kennedy. Absolutely.10121013    Senator Sanders. All right. And I believe there's1014bipartisan support for it. I believe that if the leadership1015here prioritizes that, we can do that in a very short period of1016time. Look forward to that. Let me ask you this, as Secretary1017of HHS. We have in America today some 85 million Americans who1018are uninsured or underinsured.10191020    We spend more per capita as you have indicated than any1021other country. Is healthcare a human right? Are we making1022America healthy when so many people cannot afford to go to a1023doctor, when 68,000 people a year die because they don't get to1024a doctor when they should? Is healthcare a human right? Will1025you work with us to guarantee health care to every man, woman,1026and child in America?10271028    Secretary Kennedy. Well, I think you are asking two1029different questions. You are asking a philosophical question1030about whether it is a human right, like a Constitutional right.10311032    As an attorney, I would say that it is not a right of a1033kind that we otherwise enshrined in the Constitution, because1034healthcare costs your neighbor money. If I smoke cigarettes for103520 years, I make that choice, which is my choice----10361037    Senator Sanders. I don't have a lot of time, so I just--1038what I am get----10391040    Secretary Kennedy. If you ask a question--if you are asking1041me a philosophical question, I got to give you a thoughtful1042answer.10431044    Senator Sanders. Within 30 seconds.10451046    [Laughter.]10471048    Secretary Kennedy. It is not like freedom of speech, which1049costs everybody----10501051    Senator Sanders. But every other country, Mr. Secretary,1052every other country guarantees health care to all people as a1053right. Should we as Americans?10541055    Secretary Kennedy. The objective is to get Americans the1056level of the health care that they want, the choice, which1057Americans want.10581059    Senator Sanders. They don't want the choice to be1060uninsured. They don't want the choice to die because they don't1061get to a doctor on time.10621063    Secretary Kennedy. Americans prefer private insurance to1064other insurance sources.10651066    Senator Sanders. Do you believe--Okay.10671068    Secretary Kennedy. What I would say is I want to find a1069solution to this. I want every American to have insurance.1070President Trump wants every American to be insured and have1071access to health care. The question is, how do we get there?1072Obamacare is not working. It is not working. And this is the--1073--10741075    Senator Sanders. We can--sorry to interrupt you. All right,1076the reconciliation----10771078    Secretary Kennedy. My job is to try to make it work.10791080    Senator Sanders. All right. I have limited time. The1081piece--the reconciliation bill that is now being worked on in1082the House will come to the Senate. As it stands right now, cuts1083Medicaid in the Affordable Care Act by more than $715 billion,1084which the CBO has estimated would eliminate health insurance1085for 13.7 million Americans.10861087    Also raise those payments for millions of others. Is1088throwing 13 million Americans off of the health care they have,1089poor and working class people, keeping America healthy?10901091    Secretary Kennedy. I haven't seen that number. I have seen1092the number 8 million. And you are the people--the cuts are not1093true cuts. The cuts are eliminations of waste, abuse, and1094fraud. And I can go through--I can go through with the people1095who will lose it. A million people--there are million people--1096--10971098    Senator Sanders. Mr. Secretary, I really don't mean to be1099rude, but as you know, I have a very limited amount of time.11001101    Secretary Kennedy. You asked the question. I am going to1102answer it.11031104    Senator Sanders. Well--yes, I have got a bunch of questions1105that I would like you to answer as well. All right. We talk1106about austerity, doing more with less, but in that very same1107bill that is being worked on in the House right now, there are1108$235 billion in tax breaks for the top two-tenth of 1 percent.1109Do you think that makes sense, when that same bill would throw111013 million people off of Medicaid? Should we give tax breaks to1111billionaires and throw kids and others off of Medicaid?11121113    Secretary Kennedy. You are conflating the Congressional1114bills with proposals from the President. The President----11151116    Senator Sanders. No, I am talking about the Congressional1117bill. I am talking about the bill, the reconciliation bill.11181119    Secretary Kennedy. I mean the President is not trying to do1120tax cuts for billionaires. He is trying to have no tax on tips1121and no tax for overtime.11221123    Senator Sanders. $235 billion by--through the estate tax.11241125    Secretary Kennedy. How many people--how many billionaires1126do you know that are making overtime or making any--tips----11271128    Senator Sanders. $235 billion--look, it is a big bill.1129There are a lot of provisions in it. But you cannot deny, the1130top two-tenths of 1 percent will get $235 billion in tax rates1131while we cut Medicaid.11321133    The Chairman. Okay.11341135    Senator Paul.11361137    Senator Paul. Thank you. I want to commend Secretary1138Kennedy and the Administration for putting forward less1139spending. And one of the reasons I think we need to look at NIH1140and other grant-making organizations is, if you keep giving1141them the same amount, you will keep getting the same frivolous1142grants.11431144    I will recite a couple of them so people can remember.1145660,000 was given to study the impact of microaggressions on1146obesity-related eating in Latino Americans. Really maybe heart1147disease, diabetes, obesity, but eating disorders in Latino1148Americans. Here is another one.11491150    $419,000 to study if lonely rats seek cocaine more than1151happy rats. Maybe we could eliminate that and that could go to1152a real disease. Most recently, NIH recorded a $620,000 grant1153for LGBTQ+ inclusive teen pregnancy prevention program for1154transgender boys. And what they discovered was that girls who1155think they are boys are at least as likely to get pregnant as1156girls who thinks they are girls.11571158    Amazing, the science. But we should all agree that is just1159left-wing ideology. That is not science. We should study1160obesity, and cancer, and diabetes. I commend you for shifting1161the balance. I have a specific question about closing down Fort1162Detrick recently. My understanding is that a contractor1163intentionally slashed the hazmat suit or the biosafety suit of1164someone who was handling Ebola.11651166    You were immediately attacked in the press by saying it was1167just anti-science. Once again shutting down science. Was this a1168serious breach, and is it being investigated?11691170    Secretary Kennedy. We brought in the FBI to investigate it.1171And as you say, it appears like it was a deliberate criminal1172act to try to--that was a kind of--that is equivalent to1173attempted murder because the kind of microbe, the pathogens1174that they were handling have a very, very high case fatality1175rate--up to 50 percent.11761177    The disturbing thing about it is that there are three leaks1178a week globally from BSL4 labs, and any of those could be1179cataclysmic for humanity. And as a result, we not only closed1180Fort Detrick, and we brought the FEI in to investigate that. We1181also declared the end of gain of function studies, again, that1182will allow those kind of leaks to continue.11831184    Senator Paul. I commend you for that. I think ultimately1185legislation will be needed because the next Administration1186could reverse it. I think there is bipartisan support for some1187controls on gain of function. As you shut down gain of function1188though, you have to decide what it is, and then you have to1189look for it.11901191    I would suggest that at both Fort Detrick and at the NBAC1192lab that is nearby run by the DHS, that we look at experiments1193involving Ebola, avian flu, Marburg virus, to determine one,1194whether they are gain a function, but also just determine1195whether the experiments are wise. I am told in public records1196that they are doing experiments or have done experience to1197aerosolize Ebola at the NBAC lab. That is the DHS lab nearby to1198Fort Detrick.11991200    My hope is that when you investigate whether to do gain of1201function or what is gain of function, what is being done, that1202you will compile that and at least give us a report in1203Congress, and we are going to ask for it. But so there can be1204public scrutiny of these things. You will help scrutinize it,1205but the whole public needs to know how dangerous some of these1206things are and whether we should be doing them.12071208    The idea of aerosolizing Ebola, I think, is a--and, or1209training Ebola to be aerosolized is incredibly dangerous,1210probably goes against the biological weapons convention, and I1211would like to hear a little bit about whether or not as you1212investigate this, you plan on bringing information back to1213Congress or to the public.12141215    Secretary Kennedy. Yes, we are going to be absolutely1216transparent. I am--I have a trip planned to Fort Detrick with1217Kristi Noem, the Director of DHS, and with Jay Bhattacharya and1218other people in my agency, or experts on bioweapons, or experts1219on gain-of-function research and we are going to be absolutely1220transparent.12211222    We have also proposed a methodology for regulating and for1223determining which--what is dangerous gain of function and what1224is legitimate scientific investigation, and how to bring the1225public into that debate, which I think as you point out is1226absolutely critical.12271228    That is where we messed up last time, and as you know, we1229have some of the Democrats here who are talking about the great1230science from NIH, but now we have a major agency, intelligence1231agency, the CIA, the FBI, the DOE, and the State Department1232have all agreed that NIH research almost certainly led to the1233pandemic, the COVID pandemic.12341235    That is not the kind of the result that we should be1236allowing or enabling, and we are going to end that now.12371238    Senator Paul. If possible--the trip to Fort Detrick and to1239NBAC, we would like to be included or invited on that trip, if1240possible.12411242    Secretary Kennedy. Absolutely.12431244    The Chairman. Senator Murray.12451246    Senator Murray. Thank you, Mr. Chairman. Mr. Secretary, one1247of my constituents, her name is Natalie Phelps. She is a mom of1248two from Bainbridge Island in Washington State. She has been1249fighting aggressive stage four colorectal cancer for nearly 51250years now. Her best hope now is a clinical trial she is1251participating in at the NIH Clinical Center. She flew out to1252NIH a few weeks ago for her first appointment, and her care1253team there wanted her to come back in 4 weeks to start1254treatment.12551256    But because of the thoughtless mass firing of thousands of1257critical employees across NIH and HHS that you have carried1258out, Natalie's doctors at that clinical center have told her1259they have no choice but to delay her treatment by an additional12604 weeks.12611262    Now, an extra 4 weeks may not sound like a long time, but I1263will tell you, for stage four cancer patients like Natalie,1264this could mean the difference between life and death.1265Secretary Kennedy, how many staff have been cut from the NIH's1266Clinical Center? I want a specific number.12671268    Secretary Kennedy. I can't tell you that now, Senator1269Murray. But what I can tell you is that if you contact my1270office tomorrow, I will look specifically into that.12711272    Senator Murray. Well, that is not acceptable. I want an1273answer back on that. She deserves it. I do--she doesn't have1274much time. She deserves an answer back.12751276    Secretary Kennedy. Wouldn't you rather get her into that1277clinical trial as fast as you can?12781279    Senator Murray. Absolutely. I wanted----12801281    Secretary Kennedy. If you contact my office tomorrow, this1282is a--if that happened----12831284    Senator Murray. You are here to defend your budget. I am1285here to ask you questions about the impact of that.12861287    Secretary Kennedy. You asked me--you asked me about a1288specific case that I want to help with. I don't think anybody--1289I don't think that should happen to anybody.12901291    Senator Murray. Okay. Well, what have you, and I mean you1292personally, done to assess how those staff cuts are impacting1293patient care? She is one of many. What have you done to assess1294that?12951296    Secretary Kennedy. I provided the guidelines that said we1297shouldn't--no clinical trials should be affected by the cuts. I1298have--Matt----12991300    Senator Murray. Mr. Secretary, I just have a short amount1301of time. They are impacting clinical trials.13021303    Secretary Kennedy. You asked me a question. Do you want me1304to answer it?13051306    Senator Murray. I want to tell you. You need to know this.1307You are here to defend the NIH budget which you are----13081309    Secretary Kennedy. Senator, do you want me to answer your1310question? Do you want me to answer your question, Senator?13111312    Senator Murray. I want to tell you that Natalie is sitting1313there waiting for treatment and you are here to----13141315    Secretary Kennedy. I am offering to help her, but you don't1316care. You don't care about Natalie. I've offered to help1317Natalie.13181319    Senator Murray. I am asking you a question and it is1320critical. You are here to defend cutting NIH by half. Do you1321genuinely believe that won't result in more stories like1322Natalie's?13231324    Secretary Kennedy. I think the cuts that we are--that are1325now proposed by the NIH are going to hurt. I think that1326President Trump, listen, there is no agency head in the1327Government, like myself, that wants to see their budget cut.1328And----13291330    Senator Murray. Well, and I asked you, have you personally1331assessed what this is doing to patients? And I am telling you1332one story of one person. It is an impacting life or death1333situation. I think it is pretty----13341335    Secretary Kennedy. You want me to answer your question,1336Senator?13371338    Senator Murray. Well, you did.13391340    Secretary Kennedy. Okay. I have not. You have not allowed1341me to answer it.13421343    Senator Murray. Well, I will just say that it is my job to1344be a voice for people like Natalie and countless other patients1345who are like her. So, you have got to fix this. I want to know,1346and I want a personal update on Natalie's case. And you have1347offered that. Please give that to me in the next 24 hours. And1348I expect details and transparency about the state of NIH1349clinical care.13501351    Secretary Kennedy. You contact my office, Senator, and I1352will do everything in my power to try to get Natalie into1353that----13541355    Senator Murray. Let me--I have got 1 minute left, and I1356want to ask you about the NIOSH cuts. I am really alarmed by1357your decision to essentially eliminate the National Institutes1358for Occupational Safety and Health. You have already fired1359nearly 90 percent of the staff.13601361    That includes the staff in my state at the Spokane Research1362Lab. Those are experts. They do essential work to protect1363miners, and firefighters, and farm workers. People who work in1364dangerous conditions. I am told that after backlash you are1365reinstating some of those, mainly in the West Virginia office.13661367    But there doesn't--nobody in the Western United States. And1368there doesn't seem to be any rhyme or reason to how you have1369made these decisions. And how do you explain this to my1370constituents in Spokane who are out of a job, and the workers1371that are being impacted by that?13721373    Secretary Kennedy. The work in NIOSH will not be1374interrupted. We are going--I have brought back 328 workers,1375mainly in the Cleveland office, and the Morgantown office, and1376for the World Trade Center site.13771378    That work will continue. The work on mine safety will1379continue. The epicenter of that work has been Cleveland, and it1380has been Morgantown. We understand it is a critically important1381function, and I did not want to see it end.13821383    Senator Murray. Mr. Chairman, I would just say you can't1384fire 90 percent of the people and assume the work gets done.13851386    The Chairman. Senator Collins.13871388    Senator Collins. Thank you, Mr. Chairman. Mr. Secretary,1389nearly seven million Americans are living with Alzheimer's1390disease. And caring for people with this devastating chronic1391disease costs us some $360 billion a year. I am the author of1392the law that is known as the BOLD Act.13931394    It takes a public health approach to Alzheimer's. It1395educates providers, promotes earlier diagnosis. It helps1396caregivers, and it also promotes lifestyle changes. I have1397worked very hard to make sure that HHS has the resources to1398carry out this law, which was just recently extended. I am1399concerned that the reductions in force of approximately 10,0001400staff across HHS will completely undermine this Act.14011402    This Act in many ways is very consistent with your approach1403of looking at public health issues for chronic diseases. For1404example, the Healthy Aging branch administers the BOLD Act for1405Alzheimer's. It has lost all of its staff.14061407    How can you ensure that the CDC continues to implement the1408BOLD Act and the Alzheimer's programs under it when all of the1409staff responsible for that administration have either been1410placed on administrative leave or let go?14111412    Secretary Kennedy. I Don't know enough about that program.1413I know that under the--that division has been folded into the1414America--the Agency for Healthy America. And a lot of the1415reports that whole divisions have been liquidated were just1416wrong. They were divisions that were being reassigned under the1417reorg.14181419    Now, I am under a constrain here because at 4 o'clock1420yesterday afternoon we were told that there was--that a Federal1421judge granted a TRO in our case on the reorg. And my attorneys1422have asked me not to talk about any details of the reorg today.1423So I--but on that budget line, I will work with you. I am1424committed, Alzheimer's has run in my family.14251426    As you know my cousin Maria Shriver who is deeply involved1427in it. The NIH had a very, very checkered history on studying1428Alzheimer's because of the amyloid plaque scandal. And we have1429an opportunity now to do really good science and find a cure1430very quickly.14311432    Also find out equally, importantly, why so many people are1433getting Alzheimer's in this generation. I want to make that1434happen. I want to work with you, Senator, to make sure that1435happens and that those programs continue.14361437    Senator Collins. Thank you. I chaired recently the first1438Appropriations Committee hearing of the year, and we have1439focused on biomedical research and how important it is that1440America not lose its global edge in innovation that is1441producing life-saving and life-enhancing discoveries.14421443    Among the many issues that we covered, as you might expect,1444the hearing explored the 15 percent arbitrary, one size fits1445all percent cap that NIH has imposed on indirect, but still1446research-related costs for its grants. What we heard is that1447this cap will mean less basic research, fewer clinical trials,1448and that it will also cause our scientists and researchers to1449leave the United States and go to other countries.14501451    I believe strongly that this proposed cap is poorly thought1452out, that it is harmful, and I know that it violates current1453law because since 2018, we have included in the Appropriations1454bill specific language that prevents NIH from imposing such a1455cap.14561457    I know the system needs to be looked at, but are you1458reviewing how NIH's approach of this one size fits all 151459percent on indirect costs would affect laboratories, whether1460they are private, nonprofit labs, or whether they are in1461universities, as far as doing crucial biomedical research?14621463    Secretary Kennedy. Senator, we are. And you and I have1464talked about this issue. And I think that the impetus for the1465cap was that there were a lot of private universities with1466giant endowments like Stanford and Harvard that were getting1467indirect payments of 78--70, 78 percent.14681469    What that means if you get a million dollar grant, NIH then1470has to pay you an extra $780,000, or administrative costs. And1471a lot of those costs weren't even going to anything to do with1472science. They were going to the university budget. And in order1473to curb that abuse, we adopted a 15 percent which is the1474industry standard. That is what the Gates Foundation or any1475other foundation would pay.14761477    But I understand the University of Maine, University of1478Alabama, many other universities, state universities were not1479abusing it. We lost about $9 billion a year in those kind of1480costs. And so, we have a plan for how to address.14811482    Issues like what is happening at the University of Maine. I1483am being gaveled out, so I will talk to you privately about1484that.14851486    Senator Collins. Thank you.14871488    The Chairman. Senator Baldwin.14891490    Senator Baldwin. Thank you, Mr. Chairman. Secretary1491Kennedy, you run a Department that touches the lives of almost1492every American. Yet for this budget hearing, these are the six1493pages that we have gotten in terms of your budget request.14941495    We are also seven and a half months into this fiscal year,1496and yet you are not telling the American public anything about1497how you are spending the billions in taxpayer dollars right1498now. You had to submit an operating plan to the Congress, and1499this is just a sample page. But 530 programs simply have1500asterisks. Secretary Kennedy, this isn't about your hiding1501information from me.15021503    This is about your hiding information from the American1504public. And if you are going to cut cancer research or gut1505mental health support at least stand by your work and explain1506it to the American people.15071508    Now, Secretary Kennedy, I want to start with what I hope is1509an easy question for you. Do you think lead poisoning in1510children is a significant concern?15111512    Secretary Kennedy. Is lead poisoning--?15131514    Senator Baldwin. In children a significant concern.15151516    Secretary Kennedy. Is an extremely significant concern.15171518    Senator Baldwin. Thank you. Then I would like to know why1519your Department has effectively shut down the very program to1520address lead poisoning in children. The city of Milwaukee1521requested assistance from the CDC to help the city respond to1522lead poisoning cases tied to public schools.15231524    Six schools have been closed, displacing more than 1,8001525school children. The request for Federal assistance was denied1526because of lack of staff. The entire childhood lead poisoning1527branch has been fired. In the words of a Milwaukee mom, it1528really sends a message of, you don't matter.15291530    I don't know what you would say to parents who must now1531test their children for lead and deal with school closures. But1532do you intend to eliminate this branch at CDC, yes or no?15331534    Secretary Kennedy. No, we do not.15351536    Senator Baldwin. Okay. Because you cannot tell us that you1537want to make America healthy again when you are willfully1538destroying programs that keep children safe and healthy from1539lead poisoning. Congress dedicated $51 million in funding for1540this particular program.15411542    But when a community asks for help to prevent lifelong1543complications for children, and there was no one there to pick1544up the phone--and it is not because this program is1545ineffective. It is because you fired the entire team whose job1546it is to support communities like Milwaukee.15471548    Secretary Kennedy. If that money has been appropriated, we1549will spend that money. If it has been appropriated to1550Milwaukee, we will spend it in Milwaukee. I have spent a lot of1551time in Milwaukee working on that----15521553    Senator Baldwin. It is to provide expert--the entire staff1554has been fired. Secretary Kennedy, I did note in your opening1555testimony, although we wouldn't know it from the skinny budget1556that we have, that you plan on funding the Head Start program.15571558    But I want to tell you about the ramifications of what has1559happened to date with regard to Head Start. I have heard from1560families across the state. People who are terrified about these1561uncertainty and instability surrounding Head Start. Just 1 week1562into President Trump's administration, Head Start programs in1563Wisconsin suddenly couldn't access their grant funding.15641565    It forced one Head Start in Waukesha, Wisconsin to1566temporarily close, leaving 250 families without care. Over the1567last 4 months, HHS has provided roughly $1 billion less to Head1568Start programs across the country than during the same period1569last year. The delays in funding have exacerbated uncertainty1570for programs needing to make payroll. And in some instances,1571like the one I cited in Waukesha, programs have had to shut1572their doors until the payments came through.15731574    Now, I don't know what you would say to a parent who is1575unable to drop their child off at preschool because you failed1576to get already appropriated money out the door. Or maybe I1577should ask you, what would you say to a parent who shows up for1578childcare or for Head Start and the doors are closed?15791580    Secretary Kennedy. I would be very sad if somebody showed1581up--I fought very, very hard to make sure that there would be1582no cuts.15831584    Senator Baldwin. What is causing the delays in Head Start1585funding? That is my question.15861587    Secretary Kennedy. I fought very hard to make sure that1588Head Start gets all of its funding next year.15891590    Senator Baldwin. Well, we need it this year. And why are1591there delays now?15921593    Secretary Kennedy. I don't know that there are, Senator,1594and I will look into it. But I don't know--there should not be1595any delays. The funding is there. We are spending it. It is1596allocated. I don't know why there would be those kind of1597problems.15981599    There were--I can tell you that within the agency, there1600were, there were people who wanted to make the Trump1601administration look bad and that there were checks held up that1602shouldn't have been. I will have to look into that, Senator.16031604    The Chairman. Senator Murkowski.16051606    Senator Murkowski. Thank you, Mr. Chairman. Mr. Secretary,1607welcome. Good to see you. I want to talk a little bit about the1608HHS reorganization on some of the programs that impact Alaska's1609most vulnerable populations. I sent you a note letting you know1610that just after this hearing, I am going to be chairing a1611Senate Committee on Indian Affairs, specifically examining HHS1612tribal programs that are outside of IHS.16131614    I really thank you for your early efforts to exempt IHS1615health care providers from the RIFs. That was very important.1616But I have also heard concerns from tribal leaders on the1617impacts of RIFs to key HHS programs serving their communities.16181619    I know you are going to have some of your folks tuning in1620on that, and I really appreciate that. But some of the other1621reductions that we are looking at within your budget do have1622significant consequences to a state like mine.16231624    One is the LIHEAP program, the Low Income Energy1625Assistance. For us, it is not a budget line item. You have been1626to Alaska. You know that the temperatures there can get really,1627really tough. Keeps people from freezing to death in their1628homes. Another program is NIOSH.16291630    I know that HHS had rescinded a number of those employees.1631That was great news. But the employees that received RIF1632notices for the program were not rescinded in the NIOSH Center1633for Marine Safety and Health Studies. So this is--this is a big1634deal for our commercial fishing safety.16351636    It could effectively leave our fishing fleet out of1637compliance with Coast Guard safety regs, so we are watching1638that very, very carefully. And then, again, shared focus here1639on making sure that our children are as healthy as they1640possibly can be.16411642    I want to look to ways that we can strengthen and not1643eliminate the Head Start program. But I wanted to ask you----16441645    Secretary Kennedy. You are talking about the NIOSH program.16461647    Senator Murkowski. NIOSH, yes.16481649    Secretary Kennedy. You should talk to me about that. And as1650you know, that is something that I am deeply concerned with the1651commercial fishery. So, we should talk about it and let's, and1652let's work for a solution.16531654    Senator Murkowski. Got it. I am with you right there. Let1655me ask about domestic violence and sexual assault funding.1656Right now I am talking--I am receiving a lot of incoming from1657our community based domestic and sexual violence program1658operators.16591660    They are really concerned about the delayed release of1661Fiscal Year 2025 funding, the absence of notices of funding1662opportunities, as well as proposed cuts or consolidations that1663might threaten the Office of Family Violence Prevention and1664CDC's Division of Violence Prevention.16651666    You have got some programs there that are really1667foundational to domestic and sexual violence. They have been1668reauthorized with bipartisan support, so. I am going to enter1669into the record a letter from the National Task Force. And it1670basically--was sent to you, I guess, yesterday. Just urging the1671communication of concrete plans for releasing some of these1672funds.16731674    [The following information can be found on page 55 in1675Additional Material:]16761677    You are--I am going to raise that to your level. But I want1678to make sure that we are sending the right signal to so many1679who are just really on the edge with, again, these community1680based services that are helping the most vulnerable of the most1681vulnerable. So we have got the funding that is out there. It is1682just delayed. We need help releasing that.16831684    Secretary Kennedy. My understanding is that the domestic1685violence funding was not cut, so I don't know. I mean, I have1686to go back and check, but I specifically asked about that1687program last night and was told that there was no cuts. That1688President Trump is committed to it. And so, I don't know why1689people would be experiencing even delays.16901691    Senator Murkowski. It may be that it is--with the RIFs, you1692don't have people that are processing these things. So again, I1693want this to be at the top of your screen.16941695    Secretary Kennedy. That could be.16961697    Senator Murkowski. Last question for you. I mentioned1698LIHEAP. The budget proposal, the skinny budget proposes to1699eliminate LIHEAP. And the proposal says that it is unnecessary1700because states have policies preventing utility disconnection1701for low-income households, effectively making LIHEAP a pass-1702through benefiting utilities in the Northeast.17031704    Further, LIHEAP rewards States like New York and1705California, two of the top recipients for LIHEAP funding, which1706have implemented anti-consumer policies. I am just telling you,1707we are not in the Northeast. We are not in that bucket. We are1708cold. There are other places that are hot. LIHEAP is a1709lifesaver.17101711    I did see your statement from yesterday saying that OMB was1712thinking that President Trump's energy policy is going to1713reduce costs dramatically. It may. It may be a while. Right now1714folks in Alaska still need those ugly diesel generators to keep1715warm, so I would ask----17161717    Secretary Kennedy. I know. I was on a Navajo--first of all,1718I have heard that my whole life because my family was involved1719in providing low-cost energy to the poor in New England. And1720there are people in New England who suffer from--if energy1721prices are high and you have a cold winter.17221723    I was on the Navajo Reservation a couple of weeks ago and1724the Navajo President, Buu Nygren, said to me, if we cut LIHEAP,1725people will die on this reservation. I know the same is true in1726Alaska.17271728    The presumption behind the budget cuts were that the energy1729prices were going to drop dramatically in which case these1730payments would just become a subsidy to the oil industry. If1731that doesn't happen, I would expect Congress would then still1732appropriate the money and I will spend it.17331734    I have already spent $400 million between January and now1735on this program, and we have made to get it out--made sure to1736get it out to all the families that needed it, so----17371738    Senator Murkowski. I think you are going to find a lot of1739support on this Committee for that.17401741    Senator Murphy.17421743    Senator Murphy. Thank you very much, Madam Chair. Secretary1744Kennedy, I want to talk to you about your relationship with1745this Committee and this Congress. I want to talk to you about1746the statements that you made to the Chairman of this Committee1747and to Members of this Committee during your confirmation1748hearing about vaccines.17491750    You didn't tell the truth. I find that to be really1751dangerous for our relationship. If I were the Chairman, who1752believes in vaccines and voted for you because he believed what1753you said about supporting vaccines, my head would be exploding.17541755    In the hearing, you told us, ``I will not work to impound,1756divert, or otherwise reduce any funding appropriated by1757Congress for the purpose of vaccination programs.'' That is not1758the truth. You have done exactly----17591760    Secretary Kennedy. I have----17611762    Senator Murphy. Let me finish my question.17631764    Secretary Kennedy. I didn't hear what you said. I am just1765asking you to repeat it so I can understand your question.17661767    Senator Murphy. During the hearing--during the hearing--I1768will repeat it. During the hearing, you said to this Committee1769and to the Finance Committee, ``I will not work to impound,1770divert, or otherwise reduce funding appropriated by Congress1771for the purpose of vaccination programs.''17721773    That is not what happened. You have done the opposite. You1774canceled $12 billion in grants to the states, including my1775state, that are used to administer and track vaccines. You1776promised Chairman Cassidy----17771778    Secretary Kennedy. When did I do that?17791780    Senator Murphy. Madam Chair, would you allow me to finish1781my question?17821783    Secretary Kennedy. When did I do that?17841785    Senator Murphy. Let me--let me finish my question----17861787    Secretary Kennedy. You are making accusations. Just tell me1788when I did it so I can understand what the question is.17891790    Senator Murphy. You have canceled $12 billion in public1791health grants to states. Whether you know this or not, that1792funding is used by the states in part to be able to administer1793and dispense information about vaccines. Let me give you----17941795    Secretary Kennedy. Which programs?17961797    Senator Murphy. Mr. Secretary, let me give you the full1798panoply of the things you have said before this Committee that1799didn't turn out to be true. You also promised Chairman Cassidy1800that the FDA would not change vaccine standards from1801``historical norms.'' But what happened as soon as you were1802sworn in?18031804    You announced new standards for vaccine approvals that you1805proudly referred to in your own press release as a radical1806departure from current practice. And experts say that departure1807will delay approvals. You also said specific to the measles1808vaccine that you support the measle vaccine, but you have1809consistently been undermining the measles vaccine.18101811    You told the public that the vaccine wanes very quickly.1812You went on the Dr. Phil Show and said that the measles vaccine1813was never fully tested for safety. You said there is fetal1814debris in the measles vaccine.18151816    Secretary Kennedy. All true.18171818    Senator Murphy. This morning----18191820    Secretary Kennedy. All true. All true.18211822    Senator Murphy. This morning in front of----18231824    Secretary Kennedy. Do you want me to lie to the public?18251826    Senator Murphy. That is not--none of that is true.18271828    Secretary Kennedy. Of course it is true. Of course it is1829true, Senator. Senator, begging your pardon, you do not know1830what you are talking about.18311832    Senator Murphy. I will submit for the record----18331834    Senator Murkowski. Let's have a little bit of order so that1835you can get your question, and he can get his statement.18361837    Senator Murphy. Madam Chair, I didn't ask for a response1838yet.18391840    Senator Murkowski. I understand.18411842    Senator Murphy. I would like to lay out the predicate of my1843question before I am interrupted by the witness. He should have1844some respect for this Committee.18451846    Senator Murkowski. Go ahead. Go ahead.18471848    Senator Murphy. Just this morning in front of the House of1849Representatives, you also said that you, in fact, would not1850recommend that kids get vaccinated for measles. You said you1851would just lay out the pros and cons.18521853    Okay, so this is the summation of everything that you have1854said to compromise people's faith in the measles vaccine in1855particular. It is contrary to what you said before this1856Committee. You said you support the measles vaccine, but then1857you have laid out a set of facts that are contested.18581859    I will submit information for the record from experts who1860can contest what you have said about the vaccine. And the1861result is to undermine faith in the vaccines. Kind of like1862saying, listen, I think you should swim in that lake, but the1863lake is probably toxic, and there is probably a ton of snakes1864and alligators in that lake, but I think you should swim in it.1865Nobody is going to swim in that lake if that is what you say.18661867    I want you to acknowledge that when you say you support the1868measles vaccine, and then go out and repeatedly undermine the1869vaccine with information that is contested by public health1870experts, that is not supporting the vaccine. And so, I guess I1871have two simple questions for you.18721873    One is, can you clarify what you said in the House this1874morning? Are you or are you not recommending that families get1875their children vaccinated, or are you just giving people the1876pros and cons? And do you understand that when you say these1877things about the measles vaccine, what ends up happening is1878less people get the vaccine. That may be what you want.18791880    But do you understand that the result of constantly1881questioning the efficacy or safety of the vaccine results in1882less people getting the vaccine. So, I don't necessarily want1883to spend the remaining 20 seconds in an argument over the1884science, but you at least understand that is the consequence of1885what you are saying? And are you actually still recommending1886people get the vaccine or are you not?18871888    Secretary Kennedy. If I advise you to swim in a lake that I1889knew there to be alligators in, wouldn't you want me to tell1890you there were alligators in it?18911892    Senator Murphy. Are you recommending the measles vaccine or1893not?18941895    Secretary Kennedy. What I have said, and what I said in1896the----18971898    Senator Murphy. It doesn't sound like you are if that is--1899--19001901    Secretary Kennedy. Are you going to let me answer? Are you1902going to keep----19031904    Senator Murphy. Are you or are you not?19051906    Secretary Kennedy. Are you going to let me answer? What I1907pledged before this Committee during my confirmation is that I1908would tell the truth--that I will have radical transparency. I1909am going to tell the truth about everything we know, and we1910don't know about vaccines.19111912    Senator Murphy. Are you recommending the measles vaccine or1913not?19141915    Secretary Kennedy. I am not going to just tell people that1916everything is safe and effective if I know that there is1917issues. I need to respect people's intelligence.19181919    Senator Murphy. I think you are answering the question. I1920think you are answering the question. That is really dangerous1921for the American public and for families in this country.19221923    Senator Murkowski. We are going to--we are going to move to1924Senator Marshall.19251926    Secretary Kennedy. The reason they have lost faith in this1927program is because they have been lied to by public officials1928for year, after year, after year.19291930    Senator Murphy. The Secretary of Health and Human Services1931is no longer recommending the measles vaccine----19321933    Senator Murkowski. Senator Marshall.19341935    Secretary Kennedy. By the way, I said at the hearing this1936morning that I was recommending the measles vaccine. You can go1937look at the transcript.19381939    Senator Murkowski. Senator Marshall.19401941    Senator Marshall. Madam Chairman. Thank you so much for1942being here, Mr. Secretary. We are glad you are here. Let's stay1943on the measles vaccine just for a second. Let me catch my1944breath after that--all that. I am an obstetrician. If a 25-1945year-old pregnant woman asked me if she should take the measles1946vaccine, the MMR, I would have--give her the answer, no you1947shouldn't.19481949    But if she was 25 and trying to get pregnant, I would give1950her different advice. I have always valued the sanctity of the1951physician-patient relationship. I went to medical school for 41952years. I did 4 years of residency. I delivered thousands of1953babies.19541955    It is my job to give that recommendation. What is the role1956of the Secretary of HHS as far as recommendations of vaccine,1957and just discuss it a little bit further.19581959    Secretary Kennedy. Well, the vaccine recommendations,1960Senator, are normally made through ACIP, the Advisory Committee1961of Immunization Practices, which is an outside consulting1962committee at the CDC.19631964    There is another committee called FERPAC which is within1965FDA that actually recommends whether the vaccines get licensed1966or not. And so, that is where the recommendations come from.19671968    Traditionally, they have not done evidence-based medicine.1969They only adopted evidence-based medicine about 12 years ago.1970And what we have said during our Administration is we want to1971have safety studies prior to the licensure and recommendation1972of vaccines.19731974    Vaccines are the only medical product that is exempt from1975pre-licensing safety testing. So the only vaccine that has been1976tested in a full-blown placebo trial against an inert placebo1977was the COVID vaccine.19781979    The other 76 shots that children in this country receive1980between birth and 18 years old, none of them have been safety1981tested in pre-licensing studies against the placebo, which1982means we don't understand the risk profile for those products.1983And that is something that I intend to remedy.19841985    Senator Marshall. Okay. You said earlier you couldn't talk1986about the reorganization, and maybe you cannot answer this1987question, but I--maybe you can at least confirm these facts for1988me or not.19891990    Isn't it true that under Joe Biden's White House, they1991added 20,000 employees to HHS? When you were nominated, there1992was 28 divisions with HHS. 100 communication offices, 40 IT1993Departments, 9 H.R. units as well. Is that--can you answer that1994question?19951996    Secretary Kennedy. Yes, that is right there. There are1997dozens of IT Departments. There are eight senior finance1998officials.19992000    There are nine separate offices on women's health. Eight2001separate offices for minority health. Twenty-seven separate2002offices for HIV. Fifty-nine behavioral health programs. Forty2003opioid programs.20042005    What we are trying to do is consolidate, streamline,2006eliminate the redundancies, eliminate all those administrative2007costs for each one of those little Departments, consolidate2008them, and make them make sense and make them accountable to the2009American people.20102011    Senator Marshall. I don't--or I suppose all those IT2012systems communicate with each other? You all are on one IT2013system?20142015    Secretary Kennedy. There is 40--as you pointed out, there2016is 40 procurement Departments with four separate computer2017systems that don't talk to each other. So and as you pointed2018out, this--my Department grew by 38 percent over the last 42019years. I would say that is great if Americans got healthier,2020but they didn't. It got worse.20212022    What we are trying to do is go back to the pre-COVID2023levels, and to start making the Department function as it would2024if you, in a rational universe. And to bring in modern AI and2025telemedicine and all the opportunities we have now. These new2026efficiencies, and for medical delivery to the American people2027and for patient care.20282029    We are not able to take advantage of any of them because2030there is so much chaos and disorganization in this Department2031and everybody who has gone up against it in the past has thrown2032their hands up and given up. What we are saying is let's2033organize in a way that it can quickly adopt and deploy all2034these opportunities. We have to really deliver high-quality2035health care to the American people.20362037    Senator Marshall. If I could--this was going be a question.2038I am just going to make a statement. All the research that we2039do on MAHA, on soil health, on nutrition, in my heart, that is2040research on cancer. It is research of Alzheimer's.20412042    At the end of the day as well, we should be spending as2043much money at the front side of this as we are trying to cure2044the end of it. We are seeing epidemics of colorectal cancer.2045Young age Alzheimer's. All these things, and I think the2046research at the front end is every bit as important at the hind2047end.20482049    Secretary Kennedy. Senator Murphy made a good point. We2050have--the NIH has made all these extraordinary breakthroughs,2051and particularly in treating cancer reducing mortalities for2052colorectal cancer, but my question is, wouldn't it be--isn't it2053as important to find out why kids are getting colorectal2054cancer.20552056    When you and I were a kid, there were zero kids with2057colorectal cancer. It is epidemic now. So it is not really a2058badge for us when we say, oh, we can make it less lethal. Why2059don't we go figure out what is causing it and eliminate that2060exposure?20612062    With all of these, with Alzheimer's, with heart disease.2063Something is making Americans very, very sick. And our response2064should not be just, Okay, we will develop a pharmaceutical fix2065for it, or a medical fix. Let's figure out what it is and get2066rid of it so we can have healthy kids again.20672068    Senator Murkowski. Thank you.20692070    Senator Kaine.20712072    Senator Kaine. Thank you. Mr. Kennedy, I want to ask you2073some questions about staff reduction and kind of the timing of2074it. You were confirmed by the Senate on February 13, so I am2075sort of assuming that things happened before you were confirmed2076where other people's work.20772078    On January 28th, the fork in the road letter came out to2079people across the Federal employment space. Widely attributed2080to OPM and Elon Musk and DOGE. But that was before you were2081confirmed, so you had nothing to do with the fork in the road2082letter, correct?20832084    Secretary Kennedy. Correct.20852086    Senator Kaine. Okay. You were confirmed on February 13. On2087February 14, 1 day later, HHS announced that 3,500 probationary2088employees were going to be laid off. I know you are a hard2089worker, but am I right to assume that in the 1-day between your2090confirmation and the next day, you weren't the primary decision2091maker about laying off probationary employees at HHS?20922093    Secretary Kennedy. I was aware of it, and I could have2094blocked it.20952096    Senator Kaine. Yes. You were aware of it. So, you weren't2097the primary decision maker. Was that a decision that was made2098like OPM or DOGE? And because it wasn't just HHS, it was all2099Federal agencies who would lay off probation. Do you know where2100that decision was made?21012102    Secretary Kennedy. I had my full upper staff in place2103before I got there.21042105    Senator Kaine. Right, but did they make the decision or was2106it White House and DOGE to lay off probationary employees.21072108    Secretary Kennedy. They made the decision. My staff made2109the decision.21102111    Senator Kaine. Okay.21122113    Secretary Kennedy. Although, DOGE came in and DOGE gave us2114information that we wouldn't otherwise have had access to.21152116    Senator Kaine. Okay. Next we go to April 1st.21172118    Secretary Kennedy. I can also say this----21192120    Senator Kaine. No, all I asked was if you made it and you2121answered the question. And I appreciate it. April 1, HHS RIFs212210,000 employees effective June 2. Now, by this point you had2123been Secretary for about 6 weeks.21242125    A few days after that announcement, HHS staff briefed our2126staff at the Senate HELP staff, and basically just here are2127some highlights. In that 10,000 RIF, 467 staff at the2128Administration for Children and Families, 2,473 at the Centers2129for Disease Control, 322 at CMS, 400 at HRSA, 1,312 at National2130Institutes of Health, 197 at SAMHSA, 2,019 at the Food and Drug2131Administration.21322133    By now, you have been Secretary for 6 weeks, so this was2134RIFs, not the forks, but you were involved in the decision2135about these 10,000 RIFs, correct?21362137    Secretary Kennedy. Yes.21382139    Senator Kaine. In tandem with your leadership team,2140correct?21412142    Secretary Kennedy. Yes. And as I said before, I pushed back2143on certain ones and canceled certain ones.21442145    Senator Kaine. Yes. I think yesterday, it might have been2146earlier today, you confirmed that 20,000 employees have been2147let go--at HHS. 10,000 RIF-ed and 10,000 forked. Do you know2148how many of the 20,000 were veterans?21492150    Secretary Kennedy. No, I don't know.21512152    Senator Kaine. That is a fact that is very easy to2153determine from someone's personnel file, so I am going to ask2154that question for the record. We are finding across the2155Government that Veterans are disproportionately being let go,2156(A), because they are a higher percentage of the Federal2157workforce and (B), there a dramatically higher percentage of2158probationary employees because they leave military service2159after 10 or 25 years, and then they are probationary new2160employees when they join the civilian service.21612162    I want to find the answer to that question. Where does the2163rubber meet the road on 20,000 RIFs, and layoffs, and forks? In2164people not getting cancer trials--and I appreciate your2165willingness to help Senator Murray's constituents. In state2166grants being canceled. In Virginia losing $425 million in2167funding to the Virginia Department of Health. But here is a2168small example.21692170    All of our offices do case work. All of them do casework.2171And we get requests from constituents all the time. CMS is the2172largest agency in the Federal Government. Its budget is nearly2173twice the size of the Pentagon. And people who depend on2174Medicaid, Medicare, and the S-CHIP program really, really2175depend on.21762177    It is the most consistent in the top three or four in terms2178of constituent requests to my office. Answer this question2179about Medicare, or Medicaid, or the S-CHIP program. In every2180Administration I have served with, Obama, Trump one, Biden, I2181get answers to questions on behalf of constituents.21822183    I may not get them as fast as I like, and sometimes I like2184the answer and sometimes I don't. But let me show you what CMS2185is now doing to answer constituents' questions. I have omitted2186the name of the constituent, and I have omitted the name of my2187staffer. This was very recent.21882189    A hard-working retiree, patriotic, taxpaying American who2190is on Medicare wrote to ask CMS a very simple question about2191Medicare. Couldn't get an answer. Asked us to reach out. We2192reached out to the Medicare Part C and D Congressional Liaison2193Office, and here was their answer to our basic question.2194Unfortunately, there is not an update to provide. With the2195recent change of Administration, we are unable to provide any2196information related--on matters related to Mr. X's request.2197Congressional casework team.21982199    I mean, if you are just an everyday, hard-working American2200retiree on Medicare and you have a basic question about it, you2201ought to be able to get an answer. And I am just going to say,2202I have shared this with my colleagues, and many of us are2203having the same experience where our constituents can't get a2204basic question answered. I wonder if 20,000 fewer employees is2205connected to this. I yield back, Mr. Chair.22062207    The Chairman. Senator Husted.22082209    Senator Husted. Thank you, Mr. Chairman. Secretary Kennedy,2210thank you for being with us today. I appreciate the work that2211you have done in trying to raise awareness about making America2212healthy again, particularly as it relates to our dietary2213consumption. How food can be medicine, and food can make us2214sick. You have raised a great deal of awareness.22152216    When we talk about public education campaigns, I think you2217have done more to shine the light on things that average2218American can do to make themselves healthier than almost any2219Secretary I can recall. So, thank you for that service. I also2220have listened to a lot of the conversation today where somehow2221we think that spending more is somehow compassionate.22222223    On every single thing, like you have to spend more to do it2224even though every single person in this Congress knows that2225they are spending borrowed money that our children will have to2226repay. $106,000, their share of the national debt when you are2227a child born into this Nation right now. And everything that2228you can do to create savings and improve the quality of2229services that American taxpayers get from your agency, I2230commend you on it. I encourage you to do so.22312232    I want to give you the opportunity to share a couple points2233that you might want to share some of the work that you are2234doing in this budget is going to help people become healthier,2235generate some better outcomes for them, and savings that you2236think can be created that would not harm somebody's health, but2237actually preserve the fiscal future of this Nation, so that2238those children can grow up and have access to the American2239dream that we all had access to when we were born in this2240Nation. So, share your thoughts.22412242    Secretary Kennedy. I appreciate you raising that about the2243debt issue because the point I was making earlier was that2244there is no agency head that wants to reduce the size of their2245agency. I would rather have as much money and power as I can2246possibly have.22472248    I recognize that President Trump and the OMB Director have2249a larger duty and a larger vision, which is we are spending $22250trillion a year that we don't have, and we are billing our2251children, and that is a moral deficiency. Senator Sanders asked2252me about the morality of universal health.22532254    You can--there is a good moral argument for that, but there2255is also a moral argument--and, when we are spending $1 trillion2256a year just to service that debt, within 5 years, half of every2257dollar collected in taxes is going to go to servicing the debt2258and within 10 years it could be 100 percent and then our kids2259are doomed.22602261    That is a, the debt is a social determinant of health. We2262are trying to reverse that, and we are doing it in a way that2263it is not just throwing more money at the problem. We are2264revising the GRAS standards.22652266    Twenty years of Democrats have said, we need to revise the2267GRAS standards. I have done it in 100 days. We are getting rid2268of nine synthetic--petroleum-based synthetic dyes in our food.2269Twenty years the Democrats have been saying we want to do this,2270and I have done that in 100 days.22712272    I am--we are rewriting the dietary guidelines. The dietary2273guidelines that President Biden gave us, 453 pages long, and it2274is just an industry-generated document. The same industry2275impulse that put Froot Loops at the top of the food pyramid.22762277    We are creating a four-page document that can be locally2278sourced that will drive the school lunch program. We have2279called on and inspired Governors and Legislatures across the2280country to ask for exemptions to the SNAP program to get soda2281and candy off of SNAP. We have--am I getting--is that a timer?22822283    Senator Husted. You are good. Thank you for the work on2284SNAP, by the way, because getting unhealthy foods out of that2285program--if you are at the bottom quartile of income, you are2286almost twice as likely to be obese as if you are for the top2287cohort.22882289    Secretary Kennedy. Also diabetic.22902291    Senator Husted. It is costing people their productivity,2292their quality of life. It is costing the American taxpayer more2293money through Medicare, Medicaid, and other health services we2294provide.22952296    I just would say, we talked about kids. I want to give you2297a moment to share a thought. In 2022, we had a shortage of2298infant formula. There is a look at children now about how--what2299they should have in that infant formula. You are doing that2300with the----23012302    Secretary Kennedy. Operation Stork Speed.23032304    Senator Husted. Yes, exactly. Tell us a little bit about2305that and just--if you have a moment.23062307    [Technical problems.]23082309    Senator Husted. Well, I will just say, Mr. Chairman, thank2310you for doing that. How about that? There we go.23112312    The Chairman. But the Secretary made the statement that no2313vaccines except for COVID have been evaluated against placebo.2314For the record, that is not true. Coronavirus, measles, and HPV2315vaccines have been.23162317    Some vaccines are tested against previous versions. So just2318for the record to set that straight.23192320    Next, Senator Hassan.23212322    Senator Hassan. Thank you, Mr. Chairman. And Secretary2323Kennedy, thank you for being here. I would like to start by2324talking about the current measles outbreak, which I know is a2325concern for all of us here today.23262327    Two children in Texas have tragically died from measles2328this year, the first children to die from measles in our2329Country in more than 20 years. Measles is almost completely2330preventable with the measles vaccine. As you know, it is2331critical that families hear directly and clearly from2332healthcare leaders about how they can best protect their2333children.23342335    Mr. Secretary, I would like to give you an opportunity to2336sate clearly here today to any parents who are watching that2337the best way to protect their children from measles is to2338vaccinate them.23392340    Secretary Kennedy. I have said that the best way to stop2341the spread of measles is through vaccination. I would say this,2342we have handled this measles outbreak--we get a measles break2343every year. We have handled this measles outbreak better than2344any other nations affected----23452346    Senator Hassan. What I was interested in--I am just--you2347can say you--what I asked you to do was to say straight to the2348camera as you did on social media that it is your position that2349the best way for parents to prevent their kids from getting2350measles is to vaccinate them, and that is your statement2351today----23522353    Secretary Kennedy. I said that to you.23542355    Senator Hassan. All right. Well, that is great. Thank you.2356Now, you lead the Nation's health department, so let me ask you2357a couple of questions. Do you think HHS should employ anyone2358who has endangered the health of children?23592360    Secretary Kennedy. No.23612362    Senator Hassan. You hired David Geier to lead autism2363research at HHS, an individual who fraudulently posed as a2364doctor and gave dangerous medications and medical tests to2365children with autism.23662367    According to the State of Maryland's investigation, David2368Geier, who has no medical license or training gave hormone2369blocker injections to children with autism who were as young as23708 years old, which the Maryland Board of Medicine said poses a2371substantial risk of harm. Secretary Kennedy, yes or no, will2372you fire David Geier?23732374    Secretary Kennedy. First of all, what you are saying is not2375true. And we did not hire David Guyer to manage autism research2376at HHS. And----23772378    Senator Hassan. What is his job--what is this job then?23792380    Secretary Kennedy [continuing]. They have just said some2381very defamatory things----23822383    Senator Hassan. Well, no, I----23842385    Secretary Kennedy [continuing]. About a person who, by the2386way----23872388    Senator Hassan. Let me just be clear for the record----23892390    Secretary Kennedy. Those charges, Senator. I am going to2391correct the record on this because you have defamed----23922393    Senator Hassan. No, let me tell you what the record says2394and then I will hear from you. Last week when Mr. O'Neill was2395here in his confirmation hearing, I submitted for the record2396the charge that the State of Maryland laid out.23972398    Now, if you would like also for me to submit to the record2399with unanimous consent today the findings of the State of2400Maryland, which fined him $10,000 for practicing medicine2401without a license--he does not have a medical license--and for2402providing and instructing and giving children hormone blockers.24032404    That is what the finding of the Maryland Department--the2405State of Maryland, its medical licensing board was. And I will2406submit that for the record I hope with unanimous consent.24072408    Secretary Kennedy. I am assuming that you don't know what I2409am about to tell you, or you wouldn't say something that was so2410dishonest. You may or may not know that David Geier sued the2411American----24122413    Senator Hassan. Oh, I do know that. I do know that. That2414doesn't change the findings, nor does it change the experience2415of the parents who testified.24162417    Secretary Kennedy. That finding was reversed by court, and2418he was awarded $5 million.24192420    Senator Hassan. That is not true. Now, let me ask you, so I2421just want confirmation. David Geier is still at HHS. I wrote2422you a letter about this a month ago and you have not responded.24232424    Secretary Kennedy. Well, I apologize for that. That is our2425bad, and I will respond. But David Geier is not managing autism2426research at my agency, and we never said that he was.24272428    Senator Hassan. What is his job at HHS? This is somebody2429who gave parents the impression that he was a doctor and gave2430hormone blockers to children as young as eight, telling them2431that hormone blockers would somehow magically help their kids2432with autism.24332434    Senator Hassan. His father was----24352436    Secretary Kennedy. His father is a doctor, but he is not.2437And his father was not in the room and did not--and he faked2438his father's signature according to the State Board of2439Medicine.24402441    Secretary Kennedy. That ruling was overturned by a court.2442So what you are saying is just wrong. It is just a lie. And2443they were actually--the court said that the Maryland Board of2444Physicians was guilty of actual malice in fabricating those2445charges against David Geier.24462447    Senator Hassan. Well, we will pursue this. Last--and I will2448submit for the record----24492450    Secretary Kennedy. Do you want to know why we brought David2451Geier in?24522453    Senator Hassan. Sure.24542455    Secretary Kennedy. Because it wasn't to run autism2456research. In 2002, the CDC runs a vaccine safety data link,2457which is supposed to be the vaccine information, were the2458biggest HMOs that are supposed to allow CDC to have a2459surveillance system for vaccine injury. It is a backstop2460system. The CDC will not let any physicians in there to look at2461it, or any scientists, independent scientists.24622463    Senator Hassan. He is neither a scientist nor physician.24642465    Secretary Kennedy. The Congress ordered. CDC to open it to2466the Geiers. So they are the only scientists who have ever been2467in there.24682469    Senator Hassan. Yes, but again, Mr. Geier is not a2470scientist. Thank you.24712472    Senator Hawley. Okay. Senator Hassan's time has expired.2473But before we move on, did you have a unanimous consent request2474that I heard in there, Senator?24752476    Senator Hassan. Senator Hawley, I have a unanimous consent2477request for the web--the printout of the Web site that shows2478Dr. Geier is--not Dr. Geier, that is his father. Mr. Geier is2479employed. And also a unanimous consent request for the finding2480from the Board of Licensing in Maryland.24812482    Senator Hawley. Without objection to both of those.24832484    [The following information can be found on page 58 in2485Additional Material:]24862487    Senator Hawley. Now, Mr. Kennedy, before we get to my time,2488do you want--if you would like to finish your response, go2489ahead and I will recognize myself.24902491    Secretary Kennedy. Yes. Let me say that David Geier is the2492only living independent scientist who has seen the VSD inside.2493There has been a lot of monkey business with the VSD, including2494allegations of fraud.24952496    He was hired by an independent contractor, not as an HHS2497employee, but by an independent contractor to look at the2498documents that we were getting from the VSD to see if they2499conformed with what he saw between 2002 and 2016. And that is2500the only reason that he was brought in, to see if there was--2501there is so much information that has disappeared from that2502data base.25032504    The only way we could find out what information disappeared2505was because he was the one guy who saw it.25062507    Senator Hassan. Just let the record show he is not a2508scientist. Thank you very much.25092510    Senator Hawley. All right. Secretary Kennedy, different2511subject--on a different subject. You and I have talked before,2512and when you have been before this Committee and you, and I2513have talked in person a number of times about Mifepristone.25142515    I just want to follow-up with you because since the last2516time you were before the Committee the last time you and I2517spoke, there has been a major study by the Ethics and Public2518Policy Center of 865,727 prescribed cases of Mifepristone2519abortions, chemical abortions between 2017 and 2023. Have you2520seen this study? Are you familiar with this? Do you know what I2521am saying?25222523    Secretary Kennedy. Yes, I am.25242525    Senator Hawley. You will remember then that this data shows2526the biggest study on Mifepristone done, I think, ever. And it2527showed that nearly 11 percent of women experience very serious2528adverse health effects, to include sepsis, hemorrhaging,2529infection, of course, emergency room visits.25302531    Now, and by the way, that is 22 times higher, that rate is253222 times higher than the FDA's current label, which says it is2533just 0.5, the incidence of serious adverse health events. So my2534question to you is this. You previously testified to the2535Committee that you would do a top to bottom review of2536mifepristone.25372538    Mifepristone is subject to a REMS currently. You have said2539you will do a top to bottom review. Do you continue to stand by2540that? And don't you think that this new data shows that the2541need to do a review is, in fact, very pressing?25422543    Secretary Kennedy. I think the new--first of all, it2544validates the CAS study, which is previously probably the most2545comprehensive data that we have seen on it. And it is--and it2546is alarming. And clearly it indicates that at very least the2547label should be changed. I have asked Marty Makary, who is the2548Director of FDA, to do a complete review and to report back.25492550    Senator Hawley. Good. Do you have any sense of timeline,2551Mr. Secretary, on that?25522553    Secretary Kennedy. I do not.25542555    Senator Hawley. It will be a top priority though for you,2556is that safe to say?25572558    Secretary Kennedy. Yes.25592560    Senator Hawley. You say that it probably indicates the2561label needs to be changed. Do you think it is also important as2562part of your review to consider whether it is necessary now to2563put back in place the long-standing safety protocols that2564always accompanied Mifepristone until the last Administration,2565in-person dispensing, doctor visits, screening for ectopic2566pregnancies?25672568    Secretary Kennedy. I know that Marty Makary will make a2569recommendation. I feel that the policy changes will ultimately2570go through the White House, through President Trump.25712572    Senator Hawley. But you will make a recommendation based on2573the data?25742575    Secretary Kennedy. Yes.25762577    Senator Hawley. Good. On a different subject.25782579    Talking about the advertising that is routinely done by2580pharmaceutical companies. You have been a long-time critic of2581direct to consumer pharmaceutical advertising. You wrote, I2582think in the Wall Street Journal a little over a year ago,2583about the need to revisit guidelines around pharmaceutical2584advertising. Is that still your view? I mean, has your view2585changed?25862587    Secretary Kennedy. Yes. Pharmaceutical advertising is2588particularly insidious because commercial advertising has some2589level of First Amendment protection, not as great as political2590speech. It doesn't have the kind of strict scrutiny applied to2591political speech. It still has a level of protection.25922593    But pharmaceutical advertising is unique because if a2594company is advertising, for example, Coca-Cola, the consumer2595has a choice whether to buy it, and then he is spending his own2596money on it, so he has got skin in the game. With2597pharmaceutical advertising, the consumer is purchasing the2598product, and it is usually the most expensive form of the2599product.26002601    They are usually advertising because they want to vary the2602existence and the availability of generic drugs that are much2603cheaper and equally effective. And the consumer is spending not2604his own money but most often our money--taxpayer money.2605Furthermore, the pharmaceutical ad is getting tax deduction, so2606we are funding it.26072608    Senator Hawley. I want to ask you just about that. Under2609current law, pharma companies can deduct their advertising cost2610as a business expense. Do you think it is time to change that?26112612    Secretary Kennedy. I actually have a call in to Scott2613Bessent about that, but I am working very hard on this issue,2614and we expect to come out with a policy within the next few2615weeks.26162617    Senator Hawley. Well, let me propose that we work together.2618Today, I am introducing legislation to repeal the tax2619deductibility of these advertisements. It is a bipartisan bill2620with Senator Shaheen on the other side of the aisle here.26212622    It is a bicameral bill with both the Democrat and2623Republican sponsors in the House of Representatives. And my2624view is it is time to get rid of these tax breaks for these2625companies and to end this practice. Can you support that?26262627    Secretary Kennedy. 100 percent support it.26282629    Senator Hawley. Fantastic. I look forward to working with2630you on that. Alright, let the record reflect I am giving up2631Senator Hickenlooper 15 seconds----26322633    Secretary Kennedy. I assume Senator Sanders will also2634support that.26352636    Senator Sanders. Absolutely. I will go further. I mean, the2637idea----26382639    Senator Hawley. This is coming out of your time now, John.26402641    Senator Sanders. All right. The answer is yes.26422643    [Laughter.]26442645    Senator Hawley. All right. Senator Hickenlooper.26462647    Senator Hickenlooper. Senator Sanders can finish your2648thought, please.26492650    Senator Sanders. We are the, I think along with New2651Zealand, the only countries on earth that allow for2652pharmaceutical advertising. I think it is time we ended that.26532654    Senator Hickenlooper. Thank you, Mr. Chairman. And thank2655you, Mr. Secretary, for taking the time and for your2656willingness to come into public sector. I am not going to try2657and play got 'cha, but it is an opportunity to spend a little2658bit of philosophical time. And I guess one question is, do you2659think our Country spends too much on scientific research?26602661    Secretary Kennedy. No.26622663    Senator Hickenlooper. Okay. And so, obviously the NIH is2664the largest--in terms of biomedical research, there is the2665Howard Hughes Institute, but the NIH----26662667    Secretary Kennedy. 70 percent of the world.26682669    Senator Hickenlooper. Exactly, 70 percent the world. And I2670guess when you look at the level of cuts that we are facing2671over there--and I recognize that a lot of these cuts are2672imposed upon you, so. But there is a gap in basic fundamental2673research that is going to have to be filled somehow. And have2674you got any ideas of how we can do that, given the scale, the2675dimension of the loss we are facing?26762677    Secretary Kennedy. Well first of all, my job is to support2678the President on this and to support OMB. But the reality is2679that, as I have said, no agency head wants to see cuts to his2680agency.26812682    I love scientific research, so I want to do as much as2683possible. But I think because of the--we are very, very2684aggressively implementing AI, and I think we are going to do it2685faster and better than anybody else in Government, any other2686agency. We brought very, very high caliber people from Silicon2687Valley.26882689    Senator Hickenlooper. I get that. And that will accelerate2690and help us do more research----26912692    Secretary Kennedy. We can shorten clinical trials. We can2693get rid of animal trials, which we are already doing.26942695    Senator Hickenlooper. I am in support of all that, and we2696have talked about that for years.26972698    Secretary Kennedy. We can do--we can now do----26992700    Senator Hickenlooper. But the research I am talking about2701is not that so much as the fundamental science, basic science2702research.27032704    Secretary Kennedy. Like bench science, or epidemiological2705studies, or whatever. And I think we can do a lot of that stuff2706quicker. I will take as much money as you give me, and I will2707spend it well.27082709    Senator Hickenlooper. I just want to make sure to urge you2710to be a fighter for more of that research because there is a2711questioning of science right now within many in the White2712House--not everyone, but many in White House. It really needs2713to be pushed back. Senator Hawley, I will sign on to that bill2714as well. Second question I have got.27152716    We have a lot of issues around wildfires in Colorado right2717now, and with the--I will just go back to the NIOSH, the2718National Institute of Occupational Safety. You mentioned that2719they kept them in Cleveland, and I think somewhere in2720Pennsylvania. Pretty much everyone was laid off in Colorado.27212722    Secretary Kennedy. In Morgantown, yes.27232724    Senator Hickenlooper. Yes. Everyone is laid off in2725Colorado. And the question really--and I think a couple have2726been ordered to be reinstated. But all the West is dealing with2727these--I mean, thousands, tens of thousands, probably hundreds2728of thousands of people out fighting fires.27292730    These are people risking their lives. Walk away from their2731families every day. And the basic research that needs to be2732done, I don't think the replacements are going to be--in many2733cases, they are new onto the job.27342735    They are not going to be sufficient to address and really2736make sure the specific health needs of these workers, these2737outdoor workers are addressed. So, questions. How can we, how2738can you make sure that folks in Colorado like firefighters are2739able to do their job safely?27402741    Secretary Kennedy. I think a lot of the cuts there we are2742implementing now are painful cuts. And that they are cuts that2743are going to--are going to be difficult.27442745    But I think the President's position is that we are2746spending two trillion dollars that we don't have, that we are2747taking from our children. And we have got to protect their2748rights to prosperity, to enrichment, to dignity, to choice.2749And----27502751    Senator Hickenlooper. Again, I have heard that argument and2752I appreciate it. And I am a great frugal--a voice of frugality,2753at least in my office, and try to push around the Senate where2754it is allowed.27552756    But we are looking at a budget that is going to increase2757the deficit by who knows how much, $4 to $5 trillion. To take2758things like this that we know are successful--and not just for2759Colorado, but for almost every Western state essentially, and2760we are cutting receiving such a small amount of money for2761something that is so important.27622763    I just hope that you can push back on that a little bit.2764And someone has got to take a stand for these things that are2765minor financial benefits, but significant losses to how we2766provide safety for workers and our citizens.27672768    Secretary Kennedy. I am happy to work with you on that,2769Senator.27702771    Senator Hickenlooper. Okay. Great. I yield back to the2772Chair.27732774    The Chairman. The Committee will be adjourned for 5 minutes2775subject to the call of the Chair.27762777    [Recess.]27782779    The Chairman. The Committee will come to order.27802781    Senator Banks, you are next.27822783    Senator Banks. Thanks, Chairman.27842785    Secretary Kennedy. Senator, can I just say one word?27862787    The Chairman. Yes, sir.27882789    Secretary Kennedy. I want to clarify an issue that we2790talked about before. Senator Murray had raised the issue of a2791constituent of hers who she said had been denied a place in a2792clinical trial in Washington due to the RIF. We have been able2793to run down that case. The patient was medically ineligible for2794that trial.27952796    The Chairman. Ineligible?27972798    Secretary Kennedy. Medically ineligible, and nothing to do2799with the RIF. And NIH had been trying to get her into another2800clinical trial, but none of our clinical trials were shut down2801because of the RIF. That was a canard.28022803    The Chairman. Thank you for the clarification.28042805    Senator Banks.28062807    Senator Banks. Thank you, Mr. Chairman. Secretary Kennedy,2808you have--[technical problems]--compassion for Americans with2809autism and their families. There is still so much that we don't2810know about the conditions, and there are many questions to be2811answered.28122813    That is why I was glad that you recently announced an2814autism research data base similar to a registry that you2815created. The NIH has more than 80 registries for different2816diseases, and they are a critical tool to understand disease2817progression.28182819    But even in spite of all of that, you were immediately2820attacked for privacy violations and accused of ulterior2821motives. Can you tell us today how will this data base handle2822protected health information, and is it an opt-in or an opt out2823database?28242825    Secretary Kennedy. This is like--thank you for that,2826Senator--for asking that. This is a database--as you say, there2827is actually 190 disease databases at my agency. Almost every2828important disease has a registry.28292830    Arthritis has a registry, for example. Heart disease,2831cancer, various kinds of cancers. And the registry is intended2832to help scientists research what causes the etiology of disease2833and also what the cures are. It is entirely voluntary.28342835    Patient privacy is protected. The data is digitalized and2836depersonalized so that people cannot find out who the patient2837is. And patients have an absolute right to opt out of it. So,2838it is entirely voluntary.28392840    But it is a very important tool for scientists to use who2841want to understand how to treat diseases. If there is a number2842of people who have used, for example, chelation therapies on2843autism. And you can look at that. You can see what the outcomes2844were--or other kinds of therapies.28452846    Microbiome treatments, all these other--these various2847treatments that physicians and frontline treatment nurses and2848doctors are using across the country to address disease and2849find out which ones work and which ones don't.28502851    Senator Banks. You have also been accused of assuming an2852environmental cause of autism and rejecting a genetic cause.2853Can we say that your critics are misrepresenting what you2854really believe?28552856    Secretary Kennedy. Well, I don't believe--I don't think--I2857think if my critics are saying that I reject a genetic cause, I2858think they are correct in the sense that autism is an epidemic,2859and the genes do not cause epidemics. They can contribute2860vulnerability, but you need an environmental toxin.28612862    It is like cigarettes and smoking. Smoking cigarettes was2863killing one out of every five of its customers, the tobacco2864industry. That meant four out of five survived. So there is a2865genetic component to the ones who got lung cancer and died.28662867    That is a genetic vulnerability, but you also need an2868environmental toxin. You cannot have a sudden epidemic without2869an environmental exposure.28702871    Senator Banks. Have you halted or redirected funding away2872from any pre-existing autism research?28732874    Secretary Kennedy. I am told, and I haven't done this2875calculation myself, but I am told that there was a 20 to 12876research ratio for genetic cause of autism over the past 202877years at NIH.28782879    If you ask me, I believe that was because they did not want2880to look at the environmental exposures because they were scared2881of what they found. So, I don't think we should be funding that2882genetic work anymore. I think we know a lot about the genes,2883the upper fold-field vulnerabilities, high testosterone, low2884glutathione on the MTHFR gene, the genes that control2885methylation.28862887    All of these are involved, and we know that. And what we2888really need to do now is to identify the environmental toxins.28892890    Senator Banks. I appreciate greatly your attention and2891effort on that. Secretary Kennedy, we are importing a third of2892our medicines from China. It is a public health risk, as well2893as a national security risk, and you and I discussed this in2894your confirmation hearing. I asked you at that point about2895reshoring medicine production from China during that hearing. I2896wonder if you could give us any updates on how that is2897happening.28982899    Secretary Kennedy. Yes. I think there are very exciting2900things happening, and some of them as a direct result of2901President Trump's tariffs. And I have been working very closely2902with David Ricks of Eli Lilly.29032904    I think they have been the most aggressive of any of the2905pharmaceutical companies about answering President Trump's2906summons to onshore production. They have nine facilities now2907that are breaking ground. And one of them, the API facility,2908that they are breaking ground on will be, I believe, the2909biggest API facility in the world. These are ingredients active2910pharmaceutical ingredients.29112912    China controls that market right now, and this single2913facility could give us back dominance of that market. So I am2914very, very optimistic about what is happening. And I am2915grateful to Eli Lilly, which has not always been a big ally of2916mine.29172918    I am grateful, and we have been working very closely with2919the leadership of Eli Lilly to make sure they get what they2920need to onshore production because we saw during COVID that for2921essential medicines, we cannot afford to have the ingredients2922offshored.29232924    Senator Banks. Thank you for your leadership. I yield back.29252926    The Chairman. Senator Markey.29272928    Senator Markey. Thank you. Mr. Secretary, all I have been2929hearing from you today is your defense of and advocacy for2930brutal cuts to Medicaid, brutal cuts to NIH research to find2931the cure for Alzheimer's and cancer or other diseases, brutal2932cuts to community health centers, brutal cuts to the CDC, the2933early warning system for diseases.29342935    All to find the funding for tax cuts for billionaires and2936millionaires. That is all I have been hearing. And it is2937absolutely unbelievable that the Secretary of Health and Human2938Services can sit before the HELP Committee and make such an2939argument.29402941    Secretary Kennedy, for months I have been hearing from2942people about the impact that you and Donald Trump have had on2943them. And for months I have been sharing their stories. And I2944have compiled them here. And Mr. Chairman, I would like to2945include my Make America sick agenda--included in the record.29462947    The Chairman. Without objection.29482949    [The following information can be found on page 115 in2950Additional Material:]29512952    Senator Markey. Thank you. This is a set of stories that2953are being told to me that I would like to relate. Jennifer is2954from Massachusetts, is a stage four cancer patient. There is no2955cure for her diagnosis. Her life depends on Federal investment2956in research and for clinical trials to continue uninterrupted2957to find a cure for Jennifer--with NIH funding. She is right to2958be worried.29592960    I heard from Henry in Rhode Island who wants a--continued2961funding for cancer research, where he works. He is worried2962about getting fired because the labs NIH grants, under new2963leadership, were cut. He wants to work on cancer research to2964find the cure for Jennifer. You have already terminated $1.82965billion in NIH funding, which for Jennifer should really stand2966for National Institutes of Hope. She is losing hope.29672968    You are defending a 40 percent cut, Mr. Secretary, in2969research for Alzheimer's, for cancer, for stroke, for diabetes,2970for mental health. They are being slowed. They are being2971slashed. And I understand streamlining, but this is not2972streamlining. It is a bludgeoning of our health's future and a2973giveaway of our global scientific leadership. And it will be2974people like Jennifer who will pay the price.29752976    Lou from Massachusetts, he wrote to me about his son who2977died of an overdose. He said his son, Zach, was ``a loving and2978loved family member who had the illness of addiction.'' He2979wants research to cure this disease, funding for treatment2980without stigma, support for health workers serving people with2981addiction to prevent any other family member from suffering2982from the same fate.29832984    Can you honestly tell us, or tell him, actually, that you2985can cut $1 billion--$1 billion from the Substance Abuse and2986Mental Health Administration, including funding for programs to2987teach First Responders how to use naloxone to help to guarantee2988that other parents not lose their children?29892990    Can you honestly tell me that the cuts you have already2991made to addiction treatment across the country will make anyone2992healthier? How can you justify a $1 billion cut to substance2993abuse and mental health, Mr. Secretary?29942995    Secretary Kennedy. Senator Markey, you weren't here when I2996was talking earlier, but one of the things that I have talked2997about is that the budget for my agency increased by 38 percent2998over the Biden administration, and Americans got sicker, and2999more Americans overdosed, and more American died from cancer.30003001    We have now an epidemic of colorectal cancers in our3002children. And the chronic disease rate has now gone up to 603003percent. The autism rate has dropped to 1 in 31 children. And3004all that money that was supposed to cure those diseases or3005revert them, none if it worked.30063007    All we need is leadership and a new vision, and I am3008bringing that to my agency. And I am realigning my agency----30093010    Senator Markey. Okay. President Trump is negotiating with3011the Chinese about keeping fentanyl out of our Country.30123013    Secretary Kennedy. Well, that is a good thing, isn't it?30143015    Senator Markey. In the meantime, we can't be cutting the3016programs for the people who are already suffering from opioid3017related diseases. We can't cut the programs. Yes, it would be3018great if we could cut it.30193020    Be great if we can reduce it. While we are waiting for that3021to happen, why would we cut $1 billion from the programs that3022go to the families that have the substance abuse issues right3023now? Why would we cut it now, before we get a solution to the3024problem. They need things right now.30253026    Secretary Kennedy. First of all, most of the programs that3027support addiction, including naltrexone, narcan, suboxone,3028methadone, housing, we operate under SAMHSA 500. Are rehabs3029that give people access on their Medicaid. We are keeping those3030intact.30313032    We have--President Trump, because of his leadership, has3033dropped the fentanyl imports from this country because of3034leadership at the border by 40 percent.30353036    We are actually doing more with less, and we are going to3037continue to do that. And what I am doing at my agency is I am3038realigning all these perverse incentives that have driven up3039cost and driven down health. I am realigning so that people can3040make money in this country and markets can make money at the3041same----30423043    Senator Markey. Look--80,000 people died last year. This is3044not about efficiency. This is about cruelty. Cutting these3045programs--these people are already addicted. These people3046already need help. You are slashing the programs that families3047need right now.30483049    The Chairman. Senator Markey--Senator Markey.30503051    Senator Markey. Thank you, Mr. Chairman.30523053    The Chairman. Senator Moody.30543055    Senator Moody. Thank you, Mr. Chairman. And thank you for3056being here. I think it is wonderful that we are doing this3057hearing. Thank you, Mr. Chairman.30583059    I believe this is the HELP Committee's first HHS budget3060hearing in more than two decades. And certainly, I don't think3061this afternoon has been easy on you. And we are grateful that3062you are willing to answer the hard questions.30633064    Secretary Kennedy. Thank you, Senator Moody.30653066    Senator Moody. Have the difficult discussions because if I3067heard you correctly the 60 percent, 50 percent, whatever3068increase in the last 5 years in your agency, you said,3069reflected or resulted in people getting sicker and more people3070dying.30713072    We have to do more than just think of throwing money at3073something is going to solve a problem. And I am grateful for3074everyone that is stepping up on the cabinet and saying, I want3075to do this job in a deliberate way that is going to deliver for3076the people that means more than just coming here to Washington,3077and throwing money at problems, and spending taxpayer moneys3078without giving a lot of deliberate forethought to results.30793080    I think that is what you have been trying to say here3081today. And I appreciate you tackling this because not many3082people would want to brave this job, certainly at this moment3083in time, and as our Nation is spiraling out of control, and3084more and more debt, and more and more spending.30853086    We have got to be responsible for the future stability and3087success of this country. So, thank you. I start there. I also3088note that in some of the numbers that we saw in this proposal,3089there wasn't much information in terms of asking for more3090money. I am assuming that you are not asking for more money.30913092    Specifically related to the FDA, and I wanted to focus on a3093few things--and I believe your approach is probably going to3094be, how can we be better? How can we use the resources we have3095to do more for the American people, deliver on their health,3096without spending more money.30973098    One of those ways I believe in the FDA would be to tackle3099Chinese illicit vapes. I think 60 percent of their vape market3100that are in no way regulated, we have no idea what are in these3101things, chemical ridden vapes. All over the United States--3102being bought by all of our kids. I would ask that you dig into3103that and look at that.31043105    I know the FDA has been backlogged and the excuse kept,3106excuses kept coming out on why they weren't following through3107and enforcing this thing. Meanwhile, we have more and more kids3108that are vaping these chemicals and we have no idea what is in3109them. So would you look at that with your department, using the3110resources that you are asking for today?31113112    Secretary Kennedy. Yes, absolutely. We are looking at it3113right now. And during the Biden administration, the FDA slow3114walked the approvals for U.S. vaping companies. And the U.S.3115vaping companies, in my view, were acting very responsibly.3116They were putting chips in their vapes that would make sure3117that young people could not use them.31183119    They were giving good information about addiction. And they3120had very extensive labels. They really went out of their way3121not to make it attractive to children. They were slowed walked,3122so they are off the market. And in order to fill the vacuum,3123hundreds of Chinese companies came in with these colored,3124beautifully, attractively comic books----31253126    Senator Moody. Sour grape, watermelon----31273128    Secretary Kennedy. Watermelons--all these flavors are3129targeted to kids. They have video games on the vapes that lure3130kids into addiction. And we are going to wipe them out. We are3131going to get rid of all of them.31323133    Senator Moody. Thank you. Thank you for that commitment. As3134a mother of a teenager and on behalf of all moms of teenagers,3135I know that vaping was going on in some of even our elementary3136and middle schools. We thank you. Using the resources that are3137given to you, if we were just more deliberate and aggressive in3138what we are doing within the agency, I think we can make a huge3139difference.31403141    I want to direct your attention to one more important3142issue. One of the things that drives me crazy is when nonsense3143regulations are on the books and they have no benefit3144whatsoever, but yet they are on the book and businesses are3145trying to comply with them. In our citrus industry, our orange3146juice producers, there is a regulation that requires a certain3147sugar content.31483149    It is called a Brick Standard. Doesn't affect quality or3150nutrition at all. In fact, our oranges now that are being3151produced in Florida produce slightly less sugar. But because of3152this arbitrary standard, producers of orange juice in Florida3153have now had to start importing--from foreign companies and3154foreign nations, oranges into our Country to mix with our3155products to deliver orange juice. The standard, it doesn't3156affect quality or nutrition.31573158    Secretary Kennedy. Raise the sugar content in the orange3159juice----31603161    Senator Moody. We want to lower the sugar content that is3162required by this regulation. I am sure you would not disagree3163with that. But would you look into an interim final rule that3164would lower that slightly to save the orange juice industry3165domestically?31663167    Secretary Kennedy. Yes. Why don't you call Heather Flick,3168who is behind me, or Hannah Anderson, this week and we will act3169on that as quickly as we can.31703171    Senator Moody. Again, using the resources we have, just3172being smarter in our approach, we can do a lot to save a once3173thriving industry. Thank you.31743175    Secretary Kennedy. Thank you.31763177    The Chairman. Senator Kim.31783179    Senator Kim. Thank you, Chairman. Mr. Secretary, I wanted3180to just relay, I had a town hall. I had a fire captain show up3181to this town hall--somebody who worked at Ground Zero.31823183    He is somebody who said he was diagnosed with cancer. He3184said he is on borrowed time, and he was livid, absolutely livid3185about what he said, the Administration gutting the World Trade3186Center Health Program. And we have talked through some of these3187cuts that have happened before. Some staff cuts. Some may be3188brought back on.31893190    The Administrator cut. I just need to hear from you. I3191promised this fire captain I would ask you about this. What in3192the world happened? Why was the staff cut for this program?3193What are we to expect going forward?31943195    Secretary Kennedy. I restored this after that program.31963197    Senator Kim. Why was it cut to start with?31983199    Secretary Kennedy. It was part of the overall budget cuts.3200Our agency was asked to make very, very serious budget cuts3201that were going to be painful. And some of them should not have3202been made, and that was one that should not have, and I3203reversed it.32043205    Senator Kim. Were you unaware, or were you aware, that the3206decision to cut NIOSH staff would cut that World Trade Center3207Health Program?32083209    Secretary Kennedy. My agency is the biggest agency in3210Government. It is twice the size of the Pentagon. It represents3211about 20 percent of the U.S. economy. We have hundreds of3212institutes and sub-agencies. We try to be as careful as we can3213about what we cut and what we didn't. We made a couple of3214mistakes. That was one----32153216    Senator Kim. No, I don't think you were trying to be as3217careful as you can. I mean, that is the problem that we have3218seen by rushing these decisions. This was, I know, already in3219your time there.32203221    Secretary Kennedy. Senator, I understand that if you look3222at this from a distance, you would say, why don't you just do3223this surgically and cut one person at a time. We--this agency3224has grown so big, so fast, and everybody who comes in says, I3225am going to cut it down, and nobody has been able to do it.32263227    There was an understanding that the longer that you wait,3228the more the inertia kicks in. And we had to act quickly so3229that we can do something for the American people that is3230lasting. And we understood that there would be some mistakes3231made, and that we would go back and reverse them when they were3232made.32333234    But it was more important to do decisive action quickly3235that could eliminate the metastasizing of this agency which was3236growing, and growing, growing as our health declined.32373238    Senator Kim. Where is this going to land now? Can you tell3239us right now that the staffing of the World Health--the World3240Trade Center Health Program will go back to where it was before3241you became Secretary? Is that----32423243    Secretary Kennedy. That program will continue. There will3244be continuity in that program. That is all I can tell you.32453246    Senator Kim. Continued, yes. But at full strength to where3247it was before you were Secretary?32483249    Secretary Kennedy. The program itself will continue.32503251    Senator Kim. Well, look, the fire captain also raised this3252issue about the National Firefighter Cancer Registry. Also3253something I promised him I would ask you about. Why was that3254shut down?32553256    Secretary Kennedy. Cancer registry--I don't know about3257that.32583259    Senator Kim. You don't know about this?32603261    Secretary Kennedy. No.32623263    Senator Kim. Okay. Well, look what I will just tell you3264is----32653266    Secretary Kennedy. I am happy to work with you on it3267though. It is----32683269    Secretary Kim. There is a National Firefighter Cancer3270Registry, and this is something that is part of NIOSH. And3271because of the cuts, when I go to the Web site, as I am right3272now, it says, ``the information on this page is not currently3273being updated and access to tool is limited.32743275    Firefighters can no longer enroll in the National3276Firefighting Registry for Cancer.'' So I just raise this3277because this is incredibly important, not just for those that3278were at Ground Zero, but just writ large across our Nation to3279try to help our firefighters. So can you promise me that we3280will work together and try to get this back up and running as3281soon as possible?32823283    Secretary Kennedy. I will work with you on those issues,3284Senator.32853286    Secretary Kim. Look, I understand what you are saying when3287it comes to your prioritization, but I will tell you, it is3288sending an absolutely disastrous message, especially to our3289firefighters.32903291    I mean, I hope that on the list of things in this Congress3292that we think are bipartisan, are unanimous, it should be about3293supporting our heroes at the World Trade Center, especially3294when we have more firefighters who have died since 9/11 because3295of medical issues that they have had working there at Ground3296Zero. Then, those number of firefighters that died on September329711th.32983299    If we can't even agree on that, if that is not seen as a3300high enough priority to try to protect, then I am worried about3301everything else that is more controversial, has less unanimity.33023303    Secretary, I will follow-up with you on the National3304Registry, and I do want a firm answer on you on what is the3305final staffing at the World Trade Center Health Program. And3306with that, I will yield back.33073308    Secretary Kennedy. Thank you, Senator.33093310    The Chairman. Senator Murray has returned. She has asked3311for a request for 30 seconds to respond to what the Secretary3312had responded to her.33133314    Senator Scott. May I ask a question?33153316    The Chairman. Yes, sir.33173318    Senator Scott. Does her 30 seconds take me down to 43319minutes and 30 seconds?33203321    The Chairman. No, sir.33223323    Senator Scott. Okay.33243325    The Chairman. I will give you 5:30 if you want.33263327    Senator Scott. Even better. Thank you.33283329    Senator Murray. Mr. Chairman, thank you for accommodating3330and letting me speak here, because Secretary Kennedy came back3331and said that my constituent that I spoke about earlier was not3332delayed by staffing cuts. First off, she is already enrolled in3333that clinical trial. It is not a question of eligibility.33343335    The issue, as I stated clearly, was the delay in care that3336she got. And what you stated, Secretary Kennedy, is not true. I3337spoke with Natalie actually last night. She asked her NIH3338doctor directly why, and she--when she was informed of the3339delay, and her doctor at NIH said very plainly twice, her care3340was delayed because of staffing cuts.33413342    I would just, Mr. Chairman, I think it is important for the3343record to show my staff has put in inquiries with HHS3344leadership, and they have been unresponsive so far. And just to3345make it clear, this is just one case of many, but those are the3346facts. Thank you, Mr. Chairman.33473348    The Chairman. Thank you.33493350    Senator Scott.33513352    Senator Scott. Thank you, Mr. Chairman. Thank you,3353Secretary Kennedy, for being here with us today. I oftentimes3354hear you say that ``happy to work with you.'' And I will say3355that you said it to Senator Kennedy, and as a person who has3356asked you to work on a number of topics, when you say happy to3357work with you, you have actually been a man of your word, and I3358truly appreciate that.33593360    We talked about the importance of sickle cell anemia and3361the research being done, and I invited you down to South3362Carolina and you took me up on my offer. You came last month,3363and I really appreciate you taking the time and investing the3364energy to talk about an issue that is critical to so many3365folks, specifically African Americans.33663367    As a guy that is thankful that we are working to eliminate3368diversity, equity, and inclusion in the Federal Government, I3369do not want some folks to think that all things racial are3370somehow DEI. And frankly, sickle cell anemia is a classic3371example of something that has a racial nexus, but it is not3372diversity, equity, and inclusion. It is just a basic fact that3373African Americans, 99.9 percent of the time, are the folks that3374are suffering through sickle cell anemia.33753376    Frankly, if you go beyond sickle cell anemic, you find3377other diseases that have a consistent presence in minority3378communities. And to that end, I think it is really important3379that we continue to work together on building on issues3380impacting minority and other communities.33813382    I would love, Senator--Secretary Kennedy, as you move3383through this reorganization that you are currently going3384through, I would like for you to answer the question, will you3385commit that programs involving minority health will continue3386and not get tied unnecessarily and inappropriately to DEI?33873388    Secretary Kennedy. Yes, absolutely. We will continue. We3389have--I think that one of the minority health programs has been3390terminated and it was one that was deeply embedded with DEI3391ideology, but there are seven others that are going to3392continue.33933394    I want to thank you for inviting me down to South Carolina.3395That was a wonderful trip. It was really--I got to witness a3396microcosm, a template for how medicine ought to be working.33973398    Senator Scott. Yes.33993400    Secretary Kennedy. You had brought together under your3401leadership, hospital systems, pharmaceutical companies, and the3402biotech companies that developed this new technology for3403treating sickle cell, and they all--and patients.34043405    They had all worked together to make it affordable so that3406South Carolina now has this extraordinary program where if you3407have sickle cell in South Carolina, you can get it 100 percent3408funding, with I think it is 100 percent cure, or close to it.34093410    Senator Scott. Yes. Very close to. Thank you. I will just3411ask the two questions I was supposed to ask in the--preliminary3412to the questions. For all the parents with children with sickle3413cell, can you please just reassure them that the Administration3414of Health for America will work on sickle cell and addressing3415minority health issues? It is a simple yes or no.34163417    Will the full budget, and when it is released, reflect3418funding at AHA for both the Office of Minority Health and3419Sickness Health Activities that used to be housed in CDC?34203421    Secretary Kennedy. Absolutely. You have my commitment. In3422fact, I had a company in this morning meeting with FDA that has3423a new technology that may--that it seems as effective and may3424be even more economical. And I am very, very excited, and I am3425excited to show it to you, if it proceeds, if makes it through3426the TRAPs at FDA.34273428    Senator Scott. Excellent.34293430    Secretary Kennedy. But yes, absolutely. I am going to3431continue to make that a priority of this agency.34323433    Senator Scott. Right. Let me change topics quickly with my34341 minute and 45 seconds left, as I was extended an extra 303435seconds. Thank you, Mr. Chairman. I really appreciate the work3436that you are doing, frankly, as it relates to addressing how3437our food supply contributes to chronic diseases, including the3438phasing out of petroleum based as part of your make America3439healthy movement.34403441    I am really encouraged by the FDA's announcement last week3442approving three new natural color additive petitions. During3443your confirmation hearing process, I shared your passion for3444shaking up the food industry, and you are truly doing just what3445you said you were going to do as it relates to food additives.34463447    Because of your bold actions at HHS regarding petroleum-3448based food additives, the food industries responded by getting3449rid of these dyes in favor of natural alternatives. Thank you3450for your work in bringing healthier food options for our kids.34513452    Can you talk about how you will use your position to3453continue to build on your work eliminating artificial food dyes3454to further improve the quality of food sold to Americans in our3455quest to make Americans healthier?34563457    Secretary Kennedy. I mean, one of the big areas of neglect3458has been linking specific food additives and food processes to3459the chronic disease epidemic. NIH has neglected that area of3460study.34613462    It is now the central focus of NIH is going to be looking3463at--and FDA, looking at ultra-process foods, at sugars, and the346410,000 additives that are in our food that are in nobody else's3465food in the world.34663467    Looking at the impact so that we can put accurate labeling3468on. And when they are really dangerous, we can require--we can3469revoke their authorizations under GRAS.34703471    Senator Scott. Thank you, sir.34723473    [Technical problems.]34743475    Senator Blunt Rochester. Thank you, Chairman Cassidy,3476Ranking Member Sanders. And welcome, Mr. Secretary. I have3477nothing personal against you. I don't even know you.34783479    But what I do know, as the former Deputy Secretary of3480Health and Social Services in Delaware, is how important your3481agency is to the lives of so many people in our Country. During3482the confirmation, your confusion of Medicaid versus Medicare3483did not instill a lot of confidence.34843485    But today, as you talk about these budget cuts being3486painful, I am reminded of Delawareans who have come up to me3487and cried, and said, please don't let folks take away my3488Medicaid--individuals with disabilities. While you talk about3489cutting this large, large department, there are talks about3490including more things in the department from the Department of3491Education.34923493    I am concerned about that. And when we met in January, you3494committed to radical transparency and responding to all3495congressional inquiries within 30 days. Since then, we have3496sent dozens of letters. And to my knowledge, like Senator3497Hassan, I haven't received any responses.34983499    Given your stated commitment to transparency, and your3500focus on efficiency and responsiveness in your opening3501comments, I think this is a great opportunity to get your3502commitment that you will respond to the letters from this3503Committee, and also an opportunity to maybe talk about a few of3504the things that I wrote to you about. So let's begin with this3505letter.35063507    In March, I wrote you expressing my concern about the3508delayed meeting of the Federal Vaccine Experts, otherwise known3509as ACIP. The meeting of this Committee is a key step in getting3510vaccines to millions of people, from babies to seniors, and3511delays can have negative impacts on vaccine accessibility and3512affordability.35133514    While I am glad that the meeting finally happened, we are3515quickly approaching flu season, and the CDC still hasn't3516adopted the April recommendations. And I can understand the3517delay, given that there seems to be no current CDC Director. So3518in the spirit of radical transparency, my question is, who is3519the Acting CDC Director?35203521    Secretary Kennedy. The Acting Director was Susan Monarez,3522but she is now up for permanent Director. And so, she has been3523replaced by Matt Buzzelli.35243525    Senator Blunt Rochester. Does this person have a medical3526background?35273528    Secretary Kennedy. I believe----35293530    Senator Blunt Rochester.--Or public health expertise?35313532    Secretary Kennedy. He is a public health expert.35333534    Senator Blunt Rochester. Public health expert. So, the fact3535that the recommendations are kind of stuck is--and the fact you3536kind of have----35373538    Secretary Kennedy. Well can I clarify something? The--ACIP3539does not do the flu shot----35403541    Secretary Blunt Rochester. Yes. I don't want to get into3542the specifics of that.35433544    Secretary Kennedy. Those--the flu shot was----35453546    Senator Blunt Rochester. My question was more about do we3547have a CDC Director. And then I want to enter into the record3548information about what harms could be caused until we get one.35493550    The Chairman. Is that a request----35513552    Secretary Kennedy. We want the director----35533554    Senator Blunt Rochester. Let the----35553556    Secretary Kennedy. We are relying on this Committee to----35573558    Senator Blunt Rochester. But this was my question. This is3559my time.35603561    Secretary Kennedy [continuing]. Confirm the director.35623563    Senator Blunt Rochester. We are Senators. And so, I don't3564want to have the same exchange that happened before with other3565people. I just want to ask my questions. I want to just shift3566gears. Your proposed compassionate budget would cut funding for3567multiple maternal and child health programs.35683569    I know as a new parent, I remember learning that my baby3570should sleep on their back. The NIH Safe to Sleep Campaign, you3571have shuttered. After launching this campaign in 1994, the rate3572of sudden infant deaths dropped by 50 percent. Many parents in3573this room maybe remember getting their children screened for3574hearing loss or rare diseases. That program has also been3575shuttered.35763577    You cut programs that collect data on IVF, maternal health,3578infant mortality, all while President Trump is calling himself3579the fertilization President. None of these policies are based3580in compassion.35813582    My only concern, even following up on Senator Kim's3583question, is understanding what goes into gutting a program3584that has increased the efficacy of parents being able to take3585care of their children. I will--my time has expired. But I will3586just say, again, a budget is a reflection of priorities.35873588    To me, this budget, the cuts to Medicaid that are talked3589about right now across--in the House of Representatives, are3590going to have real, like you said, painful impacts on people's3591lives.35923593    I hope there is some real compassion in the end, and I hope3594that you hear from our constituents as we are hearing from them3595as well. And we will continue to--we will continue to try to3596fight for them. So, I yield back.35973598    Secretary Kennedy. Let me--no time to respond, but I can3599assure you that I will act with compassion.36003601    The Chairman. Senator Alsobrooks.36023603    Senator Alsobrooks. Thank you so much, Mr. Chairman. Mr.3604Secretary--I am talking. I am over here. I have been sitting3605through this hearing all day today and have noted that you have3606been unable in most instances to answer any specific questions3607relating to your agency.36083609    Secretary Kennedy. Because I haven't been given time.36103611    Senator Alsobrooks. Well, no, you have been given time, but3612the point of the matter is you have been unable to answer3613specific questions. Sir, you are the wrong person for this job.36143615    You had in this hearing today the unmitigated gall to say3616at the beginning of your testimony that China is ahead of the3617United States in health care because China does not have DEI.36183619    Secretary Kennedy. I didn't say that.36203621    Senator Alsobrooks. We can roll back the tape. You3622absolutely----36233624    Secretary Kennedy. You can, and you will find I didn't say3625that.36263627    Senator Alsobrooks. That is absolutely what you said.36283629    Secretary Kennedy. I was talking about science. I didn't3630say they are ahead of us. They are ahead of us in some forms of3631science, certainly not in health care.36323633    Senator Alsobrooks. Well, we can roll back the tape, but3634nonetheless, let me go on with my questions and ask you this.3635You just heard about the Safe to Sleep Campaign. And you have3636made cuts. You made it very clear here today you have no3637knowledge whatsoever of the absolutely amazing scientists and3638researchers who you have callously fired. You know nothing3639about the cuts----36403641    Secretary Kennedy. I didn't fire any working scientists,3642Senator.36433644    Senator Alsobrooks. That, sir, is not true either. But3645none----36463647    Secretary Kennedy. That is true.36483649    Senator Alsobrooks. It is not true. Let me ask another3650specific question.36513652    Secretary Kennedy. It is true.36533654    Senator Alsobrooks. The Safe to Sleep Campaign. Well, can3655you name, sir, which office the Safe to Sleep Campaign operates3656out of?36573658    Secretary Kennedy. Which campaign?36593660    Senator Alsobrooks. Well, that is the one that the Senator3661just asked you about 2 minutes ago that prevents babies from3662dying in their sleep. A 30-year program inside your agency. You3663would agree that it is important----36643665    Secretary Kennedy. I think it is part of HRSA--or ACF. It3666is ACF.36673668    Senator Alsobrooks. No, actually it is in Health and Human3669Services.36703671    Secretary Kennedy. They are all within Health and Human3672Services, but the subdivision is ACF.36733674    Senator Alsobrooks. No, actually the name of the Office3675is----36763677    Secretary Kennedy. Administration of Children and Families.36783679    Senator Alsobrooks. No, let me tell you what it is. The3680National Institute of Child Health and Human Development. This3681is actually the one that your aunt, Eunice Kennedy Shriver, is3682the person who it is named after. And you noted just a moment3683ago, the Senator reminded you, that although this is a very3684important agency, prevents babies from dying, this is the same3685one you fired every single person in this office as of April3686the 1st.36873688    Secretary Kennedy. As I said, there were no working3689scientists fired during the RIF.36903691    Senator Alsobrooks. We can bring you that information3692later, because what you just said is not true. Well, then the3693question also is in addition to firing the individuals who make3694sure babies don't die in their sleep, why did you cut funding3695and staff from the CDC's National Center on Birth Defects and3696Developmental Disabilities which supports the Special Olympics?3697Was that a mistake? I have heard you say you have made some3698mistakes today. Was that also a mistake?36993700    Secretary Kennedy. We have switched those programs to the3701Administration for Healthy America. They have not been cut.37023703    Senator Alsobrooks. Well, the funding has been cut. And3704this is one that oversaw the Special Olympics. Are you aware of3705that?37063707    Secretary Kennedy. We have not cut the Special Olympics.37083709    Senator Alsobrooks. Cut the funding. And you have also3710dismantled the Division of Reproductive Health and Women's3711Health and Fertility. You are aware of that, right?37123713    Secretary Kennedy. We have--right now, we have 42 divisions3714that do maternal health, and we are consolidating them. And the3715mainstream media has portrayed those as cuts, but they are not3716cuts.37173718    They are consolidations. It is ridiculous to have 423719divisions that are all supposed to be doing the same thing with3720their own administrators.37213722    Senator Alsobrooks. Well, let me ask you a question. So3723that it doesn't exist right now. It has been dismantled. That3724is a fact. That that particular division--what you plan to do3725in the future----37263727    Secretary Kennedy. There is 42 divisions on maternal3728health. We consolidated them.37293730    Senator Alsobrooks. Sir, let me finish what I am saying3731here. The fact of the matter is you have dismantled it as we3732speak. And are you aware--what does the assistive reproductive3733technology mean to you? Are you familiar with that?37343735    Secretary Kennedy. Are you talking about IVF?37363737    Secretary Kennedy. Well, it is assisted reproductive3738technology. It is a division. Do you know what it does?37393740    Secretary Kennedy. Is it part of NIH?37413742    Senator Alsobrooks. No, it is actually a part of your3743agency.37443745    Secretary Kennedy. NIH is part of my agency, Senator. You3746should know that.37473748    Senator Alsobrooks. I do know that, but it is actually a3749part of--it is the CDC is where it is.37503751    Secretary Kennedy. Okay, then it is CDC.37523753    Senator Alsobrooks. Right. Okay. Let me just ask you--and3754again, these are all other things. You seem unfamiliar with the3755ones--the programs that you have cut out.37563757    Secretary Kennedy. You are unfamiliar with my agency--that3758NIH and the CDC are part of HHS.37593760    Senator Alsobrooks. Oh, I absolutely know. NIH is in my3761county. I was there this past weekend with the researchers that3762you have fired, so I absolutely know where NIH is, sir, and3763don't need any help from you in knowing that. I cede the time.3764Thank you.37653766    The Chairman. Senator Blunt Rochester, did you have3767something you wanted in the record? You mentioned something but3768didn't formally ask, and I want to make sure.37693770    Senator Blunt Rochester. Yes, Mr. Chairman. I would like to3771introduce this into the record. It is, the CDC has no Acting3772Director, source is confirmed.37733774    The Chairman. Without objection, it is entered into the3775record.37763777    [The following information can be found on page 135 in3778Additional Material:]37793780    Senator Blunt Rochester. Thank you so much.37813782    The Chairman. Senator Sanders.37833784    Senator Sanders. I ask unanimous consent to enter into the3785record 21 letters of groups raising concerns about the HHS3786reorganization budget and RIFs. Also ask anonymous consent on3787behalf of Senator Murphy to enter two articles into the record.37883789    The Chairman. Without objection.37903791    [The following information can be found on page 145 in3792Additional Material:]37933794    The Chairman. For any Senator wishing to ask additional3795questions, questions for the record will be due in 10 business3796days on May 28th at 5.00 p.m. Thank you again, Secretary3797Kennedy, for being here.37983799    The Committee stands adjourned.38003801                          ADDITIONAL MATERIAL3802[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]38033804    [Whereupon, at 4:02 p.m., the hearing was adjourned.]38053806                             [all]