    [Senate Hearing 119-90]
    [From the U.S. Government Publishing Office]

                                                     S. Hrg. 119-90

                          HEARING ON FISCAL YEAR 2026
                            DEPARTMENT OF HEALTH AND
                             HUMAN SERVICES BUDGET
    =======================================================================

                                    HEARING

                                  [BEFORE THE]

                        COMMITTEE ON HEALTH, EDUCATION,
                              LABOR, AND PENSIONS
                              UNITED STATES SENATE

                        ONE HUNDRED NINETEENTH CONGRESS

                                 FIRST SESSION

                                   ----------

                                  MAY 14, 2025

                                   ----------

                           Printed for the use of the
              Committee on Health, Education, Labor, and Pensions

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

                                   __________

            Available via the World Wide Web: http://www.govinfo.gov'

                         U.S. GOVERNMENT PUBLISHING OFFICE
    60-601 PDF                   WASHINGTON : 2026
    =======================================================================

              COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS

                    BILL CASSIDY, M.D., Louisiana, Chairman
    RAND PAUL, M.D., Kentucky            BERNIE SANDERS (I), Vermont,
    SUSAN M. COLLINS, Maine                  Ranking Member
    LISA MURKOWSKI, Alaska               PATTY MURRAY, Washington
    MARKWAYNE MULLIN, Oklahoma           TAMMY BALDWIN, Wisconsin
    ROGER MARSHALL, M.D., Kansas         CHRISTOPHER MURPHY, Connecticut
    TIM SCOTT, South Carolina            TIM KAINE, Virginia
    JOSH HAWLEY, Missouri                MAGGIE HASSAN, New Hampshire
    TOMMY TUBERVILLE, Alabama            JOHN HICKENLOOPER, Colorado
    JIM BANKS, Indiana                   ED MARKEY, Massachusetts
    JON HUSTED, Ohio                     ANDY KIM, New Jersey
    ASHLEY MOODY, Florida                LISA BLUNT ROCHESTER, Delaware
                                         ANGELA ALSOBROOKS, Maryland

                   Matthew Gallivan, Majority Staff Director
               Danielle Janowski, Majority Deputy Staff Director
                    Warren Gunnels, Minority Staff Director
                   Zain Rizvi, Minority Deputy Staff Director

                                C O N T E N T S

                                  ----------

                                   STATEMENTS

                            WEDNESDAY, MAY 14, 2025

                                                                       Page

                               Committee Members

    Cassidy, Hon. Bill, Chairman, Committee on Health, Education,
      Labor, and Pensions, Opening statement.........................     1
    Sanders, Hon. Bernie, Ranking Member, U.S. Senator from the State
      of Vermont, Opening statement..................................     2

                                   Witnesses

    Kennedy, Hon. Robert F., Jr., Secretary of Health and Human
      Services, Washington, DC.......................................     5
        Prepared statement...........................................     7
        Summary statement............................................    11

                              ADDITIONAL MATERIAL

    Statements, articles, publications, letters, etc.
    Murkowski, Hon. Lisa:
        National Task Force letter...................................    55
    Hassan, Hon. Maggie:
        HHS Employee Directory Geier.................................    58
        Geier Charge.................................................    59
        Geier Order..................................................    77
    Markey, Hon. Ed:
        Make America Sick Again......................................   115
    Blunt Rochester, Hon. Lisa:
        CDC has no Acting Director...................................   135
    Sanders, Hon. Bernie:
        HHS reorganization budget and RIFs letters...................   145
    Murphy, Hon. Christopher:
        Two articles about Robert F. Kennedy Jrs. vaccine opinions...   225

                          HEARING ON FISCAL YEAR 2026
                            DEPARTMENT OF HEALTH AND
                             HUMAN SERVICES BUDGET

                                  ----------

                            Wednesday, May 14, 2025

                                           U.S. Senate,
           Committee on Health, Education, Labor, and Pensions,
                                                        Washington, DC.
        The Committee met, pursuant to notice, at 1:31 p.m., in
    room 430, Dirksen Senate Office Building, Hon. Bill Cassidy,
    Chairman of the Committee, presiding.

        Present: Senators Cassidy [presiding], Paul, Collins,
    Murkowski, Mullin, Marshall, Scott, Hawley, Husted, Banks,
    Moody, Sanders, Murray, Baldwin, Murphy, Kaine, Hassan,
    Hickenlooper, Markey, Kim, Blunt Rochester, and Alsobrooks.

                      OPENING STATEMENT OF SENATOR CASSIDY

        The Chairman. I was waiting for the cameras to leave, and
    they weren't, so decided to rein them in. The Senate Committee
    on Health, Education, Labor, and Pensions will please come to
    order.

        Secretary Kennedy, thank you for coming before the
    Committee. President Trump has taken on the mission to reform
    the Federal Government, making healthcare more affordable and
    making America healthy again. It is clear the status quo does
    not work. Bureaucratic bloat, regulatory hurdles at the
    Department of Health and Human Services have made it harder to
    deliver critical services.

        HHS needs to work better for the American people. This
    means finding ways to speed up approvals for life-saving drugs,
    improving delivery of health care services so Americans who
    need these benefits can receive them, addressing the high
    levels of chronic disease, and holding bad actors accountable
    to lower health care costs for the American people.

        I am encouraged that HHS is already working to address
    these issues. I want to note that this is the first time in at
    least two decades the HHS Secretary is testifying on the
    Department's budget before the HELP Committee. And I appreciate
    Secretary Kennedy for coming to answer our questions on the
    fiscal year 2026 budget.

        Now, people fear change, even when it is from worse to
    better. But without a clearly defined plan or objective, people
    assume the worst. Much of the conversation about HHS's agenda
    has been set by anonymous sources in the media and individuals
    with a bias against the President.

        Americans need direct reassurance from the Administration,
    and from you, Mr. Secretary, that these reforms will make their
    lives easier, not harder, and that is why I have invited you.
    No one can make that case better than you. These are the
    questions about how HHS will be able to preserve its primary
    functions and duties under this proposed budget.

        Many offices and programs potentially seeing changes are
    essential for implementing bipartisan laws, including laws
    championed and signed into law by President Trump. Example, in
    2018, Congress worked with President Trump to pass the Support
    for Patients and Communities Act, provide--protecting
    communities, saving lives through increased access to naloxone,
    and prevention and treatment for fentanyl addiction.

        The HELP Committee and President Trump also worked together
    to pass laws to improve research into health disparities,
    address the needs of Americans with traumatic brain injuries,
    Alzheimer's, Lyme disease, support family caregivers, and help
    moms and babies live healthier lives, programs essential to
    achieving President Trump's goal of making America healthy
    again.

        The proposed budget offices that are responsible for
    overseeing many of these initiatives, which were initiated by
    President Trump, will be consolidated or repurposed. Now, I
    agree with Secretary Kennedy that HHS needs reform. Over the
    past several years, I have engaged stakeholders and worked with
    colleagues to identify opportunities to modernize a wide array
    of HHS agencies and programs.

        The Department needs to have an effective plan to fulfill
    statutory duties in tandem with efforts to increase
    transparency, accountability, to streamline programs, and to
    root out wasteful spending. Congress and the Administration
    should work together to ensure reform strike the right balance
    and deliver for all Americans.

        Mr. Secretary, once more, no one can set the record
    straight better than you to explain how the Department will
    maintain its critical duties and implement change important to
    Americans' health.

        By providing this clarity, we in Congress will be able to
    advocate for shared priorities in future legislation, and you
    will gain the trust of the American people, putting their minds
    at ease. I appreciate you being here.

        I look forward to hearing how the proposed HHS budget will
    advance President Trump's mission. And with that, I recognize
    Senator Sanders for his opening statement.

                      OPENING STATEMENT OF SENATOR SANDERS

        Senator Sanders. Thank you, Mr. Chairman. Mr. Secretary,
    thanks for being with us. Let me begin by quoting a sentence
    that came from your prepared remarks.

        You state, and I quote, ``The United States remains the
    sickest developed nation, and we spend $4.5 trillion annually
    on health care, two to three times more per capita than
    comparable nations. Clearly something is structurally wrong
    with our approach.'' You are right. The current healthcare
    system is broken. It is wildly expensive. It is dysfunctional.

        What do we do, Mr. Secretary, to address it? Maybe for a
    start, we do what every other major country on earth does and
    recognize that health care is a human right guaranteed to every
    man, woman, and child.

        Maybe we understand that the function of a rational health
    care system is not to make hundreds of billions of dollars in
    profit for insurance companies and drug companies who often
    engage in stock buybacks, pay their CEOs outrageous
    compensation packages. There was a guy from one of the major
    drug companies sitting exactly where you are sitting last year.
    The guy makes $50 million a year. Meanwhile, we don't have
    enough doctors.

        We don't have enough nurses. We don't have enough dentists,
    we don't have enough pharmacists, we don't have enough health
    care workers in general. You are right, the system is
    structurally broken. We spend far more, we have a shorter life
    expectancy than other countries.

        This is an issue that I want to address with you. How in
    fact do we guarantee health care to all people and do it in an
    effective way? Let me say a word about prescription drugs. You
    and President Trump had a press conference earlier this week
    discussing an Executive Order that both of you claim would make
    sure that the American people pay the lowest prices in the
    world for prescription drugs, not the highest.

        As you mentioned at your press conference, this is a
    concept that I personally strongly support, and I think you are
    aware of that. But as President Trump and you should know, this
    Executive Order, like Trump's previous Executive Orders on the
    subject, will likely be thrown out by the courts, and we will
    be back to exactly where we are today, paying by far the
    highest prices in the world for prescription drugs. In my view,
    the way forward is through Legislative action.

        If you and President Trump are serious about significantly
    lowering the outrageous price of prescription drugs in this
    country, as I hope you are, I would very much appreciate both
    of you working with me and other people on this Committee and
    in the Senate on legislation that I will soon be introducing
    which accomplishes exactly the same goal as you and the
    President talked about, making sure that we pay no more for
    prescription drugs than people in other major countries.

        If we are serious about that, let's work together and let's
    make that happen. And in fact, if Republicans and Democrats
    come together on this, if we prioritize it, we can pass that
    legislation in a couple of weeks. Thirdly, Secretary Kennedy,
    all of us want to make the Government more efficient and cost-
    effective, none fewer than I--there is too much bureaucracy.

        But let me tell you also what we want and what the American
    people want. And that is we want the Federal Government to play
    a major role in continuing its efforts to combat such terrible
    diseases. There is cancer, Alzheimer's, diabetes, heart
    disease, and others terrible illnesses that claim the lives of
    millions of Americans.

        In that regard, I must tell you that I have heard from
    citizens, patients, and doctors in Vermont and all over this
    country who are deeply concerned that under the leadership of
    you and Mr. Musk, the Trump administration has terminated at
    least $13.5 billion in health care funding, including more than
    1,600 grants to conduct vital research into cancer prevention,
    Alzheimer's, diabetes, and cardiovascular disease, among many
    other medical research investments.

        In the first 3 months of this year, the National Institute
    of Health has been effectively cut by $2.7 billion, a 35
    percent cut reversing over a decade of investment in medical
    research. Under your leadership, cancer research has been
    slashed by 31 percent.

        Further, Secretary Kennedy, under your leadership, you have
    undermined the vital role vaccines play in preventing disease
    during the single largest measles outbreak in 25 years, which
    has led to over 1,000 cases of measles, over 125
    hospitalizations, and 3 deaths.

        Let me say a word about USAID. Elon Musk, the richest man
    on earth, who has led the effort to cut health and nutrition
    programs for the poorest people on earth, has absurdly
    suggested that no one, ``no one'' has died from the massive
    cuts to USAID. Mr. Musk is 100 percent wrong.

        According to independent researchers, nearly 200,000 people
    have already died throughout the world as a result of the
    massive cuts in funding to prevent malaria, tuberculosis, HIV,
    malnutrition, and other serious diseases. Further, as a result
    of the elimination of U.S. funding for a global vaccine
    program, it has been estimated that over a million children
    will die because of the cuts that will save taxpayers very,
    very little money. So let me just conclude by saying this.

        The United States of America is the wealthiest country on
    earth. We should have the best healthcare system in the world,
    not one of the worst. Given our purchasing power, we should be
    paying the lowest prices on earth for prescription drugs, not
    the highest.

        Instead of giving hundreds of billions of dollars in tax
    breaks to the richest people in this country, we should be
    proudly investing in coming up with cures for cancer,
    Alzheimer's disease, diabetes, and other terrible illnesses.
    That is what we should be doing, but I am afraid that in too
    many ways, we are doing exactly the opposite. Thank you, Mr.
    Chairman.

        The Chairman. Thank you, Senator Sanders. I will now
    introduce the witness. We are joined today by the Hon. Robert
    F. Kennedy, Jr., the 26th Secretary of the United States
    Department of Health and Human Services.

        In his role as Secretary, Mr. Kennedy is responsible for
    overseeing the Nation's civilian Federal health agencies who
    serve over 150 million Americans. We look forward to hearing
    from you today, Secretary Kennedy. Again, thank you for joining
    us.

     STATEMENT OF HON. ROBERT F. KENNEDY JR., SECRETARY OF HEALTH
                   AND HUMAN SERVICES, WASHINGTON, DC

        Secretary Kennedy. Thank you, Senator Sanders. I just want
    to begin by saying I know how determined President Trump is for
    us to have the lowest drug prices in the world as between
    Europe and the United States. And I also know that he doesn't
    care how we get there, that is where he wants Americans to be.

        He has said I don't know how many times since I have been
    involved with him, about that. We shouldn't be paying or be
    able to go to London and buy GLP for $88 that in this country
    cost us $1,300. And I know it is something that you have been
    talking about for many years, and I look forward to working
    with you on legislation or----

        Senator Sanders. Thank you.

        Secretary Kennedy [continuing]. Any way that we can to get
    there. Thank you, Chairman Cassidy and Senator Sanders. I am
    honored to be before you today to present the Department of
    Health and Human Services Fiscal Year 2026 budget. Debilitating
    disease, contaminated food, toxic environments, addiction, and
    mental illness affect Americans across every race, class, and
    political belief.

        When my team and I took the helm at HHS, we set out with
    clear goals. First, we aim to make America healthy again with a
    special focus on the chronic disease epidemic. Second, we
    committed to delivering more efficient, responsive, and
    effective service to over 100 million Americans who rely on
    Medicare, Medicaid, and other programs.

        Third, we focus on achieving these goals by cutting costs
    for taxpayers. We intend to do more, a lot more, with less. The
    budget I am presenting today supports these goals and
    reflects----

        [Public interruption.]

        The Chairman. The witness will suspend. The Committee will
    come to order. Capitol Police are asked to remove the
    individuals from the hearing room. Members of the audience--are
    reminded disruptions will not be tolerated. Members of the
    audience are reminded disruptions will not be permitted while
    the Committee conducts its business.

        Capitol Police are asked to remove the individuals from the
    hearing room. That was a made for C-SPAN moment. The Secretary
    will resume. Just a second, Mr. Secretary. Let's get the doors
    closed and the ruckus is totally clear. Got it. Okay. And we
    thank the Capitol Police for working with due diligence. Thank
    you very much. Mr. Secretary, please resume.

        Secretary Kennedy. The budget, I am----

        The Chairman. Excuse me, Mr. Secretary. Will you reset the
    clock? The clock has been running. Whatever it would be. Okay,
    please.

        Secretary Kennedy. All right. The budget I am presenting
    today supports those goals and reflects two enduring American
    values, compassion and responsibility. I invite the Committee
    to unite around these ideals with me.

        The United States remains the sickest developed nation in
    the world, and we spend $4.5 trillion annually on healthcare.
    Two to three times more per capita than comparable nations.
    Clearly, something is structurally and systemically wrong with
    this system. Furthermore, healthcare costs are steadily
    increasing at a rate of 2 percent greater than the economy.

        If we don't staunch this unsustainable hemorrhage, we will
    ransom our children to bankruptcy, servitude, and disastrous
    health consequences. Yes, an exploding debt is a social
    determinant of health. We won't solve this problem by throwing
    more money at it. We must spend smarter. We will shift funding
    away from bureaucracy and toward direct impact.

        Some things at HHS will not change. We will preserve legacy
    programs like Medicare, Medicaid, and Head Start, as the
    foundation of the MAHA Agenda. Vulnerable populations, seniors,
    and veterans deserve consistent access to care, and I will
    ensure that they receive it.

        Today, 83 million Americans, urban and rural, lack adequate
    access to primary care physicians. We will prioritize these
    families, especially Native American and Alaskan communities.
    We will protect IHS funding, streamline its operations, and
    give the tribes more autonomy in managing their resources.

        Let me be clear, we intend to make the Trump HHS not just
    the most effective, but also the most compassionate in U.S.
    history. Our official budget statement outlines many
    priorities, but I want to highlight a few. First, we will
    consolidate programs to better tackle mental health and
    addiction.

        These issues now rival chronic disease and their impact.
    HHS will aggressively combat the opioid crisis, especially the
    spread of synthetic drugs like fentanyl. We will empower state,
    local, and tribal leaders to create effective solutions.
    Second, we will address nutrition, physical activity, and
    healthy lifestyles.

        The President's budget requests $94 billion in
    discretionary funds to support these priorities, including the
    Administration for a Healthy America. We will emphasize healthy
    eating in Head Start, and ensure the program continues to serve
    its 750,000 children and parents effectively.

        Third, we will equip FDA to expand its food safety efforts
    through research, regulation, inspection, and education, remove
    harmful chemicals from food and packaging. Fourth, we will fund
    cutting edge research at NIH while cutting risky or non-
    essential studies. That includes ending gain-of-function
    experiments and research based upon radical gender ideologies.

        At the CDC, we will return to core missions, tracking
    disease, investigating outbreaks, and sustaining public health
    infrastructure while cutting waste. Fifth, we will eliminate
    DEI funding and redirect resources toward real poverty
    reduction. We will move beyond lip service to communities of
    color and take meaningful action to meet their needs.

        Six, we will strengthen cybersecurity and health IT. The AI
    revolution has arrived, and we are already using new technology
    to manage health data more efficiently and securely. Finally,
    we will rebuild public trust, a trust that eroded through years
    of industry capture, corruption, waste, and misplaced
    priorities.

        We will launch a new era of transparency in public service,
    creating an honest science-driven HHS that answers to the
    President, to Congress, and to the American people. I look
    forward to working with Congress to pursue this mission
    together as a bipartisan cause.

        Let's work side by side to make America healthy again.
    Thank you.

        [The prepared statement of Secretary Kennedy follows.]
                  prepared statement of robert f. kennedy, jr.
        The mission of the Department of Health and Human Services (HHS or
    Department) is to enhance and protect the health and well-being of the
    American people.

        President Trump and all of us at HHS take that charge seriously.
    So, when a program is not as effective as it can be, or costs more than
    it ought to, or fails to deliver on its promise--change and reform are
    necessary.

        The President's Fiscal Year (FY) 2026 Budget applies this mindset
    to the work of the Department, making thoughtful and strategic
    decisions to transform HHS and better protect the health and well-being
    of the American people. The budget invests in methods to address
    chronic disease; protect American families from environmental toxins;
    promote nutrition as well as food and drug safety; strengthen services
    for American Indians and Alaska Natives; encourage innovation in
    America's healthcare future; and focus resources toward proven and
    effective initiatives. This budget, likewise, recognizes the fiscal
    challenges our Country faces today, and the need to update and redirect
    our investments to meet the needs of a rapidly changing world.

        The Fiscal Year 2026 Budget request includes reforms to put
    healthcare spending on a sustainable fiscal path. We must remake the
    government to maximize efficiency and productivity in order to fulfill
    the President's promise to Make America Healthy Again (MAHA). HHS has
    made progress toward these goals, promoting the health of Americans
    while instituting significant workforce reductions and identifying over
    $13 billion anticipated in contract savings--and there is more to come.
    Over the next few months, we will work together with Congress to
    restructure the Department and improve how we deliver services to the
    American people. HHS takes seriously our role as responsible stewards
    of taxpayer dollars, and we look forward to working with you to
    implement the President's agenda while continuing to cut government
    bloat and rescope the Federal role. Protecting the health of Americans
    has to be done hand in hand with protecting our Nation's fiscal
    health--they rely on each other. The Fiscal Year 2026 Budget will
    reduce duplication of programs and services, increase accountability,
    and work with state and local governments to improve flexibility.

        The Fiscal Year 2026 Budget protects key programs that Americans
    rely on that keep us competitive with our enemies, and fulfill promises
    made to Tribal Nations. This budget allows us to do our part to restore
    fiscal responsibility to the Federal Government while optimizing HHS's
    ability to improve and save American lives. The reductions made are
    necessary to right-size the Department's budget, which has ballooned by
    about 40 percent since the COVID-19 pandemic.

        The Fiscal Year 2026 Budget focuses on restructuring efforts to
    transform HHS to Make America Healthy Again. I look forward to working
    with you on our vision to Make America Healthy Again. The President's
    Budget for HHS also reflects proposals to meet the President's
    comprehensive Government-wide Transformation Plan through a sweeping
    restructuring that aims to identify opportunities to improve the work
    HHS does for the American people, in terms of its efficacy, efficiency,
    quality, and cost-effectiveness.

        The HHS restructuring will serve multiple goals without impacting
    critical services. First, beginning in fiscal year 2026 it could save
    taxpayers an estimated $1.8 billion per year through a reduction in
    workforce. Our reductions have focused on aligning HHS staffing levels
    to reflect the size of HHS prior to the COVID-19 pandemic which saw
    around a 15 percent increase in the number of employees.

        Second, it will streamline the functions of the Department.
    Currently, the 28 divisions of HHS contain many redundant units. The
    restructuring plan will consolidate them into 15 new divisions,
    including a new Administration for a Healthy America, or AHA, and will
    centralize core functions such as Human Resources, Information
    Technology, Procurement, External Affairs, and Policy. The
    restructuring plan intends to reduce regional offices from 10 to 5 by
    planning to close regional offices in high-cost cities. This
    restructuring will reduce the number of full-time employees to
    approximately 62,000, while preserving critical staff such as FDA food
    safety inspectors.

        Third, the overhaul will implement the new HHS priority of ending
    America's epidemic of chronic illness by focusing on safe, wholesome
    food, clean water, and the elimination of environmental toxins. These
    priorities will be reflected in the reorganization of HHS.

        Finally, the restructuring will improve Americans' experience with
    HHS by making the agency more responsive and efficient, while ensuring
    that Medicare, Medicaid, and other essential health services remain
    intact.

        In summary, these changes will allow us to act more nimbly and
    focus on the core mission of improving the Nation's health. Without
    duplication of resources, and reduced bureaucracy, HHS can use Federal
    dollars to more directly impact the lives of those served by HHS
    programs. HHS will be prepared to share additional information with
    Congress in the coming weeks. We look forward to congressional
    collaboration in this process.
                            Making Americans Healthy
        One of the Department's top priorities is fighting the scourge of
    chronic disease facing our Country. Today, Americans' overall health is
    in a grievous condition. Over 70 percent of adults and a third of
    children are overweight or obese. Diabetes is ten times more prevalent
    than in 1960. Cancer among people 50 and under is rising by one or 2
    percent a year. Autoimmune diseases, neurodevelopmental disorders,
    asthma, Alzheimer's, ADHD, depression, addiction, and a host of other
    physical and mental health conditions are on the rise.

        The United States has worse health than any other developed nation,
    yet we spend far more on healthcare--at least double; in some cases,
    triple. Last year we spent $4.9 trillion, not counting indirect costs
    like missed work. That's almost 17.6 percent of our Nation's GDP. But
    more than that, it's a human tragedy--today, over half of all Americans
    are chronically ill.

        The President's Budget requests $94 billion in discretionary
    funding to combat these challenges. This budget includes strategic
    investments in the new Administration for a Healthy America (AHA). It
    is my vision for this new agency to better coordinate programs targeted
    to improve chronic care, disease prevention, and other health
    resources.

        The Fiscal Year 2026 Budget provides resources to the Department of
    Health and Human Services that would allow the Secretary to tackle
    issues related to nutrition, physical activity, healthy lifestyles,
    over-reliance on medication and treatments, the effects of new
    technological habits, environmental impacts, and food and drug quality
    and safety.
                                      CMS
        Medicare, Medicaid, and the Children's Health Insurance Program
    remain a cornerstone of the MAHA agenda to improve outcomes for our
    seniors and children. This budget continues CMS program funding to
    maintain beneficiary service levels, streamline program administration,
    and move toward improved health outcomes while eliminating non-
    statutory and wasteful spending. The Trump administration remains
    committed to protecting these programs by ensuring that Federal
    taxpayer dollars are protected against waste, fraud, and abuse.
                        Mental Health and Substance Use
        It is estimated that one in five adults in the United States lives
    with mental illness--that's nearly 20 percent of the adult population.
    Approximately 16 million Americans with mental illness had serious
    thoughts of suicide. As the number of deaths by suicide continues to
    increase, it is more important than ever that HHS expand access to the
    care people need when they need it. An estimated 49.5 percent of
    adolescents have had a mental health disorder at some point in their
    lives. As child and youth mental health declines, HHS is dedicated to
    providing resources to children and youth in their communities.

        The Fiscal Year 2026 Budget invests in behavioral health by
    streamlining programs to avoid duplication and supporting block grant
    funding for these critical services. The Administration is committed to
    combating the scourge of deadly drugs, especially synthetic opioids
    like fentanyl, that have ravaged American communities, as President
    Trump did during his first term. The President has made reducing the
    initiation of drug use, particularly among young people, and increasing
    the number of individuals receiving evidence-based treatment, leading
    to long-term recovery from substance use disorders, a top priority. The
    Budget also proposes to refocus activities that were formerly part of
    the Substance Abuse and Mental Health Services Administration, by
    eliminating funding for programs that duplicate block grant funding, or
    are too small to have a national impact.
                                  Primary Care
        Under the President's Executive Order to establish the Make America
    Healthy Again Commission, I am committed to investigating any potential
    root causes of the chronic disease epidemic. As part of AHA, programs
    related to primary care will be streamlined, and focused on needs of
    all Americans no matter where they may live and at what income level.
    The Budget and the transformation at HHS support these efforts and
    ensures that primary care includes prevention and addresses the root
    causes of chronic disease.
                                   Head Start
        For Americans to be healthy, we must start when they are children.
    The President's Budget recommends Head Start continue to receive
    funding equal to the Fiscal Year 2025 Enacted level. In exchange, Head
    Start needs to be consistent with Administration priorities. This
    includes increasing parental choice; improving health, education, and
    employment outcomes; increasing program delivery efficiency; and
    promoting parental engagement. Head Start directly supports local-level
    institutions, including faith-based centers, empowering them to oversee
    care. Head Start also enables parents to find dignity in work when
    their children are enrolled in a safe and secure Head Start program.
                              Make Americans Safe
        I am committed to making Americans safer. I am working to make sure
    our tax dollars support healthy foods--and we are scrutinizing the
    chemical additives in our food supply.

        Wholesome food is a key component of the MAHA agenda and
    maintaining FDA activities that enable the United States to identify
    harmful ingredients, and overall make the food supply safer, will be a
    key component to the Department's ability to realize a healthy future.
          Protecting Our National Security and Sustaining Scientific
                                Competitiveness
        This budget also supports the Nation's public health infrastructure
    and capacity to respond to existing and emerging public health threats,
    with a focus on infectious diseases, preparedness, and outbreak
    response.

        While we need to rescale our biomedical research budget, HHS will
    continue to prioritize America's national security and competitiveness.
    Biomedical research continues to be one of our Country's biggest
    exports. NIH is the largest single public funder of biomedical and
    behavioral research in the world. This budget includes $27.5 billion
    for NIH, a rebalancing that will focus on essential research at a more
    practical cost and invest in security infrastructure. We will focus
    only on Gold Standard science at NIH and across HHS, increasing
    transparency for research done there.

        NIH has broken the trust of the American people with wasteful
    spending, misleading information, risky research, and the promotion of
    dangerous ideologies that undermine public health. The Administration
    is committed to restoring accountability, public trust, and
    transparency at the NIH.

        Supporting and encouraging scientific research is a longstanding
    Federal priority, one that results in both a growing economy and
    Americans living longer lives. Executing this responsibility demands
    that the Federal Government regularly considers how to organize this
    support in the most efficient manner possible. HHS is committed to
    safeguarding taxpayer resources so that institutions are adequately
    supported at a sustainable level, and that we are only funding
    essential costs, in line with private-sector standards. The budget
    proposes to consolidate major HHS research institutions in NIH to
    maximize the effectiveness of their research.

        The proposed budget shifts NIH's focus away from foreign interests
    and reforms its efforts on the core research activities that align with
    the President's commitment to Make America Healthy Again. NIH will no
    longer issue grants to promote radical gender ideology to the detriment
    of America's youth, or fund dangerous gain-of-function research, though
    related research will continue consistent with Administration policy
    and oversight. Our Administration is committed to eliminating radical
    gender ideologies that poison the minds of Americans.
                                Restoring Trust
        At HHS, we're committed to empowering states, localities, and
    Tribal communities by supporting science-based policies, rebuilding
    trust in public health, and protecting future generations from harmful
    exposures. We are committed to restoring a tradition of gold-standard,
    evidence-based science--not one driven by politicized DEI, gender
    ideology, nor sexual identity. We are removing the financial conflicts
    of interest in our agencies--to create an honest, unbiased, science-
    driven HHS, accountable to the President, to Congress, and to the
    American people.

        Americans do not want their tax dollars going to initiatives that
    espouse radical ideologies. We are proposing to eliminate programs like
    the Community Services Block Grants that have been hijacked from true
    poverty reduction to fund DEI initiatives, saving taxpayers $770
    million. Americans need to trust that we are good stewards of the
    dollars they entrust to us, and this budget shows our commitment to
    pursuing pathways to gain back taxpayers' trust.

        We have also ended HHS as the principal vector for child
    trafficking. The Budget re-focuses the Unaccompanied Alien Children
    (UAC) program on its core mission of sheltering unaccompanied alien
    children while also protecting them from child trafficking and labor
    exploitation. During the Biden administration, HHS became a
    collaborator in child trafficking for sex and slavery. The Biden
    administration operated the UAC program like an assembly line,
    prioritizing the quick release of children to insufficiently vetted
    sponsors over the children's safety. And we have ended that. We are
    very aggressively going out and trying to find these children that were
    lost by the Biden administration.

        The Budget refocuses the Centers for Disease Control and Prevention
    mission on core activities such as emerging and infectious disease
    surveillance, outbreak investigations, and maintaining the Nation's
    public health infrastructure, while streamlining programs and
    eliminating waste. The Budget proposes merging multiple programs into
    one grant program that will address Sexually Transmitted Diseases,
    Viral Hepatitis, and Tuberculosis giving States more flexibility to
    address local needs.
                    Strengthening the Indian Health Service
        Through the Indian Health Service (IHS), HHS is responsible for
    providing quality healthcare services to more than 2.2 million eligible
    American Indians and Alaska Natives.

        HHS has a unique trust responsibility to provide healthcare for
    Tribes, including on remote reservations and other vulnerable
    communities in Indian Country. Without this support, many of these
    communities truly have no other options for care. The budget
    prioritizes and preserves funding for this agency.

        Looking forward, and consistent with our statutory authorities, we
    recognize that our provision of quality healthcare in Indian Country
    and beyond must change to achieve and ensure the high quality of these
    services. As more Tribes have assumed the responsibilities of providing
    healthcare for their members with support from the IHS, investments in
    the budget reflect our support for the growth of Tribal self-governance
    in the provision of healthcare.

                                     * * *

        The President's 2026 budget for HHS recognizes the importance of
    focusing government spending on programs that work and reforming our
    Nation's healthcare programs for a fast-changing world. This Budget
    recognizes that securing America's future demands sound fiscal
    management and responsible decisions about our priorities. If we are
    serious about fulfilling HHS's mission of enhancing and protecting the
    well-being of all Americans, we must adopt the bold innovation and
    direction espoused by the President's Budget to Make America Healthy
    Again.
                                     ______

                    [summary statement of secretary kennedy]
        Thank you, Mr. Chairman, Members of the Committee.

        I'm honored to appear before you today to present the Department of
    Health and Human Services' Fiscal Year 2026 budget.

        Debilitating disease, contaminated food, toxic environments,
    addiction, and mental illness affect families across every race, class,
    and political belief. When my team and I took the helm at HHS, we set
    out with clear goals. First, we aimed to make America healthy again,
    with a special focus on the chronic disease epidemic. Second, we
    committed to delivering more efficient, responsive, and effective
    service to the over 100 million Americans who rely on Medicare,
    Medicaid, and other programs. Third, we focused on achieving these
    goals while cutting costs for taxpayers. We intend to do more--a lot
    more--with less.

        The budget I'm presenting today supports these goals and reflects
    two enduring American values: compassion and responsibility. I invite
    the Committee to unite around these ideals with me.

        The United States remains the sickest developed nation, and we
    spend $4.5 trillion annually on health care--two to three times more
    per capita than comparable nations. Clearly, something is structurally
    wrong with our approach.

        Furthermore, health care costs are steadily increasing at a rate 2
    percent greater than the economy. If we don't staunch this
    unsustainable hemorrhage, we will ransom our children to bankruptcy,
    servitude, and disastrous health consequences. Yes, an exploding debt
    is a social determinant of health.

        We won't solve this problem by throwing more money at it. We must
    spend smarter. The 2026 budget cuts costs through restructuring--not by
    eliminating essential services. We will reduce 28 divisions to 15,
    eliminate redundant units, and centralize functions like HR,
    procurement, and policy. These changes will return us to pre-COVID-19
    staffing levels and yield immediate savings of $1.8 billion per year,
    with more savings ahead.

        We will shift funding away from bureaucracy and toward direct
    impact.

        Some things at HHS will not change. We will preserve legacy
    programs like Medicare, Medicaid, and Head Start as the foundation of
    the MAHA agenda. Vulnerable populations, seniors, and veterans deserve
    consistent access to care, and I will ensure they receive it. Today, 83
    million Americans--urban and rural--lack adequate access to primary
    care physicians. We will prioritize these families, especially Native
    American and Alaskan communities. We will protect IHS funding,
    streamline its operations, and give tribes more autonomy in managing
    resources.

        Let me be clear: We intend to make the Trump HHS not just the most
    effective, but also the most compassionate in U.S. history.

        Our official budget statement outlines many priorities, but I want
    to highlight a few:

        First, we will consolidate programs to better tackle mental health
    and addiction. These issues now rival chronic disease in their impact.
    HHS will aggressively combat the opioid crisis, especially the spread
    of synthetic drugs like fentanyl. We will empower state, local, and
    Tribal leaders to create real solutions.

        Second, we will address nutrition, physical activity, and healthy
    lifestyles. The President's budget requests $94 billion in
    discretionary funds to support these priorities, including the
    Administration for a Healthy America (AHA). We will emphasize healthy
    eating in Head Start and ensure the program continues to serve its
    750,000 children and parents effectively.

        Third, we will equip the FDA to expand its food safety efforts--
    through research, regulation, inspection, and education--to remove
    harmful chemicals from food and packaging.

        Fourth, we will fund cutting-edge research at the NIH while cutting
    risky or nonessential studies. That includes ending gain-of-function
    experiments and research based on radical gender ideology. At the CDC,
    we will return to core missions: tracking diseases, investigating
    outbreaks, and sustaining public health infrastructure--while cutting
    waste.

        Fifth, we will eliminate DEI funding and redirect resources toward
    real poverty reduction. We will move beyond lip service to communities
    of color and take meaningful action to meet their needs.

        Sixth, we will strengthen cybersecurity and health IT. The AI
    revolution has arrived, and we must use new technology to manage health
    data more efficiently and securely.

        Finally, we will rebuild public trust--trust that eroded through
    years of industry capture, waste, and misplaced priorities. We will
    launch a new era of transparency and public service, creating an
    honest, science-driven HHS that answers to the President, to Congress,
    and to the American people.

        I look forward to working with Congress to pursue this mission
    together--as a bipartisan cause. Let's work side by side to make
    America healthy again.
                                     ______

        The Chairman. Thank you, Mr. Secretary. I will start with
    questions. Mr. Secretary, I appreciate that NIH wants to
    recalibrate its research portfolio to address conditions not
    previously attended to sufficiently, nutrition, conditions such
    as a rise after viral infection like myalgic encephalomyelitis
    or chronic fatigue syndrome.

        But this is happening in tandem with reports that HHS is
    closing the office for long COVID research and practice. And I
    talk to people for whom long COVID is seriously impacting their
    life.

        To what extent will HHS continue to support research, data
    collection, and other programs focused on understanding ongoing
    health impacts of long COVID?

        Secretary Kennedy. Senator, I am 100 percent committed to
    finding treatments for long COVID. I am deeply involved in that
    personally. I have a son who is really dramatically affected by
    long COVID.

        I have many, many friends who are affected by that, and by
    Lyme disease, incidentally, which we also--is also a priority.
    The COVID office was cut by an Executive Order from the White
    House, but we have--everybody at NIH and at CDC is committed to
    these kind of studies. And I can tell you personally, I will
    make sure that they happen.

        The Chairman. Thank you. The NIH is the largest public
    funder of biomedical research in the world, given us an edge
    over countries like China with whom we are obviously a
    geopolitical rival.

        But it takes a long time to develop this. And the rising
    prevalence of neurodegenerative disease is one area in which we
    have an impending crisis if we don't support the research and
    advanced cures. And my concern--and now I will speak as a guy
    from Louisiana. If NIH funding is substantially reduced, they
    have folks at my universities, at Tulane and LSU, who are doing
    work on these sorts of things.

        Knowing that the NIH budget is getting squeezed, and the
    indirect cost likewise, how will the NIH successfully do more
    with less? How will we build those new scientists to find these
    cures and to compete with geopolitical rivals?

        Secretary Kennedy. Well, for one thing, Senator Cassidy,
    you are talking about neurodegenerative disease. Now----

        The Chairman. For example, ALS or Alzheimer's.

        Secretary Kennedy. ALS, right. The Chinese are not spending
    a lot of money on DEI. And there are--and we are cutting those
    studies.

        We are cutting studies on gain-of-function studies, and we
    are cutting grants to foreign scientists from adversarial
    countries, and particularly the Chinese, which have the
    Thousand Talents Program, which is openly trying to exploit
    U.S. research and take our IP.

        We spend more than any country in the world on biomedical
    research. We spend--NIH controls about 70 percent of the global
    funding for biomedical research. The cuts we have made today
    are cuts--are administrative cuts.

        As far as I know, we have not fired any working scientist.
    Of the working scientists, the people who are actually doing
    science, there are some people who were--scientists that were
    doing IT or administration. But in terms of--who did lose their
    jobs. But in terms of working scientists, our policy was to
    make sure none of them were lost and that research continues.

        The Chairman. Let me--thank you. Let me ask you, the budget
    proposes to eliminate several large block grants for hospital
    and health Department emergency preparedness, and other core
    public health capabilities, explaining states are better
    equipped. To fund these activities.

        Now, I agree that frontline public health happens at the
    local level, but what works well in say Louisiana may not work
    well in a State like New York. But rural under-resourced states
    especially rely upon Federal funding to support public health.

        How do you propose we balance competing interests,
    returning power to states because there is a difference in how
    different states do it, but replace the funding necessary to
    combat these public health problems?

        Secretary Kennedy. Well, I think it is a balance, Mr.
    Chairman. And we have a legal obligation, CDC has a legal
    obligation, to do national pandemic response, and we will meet
    that obligation.

        In fact, we are going to improve it, and particularly if we
    can get support from this body, to refund, reappropriate the
    PAHPA, which is critical for a pandemic response. But there are
    some functions that are local in nature. And in those cases, we
    will be supporting local infrastructure to respond.

        They know better than we know, and we saw this during some
    of the hurricane response with Governor DeSantis's response,
    which was really Florida localized. There was no deaths and
    very little destruction to a hurricane that was as bad as the
    one that followed that relied on Federal response and was
    really a catastrophe for the state.

        I think experience shows that the locality is going to
    often do better with some functions, particularly with the
    hospitals and infrastructure. But we are not relinquishing our
    responsibility at CDC to manage national emergencies.

        The Chairman. Thank you.

        Senator Sanders.

        Senator Sanders. Thank you, Mr. Chairman. Let me start
    going back to prescription drugs. Mr. Secretary, did I hear you
    correctly to state that your goal is to have Americans pay the
    lowest prices in the world or equivalent to what is paid in
    other major countries? That is my goal. That you are prepared
    to work with us on legislation to achieve that goal?

        Secretary Kennedy. Absolutely.

        Senator Sanders. All right. And I believe there's
    bipartisan support for it. I believe that if the leadership
    here prioritizes that, we can do that in a very short period of
    time. Look forward to that. Let me ask you this, as Secretary
    of HHS. We have in America today some 85 million Americans who
    are uninsured or underinsured.

        We spend more per capita as you have indicated than any
    other country. Is healthcare a human right? Are we making
    America healthy when so many people cannot afford to go to a
    doctor, when 68,000 people a year die because they don't get to
    a doctor when they should? Is healthcare a human right? Will
    you work with us to guarantee health care to every man, woman,
    and child in America?

        Secretary Kennedy. Well, I think you are asking two
    different questions. You are asking a philosophical question
    about whether it is a human right, like a Constitutional right.

        As an attorney, I would say that it is not a right of a
    kind that we otherwise enshrined in the Constitution, because
    healthcare costs your neighbor money. If I smoke cigarettes for
    20 years, I make that choice, which is my choice----

        Senator Sanders. I don't have a lot of time, so I just--
    what I am get----

        Secretary Kennedy. If you ask a question--if you are asking
    me a philosophical question, I got to give you a thoughtful
    answer.

        Senator Sanders. Within 30 seconds.

        [Laughter.]

        Secretary Kennedy. It is not like freedom of speech, which
    costs everybody----

        Senator Sanders. But every other country, Mr. Secretary,
    every other country guarantees health care to all people as a
    right. Should we as Americans?

        Secretary Kennedy. The objective is to get Americans the
    level of the health care that they want, the choice, which
    Americans want.

        Senator Sanders. They don't want the choice to be
    uninsured. They don't want the choice to die because they don't
    get to a doctor on time.

        Secretary Kennedy. Americans prefer private insurance to
    other insurance sources.

        Senator Sanders. Do you believe--Okay.

        Secretary Kennedy. What I would say is I want to find a
    solution to this. I want every American to have insurance.
    President Trump wants every American to be insured and have
    access to health care. The question is, how do we get there?
    Obamacare is not working. It is not working. And this is the--
    --

        Senator Sanders. We can--sorry to interrupt you. All right,
    the reconciliation----

        Secretary Kennedy. My job is to try to make it work.

        Senator Sanders. All right. I have limited time. The
    piece--the reconciliation bill that is now being worked on in
    the House will come to the Senate. As it stands right now, cuts
    Medicaid in the Affordable Care Act by more than $715 billion,
    which the CBO has estimated would eliminate health insurance
    for 13.7 million Americans.

        Also raise those payments for millions of others. Is
    throwing 13 million Americans off of the health care they have,
    poor and working class people, keeping America healthy?

        Secretary Kennedy. I haven't seen that number. I have seen
    the number 8 million. And you are the people--the cuts are not
    true cuts. The cuts are eliminations of waste, abuse, and
    fraud. And I can go through--I can go through with the people
    who will lose it. A million people--there are million people--
    --

        Senator Sanders. Mr. Secretary, I really don't mean to be
    rude, but as you know, I have a very limited amount of time.

        Secretary Kennedy. You asked the question. I am going to
    answer it.

        Senator Sanders. Well--yes, I have got a bunch of questions
    that I would like you to answer as well. All right. We talk
    about austerity, doing more with less, but in that very same
    bill that is being worked on in the House right now, there are
    $235 billion in tax breaks for the top two-tenth of 1 percent.
    Do you think that makes sense, when that same bill would throw
    13 million people off of Medicaid? Should we give tax breaks to
    billionaires and throw kids and others off of Medicaid?

        Secretary Kennedy. You are conflating the Congressional
    bills with proposals from the President. The President----

        Senator Sanders. No, I am talking about the Congressional
    bill. I am talking about the bill, the reconciliation bill.

        Secretary Kennedy. I mean the President is not trying to do
    tax cuts for billionaires. He is trying to have no tax on tips
    and no tax for overtime.

        Senator Sanders. $235 billion by--through the estate tax.

        Secretary Kennedy. How many people--how many billionaires
    do you know that are making overtime or making any--tips----

        Senator Sanders. $235 billion--look, it is a big bill.
    There are a lot of provisions in it. But you cannot deny, the
    top two-tenths of 1 percent will get $235 billion in tax rates
    while we cut Medicaid.

        The Chairman. Okay.

        Senator Paul.

        Senator Paul. Thank you. I want to commend Secretary
    Kennedy and the Administration for putting forward less
    spending. And one of the reasons I think we need to look at NIH
    and other grant-making organizations is, if you keep giving
    them the same amount, you will keep getting the same frivolous
    grants.

        I will recite a couple of them so people can remember.
    660,000 was given to study the impact of microaggressions on
    obesity-related eating in Latino Americans. Really maybe heart
    disease, diabetes, obesity, but eating disorders in Latino
    Americans. Here is another one.

        $419,000 to study if lonely rats seek cocaine more than
    happy rats. Maybe we could eliminate that and that could go to
    a real disease. Most recently, NIH recorded a $620,000 grant
    for LGBTQ+ inclusive teen pregnancy prevention program for
    transgender boys. And what they discovered was that girls who
    think they are boys are at least as likely to get pregnant as
    girls who thinks they are girls.

        Amazing, the science. But we should all agree that is just
    left-wing ideology. That is not science. We should study
    obesity, and cancer, and diabetes. I commend you for shifting
    the balance. I have a specific question about closing down Fort
    Detrick recently. My understanding is that a contractor
    intentionally slashed the hazmat suit or the biosafety suit of
    someone who was handling Ebola.

        You were immediately attacked in the press by saying it was
    just anti-science. Once again shutting down science. Was this a
    serious breach, and is it being investigated?

        Secretary Kennedy. We brought in the FBI to investigate it.
    And as you say, it appears like it was a deliberate criminal
    act to try to--that was a kind of--that is equivalent to
    attempted murder because the kind of microbe, the pathogens
    that they were handling have a very, very high case fatality
    rate--up to 50 percent.

        The disturbing thing about it is that there are three leaks
    a week globally from BSL4 labs, and any of those could be
    cataclysmic for humanity. And as a result, we not only closed
    Fort Detrick, and we brought the FEI in to investigate that. We
    also declared the end of gain of function studies, again, that
    will allow those kind of leaks to continue.

        Senator Paul. I commend you for that. I think ultimately
    legislation will be needed because the next Administration
    could reverse it. I think there is bipartisan support for some
    controls on gain of function. As you shut down gain of function
    though, you have to decide what it is, and then you have to
    look for it.

        I would suggest that at both Fort Detrick and at the NBAC
    lab that is nearby run by the DHS, that we look at experiments
    involving Ebola, avian flu, Marburg virus, to determine one,
    whether they are gain a function, but also just determine
    whether the experiments are wise. I am told in public records
    that they are doing experiments or have done experience to
    aerosolize Ebola at the NBAC lab. That is the DHS lab nearby to
    Fort Detrick.

        My hope is that when you investigate whether to do gain of
    function or what is gain of function, what is being done, that
    you will compile that and at least give us a report in
    Congress, and we are going to ask for it. But so there can be
    public scrutiny of these things. You will help scrutinize it,
    but the whole public needs to know how dangerous some of these
    things are and whether we should be doing them.

        The idea of aerosolizing Ebola, I think, is a--and, or
    training Ebola to be aerosolized is incredibly dangerous,
    probably goes against the biological weapons convention, and I
    would like to hear a little bit about whether or not as you
    investigate this, you plan on bringing information back to
    Congress or to the public.

        Secretary Kennedy. Yes, we are going to be absolutely
    transparent. I am--I have a trip planned to Fort Detrick with
    Kristi Noem, the Director of DHS, and with Jay Bhattacharya and
    other people in my agency, or experts on bioweapons, or experts
    on gain-of-function research and we are going to be absolutely
    transparent.

        We have also proposed a methodology for regulating and for
    determining which--what is dangerous gain of function and what
    is legitimate scientific investigation, and how to bring the
    public into that debate, which I think as you point out is
    absolutely critical.

        That is where we messed up last time, and as you know, we
    have some of the Democrats here who are talking about the great
    science from NIH, but now we have a major agency, intelligence
    agency, the CIA, the FBI, the DOE, and the State Department
    have all agreed that NIH research almost certainly led to the
    pandemic, the COVID pandemic.

        That is not the kind of the result that we should be
    allowing or enabling, and we are going to end that now.

        Senator Paul. If possible--the trip to Fort Detrick and to
    NBAC, we would like to be included or invited on that trip, if
    possible.

        Secretary Kennedy. Absolutely.

        The Chairman. Senator Murray.

        Senator Murray. Thank you, Mr. Chairman. Mr. Secretary, one
    of my constituents, her name is Natalie Phelps. She is a mom of
    two from Bainbridge Island in Washington State. She has been
    fighting aggressive stage four colorectal cancer for nearly 5
    years now. Her best hope now is a clinical trial she is
    participating in at the NIH Clinical Center. She flew out to
    NIH a few weeks ago for her first appointment, and her care
    team there wanted her to come back in 4 weeks to start
    treatment.

        But because of the thoughtless mass firing of thousands of
    critical employees across NIH and HHS that you have carried
    out, Natalie's doctors at that clinical center have told her
    they have no choice but to delay her treatment by an additional
    4 weeks.

        Now, an extra 4 weeks may not sound like a long time, but I
    will tell you, for stage four cancer patients like Natalie,
    this could mean the difference between life and death.
    Secretary Kennedy, how many staff have been cut from the NIH's
    Clinical Center? I want a specific number.

        Secretary Kennedy. I can't tell you that now, Senator
    Murray. But what I can tell you is that if you contact my
    office tomorrow, I will look specifically into that.

        Senator Murray. Well, that is not acceptable. I want an
    answer back on that. She deserves it. I do--she doesn't have
    much time. She deserves an answer back.

        Secretary Kennedy. Wouldn't you rather get her into that
    clinical trial as fast as you can?

        Senator Murray. Absolutely. I wanted----

        Secretary Kennedy. If you contact my office tomorrow, this
    is a--if that happened----

        Senator Murray. You are here to defend your budget. I am
    here to ask you questions about the impact of that.

        Secretary Kennedy. You asked me--you asked me about a
    specific case that I want to help with. I don't think anybody--
    I don't think that should happen to anybody.

        Senator Murray. Okay. Well, what have you, and I mean you
    personally, done to assess how those staff cuts are impacting
    patient care? She is one of many. What have you done to assess
    that?

        Secretary Kennedy. I provided the guidelines that said we
    shouldn't--no clinical trials should be affected by the cuts. I
    have--Matt----

        Senator Murray. Mr. Secretary, I just have a short amount
    of time. They are impacting clinical trials.

        Secretary Kennedy. You asked me a question. Do you want me
    to answer it?

        Senator Murray. I want to tell you. You need to know this.
    You are here to defend the NIH budget which you are----

        Secretary Kennedy. Senator, do you want me to answer your
    question? Do you want me to answer your question, Senator?

        Senator Murray. I want to tell you that Natalie is sitting
    there waiting for treatment and you are here to----

        Secretary Kennedy. I am offering to help her, but you don't
    care. You don't care about Natalie. I've offered to help
    Natalie.

        Senator Murray. I am asking you a question and it is
    critical. You are here to defend cutting NIH by half. Do you
    genuinely believe that won't result in more stories like
    Natalie's?

        Secretary Kennedy. I think the cuts that we are--that are
    now proposed by the NIH are going to hurt. I think that
    President Trump, listen, there is no agency head in the
    Government, like myself, that wants to see their budget cut.
    And----

        Senator Murray. Well, and I asked you, have you personally
    assessed what this is doing to patients? And I am telling you
    one story of one person. It is an impacting life or death
    situation. I think it is pretty----

        Secretary Kennedy. You want me to answer your question,
    Senator?

        Senator Murray. Well, you did.

        Secretary Kennedy. Okay. I have not. You have not allowed
    me to answer it.

        Senator Murray. Well, I will just say that it is my job to
    be a voice for people like Natalie and countless other patients
    who are like her. So, you have got to fix this. I want to know,
    and I want a personal update on Natalie's case. And you have
    offered that. Please give that to me in the next 24 hours. And
    I expect details and transparency about the state of NIH
    clinical care.

        Secretary Kennedy. You contact my office, Senator, and I
    will do everything in my power to try to get Natalie into
    that----

        Senator Murray. Let me--I have got 1 minute left, and I
    want to ask you about the NIOSH cuts. I am really alarmed by
    your decision to essentially eliminate the National Institutes
    for Occupational Safety and Health. You have already fired
    nearly 90 percent of the staff.

        That includes the staff in my state at the Spokane Research
    Lab. Those are experts. They do essential work to protect
    miners, and firefighters, and farm workers. People who work in
    dangerous conditions. I am told that after backlash you are
    reinstating some of those, mainly in the West Virginia office.

        But there doesn't--nobody in the Western United States. And
    there doesn't seem to be any rhyme or reason to how you have
    made these decisions. And how do you explain this to my
    constituents in Spokane who are out of a job, and the workers
    that are being impacted by that?

        Secretary Kennedy. The work in NIOSH will not be
    interrupted. We are going--I have brought back 328 workers,
    mainly in the Cleveland office, and the Morgantown office, and
    for the World Trade Center site.

        That work will continue. The work on mine safety will
    continue. The epicenter of that work has been Cleveland, and it
    has been Morgantown. We understand it is a critically important
    function, and I did not want to see it end.

        Senator Murray. Mr. Chairman, I would just say you can't
    fire 90 percent of the people and assume the work gets done.

        The Chairman. Senator Collins.

        Senator Collins. Thank you, Mr. Chairman. Mr. Secretary,
    nearly seven million Americans are living with Alzheimer's
    disease. And caring for people with this devastating chronic
    disease costs us some $360 billion a year. I am the author of
    the law that is known as the BOLD Act.

        It takes a public health approach to Alzheimer's. It
    educates providers, promotes earlier diagnosis. It helps
    caregivers, and it also promotes lifestyle changes. I have
    worked very hard to make sure that HHS has the resources to
    carry out this law, which was just recently extended. I am
    concerned that the reductions in force of approximately 10,000
    staff across HHS will completely undermine this Act.

        This Act in many ways is very consistent with your approach
    of looking at public health issues for chronic diseases. For
    example, the Healthy Aging branch administers the BOLD Act for
    Alzheimer's. It has lost all of its staff.

        How can you ensure that the CDC continues to implement the
    BOLD Act and the Alzheimer's programs under it when all of the
    staff responsible for that administration have either been
    placed on administrative leave or let go?

        Secretary Kennedy. I Don't know enough about that program.
    I know that under the--that division has been folded into the
    America--the Agency for Healthy America. And a lot of the
    reports that whole divisions have been liquidated were just
    wrong. They were divisions that were being reassigned under the
    reorg.

        Now, I am under a constrain here because at 4 o'clock
    yesterday afternoon we were told that there was--that a Federal
    judge granted a TRO in our case on the reorg. And my attorneys
    have asked me not to talk about any details of the reorg today.
    So I--but on that budget line, I will work with you. I am
    committed, Alzheimer's has run in my family.

        As you know my cousin Maria Shriver who is deeply involved
    in it. The NIH had a very, very checkered history on studying
    Alzheimer's because of the amyloid plaque scandal. And we have
    an opportunity now to do really good science and find a cure
    very quickly.

        Also find out equally, importantly, why so many people are
    getting Alzheimer's in this generation. I want to make that
    happen. I want to work with you, Senator, to make sure that
    happens and that those programs continue.

        Senator Collins. Thank you. I chaired recently the first
    Appropriations Committee hearing of the year, and we have
    focused on biomedical research and how important it is that
    America not lose its global edge in innovation that is
    producing life-saving and life-enhancing discoveries.

        Among the many issues that we covered, as you might expect,
    the hearing explored the 15 percent arbitrary, one size fits
    all percent cap that NIH has imposed on indirect, but still
    research-related costs for its grants. What we heard is that
    this cap will mean less basic research, fewer clinical trials,
    and that it will also cause our scientists and researchers to
    leave the United States and go to other countries.

        I believe strongly that this proposed cap is poorly thought
    out, that it is harmful, and I know that it violates current
    law because since 2018, we have included in the Appropriations
    bill specific language that prevents NIH from imposing such a
    cap.

        I know the system needs to be looked at, but are you
    reviewing how NIH's approach of this one size fits all 15
    percent on indirect costs would affect laboratories, whether
    they are private, nonprofit labs, or whether they are in
    universities, as far as doing crucial biomedical research?

        Secretary Kennedy. Senator, we are. And you and I have
    talked about this issue. And I think that the impetus for the
    cap was that there were a lot of private universities with
    giant endowments like Stanford and Harvard that were getting
    indirect payments of 78--70, 78 percent.

        What that means if you get a million dollar grant, NIH then
    has to pay you an extra $780,000, or administrative costs. And
    a lot of those costs weren't even going to anything to do with
    science. They were going to the university budget. And in order
    to curb that abuse, we adopted a 15 percent which is the
    industry standard. That is what the Gates Foundation or any
    other foundation would pay.

        But I understand the University of Maine, University of
    Alabama, many other universities, state universities were not
    abusing it. We lost about $9 billion a year in those kind of
    costs. And so, we have a plan for how to address.

        Issues like what is happening at the University of Maine. I
    am being gaveled out, so I will talk to you privately about
    that.

        Senator Collins. Thank you.

        The Chairman. Senator Baldwin.

        Senator Baldwin. Thank you, Mr. Chairman. Secretary
    Kennedy, you run a Department that touches the lives of almost
    every American. Yet for this budget hearing, these are the six
    pages that we have gotten in terms of your budget request.

        We are also seven and a half months into this fiscal year,
    and yet you are not telling the American public anything about
    how you are spending the billions in taxpayer dollars right
    now. You had to submit an operating plan to the Congress, and
    this is just a sample page. But 530 programs simply have
    asterisks. Secretary Kennedy, this isn't about your hiding
    information from me.

        This is about your hiding information from the American
    public. And if you are going to cut cancer research or gut
    mental health support at least stand by your work and explain
    it to the American people.

        Now, Secretary Kennedy, I want to start with what I hope is
    an easy question for you. Do you think lead poisoning in
    children is a significant concern?

        Secretary Kennedy. Is lead poisoning--?

        Senator Baldwin. In children a significant concern.

        Secretary Kennedy. Is an extremely significant concern.

        Senator Baldwin. Thank you. Then I would like to know why
    your Department has effectively shut down the very program to
    address lead poisoning in children. The city of Milwaukee
    requested assistance from the CDC to help the city respond to
    lead poisoning cases tied to public schools.

        Six schools have been closed, displacing more than 1,800
    school children. The request for Federal assistance was denied
    because of lack of staff. The entire childhood lead poisoning
    branch has been fired. In the words of a Milwaukee mom, it
    really sends a message of, you don't matter.

        I don't know what you would say to parents who must now
    test their children for lead and deal with school closures. But
    do you intend to eliminate this branch at CDC, yes or no?

        Secretary Kennedy. No, we do not.

        Senator Baldwin. Okay. Because you cannot tell us that you
    want to make America healthy again when you are willfully
    destroying programs that keep children safe and healthy from
    lead poisoning. Congress dedicated $51 million in funding for
    this particular program.

        But when a community asks for help to prevent lifelong
    complications for children, and there was no one there to pick
    up the phone--and it is not because this program is
    ineffective. It is because you fired the entire team whose job
    it is to support communities like Milwaukee.

        Secretary Kennedy. If that money has been appropriated, we
    will spend that money. If it has been appropriated to
    Milwaukee, we will spend it in Milwaukee. I have spent a lot of
    time in Milwaukee working on that----

        Senator Baldwin. It is to provide expert--the entire staff
    has been fired. Secretary Kennedy, I did note in your opening
    testimony, although we wouldn't know it from the skinny budget
    that we have, that you plan on funding the Head Start program.

        But I want to tell you about the ramifications of what has
    happened to date with regard to Head Start. I have heard from
    families across the state. People who are terrified about these
    uncertainty and instability surrounding Head Start. Just 1 week
    into President Trump's administration, Head Start programs in
    Wisconsin suddenly couldn't access their grant funding.

        It forced one Head Start in Waukesha, Wisconsin to
    temporarily close, leaving 250 families without care. Over the
    last 4 months, HHS has provided roughly $1 billion less to Head
    Start programs across the country than during the same period
    last year. The delays in funding have exacerbated uncertainty
    for programs needing to make payroll. And in some instances,
    like the one I cited in Waukesha, programs have had to shut
    their doors until the payments came through.

        Now, I don't know what you would say to a parent who is
    unable to drop their child off at preschool because you failed
    to get already appropriated money out the door. Or maybe I
    should ask you, what would you say to a parent who shows up for
    childcare or for Head Start and the doors are closed?

        Secretary Kennedy. I would be very sad if somebody showed
    up--I fought very, very hard to make sure that there would be
    no cuts.

        Senator Baldwin. What is causing the delays in Head Start
    funding? That is my question.

        Secretary Kennedy. I fought very hard to make sure that
    Head Start gets all of its funding next year.

        Senator Baldwin. Well, we need it this year. And why are
    there delays now?

        Secretary Kennedy. I don't know that there are, Senator,
    and I will look into it. But I don't know--there should not be
    any delays. The funding is there. We are spending it. It is
    allocated. I don't know why there would be those kind of
    problems.

        There were--I can tell you that within the agency, there
    were, there were people who wanted to make the Trump
    administration look bad and that there were checks held up that
    shouldn't have been. I will have to look into that, Senator.

        The Chairman. Senator Murkowski.

        Senator Murkowski. Thank you, Mr. Chairman. Mr. Secretary,
    welcome. Good to see you. I want to talk a little bit about the
    HHS reorganization on some of the programs that impact Alaska's
    most vulnerable populations. I sent you a note letting you know
    that just after this hearing, I am going to be chairing a
    Senate Committee on Indian Affairs, specifically examining HHS
    tribal programs that are outside of IHS.

        I really thank you for your early efforts to exempt IHS
    health care providers from the RIFs. That was very important.
    But I have also heard concerns from tribal leaders on the
    impacts of RIFs to key HHS programs serving their communities.

        I know you are going to have some of your folks tuning in
    on that, and I really appreciate that. But some of the other
    reductions that we are looking at within your budget do have
    significant consequences to a state like mine.

        One is the LIHEAP program, the Low Income Energy
    Assistance. For us, it is not a budget line item. You have been
    to Alaska. You know that the temperatures there can get really,
    really tough. Keeps people from freezing to death in their
    homes. Another program is NIOSH.

        I know that HHS had rescinded a number of those employees.
    That was great news. But the employees that received RIF
    notices for the program were not rescinded in the NIOSH Center
    for Marine Safety and Health Studies. So this is--this is a big
    deal for our commercial fishing safety.

        It could effectively leave our fishing fleet out of
    compliance with Coast Guard safety regs, so we are watching
    that very, very carefully. And then, again, shared focus here
    on making sure that our children are as healthy as they
    possibly can be.

        I want to look to ways that we can strengthen and not
    eliminate the Head Start program. But I wanted to ask you----

        Secretary Kennedy. You are talking about the NIOSH program.

        Senator Murkowski. NIOSH, yes.

        Secretary Kennedy. You should talk to me about that. And as
    you know, that is something that I am deeply concerned with the
    commercial fishery. So, we should talk about it and let's, and
    let's work for a solution.

        Senator Murkowski. Got it. I am with you right there. Let
    me ask about domestic violence and sexual assault funding.
    Right now I am talking--I am receiving a lot of incoming from
    our community based domestic and sexual violence program
    operators.

        They are really concerned about the delayed release of
    Fiscal Year 2025 funding, the absence of notices of funding
    opportunities, as well as proposed cuts or consolidations that
    might threaten the Office of Family Violence Prevention and
    CDC's Division of Violence Prevention.

        You have got some programs there that are really
    foundational to domestic and sexual violence. They have been
    reauthorized with bipartisan support, so. I am going to enter
    into the record a letter from the National Task Force. And it
    basically--was sent to you, I guess, yesterday. Just urging the
    communication of concrete plans for releasing some of these
    funds.

        [The following information can be found on page 55 in
    Additional Material:]

        You are--I am going to raise that to your level. But I want
    to make sure that we are sending the right signal to so many
    who are just really on the edge with, again, these community
    based services that are helping the most vulnerable of the most
    vulnerable. So we have got the funding that is out there. It is
    just delayed. We need help releasing that.

        Secretary Kennedy. My understanding is that the domestic
    violence funding was not cut, so I don't know. I mean, I have
    to go back and check, but I specifically asked about that
    program last night and was told that there was no cuts. That
    President Trump is committed to it. And so, I don't know why
    people would be experiencing even delays.

        Senator Murkowski. It may be that it is--with the RIFs, you
    don't have people that are processing these things. So again, I
    want this to be at the top of your screen.

        Secretary Kennedy. That could be.

        Senator Murkowski. Last question for you. I mentioned
    LIHEAP. The budget proposal, the skinny budget proposes to
    eliminate LIHEAP. And the proposal says that it is unnecessary
    because states have policies preventing utility disconnection
    for low-income households, effectively making LIHEAP a pass-
    through benefiting utilities in the Northeast.

        Further, LIHEAP rewards States like New York and
    California, two of the top recipients for LIHEAP funding, which
    have implemented anti-consumer policies. I am just telling you,
    we are not in the Northeast. We are not in that bucket. We are
    cold. There are other places that are hot. LIHEAP is a
    lifesaver.

        I did see your statement from yesterday saying that OMB was
    thinking that President Trump's energy policy is going to
    reduce costs dramatically. It may. It may be a while. Right now
    folks in Alaska still need those ugly diesel generators to keep
    warm, so I would ask----

        Secretary Kennedy. I know. I was on a Navajo--first of all,
    I have heard that my whole life because my family was involved
    in providing low-cost energy to the poor in New England. And
    there are people in New England who suffer from--if energy
    prices are high and you have a cold winter.

        I was on the Navajo Reservation a couple of weeks ago and
    the Navajo President, Buu Nygren, said to me, if we cut LIHEAP,
    people will die on this reservation. I know the same is true in
    Alaska.

        The presumption behind the budget cuts were that the energy
    prices were going to drop dramatically in which case these
    payments would just become a subsidy to the oil industry. If
    that doesn't happen, I would expect Congress would then still
    appropriate the money and I will spend it.

        I have already spent $400 million between January and now
    on this program, and we have made to get it out--made sure to
    get it out to all the families that needed it, so----

        Senator Murkowski. I think you are going to find a lot of
    support on this Committee for that.

        Senator Murphy.

        Senator Murphy. Thank you very much, Madam Chair. Secretary
    Kennedy, I want to talk to you about your relationship with
    this Committee and this Congress. I want to talk to you about
    the statements that you made to the Chairman of this Committee
    and to Members of this Committee during your confirmation
    hearing about vaccines.

        You didn't tell the truth. I find that to be really
    dangerous for our relationship. If I were the Chairman, who
    believes in vaccines and voted for you because he believed what
    you said about supporting vaccines, my head would be exploding.

        In the hearing, you told us, ``I will not work to impound,
    divert, or otherwise reduce any funding appropriated by
    Congress for the purpose of vaccination programs.'' That is not
    the truth. You have done exactly----

        Secretary Kennedy. I have----

        Senator Murphy. Let me finish my question.

        Secretary Kennedy. I didn't hear what you said. I am just
    asking you to repeat it so I can understand your question.

        Senator Murphy. During the hearing--during the hearing--I
    will repeat it. During the hearing, you said to this Committee
    and to the Finance Committee, ``I will not work to impound,
    divert, or otherwise reduce funding appropriated by Congress
    for the purpose of vaccination programs.''

        That is not what happened. You have done the opposite. You
    canceled $12 billion in grants to the states, including my
    state, that are used to administer and track vaccines. You
    promised Chairman Cassidy----

        Secretary Kennedy. When did I do that?

        Senator Murphy. Madam Chair, would you allow me to finish
    my question?

        Secretary Kennedy. When did I do that?

        Senator Murphy. Let me--let me finish my question----

        Secretary Kennedy. You are making accusations. Just tell me
    when I did it so I can understand what the question is.

        Senator Murphy. You have canceled $12 billion in public
    health grants to states. Whether you know this or not, that
    funding is used by the states in part to be able to administer
    and dispense information about vaccines. Let me give you----

        Secretary Kennedy. Which programs?

        Senator Murphy. Mr. Secretary, let me give you the full
    panoply of the things you have said before this Committee that
    didn't turn out to be true. You also promised Chairman Cassidy
    that the FDA would not change vaccine standards from
    ``historical norms.'' But what happened as soon as you were
    sworn in?

        You announced new standards for vaccine approvals that you
    proudly referred to in your own press release as a radical
    departure from current practice. And experts say that departure
    will delay approvals. You also said specific to the measles
    vaccine that you support the measle vaccine, but you have
    consistently been undermining the measles vaccine.

        You told the public that the vaccine wanes very quickly.
    You went on the Dr. Phil Show and said that the measles vaccine
    was never fully tested for safety. You said there is fetal
    debris in the measles vaccine.

        Secretary Kennedy. All true.

        Senator Murphy. This morning----

        Secretary Kennedy. All true. All true.

        Senator Murphy. This morning in front of----

        Secretary Kennedy. Do you want me to lie to the public?

        Senator Murphy. That is not--none of that is true.

        Secretary Kennedy. Of course it is true. Of course it is
    true, Senator. Senator, begging your pardon, you do not know
    what you are talking about.

        Senator Murphy. I will submit for the record----

        Senator Murkowski. Let's have a little bit of order so that
    you can get your question, and he can get his statement.

        Senator Murphy. Madam Chair, I didn't ask for a response
    yet.

        Senator Murkowski. I understand.

        Senator Murphy. I would like to lay out the predicate of my
    question before I am interrupted by the witness. He should have
    some respect for this Committee.

        Senator Murkowski. Go ahead. Go ahead.

        Senator Murphy. Just this morning in front of the House of
    Representatives, you also said that you, in fact, would not
    recommend that kids get vaccinated for measles. You said you
    would just lay out the pros and cons.

        Okay, so this is the summation of everything that you have
    said to compromise people's faith in the measles vaccine in
    particular. It is contrary to what you said before this
    Committee. You said you support the measles vaccine, but then
    you have laid out a set of facts that are contested.

        I will submit information for the record from experts who
    can contest what you have said about the vaccine. And the
    result is to undermine faith in the vaccines. Kind of like
    saying, listen, I think you should swim in that lake, but the
    lake is probably toxic, and there is probably a ton of snakes
    and alligators in that lake, but I think you should swim in it.
    Nobody is going to swim in that lake if that is what you say.

        I want you to acknowledge that when you say you support the
    measles vaccine, and then go out and repeatedly undermine the
    vaccine with information that is contested by public health
    experts, that is not supporting the vaccine. And so, I guess I
    have two simple questions for you.

        One is, can you clarify what you said in the House this
    morning? Are you or are you not recommending that families get
    their children vaccinated, or are you just giving people the
    pros and cons? And do you understand that when you say these
    things about the measles vaccine, what ends up happening is
    less people get the vaccine. That may be what you want.

        But do you understand that the result of constantly
    questioning the efficacy or safety of the vaccine results in
    less people getting the vaccine. So, I don't necessarily want
    to spend the remaining 20 seconds in an argument over the
    science, but you at least understand that is the consequence of
    what you are saying? And are you actually still recommending
    people get the vaccine or are you not?

        Secretary Kennedy. If I advise you to swim in a lake that I
    knew there to be alligators in, wouldn't you want me to tell
    you there were alligators in it?

        Senator Murphy. Are you recommending the measles vaccine or
    not?

        Secretary Kennedy. What I have said, and what I said in
    the----

        Senator Murphy. It doesn't sound like you are if that is--
    --

        Secretary Kennedy. Are you going to let me answer? Are you
    going to keep----

        Senator Murphy. Are you or are you not?

        Secretary Kennedy. Are you going to let me answer? What I
    pledged before this Committee during my confirmation is that I
    would tell the truth--that I will have radical transparency. I
    am going to tell the truth about everything we know, and we
    don't know about vaccines.

        Senator Murphy. Are you recommending the measles vaccine or
    not?

        Secretary Kennedy. I am not going to just tell people that
    everything is safe and effective if I know that there is
    issues. I need to respect people's intelligence.

        Senator Murphy. I think you are answering the question. I
    think you are answering the question. That is really dangerous
    for the American public and for families in this country.

        Senator Murkowski. We are going to--we are going to move to
    Senator Marshall.

        Secretary Kennedy. The reason they have lost faith in this
    program is because they have been lied to by public officials
    for year, after year, after year.

        Senator Murphy. The Secretary of Health and Human Services
    is no longer recommending the measles vaccine----

        Senator Murkowski. Senator Marshall.

        Secretary Kennedy. By the way, I said at the hearing this
    morning that I was recommending the measles vaccine. You can go
    look at the transcript.

        Senator Murkowski. Senator Marshall.

        Senator Marshall. Madam Chairman. Thank you so much for
    being here, Mr. Secretary. We are glad you are here. Let's stay
    on the measles vaccine just for a second. Let me catch my
    breath after that--all that. I am an obstetrician. If a 25-
    year-old pregnant woman asked me if she should take the measles
    vaccine, the MMR, I would have--give her the answer, no you
    shouldn't.

        But if she was 25 and trying to get pregnant, I would give
    her different advice. I have always valued the sanctity of the
    physician-patient relationship. I went to medical school for 4
    years. I did 4 years of residency. I delivered thousands of
    babies.

        It is my job to give that recommendation. What is the role
    of the Secretary of HHS as far as recommendations of vaccine,
    and just discuss it a little bit further.

        Secretary Kennedy. Well, the vaccine recommendations,
    Senator, are normally made through ACIP, the Advisory Committee
    of Immunization Practices, which is an outside consulting
    committee at the CDC.

        There is another committee called FERPAC which is within
    FDA that actually recommends whether the vaccines get licensed
    or not. And so, that is where the recommendations come from.

        Traditionally, they have not done evidence-based medicine.
    They only adopted evidence-based medicine about 12 years ago.
    And what we have said during our Administration is we want to
    have safety studies prior to the licensure and recommendation
    of vaccines.

        Vaccines are the only medical product that is exempt from
    pre-licensing safety testing. So the only vaccine that has been
    tested in a full-blown placebo trial against an inert placebo
    was the COVID vaccine.

        The other 76 shots that children in this country receive
    between birth and 18 years old, none of them have been safety
    tested in pre-licensing studies against the placebo, which
    means we don't understand the risk profile for those products.
    And that is something that I intend to remedy.

        Senator Marshall. Okay. You said earlier you couldn't talk
    about the reorganization, and maybe you cannot answer this
    question, but I--maybe you can at least confirm these facts for
    me or not.

        Isn't it true that under Joe Biden's White House, they
    added 20,000 employees to HHS? When you were nominated, there
    was 28 divisions with HHS. 100 communication offices, 40 IT
    Departments, 9 H.R. units as well. Is that--can you answer that
    question?

        Secretary Kennedy. Yes, that is right there. There are
    dozens of IT Departments. There are eight senior finance
    officials.

        There are nine separate offices on women's health. Eight
    separate offices for minority health. Twenty-seven separate
    offices for HIV. Fifty-nine behavioral health programs. Forty
    opioid programs.

        What we are trying to do is consolidate, streamline,
    eliminate the redundancies, eliminate all those administrative
    costs for each one of those little Departments, consolidate
    them, and make them make sense and make them accountable to the
    American people.

        Senator Marshall. I don't--or I suppose all those IT
    systems communicate with each other? You all are on one IT
    system?

        Secretary Kennedy. There is 40--as you pointed out, there
    is 40 procurement Departments with four separate computer
    systems that don't talk to each other. So and as you pointed
    out, this--my Department grew by 38 percent over the last 4
    years. I would say that is great if Americans got healthier,
    but they didn't. It got worse.

        What we are trying to do is go back to the pre-COVID
    levels, and to start making the Department function as it would
    if you, in a rational universe. And to bring in modern AI and
    telemedicine and all the opportunities we have now. These new
    efficiencies, and for medical delivery to the American people
    and for patient care.

        We are not able to take advantage of any of them because
    there is so much chaos and disorganization in this Department
    and everybody who has gone up against it in the past has thrown
    their hands up and given up. What we are saying is let's
    organize in a way that it can quickly adopt and deploy all
    these opportunities. We have to really deliver high-quality
    health care to the American people.

        Senator Marshall. If I could--this was going be a question.
    I am just going to make a statement. All the research that we
    do on MAHA, on soil health, on nutrition, in my heart, that is
    research on cancer. It is research of Alzheimer's.

        At the end of the day as well, we should be spending as
    much money at the front side of this as we are trying to cure
    the end of it. We are seeing epidemics of colorectal cancer.
    Young age Alzheimer's. All these things, and I think the
    research at the front end is every bit as important at the hind
    end.

        Secretary Kennedy. Senator Murphy made a good point. We
    have--the NIH has made all these extraordinary breakthroughs,
    and particularly in treating cancer reducing mortalities for
    colorectal cancer, but my question is, wouldn't it be--isn't it
    as important to find out why kids are getting colorectal
    cancer.

        When you and I were a kid, there were zero kids with
    colorectal cancer. It is epidemic now. So it is not really a
    badge for us when we say, oh, we can make it less lethal. Why
    don't we go figure out what is causing it and eliminate that
    exposure?

        With all of these, with Alzheimer's, with heart disease.
    Something is making Americans very, very sick. And our response
    should not be just, Okay, we will develop a pharmaceutical fix
    for it, or a medical fix. Let's figure out what it is and get
    rid of it so we can have healthy kids again.

        Senator Murkowski. Thank you.

        Senator Kaine.

        Senator Kaine. Thank you. Mr. Kennedy, I want to ask you
    some questions about staff reduction and kind of the timing of
    it. You were confirmed by the Senate on February 13, so I am
    sort of assuming that things happened before you were confirmed
    where other people's work.

        On January 28th, the fork in the road letter came out to
    people across the Federal employment space. Widely attributed
    to OPM and Elon Musk and DOGE. But that was before you were
    confirmed, so you had nothing to do with the fork in the road
    letter, correct?

        Secretary Kennedy. Correct.

        Senator Kaine. Okay. You were confirmed on February 13. On
    February 14, 1 day later, HHS announced that 3,500 probationary
    employees were going to be laid off. I know you are a hard
    worker, but am I right to assume that in the 1-day between your
    confirmation and the next day, you weren't the primary decision
    maker about laying off probationary employees at HHS?

        Secretary Kennedy. I was aware of it, and I could have
    blocked it.

        Senator Kaine. Yes. You were aware of it. So, you weren't
    the primary decision maker. Was that a decision that was made
    like OPM or DOGE? And because it wasn't just HHS, it was all
    Federal agencies who would lay off probation. Do you know where
    that decision was made?

        Secretary Kennedy. I had my full upper staff in place
    before I got there.

        Senator Kaine. Right, but did they make the decision or was
    it White House and DOGE to lay off probationary employees.

        Secretary Kennedy. They made the decision. My staff made
    the decision.

        Senator Kaine. Okay.

        Secretary Kennedy. Although, DOGE came in and DOGE gave us
    information that we wouldn't otherwise have had access to.

        Senator Kaine. Okay. Next we go to April 1st.

        Secretary Kennedy. I can also say this----

        Senator Kaine. No, all I asked was if you made it and you
    answered the question. And I appreciate it. April 1, HHS RIFs
    10,000 employees effective June 2. Now, by this point you had
    been Secretary for about 6 weeks.

        A few days after that announcement, HHS staff briefed our
    staff at the Senate HELP staff, and basically just here are
    some highlights. In that 10,000 RIF, 467 staff at the
    Administration for Children and Families, 2,473 at the Centers
    for Disease Control, 322 at CMS, 400 at HRSA, 1,312 at National
    Institutes of Health, 197 at SAMHSA, 2,019 at the Food and Drug
    Administration.

        By now, you have been Secretary for 6 weeks, so this was
    RIFs, not the forks, but you were involved in the decision
    about these 10,000 RIFs, correct?

        Secretary Kennedy. Yes.

        Senator Kaine. In tandem with your leadership team,
    correct?

        Secretary Kennedy. Yes. And as I said before, I pushed back
    on certain ones and canceled certain ones.

        Senator Kaine. Yes. I think yesterday, it might have been
    earlier today, you confirmed that 20,000 employees have been
    let go--at HHS. 10,000 RIF-ed and 10,000 forked. Do you know
    how many of the 20,000 were veterans?

        Secretary Kennedy. No, I don't know.

        Senator Kaine. That is a fact that is very easy to
    determine from someone's personnel file, so I am going to ask
    that question for the record. We are finding across the
    Government that Veterans are disproportionately being let go,
    (A), because they are a higher percentage of the Federal
    workforce and (B), there a dramatically higher percentage of
    probationary employees because they leave military service
    after 10 or 25 years, and then they are probationary new
    employees when they join the civilian service.

        I want to find the answer to that question. Where does the
    rubber meet the road on 20,000 RIFs, and layoffs, and forks? In
    people not getting cancer trials--and I appreciate your
    willingness to help Senator Murray's constituents. In state
    grants being canceled. In Virginia losing $425 million in
    funding to the Virginia Department of Health. But here is a
    small example.

        All of our offices do case work. All of them do casework.
    And we get requests from constituents all the time. CMS is the
    largest agency in the Federal Government. Its budget is nearly
    twice the size of the Pentagon. And people who depend on
    Medicaid, Medicare, and the S-CHIP program really, really
    depend on.

        It is the most consistent in the top three or four in terms
    of constituent requests to my office. Answer this question
    about Medicare, or Medicaid, or the S-CHIP program. In every
    Administration I have served with, Obama, Trump one, Biden, I
    get answers to questions on behalf of constituents.

        I may not get them as fast as I like, and sometimes I like
    the answer and sometimes I don't. But let me show you what CMS
    is now doing to answer constituents' questions. I have omitted
    the name of the constituent, and I have omitted the name of my
    staffer. This was very recent.

        A hard-working retiree, patriotic, taxpaying American who
    is on Medicare wrote to ask CMS a very simple question about
    Medicare. Couldn't get an answer. Asked us to reach out. We
    reached out to the Medicare Part C and D Congressional Liaison
    Office, and here was their answer to our basic question.
    Unfortunately, there is not an update to provide. With the
    recent change of Administration, we are unable to provide any
    information related--on matters related to Mr. X's request.
    Congressional casework team.

        I mean, if you are just an everyday, hard-working American
    retiree on Medicare and you have a basic question about it, you
    ought to be able to get an answer. And I am just going to say,
    I have shared this with my colleagues, and many of us are
    having the same experience where our constituents can't get a
    basic question answered. I wonder if 20,000 fewer employees is
    connected to this. I yield back, Mr. Chair.

        The Chairman. Senator Husted.

        Senator Husted. Thank you, Mr. Chairman. Secretary Kennedy,
    thank you for being with us today. I appreciate the work that
    you have done in trying to raise awareness about making America
    healthy again, particularly as it relates to our dietary
    consumption. How food can be medicine, and food can make us
    sick. You have raised a great deal of awareness.

        When we talk about public education campaigns, I think you
    have done more to shine the light on things that average
    American can do to make themselves healthier than almost any
    Secretary I can recall. So, thank you for that service. I also
    have listened to a lot of the conversation today where somehow
    we think that spending more is somehow compassionate.

        On every single thing, like you have to spend more to do it
    even though every single person in this Congress knows that
    they are spending borrowed money that our children will have to
    repay. $106,000, their share of the national debt when you are
    a child born into this Nation right now. And everything that
    you can do to create savings and improve the quality of
    services that American taxpayers get from your agency, I
    commend you on it. I encourage you to do so.

        I want to give you the opportunity to share a couple points
    that you might want to share some of the work that you are
    doing in this budget is going to help people become healthier,
    generate some better outcomes for them, and savings that you
    think can be created that would not harm somebody's health, but
    actually preserve the fiscal future of this Nation, so that
    those children can grow up and have access to the American
    dream that we all had access to when we were born in this
    Nation. So, share your thoughts.

        Secretary Kennedy. I appreciate you raising that about the
    debt issue because the point I was making earlier was that
    there is no agency head that wants to reduce the size of their
    agency. I would rather have as much money and power as I can
    possibly have.

        I recognize that President Trump and the OMB Director have
    a larger duty and a larger vision, which is we are spending $2
    trillion a year that we don't have, and we are billing our
    children, and that is a moral deficiency. Senator Sanders asked
    me about the morality of universal health.

        You can--there is a good moral argument for that, but there
    is also a moral argument--and, when we are spending $1 trillion
    a year just to service that debt, within 5 years, half of every
    dollar collected in taxes is going to go to servicing the debt
    and within 10 years it could be 100 percent and then our kids
    are doomed.

        That is a, the debt is a social determinant of health. We
    are trying to reverse that, and we are doing it in a way that
    it is not just throwing more money at the problem. We are
    revising the GRAS standards.

        Twenty years of Democrats have said, we need to revise the
    GRAS standards. I have done it in 100 days. We are getting rid
    of nine synthetic--petroleum-based synthetic dyes in our food.
    Twenty years the Democrats have been saying we want to do this,
    and I have done that in 100 days.

        I am--we are rewriting the dietary guidelines. The dietary
    guidelines that President Biden gave us, 453 pages long, and it
    is just an industry-generated document. The same industry
    impulse that put Froot Loops at the top of the food pyramid.

        We are creating a four-page document that can be locally
    sourced that will drive the school lunch program. We have
    called on and inspired Governors and Legislatures across the
    country to ask for exemptions to the SNAP program to get soda
    and candy off of SNAP. We have--am I getting--is that a timer?

        Senator Husted. You are good. Thank you for the work on
    SNAP, by the way, because getting unhealthy foods out of that
    program--if you are at the bottom quartile of income, you are
    almost twice as likely to be obese as if you are for the top
    cohort.

        Secretary Kennedy. Also diabetic.

        Senator Husted. It is costing people their productivity,
    their quality of life. It is costing the American taxpayer more
    money through Medicare, Medicaid, and other health services we
    provide.

        I just would say, we talked about kids. I want to give you
    a moment to share a thought. In 2022, we had a shortage of
    infant formula. There is a look at children now about how--what
    they should have in that infant formula. You are doing that
    with the----

        Secretary Kennedy. Operation Stork Speed.

        Senator Husted. Yes, exactly. Tell us a little bit about
    that and just--if you have a moment.

        [Technical problems.]

        Senator Husted. Well, I will just say, Mr. Chairman, thank
    you for doing that. How about that? There we go.

        The Chairman. But the Secretary made the statement that no
    vaccines except for COVID have been evaluated against placebo.
    For the record, that is not true. Coronavirus, measles, and HPV
    vaccines have been.

        Some vaccines are tested against previous versions. So just
    for the record to set that straight.

        Next, Senator Hassan.

        Senator Hassan. Thank you, Mr. Chairman. And Secretary
    Kennedy, thank you for being here. I would like to start by
    talking about the current measles outbreak, which I know is a
    concern for all of us here today.

        Two children in Texas have tragically died from measles
    this year, the first children to die from measles in our
    Country in more than 20 years. Measles is almost completely
    preventable with the measles vaccine. As you know, it is
    critical that families hear directly and clearly from
    healthcare leaders about how they can best protect their
    children.

        Mr. Secretary, I would like to give you an opportunity to
    sate clearly here today to any parents who are watching that
    the best way to protect their children from measles is to
    vaccinate them.

        Secretary Kennedy. I have said that the best way to stop
    the spread of measles is through vaccination. I would say this,
    we have handled this measles outbreak--we get a measles break
    every year. We have handled this measles outbreak better than
    any other nations affected----

        Senator Hassan. What I was interested in--I am just--you
    can say you--what I asked you to do was to say straight to the
    camera as you did on social media that it is your position that
    the best way for parents to prevent their kids from getting
    measles is to vaccinate them, and that is your statement
    today----

        Secretary Kennedy. I said that to you.

        Senator Hassan. All right. Well, that is great. Thank you.
    Now, you lead the Nation's health department, so let me ask you
    a couple of questions. Do you think HHS should employ anyone
    who has endangered the health of children?

        Secretary Kennedy. No.

        Senator Hassan. You hired David Geier to lead autism
    research at HHS, an individual who fraudulently posed as a
    doctor and gave dangerous medications and medical tests to
    children with autism.

        According to the State of Maryland's investigation, David
    Geier, who has no medical license or training gave hormone
    blocker injections to children with autism who were as young as
    8 years old, which the Maryland Board of Medicine said poses a
    substantial risk of harm. Secretary Kennedy, yes or no, will
    you fire David Geier?

        Secretary Kennedy. First of all, what you are saying is not
    true. And we did not hire David Guyer to manage autism research
    at HHS. And----

        Senator Hassan. What is his job--what is this job then?

        Secretary Kennedy [continuing]. They have just said some
    very defamatory things----

        Senator Hassan. Well, no, I----

        Secretary Kennedy [continuing]. About a person who, by the
    way----

        Senator Hassan. Let me just be clear for the record----

        Secretary Kennedy. Those charges, Senator. I am going to
    correct the record on this because you have defamed----

        Senator Hassan. No, let me tell you what the record says
    and then I will hear from you. Last week when Mr. O'Neill was
    here in his confirmation hearing, I submitted for the record
    the charge that the State of Maryland laid out.

        Now, if you would like also for me to submit to the record
    with unanimous consent today the findings of the State of
    Maryland, which fined him $10,000 for practicing medicine
    without a license--he does not have a medical license--and for
    providing and instructing and giving children hormone blockers.

        That is what the finding of the Maryland Department--the
    State of Maryland, its medical licensing board was. And I will
    submit that for the record I hope with unanimous consent.

        Secretary Kennedy. I am assuming that you don't know what I
    am about to tell you, or you wouldn't say something that was so
    dishonest. You may or may not know that David Geier sued the
    American----

        Senator Hassan. Oh, I do know that. I do know that. That
    doesn't change the findings, nor does it change the experience
    of the parents who testified.

        Secretary Kennedy. That finding was reversed by court, and
    he was awarded $5 million.

        Senator Hassan. That is not true. Now, let me ask you, so I
    just want confirmation. David Geier is still at HHS. I wrote
    you a letter about this a month ago and you have not responded.

        Secretary Kennedy. Well, I apologize for that. That is our
    bad, and I will respond. But David Geier is not managing autism
    research at my agency, and we never said that he was.

        Senator Hassan. What is his job at HHS? This is somebody
    who gave parents the impression that he was a doctor and gave
    hormone blockers to children as young as eight, telling them
    that hormone blockers would somehow magically help their kids
    with autism.

        Senator Hassan. His father was----

        Secretary Kennedy. His father is a doctor, but he is not.
    And his father was not in the room and did not--and he faked
    his father's signature according to the State Board of
    Medicine.

        Secretary Kennedy. That ruling was overturned by a court.
    So what you are saying is just wrong. It is just a lie. And
    they were actually--the court said that the Maryland Board of
    Physicians was guilty of actual malice in fabricating those
    charges against David Geier.

        Senator Hassan. Well, we will pursue this. Last--and I will
    submit for the record----

        Secretary Kennedy. Do you want to know why we brought David
    Geier in?

        Senator Hassan. Sure.

        Secretary Kennedy. Because it wasn't to run autism
    research. In 2002, the CDC runs a vaccine safety data link,
    which is supposed to be the vaccine information, were the
    biggest HMOs that are supposed to allow CDC to have a
    surveillance system for vaccine injury. It is a backstop
    system. The CDC will not let any physicians in there to look at
    it, or any scientists, independent scientists.

        Senator Hassan. He is neither a scientist nor physician.

        Secretary Kennedy. The Congress ordered. CDC to open it to
    the Geiers. So they are the only scientists who have ever been
    in there.

        Senator Hassan. Yes, but again, Mr. Geier is not a
    scientist. Thank you.

        Senator Hawley. Okay. Senator Hassan's time has expired.
    But before we move on, did you have a unanimous consent request
    that I heard in there, Senator?

        Senator Hassan. Senator Hawley, I have a unanimous consent
    request for the web--the printout of the Web site that shows
    Dr. Geier is--not Dr. Geier, that is his father. Mr. Geier is
    employed. And also a unanimous consent request for the finding
    from the Board of Licensing in Maryland.

        Senator Hawley. Without objection to both of those.

        [The following information can be found on page 58 in
    Additional Material:]

        Senator Hawley. Now, Mr. Kennedy, before we get to my time,
    do you want--if you would like to finish your response, go
    ahead and I will recognize myself.

        Secretary Kennedy. Yes. Let me say that David Geier is the
    only living independent scientist who has seen the VSD inside.
    There has been a lot of monkey business with the VSD, including
    allegations of fraud.

        He was hired by an independent contractor, not as an HHS
    employee, but by an independent contractor to look at the
    documents that we were getting from the VSD to see if they
    conformed with what he saw between 2002 and 2016. And that is
    the only reason that he was brought in, to see if there was--
    there is so much information that has disappeared from that
    data base.

        The only way we could find out what information disappeared
    was because he was the one guy who saw it.

        Senator Hassan. Just let the record show he is not a
    scientist. Thank you very much.

        Senator Hawley. All right. Secretary Kennedy, different
    subject--on a different subject. You and I have talked before,
    and when you have been before this Committee and you, and I
    have talked in person a number of times about Mifepristone.

        I just want to follow-up with you because since the last
    time you were before the Committee the last time you and I
    spoke, there has been a major study by the Ethics and Public
    Policy Center of 865,727 prescribed cases of Mifepristone
    abortions, chemical abortions between 2017 and 2023. Have you
    seen this study? Are you familiar with this? Do you know what I
    am saying?

        Secretary Kennedy. Yes, I am.

        Senator Hawley. You will remember then that this data shows
    the biggest study on Mifepristone done, I think, ever. And it
    showed that nearly 11 percent of women experience very serious
    adverse health effects, to include sepsis, hemorrhaging,
    infection, of course, emergency room visits.

        Now, and by the way, that is 22 times higher, that rate is
    22 times higher than the FDA's current label, which says it is
    just 0.5, the incidence of serious adverse health events. So my
    question to you is this. You previously testified to the
    Committee that you would do a top to bottom review of
    mifepristone.

        Mifepristone is subject to a REMS currently. You have said
    you will do a top to bottom review. Do you continue to stand by
    that? And don't you think that this new data shows that the
    need to do a review is, in fact, very pressing?

        Secretary Kennedy. I think the new--first of all, it
    validates the CAS study, which is previously probably the most
    comprehensive data that we have seen on it. And it is--and it
    is alarming. And clearly it indicates that at very least the
    label should be changed. I have asked Marty Makary, who is the
    Director of FDA, to do a complete review and to report back.

        Senator Hawley. Good. Do you have any sense of timeline,
    Mr. Secretary, on that?

        Secretary Kennedy. I do not.

        Senator Hawley. It will be a top priority though for you,
    is that safe to say?

        Secretary Kennedy. Yes.

        Senator Hawley. You say that it probably indicates the
    label needs to be changed. Do you think it is also important as
    part of your review to consider whether it is necessary now to
    put back in place the long-standing safety protocols that
    always accompanied Mifepristone until the last Administration,
    in-person dispensing, doctor visits, screening for ectopic
    pregnancies?

        Secretary Kennedy. I know that Marty Makary will make a
    recommendation. I feel that the policy changes will ultimately
    go through the White House, through President Trump.

        Senator Hawley. But you will make a recommendation based on
    the data?

        Secretary Kennedy. Yes.

        Senator Hawley. Good. On a different subject.

        Talking about the advertising that is routinely done by
    pharmaceutical companies. You have been a long-time critic of
    direct to consumer pharmaceutical advertising. You wrote, I
    think in the Wall Street Journal a little over a year ago,
    about the need to revisit guidelines around pharmaceutical
    advertising. Is that still your view? I mean, has your view
    changed?

        Secretary Kennedy. Yes. Pharmaceutical advertising is
    particularly insidious because commercial advertising has some
    level of First Amendment protection, not as great as political
    speech. It doesn't have the kind of strict scrutiny applied to
    political speech. It still has a level of protection.

        But pharmaceutical advertising is unique because if a
    company is advertising, for example, Coca-Cola, the consumer
    has a choice whether to buy it, and then he is spending his own
    money on it, so he has got skin in the game. With
    pharmaceutical advertising, the consumer is purchasing the
    product, and it is usually the most expensive form of the
    product.

        They are usually advertising because they want to vary the
    existence and the availability of generic drugs that are much
    cheaper and equally effective. And the consumer is spending not
    his own money but most often our money--taxpayer money.
    Furthermore, the pharmaceutical ad is getting tax deduction, so
    we are funding it.

        Senator Hawley. I want to ask you just about that. Under
    current law, pharma companies can deduct their advertising cost
    as a business expense. Do you think it is time to change that?

        Secretary Kennedy. I actually have a call in to Scott
    Bessent about that, but I am working very hard on this issue,
    and we expect to come out with a policy within the next few
    weeks.

        Senator Hawley. Well, let me propose that we work together.
    Today, I am introducing legislation to repeal the tax
    deductibility of these advertisements. It is a bipartisan bill
    with Senator Shaheen on the other side of the aisle here.

        It is a bicameral bill with both the Democrat and
    Republican sponsors in the House of Representatives. And my
    view is it is time to get rid of these tax breaks for these
    companies and to end this practice. Can you support that?

        Secretary Kennedy. 100 percent support it.

        Senator Hawley. Fantastic. I look forward to working with
    you on that. Alright, let the record reflect I am giving up
    Senator Hickenlooper 15 seconds----

        Secretary Kennedy. I assume Senator Sanders will also
    support that.

        Senator Sanders. Absolutely. I will go further. I mean, the
    idea----

        Senator Hawley. This is coming out of your time now, John.

        Senator Sanders. All right. The answer is yes.

        [Laughter.]

        Senator Hawley. All right. Senator Hickenlooper.

        Senator Hickenlooper. Senator Sanders can finish your
    thought, please.

        Senator Sanders. We are the, I think along with New
    Zealand, the only countries on earth that allow for
    pharmaceutical advertising. I think it is time we ended that.

        Senator Hickenlooper. Thank you, Mr. Chairman. And thank
    you, Mr. Secretary, for taking the time and for your
    willingness to come into public sector. I am not going to try
    and play got 'cha, but it is an opportunity to spend a little
    bit of philosophical time. And I guess one question is, do you
    think our Country spends too much on scientific research?

        Secretary Kennedy. No.

        Senator Hickenlooper. Okay. And so, obviously the NIH is
    the largest--in terms of biomedical research, there is the
    Howard Hughes Institute, but the NIH----

        Secretary Kennedy. 70 percent of the world.

        Senator Hickenlooper. Exactly, 70 percent the world. And I
    guess when you look at the level of cuts that we are facing
    over there--and I recognize that a lot of these cuts are
    imposed upon you, so. But there is a gap in basic fundamental
    research that is going to have to be filled somehow. And have
    you got any ideas of how we can do that, given the scale, the
    dimension of the loss we are facing?

        Secretary Kennedy. Well first of all, my job is to support
    the President on this and to support OMB. But the reality is
    that, as I have said, no agency head wants to see cuts to his
    agency.

        I love scientific research, so I want to do as much as
    possible. But I think because of the--we are very, very
    aggressively implementing AI, and I think we are going to do it
    faster and better than anybody else in Government, any other
    agency. We brought very, very high caliber people from Silicon
    Valley.

        Senator Hickenlooper. I get that. And that will accelerate
    and help us do more research----

        Secretary Kennedy. We can shorten clinical trials. We can
    get rid of animal trials, which we are already doing.

        Senator Hickenlooper. I am in support of all that, and we
    have talked about that for years.

        Secretary Kennedy. We can do--we can now do----

        Senator Hickenlooper. But the research I am talking about
    is not that so much as the fundamental science, basic science
    research.

        Secretary Kennedy. Like bench science, or epidemiological
    studies, or whatever. And I think we can do a lot of that stuff
    quicker. I will take as much money as you give me, and I will
    spend it well.

        Senator Hickenlooper. I just want to make sure to urge you
    to be a fighter for more of that research because there is a
    questioning of science right now within many in the White
    House--not everyone, but many in White House. It really needs
    to be pushed back. Senator Hawley, I will sign on to that bill
    as well. Second question I have got.

        We have a lot of issues around wildfires in Colorado right
    now, and with the--I will just go back to the NIOSH, the
    National Institute of Occupational Safety. You mentioned that
    they kept them in Cleveland, and I think somewhere in
    Pennsylvania. Pretty much everyone was laid off in Colorado.

        Secretary Kennedy. In Morgantown, yes.

        Senator Hickenlooper. Yes. Everyone is laid off in
    Colorado. And the question really--and I think a couple have
    been ordered to be reinstated. But all the West is dealing with
    these--I mean, thousands, tens of thousands, probably hundreds
    of thousands of people out fighting fires.

        These are people risking their lives. Walk away from their
    families every day. And the basic research that needs to be
    done, I don't think the replacements are going to be--in many
    cases, they are new onto the job.

        They are not going to be sufficient to address and really
    make sure the specific health needs of these workers, these
    outdoor workers are addressed. So, questions. How can we, how
    can you make sure that folks in Colorado like firefighters are
    able to do their job safely?

        Secretary Kennedy. I think a lot of the cuts there we are
    implementing now are painful cuts. And that they are cuts that
    are going to--are going to be difficult.

        But I think the President's position is that we are
    spending two trillion dollars that we don't have, that we are
    taking from our children. And we have got to protect their
    rights to prosperity, to enrichment, to dignity, to choice.
    And----

        Senator Hickenlooper. Again, I have heard that argument and
    I appreciate it. And I am a great frugal--a voice of frugality,
    at least in my office, and try to push around the Senate where
    it is allowed.

        But we are looking at a budget that is going to increase
    the deficit by who knows how much, $4 to $5 trillion. To take
    things like this that we know are successful--and not just for
    Colorado, but for almost every Western state essentially, and
    we are cutting receiving such a small amount of money for
    something that is so important.

        I just hope that you can push back on that a little bit.
    And someone has got to take a stand for these things that are
    minor financial benefits, but significant losses to how we
    provide safety for workers and our citizens.

        Secretary Kennedy. I am happy to work with you on that,
    Senator.

        Senator Hickenlooper. Okay. Great. I yield back to the
    Chair.

        The Chairman. The Committee will be adjourned for 5 minutes
    subject to the call of the Chair.

        [Recess.]

        The Chairman. The Committee will come to order.

        Senator Banks, you are next.

        Senator Banks. Thanks, Chairman.

        Secretary Kennedy. Senator, can I just say one word?

        The Chairman. Yes, sir.

        Secretary Kennedy. I want to clarify an issue that we
    talked about before. Senator Murray had raised the issue of a
    constituent of hers who she said had been denied a place in a
    clinical trial in Washington due to the RIF. We have been able
    to run down that case. The patient was medically ineligible for
    that trial.

        The Chairman. Ineligible?

        Secretary Kennedy. Medically ineligible, and nothing to do
    with the RIF. And NIH had been trying to get her into another
    clinical trial, but none of our clinical trials were shut down
    because of the RIF. That was a canard.

        The Chairman. Thank you for the clarification.

        Senator Banks.

        Senator Banks. Thank you, Mr. Chairman. Secretary Kennedy,
    you have--[technical problems]--compassion for Americans with
    autism and their families. There is still so much that we don't
    know about the conditions, and there are many questions to be
    answered.

        That is why I was glad that you recently announced an
    autism research data base similar to a registry that you
    created. The NIH has more than 80 registries for different
    diseases, and they are a critical tool to understand disease
    progression.

        But even in spite of all of that, you were immediately
    attacked for privacy violations and accused of ulterior
    motives. Can you tell us today how will this data base handle
    protected health information, and is it an opt-in or an opt out
    database?

        Secretary Kennedy. This is like--thank you for that,
    Senator--for asking that. This is a database--as you say, there
    is actually 190 disease databases at my agency. Almost every
    important disease has a registry.

        Arthritis has a registry, for example. Heart disease,
    cancer, various kinds of cancers. And the registry is intended
    to help scientists research what causes the etiology of disease
    and also what the cures are. It is entirely voluntary.

        Patient privacy is protected. The data is digitalized and
    depersonalized so that people cannot find out who the patient
    is. And patients have an absolute right to opt out of it. So,
    it is entirely voluntary.

        But it is a very important tool for scientists to use who
    want to understand how to treat diseases. If there is a number
    of people who have used, for example, chelation therapies on
    autism. And you can look at that. You can see what the outcomes
    were--or other kinds of therapies.

        Microbiome treatments, all these other--these various
    treatments that physicians and frontline treatment nurses and
    doctors are using across the country to address disease and
    find out which ones work and which ones don't.

        Senator Banks. You have also been accused of assuming an
    environmental cause of autism and rejecting a genetic cause.
    Can we say that your critics are misrepresenting what you
    really believe?

        Secretary Kennedy. Well, I don't believe--I don't think--I
    think if my critics are saying that I reject a genetic cause, I
    think they are correct in the sense that autism is an epidemic,
    and the genes do not cause epidemics. They can contribute
    vulnerability, but you need an environmental toxin.

        It is like cigarettes and smoking. Smoking cigarettes was
    killing one out of every five of its customers, the tobacco
    industry. That meant four out of five survived. So there is a
    genetic component to the ones who got lung cancer and died.

        That is a genetic vulnerability, but you also need an
    environmental toxin. You cannot have a sudden epidemic without
    an environmental exposure.

        Senator Banks. Have you halted or redirected funding away
    from any pre-existing autism research?

        Secretary Kennedy. I am told, and I haven't done this
    calculation myself, but I am told that there was a 20 to 1
    research ratio for genetic cause of autism over the past 20
    years at NIH.

        If you ask me, I believe that was because they did not want
    to look at the environmental exposures because they were scared
    of what they found. So, I don't think we should be funding that
    genetic work anymore. I think we know a lot about the genes,
    the upper fold-field vulnerabilities, high testosterone, low
    glutathione on the MTHFR gene, the genes that control
    methylation.

        All of these are involved, and we know that. And what we
    really need to do now is to identify the environmental toxins.

        Senator Banks. I appreciate greatly your attention and
    effort on that. Secretary Kennedy, we are importing a third of
    our medicines from China. It is a public health risk, as well
    as a national security risk, and you and I discussed this in
    your confirmation hearing. I asked you at that point about
    reshoring medicine production from China during that hearing. I
    wonder if you could give us any updates on how that is
    happening.

        Secretary Kennedy. Yes. I think there are very exciting
    things happening, and some of them as a direct result of
    President Trump's tariffs. And I have been working very closely
    with David Ricks of Eli Lilly.

        I think they have been the most aggressive of any of the
    pharmaceutical companies about answering President Trump's
    summons to onshore production. They have nine facilities now
    that are breaking ground. And one of them, the API facility,
    that they are breaking ground on will be, I believe, the
    biggest API facility in the world. These are ingredients active
    pharmaceutical ingredients.

        China controls that market right now, and this single
    facility could give us back dominance of that market. So I am
    very, very optimistic about what is happening. And I am
    grateful to Eli Lilly, which has not always been a big ally of
    mine.

        I am grateful, and we have been working very closely with
    the leadership of Eli Lilly to make sure they get what they
    need to onshore production because we saw during COVID that for
    essential medicines, we cannot afford to have the ingredients
    offshored.

        Senator Banks. Thank you for your leadership. I yield back.

        The Chairman. Senator Markey.

        Senator Markey. Thank you. Mr. Secretary, all I have been
    hearing from you today is your defense of and advocacy for
    brutal cuts to Medicaid, brutal cuts to NIH research to find
    the cure for Alzheimer's and cancer or other diseases, brutal
    cuts to community health centers, brutal cuts to the CDC, the
    early warning system for diseases.

        All to find the funding for tax cuts for billionaires and
    millionaires. That is all I have been hearing. And it is
    absolutely unbelievable that the Secretary of Health and Human
    Services can sit before the HELP Committee and make such an
    argument.

        Secretary Kennedy, for months I have been hearing from
    people about the impact that you and Donald Trump have had on
    them. And for months I have been sharing their stories. And I
    have compiled them here. And Mr. Chairman, I would like to
    include my Make America sick agenda--included in the record.

        The Chairman. Without objection.

        [The following information can be found on page 115 in
    Additional Material:]

        Senator Markey. Thank you. This is a set of stories that
    are being told to me that I would like to relate. Jennifer is
    from Massachusetts, is a stage four cancer patient. There is no
    cure for her diagnosis. Her life depends on Federal investment
    in research and for clinical trials to continue uninterrupted
    to find a cure for Jennifer--with NIH funding. She is right to
    be worried.

        I heard from Henry in Rhode Island who wants a--continued
    funding for cancer research, where he works. He is worried
    about getting fired because the labs NIH grants, under new
    leadership, were cut. He wants to work on cancer research to
    find the cure for Jennifer. You have already terminated $1.8
    billion in NIH funding, which for Jennifer should really stand
    for National Institutes of Hope. She is losing hope.

        You are defending a 40 percent cut, Mr. Secretary, in
    research for Alzheimer's, for cancer, for stroke, for diabetes,
    for mental health. They are being slowed. They are being
    slashed. And I understand streamlining, but this is not
    streamlining. It is a bludgeoning of our health's future and a
    giveaway of our global scientific leadership. And it will be
    people like Jennifer who will pay the price.

        Lou from Massachusetts, he wrote to me about his son who
    died of an overdose. He said his son, Zach, was ``a loving and
    loved family member who had the illness of addiction.'' He
    wants research to cure this disease, funding for treatment
    without stigma, support for health workers serving people with
    addiction to prevent any other family member from suffering
    from the same fate.

        Can you honestly tell us, or tell him, actually, that you
    can cut $1 billion--$1 billion from the Substance Abuse and
    Mental Health Administration, including funding for programs to
    teach First Responders how to use naloxone to help to guarantee
    that other parents not lose their children?

        Can you honestly tell me that the cuts you have already
    made to addiction treatment across the country will make anyone
    healthier? How can you justify a $1 billion cut to substance
    abuse and mental health, Mr. Secretary?

        Secretary Kennedy. Senator Markey, you weren't here when I
    was talking earlier, but one of the things that I have talked
    about is that the budget for my agency increased by 38 percent
    over the Biden administration, and Americans got sicker, and
    more Americans overdosed, and more American died from cancer.

        We have now an epidemic of colorectal cancers in our
    children. And the chronic disease rate has now gone up to 60
    percent. The autism rate has dropped to 1 in 31 children. And
    all that money that was supposed to cure those diseases or
    revert them, none if it worked.

        All we need is leadership and a new vision, and I am
    bringing that to my agency. And I am realigning my agency----

        Senator Markey. Okay. President Trump is negotiating with
    the Chinese about keeping fentanyl out of our Country.

        Secretary Kennedy. Well, that is a good thing, isn't it?

        Senator Markey. In the meantime, we can't be cutting the
    programs for the people who are already suffering from opioid
    related diseases. We can't cut the programs. Yes, it would be
    great if we could cut it.

        Be great if we can reduce it. While we are waiting for that
    to happen, why would we cut $1 billion from the programs that
    go to the families that have the substance abuse issues right
    now? Why would we cut it now, before we get a solution to the
    problem. They need things right now.

        Secretary Kennedy. First of all, most of the programs that
    support addiction, including naltrexone, narcan, suboxone,
    methadone, housing, we operate under SAMHSA 500. Are rehabs
    that give people access on their Medicaid. We are keeping those
    intact.

        We have--President Trump, because of his leadership, has
    dropped the fentanyl imports from this country because of
    leadership at the border by 40 percent.

        We are actually doing more with less, and we are going to
    continue to do that. And what I am doing at my agency is I am
    realigning all these perverse incentives that have driven up
    cost and driven down health. I am realigning so that people can
    make money in this country and markets can make money at the
    same----

        Senator Markey. Look--80,000 people died last year. This is
    not about efficiency. This is about cruelty. Cutting these
    programs--these people are already addicted. These people
    already need help. You are slashing the programs that families
    need right now.

        The Chairman. Senator Markey--Senator Markey.

        Senator Markey. Thank you, Mr. Chairman.

        The Chairman. Senator Moody.

        Senator Moody. Thank you, Mr. Chairman. And thank you for
    being here. I think it is wonderful that we are doing this
    hearing. Thank you, Mr. Chairman.

        I believe this is the HELP Committee's first HHS budget
    hearing in more than two decades. And certainly, I don't think
    this afternoon has been easy on you. And we are grateful that
    you are willing to answer the hard questions.

        Secretary Kennedy. Thank you, Senator Moody.

        Senator Moody. Have the difficult discussions because if I
    heard you correctly the 60 percent, 50 percent, whatever
    increase in the last 5 years in your agency, you said,
    reflected or resulted in people getting sicker and more people
    dying.

        We have to do more than just think of throwing money at
    something is going to solve a problem. And I am grateful for
    everyone that is stepping up on the cabinet and saying, I want
    to do this job in a deliberate way that is going to deliver for
    the people that means more than just coming here to Washington,
    and throwing money at problems, and spending taxpayer moneys
    without giving a lot of deliberate forethought to results.

        I think that is what you have been trying to say here
    today. And I appreciate you tackling this because not many
    people would want to brave this job, certainly at this moment
    in time, and as our Nation is spiraling out of control, and
    more and more debt, and more and more spending.

        We have got to be responsible for the future stability and
    success of this country. So, thank you. I start there. I also
    note that in some of the numbers that we saw in this proposal,
    there wasn't much information in terms of asking for more
    money. I am assuming that you are not asking for more money.

        Specifically related to the FDA, and I wanted to focus on a
    few things--and I believe your approach is probably going to
    be, how can we be better? How can we use the resources we have
    to do more for the American people, deliver on their health,
    without spending more money.

        One of those ways I believe in the FDA would be to tackle
    Chinese illicit vapes. I think 60 percent of their vape market
    that are in no way regulated, we have no idea what are in these
    things, chemical ridden vapes. All over the United States--
    being bought by all of our kids. I would ask that you dig into
    that and look at that.

        I know the FDA has been backlogged and the excuse kept,
    excuses kept coming out on why they weren't following through
    and enforcing this thing. Meanwhile, we have more and more kids
    that are vaping these chemicals and we have no idea what is in
    them. So would you look at that with your department, using the
    resources that you are asking for today?

        Secretary Kennedy. Yes, absolutely. We are looking at it
    right now. And during the Biden administration, the FDA slow
    walked the approvals for U.S. vaping companies. And the U.S.
    vaping companies, in my view, were acting very responsibly.
    They were putting chips in their vapes that would make sure
    that young people could not use them.

        They were giving good information about addiction. And they
    had very extensive labels. They really went out of their way
    not to make it attractive to children. They were slowed walked,
    so they are off the market. And in order to fill the vacuum,
    hundreds of Chinese companies came in with these colored,
    beautifully, attractively comic books----

        Senator Moody. Sour grape, watermelon----

        Secretary Kennedy. Watermelons--all these flavors are
    targeted to kids. They have video games on the vapes that lure
    kids into addiction. And we are going to wipe them out. We are
    going to get rid of all of them.

        Senator Moody. Thank you. Thank you for that commitment. As
    a mother of a teenager and on behalf of all moms of teenagers,
    I know that vaping was going on in some of even our elementary
    and middle schools. We thank you. Using the resources that are
    given to you, if we were just more deliberate and aggressive in
    what we are doing within the agency, I think we can make a huge
    difference.

        I want to direct your attention to one more important
    issue. One of the things that drives me crazy is when nonsense
    regulations are on the books and they have no benefit
    whatsoever, but yet they are on the book and businesses are
    trying to comply with them. In our citrus industry, our orange
    juice producers, there is a regulation that requires a certain
    sugar content.

        It is called a Brick Standard. Doesn't affect quality or
    nutrition at all. In fact, our oranges now that are being
    produced in Florida produce slightly less sugar. But because of
    this arbitrary standard, producers of orange juice in Florida
    have now had to start importing--from foreign companies and
    foreign nations, oranges into our Country to mix with our
    products to deliver orange juice. The standard, it doesn't
    affect quality or nutrition.

        Secretary Kennedy. Raise the sugar content in the orange
    juice----

        Senator Moody. We want to lower the sugar content that is
    required by this regulation. I am sure you would not disagree
    with that. But would you look into an interim final rule that
    would lower that slightly to save the orange juice industry
    domestically?

        Secretary Kennedy. Yes. Why don't you call Heather Flick,
    who is behind me, or Hannah Anderson, this week and we will act
    on that as quickly as we can.

        Senator Moody. Again, using the resources we have, just
    being smarter in our approach, we can do a lot to save a once
    thriving industry. Thank you.

        Secretary Kennedy. Thank you.

        The Chairman. Senator Kim.

        Senator Kim. Thank you, Chairman. Mr. Secretary, I wanted
    to just relay, I had a town hall. I had a fire captain show up
    to this town hall--somebody who worked at Ground Zero.

        He is somebody who said he was diagnosed with cancer. He
    said he is on borrowed time, and he was livid, absolutely livid
    about what he said, the Administration gutting the World Trade
    Center Health Program. And we have talked through some of these
    cuts that have happened before. Some staff cuts. Some may be
    brought back on.

        The Administrator cut. I just need to hear from you. I
    promised this fire captain I would ask you about this. What in
    the world happened? Why was the staff cut for this program?
    What are we to expect going forward?

        Secretary Kennedy. I restored this after that program.

        Senator Kim. Why was it cut to start with?

        Secretary Kennedy. It was part of the overall budget cuts.
    Our agency was asked to make very, very serious budget cuts
    that were going to be painful. And some of them should not have
    been made, and that was one that should not have, and I
    reversed it.

        Senator Kim. Were you unaware, or were you aware, that the
    decision to cut NIOSH staff would cut that World Trade Center
    Health Program?

        Secretary Kennedy. My agency is the biggest agency in
    Government. It is twice the size of the Pentagon. It represents
    about 20 percent of the U.S. economy. We have hundreds of
    institutes and sub-agencies. We try to be as careful as we can
    about what we cut and what we didn't. We made a couple of
    mistakes. That was one----

        Senator Kim. No, I don't think you were trying to be as
    careful as you can. I mean, that is the problem that we have
    seen by rushing these decisions. This was, I know, already in
    your time there.

        Secretary Kennedy. Senator, I understand that if you look
    at this from a distance, you would say, why don't you just do
    this surgically and cut one person at a time. We--this agency
    has grown so big, so fast, and everybody who comes in says, I
    am going to cut it down, and nobody has been able to do it.

        There was an understanding that the longer that you wait,
    the more the inertia kicks in. And we had to act quickly so
    that we can do something for the American people that is
    lasting. And we understood that there would be some mistakes
    made, and that we would go back and reverse them when they were
    made.

        But it was more important to do decisive action quickly
    that could eliminate the metastasizing of this agency which was
    growing, and growing, growing as our health declined.

        Senator Kim. Where is this going to land now? Can you tell
    us right now that the staffing of the World Health--the World
    Trade Center Health Program will go back to where it was before
    you became Secretary? Is that----

        Secretary Kennedy. That program will continue. There will
    be continuity in that program. That is all I can tell you.

        Senator Kim. Continued, yes. But at full strength to where
    it was before you were Secretary?

        Secretary Kennedy. The program itself will continue.

        Senator Kim. Well, look, the fire captain also raised this
    issue about the National Firefighter Cancer Registry. Also
    something I promised him I would ask you about. Why was that
    shut down?

        Secretary Kennedy. Cancer registry--I don't know about
    that.

        Senator Kim. You don't know about this?

        Secretary Kennedy. No.

        Senator Kim. Okay. Well, look what I will just tell you
    is----

        Secretary Kennedy. I am happy to work with you on it
    though. It is----

        Secretary Kim. There is a National Firefighter Cancer
    Registry, and this is something that is part of NIOSH. And
    because of the cuts, when I go to the Web site, as I am right
    now, it says, ``the information on this page is not currently
    being updated and access to tool is limited.

        Firefighters can no longer enroll in the National
    Firefighting Registry for Cancer.'' So I just raise this
    because this is incredibly important, not just for those that
    were at Ground Zero, but just writ large across our Nation to
    try to help our firefighters. So can you promise me that we
    will work together and try to get this back up and running as
    soon as possible?

        Secretary Kennedy. I will work with you on those issues,
    Senator.

        Secretary Kim. Look, I understand what you are saying when
    it comes to your prioritization, but I will tell you, it is
    sending an absolutely disastrous message, especially to our
    firefighters.

        I mean, I hope that on the list of things in this Congress
    that we think are bipartisan, are unanimous, it should be about
    supporting our heroes at the World Trade Center, especially
    when we have more firefighters who have died since 9/11 because
    of medical issues that they have had working there at Ground
    Zero. Then, those number of firefighters that died on September
    11th.

        If we can't even agree on that, if that is not seen as a
    high enough priority to try to protect, then I am worried about
    everything else that is more controversial, has less unanimity.

        Secretary, I will follow-up with you on the National
    Registry, and I do want a firm answer on you on what is the
    final staffing at the World Trade Center Health Program. And
    with that, I will yield back.

        Secretary Kennedy. Thank you, Senator.

        The Chairman. Senator Murray has returned. She has asked
    for a request for 30 seconds to respond to what the Secretary
    had responded to her.

        Senator Scott. May I ask a question?

        The Chairman. Yes, sir.

        Senator Scott. Does her 30 seconds take me down to 4
    minutes and 30 seconds?

        The Chairman. No, sir.

        Senator Scott. Okay.

        The Chairman. I will give you 5:30 if you want.

        Senator Scott. Even better. Thank you.

        Senator Murray. Mr. Chairman, thank you for accommodating
    and letting me speak here, because Secretary Kennedy came back
    and said that my constituent that I spoke about earlier was not
    delayed by staffing cuts. First off, she is already enrolled in
    that clinical trial. It is not a question of eligibility.

        The issue, as I stated clearly, was the delay in care that
    she got. And what you stated, Secretary Kennedy, is not true. I
    spoke with Natalie actually last night. She asked her NIH
    doctor directly why, and she--when she was informed of the
    delay, and her doctor at NIH said very plainly twice, her care
    was delayed because of staffing cuts.

        I would just, Mr. Chairman, I think it is important for the
    record to show my staff has put in inquiries with HHS
    leadership, and they have been unresponsive so far. And just to
    make it clear, this is just one case of many, but those are the
    facts. Thank you, Mr. Chairman.

        The Chairman. Thank you.

        Senator Scott.

        Senator Scott. Thank you, Mr. Chairman. Thank you,
    Secretary Kennedy, for being here with us today. I oftentimes
    hear you say that ``happy to work with you.'' And I will say
    that you said it to Senator Kennedy, and as a person who has
    asked you to work on a number of topics, when you say happy to
    work with you, you have actually been a man of your word, and I
    truly appreciate that.

        We talked about the importance of sickle cell anemia and
    the research being done, and I invited you down to South
    Carolina and you took me up on my offer. You came last month,
    and I really appreciate you taking the time and investing the
    energy to talk about an issue that is critical to so many
    folks, specifically African Americans.

        As a guy that is thankful that we are working to eliminate
    diversity, equity, and inclusion in the Federal Government, I
    do not want some folks to think that all things racial are
    somehow DEI. And frankly, sickle cell anemia is a classic
    example of something that has a racial nexus, but it is not
    diversity, equity, and inclusion. It is just a basic fact that
    African Americans, 99.9 percent of the time, are the folks that
    are suffering through sickle cell anemia.

        Frankly, if you go beyond sickle cell anemic, you find
    other diseases that have a consistent presence in minority
    communities. And to that end, I think it is really important
    that we continue to work together on building on issues
    impacting minority and other communities.

        I would love, Senator--Secretary Kennedy, as you move
    through this reorganization that you are currently going
    through, I would like for you to answer the question, will you
    commit that programs involving minority health will continue
    and not get tied unnecessarily and inappropriately to DEI?

        Secretary Kennedy. Yes, absolutely. We will continue. We
    have--I think that one of the minority health programs has been
    terminated and it was one that was deeply embedded with DEI
    ideology, but there are seven others that are going to
    continue.

        I want to thank you for inviting me down to South Carolina.
    That was a wonderful trip. It was really--I got to witness a
    microcosm, a template for how medicine ought to be working.

        Senator Scott. Yes.

        Secretary Kennedy. You had brought together under your
    leadership, hospital systems, pharmaceutical companies, and the
    biotech companies that developed this new technology for
    treating sickle cell, and they all--and patients.

        They had all worked together to make it affordable so that
    South Carolina now has this extraordinary program where if you
    have sickle cell in South Carolina, you can get it 100 percent
    funding, with I think it is 100 percent cure, or close to it.

        Senator Scott. Yes. Very close to. Thank you. I will just
    ask the two questions I was supposed to ask in the--preliminary
    to the questions. For all the parents with children with sickle
    cell, can you please just reassure them that the Administration
    of Health for America will work on sickle cell and addressing
    minority health issues? It is a simple yes or no.

        Will the full budget, and when it is released, reflect
    funding at AHA for both the Office of Minority Health and
    Sickness Health Activities that used to be housed in CDC?

        Secretary Kennedy. Absolutely. You have my commitment. In
    fact, I had a company in this morning meeting with FDA that has
    a new technology that may--that it seems as effective and may
    be even more economical. And I am very, very excited, and I am
    excited to show it to you, if it proceeds, if makes it through
    the TRAPs at FDA.

        Senator Scott. Excellent.

        Secretary Kennedy. But yes, absolutely. I am going to
    continue to make that a priority of this agency.

        Senator Scott. Right. Let me change topics quickly with my
    1 minute and 45 seconds left, as I was extended an extra 30
    seconds. Thank you, Mr. Chairman. I really appreciate the work
    that you are doing, frankly, as it relates to addressing how
    our food supply contributes to chronic diseases, including the
    phasing out of petroleum based as part of your make America
    healthy movement.

        I am really encouraged by the FDA's announcement last week
    approving three new natural color additive petitions. During
    your confirmation hearing process, I shared your passion for
    shaking up the food industry, and you are truly doing just what
    you said you were going to do as it relates to food additives.

        Because of your bold actions at HHS regarding petroleum-
    based food additives, the food industries responded by getting
    rid of these dyes in favor of natural alternatives. Thank you
    for your work in bringing healthier food options for our kids.

        Can you talk about how you will use your position to
    continue to build on your work eliminating artificial food dyes
    to further improve the quality of food sold to Americans in our
    quest to make Americans healthier?

        Secretary Kennedy. I mean, one of the big areas of neglect
    has been linking specific food additives and food processes to
    the chronic disease epidemic. NIH has neglected that area of
    study.

        It is now the central focus of NIH is going to be looking
    at--and FDA, looking at ultra-process foods, at sugars, and the
    10,000 additives that are in our food that are in nobody else's
    food in the world.

        Looking at the impact so that we can put accurate labeling
    on. And when they are really dangerous, we can require--we can
    revoke their authorizations under GRAS.

        Senator Scott. Thank you, sir.

        [Technical problems.]

        Senator Blunt Rochester. Thank you, Chairman Cassidy,
    Ranking Member Sanders. And welcome, Mr. Secretary. I have
    nothing personal against you. I don't even know you.

        But what I do know, as the former Deputy Secretary of
    Health and Social Services in Delaware, is how important your
    agency is to the lives of so many people in our Country. During
    the confirmation, your confusion of Medicaid versus Medicare
    did not instill a lot of confidence.

        But today, as you talk about these budget cuts being
    painful, I am reminded of Delawareans who have come up to me
    and cried, and said, please don't let folks take away my
    Medicaid--individuals with disabilities. While you talk about
    cutting this large, large department, there are talks about
    including more things in the department from the Department of
    Education.

        I am concerned about that. And when we met in January, you
    committed to radical transparency and responding to all
    congressional inquiries within 30 days. Since then, we have
    sent dozens of letters. And to my knowledge, like Senator
    Hassan, I haven't received any responses.

        Given your stated commitment to transparency, and your
    focus on efficiency and responsiveness in your opening
    comments, I think this is a great opportunity to get your
    commitment that you will respond to the letters from this
    Committee, and also an opportunity to maybe talk about a few of
    the things that I wrote to you about. So let's begin with this
    letter.

        In March, I wrote you expressing my concern about the
    delayed meeting of the Federal Vaccine Experts, otherwise known
    as ACIP. The meeting of this Committee is a key step in getting
    vaccines to millions of people, from babies to seniors, and
    delays can have negative impacts on vaccine accessibility and
    affordability.

        While I am glad that the meeting finally happened, we are
    quickly approaching flu season, and the CDC still hasn't
    adopted the April recommendations. And I can understand the
    delay, given that there seems to be no current CDC Director. So
    in the spirit of radical transparency, my question is, who is
    the Acting CDC Director?

        Secretary Kennedy. The Acting Director was Susan Monarez,
    but she is now up for permanent Director. And so, she has been
    replaced by Matt Buzzelli.

        Senator Blunt Rochester. Does this person have a medical
    background?

        Secretary Kennedy. I believe----

        Senator Blunt Rochester.--Or public health expertise?

        Secretary Kennedy. He is a public health expert.

        Senator Blunt Rochester. Public health expert. So, the fact
    that the recommendations are kind of stuck is--and the fact you
    kind of have----

        Secretary Kennedy. Well can I clarify something? The--ACIP
    does not do the flu shot----

        Secretary Blunt Rochester. Yes. I don't want to get into
    the specifics of that.

        Secretary Kennedy. Those--the flu shot was----

        Senator Blunt Rochester. My question was more about do we
    have a CDC Director. And then I want to enter into the record
    information about what harms could be caused until we get one.

        The Chairman. Is that a request----

        Secretary Kennedy. We want the director----

        Senator Blunt Rochester. Let the----

        Secretary Kennedy. We are relying on this Committee to----

        Senator Blunt Rochester. But this was my question. This is
    my time.

        Secretary Kennedy [continuing]. Confirm the director.

        Senator Blunt Rochester. We are Senators. And so, I don't
    want to have the same exchange that happened before with other
    people. I just want to ask my questions. I want to just shift
    gears. Your proposed compassionate budget would cut funding for
    multiple maternal and child health programs.

        I know as a new parent, I remember learning that my baby
    should sleep on their back. The NIH Safe to Sleep Campaign, you
    have shuttered. After launching this campaign in 1994, the rate
    of sudden infant deaths dropped by 50 percent. Many parents in
    this room maybe remember getting their children screened for
    hearing loss or rare diseases. That program has also been
    shuttered.

        You cut programs that collect data on IVF, maternal health,
    infant mortality, all while President Trump is calling himself
    the fertilization President. None of these policies are based
    in compassion.

        My only concern, even following up on Senator Kim's
    question, is understanding what goes into gutting a program
    that has increased the efficacy of parents being able to take
    care of their children. I will--my time has expired. But I will
    just say, again, a budget is a reflection of priorities.

        To me, this budget, the cuts to Medicaid that are talked
    about right now across--in the House of Representatives, are
    going to have real, like you said, painful impacts on people's
    lives.

        I hope there is some real compassion in the end, and I hope
    that you hear from our constituents as we are hearing from them
    as well. And we will continue to--we will continue to try to
    fight for them. So, I yield back.

        Secretary Kennedy. Let me--no time to respond, but I can
    assure you that I will act with compassion.

        The Chairman. Senator Alsobrooks.

        Senator Alsobrooks. Thank you so much, Mr. Chairman. Mr.
    Secretary--I am talking. I am over here. I have been sitting
    through this hearing all day today and have noted that you have
    been unable in most instances to answer any specific questions
    relating to your agency.

        Secretary Kennedy. Because I haven't been given time.

        Senator Alsobrooks. Well, no, you have been given time, but
    the point of the matter is you have been unable to answer
    specific questions. Sir, you are the wrong person for this job.

        You had in this hearing today the unmitigated gall to say
    at the beginning of your testimony that China is ahead of the
    United States in health care because China does not have DEI.

        Secretary Kennedy. I didn't say that.

        Senator Alsobrooks. We can roll back the tape. You
    absolutely----

        Secretary Kennedy. You can, and you will find I didn't say
    that.

        Senator Alsobrooks. That is absolutely what you said.

        Secretary Kennedy. I was talking about science. I didn't
    say they are ahead of us. They are ahead of us in some forms of
    science, certainly not in health care.

        Senator Alsobrooks. Well, we can roll back the tape, but
    nonetheless, let me go on with my questions and ask you this.
    You just heard about the Safe to Sleep Campaign. And you have
    made cuts. You made it very clear here today you have no
    knowledge whatsoever of the absolutely amazing scientists and
    researchers who you have callously fired. You know nothing
    about the cuts----

        Secretary Kennedy. I didn't fire any working scientists,
    Senator.

        Senator Alsobrooks. That, sir, is not true either. But
    none----

        Secretary Kennedy. That is true.

        Senator Alsobrooks. It is not true. Let me ask another
    specific question.

        Secretary Kennedy. It is true.

        Senator Alsobrooks. The Safe to Sleep Campaign. Well, can
    you name, sir, which office the Safe to Sleep Campaign operates
    out of?

        Secretary Kennedy. Which campaign?

        Senator Alsobrooks. Well, that is the one that the Senator
    just asked you about 2 minutes ago that prevents babies from
    dying in their sleep. A 30-year program inside your agency. You
    would agree that it is important----

        Secretary Kennedy. I think it is part of HRSA--or ACF. It
    is ACF.

        Senator Alsobrooks. No, actually it is in Health and Human
    Services.

        Secretary Kennedy. They are all within Health and Human
    Services, but the subdivision is ACF.

        Senator Alsobrooks. No, actually the name of the Office
    is----

        Secretary Kennedy. Administration of Children and Families.

        Senator Alsobrooks. No, let me tell you what it is. The
    National Institute of Child Health and Human Development. This
    is actually the one that your aunt, Eunice Kennedy Shriver, is
    the person who it is named after. And you noted just a moment
    ago, the Senator reminded you, that although this is a very
    important agency, prevents babies from dying, this is the same
    one you fired every single person in this office as of April
    the 1st.

        Secretary Kennedy. As I said, there were no working
    scientists fired during the RIF.

        Senator Alsobrooks. We can bring you that information
    later, because what you just said is not true. Well, then the
    question also is in addition to firing the individuals who make
    sure babies don't die in their sleep, why did you cut funding
    and staff from the CDC's National Center on Birth Defects and
    Developmental Disabilities which supports the Special Olympics?
    Was that a mistake? I have heard you say you have made some
    mistakes today. Was that also a mistake?

        Secretary Kennedy. We have switched those programs to the
    Administration for Healthy America. They have not been cut.

        Senator Alsobrooks. Well, the funding has been cut. And
    this is one that oversaw the Special Olympics. Are you aware of
    that?

        Secretary Kennedy. We have not cut the Special Olympics.

        Senator Alsobrooks. Cut the funding. And you have also
    dismantled the Division of Reproductive Health and Women's
    Health and Fertility. You are aware of that, right?

        Secretary Kennedy. We have--right now, we have 42 divisions
    that do maternal health, and we are consolidating them. And the
    mainstream media has portrayed those as cuts, but they are not
    cuts.

        They are consolidations. It is ridiculous to have 42
    divisions that are all supposed to be doing the same thing with
    their own administrators.

        Senator Alsobrooks. Well, let me ask you a question. So
    that it doesn't exist right now. It has been dismantled. That
    is a fact. That that particular division--what you plan to do
    in the future----

        Secretary Kennedy. There is 42 divisions on maternal
    health. We consolidated them.

        Senator Alsobrooks. Sir, let me finish what I am saying
    here. The fact of the matter is you have dismantled it as we
    speak. And are you aware--what does the assistive reproductive
    technology mean to you? Are you familiar with that?

        Secretary Kennedy. Are you talking about IVF?

        Secretary Kennedy. Well, it is assisted reproductive
    technology. It is a division. Do you know what it does?

        Secretary Kennedy. Is it part of NIH?

        Senator Alsobrooks. No, it is actually a part of your
    agency.

        Secretary Kennedy. NIH is part of my agency, Senator. You
    should know that.

        Senator Alsobrooks. I do know that, but it is actually a
    part of--it is the CDC is where it is.

        Secretary Kennedy. Okay, then it is CDC.

        Senator Alsobrooks. Right. Okay. Let me just ask you--and
    again, these are all other things. You seem unfamiliar with the
    ones--the programs that you have cut out.

        Secretary Kennedy. You are unfamiliar with my agency--that
    NIH and the CDC are part of HHS.

        Senator Alsobrooks. Oh, I absolutely know. NIH is in my
    county. I was there this past weekend with the researchers that
    you have fired, so I absolutely know where NIH is, sir, and
    don't need any help from you in knowing that. I cede the time.
    Thank you.

        The Chairman. Senator Blunt Rochester, did you have
    something you wanted in the record? You mentioned something but
    didn't formally ask, and I want to make sure.

        Senator Blunt Rochester. Yes, Mr. Chairman. I would like to
    introduce this into the record. It is, the CDC has no Acting
    Director, source is confirmed.

        The Chairman. Without objection, it is entered into the
    record.

        [The following information can be found on page 135 in
    Additional Material:]

        Senator Blunt Rochester. Thank you so much.

        The Chairman. Senator Sanders.

        Senator Sanders. I ask unanimous consent to enter into the
    record 21 letters of groups raising concerns about the HHS
    reorganization budget and RIFs. Also ask anonymous consent on
    behalf of Senator Murphy to enter two articles into the record.

        The Chairman. Without objection.

        [The following information can be found on page 145 in
    Additional Material:]

        The Chairman. For any Senator wishing to ask additional
    questions, questions for the record will be due in 10 business
    days on May 28th at 5.00 p.m. Thank you again, Secretary
    Kennedy, for being here.

        The Committee stands adjourned.

                              ADDITIONAL MATERIAL
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

        [Whereupon, at 4:02 p.m., the hearing was adjourned.]

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