[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.]

                             [all]