▶ 0:46:19Ignored the law in order to protect the far left government, forcing their views on faith based providers. Just last month, the department of health and human services announced an investigation into 13 states for violation of the weldon amendment. So thank you, secretary kennedy. Thank you for your agency standing up and doing the right thing. Another area that I want to see the administration focus more on is the status of rural health care.
▶ 0:46:48Hospital closures, uh, maternity deserts, and limited access to general surgery abounds in much of the united states. Being from alabama and being from a rural state, uh, rural communities deserve better, uh, from their government. The one big, beautiful bill provided 50 billion for rural health care transformation. And I think discretionary investments into this space can complete all this effort.
▶ 0:47:16Like with any other budget, the proposal puts forward by your agency seeks to balance objectives of fiscal stewardship while putting a priority on the most critical investments. Like last year, I doubt that we will be able to agree on areas for reduction. I'm a strong supporter of investments for nih and believe extreme swings in funding supporting biomedical research are counterproductive.
▶ 0:47:44I respect that to fit the president's objective, you've had to make some hard decisions, and I look forward to working with you and the director of nih. Uh, doctor potter, to finding the right balance on spending on research to ensure that america's rightful place are at the forefront of scientific breakthroughs. So, Mr.
▶ 0:48:07Secretary, as I'm sure you've learned in your time in federal service, implementing reforms in washington is not an easy task. The president has asked you to take on a very mighty challenge, and I look forward to your continued success in ways that we can work together to continue making america healthy again. And with that, I would like to recognize the ranking member, Mr. laurel lee, for any opening remarks she might have.
▶ 0:48:34>> thank you so much, chairman aderholt, for convening today's hearing on the department of health and human services proposed budget. Now, I say a thank you to secretary kennedy for taking the time to join us today and to hear his testimony and to be able to engage in a dialog over our questions.
▶ 0:48:50Um, uh, secretary kennedy, you and I spoke on the phone recently about this, but let me just commend you on your recent efforts to reduce the amount of microplastics, um, in american drinking water. Um, we know there's a pervasive, pervasive problem with these contaminants. And I applaud the department's efforts alongside the epa to classify microplastics for the first time as water contaminants.
▶ 0:49:19Um, microplastics have been shown to cause damage to our respiratory system, increase our risk of heart attack and stroke, potentially lead to colon and lung cancer, along with a slew of other negative health effects. They have been found just about everywhere in just. And in just about everyone, even newborns, enter the world with microplastics already, um, in their in their bodies. And I did mention this to you on the phone.
▶ 0:49:45And for anyone who wants to bother to take a look, there is a book out called plastics, inc. The secret history and shocking future of big oil's biggest, uh, biggest bet. Our oil companies are upping the production of plastic as a safeguard against falling revenue, which talks about, um, uh, the, um, this issue here is that each person's brain contained around seven grams of plastic in entire disposable spoons worth.
▶ 0:50:13Those who suffered from dementia had more plastic in their brains than those who did not. So again, let me commend you in the department for for walking down that road and getting that done. Um, we need to act quickly and seriously to stop this pollution of ourselves and our planet. This designation is an important step in the right direction.
▶ 0:50:36I was very proud of the work that chairman aderholt and I and every member of this subcommittee were able to do earlier this year on the fiscal year 2026 funding bill for the departments of labor, hhs, and education. It illustrates that despite partizan divisions, we can still come together on a bipartisan basis, negotiate in good faith, and forge an agreement that passed overwhelmingly.
▶ 0:51:02I was extremely disappointed to see that the white house budget request did not build on that progress we made, but instead has proposed extreme cuts to programs that the american people rely on. Uh, Mr. secretary, the budget request proposes a $16.5 billion cut to health agencies funded by this subcommittee. That adds up to 14%.
▶ 0:51:26And frankly, it lacks it signals a lack of good faith on the part of the administration and indicates to me a shameful reversion to the same extremism we found in the pages of project 2025. The president is failing the american people. He is failing to bring down the rising cost of living, which he promised to do again and again on the campaign trail.
▶ 0:51:50Instead of taking any action to bring down costs, he has called affordability a, quote, con job, a hoax. Uh, just the other day, he said, and I quote, the united states can't take care of daycare or medicare or medicaid because, quote, we're fighting wars, wars of choice, not necessity, that the vast majority of americans are opposed to.
▶ 0:52:13The president wants to increase funding for the pentagon by half $1 trillion to fight his wars overseas. Meanwhile, his budget proposals includes no increase in funding for child care. Inflation is surging. The cost of gas, groceries, everyday. Necessity is climbing day by day. And all of this administration has done is to start more wars, raise more tariffs, create more uncertainty, but no relief for the american people.
▶ 0:52:42The only thing this administration has managed to accomplish is cutting taxes for the wealthiest americans and the largest corporations paid for by defunding medicaid and nutrition assistance by $1.2 trillion and pushing 15 million people off their health insurance. The consequences of these cuts will extend far beyond just medicaid enrollees. They will raise the cost of coverage for everyone. And under your tenure, a top hhs.
▶ 0:53:12You have fired thousands of department personnel, decimated our public health system, incapacitated critical agencies like the substance abuse and mental health services administration, samhsa, and the administration for healthcare research and quality arc. Almost 300 cdc staff have been on administrative leave for over a year. They are being paid not to work, taxpayers dollars not to work.
▶ 0:53:39Officials at samhsa have not directly responded to inquiries from this committee for a full year, undermining our oversight responsibility. The hhs funding bill we passed in january requires monthly agency briefings for the committee, but not a single one has been scheduled.
▶ 0:54:00It has been even longer since arc awarded funding for a new research grant, and as far as we can tell, they have ceased to function as independent health agencies over the past year. Mr. secretary, you have terminated hundreds of nih research grants, not because there was any problem with the research being conducted, not because they were breaking any rules, but because they were researching issues that you just personally do not like.
▶ 0:54:25We must fund research that is based on scientific evidence and not on subjective opinion. This administration has extorted public universities in order to extract ideological concessions. Again, the problem here was not that they were engaged in misconduct, but that you just did not agree with them politically. You choose to use your power to force them to agree with you.
▶ 0:54:51And this is a pattern that extends beyond public funding for health research. In august, you fired the director of the cdc, susan monarrez, because she refused to put blind loyalty to your own personal beliefs above empirical data and scientific research. You replaced the cdc's vaccine advisory panel with people who share your anti-vaccine agenda. Fortunately, a federal judge blocked their attempts to gut the childhood immunization schedule.
▶ 0:55:21The judge correctly ruled that your hand-picked advisors were, quote, distinctly unqualified, unquote, due to their lack of vaccine experience. You are the secretary of health and human services. You've been in this position for 14 months.
▶ 0:55:36If you still claim today that you have not, quote, seen the evidence that supports vaccines as a remarkable failure of leadership and an evidence of refusal to avail yourself of information that is extremely relevant to your role in government. Some of the leading experts in this field work at the cdc, but it's my understanding that you are unwilling to even meet with them in 2025.
▶ 0:56:04Measles cases in the united states shot up to more than 2200 in the first three months of 2026. There have been already more than 1700 measles cases. We have seen outbreaks in south carolina, texas, florida and utah. Under your leadership, the us is on the brink of losing its meals. Measles elimination status, which we have held for more than 25 years.
▶ 0:56:29In january, hhs attempted to block $10 billion in federal funding for child care and assistance for needy families in five states. With democratic leadership. Once again, a federal judge blocked you, but did not prevent you from attempting to coerce the public in the first place. Now, we are more than halfway through the fiscal year, and grant making at hhs has slowed to a trickle.
▶ 0:56:53The administration is withholding billions of dollars owed to states and communities money that came from their taxes for the last ten weeks. Omb has used unprecedented 15 day funding schedules to prohibit hhs agencies from making the grants to carry out their programs, which is the core function of many hhs agencies.
▶ 0:57:20And only this week, as you are testifying before congress to the omb finally released those funds. It should not take a congressional hearing for omb to release funds appropriated by congress to your agencies. So, secretary, you are the secretary. Omb is not the secretary of hhs. The constitution is clear. Congress has the power of the purse.
▶ 0:57:46It is the executive branch's job to execute the laws we passed, not manipulate the process to advance a partizan agenda. The president's budget proposes to cut funding for nih research by $6 billion. We are not going to do that. I just will tell you that right now. You propose cutting cdc funding by 30%. We are not going to do that.
▶ 0:58:07You propose eliminating the substance abuse and mental health services administration, which helps prevent overdose and supports people with substance use disorders. And we are not going to do that. You propose eliminating the leahy program, which would raise energy costs for 6 million american households, even as president trump's war with iran has led to a 40% increase in the price of gas. You can be sure we are not going to do that.
▶ 0:58:36None of these proposals make americans better off. All of them make it more expensive, more difficult for people to live their lives. Mr. secretary, you cannot strengthen public health systems by defunding the cdc. You cannot support medical research by cutting $6 billion from the nih, and you cannot improve access to quality health care by kicking 15 million people off of their health insurance. We'll have more questions, Mr. secretary, when the time comes.
▶ 0:59:05I look forward to your testimony and look forward to engaging on the question and answer. Thank the chair, and I yield back. >> thank you, ranking member. At this time, I'll recognize the secretary for his comments. >> thank you, Mr. chairman. Thank you. Thank you all. I look forward to.
▶ 0:59:30>> um, that you just outlined and thank you for the, uh, the opportunity to appear before you today to discuss the president's fiscal year 2027 budget request. We stand at a generational turning point. Our children are the sickest generation in modern history, and decades of failed policies, captured agencies and profit driven systems have caused it. Parents across the country demanded change, and we are delivering it.
▶ 0:59:59We are ending the era of federal policies that fueled the chronic disease epidemic, and replacing them with policies that put the health of american people first. President trump and I are challenging the status quo and the institutions that defend it. As he worked to make america healthy again. In just 15 months, hhs has delivered historic wins. We negotiated most favored nation drug prices with 16 of the largest pharmaceutical companies.
▶ 1:00:30Americans no longer pay more than people in other wealthy countries for the same medications. We're bringing real transparency to healthcare pricing so patients know the costs before they receive it. I used the full convening power of the federal government to bring health insurance ceos to the table to reform prior authorization or cutting red tape, speeding decisions and demanding transparency. We're also cracking down on waste, fraud and abuse.
▶ 1:00:59This year, hhs and usda issued new dietary guidelines that put real, whole food at the center of the american plate. We flipped the food pyramid upside down and sent a clear message to the american people eat real food. Hhs is also open the door to partnerships with industry, trade association, nonprofits and advocacy organizations.
▶ 1:01:25More than 50 medical schools have committed to expand nutrition education, from an average of just 2 hours to 40 hours. Food manufacturers are stepping up to more than 40% of the food industry is committed to phase out petroleum based dyes by the end of the year, and many have already eliminated them. In conjunction with these efforts, fda approved six natural food colorings derived from fruits and vegetables. Through president's trump's great american recovery initiative.
▶ 1:01:56Hhs, matching compassion with action to help americans break the cycle of addiction. At hhs, we are prioritizing patients with ultra rare diseases and their families and driving faster access to life saving treatments, restoring gold standard science and integrity across the agency. We're protecting children from sex, rejecting procedures that expose them to irreversible harm.
▶ 1:02:24You're eliminating outdated and misleading warning labels on hormone therapies used to treat women during menopause. We're strengthening our oversight of organ procurement. We're implementing operations historic speed to ensure the safety and quality of infant formula. We're applying that same focus and urgency to rural america.
▶ 1:02:46The rural health transformation fund, which the chairman mentioned, delivers the largest investment in rural health in our nation's history $50 billion over five years to strengthen rural hospitals and ensure americans can access the care they need no matter where they live.
▶ 1:03:04Members of congress on both sides of the aisle have made rural health a clear priority in their conversations with me, because every state is feeling the strain of hospital closures, workforce shortages and gaps in access. Hhs announced more than $135 million investment this month to expand rural residency programs and nutrition services. The data is clear.
▶ 1:03:30When physicians train in rural communities, they're far more likely to stay and serve their. The president's budget puts all these priorities into action. It invests in prevention because preventing disease costs less and delivers better outcomes than treating it as my uncle, president john f kennedy, said, progress is a nice word, but change is its motivator and change has its enemies.
▶ 1:03:55We see those forces clearly entrenched interests, defenders of the status quo and institutions that put profits ahead of the american people. That resistance underscores the urgency of this moment.
▶ 1:04:12We can reverse chronic disease, improve public health and lower costs, and I stand ready to work with this committee and congress to seize this opportunity to implement and codify lasting generational reform in american health care for our country, for our children, and for the health of the american people. Together, we can make america healthy again. Thank you. >> thank you, Mr.
▶ 1:04:40Secretary, and we appreciate you being here today. I know you've had a long day and I've been on the hill, so we thank you for spending time with us this afternoon. Um, I want to, um, mention the chemical abortion, um, mifepristone.
▶ 1:04:58Um, it is um, as you probably know, fda has issued a black box warning and I'm going to read what the, the warning says serious and sometimes fatal infections and bleeding occur very rarely following spontaneous surgical and medical abortions.
▶ 1:05:21Recent data shows that the rate of serious adverse events is closer to 1 in 10 or 10% of women who take the drug. However, at the same time, fda does not currently require reporting serious non-fatal events.
▶ 1:05:39Uh, my question is, how can the department appropriately address the risk of chemical abortion drugs to the health and safety of women without the reporting of serious adverse events? >> uh, Mr. chairman, I regret that I can't talk about that issue because, as you know, it's under litigation in louisiana, and I've been advised by the office of general counsel to not discuss it. >> oh.
▶ 1:06:09So, um, so right now you don't have any, uh, about any reporting requirements or any changes right now is that, uh, you are you, um. >> they've asked me not to discuss it because anything I say may have implications on the litigation. >> yeah. Okay.
▶ 1:06:28Well, I, I do want to mention, and I understand that, uh, but I do want to point out that that, you know, modifications issued by fda under the previous administration created a mail in order abortion scheme that completely removed the in-person dispensing requirement. It requires no ultrasound, no gestational age confirmation, and no assessment of risk.
▶ 1:06:53Uh, the black box warning directs physicians to inform the patient about risks such as severe pain or heavy bleeding, and advise them to bring the medication guide with them. So a potential emergency room provider knows what they're undergoing for a medical abortion.
▶ 1:07:12And so, uh, even though you can't speak, speak to it, uh, according to your counsel, I do want to say that when you do have serious risk factors like atopic pregnancies, um, that it's very difficult when you, um, have no requirement that any be any physical examination of a woman. And so, uh, we would clearly this is an important issue for many members of congress.
▶ 1:07:39And I would be remiss if I didn't take this opportunity to let you know that some strong feelings on, uh, on behalf of members of congress, let me go to, um, I talked a little about rural health care as you, as you mentioned, uh, hospital leaders in my state of alabama have documented for decades that, uh, medicare hospital wage index is seriously flawed.
▶ 1:08:05Um, that it is heavily distorted by exceptions and it creates a self perpetuating disadvantages for low wage and rural states. And that results in, I know in alabama alone, hospitals being paid substantially less for providing the same care. My question is, how is cms evaluating whether the current wage index methodology accurately reflects true labor market costs today?
▶ 1:08:37>> Mr. chairman, the um, as you know, the social security act makes it, uh, requires any changes in the wage area index to be budget neutral. And so, uh, making changes in it is very complex because if you raise somebody's compensation, you're choosing to lower somebody else's compensation.
▶ 1:09:02And ultimately, this is a, uh, it's a problem that is, as you say, helping to destroy rural hospitals. We've lost 120 rural hospitals since 2010, but it's something that we can't fix at hhs. We need congress to intervene, and we are here to to provide technical advice and to work with you to make sure that we get something that works. >> yeah.
▶ 1:09:30Well, you know, like I say, the the in cms and evaluating whether the current wage index, uh, methodology accurately reflects the true labor cost. Um, you know, I think that's something that should be looked into if they could look at the true labor cost and then they could help congress determine a statutory statutory solution to it.
▶ 1:09:53So getting that information to congress and how it is substantially different for rural areas and how that methodology is, doesn't really reflect the true market cost, I think is something that the department could could take a look at. Do you agree? >> I'm happy to work with you and to bring doctor oz in to work with you on, uh, on possibly developing that kind of study.
▶ 1:10:22>> and that's, and that's what the request would be is we want to, you know, have the information so we can where the information is laid out. So congress, you know, if we need to be, we can determine statutory solutions, solutions to it. And with that, I will, um, now recognize the ranking member. >> thank you, Mr. chairman. I would just make this reference to you. This is a different attack on rural health.
▶ 1:10:47Is a $50 billion rural health fund is talks this article talks about it's coming up short and that that will be a very detrimental, uh, effect on rural hospitals and their abilities to, to stay open. Um, my time is limited. Um, Mr. secretary, so I'm going to ask a couple of quick yes or no questions to start. Tobacco is the leading cause of death and disease in the united states, uh, killing half a million americans every year. Do you think it's important to prevent youth from starting to use tobacco? Yes or no?
▶ 1:11:18>> yes I do. >> okay. Uh, do you think it's important to raise awareness about pregnancy related complications that lead women lead to women dying? Yes or no? >> yes, I do. >> okay. On april 1st, it marked one year that american taxpayers are paying nearly 300 cdc staff, including those who work on tobacco prevention, maternal mortality and disability and health, which advises a program synonymous with the kennedy name, kennedy shriver name.
▶ 1:11:45Special olympics to be on administrative leave for more than one year. Public health experts are being paid not to work. Waste of taxpayer dollars $38 million. You can bring the staff back from administrative leave, just as you brought back the cdc, employees focused on occupational health. Can you commit to bringing back these experts from administrative leave and and really end this wasting of taxpayers funds?
▶ 1:12:13>> I expect that, uh, president trump, I believe that he is going to release the nominations of the new team at cdc, including the new cdc, um, administrator or director. Um, this week, hopefully today or tomorrow. And, uh, and that will decision will be in their hands. >> okay.
▶ 1:12:37But you could bring back as you did, um, the, the folks with regard to focus on occupational health, but from your point of view, can you bring these folks back, uh, that have been on administrative leave? These are people who were, you know, your, your employees. >> well in, you know, this is a issue that at this time, jay bhattacharya is acting as head of cdc. That's a decision that he would normally make.
▶ 1:13:05Um, the, uh, you know, we, we lost a lot of employees at cdc, but. >> the answer is no, you won't bring them back. Thank you, thank you. Okay, uh, let me, uh, I actually have two other questions. I'm going to try to move as quickly as I can. Uh, march 15th, the fda recommended that raw farm voluntary recall. It's cheddar cheese made from raw milk linked to e coli contamination. April 2nd.
▶ 1:13:32After 18 days, company finally initiated voluntary recall, but only quote under protest. According to the gentleman in charge, um aaron mcafee. Um 18 days, 18 days, nine people sick and three hospitalizations. One case of serious kidney condition. More than half the cases involving children three or younger.
▶ 1:13:53The fda's initial outbreak alert, the agency stated that they were, quote, providing information to consumers and retailers so they are aware of this outbreak before deciding to eat raw farm brand cheddar cheese or to serve it to children. Usually, the alert says, consumers, retailers.
▶ 1:14:12It's a quote should not eat, sell or serve, or consumers should check their homes for recalled products and throw those products away that wasn't there, quite frankly, never have seen anything like this, uh, with with regard to, to roll call. Now, I know, Mr. secretary, that you have been a staunch advocate of raw milk, positioning it as at a, quote, superfood, a key element of make america healthy again. Um, talk about it.
▶ 1:14:42Reducing chronic disease. Um, you know, describe the fda's aggressive suppression. That's a quote of natural, unprocessed foods. You've said that you've drinking it yourself despite federal health agencies warning of safety risks. Um, and you have said that you promised to end what you called the food and drug administration's, quote, aggressive suppression of raw milk.
▶ 1:15:06You urged the ceo of raw farm to previously apply for an advisory role at the fda to establish national standards for raw milk, uh, distribution. And you're a long time promoter of raw milk and a customer and a customer of raw farm. I just have to ask this question, Mr. secretary, did you or another senior officials exert any influence on the way the fda alerted consumers about this outbreak?
▶ 1:15:33>> I agree with you that the, uh, the behavior of the company during the outbreak was unprecedented. We immediately told them that they needed to do a recall. In virtually every case, that recall happens voluntarily and immediately, but there was foot dragging by the initially refused. And we put tremendous pressure on them and told them that we were doing a forceful recall. And finally they complied. >> did the fda refuse to use its mandatory recall?
▶ 1:16:05>> yes, we were going to do it, but usually we don't have to. And virtually every case. >> we should use. >> the company steps up and voluntarily removes it in. This company was, uh, intransigent, let me put it that way. >> mhm. I just have I'm having, you know, said what I said and what your view is on raw milk, unpasteurized milk. And the fda's website says raw milk.
▶ 1:16:34Unpasteurized milk can harbor dangerous germs that can pose serious health risks to you and your family. You have your own personal views about raw milk. They cannot be part of of a health protocol. >> that raw milk is not regulated by the federal government. Uh, um, uh, congresswoman laura. >> unpasteurized milk. >> is regulated by the states. It's not regulated by us.
▶ 1:17:04>> mhm. Well, they. Can revise it within their. >> borders, regulate it. Fda does not regulate it. It's regulated. >> by it can't be circulated across states. >> allow it. Some states do not. It's up to the state. It's not up to us. >> well, you are the head of the health and human services.
▶ 1:17:26If raw milk has the ability to put nine people into the hospital, serious kidney says more than half the cases involving children three years and younger. You are the secretary of health and human services. Is there not some moral responsibility or compunction to say, don't drink raw milk, don't do that because it's unpasteurized and it can cause you serious harm to your health? That is is that not your view? Is your responsibility.
▶ 1:17:56>> you just pointed out that processed cheese can also contain contaminants. There's all every product can contain contaminants. What we do is we inform the public and we let people make. >> choices gobbling down. And I'll just say this, if if I were the head of hhs, I would by god say, don't take raw milk. It is dangerous to your health. And if you can't say that, well, maybe there's some other conclusions that can be drawn.
▶ 1:18:27Thank you, Mr. chairman. >> miss ludlow. >> thank you so much, Mr. chairman and secretary, thank you so much for being with us today. Um, it's an honor to be with you. And, um, it is clear that we need strong, uh, forward thinking leaders in place at h.r. To advance the agenda. Americans are fed up with the status quo that has worked to stall the momentum of the maha movement.
▶ 1:18:53We're ready for leaders who go against the grain, who challenge outdated ways of thinking, and put forth innovative solutions to our country's most pressing public health issues. Thank you for doing that. And that's also why I strongly support the immediate confirmation of president trump's nominee, casey means. For us surgeon general. Means has been a leader in uncovering the root causes of chronic disease and shedding light on our broken health care system.
▶ 1:19:21Through her work, she has amplified the concerns of american families, especially mothers whose opinions and decisions on their children's health care have too often been an afterthought rather than a priority. Secretary kennedy, can you elaborate why casey means nomination for us surgeon general is critical to advancing the maha agenda, and how will a continued delay affect the american people? >> thank you.
▶ 1:19:47Congresswoman casey means is the most articulate, eloquent and erudite evangelists for the maha movement. She wrote the bible on metabolic health, the best selling book that has changed the way that people think about metabolism. It was number one in her stanford medical school class. She practiced medicine for a while until she realized we were in a secure system. We weren't. She was healing people who never should have been sick.
▶ 1:20:17She decided to devote her life instead to actually preventing disease by educating mothers, educating the american people. And, you know, casey means is not a political person. She is just a very, very effective evangelist. The kind of changes that we need to end the chronic disease epidemic in this country.
▶ 1:20:41And I hope that she gets support any, you know, all the democrats on this committee are people who I've worked with for many years to try to get get guys out of the food, to get people eating, to reform infant formula, to do all the things we need to get americans healthier. And what I would say to you is democrats and republicans should support her nomination because she's going to help our country.
▶ 1:21:07And, you know, the only thing that would prevent that is the kind of lack of integrity, lack of courage, and the tribalism that is polarizing and destroying our country. >> thank you so much. I hope they move swiftly with that confirmation. Um, I now love to turn to your work on women's health initiatives.
▶ 1:21:27Uh, this is so incredibly important to me, uh, on a personal level, but also to my district, um, we from eliminating the black box warnings for menopause treatments to hosting the 2026 national conference on women's health, it's clear that your agency is challenging the status quo to harness innovative breakthrough treatments and research that have been largely overlooked.
▶ 1:21:52And the urgency of this work is especially evident in places like louisiana, where high rates of chronic disease, the prevalence of medical deserts, and the ongoing health care workforce shortage have consistently resulted in poor health outcomes for women across the state. Secretary kennedy, based on the lessons your agency learned in the recent national conference on women's health, what specific actions will the department be taking to build out the administration for a healthy. America's new maternal and child health bureau?
▶ 1:22:22>> well, we've released a number of initiatives that are now funded in the proposed budget, specifically for maternal health. We have the worst maternal health record of any developed nation in the world, and particularly black americans. Women are dying at two and a half times the rate of white women in this country.
▶ 1:22:44A college educated black woman is more likely to die two times, more likely to die than a white woman with a high school education. We are trying to fix that. President trump is trying to fix that disparity and to fix maternal health across the board. I want to just mention one very, very promising initiative under the trump administration. We've initiated a pilot program where we provide called the perinatal pilot program.
▶ 1:23:12It provides protocols to hospitals for how to improve the outcomes for maternal health. If 220 hospitals that signed up and in those hospitals, maternal mortality has dropped by almost 42%. So we have solutions for this. We need to now expand that to every hospital in this country. But help is around the corner. >> thank you so much for your work. I yield back.
▶ 1:23:45>> thank you very much, Mr. secretary. It's always good to see you. I have 77,000 federal employees in my district, so it will not surprise you that I'm going to ask some questions, deal with ftes and the ability of your agency to respond to the challenges that you put forward that we all know are challenging the health of our country.
▶ 1:24:08But you need people with talent, with expertise, and with conviction to pursue solutions. So I'm going to ask you some questions. When when we talked last year, um, I asked you about this and you said to me that in talking about doj's personnel, that should not have been cut or cut.
▶ 1:24:36Um, I don't know whether you still believe that, but that's what you said last year. Um, how many full time employees do we have in hhs now, which includes. >> last year when I talked to you, there were 62,000 down from 82,000. We are now at 72,000 and we're hiring 12,000 new employees.
▶ 1:24:56We will have made up all the employees that we lost, and we've replaced them with a better group of people who are actually going to address chronic health. >> your judgment is that the the other, uh, 20,000 that were reduced were not capable. We're not motivated. >> it's not my judgment.
▶ 1:25:22It's the record they presided over the biggest decline in in health, in the in the history of the world, you now have the sickest generation in history. We have the sickest population on the face of the earth. That is a failure of government. They weren't looking at chronic disease. They were focused on other things, and they did nothing to prevent food dyes, the bad food, all the things that are making us sick.
▶ 1:25:48It was their job to protect us and they did not do it. They failed at their job. And if this was private industry, they would have all been fired. Oh, we did what we had to do to change the culture at these agencies. So they're now doing what they can do to pretend that they're what they were hired to do, which is to protect the health of our country and restore us once again to the healthiest country in. >> the world.
▶ 1:26:15Secretary, you and I don't agree because I don't think doge, and I think doge was in charge of these, uh, unless you indicate to me that it was your evaluation that led to the firing of these folks. Um, essentially most of us believe that they were fired to reach a number, uh, a lesser number.
▶ 1:26:38It is ironic that you've just told me we've reached back to that number because, uh, if you're telling me that doge and the people who, uh, resulted in the firing of those folks or forcing them to retire, uh, was made on the basis of, uh, ability and talent. I hear what you're saying about the result. Um, but, uh, I don't think that was. I don't think that's accurate.
▶ 1:27:06>> well, first of all, uh, congressman, I appreciate the dialog that you and I are now having because I experienced with talking to the democrats on some of the other committees is they don't let me answer questions. And so I cannot tell you how deeply I am grateful for the the chance to respond. The, um, uh, with during the biden administration, my agency grew by 38%, mainly during because of covid.
▶ 1:27:36And so we had at the end ten people doing one job. We cut that down to five people doing the same job. I can talk about the duplication that happened at my agency, which is just insane. Nine offices for women's health, eight offices for minority health, 27 separate hiv programs, or 59 behavioral health, 40 opioid programs.
▶ 1:28:01We had 1400 external affairs officers and 100 communications officer offices, 41 information officers, 40 procurement departments, uh, dozens of it departments, none of them talking to each other. Oh, we had to do a consolidation of the agency to make it work efficiently. And that's what we did. And I'm not saying the people who lost their jobs were bad actors. They weren't.
▶ 1:28:28Any of them were doing jobs they were hired to do. We needed to do something drastic to change the institutional culture of this agency and realign it with the new trajectory and the chronic disease epidemic. >> exactly. My point is that we're going to be back, apparently pretty close to the same complement of ftes that we had.
▶ 1:28:51I understand that, um, now, how many of the replacements are, uh, political as opposed to career? >> virtually all of them are career. >> um, so I wanted to ask you a question about experts having been rehired, but is your position that all of the people that were hired to fill these positions are, uh, did not work there, uh, in the past?
▶ 1:29:23>> some of them, I think many of them were recalled. >> yeah. And that of course makes my point about they were removed to get to a number, not to affect the result, but and the problem with my letting you speak, I still get five minutes, no matter how long your answer is. Um, lastly. >> it's a pleasure to talk to you. >> he's giving me a little bit of latitude. Uh.
▶ 1:29:48Let me let me ask you about, uh, the morale at cdc. I talked to this, uh, the, the nih director, who is also temporarily acting as the cdc director. He told me because I asked him the question. I said it's reported as being so that the morale at cdc was, in fact, very low.
▶ 1:30:10If the morale is low at cdc, it inevitably the work that they do will not be up to the standard you want or that I want, or the american people want. Uh, what is your assessment of the morale at cdc? >> I can't give you an honest assessment. I can give you what I've been told by j.
▶ 1:30:29Which is the morale is much better than it was a year ago, I think a year ago, it was really at a nadir, you know, during all the, um, the rifts, I think it was at a nadir now I, I would say that we're bringing in an extraordinary team and, and you know, it, the team has been leaked and it's gotten applause from both republicans and democrats.
▶ 1:30:56I think this new team is really going to be able to revolutionize cdc and get it back on track and get it doing the job that it that it is, that it does better than any other health agency in the world. >> well, the proof is in the pudding. Right? >> right. >> thank you, Mr. chairman. >> Mr. ellzey. Thank you, Mr. chairman. Thank you, Mr. secretary, for being here.
▶ 1:31:20Uh, well, as fun as that was to talk about, let's talk about anthrax, I think is a lot more fun. The nation's most likely biological weapon, whose risk is substantially elevated with the widespread availability of ai tools and drones, it has the potential to kill hundreds of thousands of americans in a single drone disseminated attack. Despite these concerns, the previous administration planned to eliminate anthrax antitoxin countermeasures, gusts that may embolden adversaries to exploit these vulnerabilities.
▶ 1:31:49Does the president's budget ensure that the strategic national stockpile is able to fully meet its anthrax antitoxin requirements? >> yes, it does. And, you know, um, we're stocking the anthrax vaccine, uh, but also antibiotics, which also cure anthrax. >> okay. Uh, something that, you know, the chinese, everything they do is a pattern of life.
▶ 1:32:15They want to, uh, they want to find out everything about american life and they want to use that in a military means. So texas governor greg abbott has directed state agencies and state owned medical facilities to assess the potential cybersecurity risks associated with medical equipment manufactured in china. In addition, recent reporting has highlighted concerns regarding patient data security and patient safety risks associated with medical devices produced by chinese owned companies and used in the united states.
▶ 1:32:42House department of health and human services assess these emerging cybersecurity and data security risks, and what steps does the department taken to ensure the americans health, data and health care systems are safeguarded? >> this is an issue that we pay a lot of attention to. We're working with aspr, with barda and cms, reduce the use of chinese products, not only medical devices, but also to.
▶ 1:33:07We're putting this year $325 million into reshoring apis and pharmaceutical production in this country, so that in future pandemics, we won't be reliant on a supply chain that china controls. >> absolutely. How does the. How does your department plan to sustain the nation's medical countermeasure, pipeline and preparedness posture against evolving cbrn threats, chemical, biological, radiological, and nuclear threats?
▶ 1:33:38>> as I said, aspr and barda are are funded in this round. And, uh, I feel very, very confident in john knox and the team that we have there that they will that they're on top of those issues. >> okay. Thank you. And on a personal note, I'd like to say that a couple of weeks ago, I found myself in a foreign nation. Tmz wasn't there. They didn't find me. But, uh, I got the opportunity to, uh, have a have an infection in my leg.
▶ 1:34:07Probably too much information, but I want the point I'm trying to make is this. I got to go to a national health service hospital where nobody was kind, nobody was caring, and they gave me just enough sugar tablets to leave the hospital and not die. So I just want to say that coming back home and getting medical care, we still have the best medical care in the country. Nobody is denied service. You get exactly what you need. And I'm proud to be an american because of that. So thank you for the job that you're doing and and the work that you're doing.
▶ 1:34:35>> and agreed on your assessment of the quality of health care in this country. It's the best. We have other problems. We have misaligned incentives, and we spent too much money. But if you're sick, there's no place you'd better you you would want to be sick than in this country. >> the spokane. >> thank you, Mr. chairman. Thank you, Mr. secretary. Um, last year when you came here, there's a number of things we agreed on. It started out with right away. And, uh, you even commented you wish that everyone had asked questions the way I did.
▶ 1:35:05And we had a specific request to talk to you about the 988 line, uh, and lgbt funding. And you said you'd be glad to have a follow up conversation. We reached out to your office, your scheduler got back to us, said they were throwing on jordan cox onto it. We followed up and we followed up and you and I never had a conversation. And I just want to let you know, I was very disappointed because I you know, that's something that you had promised to do. We should have had that conversation.
▶ 1:35:32And if we're can't have a conversation, it's not ideological. And that's a problem and a disconnect that we've got to figure out for the future. >> I apologize again before I leave today, I'm going to give you ken callahan's number. And if you can't reach me, you reach him and he will get me. So I don't know how that happened. It should not have happened. >> I and I'll. >> share calls from congress all the time, so I apologize for that. >> no problem. Um, just. >> I would say I think.
▶ 1:36:02>> I really have a lot of issues. I we're done. I agree with you. I accept your apology. No worries. Um, in the ranking members opening comments, she mentioned a lot of the funding that we've seen that has not gotten out of your agency, um, that has been approved by congress. Do you believe it's the responsibility of the hhs secretary to expend funds that congress has appropriated a timely manner? Okay.
▶ 1:36:23I just hope that, you know, we can follow up maybe on that issue, because a lot of I've had three groups this week came in with funds that have not been released going back two years from the agency. And because of that, you know, at some point, uh, where we sit on this dais might change a little bit and we want to make sure that, you know, we have those funds expended, or else we may have to look at how to make sure they're happening out of your office.
▶ 1:36:50The main thing I really want to ask about is something I think much of what you're doing around healthy foods and health is right on dead on with the maha movement. But there's other things that I gotta admit, honestly confuse me. Um, we won't talk vaccines at all this year, but I do want to talk about glysophate this. >> about glyphosate? >> yeah. This is something you've got a record on. You said it was probably a carcinogen.
▶ 1:37:15You've talked about, uh, one of your tweets, likely one of the most chronic disease epidemic, most widely used here in europe. Shockingly, much of our exposure comes as its use as a on and on. You said your usda, when you're running for president, will ban that practice. Um, and casey means, who you just brought up also talked about, uh, grave concerns and about it as a carcinogenic. And you said, I believe it causes cancer. Those are all your words. And yet the white house came and decided they want to expand the production of this.
▶ 1:37:45And you were supportive. And I'm just trying to understand, did the evidence change between now and then and just and again, briefly, if you could, why shift on that recommendation? >> no, I had grave reservations about the president's executive order. Um, I understand why he did it. The executive order right now, we there's a problem in this country. The president didn't create 97% of corn is glyphosate. >> do it in 60s because I.
▶ 1:38:15>> got one more. 98% of soy is glyphosate dependent. 100% of glyphosate is made in china. >> do you still think it's carcinogenic? Maybe that's easier. Oh yeah. Yeah. >> so yeah. >> I would like to make sure that maha does not become mahuika, which is make america healthy when it's convenient again. Right. And this is kind of out of convenience, right? If you know, it's. >> it's a national security issue because china can shut off our food supply. >> would you right now eat something with with glysophate on it. Would I? Yeah.
▶ 1:38:44You've got a reputation. >> for. >> doing things. Would you eat. >> a by choice, right? >> yeah. Yeah. I mean, I just, I wish, you know, maha stands for something and I actually like a lot of what maha stands for and eating healthier foods and it's an integral part of health. But if we're not consistent on it, for whatever reason, we don't really have a maha movement. I just want to express that concern. >> the president has put more money into developing alternatives for glyphosate than any other president my age.
▶ 1:39:15>> gotcha, gotcha. >> but right now. >> you're saying it's okay to have a known carcinogenic. >> I don't think that's my concern. I think we inherited a problem in this country. >> I would just like one more subject if I could. I'm trying not to be rude. I really. Appreciate it. I just have one last one, because in my district, we have something called richland farms. That's a beagle breeder for research.
▶ 1:39:35They've had 311 code violations, including very serious harm to the health of dogs, uh, the nih, which you can ask, I said some of the nicest things about I really like your head of the nih that you have said that there's a policy about beagle testing that would not allow animals to be tortured. And that's part of what's happening with this facility. So grants are still in the last month going to groups that are getting beagles from richland farms.
▶ 1:40:00Could you please take a look at this because they are under, uh, right now, not a court order, a settlement to close down part of their breeding facility by july 1st, but they're not getting rid of the 2000 beagles they have. And if they don't, we know what's going to happen. They're going to get euthanized. And I just want to make sure that for that commitment, which is a good commitment not to harm the beagles right now, you're still giving money to groups through the nih that are using beagles from this highly questionable farm.
▶ 1:40:29>> I have a hard time, I believe you, but I have a hard time believing that I. I need to look into this. I would appreciate talk to the office because we're trying to end. We've done more than any other administration in history to end animal testing. And. In fact, in this year's budget, there's $25 million budget request that will allow us to, uh, attend. We've ended most of it.
▶ 1:40:52There's a few things that are going on, mainly veterinary, that we have to use animals, but that you're describing should not be happening. >> I'd be glad to share these with you so you have them. And if we could have that follow up, I really would appreciate it. >> I will. And again, I'm going to give you ken calvert number and. >> I really. >> appreciate it. We will get back to you. >> thank you. >> yeah. Recognize the gentlelady from oklahoma? >> thank you, Mr. chairman. And thank you, Mr. secretary, for being with us this afternoon. It's been a long day, I'm sure.
▶ 1:41:23Um, so let me start by saying that I applaud the work that your agency has done to keep americans healthy. I believe in hhs mission, and it's anchored by a simple but essential truth. There is no path to a healthier nation without a strong and sustained investment in scientific research. It was mentioned earlier the discussion with nih. I had the great pleasure of hosting doctor bhattacharyya in oklahoma last year, and it was a wonderful experience.
▶ 1:41:48I believe that sustained strategic investment in nih will maintain our global leadership in biomedical science, accelerate medical breakthroughs, and confront the chronic disease epidemic that burdens families across this country. A robust and reliable nih budget is the cornerstone of that mission. Breakthroughs do not happen by accident.
▶ 1:42:10They grow from long term commitments to discovery, stable funding streams and a national belief that medical innovation is both possible and necessary. Moreover, strong nih funding is not just about today's research. It is about maintaining U.S. leadership in biomedical innovation. Someone who is a commissioner on the national security commission on biotech biotech.
▶ 1:42:37I am committed to making sure that we continue to invest in biomedical innovation and as our adversaries accelerate their investments, especially in early phase clinical trials and research. We cannot afford to fall behind in investing in the future. Nih budget budget is essential to ensuring that scientists, universities and research institutions remain unmatched engines of discovery and innovation.
▶ 1:43:04So nih has historically had bipartisan support. What are the primary areas within nih that would see either reductions or expansions under your proposed funding plan, and how will you ensure that those shifts don't impede ongoing research? >> let me give you a couple example.
▶ 1:43:22800,000 of the medical college of wisconsin, or cardio metabolic impact of gender affirming hormone therapy and trans masculine young adults 650,000 to georgia state university for an intersectional approach linking minority stressors experienced by transgender and gender diverse adults. Alcohol and drug use comorbid with mental and physical health outcomes. I can give you hundreds of those.
▶ 1:43:49There was $1 billion being spent on the genetic cause of autism. That's like studying the genetic cause of lung cancer and not wanting to look at cigarettes. There was so much waste there. Now nobody wants to cut nih funding. I don't want to cut it. Just doesn't want to cut it. The president doesn't have a $39 trillion debt. It is a social determinant of health.
▶ 1:44:12Every child in this country has a $6,600 debt, and that before they make a single health care claim. And so we've been asked to cut by 12% across my agency. And all of those cuts are painful. Nobody wants to do them. But somehow we've got to tighten our belt in order to save our kids from these kind of costs. And my agency gets twice as much as the defense department.
▶ 1:44:42We're spending a lot on health care, but we're also recalibrating nih spending with 30 billion of it is going to to chronic disease, which they've never studied before. We're going to find out what the causes are, what the etiology is, and how to eliminate those exposures. >> thank you. You weren't in your testimony that china now conducts more phase one clinical trials than the us, citing this as a competitiveness risk.
▶ 1:45:09What measurable outcomes should congress expect from the fy 27 nih investment to reverse the trend? >> can you repeat the first sentence? >> I. Sir, you warned in testimony that china now conducts more phase one trials than the us. Um, what can congress do to um, expect what can congress expect from the fy 27 nih investment that will reverse this trend?
▶ 1:45:35>> I mean, we're already doing um, we are accelerating drug drug approvals like it never happened before. We're also doing more surprise inspections in china because they're using unethical practices to steal our ip, to steal our best scientists, to steal our doctors. This year, china approved more or produced more drugs that were licensed than the united states.
▶ 1:46:01Almost half of the world have gone from 3% of clinical trials to about almost 40%. They are eating our lunch and we are responding. You know, we just rt mike carey just approved two new drugs, uh, oncology drugs, 1 in 55 days and 1 in 44 days, the fastest in history. So we are accelerating approvals, accelerating the times from conception to commercial use.
▶ 1:46:33And in order to bring that to to make us competitive with china and australia, by the way, we're also investing 325 million in reshoring pharmaceuticals. And we have a great american plan, which requires that that puts first in line drugs that were researched in the united states.
▶ 1:46:57So we are doing everything we can to restore the advantage the united states have and keep america number one in bio, bio medical research. >> thank you, Mr. secretary. I appreciate the answer. And my time is expired. I yield back. >> lois frankel. >> good afternoon. Thank you for being here. So, uh, you you mentioned to Mr.
▶ 1:47:24Pocan that you agreed that when congress appropriates money, that that money should be released. So I want to talk to you about gavi. Gavi is an organization that procures vaccines for use in developing countries, mainly in africa, to help prevent deadly diseases, including malaria, measles, ebola, yellow fever. Since 2000, gavi has helped prevent nearly 20 million deaths, mostly children, and stopping deadly diseases before they spread.
▶ 1:47:53It's one of the most effective tools we've had to prevent outbreaks from reaching our shores. Now congress in a different subcommittee. But in the with the full budget, we appropriated $300 million to gavi, both in f 25 and f 26. None of this funding has been released, and we are told it's.
▶ 1:48:14The state department has told us they're waiting for your approval at hhs to obligate these funds and that you are holding up, uh, based on unproven anti-vaccine beliefs. So I just, I want to just say this, I get into an argument with you, but these funds must be released immediately. It was a bi partizan appropriation, and we're trying to keep people alive and keep people healthy. That's number one.
▶ 1:48:43Number two, I want to go to a little different subject, which is, uh, medicaid. In florida, we have 4 million people on medicaid. Half of them are children.
▶ 1:48:56And right now, florida's hospitals receive standard medicaid reimbursements at only 50% of the care to close this gap, florida uses the state directed payment program, which is a federal program to secure additional federal funding for the hospitals, and they're providing essential services to our local populations.
▶ 1:49:18Florida is one of three states where one of three states whose state directed payment programs have not been approved by cms and without approval. Florida's facing a 4.5 billion annual federal funding shortfall. This is not just a budget issue. It's an access to care issue. It's going to hospitals. Some will go out of service, some will cut services.
▶ 1:49:42We are going to lose thousands and thousands of health care jobs, and patients are going to get sicker. Uh, this delay is unnecessary. It's dangerous. And I am requesting that you take a look at this and cms act immediately to, to update to, to do this. >> we are meeting every week with florida officials to try to make this happen. All right. Isn't it $8 billion. So they get florida gets more than any other state.
▶ 1:50:11It's a huge amount of money. And as you know, it's been used to game the system. >> well, okay, I'm going to I don't want to get into an argument because I got some other things for you, but please take a look at it. We're a very big state with a lot of people. >> we know that. Are working. >> and we we did not expand medicaid. Okay, I'm going to go to the next one. I want to I want to just repeat something that you said. You said that these cuts now are to save children later.
▶ 1:50:40I'm telling you that your cuts, these children are not going to be around because of your cuts. I don't know who you're you're killing children to save children. One one of your budget calls. Your budget calls for the elimination of title ten, which serves 2.8 million low income patients a year, provides basic care, birth control, cancer screening, sti test testing and fertility services, and eliminating this program would be a dangerous mistake.
▶ 1:51:08It means more undetected cancers, more unintended pregnancies, fewer preventive care options. Um, and we've also been told that if you have the funds, you're going to divert them to clinics that do not provide evidence based care and push anti-abortion narratives. This is going to make things worse. So title ten has been bipartisan. It's worked because it delivers real trusted care to people who need it the most.
▶ 1:51:36And I am just urging you to keep that in your budget. And my last 45 seconds. You're also want to eliminate your fall prevention program. Fall falls is the number one injury related death for americans over 65. 1 in 4 seniors, 14 million a year experience. A fall leads to 3 million emergency room visits, 1 million hospitalizations, and a $50 billion cost to the health care system annually.
▶ 1:52:05Fall prevention programs work. And, uh, so it doesn't seem to me it make any sense to cut those programs. And with that ten 987654321. Thank you for being here. I yield back. >> Mr. >> thank you, Mr. chairman. Mr. secretary, thank you for being here with us today. Um, I want to follow up with you on a few of the questions that have been raised.
▶ 1:52:34Uh, first, I appreciate learning about the reshoring effort for apis and, uh, our medicines. And I wonder if you could talk a little bit more about that because I, one of the things we've learned over the last year especially is our dependency on china for rare earths and critical minerals and pharmaceuticals seem to be in that same situation. And I'm encouraged to hear about this investment.
▶ 1:53:01And I wonder if you could talk a little bit more about that. >> I mean, we we are, um, president trump has made it a priority to reshore all pharmaceutical production for critical medicines in this country. The apis, you know, are the precursor chemicals and compounds that go into building a variety of pharmaceutical drugs. During covid, it was became clear that we did not have any control.
▶ 1:53:30We were not producing, we were virtually producing no apis. There are all coming from china and india, most of them from china. So president trump has made this a priority. And we have, in addition to the 325 billion that we're putting into it, there's also 4 million that we're putting into it.
▶ 1:53:53President trump is putting billions in from the tariffs, and we have secured agreements during the mff negotiations with these companies to build billions and billions of dollars of plans right here in the united states. I think lily alone is building six new plants, pfizer's building plans, all the big companies are now building here in the united states. We're going to be in a lot more secure position 2 or 3 years from now than we are today. >> wonderful.
▶ 1:54:21Does barda need any more contracting authorizations to help accelerate domestic production? >> uh, you know what? I will have to meet with you. I know we have a slightly expanded power under the last bill, and I need to meet with my staff over there to see if there's something additional that we need. And I appreciate that offer, and we will get back to you. >> okay. Thank you.
▶ 1:54:44Um, also wanted to follow up with you, um, on some of the unethical practices used by china because one of the concerns with their clinical data is sometimes, uh, it may be linked to forced labor or other human rights abuses. Is there anything hhs can do about those kinds of. >> well, uh, they before we came in, there were no surprise inspections.
▶ 1:55:11And, uh, and now we're doing that and we're doing a lot of them. We're doing surprise inspections over there to make sure that they have their I n d to make sure that they have their irb approvals and to make sure that they're conducting this ethically, that they're not, you know, going to, uh, to minority groups and forcing them to participate in studies where they have no choice over. And that's something that we've seen there in the past. >> thank you.
▶ 1:55:38Um, rural providers, uh, increasingly vulnerable to cyber attacks that can disrupt care and compromise patient data. Is there anything hhs can do to help these providers strengthen their cyber security before an attack, and then also maintain operations after an attack? >> well, the rural health I mean, I think that there's two things I, I can't answer that with the specificity that you deserve.
▶ 1:56:08I can say the rural health transformation fund has a lot of the states have have have chosen to spend that money on ai and telemedicine. And that has to be very, very heavily armored against cyber attacks. Otherwise you can get patient information. We have at hhs now the best team in its history for cybersecurity.
▶ 1:56:32And we've been able to recruit the top names in silicon valley who are now working in the agency to to armor to fortify our biosecurity capacity. And, uh, and it's something that is a huge priority for us as we move to ai.
▶ 1:56:56And, you know, they can track pass codes and, uh, there's, there's a lot of scary things happening where, and we don't want people stealing patient information. >> and then just one final thing on the glyphosate, um, you know, I represent a district that's rural, strong agricultural, um, you know, you got corn, beans, sugar beets, all, uh, benefit from glyphosate.
▶ 1:57:23And, and I think it's important when we talk about some of these products about carcinogenic, it certainly depends on, uh, you know, the content and, um, and it's not just sort of a one size fits all. And I appreciate the fact that you recognize our dependency on china with that. And as we look for alternatives that may, uh, be better fitted that it's not a knee jerk reaction on that. So thank you.
▶ 1:57:52>> and I think, you know, there's now very, very promising technology to replace, um, intensive pesticide use, particularly in sugar beet fields, less so with corn and soy, but, um, laser technology, laser weed killing technology, which is now beginning to proliferate around the country and kind of promises an era of chemical free agriculture. >> thank you very much. Thank you, Mr. chairman, I yield back.
▶ 1:58:26>> good afternoon, Mr. secretary. I want to ask you a question about who are you citing? Um, when you said that we had the biggest decline in health and that this is the sickest generation of children, where does that information come from? I've not read that. >> well, I don't think there's anybody who doesn't is associated with public health who, um, doesn't know that.
▶ 1:58:54I mean, cdc in fact, said the reason that we had the highest death rate during covid of any country in the world, we had more americans, 3000 per million population, huge. Ten times what they had in europe was because we have the highest chronic disease burden of any country in the world.
▶ 1:59:12America has higher diabetes, higher obesity, higher heart disease, higher cancer, less lifespan, more fertility issues than any other country, autoimmune disease, neurological disease. We need. >> any kind of a report, any. I would just love to read it for myself. >> I would say there's hundreds of reports and we're happy to provide them. >> I would thank you.
▶ 1:59:37Um, when we met last year, uh, we talked a little bit about liheap and you told us that you did understand that it had it had a life saving importance. And so however we look at this and we look at the budget and once again, it proposes the elimination of this program, which has helped more than 240,000 households in my state of new jersey alone.
▶ 2:00:03Um, families already facing extreme weather and rising energy prices, especially with the threat of all these ai data centers, etc. Etc. And the costs that are associated with them. You also claimed the administration's energy policies would lower utility bills, and that liheap would merely subsidize the oil industry.
▶ 2:00:26But according to the joint economic committee minority analysis, households in new jersey are paying 17% more for electricity than they were a year ago. And so for many families, this means $260, in addition to every other aspect of their living, cost of living has increased. How does cutting the assistance that helps these working families afford their utility bills?
▶ 2:00:53Building buildings aligned with making america healthy again? And what do you have to say about saying last year how important you thought this was and the fact that it doesn't exist in this budget? >> I mean, I listen, I understand the importance of ieee to communities. My my brother joe was the biggest provider to, of, um, of low cost home heating oil to families across new england.
▶ 2:01:20And I have had people come up to me for years saying, you know, your brother saved my life. I go on the indian reservations today and people tell me that people will die on the reservations. >> I I'm well. >> aware of it. >> I'm aware of your brother's work in this area. Um. >> and. >> you know, in this position.
▶ 2:01:40>> there are issues with liheap on I the, the ig report that came out in february showed a lot of corruption in liheap and there's a lot of duplication in the states. But I want to say this, you gave me money this year for liheap, and I spent that money on 90% of it. And uh, working. >> with me again this year. This is not a question. >> if you give me the money, I'm going to spend it.
▶ 2:02:07>> we should not have to have this discussion about something as so obviously important to the well-being of vulnerable communities, low income communities, and minority communities. I want to go to the issue of minority health. Black women die from childbirth complications, a higher rate in this country than any other high income country. The rate of colorectal cancer is 20% higher among black men and 14% higher among among black women compared to white women, according to the cdc.
▶ 2:02:36In 2023, the average life expectancy for black americans was 74 years, compared to 78 4.4 years for all other races.
▶ 2:02:49Hhs says fy 27 budget proposes eliminating the national institute on minority health and health disparities at nih, nih, as well as the minority fellowship program at samhsa, which recognizes the, um, disproportionate underrepresentation of minority experts in those fields. And I have successfully fought to get those reauthorized along with the other programs.
▶ 2:03:17The work of the government should look at all americans, and that includes those who don't look like you or our president. So, Mr. secretary, do you believe that some diseases have a higher incidence rate in a minority population than in others? Could you just say yes or no? >> I do, and I think particularly with chronic disease, the minority population is substantially overburdened.
▶ 2:03:41>> do you agree that we need to pay particular attention and use our resource research dollars to try to figure out exactly why? Similarly situated people economically, educationally, etcetera, um, have these disparities simply because of race. >> well, I think the answer is because they're not similarly situated. And president trump, um, his policy is to make all americans healthier. And we.
▶ 2:04:10>> heard you say that we're not similarly situated. >> well, because. >> what regard are we not? >> similarly, minorities are more likely to live in food deserts. They're more likely to live in neighborhoods. >> with exactly why I said to you. >> are there not. >> similarity exists even when there is a an equity in education, equity in, um, income.
▶ 2:04:37Excuse me, economic in income, but there still are these disparities that exist and these institutions that look at the and research into why that possibly is happening. They're losing money because of the decisions that you and donald trump have made. And I'm asking, how can you, um, how can you believe that that's the right thing to do?
▶ 2:05:06>> president trump wants to focus on all americans getting all healthier again. >> thank you sir. >> Mr. clyde. >> thank you, Mr. chairman, and thank you, um, secretary kennedy, for appearing before the subcommittee today. Um, first, before discussing hhs funding, I want to thank you for your work restoring accountability and protecting personal freedoms in health care.
▶ 2:05:34Um, in particular, I appreciate the fda's efforts under your leadership to expand access to investigational drugs for patients with no other options. Your personal work and the approval of the ama, now known as, uh, for xfinity, uh, has been a lifeline for one of my constituents. Uh, she was a five year old little girl. Her name was hope, and she now has hope because she, uh, battles a rare mitochondrial disease.
▶ 2:06:05This was meaningful. This this approval by the fda of this drug, uh, was not only meaningful for hope, but for countless other americans living with debilitating mitochondrial diseases. So I want to tell you from the bottom of my heart, face to face. Thank you. You have done great work for my district. >> thank you very much. >> you're welcome.
▶ 2:06:27As we turn to the fiscal year 2027 appropriations, I'd like to discuss how hhs is ensuring that health funding serves the interests of americans, specifically what actions hhs is taking to protect life, uh, prevent fraud, and prioritize merit over die vendors. Um, for most, most americans agree that taxpayer dollars should not fund abortion regardless of political affiliation.
▶ 2:06:52Title x of public health of the public health service act has explicitly excluded abortion since its creation in 1970. Yet previous administrations allowed large abortion providers to receive title x grants without meaningful separation between family planning and abortion services during president trump's first term.
▶ 2:07:12The protect life rule in enforced congressional intent by requiring that title x providers maintain this separation, comply with abuse reporting laws, and prohibit abortion referrals, a rule that was later rescinded by the biden administration. Um, so does hhs plan to issue a new protect life rule to protect the integrity of the title x funding going forward? Is that something that's in the docket for you guys?
▶ 2:07:41>> uh, we are about to issue your new gnophos, and I think you'll be very happy with them. >> okay. All right. Great. Um. Given last month's announcement that hhs is unfreezing the funds that were previously frozen for this, what assurances can you provide that taxpayer dollars are not subsidizing abortion or abortion referrals through title x? >> well, it's illegal and we take our responsibilities.
▶ 2:08:08Uh, uh, in terms of monitoring grants to make sure that that doesn't happen. >> okay. >> I also would add that at nih, we have now banned fetal stem cells funding from nih for external researchers, and we banned the use also of fetal tissue. >> well thank you.
▶ 2:08:36So now on the on the subject of welfare fraud in minnesota, uh, as we work to restore accountability and ensure taxpayer dollars are used as intended, I want to highlight the billion dollar childcare fraud scheme that was documented in minnesota, linked to somalia networks. This scandal reveals how gaps in oversight can be exploited.
▶ 2:08:59That being said, what specific steps is hhs taking to strengthen oversight of the block grant programs like the child care and development blocks, and how can congress support additional efforts to hold these criminal actors accountable? >> yeah, I mean, I, I want to say this in the autism program there, we expected to pay about this is for, you know, 88 care for autism.
▶ 2:09:24We expected to pay $7 million a year, and we were paying $200 million a year. That was stolen money. And we have impounded now 349 million on the state of minnesota. This is money that has already been, uh, paid to the providers. We are holding our reimbursement until they can show us receipts.
▶ 2:09:54And that's what we will do in the future. We also have changed our payment methodology on the biden administration. They implemented rules that were that required us to pay claims even when we knew they were fraudulent. It was called a pay and chase system. And then we were supposed to go and call them back. And of course, that never happened. Right.
▶ 2:10:19So now we have a catch and stop system where we look at it before it goes out. We have ai now monitoring all of the grants, looking for fraud, flagging fraudulent cases for us. Potentially fraudulent cases have human review and we stop them before they go out the door. We've already saved $2.1 billion just in the last few months that would have been stolen from us. >> well, thank you very much.
▶ 2:10:48My time has expired, but I just want to say I appreciate you taking good care of taxpayer dollars in that regard and eliminating the waste, fraud and abuse. And I yield back, Mr. chairman. >> Mr. carter. >> thank you, Mr. chairman. Mr. secretary, as you know, mercury exposure can have significant harmful effects on kids, including permanent cognitive deficits, lowered iq, poor memory, language delays.
▶ 2:11:13During your career as an environmental lawyer, you brought lawsuits targeting coal burning utilities specifically over their mercury emissions. When president trump tried to rollback mercury wastewater rule during his first term, he went to the epa's own public hearing to fight it, warning that allowing more power plant pollution into waterways would poison people through mercury contaminated fish, a problem you said you experienced personally. You said at the time, and I'm quoting you directly.
▶ 2:11:41It's really troublesome for those of us who will suffer from your irresponsibility. Given your long history of advocacy on this issue, do you still believe, as you've argued for decades, that mercury emissions from coal plants harm kids? >> I do. >> terrific. In february of this year, the trump administration finalized the repeal of the mercury and air toxic standards. As a result, coal burning power plants are now allowed to emit more than twice as much mercury as they were before.
▶ 2:12:08Just last week, the trump administration proposed to weaken a rule that monitors and protects groundwater from coal ash, a waste product that contains heavy metals like mercury and lead. How were these actions consistent with your agenda to make our children healthy again? >> those are actions that are not taken by my agency and I. I am not familiar with exactly what's happening at epa, so I would have to ask lee zeldin about that. >> this has been a major news story. You're the secretary of health and human services.
▶ 2:12:37You made a career out of fighting mercury pollution. Are you telling me that you don't have an opinion about this mercury rule? >> well, I don't think any mercury is good. And that's one of the reasons we're holding up the gavi grants, because they're giving mercury vaccines that are banned in europe and the united states. >> secretary. >> I 161 million kids in africa. >> this is your administration making this decision. Are you critical of it? Why have you stayed silent on this? >> you should call lee zeldin here and ask him about those.
▶ 2:13:08That's not in my. I have a $2.3 trillion agency. I've got you. >> you had in your testimony, you wrote. >> I was part of the hearings. I was not part of that decision. I'm not going to comment on it because I don't know anything about it. >> it sounds like pretty convenient amnesia to me, because you wrote a report where you talked about the damage of. >> toxic air and pollution. Mercury is absolutely it's the most powerful neurotoxin we know of in the universe.
▶ 2:13:40>> so are you working for an administration that is doubling the amount of mercury pollution in our air and water? >> I am I am running hhs and I'm ending the chronic disease epidemic. >> I think it sounds like. >> an awful lot. President trump wants, and I'm not going to comment on that because I don't know anything about it. >> well, I think that's very convenient for you. And it shows a significant degree of cowardice. It's not just mercury. Uh, president trump in july 2025, granted 50 chemical plants.
▶ 2:14:09>> why don't you ask me something that I'm in charge of instead of other things? >> are you not in charge of health and human services? >> yeah. >> hhs and you wrote a report about how we want to make sure that our kids. >> you're asking me about is not a decision that's being made by my agency. Why don't you ask me about something? And I want to ask you about something that's happening in the united states senate. >> sir, I'm happy to talk about what's going on in the united states senate. I'd be happy to talk about the damages that mercury pollution do. Did. I think it's pretty disturbing.
▶ 2:14:39>> I'm telling you what I know, which is mercury is a toxin. You should be minimizing the exposure to that in the environment. I don't know anything about the particular running this agency is a big job and it's pretty consuming. Well, I don't get into what the other agencies are doing. >> I think this sounds like a pretty simple story. >> why don't you ask me something that's happening in my agency? >> I think. >> if you asked me about a decision that I've made.
▶ 2:15:07>> you wrote a report, you wrote a report talking about what we need to do to make our kids healthy. >> I've admitted it. You're talking in circles. I said. >> I think it's pretty disturbing to me that you don't want to talk about a doubling of mercury. >> you want to talk about. >> a career, about this. >> I don't want to talk about a regulation or a policy that I don't know anything about. >> well, I hope you learn about it because this is a big deal. And you spent your entire career advocating to lower mercury pollution, which I think is really admirable.
▶ 2:15:37>> let me just say, I think I think you all are talking over each other. You you definitely the secretary has acknowledged he has some issues about that, but obviously he cannot speak to the epa. So y'all are both really agreeing but won't agree. So. >> well, let me close, Mr. chairman. >> we did that in part because we run arpa. Yeah. So that for me was a decision that I had something to do with. I don't know if anything.
▶ 2:16:04And I can tell you this, president trump, when he gave me this job, he made a condition precedent and he was very open about it. He said, I want you to stay away from energy policy. And I agreed to do that. So I don't comment on energy policy. I comment and work I've got enough to do in my agency to. >> make sure this is a health care issue. And just in closing, I think this sounds like a pretty simple story to me.
▶ 2:16:30An administration that took $219 million from the oil and gas industry in 2024 and in exchange, doubled the amount of mercury pollution in our air and water. And so what I don't understand is how you can spend your entire career talking about this issue. And then the first minute that you get power to do something about it, you take off the mask and become an apologist for an administration that is increasing mercury more than any. >> other organization. I'm shocked that you'd come to this meeting and not have a single question to ask me about my agency.
▶ 2:17:00>> I had plenty of questions, sir. >> well. >> go ahead, whether you want to answer. >> all right. Your time has expired, Mr. moore. >> thank you, Mr. chairman. And thank you, secretary kennedy, for being here. Thank you for all of your hard work. As a side note, I would applaud being from the state of west virginia. What the administration has done as it relates to the coal industry. And we heard some numbers cited in terms of life expectancy in certain communities. I can tell you my state life expectancy is 71 years.
▶ 2:17:29It's the lowest in the country. And part of that is obviously we live in food deserts, right? That point that you made earlier is just that. And part of the reason we live in food deserts is because we had 20 years of democratic elected officials shutting down our coal industry against our united mine workers, our great united mine workers unite unionized guys losing their jobs. But anyway, um, I guess we don't care about the unions. So, um, Mr.
▶ 2:17:56Secretary, thank you very much, though, for your decisive leadership you brought to the department of health and human services, and I commend you on the work on advancing to make america healthy again. And the agenda, particularly the maha commission, to confront the root causes of chronic disease, taking bold action on infant formula safety through operation stork speed and fighting to finally deliver fair, most favored nation prescription drug pricing for
▶ 2:18:27Americans. And as a side, want to thank you for coming to the great state of west virginia, uh, with my governor. You're actually at my children's school, uh, where you're trying to help him actually get a little healthy there as well. >> I'm trying. >> yeah. You you might want to check back in on it. Uh, but, uh. >> it lost 15 pounds the last time. >> he did. He did. He's getting there. He's doing good.
▶ 2:18:48Uh, I also sincerely appreciate you working with, um, working with me last year to help ensure critical niosh funding for, uh, restoring niosh in morgantown, west virginia, where black lung testing occurs, which is vital for hard working coal miners and their families across west virginia. Mr.
▶ 2:19:05Secretary, I've introduced the respect parents child care choice act, which would ensure child care and development block grant funds are delivered directly to parents, allowing them to choose the best caregiver for their family, whether that be a parent, a grandparent, an aunt or an uncle, or a sibling. Uh.
▶ 2:19:27Given your emphasis on empowering families and improving outcomes, will you commit to working with me to ensure the cdbg funds can more readily support kinship and in-home care, rather than being disproportionately steered toward institutional providers? >> yes, I will absolutely commit with you to work with you on that.
▶ 2:19:51And as you probably know, the first lady has been driving this effort to keep families, to keep children with their families. We have programs at hhs that are funding substance abuse, which is one of the primary reasons that families are losing their children. And partially as a result of the programs that we have in place, the number of foster children has dropped from 425,000 to 325,000.
▶ 2:20:18And it's because we're we're focused on keeping them with their family of origin, which is where they belong. >> it really is. And in a state like mine, uh, next of kin and the kinship that it happens more in west virginia than a lot of other states. And I think it's really important to keep them with their family of origin.
▶ 2:20:41Just shifting gears here real quick, I was encouraged by the announcement that the trump administration would be ending the use of human fetal tissue from abortions in nih supported research. Can you give me an update on the implementation of that policy? >> I our regulations are we have finalized regulations on that. >> that's wonderful. That is excellent. Um, well, with that, Mr. secretary, please keep up the good work.
▶ 2:21:10Come back to west virginia anytime. We'd love to have you. Uh, your father was very popular there, as was your uncle, so we'd love to have you back anytime I yield back. Mr. chairman. >> miss dean. >> thank you, Mr. chairman. Uh, good to be with you. Uh, secretary kennedy, uh, I hail from philadelphia region, suburban philadelphia. And I have to admit to you, this last round with Mr.
▶ 2:21:33Carter was relatively revealing that maha, apparently, as you sit around the cabinet table, works only in silos. That's something you care desperately about. You have not had a conversation with the epa secretary. That's rather. >> I have a lot of conversations. >> that was my comment. Excuse me. That was my comment. Uh, let me go to. >> what you said. >> thank you.
▶ 2:21:54Uh, let me go to, um, let's talk about vaccines before the trump administration came back into office and you came into office as secretary, 2024, how many measles cases were there in the united states? >> I think during the four years. >> I'm asking a specific year, the year before you came in. >> I but I a very few. >> yes, you're right, 285 yeah.
▶ 2:22:21How about in the first year of the trump administration, 2025, how many cases of measles? >> 2500. >> uh, you're very close. Yes. You're right. So we went from less fewer than 300 to more than much more than 2000. Um, how about this year? Up to. 1700 this year we're talking january to april the 9th, 17. >> 1700, 1714. >> how many deaths have we had?
▶ 2:22:53>> 3 or 2. >> three. >> two children in texas. You're aware of those. And an adult in new mexico, unvaccinated. Unvaccinated. Um, can you tell me, can you tell all of us? Is the mmr vaccine safe and effective? Yes or no? >> the mmr. >> yes or no? >> yes. >> thank you. >> it's safe for most people. >> can you agree that getting the vaccine is a lot safer than getting measles? >> yes. >> terrific.
▶ 2:23:22That's why I am deeply troubled that vaccination rates are declining under your leadership. Under this administration, mmr coverage has dropped dropped to just 92.5%, well below the 95% threshold needed to prevent outbreaks such as we are seeing in this country like we have not seen in decades, deaths that we have not seen in decades. Mr.
▶ 2:23:46Secretary, how many members of the advisory committee on immunization practices did you replace when you came in? >> well, I fired all 17 members. >> that's correct. You fired all of them? Yeah, all of the vaccine board. >> the entire corrupt vaccine board. >> okay, thanks.
▶ 2:24:07You've decided they were corrupt and apparently what their practices were, what their recommendations were, were keeping us healthier children, healthier children, children alive. >> you're not. >> going to replace them. >> you will not. Let me reply because you do not dare talk to me about what you just talked about. Measles. You do not have the courage to allow me to reply. >> I told you the numbers. You know the numbers. I would think that would concern you.
▶ 2:24:35>> that you're implying that that is because of a drop in vaccination rate. I those numbers are people who are over five and nothing to do with me. >> that that. >> vaccination rates dropped after covid because of mismanagement. >> I'll reclaim my time. Mr. secretary. Thank you. And you replaced all 17 members with people who lack the expertise required to make evidence based recommendations. >> wrong. Absolutely. Completely, utterly wrong. >> okay.
▶ 2:25:03Let me turn to two other areas that I know you care about. I care about mental health and addiction. As you know from our past conversations, substance use disorder and addiction, it's a health issue that is, I bet, matters to everybody in this room. It matters to me and my family. I have a son, harry, 13.5 years in long term recovery from addiction to opioids. Uh, so many of my constituents have had this same struggle.
▶ 2:25:29So many of my constituents have lost family members to addiction and to overdose. I know you two have been open about your own recovery. Would you agree that addressing our nation's mental health and substance use crisis is a priority of yours? >> absolutely. >> in your testimony, you state, quote, we must address the root causes of behavioral health conditions, end quote. And that hhs will focus on strengthening prevention. Secretary kennedy, you stand by that testimony. >> yes. >> thank you.
▶ 2:25:57Did you recommend cutting 261 million from samhsa's center for substance abuse prevention? Yes or no? >> we didn't cut that money. >> have you read your budget? Have you read your budget proposal. >> for this year? And we could talk about samhsa before, but for this year. Did you read your budget proposal? >> I thought you were talking about another issue. >> okay, you you've cut samhsa. >> but we've increased. We've also elsewhere increased.
▶ 2:26:29>> am I right? >> medically, we've dramatically increased our investment in addiction elsewhere. >> your. That is actually not true. That is seriously not true. And that's why we have to have these budget hearings. And you have to come in knowing what your budget request was. I have read the budget and your testimony. You state in your testimony that, aha, I'm not sure that acronym, but aha will focus on high impact priority areas, including mental health.
▶ 2:26:54Did you recommend cutting 1.3 billion from the center for mental health, $1.3 billion cut in your budget? >> I think that's the proposal. >> okay. You're comfortable with that. Your testimony cites a white house report finding a shortage of behavioral health providers. Do you agree with that finding? Did you recommend cutting 68 million from behavioral health workforce development? 8 million proposal. That's terrific.
▶ 2:27:21And you also propose consolidating substance use and mental health block grants, along with state opioid response funding. Just as we're finally making some progress, you did not increase the overall funding. You're trying to cut all of these things. In my neck of the appropriations woods, we call that kind of block granting, shifting and shifting. We move all of you into one fund of money. We don't give you any more. In fact, we cut a whole lot.
▶ 2:27:48And good luck finding your resources. We've asked. >> you to rick allen. >> new programs because the other ones were so lousy. >> samhsa wasn't they weren't they? >> samhsa was a bad program. I guess. >> that's why you. >> did it earlier. >> this year. I'm happy to explain why, congresswoman. >> well, let me just finish with you. Cut it entirely. Earlier this year, sending 8800, I think, notices of grant cancellations, which the administration had to reverse in a matter of a day.
▶ 2:28:16What kind of incompetent decision making is that? When lives are at risk. >> termination notices went out in samhsa and I reversed them as soon as I found out about it within 24 hours. >> yes, it was a crazy mistake. >> thank you very much. >> good to see you, Mr. secretary. >> you too.
▶ 2:28:43>> I gotta tell you, I like the idea that finally someone is questioning how things have been done in this country for 20 years, because the observation I made, I don't know if it might have been with you last year, might have been with the head of the nih, that the country is clearly sicker now than it was 20 years ago.
▶ 2:29:03There's no question there should be no question in anyone's mind, despite the fact that we spend hundreds and hundreds of billions of dollars on things like and, you know, this was one of my pet projects, you know, $10 billion a year on sweetened beverages on that program that I'm convinced all that did is lead to higher rates of obesity, higher rates of metabolic disease, higher rates of insulin resistance.
▶ 2:29:26And we were spending federal money and then on the other end, spending federal dollars to treat the people who got the chronic illness because we that's what we were allowing them to buy with federal dollars. And we're slowly unraveling that. So thank you very much. Um, you know, with regards to the vaccines, the reason why people are skeptical of vaccines, because what happened during covid, when I had the cdc director sitting where you were and asked her, well, why did you exactly propose that children should be getting it like young, healthy children?
▶ 2:29:54Oh, well, because otherwise it wouldn't be covered under the the free vaccine program. Oh, so it's not for medical reasons. It's because there were some children who wouldn't be covered. So why didn't you come to congress and just ask us to cover those children? If the if their parents decided they needed the vaccine. But no, for unscientific reasons, they said every healthy child should get it. And most parents figured out that covid really wasn't dangerous for young, healthy children, despite the fact we made a lot of children get a vaccine.
▶ 2:30:24That's where it started. So that's not your responsibility. That's that's where, uh, vaccine questioning vaccines started. I do want to just mention, I thank you in the nih budget that once again, you dealt with the issue of indirect costs, uh, because as you know, large universities shift a lot of costs to doing research over to the federal government through what are much higher indirect costs.
▶ 2:30:49And the variance between universities could be as low as 15%, high as 70% overhead should be about the same everywhere. And what you're finding is that in some of the universities, especially the wealthier universities, choose not to use their endowments, but instead depend on the federal government indirect cost rate on nih to fund their research. And I have always said that a much better approach is to keep the nih budget constant, but reduce that indirect cost rate so you can find more research.
▶ 2:31:17And, you know, when I've talked to university directors, you know, people high up, they say, well, we can't spend our endowments on that because those endowments are targeted. Well, they're not targeted to research because you're passing the cost on to the federal government. Philanthropists will target that. They will they will they they can fund those labs.
▶ 2:31:39Uh, with regard to medicare advantage, I just want to bring your attention to the fact that I was a little disappointed that we allowed the insurance companies a little higher, uh, increase this year for medicare advantage. I understand that there were some areas where they were going to withdraw product, but there is still that problem of, uh, of abuse of the program by what's called upcoding. Uh, you may be aware of it. If not, doctor oz, I'm. >> very much. >> aware of that. Upcoding has got to go away. This is totally.
▶ 2:32:09Fixing it. Thank you very much. Because this is tens of billions of dollars a year goes right into the the bottom line profits of insurance companies that are making a lot of money and not not to delivering health care. Thank you very much. Uh, on nutrition, obviously, we're aligned on that. Uh, we really have to, uh, think long and hard about how we, uh, you know, the kind of signals we send, send to people about what, what, what you should be eating, what you shouldn't be eating.
▶ 2:32:35And, and I think we got to start with the, you know, 22 states that have the snap waivers. It might even be more than 22 now. But what I want to ask you is what, what work are you doing to crack down on the fraud, waste and abuse in hhs? Because we know that when you have a budget that large, there is going to and at many different levels, it's going to be fraud, waste and abuse. Can you give us some examples of where you're where you found it and where you're dealing with it?
▶ 2:33:02>> I mean, we've ended the a pay and chase system so that every grant that goes out is monitored before it goes out to make sure that we're not sending it to fraudsters instead of human beings. We're doing, hi, we're, you know, we've withdrawn $350 million from we've withheld from payments to minnesota to force them to audit and give us receipts.
▶ 2:33:28We're doing the same thing in florida with the d, with the durable medical equipment. Lord is absolutely cooperating with us. Minnesota is not the same. Things are happening in new york and, um, los angeles and los angeles. We have terminated 500 hospices hospices in california, uh, which has more than any in the country are, um, they're empty. Many of them.
▶ 2:33:58We were finding an entire hotel filled with hospices almost in every room. And of course, they weren't, didn't have any patients. They had fake patients. They were buying patient numbers or they were going to poor areas of town, giving a flat screen tv that cost them for $600 and getting the patient to register for the hospice, and then collecting from us $6,000 a month. The odd thing that we were able to see is that the patients never died.
▶ 2:34:27Typically, a patient goes to hospice, they die within 18 days. Each patient live forever. And they were just billing us month after month after month, and they stole billions and billions of dollars from us, and we're shutting that down. >> thank you very much for looking after the taxpayer dollars that that that, you know, stealing money from people who really need the health care is just immoral. That's all I can tell you. >> we can extend medicaid supposed to expire in 2033.
▶ 2:34:56It goes bankrupt just by eliminating the fraud. We extend it for another five years. >> Mr. fleischman. >> thank you, Mr. chairman. Welcome. Mr. secretary, I want to at the outset, thank you for your thoughtful, constructive and and really, uh, outstanding participation today. I know you've faced some adversity, uh, and the like. I chair the energy and water subcommittee.
▶ 2:35:23I'm the cardinal there, and I promise not to ask you any energy questions. Um, but I have a great affinity for this subcommittee, so I'm going to try to limit my questions, uh, to, to, to relevant topics. My first question, sir, in, in january of 2025, the fda approved the first oral self-administered non-opioid to treat moderate to severe pain. I think this is really a big, big accomplishment.
▶ 2:35:49Um, it's my understanding, though, that now, nearly a year later, medicare part d plans are not covering newly approved non-opioids, which provide patients and prescribers with these alternatives. Um, I'd rather ask this in the most benign way because I know you've been through through a lot today. Would you commit to working to help to ensure that medicare beneficiaries would have access to opioid alternatives?
▶ 2:36:17Uh, and I'll just leave it at that. >> yeah, I mean, we're doing everything that we can to make that happen. There was a complication because if you allow certain companies change their label for non-surgical pain, if then applies to every non non-surgical painkiller across the board and they all then get cms refunds.
▶ 2:36:42And there's a lot of those that we don't want to pay for. And so we tried everything that we could to figure out how to do that because they're approved. All of them are approved for surgical pain and immediately post-surgical while you're still in the hospital. But and we tried to figure out how to get them to change the label so that it so that they would continue to apply even after you left the hospital.
▶ 2:37:10But if we did that, it would open up cms to tens of billions of dollars in costs or for pills that are not covered right now that people just buy in the drugstore. >> thank you. Sir. Uh, my final question deals with illegal vape products. It's my understanding, Mr. secretary, that, uh, this is a staggering problem.
▶ 2:37:38Uh, a lot of these apparently come in from china, um, into the us market. Um, and my question for you is that last year, congress directed the fda, um, to dedicate $200 million towards enforcement to crack down on illicit vapes and illicit nicotine products. Uh, do you know how those funds are going to be spent? And what are your thoughts on this issue? >> well, some of it has been spent on enforcement.
▶ 2:38:06I participated with pam bondi and a big bust in illinois. I think we I think we confiscated a million vapes that were chinese. Um, there's a complication because, um, a regulatory complication with an fda because we were not able to get enough american vapes approved for this country. There's a giant market. People are using those vapes to quit smoking, which is something that we like.
▶ 2:38:39And, um, the, it was further complicated about whether or not we should allow the companies to make vapes that were designed essentially to attract children, cotton candy and bubble gum flavors. So which flavors we would approve menthol tobacco versus those. And that got caught up in the regulatory process. And we are doing everything we can now to approve american vapes as quickly as we can.
▶ 2:39:06And as soon as we get a few more on, the market, will be able to do the bus, the chinese vapes, more aggressively? >> yes, sir. Well, Mr. secretary, I begin with thanks. Let me conclude with thanks. I appreciate your service in this position and to this administration. Thank you, sir, and I yield back. >> thank you, Mr. fleischer. Uh, well, I think we've had a very good, uh, robust hearing today. Uh, and I know we've been going for almost 2.5 hours now.
▶ 2:39:32So, uh, and I know the secretary's had a long day, but, uh, I would, I would like to recognize the ranking member, uh, for some closing remarks that you'll have. And then I will and I will close. >> thank you very much, Mr. chairman. And, uh, just just one point. And this follows up on something that Mr. pocan said earlier, because it had to do with last year's hearing.
▶ 2:39:55Um, because I asked you if you would fully commit to obligating funding that was appropriated and you said yes in the same way you said yes to this inquiry by by congressman, uh, pocan. Um, >> and, um, you know, I make an assumption that you would just say yes to do you commit to fully obligating funding appropriated to hhs for fiscal year 2026, and that you would be that you agree to that? >> I agree to that. >> yes. Fine.
▶ 2:40:23But I just want to just say, with regard to that, Mr. secretary, and, um, I don't this is, um, we passed the labor hhs appropriations more than ten weeks ago. Throughout most of the ten weeks, omb, omb has prohibited your agencies from awarding funds to carry out their missions. I mean, I have to ask the question, who's in charge? Who's in charge? Family violence prevention grants are not going out. Community service block grants are not going on.
▶ 2:40:51And the list and the list goes on. I understand they have now approved that, but that's quite frankly, because of your presence here today. Um, I'm going to just pose these. You don't have to answer them, but I want answers to these. Have all of your agencies received their 2026 funds from omb?
▶ 2:41:09And would you commit to sharing with this committee the spend plans that each of your agencies are required to negotiate with omb, which are currently now being withheld from the congress and from this committee? Two important areas that I would hope that could be answered in the affirmative. >> I will work with your staff on that. Okay, congresswoman. >> okay. Um. Thank you. And if there are agencies who have not been approved, let us know that we want to.
▶ 2:41:38Let us help you get the money that we have appropriated to go out to people. I said in my opening remarks that the country is suffering from an affordability crisis. Cost of everyday items goes up. I don't believe, as I said, that, um, there isn't anything being done by the administration to address this issue. As a matter of fact, calling it a hoax.
▶ 2:42:02Um, and, um, you passed a law instead, the trump administration and republicans in the congress passed a law last year to cut medicaid and nutrition assistance by $1.2 trillion. 1550 million americans will lose their health insurance. Millions of americans are seeing their health insurance premiums increase by thousands of dollars. Hospitals are going to close. That's especially true in rural areas of the country.
▶ 2:42:29Um, and that are on medicaid coverage. In your written testimony, you said, and I quote, behavioral health conditions are a major contributor to chronic illness, disability and rising health care costs, end quote, the largest payer for behavioral health care is medicaid. And if you're going to, the republicans are going to cut medicaid by $1 trillion over the next decade.
▶ 2:42:55Now, the president's budget is proposing to cut funding for health agencies by $16 billion next year. Uh, we can't afford child care because we are fighting wars.
▶ 2:43:10But you so you are proposing to cut life saving medical research at $6 billion public health programs by $3 billion, energy assistance by $4 billion, mental health services by $500 million, workforce training programs, including nurses training by more than $600 billion. Uh, and I said to you, and I think it was very clear, Mr. secretary, we're not going to do that.
▶ 2:43:36And maybe that's what you are relying on, but we're not going to do that. We can't in good conscience do that. You can't support medical research by cutting $6 billion from the nih. You can't strengthen public health by defunding the cdc. You can't improve access to quality health care by kicking kicking 15 million people off their health insurance and raising health care costs for millions of families.
▶ 2:44:01This is an agency that has an enormous portfolio, all of it geared toward saving lives. I believe you want to do that. I believe that this budget is contrary to doing that.
▶ 2:44:22And we will from this side of the the dais, I said we will be there will be some of our colleagues on the other side that will join us in saying no to what these cuts mean, because the best, the most important thing we have to do, our most the biggest cause we have the biggest job that we can do with this institution, uh, is, is to prevent illness
▶ 2:44:53And to save people's lives. There is no more noble cause that we are engaged in. I work on helicopters, roads, bridges, all of that stuff. Nothing is more important than what happens if it's coming out of this, this, this subcommittee and what we do to save lives. We're going to we are going to do that. And thank you, Mr. chairman. Thank you. >> thank you. >> Mr. chairman. Can I say. >> please. >> a couple of quick things on his.
▶ 2:45:20First, I want to thank this committee for its civility and its congeniality. Uh, it is way different than going in front of any other committee, and I'm happy to come back here any time. So I want to thank all of you democrats and republicans. Um, second of all, we're not cutting medicaid. The cbo report came out, medicaid increased by 47% over the next ten years. So there is no cut to medicaid.
▶ 2:45:45Um, and number three, um, it's easy to demonize omb and roosevelt, but roosevelt is looking out for our country. We are the $39 trillion debt. Each child born in this country is paying $6,600 for. They pay a single health, 25,000 for a family of four. Russ is trying to make sure that these programs are alive for future generations.
▶ 2:46:15And that's what the president wants. So I just want to, um, I just want to mention that. >> thank you, thank you, thank you miss thank. >> you. >> thank you, Mr. secretary. >> tax no tax. >> on my time. >> no tax on social security. Uh. >> let me just say, Mr. uh, secretary, I will say thank you for your compliments on our committee, our subcommittee here.
▶ 2:46:40And there was a common theme, I think, up and down the aisle that everyone agreed with you on so many issues, maybe not 100%, but there was I there was, uh, I go to some hearings and when some of my colleagues on this aisle, they don't agree with anything. So, uh, you were given a lot of compliments here today, but, uh, thank you. I know it's been a long day for you and thank you for your time here.
▶ 2:47:04But just just in closing, I do want to mention, of course, uh, I mentioned the, uh, freestone issue, and I understand you're not allowed to, uh, to speak to that right now because of the litigation, but, uh, obviously abortion is, is a very big issue to, to many of us.
▶ 2:47:21And, uh, I just want to mention that planned parenthood released its annual report, uh, that I don't know if you saw it or not, but it state that, uh, that, that more than 2 billion of dollars have come in, in revenue, uh, from grants and contracts and medical payments. Um, and it's one of the largest abortion providers in the united states. Planned parenthood uses its resources to pursue a very radical left wing agenda. And I would just ask you to look into this.
▶ 2:47:51And as they as they address this and and how you can deal with that. And then in closing, again, uh, rural health is very near and dear to many on this issue, on this dais and across the board and democrat and republican.
▶ 2:48:08So, um, you know, I know that the, the wage index is a tricky matter and how you deal with it, but I would look, ask you to look at some options that in your existing authority and what y'all could do to address these persistent inequities for rural areas and where there are low wage states. So it would be, uh, I think this would be something that democrats and republicans would very much appreciate you looking at what your authority is in that regard.
▶ 2:48:37So with that, thank you for being here today, and we look forward to working with you and send you back in alabama and back in winston county. >> thank you. >> alright. Bye bye.