Introduction
Robert F. Kennedy Jr., President Donald Trump’s nominee to serve as Secretary of Health and Human Services (HHS), appeared before the Senate Finance Committee on January 29 for his confirmation hearing, followed by a courtesy hearing before the Senate Health, Education, Labor & Pensions (HELP) Committee on January 30. The Finance Committee holds the authority to advance the nomination, while the HELP Committee hearing served as an opportunity for senators to further question the nominee without voting on his confirmation.
Kennedy’s testimony covered a range of issues, including his commitment to addressing chronic disease, promoting transparency in healthcare, and reforming the nation’s regulatory and policy approach to public health. While some Republican senators praised his focus on patient empowerment and reducing bureaucratic inefficiencies, Kennedy’s responses to key policy questions—especially regarding Medicare, Medicaid, and vaccines—raised concerns about his preparedness for the role.
Kennedy’s Opening Remarks and Policy Focus
- Chronic Disease and Healthcare Costs: Kennedy cited rising rates of chronic disease, particularly obesity, diabetes, and autoimmune conditions, as primary drivers of healthcare costs. He argued for increased research into environmental factors contributing to these conditions and called for policies to promote preventive care. He provided specific statistics, noting an increase from 2% to 66% in childhood chronic disease rates since the 1960s, $4.3 trillion annual spending on chronic disease management, and that 38% of teens are now diabetic or pre-diabetic according to NIH data.
- Healthcare Transparency: He advocated for greater price transparency in medical billing and pharmaceutical costs, stating that increased transparency would lead to competition and lower costs. However, he did not specify how his approach might differ from existing transparency requirements.
- Regulatory Reform: Kennedy pledged to eliminate inefficiencies within HHS agencies, reduce regulatory burdens on healthcare providers, and remove perceived financial conflicts of interest in federal health agencies.
- Patient-Centered Care: He underscored the importance of shifting healthcare toward a more personalized and patient-driven approach, including alternative care models and holistic treatment strategies.
Medicare and Medicaid: Key Challenges and Concerns
The hearings revealed significant gaps in Kennedy’s understanding of fundamental Medicare and Medicaid operations. Key misstatements included:
- Medicare Basics: Sen. Maggie Hassan (D-NH) asked Kennedy to define Medicare Part A. Kennedy incorrectly responded that it primarily covers primary care organizations.
- Medicaid Funding and Reform: Kennedy mistakenly stated that Medicaid is entirely federally funded, whereas it is a joint federal-state program.
- Healthcare Affordability: When asked about Medicaid beneficiaries’ financial challenges, Kennedy inaccurately described high premiums and deductibles, which are typically associated with private insurance rather than Medicaid.
Additional Medicare and Medicaid Positions:
- Expressed strong support for Medicare Advantage while acknowledging “people can’t afford it. It’s much more expensive”.
- Stated Medicaid “is not working for Americans” and that “the poorest Americans are now being robbed” despite increased program spending.
- Proposed experimenting with pilot programs in each state focused on value-based care.
- Advocated for transitioning to direct primary care systems and expanding telehealth access.
Healthcare Payment Reform
Kennedy proposed several changes to healthcare payment systems:
- Suggested implementing “health savings accounts and cooperatives” within Medicare and Medicaid programs, though he did not provide specific details about implementation.
- When questioned about site-neutral payments and other payment reforms, he deferred to Congress’s authority, stating that “regional price points are set by Congress and not by HHS”
- Advocated for changes in reimbursement structures, though specific proposals were not detailed
New Administrative Initiatives:
- Committed to implementing “radical transparency” across HHS operations
- Plans to appoint a former prosecutor as general counsel to address Medicare fraud
- Pledged to coordinate payment reforms with healthcare providers
- Emphasized transitioning to value-based care while maintaining provider stability
Vaccine Policy and Public Health
- Bill Cassidy’s (R-LA) Concerns: Cassidy repeatedly asked Kennedy to affirm that vaccines do not cause autism. Kennedy declined to make a definitive statement.
- Republican Concerns: Moderate Republican senators Lisa Murkowski (R-AK) and Susan Collins (R-ME) expressed skepticism about Kennedy’s ability to lead HHS given his past statements.
- Kennedy’s Commitments: Under questioning, Kennedy pledged not to change vaccine recommendations without scientific consensus and stated he would not divert funding away from vaccine programs.
Key Issues Left Unaddressed
Despite the breadth of the hearings, Kennedy did not address several critical policy issues relevant to the healthcare sector:
- Hospital Funding and Provider Reimbursement
- Immigration and Healthcare Access
- Site-Neutral Payment Policies
- Medicaid Disproportionate Share Hospital (DSH) Payments
- Tax Changes for Healthcare Providers
- Cybersecurity in Healthcare
- Supply Chain Resilience
- Home Care and Hospital-at-Home Models
- 340B Drug Pricing Program
Confirmation Prospects and Next Steps
Sen. Bill Cassidy, a crucial vote on the Senate Finance Committee, remained undecided following the hearings. If the nomination reaches the full Senate, Kennedy could face significant challenges. With most Democrats expected to oppose him, he can afford to lose only a few Republican votes and still be confirmed.
The committee has set a deadline of 5:00 PM on January 31 for additional questions for the record, with responses expected to provide further clarity on Kennedy’s positions and plans. If confirmed, Kennedy would become the 28th Secretary of Health and Human Services.
RFK Jr.’s HHS Nomination: Key Takeaways from Senate Hearings
Washington Strategic Consulting
January 31, 2025 11:54 am
Introduction
Robert F. Kennedy Jr., President Donald Trump’s nominee to serve as Secretary of Health and Human Services (HHS), appeared before the Senate Finance Committee on January 29 for his confirmation hearing, followed by a courtesy hearing before the Senate Health, Education, Labor & Pensions (HELP) Committee on January 30. The Finance Committee holds the authority to advance the nomination, while the HELP Committee hearing served as an opportunity for senators to further question the nominee without voting on his confirmation.
Kennedy’s testimony covered a range of issues, including his commitment to addressing chronic disease, promoting transparency in healthcare, and reforming the nation’s regulatory and policy approach to public health. While some Republican senators praised his focus on patient empowerment and reducing bureaucratic inefficiencies, Kennedy’s responses to key policy questions—especially regarding Medicare, Medicaid, and vaccines—raised concerns about his preparedness for the role.
Kennedy’s Opening Remarks and Policy Focus
- Chronic Disease and Healthcare Costs: Kennedy cited rising rates of chronic disease, particularly obesity, diabetes, and autoimmune conditions, as primary drivers of healthcare costs. He argued for increased research into environmental factors contributing to these conditions and called for policies to promote preventive care. He provided specific statistics, noting an increase from 2% to 66% in childhood chronic disease rates since the 1960s, $4.3 trillion annual spending on chronic disease management, and that 38% of teens are now diabetic or pre-diabetic according to NIH data.
- Healthcare Transparency: He advocated for greater price transparency in medical billing and pharmaceutical costs, stating that increased transparency would lead to competition and lower costs. However, he did not specify how his approach might differ from existing transparency requirements.
- Regulatory Reform: Kennedy pledged to eliminate inefficiencies within HHS agencies, reduce regulatory burdens on healthcare providers, and remove perceived financial conflicts of interest in federal health agencies.
- Patient-Centered Care: He underscored the importance of shifting healthcare toward a more personalized and patient-driven approach, including alternative care models and holistic treatment strategies.
Medicare and Medicaid: Key Challenges and Concerns
The hearings revealed significant gaps in Kennedy’s understanding of fundamental Medicare and Medicaid operations. Key misstatements included:
- Medicare Basics: Sen. Maggie Hassan (D-NH) asked Kennedy to define Medicare Part A. Kennedy incorrectly responded that it primarily covers primary care organizations.
- Medicaid Funding and Reform: Kennedy mistakenly stated that Medicaid is entirely federally funded, whereas it is a joint federal-state program.
- Healthcare Affordability: When asked about Medicaid beneficiaries’ financial challenges, Kennedy inaccurately described high premiums and deductibles, which are typically associated with private insurance rather than Medicaid.
Additional Medicare and Medicaid Positions:
- Expressed strong support for Medicare Advantage while acknowledging “people can’t afford it. It’s much more expensive”.
- Stated Medicaid “is not working for Americans” and that “the poorest Americans are now being robbed” despite increased program spending.
- Proposed experimenting with pilot programs in each state focused on value-based care.
- Advocated for transitioning to direct primary care systems and expanding telehealth access.
Healthcare Payment Reform
Kennedy proposed several changes to healthcare payment systems:
- Suggested implementing “health savings accounts and cooperatives” within Medicare and Medicaid programs, though he did not provide specific details about implementation.
- When questioned about site-neutral payments and other payment reforms, he deferred to Congress’s authority, stating that “regional price points are set by Congress and not by HHS”
- Advocated for changes in reimbursement structures, though specific proposals were not detailed
New Administrative Initiatives:
- Committed to implementing “radical transparency” across HHS operations
- Plans to appoint a former prosecutor as general counsel to address Medicare fraud
- Pledged to coordinate payment reforms with healthcare providers
- Emphasized transitioning to value-based care while maintaining provider stability
Vaccine Policy and Public Health
- Bill Cassidy’s (R-LA) Concerns: Cassidy repeatedly asked Kennedy to affirm that vaccines do not cause autism. Kennedy declined to make a definitive statement.
- Republican Concerns: Moderate Republican senators Lisa Murkowski (R-AK) and Susan Collins (R-ME) expressed skepticism about Kennedy’s ability to lead HHS given his past statements.
- Kennedy’s Commitments: Under questioning, Kennedy pledged not to change vaccine recommendations without scientific consensus and stated he would not divert funding away from vaccine programs.
Key Issues Left Unaddressed
Despite the breadth of the hearings, Kennedy did not address several critical policy issues relevant to the healthcare sector:
- Hospital Funding and Provider Reimbursement
- Immigration and Healthcare Access
- Site-Neutral Payment Policies
- Medicaid Disproportionate Share Hospital (DSH) Payments
- Tax Changes for Healthcare Providers
- Cybersecurity in Healthcare
- Supply Chain Resilience
- Home Care and Hospital-at-Home Models
- 340B Drug Pricing Program
Confirmation Prospects and Next Steps
Sen. Bill Cassidy, a crucial vote on the Senate Finance Committee, remained undecided following the hearings. If the nomination reaches the full Senate, Kennedy could face significant challenges. With most Democrats expected to oppose him, he can afford to lose only a few Republican votes and still be confirmed.
The committee has set a deadline of 5:00 PM on January 31 for additional questions for the record, with responses expected to provide further clarity on Kennedy’s positions and plans. If confirmed, Kennedy would become the 28th Secretary of Health and Human Services.