This analysis was prepared by Crossroads Strategies, LLC on behalf of AACOM.

On May 14, 2025, the House Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a hearing titled “Budget Hearing - U.S. Department of Health and Human Services.” 

The hearing featured sharp partisan debate over proposed health program cuts, agency reorganizations, and public health priorities. Secretary Kennedy defended restructuring efforts, emphasizing efficiency, cost savings, and a focus on chronic disease, mental health, and addiction, while pledging to preserve core programs like Medicare and Medicaid. Democrats criticized deep funding cuts to NIH, CDC, and minority health initiatives, warning of threats to research, vulnerable populations, and public safety. Key topics included rural health, vaccine policy, missing migrant children, Medicaid eligibility, and domestic drug production. Kennedy committed to transparency, scientific integrity, and working with Congress, but faced skepticism over the impact of proposed changes. A link to the full hearing video may be found: Link.

Witnesses

• The Honorable Robert F. Kennedy, Jr. — Secretary, U.S. Department of Health and Human Services

Opening Statements

Subcommittee Chair Robert Aderholt (R-AL):

• I'm encouraged by President Trump's success in controlling the border, which benefits public health by reducing illicit drug flow.
• The President's actions have decreased the trafficking of unaccompanied minors.
• I look forward to hearing about Secretary Kennedy's plans to reform the Department of Health and Human Services.
• Secretary Kennedy has proposed structural reforms, including a new administration for Healthy America.
• Congress is engaged in health care reform, and I look forward to collaborating with the Secretary on these initiatives.

Subcommittee Ranking Member Rosa DeLauro (D-CT):

• I view President Trump's budget request to cut $33 billion from health programs as a disgrace.
• The administration is unlawfully freezing funds and attacking health programs to benefit billionaires.
• Cuts to NIH, CDC, and FDA are endangering public health and driving scientists away.
• Eliminating agencies like SAMHSA and HRSA will result in needless deaths.
• The administration's actions are dismantling critical health institutions and jeopardizing public safety.

Secretary Robert Kennedy:

• Debilitating diseases and other health issues affect all families, and we aim to make America healthy again, focusing on chronic disease.
• We are committed to delivering efficient services to over 100 million Americans relying on Medicare, Medicaid, and other programs while cutting costs.
• The U.S. spends $4.5 trillion annually on health care, more per capita than other nations, indicating systemic issues.
• We will preserve legacy programs like Medicare and Medicaid and prioritize access to care for vulnerable populations, including Native Americans and Alaskan communities.
• HHS will consolidate programs to tackle mental health and addiction, aggressively combat the opioid crisis, and empower local leaders.
• We will address nutrition and healthy lifestyles, requesting $94 billion in discretionary funds for these priorities.
• The FDA will expand food safety efforts, and NIH will fund cutting-edge research while cutting nonessential services.
• We will eliminate DEI funding, redirect resources to poverty reduction, and strengthen cybersecurity and health IT.
• We aim to rebuild public trust with transparency and a science-driven HHS, working with Congress to make America healthy again.

Question and Answer

Subcommittee Chair Robert Aderholt (R-AL):

• What steps is the Department taking to protect the right to life and conscience rights of pro-life medical providers and students?
  • Kennedy: Every abortion is a tragedy. Under Trump's leadership, we ended federal funding for programs that fund or counsel abortions. We withheld Title X funding from NGOs that don't differentiate funding streams. The proposed budget cuts out Title X funding due to non-compliance concerns.
• Has CMS taken steps to review the impact of the area wage index on rural hospitals, and will you work with me and Administrator Oz on a solution?
  • Kennedy: The Trump administration tried to address this disparity, crucial for rural healthcare. Rural hospitals are vital for access and economic stability. The Biden administration didn't defend the policy in court, resulting in a bad decision. Change must be statutory, and we will provide technical support and studies.

Subcommittee Ranking Member Rosa DeLauro (D-CT): 

• Why are you freezing or withholding funding that Congress appropriated in 2025 for life-saving NIH research?
  • Kennedy: We are not withholding any funding for life-saving research.
• Do you commit to fully obligating funding that Congress appropriated for NIH research by September 30th, or are you planning to break the law by impounding funds?
  • Kennedy: If you appropriate me funds, I'm going to spend them.
• How can you justify cutting $20 billion from the NIH budget when Congress appropriated those funds?
  • Kennedy: If Congress appropriates the money, I'm going to spend it.
• Will you commit to spending the money appropriated in the 2024 budget for NIH?
  • Kennedy: If you appropriate the money, I'm going to spend that money.
• Why did you eliminate CDC's Office of Smoking and Health, which helps reduce tobacco use and saves taxpayer dollars?
  • Kennedy: Programs were transferred to the Administration for Healthy America, not cut, but I can't discuss details due to a court order.
• Do you commit to fully obligating funds appropriated for CDC's tobacco prevention programs?
  • Kennedy: We are consolidating programs for efficiency, not eliminating them, and will provide details when possible.

Rep. Mike Simpson (R-ID): 

• How does your budget maintain forward appropriations for Indian Health Services?
  • Kennedy: I am committed to protecting Indian Health Services and ensuring they are not affected by budget cuts. I have a long history of working on tribal issues and will prioritize improving health outcomes for Native populations.
• How does the reorganization of NIH affect the Division of Oral Health at the CDC?
  • Kennedy: I am committed to dental health and recognize its importance to overall health. We need to focus on new science linking dental health to other health areas.
• What are your thoughts on the FDA's action regarding ingestible fluoride products for children?
  • Kennedy: Emerging science shows fluoride benefits are from topical exposure, not ingestion. We need to consider the potential negative effects of ingestible fluoride on children's health.

Rep. Steny Hoyer (D-MD): 

• Do you consider the budget passed by Congress a suggestion or a directive?
  • Kennedy: I see it as the President's budget, and my duty is to defend it. Congress appropriates funding, and I must follow that.
• Was there an analysis of the consequences of the department's workforce reduction?
  • Kennedy: Yes, there were analyses. We focused on cutting duplication and redundancy, not essential services like Indian Health Services or Head Start.

Rep. Chuck Fleischmann (R-TN): 

• Will you work with me to ensure the safety of replacement food colorings?
  • Kennedy: Yes, we are working with the food industry to phase out harmful dyes and fast-track vegetable dye substitutes.
• Can you confirm if oversight of the 340B program will move from HRSA to CMS?
  • Kennedy: I can't confirm due to a court order, but we recognize the program's importance to rural hospitals and are committed to supporting them.

Rep. Mark Pocan (D-WI): 

• As I understand it, you focus has been chronic disease, ultra-processed foods, and non-pharmaceutical health care. Is that correct?
  • Kennedy: Yes, I focus on these areas.
• Would you vaccinate your child for measles?
  • Kennedy: Probably for measles, but I want people to make their own decisions.
• Would you vaccinate your child against chicken pox?
  • Kennedy: I don't want to give advice; in Europe, they avoid the chicken pox vaccine due to shingles risk.
• Would you vaccinate for polio?
  • Kennedy: I don't want to give advice.
• Can we discuss the removal of the LGBTQ+ youth button from the 9-8-8 hotline?
  • Kennedy: I'm open to discussing it; I aim to avoid isolating demographics.
• Are you committed to addressing overpayments in Medicare Advantage and discussing its cost-effectiveness?
  • Kennedy: I want to address waste and abuse; Medicare Advantage works well for many, including me, but it costs more.

Rep. Stephanie Bice (R-OK): 

• What will HHS do to help attract biotech researchers?
  • Kennedy: We spend 70% of global research funding on biotech. We aim to keep the U.S. as the biotech hub by changing FDA policies for faster approvals and using AI to reform phase three studies. We've phased out most animal studies and brought top AI developers to HHS.
• Can you talk about changes at NIH and your vision moving forward?
  • Kennedy: NIH was once the gold standard but became ossified and corrupt. We're focusing on ending the chronic disease epidemic and ensuring scientific integrity. We aim to publish raw data and peer reviews and support younger scientists. The amyloid plaque scandal is an example of past corruption, and we're committed to finding a cure for Alzheimer's.

Rep. Lois Frankel (D-FL): 

• Were any cuts made before you were sworn into office, and were people fired before you?
  • Kennedy: I think so, but I can't say with certainty.
• Was any member of Congress or anyone on this committee consulted before the cuts were made?
  • Kennedy: I stayed in pretty close touch with Bill Cassidy.
• Were your decisions on cuts based on merit or generated by Elon Musk’s algorithm?
  • Kennedy: I disagree with your entire characterization; it's the Democratic Party narrative.
• How many employees have been let go so far?
  • Kennedy: About 10,000 left, about 10,000 more were let go.
• How many are on administrative leave now, waiting to be fired in June?
  • Kennedy: That’s the second group of 10,000 I mentioned.
• Are they currently being paid?
  • Kennedy: Yes, but we want them working.
• Are you empowered to reverse these decisions?
  • Kennedy: Yes.
• How was the 15% indirect research cost cap decided?
  • Kennedy: It's about two to three points above industry standards, similar to the Gates Foundation.
• Can we trust you to spend the budget as directed?
  • Kennedy: Yes, that's what the law requires.

Rep. Riley Moore (R-WV): 

• What is the status of the NIOSH employees in Morgantown?
  • Kennedy: I reinstated 328 employees at NIOSH, with about a third in Morgantown.
• Will the Coal Workers Health Surveillance Program at NIOSH be fully reinstated?
  • Kennedy: Yes, the program will continue with continuity.
• Will the occupational safety and respirator testing programs be fully operational again?
  • Kennedy: Yes, that's accurate.

Rep. Bonnie Watson Coleman (D-NJ): 

• How will eliminating minority health offices and initiatives improve health outcomes for black Americans? How do you intend to address disparities in black health with the changes in your department?
  • Kennedy: I've worked on these priorities for a lifetime. We have eight programs for minority health at HHS, closed one office, maintaining seven. We have 42 programs for maternal health, consolidating a couple, still spending $1.7 billion annually. Commitment remains, just reorganizing.
• Why is the LIHEAP program, which supports low-income and minority families with heating and air conditioning, being eliminated?
  • Witness was not allowed to respond. 

Rep. John Moolenaar (R-MI): 

• Do you care to respond to the previous question?
  • Kennedy: LIHEAP is crucial for poor people nationwide. My brother's non-profit fuel company has saved lives. Cuts to LIHEAP could be deadly, as per Navajo Nation's president. OMB believes Trump's energy policy will lower energy costs, making LIHEAP unnecessary. If not, Congress should fund it, and I will allocate it as needed.
• Do you agree that reliance on the CCP in the U.S. biotech and health ecosystem is a threat, and should we develop independent supply chains?
  • Kennedy: China focuses its biomedical research on global dominance, not DEI. The 1,000 Talents Program is designed to steal U.S. IP and technology. NIH previously funded Chinese scientists without requiring them to report back, aiding Chinese military research. We are working to bring production home, with Eli Lilly building nine factories in the U.S. We prioritize producing all essential medicine parts domestically and have launched a successful program for this.
• What challenges are facing BARDA and the Strategic National Stockpile, and how can Congress help?
  • Kennedy: We are redirecting BARDA for gold standard research. BARDA has produced over 103 FDA-licensed products. The national stockpile has $17 billion in supplies, some misaligned. We need better preparation for emergencies and would love to work with Congress on this.
• How can we promote healthy lifestyles and nutrition for young children, especially in rural areas?
  • Kennedy: We are reissuing the Dietary Guidelines, simplifying them to four pages. This will drive changes in school lunch programs. We need help to provide good school lunches to Head Start. Our children are facing high rates of diabetes, and we must work together for healthier kids.

Rep. Madeleine Dean (D-PA):

• The mission of HHS is to enhance and protect the health and well-being of Americans.
• We need to distinguish between the 2026 budget proposal and current cuts to appropriated funds.
• I am more interested in substance than slogans like MAGA, MAHA, or AHA.
• Addiction and mental health are personal issues for me; my son Harry is in recovery from opioid addiction.
• Overdose deaths have decreased by 27% to 81,000 annually, but it's still a crisis.
• Why are we closing SAMHSA when overdose is still a major issue? 
  • Kennedy: We are not shuttering SAMHSA; we are running 500 addiction centers.
• Why shift SAMHSA to AHA when we are seeing success in saving lives?
  • Kennedy: We want to administrate more efficiently by shifting functions to AHA.
• What analysis supports the decision to shift SAMHSA to AHA?
  • Kennedy: We aim to provide naloxone and ensure addicts have options like Suboxone and methadone.
• Are you eliminating training for naloxone?
  • Kennedy: We want 500 addiction centers and to operate more efficiently with other chronic diseases.

Rep. Andrew Clyde (R-GA): 

• How many children have gone missing or remain unaccounted for after being released by HHS over the last four years?
  • Kennedy: The Office of the Inspector General estimates 291,000 missing children, likely a low estimate. Actual numbers could be up to half a million; many children faced horrific situations. Previous policies prioritized speed over safety, waiving ID and fingerprint requirements for sponsors. Instances of abuse include a man in Cleveland who repeatedly exploited children. The Biden administration was aware but did nothing; 160,000 health complaints were ignored. A criminal task force has been launched, with 500 investigations and 80 cases in court. New measures include fingerprinting, DNA testing, income testing, and valid ID checks for sponsors.

Rep. Josh Harder (D-CA): 

• How much did your family spend on your addiction treatment?
  • Kennedy: I spent the money on my addiction treatment, and it was about $800 a day back then.
• Why do you think my community doesn't deserve access to Medicaid-provided healthcare like you had?
  • Kennedy: I believe that is the design of the Medicaid program.
• Do you disagree with the proposed Medicaid cuts?
  • Kennedy: The cuts target fraud, waste, and abuse, affecting about 8 million people due to illegal claims.
• That has nothing to do with the proposed budget cuts.
  • Kennedy: These are the only cuts being made; illegal aliens are being removed from Medicaid rolls.
• The proposed budget will cause 13 million to lose healthcare.
  • Kennedy: The last category affected are able-bodied adults not seeking employment.
• That's not true; most on Medicaid in my community are working.
  • Kennedy: Then they are not in danger of losing Medicaid.
• More red tape prevents access to life-saving care.
  • Kennedy: Medicaid is for poor children, mothers, and the disabled.
• 13 million will lose insurance if the budget passes.
  • Kennedy: They're losing insurance due to able-bodied people on Medicaid.

Rep. Andy Harris (R-MD):

• No pregnant woman or single mom on traditional Medicaid will lose benefits; claims of fraud are concerning.
• The $2 trillion deficit is unsustainable; we need to return to pre-COVID spending levels.
• The country is getting sicker, not healthier; life expectancy is decreasing, and chronic diseases are worsening.
• NIH should focus more on nutrition to prevent diseases; current focus is too much on treating diseases.
• Nutrition is linked to cancer; we need to study the impact of diet on health outcomes.
• What should we focus on to improve national nutrition and health?
  • Kennedy: NIH has done great science to cure cancers faster, but we need to ask why colorectal cancer is now an epidemic in children. There's no research at NIH on the etiology of chronic diseases due to fear of offending large industries. We should inform the public about ingredients that may increase cancer and diabetes risks, allowing them to make informed choices. We plan to study ingredients, starting with the most common culprits, and work with industry to remove harmful ones.
• If we add money to the NIH budget, it should focus on nutrition spending.
• Farmers are concerned about the impact of pesticide scrutiny on the agriculture economy, and we must work together to avoid harming it.
  • Kennedy: We can't make America healthy without partnering with American farmers, who are already operating on thin margins.

Rep. Jake Ellzey (R-TX): 

• What capabilities do you have in coordination with other agencies to find missing children?
  • Kennedy: We don't have enforcement capability at HHS. We're doing unprecedented data sharing and have a war room to locate children, then turn information over to ICE and DHS for enforcement. It's very difficult to track them down.
• How can we improve school lunches and return to local control?
  • Kennedy: We support local control. FDA can provide simple guidelines like avoiding packaged foods and chemicals, allowing local solutions for what's best.

Rep. Julia Letlow (R-LA): 

• What actions will the department take to enhance women's health research and ensure funding reflects women's health needs?
  • Kennedy: We strongly support women's health research and will continue our commitment with 42 maternal health programs. We aim for great detection, diagnosis, early detection, and prevention. 
• What initiatives are planned to improve health outcomes in the Delta region, and how can Congress assist?
  • Kennedy: Rural health is a priority. We will support rural hospitals, increase personnel, and revolutionize telehealth and AI to improve access and treatment.

Subcommittee Ranking Member Rosa DeLauro (D-CT):

• The 2026 budget eliminates the CDC's breast and cervical cancer program, impacting women's health.
• Secretary Kennedy, you are withholding $2.7 billion in NIH research funds, which is illegal.
• You lack the authority to reorganize the NIH or cut its funding by $20 billion in 2026.
• Vaccines save lives, and it's tragic that the HHS Secretary won't encourage child vaccinations.
• NIH has achieved significant successes, like the Human Genome Project and mRNA vaccines.
• Who do Democrats contact to reinstate programs like tobacco prevention and lead poisoning?
• Medicaid beneficiaries, including children and seniors, are at risk of cuts.
• The U.S. separated 4,600 children from families; 1,300 remain unaccounted for.
• HHS's role is to save lives, and proposed cuts will endanger research and public health.

Subcommittee Chair Robert Aderholt (R-AL):

• I appreciate the fresh perspective you bring to public health and the healthcare system.
• It's important to evaluate what is working and what is not, rather than accepting the status quo.