Wednesday’s hearing covered a range of health topics, from vaccine mandates to rural hospital closures and plans for Medicare and Medicaid. Mr. Kennedy faces another hearing Jan. 30 with the Senate Committee on Health, Education, Labor and Pensions.
Here are seven takeaways and excerpts from the hearing. A recording of the hearing in full can be found here.
1. Medicare and Medicaid: There were nearly 80 mentions of Medicaid, about 40 mentions of Medicare and only five mentions of Medicare Advantage throughout the Senate Finance Committee hearing.
The focus on Medicaid came one day after widespread disruptions to the program’s portals and confusion about the program’s inclusion in the Trump administration’s plans to freeze an array of federal funds, grants and programs. This became a point of contention, with Sen. Ron Wyden, D-Ore., claiming the Trump budget office shut down the federal Medicaid payment portal, while Committee Chairman Sen. Mike Crapo, R-Idaho, countered that reports of disruptions were “proven false overnight,” asserting that the portal was fully operational at the time of the hearing.
Sen. Bill Cassidy, MD, R-La., pressed Mr. Kennedy about his plans to reform Medicare and Medicaid, which collectively provide health coverage to more than 150 million Americans.
At times, Mr. Kennedy’s comments indicated confusion between the two programs. When asked about integrating Medicare and Medicaid for dual-eligible individuals, he inaccurately described Medicaid as being “fully paid for by the federal government,” when in fact it is funded jointly by state and federal governments.
Mr. Kennedy suggested that most people are unhappy with federal health programs, and stated several times throughout the hearing that Medicaid premiums and deductibles are too high. A relatively small portion of Medicaid beneficiaries pay premiums and deductibles, however. He did not confirm whether he supports adding work requirements for Medicaid coverage or cuts to the program, though suggested improvements are needed. “I don’t have a broad proposal for dismantling the program,” Mr. Kennedy said.
A KFF poll conducted in 2023 found strong satisfaction with federal insurance programs, with 91% of Medicare beneficiaries and 83% of Medicaid enrollees rating their coverage positively.
Despite its prominence in previous policy discussions, Medicare Advantage received little attention during the hearing. One of its few mentions came when Mr. Kennedy disclosed that he is personally enrolled in a Medicare Advantage plan. “Most Americans like myself, I’m on Medicare Advantage and I’m very happy with it,” he said during an exchange with Mr. Cassidy about Medicare and Medicaid.
As of 2024, 32.8 million people — 54% of Medicare beneficiaries — are enrolled in a Medicare Advantage plan. Mr. Kennedy suggested that even more people would prefer it “because it offers very good services,” but are deterred by cost. “People can’t afford it. It’s much more expensive,” he said.
While Medicare Advantage has grown in popularity, it faces scrutiny over wasteful spending and questionable business practices. Investigations revealed an estimated $7.5 billion in questionable risk-adjustments for 2023, while Senate findings indicate major insurers prioritized profits over patient care through aggressive prior authorization practices, often denying necessary post-acute care services to seniors. Sen. Peter Welch, D-Vt., later criticized Mr. Kennedy’s praise of Medicare Advantage, highlighting recent reporting on insurer practices.
“You mentioned that you thought Medicare Advantage was good, you have a good plan,” Mr. Welch said. “No focus on what an incredible ripoff was reported in The Wall Street Journal by UnitedHealthcare, which was marketing Medicare Advantage and then paying doctors and nurses where they had assignments essentially to over diagnose illnesses that didn’t exist. So they made billions and billions of dollars. And I’ve seen nothing coming out of the Trump administration, and I’ve seen nothing coming out of your advocacy that is going after what is a rampant abuse by the insurance companies and overcharging people and not doing the job.”
2. Rural healthcare: Mr. Kennedy addressed the importance of tackling rural healthcare challenges like workforce shortages and hospital cuts and closures. In 2024, Becker’s reported on 705 rural hospitals at risk of closure and 37 maternity service closures.
“Our nation made a commitment over 100 years ago to put a hospital within 30 miles of every American,” he said during the hearing. “We generally succeeded in doing that. It’s absolutely critical. It’s life saving and rural hospitals are closing at an extraordinary rate right now. They not only provide important healthcare for the localities, but also they’re economic drivers for localities all over this country.”
Mr. Kennedy said President Trump has asked him to tackle these challenges through strategies like AI and telemedicine.
3. Vaccines: While Mr. Kennedy’s stance on vaccinations has been critiqued in the past, he reassured the committee that he is not anti-vaccine or any industry but “pro-safety.”
“I believe that vaccines play a critical role in healthcare,” he said. “All of my kids are vaccinated. I’ve written many books on vaccines. My first book in 2014, the first line of it is, ‘I am not anti-vaccine.’ The last line is, ‘I am not anti-vaccine.'”
Despite pushback and accusations that he has endorsed “radical fringe conspiracies,” he reassured senators that he also supports both the measles and polio vaccines and will do “nothing as HHS secretary that makes it difficult or discourages people from taking either.”
4. Chronic disease: Mr. Kennedy firmly supported his Make America Healthy Again agenda during the hearing. He claimed that when his uncle, President John F. Kennedy, was in office, only 2% of American children had chronic illnesses, but that number has risen to 66% today. He also said recent National Institutes of Health data show 38% of teens are pre-diabetic and diabetic. He claimed autism rates are up from one in 10,000 to one in 1,500, “depending on what studies you look at.”
“We spent zero on chronic disease during [the] Kennedy administration,” he said. “Today, we spend $4.3 trillion a year [and] 77% of our kids can not qualify for military service.”
Mr. Kennedy’s spending reference aligns with an Association of American Medical Colleges report that found the U.S. spent $4.3 trillion in healthcare in 2021.
To combat this, Mr. Kennedy pointed to improvements needed in the SNAP program to ensure kids are receiving healthier, less processed meals. He also highlighted a need to focus on more outcome-based medicine to put “people in charge of their own healthcare,” along with the need to deploy NIH and the FDA to further research the link between food additives and chronic disease.
5. Prescription drug prices: Mr. Kennedy suggested the Trump administration would preserve Medicare’s authority to negotiate drug prices with pharmaceutical companies. As the hearing began, CMS published a statement on its website saying the agency is “committed to incorporating lessons learned to date from the program and to considering opportunities to bring greater transparency in the Negotiation Program.” The Biden administration on Jan. 17 named the next 15 drugs that will be eligible for drug price negotiations in 2027.
Mr. Kennedy also identified pharmacy benefit manager reform as one of the most common unifying issues he has heard during meetings with more than 60 senators on both sides of the aisle. He expressed support for PBM support and the need to eliminate excess profits from the drug pricing system. Outside of endorsing bipartisan legislation in general, he did not share specific proposals for how he would address this issue.
6. Abortion: Abortion was mentioned 28 times throughout the hearing, with Mr. Kennedy expressing he intends to follow the president’s lead on the issue. “I serve at the pleasure of the president — I’m going to implement his policies,” he said. Mr. Kennedy said he supported the Trump administration’s stance that the legality of abortion be left to the states.
If confirmed as HHS secretary, Mr. Kennedy would oversee the FDA’s regulation of abortion pills. When asked about mifepristone, one of two drugs used to terminate pregnancies, Mr. Kennedy said Mr. Trump “has not yet taken a stand on how to regulate it” and has asked him to initiate studies on the drug’s safety. He added that the president has told him he wants to end late-term abortions, protect conscientious exemptions and end federal funding for abortions in the U.S. and abroad.
Mr. Kennedy appeared uncertain when the Emergency Medical Treatment and Labor Act was mentioned. EMTALA — a 40-year-old federal law requiring Medicare hospitals to provide all patients appropriate emergency care, including a medical screening examination and stabilizing treatment, if necessary — has as been at the center of legal disputes over whether it preempts state law when abortion is prohibited and does not make exceptions for the health or life of a pregnant person.
Sen. Catherine Cortez Masto, D-Nev., pressed Mr. Kennedy on whether the federal law protects a woman’s right to an abortion in emergency situations, such as when a woman suffers a life-threatening bleed due to an incomplete miscarriage. “You would agree, as an attorney, that federal law protects her right to that emergency care, correct,” she asked, to which Mr. Kennedy replied, “I don’t know.”
When asked about HHS’ authority over EMTALA, Mr. Kennedy incorrectly indicated his oversight would mostly be limited to budgetary affairs. CMS is responsible for investigating EMTALA complaints and enforcing violations.
7. Mental healthcare: Drawing from his personal experience with addiction and recovery, Mr. Kennedy said he would work to improve access to timely and effective care for the millions of Americans facing mental health and substance abuse issues. He proposed using Graduate Medical Education funding to increase the number of primary care physicians trained in addiction care. Additionally, Mr. Kennedy expressed support for repealing a Medicaid rule that prohibits funds for mental illness or substance use disorder provided by psychiatric hospitals or residential treatment facilities.
Later in the hearing, Sen. Tina Smith, D-Minn., questioned Mr. Kennedy about past remarks suggesting a link between the rise of SSRIs and school shootings. While Mr. Kennedy acknowledged he could not confirm this link, he advocated for further study of SSRIs alongside other potential contributing factors, such as social media. Ms. Smith noted that no scientific evidence currently supports this connection. Mr. Kennedy also suggested that individuals on SSRIs and other antidepressants should have access to wellness farms as a means of safely being weaned off the medications.