Hearings to examine proposed budget estimates for fiscal year 2026 for the Department of Health and Human Services.

Senate Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies

2025-05-20

Source: Congress.gov

Summary

The meeting primarily addressed the Department of Health and Human Services (HHS) fiscal year 2026 budget request and the ongoing reorganization efforts within the department. Secretary Kennedy presented the budget as a plan to improve American health through efficiency, cost-cutting, and a renewed focus on core missions, while many senators raised significant concerns about proposed funding reductions, staff layoffs, and a perceived lack of transparency regarding departmental changes.

Themes

HHS Budget and Reorganization

Secretary Kennedy outlined the FY2026 budget, aiming to make America healthy again by focusing on chronic diseases, improving efficiency, and cutting costs, including a proposed 26% reduction in HHS funding . He expressed intentions to shift funding from bureaucracy to direct impact and preserve legacy programs like Medicare, Medicaid, and Head Start . Several senators, however, expressed deep concern about the "massive and disruptive overhaul" of the department, citing a lack of detailed plans and thousands of staff firings [ 00:30:02-00:30:07 ]

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. The Secretary defended the staff reductions by comparing HHS to other organizations that have downsized and attributing the cuts to eliminating waste and duplicated programs . He cited numerous redundant offices and departments within HHS, asserting that reorganization is necessary due to the agency's current lack of governance and inefficient structure, which he believes contributes to poor health outcomes despite high spending .

Biomedical Research Funding and Impact

A major point of contention was the proposed $18 billion cut to the National Institutes of Health (NIH), which critics warned would devastate life-saving research, hinder medical innovation, and cede U.S. leadership in biomedical research [ 00:31:11 ]

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. Senators alleged that HHS was actively stopping billions in NIH funding for research on diseases like cancer and Alzheimer's, and that over 3,200 grants had been withheld . Secretary Kennedy countered that NIH's high spending hasn't resulted in better American health, and that his department is cutting wasteful and non-essential studies, not life-saving research or clinical trials . He specifically mentioned cutting research based on "radical gender ideology" and gain-of-function experiments . Concerns were also raised about the reduction of NIH funding going directly to research due to high indirect costs charged by universities .

Specific Program Oversight and Changes

Senators questioned cuts or changes to several specific programs. The status of the CDC's childhood lead poisoning program was debated, with senators claiming staff were fired and services reduced, while the Secretary stated the program was continuing and efforts were being made in specific locations like Milwaukee . The elimination of the "Safe to Sleep" program and the NIOSH coal programs also drew criticism, although the Secretary noted that some NIOSH employees had been brought back to work . The budget's impact on LIHEAP (Low Income Home Energy Assistance Program) was a concern, with Senator Collins emphasizing its critical role for vulnerable populations, which Secretary Kennedy acknowledged while noting the administration's rationale for energy cost reductions . The Secretary also committed to supporting state opioid response programs, despite proposed SAMHSA eliminations, and to examining a paused Diabetes Prevention Program study [ 01:38:23-01:38:49 ]

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Rural Health and Access to Care

Concerns were voiced about healthcare access in rural America, including higher rates of chronic conditions and hospital closures . Senators questioned how the HHS budget proposal would invest in rural areas, particularly given proposed cuts to HRSA programs . Secretary Kennedy emphasized his commitment to rural health, citing HRSA programs, community health centers, and the National Health Service Corps . He also highlighted the potential of new technologies like telehealth, AI, and wearables to "revolutionize" healthcare delivery in rural areas .

Transparency and Congressional Oversight

A significant issue raised by several senators was the perceived lack of transparency from HHS regarding its reorganization and spending plans [ 00:30:02-00:30:07 ]

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. Senators criticized the department for providing a budget plan with numerous asterisks instead of actual spending levels for over 530 programs, hindering congressional oversight [ 00:25:40-00:25:51 ]

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. They accused HHS of unilaterally implementing budget cuts and departmental changes without congressional approval, potentially impounding funds illegally . Secretary Kennedy stated that decisions regarding spending plans with asterisks were made by OMB, not HHS, and that he would cooperate with requests for information .

Tone of the Meeting

The meeting was characterized by a highly contentious and confrontational tone, particularly between several Democratic senators and Secretary Kennedy . Senators expressed anger and frustration over perceived unilateral budget cuts, lack of transparency, and the dismantling of crucial public health programs, frequently accusing the Secretary of lying or being uninformed about departmental actions . Secretary Kennedy, in turn, adopted a defensive but assertive posture, challenging senators' assertions, highlighting his commitment to efficiency, and criticizing past congressional oversight for contributing to the nation's poor health outcomes . While some moments involved shared concerns (e.g., rural health, Alzheimer's), the overall atmosphere was one of deep disagreement and mistrust regarding the direction and management of HHS [ 00:56:40-00:56:50 ]

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Participants

Transcript

Thank you.
Good morning, everybody.  Great to be here.  This is our first labor HHS subcommittee hearing for the fiscal year of 2026.   and the first hearing as my new role as the chair.  Vice Chair Baldwin and I have served together for several years on this committee, and I look forward to continuing with you in our new roles.  I always want to take a moment, too, to recognize Senators Collins, and I know Senator Murray will be here shortly.  As the chair and vice chair of the Appropriations Committee, they are committed to regular order and maintaining our track record of writing and passing bipartisan appropriations bills in a timely manner.   Today's budget hearing is a first step in that process.  Secretary Kennedy, thank you so much for being with us today.  I know that we all share the goal of improving the health of Americans.  This hearing is an important opportunity for the subcommittee to hear from you on the HHS's budget proposal and better understand your priorities for fiscal year 2026.  You've taken the helm of a large agency with thousands of dedicated career staffers whose work each day makes Americans healthier and safer,   and ensures our global leadership in science and biomedical research.  In your first few months as Secretary, you've made many changes in the department that will lead, I believe, to a healthier America.  This committee looks forward to hearing more from you on the details of your proposed reorganization for HHS and working together to make America healthy again.  HHS has always worked with Congress when considering and designing reorganizations, and I encourage you and your staff   to work closely with us as you move forward.  Your fiscal year 2026 budget proposes a reduction in funding for HHS of 26%.  I would say, ask you to take a careful look at each and every program at the department and I look forward to reviewing your full budget request hopefully very soon.  This committee wants to work with you on improving HHS so that the agency can move more efficiently and fund the basic science.
I'm concerned that our country is falling behind in biomedical research, and this should be a concern for all of us who want to make investments in biomedical research.  Investing in that has proven to save lives while exponentially strengthening our economy.  NIH-funded basic research is also behind many of the 600-plus new cancer   treatments that FDA has approved over the last 20 years.  NIH-funded research led to the development of buprenorphine, a medication for opioid addiction.  NIH-funded research led to the development of the first overdose naloxone nasal spray, Narcan.  For almost a decade, this committee has increased funding towards the goal of finding treatments and a cure for Alzheimer's disease.  This goal is very personal to me, since both of my parents lived with and eventually succumbed to this horrible disease.   These investments have allowed NIH to fund research into a wide variety of potential causes of the disease and build evidence for prevention based on a healthy lifestyle.  NIH-funded research of the amyloid protein led to the development of the FDA-approved Alzheimer's drugs in 23 and 24 to slow progression of the disease.  All this research is extremely important, and I look forward to working with you to continue to look at diversified research   Alzheimer's research.  Wasteful spending of taxpayers' dollars must end, and I applaud you for taking a hard look at what federal research dollars are funding, and I encourage you to ensure that the fiscal year 2025 funding that Congress has already appropriated is spent in a timely manner, in particular for the vital biomedical research which could lead to lifesaving breakthroughs in science.  Too many families are waiting for a cure, as you know.  We have a responsibility to make sure   Their taxpayers' dollars fund that research.  You and I have talked several times, and I appreciate it so much, about the importance of the NIOSH coal programs in West Virginia and how the work conducted by NIOSH in Morgantown is unique across the federal government.
I'm pleased that you brought some of these specialized NIOSH employees back to work earlier this month and then just last week.   reverse their rifts so that their return to the office will not be temporary.  Thank you.  Your decision to return NIOSH staff to the office meant that the Firefighter Fatality Investigation and Prevention Program could issue the final report on the December 27, 2020 fire that killed a 30-year-old firefighter and injured three others in West Virginia.  Senior Airman Logan Young was one of many who responded to the Carniesville fire.   I'm glad NIOSH was able to finish their investigation and issue recommendations and final report.  While your action last week was a good step, there are still other divisions within NIOSH with specialized staff who conduct essential, unique work.  I support the President's vision to right-size our government, but as you and I have discussed, I don't think eliminating NIOSH programs will accomplish that goal.  I encourage you to look at this closely.   West Virginia, my own home state, continues to rank above the national average in both new cancer diagnoses and death.  We are thankful for the work performed by the CDC National Center for Chronic Disease Prevention and Health Promotion, and I look forward to learning more about how this important work will be continued on the administration of a healthy America.  Substance abuse challenges also continue to be a real problem facing West Virginia and the nation.

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