Hearings to examine the nomination of Susan Monarez, of Wisconsin, to be Director of the Centers for Disease Control and Prevention, Department of Health and Human Services.

Committee on Education

2025-06-25

Source: Congress.gov

Summary

This meeting of the Senate Committee on Health, Education, Labor, and Pensions convened to consider the nomination of Dr. Menares as the director of the Centers for Disease Control and Prevention (CDC). The discussion encompassed criticisms of the CDC's past performance, particularly during the COVID-19 pandemic, and explored Dr. Menares's vision for reforming the agency to restore public trust and enhance its response capabilities.

Themes

CDC's Past Performance and Future Reforms

Senators expressed significant concerns regarding the CDC's performance during the COVID-19 pandemic, citing failures in communication, data availability, and the agency's coordination with political groups like teachers' unions. Dr. Menares outlined her three top priorities if confirmed: restoring trust through public-facing leadership, data transparency, and science-backed recommendations; strengthening public health infrastructure with innovation and real-time awareness; and implementing evidence-based rapid decision-making with clear protocols and consistent guidance. She emphasized a return to the CDC's core mission of preventing, detecting, and responding to infectious diseases and emerging threats[ 00:46:09-00:46:11 ]

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Healthcare Policy and Funding

A major point of contention was the proposed reconciliation bill, which Senator Sanders argued would enact the largest cuts to healthcare in the nation's history, leading to 16 million Americans losing health insurance and potentially 50,000 unnecessary deaths annually. He also warned of rural hospital closures due to Medicaid cuts. Senator Marshall countered that the legislation would strengthen Medicaid, increase funding, and support rural health through local economies and community health centers. Dr. Menares largely avoided direct comment on the reconciliation bill but acknowledged the struggles of rural hospitals and the importance of rural health services.

Vaccine Policy and Trust

The composition and integrity of the Advisory Committee on Immunization Practices (ACIP) were heavily debated, following Secretary Kennedy's removal of its members and appointment of new ones. Senators raised concerns about the new members lacking broad vaccine and immunological expertise, potentially including vaccine skeptics, and the need for thorough ethics reviews and transparent disclosure of pharmaceutical royalties[ 00:55:34 ]

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. Dr. Menares stated she has not seen a causal link between vaccines and autism, aligning with the American Medical Association. She committed to ensuring vaccine availability and science-driven ACIP decisions[ 01:48:44-01:48:51 ]

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[ 01:52:58-01:53:09 ]

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Role of Technology and Innovation

Drawing on her extensive background, Dr. Menares highlighted the importance of science, technology, and innovation for the CDC. She plans to modernize laboratory capabilities, invest in diagnostics, and integrate AI for operational efficiency and public health outcomes. Dr. Menares emphasized a disciplined approach to AI implementation, ensuring it solves defined problems and incorporates necessary safeguards. She also expressed an open mind regarding various vaccine platforms, including mRNA technology, based on safety and efficacy standards.

Specific Public Health Programs and Cuts

Several senators questioned Dr. Menares about recent or proposed cuts to specific public health programs. Concerns were raised about staffing cuts in the Childhood Lead Poisoning Prevention Program and its impact on affected cities like Milwaukee. Senator Baldwin also noted the potential elimination of CDC cancer prevention programs in the President's budget. Senator Kaine criticized the complete elimination of the CDC's Office on Smoking and Health and accompanying layoffs. Dr. Menares generally responded by promising to "look into" these issues if confirmed and to ensure successful transitions or continuity of critical public health activities[ 01:03:31 ]

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[ 01:34:45 ]

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Tone of the Meeting

The tone of the meeting was largely contentious and adversarial, especially from Democratic senators. Many expressed frustration and skepticism regarding Dr. Menares's reluctance to directly criticize Secretary Kennedy or recent administration decisions, particularly concerning ACIP appointments and program cuts[ 00:41:43-00:41:43 ]

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[ 01:13:51-01:13:51 ]

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. Republican senators generally offered support, focusing on specific public health challenges and Dr. Menares's professional expertise. Dr. Menares maintained a cautious and diplomatic stance, often deferring to the Secretary's vision or committing to review issues if confirmed[ 00:36:08 ]

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[ 00:41:35 ]

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[ 01:03:53 ]

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[ 01:34:45 ]

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. An underlying tension existed regarding the balance between scientific independence and political alignment within federal health agencies.

Participants

Transcript

Oh, we're waiting for our witness, our nominee.  We do.   The Senate Committee on Health, Education, Labor, and Pensions will please come to order.  Thank you, Dr. Menares, for appearing before the committee.  During the COVID-19 pandemic, the Centers for Disease Control and Prevention failed to communicate crucial information to the American people.  When the public needed to know the most up-to-date information on the outbreak, they relied on a Johns Hopkins data dashboard because the CDC did not have that information readily available.   The agency failed to detect and anticipate the spread of COVID-19 even when the virus had already reached the United States.  And under President Biden, instead of acting impartially, CDC coordinated with outside political groups like teachers unions, allowing them to influence pandemic health guidance.   By the way, the teachers' unions then used CDC guidance, which they helped write, as justification to push for continued closure of schools nationwide when other public health officials were saying it was safe to open, a great detriment to American children's learning and mental health.  So when the American people needed the CDC the most, the agency failed.  Bureaucratic decision-making impeded CDC's ability to improve Americans' health, and continued reforms are needed to regain public trust.
Earlier this year, Senate Republicans launched a working group to develop legislative solutions to improve the CDC.  As a public health official for nearly 20 years, Dr. Menares brings insight that can guide this process.  I look forward to working together if she is confirmed.   For the last four years, Republicans have understood the deficiencies in the CDC and desired change, but restoring Americans' trust in the CDC requires more than policy.  It requires a strong leader committed to achieving permanent culture change within the agency.   This is the time with President Trump and a Republican Congress to put someone in charge of the CDC who can institute systemic change and ensure the agency operates effectively to benefit Americans.  Above all, the CDC director must ensure agency decisions are transparent and based on science.   I want to acknowledge that the Advisory Committee on Immunization Practices, the ACIP, is meeting as we speak.  The CDC director plays a vital role in this process, having the power to choose whether to adopt ACIP recommendations.  I want President Trump to be successful in his efforts to restore trust in our public health system.   Given that there is no confirmed CDC director, along with an ACIP panel which has very few members, many of whom lack broad vaccine and immunological expertise, there are concerns about the rushed nature of this process.   To be clear, there's a difference between reviewing recommendations about the appropriateness of a patient receiving an immunization and broadly declaring a vaccine to be dangerous or unsafe if received without the evidence to support such a declaration.
S
Susan Monarez
If confirmed, Dr. Menares, you will be tasked with strengthening public trust in CDC, ensuring decisions on immunizations are rooted in the gold standard of science.
This mission is crucial to your success and the success of the entire Trump administration.  I want to work with you and with Secretary Robert Kennedy to ensure the agency is successful in restoring its credibility and in making America healthy again.   The Director also needs to ensure the agency is nimble and not caught flat-footed in response to public health threats, while also addressing drivers of disease to make America healthy again.  The CDC's unique capabilities in data analysis, laboratory science, and public health responses are key to achieving President Trump's goal.   Continued data modernization while preserving privacy will be crucial to restoring faith in the CDC.
S
Susan Monarez
Dr. Menares and I have talked about these issues at length.
I look forward to continuing our discussion.
With that, I recognize Senator Sanders.  Chairman, thanks very much.  Dr. Menares, thanks very much for being here.  Before I comment on your nomination to become CDC director, I want to say a few words about   about maybe the most important and disastrous healthcare legislation to come before Congress in a very, very long time.  That is the so-called reconciliation bill, which the Senate will be dealing with in a few days.  So let's be clear.  This legislation, Dr. Monarez, if enacted, would make the largest cut to healthcare in our nation's history   in order to pay for the largest tax breaks for billionaires in our nation's history.  At a time when everybody understands, including I suspect every member of this committee, that our current healthcare system is broken, is dysfunctional, this bill would make it even worse.   The Congressional Budget Office has estimated this legislation would cut Medicaid and the Affordable Care Act by over $1 trillion.  Those cuts, along with ending the enhanced premium credits, will lead to 16 million Americans losing their health insurance.  In other words, right now, we are the only major country on Earth not to guarantee health care to all people.   85 million are uninsured or underinsured, and this bill makes a awful situation even worse.  Researchers at the Yale School of Public Health and healthcare economists at the University of Pennsylvania have found that these healthcare policies would cause over 50,000 Americans to die unnecessarily every single year.
That's what happens when you throw 16 million low-income and working-class people off the healthcare they have.  That's what we're dealing with here, folks.  In order to give tax breaks to billionaires, we're endangering the lives of 50,000 Americans every year.  Not only would millions lose their health insurance, and tens of thousands of our constituents needlessly die if this legislation is enacted, rural hospitals, and I come from one of the most rural states in America,

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