Seven Key Moments: Hearing with HHS Secretary Robert F. Kennedy, Jr.

WASHINGTON, D.C. - Ways and Means Committee Republicans emphasized the importance of expanding access to health care for Americans - particularly those in rural areas, prosecuting billions of dollars in Medicare fraud, and advancing policies to address high rates of chronic disease prevalence during a hearing with Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. A major focus was examining the ways that Congress and the Trump Administration can work together to implement changes in policy that align with the nutritional and lifestyle changes and preventive care advocated by the Make America Healthy Again movement. Committee members focused on federal policies that fuel the growing consolidation and vertical integration in the health care industry and lead to skyrocketing health care costs and prevent access.

Secretary Kennedy highlighted the clear contrast between the successes of the Trump Administration - which is making changes to national food and health care standards long demanded by Americans while leaning into the fight against waste, fraud, and abuse within the health care system - with the failures of the Biden Administration, which expanded Obamacare subsidies for the wealthy and illegal immigrants that cost taxpayers billions of dollars in fraudulent payments to major insurance companies.

Trump Administration Commits to Expanding Access to Rural Health Care By Boosting Low Rural Medical Professional Pay

Medicare reimbursement for rural medical providers lags far behind those given to equivalent health care professionals in urban areas. The smaller rural reimbursement contributes to the dangerous lack of medical professionals and health facilities serving rural communities, leading to serious challenges for patients to access care. The Trump Administration is focused on eliminating discrepancies in Medicare reimbursement for care between urban and rural providers and Secretary Kennedy committed to working with Congress to bring fairness to Medicare reimbursements for rural medical professionals.

Chairman Jason Smith (MO-08): "There are stark discrepancies in the way Medicare reimburses rural health care compared to their urban counterparts. As we know, it is an unfortunate reality that health care often follows the dollar, making reimbursement policies not just a financial question but a life and death concern for growing access to care. I had a medical technology company tell me about a remote monitoring device that they were paid twice as much for in San Francisco than in Missouri. With this discrepancy, it's not a matter of if, it's a question of when rural areas will be left behind…Will you and the Administration commit to working to bring rural reimbursements more in line with the same treatments done in urban settings?"

Secretary Robert F. Kennedy, Jr: "Yes we will, and we've already addressed some of that discrepancy through our promulgation of the site neutrality rule. We need your help on the wage area index to really correct those disparities."

Screening is a Powerful Tool for Preventing Chronic Disease

Early screening can detect potential chronic and debilitating diseases before it's too late for patients. Unfortunately, Medicare spends a disproportionate share of its funding on treatment of chronic disease and far too little on prevention, increasing the prevalence of disease and costs. Secretary Kennedy pointed to proactive efforts to consider Medicare coverage for preventive medicine, treatments, and tests.

Rep. Vern Buchanan (FL-16): "I'm deeply passionate about promoting access to screening as a way to prevent diseases. Through my personal experience with Alzheimer's and lung cancer, I've become a strong believer in the power of detection and prevention. I'd like to get your thoughts and ideas on that in terms of screening, like screening for lung cancer."

Secretary Robert F. Kennedy, Jr: "Screening for prevention is absolutely critical. We are reforming now the USPSTF (U.S. Preventive Services Task Force), which is the committee that decides on new procedures and interventions that need to get CMS (Centers for Medicare & Medicaid Services) compensation. That committee has been lackadaisical and negligent for 20 years. Now, bringing new members on who have a clear mission, we're going to have much more frequent meetings. We're going to have, for the first time, transparency."

Trump Administration Commits to Fix Biden's Mistakes in No Surprises Act Implementation

The No Surprises Act makes health care more affordable by banning surprise billing for out-of-network care. Unfortunately, in the half-decade since President Trump signed the No Surprises Act into law, patients have thus far missed out on the full promise of the law due to the failures of the Biden Administration to implement the black-and-white letter of the law. In response to Ways and Means Committee demands that the Trump Administration implement the law as written to protect patients and preserve access to care, Secretary Kennedy announced the Department of Health and Human Services is finalizing the rule.

Chairman Jason Smith (MO-08): "The implementation of the No Surprises Act was a disaster under the Biden Administration, losing four lawsuits and harming patient access to care. One of the things that frustrates me the most about government agencies is a tendency to ignore the written statutes of Congress. The Ranking Member raised this earlier in regards to the No Surprises Act, but Ways and Means Republicans have requested your department urgently finalize a needed rule that is in line with what we passed out of this committee and what was signed into law…Will you commit to me now to finalize this rule as it was written by Congress as a top priority for your department?

Secretary Robert F. Kennedy, Jr: "We're working as fast as we can to finalize that rule now."

Rural Health Transformation Program Tackles Rural Health "Crisis"

Rural hospital closures have devastated cornerstones of rural economies and denied Americans access to health care. The Working Families Tax Cuts included a new $50 billion Rural Health Transformation Program that will improve access to health care for 60 million rural Americans. The first installment was distributed to all 50 states and will help stabilize rural hospitals and ensure primary care and medical specialties remain in rural communities.

Rep. Adrian Smith (NE-03): "What is your approach to improving access to health care services for Americans who live in rural and remote areas. And what can we do to ensure Americans in rural areas aren't left behind in our health care system?"

Secretary Robert F. Kennedy, Jr: "…We've seen closures of 120 rural hospitals since 2010. It is a crisis. When these hospitals close, it doesn't just deny access to health care. Those hospitals are economic drivers for their community. They're the highest-paid jobs. They're often the biggest employer. That is the reason President Trump made the biggest investment in rural health care in American history, the $50 billion Rural Health Transformation Fund. Right now, Medicaid gives about seven percent of its money to rural hospitals, and it's about $20 million a year. We're increasing the flow of federal dollars to rural community health care, an extra $10 million a year."

Bad Washington Policy Drives Doctors Out of Business and Drives Up Costs

Misguided Washington policies encourage consolidation and vertical integration in the health care industry. Policies, such as arbitrarily paying hospitals more than a doctors' office for the same service provided at an outpatient facility and urban health workers receiving a larger reimbursement compared to rural workers, have tipped the scale toward ever-larger urban health systems at the expense of independent medical providers, rural hospitals, and patients nationwide. These realities result in rising health care costs for working families as access to care continues to shrink.

Rep. Jodey Arrington (TX-19): "This disparity between what we pay hospitals and physician groups for the same outpatient service, and the effects of that are not just higher premiums on seniors in Medicare, but higher cost for taxpayers. There's a giant sucking sound of independent physician groups and doctors into hospital systems, leaving us with less choice…I think the problem with all these distortions is that we have too much special interest, too much incumbent resistance, too much parochial politics…Give me your best shot on the monopoly forces and anti-competitive behavior. What are one or two things that you think this body could do to address that and go a long way to make things more affordable for working people in this country?"

Secretary Robert F. Kennedy, Jr: "10 or 15 years ago, 80 percent of the doctors in our country were independent and 20 percent were corporate. Today, 20 percent are independent and 80 percent are corporate, and the number that are independent are dropping precipitously because of the economic forces that are the result of these perverse incentives. Site neutrality, which we're fixing, is key to that, the wage area index, reforming the PBMs, that is one of the most anti-competitive forces out there, and we're doing that."

Food is Medicine: "To End Chronic Disease Epidemic, We Have to Start with Food"

Good nutrition has been linked to lower rates of common chronic diseases such as diabetes, cardiovascular disease, and cancer. The Trump Administration has taken action to end the chronic disease epidemic through better nutrition, like redesigning the food pyramid to emphasize whole foods and partnering with 53 medical colleges to provide students with at least 40 hours of nutrition training. Medicare represents an opportunity to improve the nation's physical health and lower the costs of chronic disease treatment by keeping Americans healthy.

Rep. Carol Miller (WV-01): "The second issue that I wanted to talk to you about is that it is clear that what we eat plays a direct role in our health. And quite frankly, many Americans don't eat right, and these poor nutrition choices are a major driver of chronic disease. I believe there's a strong case of expanding access to MNT [medical nutrition therapy] for targeted and specific groups among Medicare beneficiaries whose outcomes could actually measurably improve as a result. With that in mind, can you share your perspective on the role medical nutrition therapy should play in improving health outcomes for Medicare beneficiaries, and how we can most effectively and responsibly expand to those who would benefit from the most, particularly in the rural and underserved areas?"

Secretary Robert F. Kennedy, Jr: "I think there's nobody at this agency who is not committed to the idea that food is medicine. If we want to do prevention in this country and end the chronic disease epidemic, we've got to start with food. That's one of the reasons we're pushing nutrition into the colleges, we're pushing it into the hospitals, we're pushing it into the community health centers to make it the central focus of healing and prevention."

After Biden Administration, Ways and Means Republicans Finally Get Answers About Medicare Fraud

The Biden Administration refused to acknowledge or address fraud in federal programs, including Medicare and its $60 billion in benefits lost to waste, fraud, and abuse. In a 2024 hearing, former Biden HHS Secretary Xavier Becerra refused to acknowledge the truth when Representative Beth Van Duyne (TX-24) confronted him with a building in Los Angeles County, California that had over 100 hospice companies registered to it.

Secretary Kennedy acknowledged the vast scale of hospice fraud at that site and how the Trump Administration has already shut down 500 fake hospices in Los Angeles alone, where there is an estimated $3.5 billion in alleged Medicare hospice fraud. The Trump Administration has adopted a whole-of-government approach - including a new anti-fraud task force - to root out fraud in health care to protect benefits for Americans.

Rep. Beth Van Duyne (TX-24): "I asked Secretary Becerra the same question, what's going on at 14545 Friar Street in Van Nuys, California. Does that ring a bell to you at all?"

Secretary Robert F. Kennedy, Jr: "No, I could guess."

Rep. Van Duyne: "We had over 100 different licenses for hospices right at this address, and we asked him what he was doing about it. Basically nothing. Can you walk through what your office is actually doing on the waste, fraud and abuse?"

Secretary Kennedy: "We've already shut down 500 hospices in Los Angeles, and incidentally, we haven't had one call from Congress or anybody else about complaining, because clearly, these were fraudulent. A lot of these places were just invented addresses. They would obtain patient identification or they would pay people. They were going and giving people in poor neighborhoods flat-screen televisions and they would enlist them and enroll them in the hospice. We were paying them $6,000. The interesting thing is almost none of them ever died. Typically, they stay in a hospice for about 18 days. These people stayed forever. Nothing ever happened, because they weren't actually there."