The next issue up for consideration by the Senate is cloture on the Robert F. Kennedy Jr. [nomination] to be Secretary of Health and Human Services.
This cabinet position is responsible for implementing the administration’s health agenda.
As Secretary, Mr. Kennedy must spend his time focused on improving the health of all Americans, ensuring HHS is transparent and accountable to congressional oversight and respecting whistleblowers.
I think Kennedy has made it very clear in his life as a citizen talking about improving the health of all Americans.
I would like to outline some of the priorities that Mr. Kennedy should focus on at Health and Human Services.
Obviously, I’m asking him to focus on issues that are very dear to my heart, and take up a lot of my time, as a Senator from Iowa and as a person very concerned about the quality of health care in rural America.
Our country spends more than $4.5 trillion annually on health care. Growing health care costs don’t just strain Americans’ pocketbooks – health care is also a major driver of widening budget deficits and the federal government’s unsustainable fiscal outlook.
We’re not getting our money’s worth for all that spending.
Major health care program spending eats up 34 percent of the federal revenue today, and that will grow to 41 percent of revenue by 2055.
Mr. Kennedy must – and I think he’s committed to – ensure key health programs, such as Medicare and Medicaid, are protected and strengthened by rooting out waste, fraud and abuse.
The nominee must increase transparency and accountability.
These actions will help make our health care system more efficient for taxpayers and consumers.
I’m the author of major and more recent updates to the federal government’s most powerful tool in fighting fraud – that’s people that use the False Claims Act.
Since the enactment of this legislation – I’m talking about reforms to the False Claims Act – the federal government has recovered more than $78 billion lost to fraud and saved billions more by deterring would-be fraudsters.
People in the Justice Department, both Republicans and Democrats, say that the False Claims Act is their best tool to get after these fraudsters.
In the one year of 2024 – Attorney General Garland reported this to me just a couple days before he left office – in 2024, there was more than $2.9 billion in False Claims Act settlements and judgments, with $1.7 billion of it involving the health care industry.
As you know, I listen to a lot of whistleblowers, and whistleblowers were responsible for helping recover nearly all of that $1.7 billion.
I discussed the False Claims Act, and the use of it, [with] soon-to-be Secretary Kennedy.
He seemed to be very enthused about listening to whistleblowers and use of the False Claims Act. I think he was being made aware of it for the first time.
I hope he will look into how he can use this act, particularly by listening to reports from whistleblowers of the waste of taxpayers’ money.
The Justice Department and HHS in combination need to more aggressively go after health care waste, fraud and abuse, and empower and encourage whistleblowers.
My top health care priority is lowering the cost of prescription drugs. We can start by putting more sunshine on pharmacy benefit managers’ practices and holding these PBMs accountable.
We should also establish price transparency on prescription drug TV ads.
Knowing what something costs before buying it is just common sense, and very helpful to the consumer.
Transparency will bring more accountability and lower costs for consumers.
Mr. Kennedy must also protect and improve access to rural health care.
The previous administration dragged its feet in opening up spots for the Rural Community Hospital demonstration program.
HHS must also listen to concerns from rural pharmacies and ensure rural hospitals benefit from additional physician residency slots that Congress has authorized.
I look forward to strengthening the new and voluntary Rural Emergency Program to ensure it’s working for rural communities, extending telehealth access and supporting physicians getting a fair reimbursement under Medicare.
I also expect HHS to support healthy moms and babies by improving care coordination and using telehealth in rural areas.
HHS should work with me to support kids with complex medical needs, so these kids and their families are getting the right care, at the right time and in the right place.
Our [bill] help[s] support kids with complex medical needs … they have to navigate across several different programs.
What we’re trying to do through legislation is to [provide] help [to these kids], so that when [they] have to see five or six different specialists, [there’s] somebody saying what’s available, and [helping kids get] access to all of this.
I also expect HHS to protect the most vulnerable and older Americans.
I’ve spoken at length with Mr. Kennedy about some comments he made with regard to agriculture.
I’ve heard from farmers in Iowa, agricultural organizations and commodity groups in the state who are fearful that Mr. Kennedy has some radical ideas on agriculture.
At the end of the hour meeting I had with [Mr. Kennedy] in [my] office, prior to his hearing before the Finance Committee, I was calmed quite a bit about his views on agriculture.
I hope that calm can be maintained – but if it’s not, Mr. Kennedy is sure to hear from me.
When we talked about this in my office, Mr. Kennedy prefaced our initial conversation by saying he, as HHS Secretary, will not have jurisdiction over agriculture issues.
So, you can expect that I will expect him to leave agricultural practices regulations to the proper agencies – and for the most part that’s the U.S. Department of Agriculture and the Environmental Protection Agency.
I’ve also sent letters to the Secretaries of Agriculture and HHS requesting they provide information regarding conflicts of interest on the Dietary Guidelines Advisory Committee to increase transparency.
The problem is, there’s a feeling among a lot of the members of the advisory committee that they may have an unjustified conflict of interest in what they’re suggesting we eat and the type of diet we have.
I expect Mr. Kennedy to provide Congress with confidential financial disclosures from the Advisory Committee before finalizing dietary guidelines, so we know that nobody has a vested interest however those guidelines are written.
On issues of health care and agriculture, Mr. Kennedy said at his nomination hearing,
“I agree with all those provisions, Senator. My approach to the administration of HHS will be radical transparency. If a member of this committee or other members of Congress want information, the doors are open … If Congress asked me for information, you would get it immediately.”
I don’t know whether people … on the outside [of the Senate] know how refreshing it is to have a member of the Cabinet say, “If Congress asked me for information, you would get it immediately.”
Over the years I’ve been in the United States Senate – it doesn’t matter if it’s a Republican or a Democrat administration – carrying out our constitutional responsibilities of checks-and-balances to see that the executive branch and the President faithfully execute the laws, is not an easy process.
We have difficultly getting answers to our questions.
I don’t know how much of this I’ve had trouble with HHS in the past – but, I know when Pam Bondi came to my office, I showed her a file of 158 letters that I had written to the Justice Department in the last four years to get information and documents in regard to my investigations of wrongdoing.
Most of them weren’t answered, or if we got answers, it was merely words on a sheet of paper – not very helpful.
So, thank you Mr. Kennedy for your promise that “if Congress asks me for information, you will get it immediately,” because that’s what our job is.
Every high school student learns in government [class] about the checks –and balances in government – that [Congress] not only passes laws and appropriates money, but has a responsibility to the taxpayers and citizens of this country to make sure the President does what the Constitution says he should do – faithfully execute the laws.
Cabinet people are bound by that same thing. Every Cabinet member that comes to my office, I tell them about the importance of my constitutional responsibility of oversight, answering our letters and listening to whistleblowers.
In regard to answering letters, every [nominee] that comes before a committee is asked by the chairman of that committee, “Will you answer our letters?”
Everybody says “yes,” but I advise them to say “maybe,” so that they don’t turn out to be liars.
I expect Mr. Kennedy’s agency to provide timely and complete responses to congressional oversight.
Oversight allows us to hold bureaucrats accountable to the rule of law, and it helps keep faith with the taxpayers.
I look forward to working with Mr. Kennedy to improve the health of all Americans, make our health care system more efficient and ensure HHS’ adherence to Kennedy’s “radical transparency” commitment.
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