Kennedy Defends ‘Streamlining’ of HHS During Budget Hearings 

WASHINGTON — Testifying on Capitol Hill for the first time as the nation’s leading health official, Health Secretary Robert Kennedy Jr. on Wednesday defended his bare bones request for $94 billion to run his department, as well as steps he’s taken since January to dramatically cut staff and slash long-standing programs.

Appearing before the House Appropriations Committee Wednesday morning, Kennedy said President Donald Trump’s FY 2026 budget request includes reforms to put health care spending “on a sustainable fiscal path.”

“We must remake the government to maximize efficiency and productivity in order to fulfill the president’s promise to make America healthy again,” the secretary said during his prepared remarks before the panel chaired by Rep. Tom Cole, R-Okla.

“Protecting the health of Americans has to be done hand in hand with protecting our nation’s fiscal health — they rely on each other,” he continued. “The FY 2026 budget will reduce duplication of programs and services, increase accountability, and work with state and local governments to improve flexibility.” 

Later, Kennedy was expected to make the same case before the Senate Health, Education, Labor and Pensions Committee, a panel chaired by Sen. Bill Cassidy, R-La., a medical doctor and frequent critic of Trump’s policies.

Sen. Bernie Sanders, I-Vt., an independent who caucuses with Democrats, is the ranking member on the committee.

Trump’s so-called $1.7 trillion “skinny” budget proposal for fiscal year 2026 reduced non-defense spending by 23% compared to 2025.

Its proposal for the Department of Health and Human Services is about 26% lower than last year, and includes across the board cuts to staff and programs at agencies ranging from the National Institutes of Health to the Centers for Disease Control and Prevention.

At the same time, the proposed budget includes roughly $500 million to support Kennedy’s Make America Healthy Again Initiative, which he said would better coordinate programs targeted at the “chronic disease epidemic.”

These programs he said not only would improve the case of chronic conditions, but would seek to prevent them through nutrition, physical activity, reducing the number of medications people take and improving food quality.

In his opening remarks alone, Kennedy used the words “reform” and “refocus” a half dozen times, and “streamline” and “streamlining,” at least five times.

Since taking office, Kennedy has moved quickly to shrink the Department of Health and Human Services and the affiliated agencies it oversees.

In addition to firing thousands of staffers, the secretary has canceled billions in grants to universities and public health departments.

While many of these actions are on hold after being challenged in court, Democrats on the Appropriations Committee expressed concern that Kennedy has been cavalier in his approach to the nation’s health and damaged the scientific review process of the agencies he oversees in the process.

Rep. Rosa DeLauro, D-Conn., the ranking member on the panel, was particularly withering, calling the administration’s budget request, which cuts $33 billion in funding for health programs, “a disgrace.”

“With you at the helm, the Trump administration and Republicans in Congress are destroying the crown jewels of our health system — the National Institutes of Health, the Centers for Disease Control and Prevention and the Food and Drug Administration.

“At the NIH, the world’s largest funder of lifesaving biomedical research, you and Elon Musk have fired or driven out nearly 5,000 personnel, including some of the world’s most preeminent scientists, and frozen billions of dollars in research to develop cures for cancer, Alzheimer’s disease, women’s health, and the list goes on,” she continued, noting that “China and Europe are taking advantage of this disaster by recruiting American scientists away from the United States.”

“As part of your drastic and haphazard purge of CDC, you and Elon Musk eliminated entire divisions without consideration of what is being lost,” DeLauro said. “More than 70% of CDC’s funding is provided to state and local jurisdictions. These cuts affect families and communities in every one of our districts. These cuts are dangerous.”

“The mission of the Department of Health and Human Services is to enhance and protect the health and well-being of the American people. President Trump and all of us at HHS take that charge seriously,” Kennedy said.

“When a program is not as effective as it can be, or costs more than it ought to, or fails to deliver on its promise – change and reform are necessary,” he continued.

DeLauro dismissed Kennedy’s contentions, implying that through his actions he’s been little more than a pawn in Trump’s efforts to “pay for tax cuts for billionaires.”

“The destruction of HHS is not limited to NIH, CDC and FDA,” she said. “Mr. Secretary, you are eliminating entire agencies that have saved the lives of someone near to each and every one of us. Because of these cuts, people will die.”

DeLauro then ticked off some of the specific cuts she objects to:

“The Substance Abuse and Mental Health Services Administration, eliminated,” she said.

“Health Resources and Services Administration, which as you know is responsible for ensuring access to health care for uninsured, isolated, and vulnerable people, eliminated.

“The Administration for Strategic Preparedness and Response, which was created to prepare for and respond to public health emergencies, was eliminated.

“The Administration for Community Living, eliminated, hurting seniors and people with disabilities.

“You can make the baseless claim that you are simply reorganizing these functions of HHS all you want — it is simply a matter of fact that you cannot cut the department’s budget and maintain all of its life-saving programs and services,” DeLauro said. 

“HHS has closed half of its regional offices, which served 22 states and five territories. Twenty thousand HHS employees are gone,” she said. “And Republicans have set the stage to cut Medicaid benefits from people who rely on that program to see a doctor — including roughly half of our nation’s children.”

In addition, DeLauro said, HHS has terminated more than $12 billion in funding for state and local health departments, “including funding for mental health and substance use prevention and treatment, sabotaging our progress in addressing the opioid crisis.”

“The HHS restructuring will serve multiple goals without impacting critical services,” Kennedy asserted.

Noting that the departments reduction in workforce will save taxpayers about $1.8 billion a year, starting in FY 2026, the health secretary said the reductions have focused “on aligning HHS staffing levels to reflect the size of HHS prior to the COVID-19 pandemic which saw around a 15% increase in the number of employees.

“Secondly, it will streamline the functions of the department,” Kennedy said. “Currently, the 28 divisions of HHS contain many redundant units. The restructuring plan will consolidate them into 15 new divisions, including a new Administration for a Healthy America, or AHA, and will centralize core functions such as human resources, information technology, procurement, external affairs, and policy.

“The restructuring plan intends to reduce regional offices from 10 to five by planning to close regional offices in high-cost cities. This restructuring will reduce the number of full-time employees to approximately 62,000, while preserving critical staff such as FDA food safety inspectors,” he said.

“Third, the overhaul will implement the new HHS priority of ending America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins,” Kennedy continued, adding, “In summary, these changes will allow us to act more nimbly and focus on the core mission of improving the nation’s health.”

Kennedy also spoke of the current woeful state of American health, which he said “is in a grievous condition.”

“Over 70% of adults and a third of children are overweight or obese,” he said. “Diabetes is ten times more prevalent than in 1960. Cancer among people 50 and under is rising by one or two percent a year. Autoimmune diseases, neurodevelopmental disorders, asthma, Alzheimer’s, ADHD, depression, addiction, and a host of other physical and mental health conditions are on the rise. 

“The United States has worse health than any other developed nation, yet we spend far more on health care—at least double; in some cases, triple.Last year we spent $4.9 trillion, not counting indirect costs like missed work. That’s almost 17.6% of our nation’s GDP.But more than that, it’s a human tragedy — today, over half of all Americans are chronically ill.”

Kennedy assured the committee that Medicare, Medicaid, and the Children’s Health Insurance Program remain a cornerstone of the MAHA agenda to improve outcomes for our seniors and children.

“This budget continues CMS program funding to maintain beneficiary service levels, streamline program administration, and move toward improved health outcomes while eliminating non-statutory and wasteful spending,” he said.

Kennedy went on to say he and others in the administration believe the NIH “has broken the trust of the American people with wasteful spending, misleading information, risky research and the promotion of dangerous ideologies that undermine public health.

“The administration is committed to restoring accountability, public trust, and transparency at the agency,” he said.

But DeLauro wasn’t biting. She said she found it incomprehensible that Kennedy could talk about the high rate of chronic disease in the U.S. on one hand, and eliminate the CDC’s Center for Chronic Disease Prevention and Health Promotion on the other.

“And with respect to your views on vaccines, quite frankly, I believe you are promoting quackery,” she said. “Under your watch, our country is now failing to contain vaccine-preventable diseases. 

“Measles, a disease eliminated in the United States just decades ago, has now claimed the lives of three Americans — including two children who died needlessly — and over 1,000 are confirmed to have contracted the disease. All while you peddle unfounded and dangerous vaccine skepticism, and spread lies and misinformation about people living with autism.

“Vaccine programs for millions of Americans, including children, so they do not get diseases, like measles, are not waste … These programs help save the lives of men and women and children from all walks of life in this country,” she said.

“I do not believe the American people want less cancer research and fewer people tracking infectious diseases, but that is exactly what this budget will deliver,” DeLauro said. 

“We are in the middle of a cost-of-living crisis — driven in part by skyrocketing health care costs — and you, Elon Musk, and President Trump are making it worse. You are wreaking havoc at every level of our most critical health institutions,” she said.

“The budget I’m presenting today … reflects two enduring American values, compassion and responsibility,” Kennedy said. “I invite the committee to rally around these ideals with me. 

“The United States remains the sickest developed nation in the world, and we spend $4.5 trillion annually on health care, two to three times more per capita than comparable nations,” he said. “Clearly, something is structurally and systemically wrong with our approach. 

“Furthermore, health care costs are steadily increasing at a rate 2% greater than the economy. If we don’t staunch this unsustainable hemorrhage, we will ransom our children to bankruptcy, servitude and disastrous health consequences. Yes, an exploding debt is a social determinant of health,” the secretary said. “We won’t solve this problem by throwing more money at it. We must spend smarter. We will shift funding away from bureaucracy toward direct impact.”

Dan can be reached at [email protected] and @DanMcCue