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Over the past two weeks, Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. testified before several Congressional committees regarding the FY26 HHS budget request, including the Senate Appropriations Subcommittee on Labor-HHS, the House Appropriations Subcommittee on Labor-HHS, and the Senate Committee on Health, Education, Labor, and Pensions (HELP). These hearings covered a wide range of topics, including HHS reorganization, Medicaid changes, vaccine policies, chronic disease, rural health, research funding, and the broader Make America Healthy Again (MAHA) agenda. The hearings marked the first round of Congressional review of the FY26 request.
Budget Request Priorities and Testimony Highlights
In his testimony, Sec. Kennedy highlighted the administration’s focus on reducing chronic disease and increasing operational efficiency. The FY26 budget proposal includes:
- Consolidating mental health programs to better address rising rates of mental illness and substance use.
- Prioritizing nutrition, physical activity, and exercise, with $94 billion requested for the Administration for a Healthy America (AHA).
- Expanding FDA food safety efforts.
- Cutting research deemed redundant, dangerous, or overly focused on DEI metrics.
- Leveraging AI and other technologies to improve health data management and service delivery.
- Restoring public trust in federal health agencies.
HHS Reorganization and Withholding Funds
The reorganization of HHS drew criticism from Democrats. Democrats, including Sen. Tammy Baldwin (D-WI) and Rep. Rosa DeLauro (D-CT), raised alarms about funds appropriated by Congress being withheld, particularly for NIH immunotherapy research. Sec. Kennedy defended the actions as part of a larger effort to cut waste and emphasized OMB’s role in making final funding decisions. He stated that while legal action prevents him from commenting on specifics like the CDC brain injury program, all actions are intended to increase agency efficiency. Sen. Susan Collins (R-ME) and others expressed concern about funding uncertainty impacting key health initiatives.
HHS Workforce Reductions
Reductions in the HHS workforce were another flashpoint. Sec. Kennedy stated that he and his staff made the final decisions, though Elon Musk offered informal guidance. Rep. Steny Hoyer (D-MD) and Sen. Tim Kaine (D-VA) pressed for clarity on the decision-making process, while Democrats questioned whether Congress had been consulted. Republicans largely defended the cuts as part of broader government reform efforts.
Medicaid
Democratic lawmakers criticized the proposed Medicaid reforms included in the reconciliation bill, arguing the changes would significantly reduce coverage for vulnerable populations. Sec. Kennedy, joined by Republicans like Rep. Andy Harris (R-MD), countered that the reforms would reduce fraud, eliminate waste, and target coverage toward eligible recipients. Provisions such as work requirements for non-disabled adults and limits on care for undocumented immigrants were especially contentious.
Chronic Disease
Members across party lines acknowledged the importance of addressing chronic disease. While Republicans praised Kennedy’s Make America Health Again (MAHA) initiative, Democrats objected to cuts at Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of Minority Health. Sec. Kennedy characterized the changes as a realignment, not a reduction. Sen. Jon Husted (R-OH) expressed enthusiasm for MAHA’s direction, and Sen. Tim Scott (R-SC) advocated banning artificial dyes in foods.
Rural Health
Rural health care emerged as a significant theme. Lawmakers highlighted hospital closures and provider shortages. Sec. Kennedy pointed to partnerships with health tech firms and AI applications as potential solutions. He cited support for Health Resources Services and Administration (HRSA) programs like 340B and mentioned efforts to improve access to cancer treatments and preventive care. Sen. Brian Schatz (D-HI) raised equity concerns regarding DEI rollbacks, which Kennedy dismissed, citing bipartisan efforts to ensure equitable access, such as sickle cell treatment expansion in South Carolina.
Vaccines
Amid a growing measles outbreak, Democratic lawmakers pressed Kennedy on his stance on vaccines. Although Kennedy acknowledged public mistrust and concerns, he ultimately affirmed that the measles vaccine is the most effective means of prevention. He emphasized that his recommendations are based on multiple sources.
Other Topics
- Sen. Moran (R-KS) expressed support for the BOLD Act.
- Sen. Jeanne Shaheen (D-NH) expressed support for opioid crisis grants and Sec. Kennedy agreed.
- Sen. Collins discussed restoring the LEAH program and boosting aid for low-income families.
- Reps. Clyde (R-SC), Ellzey (R-TX), and DeLauro (D-CT) raised concerns over unaccompanied minors and family separation accountability.
- Members from both parties emphasized the need to reduce dependency on Chinese pharmaceutical supply chains.
- Sen. Cassidy (R-LA) voiced concerns about the closure of the Office of Long COVID Research.
- Sen. Josh Hawley (R-MO) is reportedly drafting legislation to limit pharmaceutical advertising.
The reauthorization of the Dr. Lorna Breen Health Care Provider Protection Act marks an ongoing effort to support the mental health of health care professionals. This bipartisan legislation not only continues the legacy of Dr. Lorna Breen but also reflects the importance of a robust mental health infrastructure for those on the front lines of medical care.
The Dr. Lorna Breen Health Care Provider Protection Act is up for reauthorization. A bipartisan bill in Congress demonstrates ongoing support for the mental health of health care professionals. What’s the latest on this legislation?
Dr. Lorna Breen
Dr. Lorna Breen was an emergency physician and medical director at New York-Presbyterian Allen Hospital in Manhattan. She was known for her dedication during the early days of the COVID-19 pandemic, which took a severe toll on her mental health. After her death by suicide in April 2020, her family founded the Dr. Lorna Breen Heroes Foundation to improve mental health support for health care workers.
The Dr. Lorna Breen Health Care Provider Protection Act was enacted in 2022 to help break down the stigma that often prevents medical professionals from seeking help. The bill established a new standard for embedding mental health into health care practices, reinforcing the idea that provider well-being is vital to delivering quality patient care.
Key Provisions of the Reauthorization
The reauthorization would extend critical programs from 2026-2030, focusing on:
- Grant Programs: Continued funding for health care organizations and professional associations to implement strategies that reduce burnout, provide peer support, and offer mental health treatment.
- Educational Initiatives: Support for health profession schools to train students and professionals in preventing suicide, burnout, and substance use disorders.
- Awareness Campaigns: Expansion of national campaigns to educate health care leaders on evidence-based solutions to mitigate provider burnout and promote well-being.
This extended funding at $45 million annually, totaling $225 million over five years prioritizes communities with health care worker shortages, rural areas, and those experiencing high levels of burnout due to administrative burdens.
Bicameral Support Reflects National Consensus
The act’s reauthorization has garnered support from both sides of the political aisle, demonstrating a strong commitment to address the mental health crisis among health care workers. Senators Tim Kaine (D-VA), Jack Reed (D-RI), Roger Marshall (R-KS) and Todd Young (R-IN), along with Representatives Debbie Dingell (D-MI-06), Jen Kiggans (R-VA-02), Jennifer McClellan (D-VA-04) and Miller-Meeks (R-IA-01), have been instrumental in championing this cause.
Outlook for the Breen Act
Corey Feist, CEO of the Dr. Lorna Breen Heroes Foundation, has been making the rounds in Congress advocating for the bill’s reauthorization. Despite bipartisan support, there is no clear path yet for the legislation.
Congressional Democrats remain frustrated that the measure wasn’t renewed in December 2024, blaming its failure in part on social media posts by Elon Musk that were later backed by Donald Trump. Musk tweeted that the health care package, which included this bill, should not pass Congress.
Partisanship again is prevailing in Congress over budget legislation to reduce Medicaid spending and extend tax cuts. The Chair of the House Energy and Commerce Health Subcommittee, Rep. Buddy Carter (R-GA-01), remains supportive but has deferred action on the measure so far. When the subcommittee unanimously advanced the measure in March 2024, Carter called it a “landmark” law and a “lifeline for health workers.” While acknowledging that Congress is currently focused on other priorities, he recently expressed confidence that the Breen Act will ultimately be renewed, saying, “It will be alright.”
Looking Ahead
The timing of reauthorizing the Breen Act is uncertain, but the urgency of addressing health care worker burnout remains. As Congress wrestles with competing priorities, this legislation serves as a reminder that providers’ mental well-being must not be overlooked.
It’s crunch time in the House of Representatives, as Republican leadership has just a few days to pass their reconciliation bill before their self-imposed Memorial Day recess. It’s been a wild May here so far here in DC – so let’s get into it. Welcome to the Week Ahead!
The Administration
The Food and Drug Administration (FDA) is expected to unveil a new framework for vaccine regulation, which is making vaccine advocates nervous. Potential changes include requiring all vaccines to be tested against placebos and ending the use of the Vaccine Adverse Events Reporting System, which vaccine skeptics have long criticized as inadequate for addressing vaccine injury claims. Vaccine advocates are also raising concerns that Dr. Vinay Prasad, whom they count as a vaccine skeptic, will oversee this framework as the newly appointed director of the FDA’s Center for Biologics Evaluation and Research.
The Centers for Medicare and Medicaid Innovation (CMMI) is also undergoing a makeover to align with the Make America Healthy Again (MAHA) agenda. In a blog post, CMMI Director Abe Sutton unveiled a three-pronged strategy to achieve this by promoting evidence-based prevention, empowering individual health choices, and driving choice and competition. While light on specifics, the announcement is a sign that the Trump administration still sees a place for CMMI despite longstanding Republican concerns about the Center’s value and return on investment.
HHS is also rescinding guidance documents, including a 2001 guidance on opioids and a Biden administration guidance on buprenorphine for opioid addiction. Given how quickly the second Trump administration has moved on its deregulatory agenda, we expect more regulatory changes could be in the offing.
The Senate
As Americans prepare for Memorial Day cookouts, RFK Jr. is preparing for a different kind of grilling. The HHS Secretary will return to Capitol Hill on May 20 to testify before the Senate Appropriations Labor-HHS subcommittee about his department’s FY 26 budget request. This follows appearances by Secretary Kennedy before the House Appropriations Labor-HHS Subcommittee and the Senate Health, Education, Labor and Pensions (HELP) Committee. Much like the heated exchanges at last week’s hearings, we expect sparks to fly at the upcoming Senate subcommittee hearing, especially since Chair Susan Collins (R-ME) has already expressed concerns about HHS’s actions related to National Institutes of Health research and the impact of workforce reductions on implementing Alzheimer’s funding legislation.
We could also see action on the Senate floor this week on two HHS nominations that advanced out of the Senate Finance Committee on May 15, James O’Neill to be Deputy Secretary and Gary Andres to be an Assistant Secretary. It’s important to remember, though, that Senate Democrats are not completely powerless to stall President Trump’s nominees, as Minority Leader Schumer’s (D-NY) recent hold on Department of Justice nominees shows.
Other Senate Health Hearings
- May 21, Senate Homeland Security Subcommittee on Investigations hearing on adverse events following COVID-19 vaccination
- May 21, Senate VA Committee legislative hearing (includes bills related to health care)
The House
Following marathon markups at Energy and Commerce and Ways and Means, and a Sunday night reconvening of the House Budget Committee, the House Rules Committee is scheduled to meet on May 21 at 1 am to make any agreed-upon changes, and advance the bill to the House floor with just enough time to get it passed out of the chamber before Memorial Day recess.
But that’s a lot easier said than done. For everything to go according to plan, the final bill must be acceptable to both conservative Republicans, who have been demanding further spending cuts, and moderate Republicans, who are wary of how the cuts will be perceived both politically and practically. And then, of course, you have the contingent of blue-state Republicans who must be satisfied that the bill provides a high enough state and local tax (SALT) deduction cap for their constituents.
From what we are hearing both on and off Capitol Hill, there will be a move for the Rules Committee to consider amendments that would expedite the implementation of Medicaid work requirements, address concerns of the SALT caucus Republicans, and speed up the phasing out of energy tax credits, among other things. However, some House Conservatives are reviving the possibility of changes to the federal matching rate for Medicaid, but that would threaten moderate Republican support for the bill. It remains to be seen if Republican leadership can strike the right balance and send the big, beautiful bill to the Senate (where Republican Senators have also signaled their interest in changing the bill to their liking).
Beyond all the markups, the House Oversight Committee is also scheduled to hold a subcommittee hearing on May 20 that will consider the impact of the Inflation Reduction Act’s prescription drug provisions.
There You Have It
As we approach Memorial Day, Chamber Hill Strategies pauses to thank the brave men and women of our armed forces who have made the ultimate sacrifice in defense of our freedoms. Make it a great week!
On May 14, Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. testified before the House Appropriations Labor-HHS Subcommittee and the Senate Committee on Health, Education, Labor, and Pensions (HELP) about the fiscal year 2026 (FY 26) HHS budget request. These are the first hearings for the FY 26 HHS budget request. Sec. Kennedy used these hearings to outline how the budget request aims to help HHS meet its goals of reducing the high rates of chronic disease and delivering services to Americans in the most efficient way possible. Republicans generally applauded the Secretary for focusing on trying to reduce the high rates of chronic disease and on making HHS more efficient. Democrats expressed concerns about the impact of reductions in force at HHS, the impounding or freezing of already appropriated congressional funds, and the proposed cuts and reorganization within HHS outlined in the FY 26 skinny budget request. Democrats also used the hearings to argue that Republicans plan to gut Medicaid through the reconciliation legislation currently being considered in the House of Representatives, a claim that Republicans denied.
WITNESS TESTIMONY
During his testimony in both hearings, Sec. Kennedy outlined several priorities in the FY 26 budget:
- Consolidating mental health programs to make them more efficient in addressing rising rates of mental health illnesses and substance use disorders.
- Address priorities related to nutrition, exercise, and physical activity (through $94B request, including for the Administration for a Healthy America (AHA)
- Expand food safety efforts at the Food and Drug Administration (FDA)
- Funding research that is innovative, while cutting research that he said is dangerous, and research based on diversity, equity, and inclusion.
- Promoting the use of new health technologies to manage data, including AI.
- Restoring trust in public health agencies.
OPENING STATEMENTS
- House Appropriations Labor-HHS Subcommittee Chair Robert Aderholt (R-AL)
- House Appropriations Labor-HHS Subcommittee Ranking Member Rosa DeLauro (D-CT)
- Senate HELP Chair Bill Cassidy (R-LA)
MEMBER QUESTIONS AND DISCUSSION
Allocation of Appropriated Funding and HHS Workforce Reductions
In the House hearing, Democratic representatives used much of their time to argue that the Trump administration has illegally frozen congressionally appropriated funding, including at HHS. Subcommittee Ranking Member DeLauro (D-CT) and other Democratic Representatives pressed Sec. Kennedy on this and asked if he views congressionally directed appropriations as suggestions or the law. In answer to these questions, Sec. Kennedy stated that HHS follows the law and added that if Congress appropriates funds to HHS, he will spend them. Democratic members were skeptical of Sec. Kennedy’s answers. In response to questions on this topic, Subcommittee Chair Aderholdt (R-AL) reminded members to focus on the FY 26 request.
In both the House and Senate hearings, Democratic representatives also asked for information regarding decisions to reduce the HHS workforce. In response to questions from Rep. Steny Hoyer (D-MD) and Sen. Tim Kaine (D-VA) about whether Sec. Kennedy or Elon Musk made these decisions, Sec. Kennedy said he and his staff had the final say and that Musk only provided guidance. When asked by Rep. Lois Frankel (DFL) if he had conversations with members of Congress about these decisions, Sec. Kennedy mentioned talking with Sen. Bill Cassidy (R-LA), but did not name any Representatives.
Chronic Disease
In the House hearing, Republican and Democratic representatives expressed support for addressing chronic health issues by improving nutrition and promoting physical activity. However, while Republicans mostly praised the Trump administration for what it has done so far in this area, Democratic representatives argued that the FY 26 budget request will make it harder to address chronic health issues. Representatives such as Rep. Madeline Dean (D-PA) and Rep. Watson Coleman (D-NJ) expressed concerns about proposed cuts at the Substance Abuse and Mental Health Administration and the Office of Minority Health. Sec. Kennedy expressed his view that these were not cuts, but rather about restructuring HHS to eliminate redundant programs. Democratic members rejected this answer.
In the Senate hearing, Sen. Jon Husted (R-OH) expressed satisfaction with the progress of the Make America Healthy Again (MAHA) movement and inquired about specific measures being taken. In response, Secretary Kennedy highlighted efforts to promote healthy foods through the Supplemental Nutrition Assistance Program (SNAP). Sen. Tim Scott (R-SC) expressed support for eliminating artificial dyes in food.
Medicaid
Democratic representatives and senators also took the opportunity to argue that the reconciliation legislation moving through the House of Representatives will cut Medicaid and lead to reductions in health care coverage and worse health outcomes. Rep. Josh Harder (D-CA) said that these cuts would hurt vulnerable Americans and slammed Medicaid work requirements as being overburdensome. Senate HELP Ranking Member Bernie Sanders (I-VT) said the reconciliation legislation was making these cuts to Medicaid to pay for tax cuts for the rich. Sec. Kennedy and Rep. Andy Harris (R-MD) argued that these cuts were focused on cutting waste, fraud, and abuse within the program and ensuring Medicaid does not provide coverage for illegal immigrants or non-disabled adults who are not working.
Vaccines
Many Democratic members in both the House and Senate hearings expressed concern about the ongoing measles outbreak in Texas. Sen. Patty Murphy (D-WA) questioned Sec. Kennedy about new standards for vaccine approvals and asked him to clarify remarks made in the House about vaccination, specifically whether he recommends the measles vaccine. Kennedy responded by stating that he would tell the truth, acknowledged concerns about vaccines, and claimed that people have been misled. When Sen. Roger Marshall (R-KS) asked where his vaccine recommendations come from, Kennedy said they are based on many different sources.
In response to Sen. Maggie Hassan (D-NH), he ultimately affirmed that the measles vaccine is the most effective way to prevent the spread of the disease.
OTHER TOPICS
- Reps. Andrew Clyde (R-GA) and Jake Ellzey (R-TX) expressed concerns about the whereabouts of unaccompanied immigrant children, arguing that HHS under the Biden administration failed to provide proper oversight. Sec. Kennedy said he was committed to finding these children. Rep. DeLauro (D-CT) countered that if Republicans are so concerned about this, they should start with the children who, she stated, were still missing after actions during President Trump’s term related to family separation.
- Rep. John Moolenaar (R-MI) and Sen. Jim Banks (R-IN) expressed concerns about overreliance on Chinese biotech and pharmaceutical supply chains. Sec. Kennedy agreed with these concerns.
- Rep. Chuck Fleischmann (R-TN) expressed his support for the 340B program and asked about plans to transfer the program’s oversight to the Centers for Medicare and Medicaid Services (CMS).
- Sen. Josh Hawley (R-AR) expressed opposition to pharmaceutical advertising and alluded to legislation on this topic that he is introducing.
- Reps. Aderholt (R-AL) and Julia Letlow (R-LA) expressed concerns about rural healthcare, with Rep. Aderholt (R-AL) focusing on the wage index for low-volume hospitals and Rep. Letlow (R-LA) highlighting the issue of rural health deserts. Sec. Kennedy expressed support for taking action to support rural health providers.
- Rep. Pocan (D-WI) asked Sec. Kennedy if he was committed to addressing overpayments to Medicare Advantage (MA) plans. Sec. Kennedy said he was but also expressed general support for the MA program.
- Senate HELP Committee Chair Bill Cassidy (R-LA) expressed concerns about closing the Office of Long COVID Research and reducing funding to address the prevalence of neurological diseases.
