WASHINGTON — Robert F. Kennedy Jr., President Donald Trump’s nominee to lead the Department of Health and Human Services, stumbled multiple times during his first Senate confirmation hearing Wednesday when lawmakers pressed him about potential changes to Medicaid.
The government-based health insurance program that covers nearly 80 million people with low incomes has drawn increased attention as Republicans in Congress look for ways to reduce federal spending, with Medicaid among the possible sweeping cuts.
If he is confirmed as health and human services secretary, Kennedy would oversee the implementation of Medicaid, in addition to Medicare and the Affordable Care Act.
At the end of the hearing, Sen. Ron Wyden, D-Ore., the ranking member of the Finance Committee, said Kennedy was “unprepared,” suggesting that he didn’t seem to know the difference between Medicare and Medicaid.
“My colleagues have been seeing back-and-forth between Medicare and Medicaid, and it’s not clear which program you’re using when,” Wyden said.
Sen. Bill Cassidy, R-La., repeatedly pressed Kennedy about proposed changes to the program and for his thoughts about Medicaid reform.
“Republicans, again, are looking at ways to potentially reform Medicaid to help pay for President Trump’s priorities,” Cassidy said. “What thoughts do you have regarding Medicaid reform?”
“Most people who are on Medicaid are not happy,” Kennedy responded. “The premiums are too high, the deductibles are too high, the networks are narrow.”
A 2023 poll from KFF, a nonprofit group that researches health policy issues, found that a majority of Americans have “very favorable” or “somewhat favorable” views of the program. He made similar comments about the Affordable Care Act.
People on Medicaid generally aren’t charged premiums or deductibles at all.
When Cassidy, a physician, asked for specifics about how he would improve Medicaid, Kennedy said there are “many options” with telemedicine and artificial intelligence, although he didn’t go into detail about them.
“Well, I don’t have a proposal for dismantling the program,” Kennedy said. “I think what we need to do is we need to experiment with pilot programs in each state. We need to keep our eye on the ultimate goal, which is value-based care, which is transparency, accountability, access.”
Kennedy also claimed that Medicaid isn’t producing “positive health outcomes” for people.
“We’re spending $900 billion, and our people are getting sicker every single year,” he said. Trump, he added, wants people to have high-quality health insurance.
A 2022 study published in The Lancet found that Medicaid expansion from the ACA led to a reduction in deaths from all causes. An earlier study found Medicaid expansion improved physical health for older adults.
Wyden remained skeptical of Kennedy's answers.
“You haven’t told me anything this morning that would suggest that you have a good argument that indicates you believe Medicaid is inefficient,” he said.
The hearing also gave insights into Kennedy’s thoughts about other health programs, such as Medicare.
He said, “I think more people would rather be on Medicare Advantage, because it offers very good services,” possibly signaling support for privatizing Medicare.
Medicare Advantage is coverage offered by private insurers, rather than traditional Medicare.
Dr. Mehmet Oz, the celebrity doctor whom Trump has nominated to run the Centers for Medicare & Medicaid Services, has argued for privatizing the program.
