Robert F. Kennedy Jr.’s views on vaccines were the central issue in his confirmation hearings Wednesday, and rightly so. As secretary of Health and Human Services, Kennedy would have myriad ways to undermine the availability of vaccines and public perception of their safety.
But traditionally one of the the most important jobs of an HHS secretary is oversight of government health insurance programs, especially Medicare and Medicaid. Together, those two programs pay medical bills for about one-third of the U.S. population and, alongside Social Security, they represent some of the largest claims on the federal budget.
Kennedy was asked questions about these programs too. His answers were halting, vague and in some instances flat-out incorrect.
That could mean he was nervous and misspeaking. It could also mean he does not understand the vital programs over which he would preside.
Ironically, some of the errors came in an answer to a senator who seemed inclined to go easy on Kennedy. It was Louisiana Republican Bill Cassidy, a physician who has already made clear he thinks Kennedy is “wrong” on vaccines.
Instead of pressing that case, Cassidy asked about Medicare (which is for seniors and people with disabilities) and Medicaid (which is for people with low incomes). And he zeroed in on so-called dual eligibles, meaning people who use both programs ― Medicare as their primary source of insurance and Medicaid to cover the out-of-pocket costs and other gaps in coverage.
The disposition of dual eligibles is a big, ongoing issue for policymakers because they represent both some of the most vulnerable Americans and some of the most expensive to cover. And although it’s a complex subject, anybody thinking of taking a high position at HHS ― let alone auditioning to be secretary ― would be expected to understand and discuss the issue with ease.
But the question and Cassidy’s follow-ups seemed to throw off Kennedy, who was soon making a series of incorrect statements about Medicaid.
“Medicaid is a, um, has, is fully paid for by the federal government,” Kennedy said.
In reality, more than 30% of the funding comes from states.
“The premiums are too high,” he said, coming back to that point later in the exchange when he asked rhetorically, “Are the premiums low enough?”
Actually, Medicaid doesn’t have premiums, except in special circumstances and under state waivers.
A few minutes later, Kennedy faced more adversarial questioning from one of the panel’s Democrats, Catherine Cortez Masto of Nevada. This time the subject was Medicare and its power to negotiate the price of some prescription drugs.
That power didn’t exist until last year, when the relevant portions of the 2022 Inflation Reduction Act took effect. No Republicans voted for that law, which is a Joe Biden-era Democratic legacy. And some Republicans have said they want to repeal it, though Trump has been silent on the matter.
Cortez Masto wanted to know whether Kennedy, who has said he supports efforts to lower drug prices, would fight to protect the initiative. “Why are you there,” she said, “to be a rubber stamp?”
Kennedy responded by saying, “The White House issued an executive order, I believe, today, supporting the drug negotiations under the IRA.”
No such executive order exists on the White House website.
And while it’s possible Kennedy knows about a forthcoming order, it’s more likely he was referring to a new HHS statementaffirming that the agency intends to continue implementing the IRA — which, of course, it must do by law — and was seeking input on how to improve it.
That statement didn’t address Cortez Masto’s concern, about whether the administration supports or opposes efforts to repeal the law.