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Nominee emphasizes chronic disease, nutrition and program reforms as senators press Medicaid and Medicare implications
Summary
Robert F. Kennedy Jr. told the Senate Finance Committee he would prioritize reversing the nation’s chronic disease epidemic through nutrition, prevention and value‑based care; senators pressed him on Medicaid and Medicare impacts, rural hospital closures, dual‑eligible integration and whether he supports cutting programs.
Robert F. Kennedy Jr., President Trump's nominee for Health and Human Services, told the Senate Finance Committee on Thursday that fighting chronic disease and improving nutrition are central priorities if he is confirmed.
“Chronic disease is the obvious answer,” Kennedy said in his opening testimony, linking rising rates of obesity, diabetes and other conditions to changing food supplies and chemical exposures. He said “the CDC says 90% of health care spending goes toward managing chronic disease” and pledged to use HHS tools to shift toward prevention and value‑based care.
Why it matters: Medicaid and Medicare together account for a large share of federal health spending. Committee members repeatedly pressed Kennedy on what his priorities would mean for beneficiaries, how he would protect existing services, and whether the administration plans cuts or broader reforms.
Key exchanges on Medicaid, Medicare and rural care
- Dual eligibles and program integration: Sen. Bill Cassidy asked how Kennedy would address people eligible for both Medicare and Medicaid. Kennedy said he favors greater consolidation and “integrated care” but acknowledged he did not have detailed implementation plans and would “explore options” with senators.
- Potential changes and cuts: Multiple senators pressed Kennedy on whether he would support reducing Medicaid funding. Kennedy said President Trump had not instructed him to cut Medicaid and that his goal was to “make it work better,” emphasizing transparency, accountability and pilot programs to test value‑based approaches.
- Rural hospitals and maternal care: Senators including John Cornyn, John Barrasso and Marsha Blackburn raised rural hospital closures, workforce shortages and nursing‑home staffing rules. Kennedy said he would prioritize rural healthcare, telemedicine, GME (graduate medical education) reforms and pilot programs to prevent closures.
- Nutrition and schools: Kennedy told the panel that federal programs such as SNAP and school lunches could be used to change access to processed foods, saying “we shouldn't be spending 10% of the SNAP program on sugar drinks.” He described incentives and research as tools to improve diets while saying he would not ban particular foods.
Quotes
- Robert F. Kennedy Jr., nominee: “Chronic disease is the obvious answer … 90% of health care spending goes toward managing chronic disease.”
- Sen. Bill Cassidy: “What reforms do you recommend … that would improve services … and make it more cost efficient?”
What Kennedy proposed
Kennedy repeatedly advocated for value‑based care, expanded telehealth and greater emphasis on prevention through nutrition. He endorsed pilot experiments at the state level, increased transparency of federal agencies, and greater investment in primary care models such as direct primary care and cooperatives.
Ending
Committee members from both parties signaled agreement that long‑term health outcomes must improve but pressed the nominee for specifics about protecting beneficiaries during any transition. Kennedy pledged to work with congress to develop piloted reforms and to prioritize rural hospitals and programs for veterans, the elderly and low‑income patients.
