Robert F. Kennedy Jr., Secretary of the Department of Health and Human Services (HHS), appeared before seven congressional committees in a marathon of hearings on the administration’s requested Fiscal Year 2027 (FY27) budget. NACCHO completed a comprehensive analysis of the administration’s FY27 budget request for local health departments which can be found here. This analysis covers key exchanges from each hearing, with a focus on topics relevant to local health departments.
Each year the administration puts forward a budget request to Congress. While the request is not binding, it is an important marker of funding priorities and new policy proposals from the administration. After it is released, members of the administration’s Cabinet testify before the relevant Congressional committees of jurisdiction to field questions about the proposal. Congress is ultimately responsible for drafting the budget and appropriating funds to federal agencies, and they do not always align with the administration’s priorities.
Across the hearings, members on both sides of the aisle and in both chambers acknowledged that HHS operations are not business as usual. Notably, there continues to be broad concern by members of Congress about the ongoing measles outbreaks across the county and support for ensuring that local public health can access federal support in their response efforts. There is bipartisan interest in additional support for rural health programs and chronic disease prevention remains a key priority for the administration with support from Congress.
Both the House and Senate appropriations committees have yet to release their own FY27 proposals for federal health agencies. If the final FY26 funding bill is any indication, we can expect that Congress will likely reject many of the proposed funding cuts and consolidations. NACCHO Government Affairs will continue to monitor developments and advocate for robust federal investment in the programs and infrastructure that local health departments rely on to protect the health of their communities.
Read below for specifics on each hearing.
House Ways and Means Committee — April 16, 2026
Chair Jason Smith (R-MO) opened the House Ways and Means committee hearing by noting that more than six in ten Americans have at least one chronic disease, and he applauded the Make America Healthy Again (MAHA) initiative. Ranking Member Richard Neal (D-MA) delivered an opening statement citing what he described as a measles outbreak of historic proportions and he raised concerns about proposed cuts to the National Institutes of Health (NIH) and other health programs.
Throughout the hearing, members raised their concerns regarding recent measles outbreaks, asking Secretary Kennedy to go on record to confirm that the MMR vaccine is effective. Secretary Kennedy responded that the MMR vaccine is, “safe for most people.” Representative Madeline Dean (D-PA) said she was “deeply troubled” that vaccination rates are declining, noting that MMR coverage has dropped to 92.5%, below the 95% threshold needed to prevent outbreaks.
Representative Judy Chu (D-CA) criticized the move to eliminate a long-standing recommendation for all newborns to receive a hepatitis B vaccine at birth. CDC’s Advisory Committee on Immunization Practices (ACIP) voted in December 2025 to recommend that the hepatitis B vaccine be optional for infants born to mothers who test negative for the virus, moving from a universal recommendation that had been in place since 1991. CDC adopted the recommendation on December 16, 2025, though it was subsequently put on hold by a federal judge. Secretary Kennedy acknowledged that hepatitis B is a “terrible disease” but said parents should be allowed to question its risk profile. According to Centers for Disease Control and Prevention (CDC) and Johns Hopkins, the hepatitis B vaccine has an extensive safety record, and when given within 24 hours of birth is up to 90% effective in preventing perinatal infection. Since CDC first recommended the birth dose in 1991, hepatitis B infections in children and teens have decreased by 99%. Notably, parents have always been able to discuss the risks and benefits of any vaccine with their child’s pediatrician.
The President’s Budget Request would make cuts to several programs impacting maternal and child health across CDC and HRSA. Representative Danny Davis (D-IL) raised that black women are three times as likely to die from pregnancy-related causes than white women and questioned how the administration could address those disparities while cutting maternal and child health programs. Secretary Kennedy cited the administration’s perinatal pilot program, which he said has reduced maternal mortality by 42% across 220 participating hospitals. He was referring to a report indicating a 41.5% decline in delivery-visit mortality among hospitals participating in HHS’ Perinatal Improvement Collaborative compared to a 5.9% decline in a benchmark group of similar hospitals within the same period of time. The report concludes that participating hospitals may have had more opportunities for improvement, better support from leadership, or greater organizational readiness for adjustments. Notably, the latest maternal mortality data released by CDC shows a slight decline in deaths in 2024 from causes related to pregnancy or childbirth in the United States. While any reduction in maternal deaths is encouraging, this decrease to 17.9 deaths per 100,000 live births from 18.6 in 2023 is not statistically significant and the findings demonstrate racial disparities in outcomes persist.
Representative Don Beyer (D-VA) raised concerns about the proposed reorganization of Substance Abuse and Mental Health Services Administration (SAMHSA) and requested a bipartisan briefing for members of the House Mental Health Caucus. Secretary Kennedy expressed strong support for SAMHSA, calling mental health and addiction personal priorities, and acknowledged that the termination notices sent to SAMHSA grantees earlier this year were mistaken. In January 2026, SAMHSA sent termination letters to approximately 2,500 to 2,900 grantees, amounting to roughly $2 billion in funding, stating that the grants no longer “effectuated agency priorities.” In addition to the response from impacted grantees, including local health departments and NACCHO, a bipartisan group of approximately 100 House members sent a letter to Secretary Kennedy urging him to reverse the terminations, and within roughly 24 hours the grants were reinstated.
Representative Julia Letlow (R-LA) used some of her questioning time to express support for the appointment of Casey Means as Surgeon General, whose nomination has largely stalled in the Senate.
House Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies — April 16, 2026
Subcommittee Chair Robert Aderholt (R-AL) praised Secretary Kennedy’s MAHA initiative during the House Appropriations Labor, HHS, Education, and Related Agencies Subcommittee hearing, and called for greater focus on chronic disease prevention. He acknowledged that he and Secretary Kennedy may not agree on all budget priorities, particularly NIH funding. Ranking Member Rosa DeLauro (D-CT) opened by commending Secretary Kennedy’s efforts to classify microplastics as water contaminants. She later described the proposed cuts to health agencies funded by the Labor-HHS subcommittee as “extreme,” and stated the administration had “incapacitated” critical health agencies including SAMHSA. The administration’s proposed budget would cut multiple programs and then consolidate SAMHSA, along with HRSA (after programmatic cuts) and some CDC programs into a new entity called the Administration for a Healthy America (AHA). Some of the programs that the administration proposes moving from CDC to AHA would then be significantly reduced in funding or be eliminated.
Representative Julia Letlow (R-LA) asked Secretary Kennedy what specific actions the department would take to build out the proposed Maternal and Child Health Bureau within AHA. Secretary Kennedy acknowledged that the United States has the worst maternal health record of any developed nation, and that black women die of pregnancy-related causes at a higher rate than white women. Secretary Kennedy again cited the administration’s perinatal pilot program, which he said has reduced maternal mortality by 42% across 220 participating hospitals. Secretary Kennedy called for expanding the program to every hospital in the country during the hearing.
Representative Steny Hoyer (D-MD) inquired about the tens of thousands of HHS staff fired during the DOGE cuts last year. Secretary Kennedy said the department cut 20,000 employees, bringing the total to 62,000, but has since rehired and is now at 72,000 workers, with plans to bring on an additional 12,000. Hoyer pushed back on this process, saying the cuts were “not based on function” but “based on numbers.”
In her closing remarks, Ranking Member DeLauro noted that despite passing a final FY26 funding bill more than ten weeks ago, the Office of Management and Budget (OMB) has prevented HHS from dispersing funds to states and localities by requiring additional documentation for agency apportionment, delaying the process of transferring federal funds from the Treasury to the health agencies. This is an issue NACCHO is working on.
House Education and Workforce Committee — April 17, 2026
Chair Tim Walberg (R-MI) began the House Education and Workforce Committee hearing by praising HHS’s updated Dietary Guidelines and the department’s proposed budget restructuring. Ranking Member Bobby Scott (D-VA) delivered an opening statement raising concerns about proposed cuts to public health agencies including CDC and NIH.
Representative Alma Adams (D-NC) questioned proposed cuts to WIC’s Cash Value Benefit for fresh fruits and vegetables, arguing that the cuts contradict the administration’s stated focus on nutrition and healthy eating. Secretary Kennedy said he would urge the President to reconsider this proposed cut.
House Energy and Commerce Health Subcommittee — April 21, 2026
Subcommittee Chair Diana Harshbarger (R-TN) began the House Energy and Commerce Health Subcommittee hearing by expressing support for efforts to strengthen primary care, expand behavioral health services, and invest in maternal and child health. Ranking Member Diana DeGette (D-CO) delivered an opening statement expressing concern about the state of public health under the current administration, citing rising measles cases, canceled research grants, and what she described as the politicization of the Food and Drug Administration (FDA). DeGette pressed Secretary Kennedy on the proposed elimination of the Title X family planning program and CDC’s Safe Motherhood program, which was reauthorized as part of the bipartisan Preventing Maternal Deaths Reauthorization Act signed into law earlier this year.
Representative Kim Schrier (D-WA), a pediatrician, raised concerns about changes to the hepatitis B vaccine birth dose. Representative Schrier stated that the test used to screen mothers for hepatitis B has a false negative rate of 1 to 2%. She also raised concerns that Secretary Kennedy’s messaging on vaccines is causing parents to refuse other routine newborn care, including vitamin K shots, and asked Secretary Kennedy to directly recommend the vitamin K shot for newborns. Secretary Kennedy declined to do so directly, saying he would defer to the FDA.
Representative Marc Veasey (D-TX) discussed the deaths of two Texas children from measles and entered into the record a polling memo showing that 70% of voters oppose removing recommendations for childhood vaccines, including measles.
Representative Troy Carter (D-LA) entered into the record the termination letter sent to SAMHSA grantees in January (referring to the roughly $2 billion in grant terminations described earlier) and asked Secretary Kennedy about how such a mistake could happen in an agency of HHS’s size. He also asked whether mechanisms had been put in place to ensure it would not happen again. Secretary Kennedy acknowledged the mistake and said he reversed it within 24 hours but did not guarantee that something like this would not happen again.
Representative Mariannette Miller-Meeks (R-IA) noted that Iowa was the first state to disburse funds related to the Rural Health Transformation Program, the $50 billion, five-year investment in rural healthcare enacted as part of H.R. 1, aimed at strengthening rural hospitals and expanding access to care.
Representative John James (R-MI) raised gaps in Lyme disease testing, noting that standard drug panels sometimes fail to detect the disease. According to CDC, standard antibody tests may appear falsely negative in the early weeks of infection. Secretary Kennedy expressed strong support for Lyme disease research and diagnosis, saying the administration has held roundtables with leading experts, is investing in research, and is working to connect patients with physicians experienced in treating the disease.
Senate Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies — April 21, 2026
Senator Shelley Moore Capito (R-WV), Chair of the Senate Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies, opened by noting strong bipartisan support for NIH investment, expressing concern about substance abuse challenges in her state, and thanking Secretary Kennedy for his swift action to reverse the SAMHSA grant cancellations (described earlier in this summary). Ranking Member Tammy Baldwin (D-WI) delivered an opening statement raising concerns about proposed cuts to NIH, CDC, SAMHSA, and the Title X program, and arguing that the administration is undermining important HHS programs outside of the appropriations process. During her questioning, she pressed Secretary Kennedy on who approved the SAMHSA grant terminations. Secretary Kennedy acknowledged that he did not approve them, described them as an “over correction,” and said he reversed them within 24 hours of finding out.
Senator Susan Collins (R-ME) raised concerns about a 31% decline in NIH grants mentioning the word “women,” arguing that the administration’s emphasis on canceling diversity-related grants has resulted in less research aimed at women’s health. She noted that disparities in women’s health exist across a range of conditions, including higher maternal mortality rates in black women, and asked Secretary Kennedy how the administration will address these disparities without diversity as a criterion in funding decisions. Secretary Kennedy said the administration is focused on maternal health, once again citing the perinatal pilot program’s 42% reduction in maternal mortality in the 220 participating hospitals but did not address the proposed cuts to other maternal and child health programs.
Senator John Boozman (R-AR) raised the issue of maternity care deserts, noting that over 50% of Arkansas counties lack access to birthing facilities or obstetric providers. He asked how HHS will support state-led maternal mortality review committees (MMRCs) to ensure care is informed by local data and improves outcomes for mothers and infants. Secretary Kennedy said he would work with Boozman’s office on the issue, noting that HHS has proposed $767 million for the Title V Maternal and Child Health Block Grant in the FY27 budget request. Notably, MMRCs are primarily funded through the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) program at CDC, which is proposed for elimination in the President’s Budget Request.
Senator Dick Durbin (D-IL) raised the proposed elimination of the CDC Office on Smoking and Health. He discussed FDA’s approval of Juul e-cigarettes and the administration’s plans to allow the sale of kid-friendly flavors, arguing these decisions contradict the administration’s stated goal of improving children’s health. Secretary Kennedy acknowledged concerns about youth-targeted flavors and said FDA must make a determination based on whether vaping reduces combustible tobacco use overall.
Senator Jerry Moran (R-KS) discussed the Rural Health Transformation Program with Secretary Kennedy, noting that Kansas has received approval to proceed with its program and is using funds to expand primary and secondary prevention programs, build a sustainable workforce, enable value-based care, and harness data and technology.
Senate Finance Committee — April 22, 2026
Secretary Kennedy testified before the Senate Finance Committee on April 22. Chair Mike Crapo (R-ID) opened by praising the Rural Health Transformation Program and the administration’s focus on nutrition and chronic disease prevention. In his opening statement, Ranking Member Ron Wyden (D-OR) raised concerns about vaccine policy and cuts to Medicaid. Ranking Member Wyden questioned Secretary Kennedy on the administration’s decision to end the universal hepatitis B vaccine recommendation for newborns and the ongoing measles outbreak. Secretary Kennedy defended his record, arguing the US has handled the measles outbreak better than comparable countries on a per capita basis, citing higher case rates in Mexico and Canada relative to their populations. According to 2025 data from Pan American Health Organization (PAHO), the US recorded 2,242 measles cases and 3 deaths; Mexico recorded 6,428 cases and 24 deaths; and Canada recorded 5,436 cases and 2 deaths. Notably, the US and Mexico are both at risk of losing their measles elimination status. PAHO scheduled a review of US and Mexico data, and Canada already lost its elimination status in November 2025. The PAHO review of the US’s measles elimination status, originally scheduled for April 13, has been delayed. Secretary Kennedy said he promotes the MMR vaccine and that it is effective in 97% of people who receive it. According to CDC, two doses of the MMR vaccine are 97% effective and one dose is 93% effective.
Senator Michael Bennet (D-CO) stated that last year was the worst on record for pediatric flu deaths, noting that 89% of children who died from flu were not fully vaccinated. He asked whether Secretary Kennedy regretted removing HHS flu vaccine communications early in his tenure. Secretary Kennedy said he approves of vaccines but argued that “last year the flu vaccine had something like a 20% efficacy.” According to CDC interim estimates, flu vaccine effectiveness for the 2024-2025 season was estimated at 36-54%. Effectiveness varies across seasons depending on how well the vaccine matches circulating strains. Secretary Kennedy stated a goal of developing a more effective universal flu vaccine, which is consistent with longstanding public health priorities. In the same exchange, Senator Bennet also pressed Secretary Kennedy directly on whether he agrees the measles vaccine is vital to keeping American children healthy. Secretary Kennedy said yes, that is his position, and that HHS promotes the measles vaccine.
Senator Tim Scott (R-SC) commended CDC’s response to South Carolina’s measles outbreak, which he described as the largest in US history since measles was declared eliminated more than two decades ago. Senator Scott also mentioned that he introduced the PREDICT Act, which would strengthen and expand wastewater surveillance to detect pathogens like measles and flu before hospital admissions begin to rise. Secretary Kennedy committed to working with Scott on the bill.
Senator Steve Daines (R-MT) noted that Montana is receiving a $233 million investment through the Rural Health Transformation Program which was also commended by Senator Roger Marshall (R-KS), calling it a historic investment in rural healthcare.
Senator John Barrasso (R-WY) asked about disruptions to the US Preventive Services Task Force (USPSTF), noting that multiple meetings had been canceled, and citing concerns raised by the American Academy of Family Physicians about the risk of undermining the task force’s independence and evidence-based methodology. Secretary Kennedy said several task force members are rotating out and that he is posting applications for new members this week across a broad range of specialties. He also pushed back on concerns about the task force’s independence, saying: “we are not going to undermine any of those functions. We just want to get the best people and have a more representative group of specialties.”
Senator Tina Smith (D-MN) sought answers from Secretary Kennedy on a series of proposed cuts to preventive care programs, noting that the administration’s budget eliminates CDC’s Office on Smoking and Health and proposes cuts to programs that fund cancer screenings. She also raised the proposed elimination of Title X, which she noted saves three to seven dollars in Medicaid costs for every dollar invested.
Senator Raphael Warnock (D-GA) opened his questioning by praising the work of CDC staff in Atlanta, saying that they protect Americans every day from threats that never make headlines and rarely receive public recognition. He then raised the gutting of CDC’s rabies division, noting that only one person remains on staff and that there is a 24/7 emergency line for providers dealing with complex rabies cases. Secretary Kennedy responded that there are “one to three rabies cases a year in the United States” and that “one person manning that office full time probably can handle that.” CDC indicates that while human rabies deaths are rare, approximately 100,000 Americans require post-exposure prophylaxis each year and nearly 100,000 animals are tested annually. According to the US Department of Agriculture Animal and Plant Health Inspection Service (USDA APHIS) and a 2025 peer-reviewed study, the rabies prevention and surveillance infrastructure that keeps human cases so low costs more than $500 million per year and saves an estimated $1 billion in healthcare costs annually.
Senator Todd Young (R-IN) raised the issue of long COVID, citing a global economic cost of at least $1 trillion per year, and asked for an update on HHS efforts to advance treatment. Secretary Kennedy described work on identifying biomarkers for the various presentations of the disease and said HHS is developing a website to connect patients with specialists who have had the most success in treating their particular form of the illness.
Senate Health, Education, Labor and Pensions (HELP) Committee — April 22, 2026
Senator Bill Cassidy (R-LA), Chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, opened the hearing by discussing concerns about vaccine-preventable disease outbreaks and the need to restore public trust in vaccines. Ranking Member Bernie Sanders (I-VT) delivered an opening statement raising the issues of falling vaccination rates, the measles outbreak, and what he described as misinformation about vaccine safety coming from HHS.
Chair Cassidy, a physician who said he has seen people die from vaccine-preventable diseases, pressed Secretary Kennedy on whether the new CDC director will have the independence to make decisions free from political appointees who have worked to undermine trust in vaccines. Secretary Kennedy said the CDC director has that power. Chair Cassidy also raised the upcoming World Cup and America250 celebrations this summer as potential drivers of measles spread, noting that US vaccination rates have fallen below the 95% threshold needed to prevent outbreaks and that tourists from countries with active measles outbreaks will be traveling to the US. Secretary Kennedy argued that the US has handled the outbreak better than other countries on a per capita basis, reiterating a statement he made in previous hearings. As mentioned previously, the broad claim that the US has handled the outbreak better than any country in the world is not supported by data. The US is at risk of losing its measles elimination status.
Ranking Member Sanders quoted a passage from Secretary Kennedy’s book in which Secretary Kennedy wrote that the claim that vaccines account for dramatic declines in infectious disease mortality is “simply untrue.” Secretary Kennedy clarified that he was referring specifically to overall mortality declines in the early 20th century, not to vaccine-preventable diseases specifically. He cited the Guyer et al. study, a paper co-authored by researchers at Johns Hopkins and CDC, as the basis for his claim. Senator Sanders also cited a 2024 Lancet study led by WHO finding that global immunization efforts saved an estimated 154 million lives over the past 50 years, with measles vaccination alone accounting for approximately 94 million of those lives saved. Later in the hearing, Chair Cassidy looked up the Guyer et al. study and read back its full context, which states that “the reductions in vaccine-preventable diseases, however, are impressive” and that vaccines have virtually eliminated measles deaths, with cases dropping from roughly 500,000 annually before the measles vaccine was introduced in the 1960s to near zero afterward.
Senator Roger Marshall (R-KS) recognized the Rural Health Transformation Program, calling it a historic investment in rural healthcare. Secretary Kennedy cited it as the centerpiece of the administration’s rural health efforts.