‘The primary care physician is underpaid and undervalued’ — Reps, RFK Jr. debate best use of money for HHS

Health and Human Services Secretary Robert F. Kennedy Jr. testifies before the House Energy & Commerce Committee Health Subcommittee about his department's 2026 budget request on June 24, 2025. This image was taken from the subcommittee webcast of its meeting.

Members of the U.S. House of Representatives praised and denounced the U.S. Department of Health and Human Services’ (HHS) plans to Make America Healthy Again.

On June 24, HHS Secretary Robert F. Kennedy, Jr., testified on the department’s 2026 budget request before the Health Subcommittee of the House Committee on Energy & Commerce. Kennedy spent several hours answering questions from representatives, including physicians in Congress and members who asked about issues across health care. They touched on primary care, medical technology, pharmaceutical development and more.

Kennedy proffered a seven-page statement for written testimony and used his opening statement to touch on numerous priorities: the opioid crisis; nutrition, physical activity and lifestyle; changing the priorities for federally funded research; strengthening cybersecurity; and restoring public trust in the nation’s health department.

Primary care will have a role in investigating potential root causes of the chronic disease epidemic as ordered by President Donald J. Trump to create the Make America Healthy Again Commission.

As part of the new Administration for a Health America, “programs related to primary care will be streamlined, and focused on needs of all Americans no matter where they may live and at what income level,” Kennedy said.

“The budget and the transformation at HHS support these efforts and ensures that primary care includes prevention and addresses the root causes of chronic disease,” he said in the written testimony.

Physician reimbursement changes?

Rep. John Joyce, MD (R-Pennsylvania) and Kennedy had a dialogue specifically about physician reimbursement, recent history under the administration of President Joe Biden, and what might come during the tenure of President Donald J. Trump.

“Under the Biden administration, we saw a consistent decline in the reimbursements paid to physicians under Medicare Part B. These cuts have led to more practice consolidation and increased hospital and insurer ownership of doctors,” Joyce said.
“In turn, this is negatively impacted access to care for our nation's senior citizens and driven up out-of-pocket costs,” he said. “How do you view these concerns, and will you commit to working with me and other physicians in Congress on how we can fix this erosion of reimbursement and strengthen the private practice overall?”

“That’s only one of the perverse incentives in our system that are contributing to the crisis in primary care,” Kennedy said. “And one of the specific charges that President Trump has given me is to increase primary care access. And one of the ways that we need to do that is to make sure that primary care physicians are getting livable wages. And I look forward to working with you on that.”
“In America right now, the primary care physician is underpaid and undervalued,” Joyce said. “Your commitment to making sure that these doctors who are the front line caring for patients day in and day out are adequately compensated is important not just to American medicine, but ultimately important to the American patient. I thank you for that commitment.”

Tense testimony

Subcommittee Chair Rep. Buddy Carter (R-Georgia), a pharmacist, told his colleagues in the committee prides itself on decorum and everyone should be respectful of each other. Even so, the hearing at times was grew testy, with Kennedy verbally retracting comments he made about Energy & Commerce Committee Ranking Member Frank Pallone (D-New Jersey).

In his opening statement, Pallone said as he was growing up, Kennedy’s uncle, President John F. Kennedy, was a hero. He knew other members of the Kennedy family, and acknowledged admiring Robert F. Kennedy, Jr.’s environmental activism. That’s why the younger Kennedy’s leadership was “just very upsetting at this point to me,” Pallone said.

“I express deep concerns with your nomination, Secretary Kennedy, and somehow unfortunately, you've exceeded my expectations in the worst possible ways,” Pallone said. “You're actively undermining vaccines, the greatest public health achievement of modern history.”

Earlier this month, Kennedy unilaterally fired all 17 members of the U.S. Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP), the medical experts, who make recommendations on vaccines, and replaced them with vaccine skeptics, Pallone said. Kennedy’s pseudoscience agenda will put the lives of Americans, especially children, at risk, Pallone said.

Kennedy countered that the former members of ACIP were rife and pervasive with conflicts of interest with the pharmaceutical industry. He said Pallone, once sensitive to people hurt by vaccines and a leading member of Congress on the issue, changed his thinking based on contributions from pharmaceutical companies.

Democratic members claimed Kennedy was out of line disparaging Pallone. Carter agreed it was a valid point of order and Kennedy retracted the statement.

On the hot seat

In several hours of questioning, some of the doctors in Congress inquired about HHS programs, with Republicans generally supporting the efforts and Democrats criticizing Kennedy’s actions.

Health Subcommittee Vice Chair Rep. Neal Dunn, MD (R-Florida), asked about the national stockpile of medical supplies, budgeted for $750 million. Kennedy said he was grateful for the congressional support and the stockpile has billions of dollars worth of equipment necessary to respond to a pandemic. But it could be better, he said, because the stockpile did not distinguish itself during the COVID-19 pandemic.

In additional questioning by Dunn, Kennedy agreed on the importance of further research on mitochondrial health issues in children and adults.

‘It’s wrong’

Rep. Raul Ruiz, MD (D-California) holds up his failing grade copy of the Make America Healthy Again Report during the the House Energy & Commerce Committee Health Subcommittee hearing about the Department of Health and Human Services' 2026 budget request on June 24, 2025. This image was taken from the subcommittee webcast of its meeting.

Rep. Raul Ruiz, MD (D-California), ripped the Make America Healthy Again Report, published in May and outlining a plan to shift away from ultraprocessed foods, environmental chemicals and overmedicalizing of children. Since its publication, some citations in the report were found to be made up, and some researchers have argued with the report’s use of their findings.

Armed with a printed copy with a letter grade of “F,” Ruiz argued the misinterpretations, falsehoods, denials and non-existent references would have been failed in undergraduate pre-medical education at University of California Los Angeles, his alma mater.

Kennedy acknowledged he did not fact-check the report, but insisted all the foundational assertions in the report were accurage.

“How could they be accurate if they did not exist, sir?” Ruiz said, as Kennedy attempted to speak.

“That's lying and dishonest, sir,” Ruiz said. “My concern here is that you and this administration are undertaking vast changes to our federal public health system and using purported facts and gold-standard evidence that you claim to have as justifications for your decisions, actions, and frankly, your decimation of our nation's public health infrastructure. Yet, what you are relying upon isn't real. It isn't data driven, and it isn't based in fact, science or reality. Sir, it's wrong.”

Drug development

Joyce praised Kennedy for his commitment about unlocking American science to lead to new drug breakthroughs. The Orphan Drug Act, first passed in 1983 to spur research on rare diseases, was stymied by a reduction in incentives as part of the Inflation Reduction Act approved under the administration of President Joe Biden, Joyce said. Kennedy agreed and noted those incentives will return under the One Big Beautiful Bill Act currently pending in the Senate. Joyce also asked about price-setting for drugs, and Kennedy agreed on that as well.

Vaccine conflict

Rep. Kim Schrier, MD (D-Washington), a pediatrician, grilled Kennedy about his experience treating children diagnosed with measles, viral meningitis, and pertussis, also known as whooping cough. Kennedy acknowledged he had not worked with those patients, and Schrier described the treatments and health effects of those illnesses, including using a spinal tap to detect viral meningitis in infants.

All those diseases are preventable with vaccines, Schrier said.

“Of course, here's the thing: Vaccines only work if you actually give them, and we know your record on this,” Schrier said. “We rely on the Advisory Committee on Immunization Practices, a panel of experts to recommend, which vaccines people should get, which ages and the like.”

Schrier brought up Kennedy’s Senate confirmation hearings, when he assured Sen. Bill Cassidy, MD (R-Louisiana), then a key voter in Kennedy’s favor, that Kennedy would maintain the ACIP without changes. Answering Schrier, Kennedy said he never made that statement, but he was complying with any agreement he made with Cassidy.

Schrier said Kennedy was on the record about lying to Cassidy, the American people, and parents about vaccines for 20 years. “And I also want to be clear that I will lay all responsibility for every death from a vaccine preventable illness at your feet,” she said.