Having a hearing on the nomination of mister James O'Neil to serve as the deputy secretary of health and human services. Ranking Member, actually, Senator Alsobrook, who was, substituting for Ranking Member Sanders. She and I will both have opening statements. Then former Wisconsin Governor and HHS Secretary Tommy Thompson will introduce our witness, although I think we're gonna have senator Baldwin introduce, governor Thompson. Do I know that? I thought you told me you were. Then mister O'Neil will have five minutes for his opening statements. Senators will then each have five minutes for questions. Thank you, mister O'Neil, for being here and for your willingness to serve.
The nation faces enormous health threats, including rising health care costs, a mental health and substance use disorder crisis, a breakdown in public trust in health care institutions, two high levels of chronic disease, and a preventable measles outbreak, which has taken three lives and hospitalized many others. I will note that from February to 2024, the United States saw a total of three measles death. Now we've had three measles deaths in just four months of this current outbreak. We should be incredibly troubled.
The American people want solutions to make their lives easier. They want results and not excuses. President Trump, working with Secretary of Health and Human Services Kennedy, has laid out a bold vision to make health care more affordable and to make America healthy again. To do this, he needs officials with the expertise and vision to carry out his agenda while also increasing transparency, restoring trust, and ensuring that science, not politics, drives decision making. This is why this nomination is so important. If confirmed as deputy HHS secretary,
mister O'Neil will be responsible for implementing the president's agenda at HHS under secretary Kennedy's leadership. He will help steer a ship going through massive changes. The deputy secretary needs to be someone whom Americans can trust to make science based decisions, to strengthen HHS, and to make America healthier. I look forward to hearing your plans and vision to accomplish this. Thank you for coming before this committee and being willing to serve. I look forward to discussing how we can fulfill the vision of making America healthy again. Senator also Brooks is not here.
So, walking in right now. I'm looking out there, and I don't see anyone walking in right now. So, would you like to introduce, the honorable I'd be honored. Please. So we have, here today to introduce, our witness, governor Tommy g Thompson, the longest serving Wisconsin governor, and one who prioritized the issues that this committee focuses on, health, education, labor, and pensions. Not only did he serve his country as, the secretary of health and human services, and I remember fondly a dinner we had together with,
Diana DeGette when I was in the house to focus on biomedical research. But following that incredible tenure of service, Tommy g Thompson, filled in as president of our University of Wisconsin system during a time of, great, challenge, the pandemic, and, was a champion once again of our university system. And I'm just delighted to have you here and, would refer back to the chair of the committee to, introduce our ranking member for her opening statement. Senator Alsley. Senator Alsley Brooks. Thank you so much,
chair Cassidy. And for those who are wondering, I am not Bernie Sanders. I am Angela Alsley Brooks. Ranking member Sanders is unable to be here this morning, but I'd like to say a few words on behalf of the minority. Today, we are considering president Trump's nominee to be the department of secretary the deputy secretary of health and human services, Jim O'Neil. We were also going to consider, the president's nominee to be the next surgeon general of The United States, Doctor Jeanette Neshwat, a Fox News medical contributor and a graduate of medical school.
But for whatever reason, president Trump abruptly withdrew her nomination yesterday afternoon. And as we all know, this is the second time that president Trump has withdrawn a nominee within our committee's jurisdiction. In March, he withdrew the nomination of Dave Weldon, who spent years lying about the safety and efficacy of vaccines to head the CDC about an hour before his hearing was set to begin. At any rate, mister O'Neil, thank you so much, sir, for being here today. And mister chairman, I'd like to say that in America today,
we have a health care system that is broken, outrageously expensive, and horrifically cruel. We also spend twice as much per capita on health care as any other country on Earth, over $14,500 per year. And despite these huge ex expenditures, we remain the only major country on Earth not to guarantee health care to all people as a human right. Over eighty five million Americans are still either uninsured or underinsured. The result, over sixty thousand people in our country die each year because they cannot afford to
go to a doctor when they should. More than half a million Americans go bankrupt due to medically related debt, and one out of four Americans cannot afford to buy the medicine their doctors prescribe. Sadly, as dysfunctional as our current health care system in America is, this administration and many of my Republican colleagues are actively working to make it worse. As we speak, Republicans in Congress are writing a, quote, reconciliation bill that would decimate Medicaid and throw millions of Americans off the health care
that they have in order to give huge tax breaks to the wealthiest people and most profitable corporations in America. And let's be clear. When some of our Republican colleagues talk about cutting Medicaid by up to $880,000,000,000, they are talking about making devastating cuts to community health centers, which rely on Medicaid for 43% of their revenue, mostly children, and provide primary health care to 32,000,000 people. They're also talking about cutting funding for nursing homes,
which depend on Medicaid for some two thirds of their revenue. Further, since the president has been in office, 20,000 employees, at the Department of Health and Human Services have been terminated or forced out, threatening the health care and well-being of millions of Americans who rely on Head Start, the Older Americans Act, Medicare, Medicaid, and LIHEAP. My home state of Maryland has been reeling from these cuts. Not only do we have over 150,000 dedicated federal civil servants in Maryland, but we are home to federal health agencies like NIH,
FDA, SAMHSA, CMS, the Health Resources and Services Administration, and AHRQ. We need a deputy secretary of health and human services who will speak out against these devastating cuts and strongly oppose decimating Medicaid. All of us wanna make the government more efficient. But we don't do this by slashing the agency in charge of the health and well-being of tens of millions of seniors, children, people with disabilities, working families, and the most vulnerable people in our country. We need a deputy secretary of health and human services who will fight to continue
health care as a human right, not as a privilege, regardless of whether you are poor, working class, or wealthy. So, mister O'Neil, I have carefully reviewed your record and background. And, unfortunately, it is very clear to me that you, sir, are not that person. And I am concerned that you will be just another rubber stamp for Donald Trump's rapid movement toward the destabilization of our health care system. Thank you, mister chairman. Thank you, senator Alser Brooks. And now I recognize governor Thompson for his introduction, to introduce our, nominee. Senator Cassidy, thank you very much,
for allowing me to speak shortly and quickly about an outstanding individual, my friend, Jim O'Neil. I would like to quickly add that, thank you very kind words from senator Baldwin. I appreciate it very much. And, it's a good senator, and I go back a long time with different political parties, but we're still very close friends. And I thank you very much for your very kind words. Appreciate it. And to all the distinguished senators, thank you for giving me this opportunity. Members of the help committee, it's my pleasure to introduce Jim O'Neil,
president Trump's nominee to be deputy secretary of the United States Department of the Health and Human Services. I had the privilege of having Jim work with me and for me when I was secretary of HHS. And based on my experience, I can tell you that he's an excellent choice to help manage this department. He's a hard worker, a good listener, a brilliant thinker. And at HHS, he took the time to really learn the department, and he gained a deep understanding of how HHS works. I can also tell you that Jim is a compassionate person who cares deeply about
the mission of HHS. He's an evidence based decision maker, and he cares and believes in good science. And since his time in government, Jim has become an entrepreneurial leader and a manager of complex businesses. He has worked with and learned from some of the best and brightest minds in business and in technology. He has a deep respect for innovation and new ideas. He likes to make things work. And as the distinguished members of this committee know all too well,
our health system is broken, costs are too high, and people are too sick. We need a health system that produces better results for patients. And with all of these challenges in mind and Jim's highly relevant experience, I can tell you and testify with great certainty that Jim O'Neil is an outstanding choice for deputy secretary of HHS and will do the job well, and you will all be proud of his effort. Thank you very much,
all of you. Mister O'Neill, welcome. Thank you so much, governor. You've always been a wonderful mentor and role model, and I, if confirmed, hope to live up to your record. Good morning. Chairman Cassidy, Senator Alsom Brooks, distinguished members of this committee, thank you so much for inviting me to talk with you today. Imagine every American waking up vibrant, energetic, and free of disease. That's President Trump's vision to make America healthy again, and I'm honored to be nominated to help turn it into reality. I'm grateful to Secretary Kennedy for his bold leadership and for his trust in my
experience to deliver results. My children, Eve, Sebastian, and Cecily, are in school in California today, but they are why I'm here. I want them and every child to inherit a healthier nation. Mr. Chairman, I believe that all Americans deserve to be healthy, happy, and prosperous. Most families try to make healthy choices, but our food system pushes ultra processed foods. Our official nutrition advice creates confusion, our health care system is difficult to navigate, and it prioritizes pills over prevention. Providers spend too much time clicking through pop up screens and fighting with insurance companies
instead of looking patients in the eye. Federal policies can empower people to break this cycle. If confirmed, I'll help reform outdated rules, pursue transparency and gold standard science, and champion healthy lifestyles and prevention so Americans can thrive. For three decades, I've worked to improve health care. As a Senate staffer in the 1990s, it helped senators shape bipartisan reforms, including HIPAA, collaborating with lawmakers to protect patient privacy. During the Bush administration, I had the pleasure of working at HHS for six years with Secretary Thompson, Secretary Mike Levitt,
and thousands of talented career and appointed colleagues. I'm proud of my work there. And I learned a great deal about the responsibility structures and dedicated professionals of each of the operating divisions of the Department, and how those divisions can best serve the American people and improve their health and welfare. At HHS, I helped Congress pass the Medicare Modernization Act, modernize FDA and strengthen food safety. I improved preparedness for avian influenza and hurricanes by helping establish the Administration for Strategic Preparedness and Response after it was authorized by Congress.
I conducted health diplomacy by visiting allied countries and working with ministers of health. I served on the President's Management Council and led Aegis to earn the highest possible management score. Most recently in California, I partnered with entrepreneurs to advance cutting edge research, technologies and therapies. And this experience has reinforced my conviction that government must support, not hinder, innovators to deliver effective and affordable results that get better every year. I've seen what happens when you pair the brightest minds with the best tools and data and we must bring that same dynamism into government.
Sadly, America's health is in crisis. Three quarters of Americans are overweight or obese, leading to chronic diseases like diabetes, high blood pressure, and over time, heart attacks and kidney failure. Diabetes alone costs us $400,000,000,000 every year and has exploded in prevalence tenfold since 1960. Fentanyl ravages our cities and our countryside. Addiction and mental health are urgent unsolved problems. Since February, suicide has increased by thirty seven percent. Medicare hospital insurance is headed toward insolvency. Families struggle to avoid individual insurance. We spend $4,700,000,000,000
on healthcare, double the OECD average, Yet our life expectancy is actually shorter than it was in 2010. These aren't just numbers, they're a call to action. Overall, what we're doing is just not working. That's why I'm so grateful to President Trump and Secretary Kennedy for taking on these challenges and promoting a vision for change. Mr. Chairman, we have a century scale opportunity to act. If confirmed, I'm eager to rejoin HHS and reform our food system to prioritize health for our children and parents, pursue gold standard basic and translational research that replicates use science,
economics and artificial intelligence to improve the quality and affordability of healthcare and accelerate development and access to life saving and health extending treatments. I'm ready to work with this committee to make a generational change in our nation's health. For my children, for our families and for every American, I pledge to fight for a future where everyone can enjoy a long, vigorous and prosperous life. I look forward to your questions. Thank you, sir. I'll start. You worked on HIPAA and your previous work, I think HIPAA needs to be updated. AI, I think,
has the ability to exploit. Can you have any thoughts on that? Or how would you potentially, work with us? What are your thoughts along those lines, please? Yeah. Thank you. So, I was at HHS, during the promulgation of the HIPAA Privacy Rule, which was led by the Office of Civil Rights. I was not at the center of that discussion, but I was on the periphery. I definitely strongly support, the principle of medical privacy. Patients' private health data needs to remain private, needs to only be shared with people that they consent to be sharing to. AI, as I said, has tremendous potential to improve health care across the board
and improve the functions of the department. But yes, of course, we need to periodically review the HIPAA Privacy Rule and make sure that it is not leaving patient data open to threats because of AI. It does seem like AI could do a lot of things with, for example, my search history or my watch because I've had legislation regarding that bipartisan, which would be very impactful upon, somebody deciding whether to hire me. Should that be should we have a broader definition of what is protected health information? That seems like a reasonable thing to consider,
as as we look at the privacy rule. K. I'm not sure the privacy rule well, you might know more than I do. I I don't think employers have any current legal access to, health records. There's also health records, but I was told once by someone who was a headhunter that he can somehow access people's search history. And if someone is looking for in vitro fertilization, for example, would tell the tell the potential employer, oh, this person's investigating IVF. She may be you sure I'm going with that? That that does sound like a significant concern. And if confirmed,
I'd be happy to make sure that the HIPAA privacy rule is is up to date with regard to AI. And and and and and whatever is necessary, both legally and technologically, to ensure that patients' data is not shared anywhere without their consent, as as well as search history and other related things. You and I have discussed immunization mandates. You've mentioned that you, am I correctly characterizing your view you support immunization, but you don't think the federal government should mandate, rather that decision should be held to localities? Yes, Senator. Right now, for someone who wishes to become a permanent resident in The United States,
it is mandated that they be up to date on CDC recommended vaccines. Frankly, we don't mandate for that for those people who come across the border illegally and are then transmitted into the interior of the country. And I'd gather that a lot of the measles that we're seeing right now, for example, in my state, New Orleans, is coming from people coming to our country from elsewhere and bringing measles with them. First, do you agree that we should, that the federal government should mandate that if someone becomes a US citizen, that they'd be up to date on their immunizations? Senator, as you know, I'm very strongly pro vaccine.
I'm an adviser to a vaccine company. I I support the CDC vaccine schedule. I mean, I think by definition, illegal immigrants are not, passing through any kind of checkpoint that that could check for their vaccine. But they but when they're arrested, if you will, detained, they're brought to an area which, the which HHS has a role in. And they receive medical services, screened for tuberculosis, that sort of thing, and, and and then pass through. So there is a role that HHS has in making sure that these folks are safe, and yet we see measles introduced in our being introduced in our country by people
who are from outside our country. So first, would you accept the mandate? Do you agree with the mandate which currently exists that if somebody wishes to become a legal resident, that they'd be up to date on their immunizations as per recommended by CDC? I haven't, looked into the immigration law aspect of this, but I I do support the CDC schedule, and and that that rule seems reasonable. But this is about the mandate. Yeah. I understand. I said that rule seems reasonable to me. And then what about those who are coming? Because frankly, since we have measles coming to our country from people from outside, it seems, relevant to me. I would like to say, wait a second,
if you're coming to our country, we don't expect you to bring disease. And we expect you therefore to be up to date on immunizations. Does your opposition to mandates on a federal level, would it extend to that sort of would you oppose that sort of mandate? Because if you come here legally, you gotta get it. The crazy thing is if you come here illegally, you don't have to get it, which just doesn't make sense to me. Senator, I think, President Trump's been very successful at controlling the border at, six Yes. But there'll be a future president. Sure. So we're we're establishing law now for future presidents, not just our own. Well, I think future presidents,
could not only change border enforcement, they could also change, the rules for naturalization and for, what kind of medical requirements are I'll come back to that maybe at the very end. Okay. Sure. Thank you, senator. Senator, also Brooks. Now let me ask your side. I think I can look to the senator. Yeah. Sure. Senator Murray. Thank you very much, and thank you for the accommodation. And, Mr. Chairman, I just want you to know the Trump administration fired many of the CDC court health station staff. In fact, at CTAC in my state, there used to be four.
They are the person that screened, travelers at the ports of any in entry. So if we don't have people there to screen, even a mandate would make it very difficult to assure that. So I share share your concern, but I also think we have to have personnel there to do it. With that, Mr. O'Neil, we know right now, that at HHS, they're undertaking a massive reorganization, firing staff, canceling and terminating thousands of grants and contracts worth billions of dollars, delaying, sending that grant funding out, including, by the way, for lifesaving biomedical research.
And meanwhile, HHS is currently and I know you're not there yet but they are refusing to provide basic answers to many of our straightforward questions. They are canceling longstanding briefings. And they are telling Congress and virtually the American public nothing about these dramatic unprecedented changes. Last week, HHS submitted an operating plan for fiscal year twenty five, required by law. And it leaves it blank. The funding levels for five thirty programs were left blank.
The department is effectively telling us it doesn't have to tell us or the American people anything about how it is going to spend tens of billions of dollars, taxpayer dollars, across hundreds of programs. And that is really stunning to me. In my time at Congress, I have never seen an administration less transparent than this one. I've also never seen an administration so insistent on pretending they are transparent while going out of their way to hide basic information that we require. So, Mr. O'Neil, I want to ask you,
if you are confirmed, will you commit to prioritizing real transparency and sharing information with Congress and the American public about what HHS is doing? Thank you for the questions, senator. It's lovely to see you. I was a senate staffer in the nineteen nineties. We had a few pleasant interactions. I don't expect you to remember. But, yes, I have a kind of visceral sense that, it's Congress that authorizes all the programs at HHS. It's Congress that appropriates the money for HHS. Congress absolutely deserves to have prompt and accurate information,
both proactively about future plans and also, in reply to, questions, whether it's testimony or written questions. And, yes, I commit, if confirmed, to ensure that the whole department, takes seriously its obligation to provide good, transparent, accurate, prompt information to Congress. Well, I I appreciate that answer. I'm not holding my breath because I haven't seen it happen yet. But, mister chairman, I want you to know I am focused on real transparency here. This department is not above congressional oversight. And we have a responsibility and need to hold all the agencies accountable.
So this is something I'm tracking very closely. I I wanted to ask you quickly too about women's health. The plan to gut HHS is a disaster for health and safety, but it is based, it seems to me, on a total lack of understanding about how different agencies across the department work. For example, Senator Kennedy seems to think we shouldn't have more than one office that covers women's health. Well, women's health requires dedicated focus in different areas. For example, workforce training at HRSA, cancer prevention at CDC,
scientific research at NIH. Those are separate and distinct efforts addressing women's health, which has long been underfunded. But because of Congress's dedicated bipartisan investments, we've been able to make progress. So, if you are confirmed, will you commit to restoring women's health functions across HHS and directing the department to spend and appropriated funds for women's health as directed by Congress? Thank you for the question, senator. Obviously, women's health is, will continue to be a critical issue,
is distinct from men's health in many significant ways. The principles that the secretary outlined for the proposed reorg, said that any reorg would be based on on preserving all the central functions of the department, ensuring that they continue and that they're executed on well as as mandated by statute, and also the principle that two functions make more sense to be, conducted within the same agency or office, that that could make sense. It also makes sense to me that if if if functions are closely similar, perhaps we should consider putting them in the same office.
Well, I I would just say, mister chairman, women's health isn't just one little corner. We are affected, women are affected by many different ways, including, as I said, through workforce training, through cancer prevention, through scientific research, different agencies. Those offices all do very different things. There's a reason why congress passed funding for each one of them. Ignoring that means ignoring the law. Thank you, mister chairman. Senator Moody. Thank you, sir. Thank you for being here. And if I might just say thank you to your family.
It is a it is a senator Houston and I are the two newest members of the United States Senate, and our families are also serving. It is certainly a family sacrifice, and I'm so grateful you're willing to come back in to public service using all that you have acquired both in your government service and your private experience to benefit Americans and their health. So thank you very much. As deputy secretary, you will oversee the operations of the department from the FDA, to Office of Refugee Resettlement, including many actions related to the regulatory side of the department.
I wanted to talk to you about some issues, certainly as a mother and as the former attorney general of Florida that, I saw not handled well at all. In in fact, it was a disaster under the Biden administration, and I wanted to get your take on how you might approach, making sure that it can never happen again and any regulations or oversight is considered and modified within the agency to make sure it never happens again. And, specifically, we saw that when Biden, opened up the border and destroyed any semblance of security, we saw many, many, many young minor children smuggled into our country,
pushed into states throughout throughout. The off Office of Refugee Resettlement, was supposed to oversee this. It got so bad that they lost tens of thousands of children. In Florida, we could get no information from the Biden administration on who these children were, where they were being placed, how they were being taken care of. Even though the states have a primary responsibility of dealing with neglected, abandoned, abused children, No information was shared. In order to remedy remedy that, we went so far as to launch a grand jury investigation. And when we asked for administration officials to come down and and and testify or
share information, They refused to do so. They said that it was hard to see how it would benefit the agency when all we cared about was the interests of those children who not only were smuggled into The United States, placed in our grand jury, report showed that they had been some had been sent to strip clubs, empty lots next to container facilities, dozens placed with the same sponsor, many unvetted. It was a it was inviting trafficking. In fact, many children in The United States were found to have been in trap in trafficking
that had been smuggled over the border. I believe, and I believe the grand jury report shows, that this obfuscation or refusal to provide information or witnesses was to shield the fact they knew these kids were were not being supervised, putting being put in dangerous situations, and they were, in fact the administration, in fact, was facilitating trafficking. What will you do knowing that the Office of Refugee Resettlement is going to be, in terms of operations, is going to be under your purview. What will you do to ensure now, again, we know that in the first one hundred days,
president Trump has basically shut down the border. We're seeing nothing, like the numbers we saw last year. My hope is that this stops. The purposeful, smuggling of children into our nation, being put into dangerous situations that we we shut this down. What can you do to ensure that this never happens again? As as a mother, but certainly as the attorney general that was working with agencies desperately trying to promote safeguards for children, not getting any information, law enforcement was begging for it, child services was begging for it, what will you do to ensure that this can't happen again?
Thank you for the excellent question, senator Moody. So in the Bush administration, I worked very closely with the Office of Refugee Resettlement, especially to fight human trafficking. I was the HHS representative on the government wide senior policy and operating group to fight human trafficking. I'm very proud of the work that we did with ORR at that time. The focus of ORR was a little bit different then. The human trafficking fight was not as focused on the border as it obviously has been in the last five years. It is absolutely a priority, and I believe the secretary has set it as a priority for him, to find all the missing children and make sure that they're safe.
And, if confirmed, I look forward to working with him and the Office of Refugee Resettlement, as well as other parts of government, to ensure that all children are safe. Well, again, remember, it's not just finding these children. There are regulations in place that facilitated the government basing basically becoming traffickers of children. Can you go in and work immediately to remedy any of those that either promoted or allowed for these children to be disseminated across The United States, many never to be heard from again, placed in incredibly dangerous situations? Yes. I can. So, traditionally, the role of deputy secretary is heavily focused on regulations,
on making sure that, regulations are up to date and appropriate, making modifications when necessary. And I will absolutely review all the regulations pertaining to ORR or or other any other areas that could affect trafficking or missing children and make sure that they are appropriate. Thank you, mister O'Neill. This is senator also Brooks. Thank you so much. Thank you so much, mister O'Neil for being here today and for your Interview that twenty years ago, that there were studies looking at how much lasting value Head Start gave to children. And I quote that you said you don't have an updated view on how efficacious
it is. You said also that you didn't, have a view on the Head Start program at this time. And I have to tell you, mister O'Neil, that's a really concerning answer, from the person who is interviewing to be leader at the department and whose purview will not only be health programs, but the human services program that serve our children's our nation's children and families. As the deputy secretary, you will be responsible for helping develop the budget request for programs like Head Start, which is an extremely important program for so many children and their families and divisions
like the Administration for Children and Families. So my first question is, given your remarks just this last past week on Friday, regarding not having an updated view on Head Start, have you now today, do you have a a more have you familiarized yourself with the Head Start program, since that discussion? And do you know how many children are even served by the Head Start program? Thank you for the question, senator. And by the way, I really enjoyed our conversation in your office a few weeks ago. I have not had any input into any discussions about reorganizations or budget. If confirmed,
of course, I would be happy to and responsible for digging into every element of reorganization and budget around all HHS programs. Currently, I'm a private citizen. Regarding measles, senator, as you know, the measles outbreak, began before secretary Kennedy took office. Since he's taken office, he has recommended the MMR vaccine to parents multiple occasions, including on television. He's also deployed a CDC task force to Texas and other locations, to take charge of the measles outbreak. I think both of these actions are,
extremely appropriate. I think he's taking measles seriously as he should, and I I I support all that. I support the MMR vaccine. I support deploying And and with all due respect, I only have another minute. Let me just ask you, mister O'Neil. I'm gonna be able to talk to the secretary, I hope, next week. I don't agree that he's taking measles seriously at all. But I needed an answer from you. It's important for us to know what you think about Head Start. And so I just like you to tell me whether or not you still believe you're not sure whether or not Head Start is an efficacious, that whether or not it's efficacious as you put it.
Senator, it's essential that, children in early childhood have, good appropriate, care and cognitive development. I don't know the best way to do that. It may well be Head Start. I have not been involved in any discussions around, reorganizing it or moving it or anything like that. If confirmed, of course, I would be. Okay. And, again, this program is so important. And when the administration first announced, its funding freezes, Head Start providers were locked out of a portal. This is, of course, as you know, is devastating. And many didn't know if they'd be able to even make payroll or continue to
operate. And so if confirmed, can you commit, that the department will send all head start awards, to providers on time and that this sort of chaos won't continue to resurface regarding head start? We just need a clear answer about what you intend to do with head start. Senator, I've never been a fan of chaos. I intend to, do my best to confirm to ensure that there's no chaos in the department, in any part of the department. Payroll should be always paid on time. And, if if the department has made any mistakes, of course, it should correct them. Would that include reinstating the staff who administer the Head Start program,
and reopen the closed regional offices that are responsible for overseeing Head Start programs? Senator, I haven't been involved in any of those discussions. I would say that, making sure there's the right number of people with the right skills in every division of HHS would be a responsibility. Thank you. Thank you, mister chair. Senator Husted. Thank you, mister chairman. Thank you, mister O'Neil, for, your willingness to serve and provide testimony today and answer our questions. I look forward to working with you and the secretary to improve health outcomes. You have a very important job. President Trump recently issued an executive order this week that would prohibit federal funding for
potentially dangerous life science research such as gain of function research. In adversarial countries of concern, for example, China, which is home of the Wuhan Institute of Virology and the SARS CoV two coronavirus that killed people around the world, closed schools, cost this government at least $5,000,000,000,000, and left a a wake of devastation, behind it. Yeah. Sometimes small things can cause big problems, and this is certainly a case where it did. I applaud the administration for these efforts.
I think it's an excellent step to keep Americans and the world safe and prevent the next pandemic. And I am concerned about unsupervised high risk research right here at home, though. Specifically, I am concerned about what we can do to protect against the misuse of desktop gene synthesizers. It is, I am a fan of innovation and technology in health care. It can do amazing things, and these devices have the potential to do good to advance research. They could also, though, provide genes for deadly pandemics either to state actors or terrorists and could be used
as a bioweapon. And unlike most commercial gene sequence providers, a terrorist group or state actor could synthesize a deadly pathogen with no screen or safeguards in place. So looking at this issue through your role and through Department of Health and Human Services, what can you say to us today that can provide some reassurance, or guidance on the framework for how nucleic acid screening captures, of the desktop gene synthesis and researching, occurring outside of the commercial gene synthesis providers. How will you help make sure that this is done safely and responsibly in The
United States? Thank you for the excellent question, senator. Gain of function research imposes risks on the entire world. And, so it is not a simple matter of, you know, if, the money could better be spent elsewhere. It is a matter of, should this research be done at all? And, how to account for the fact that it might be conducted in other countries that we have little influence over. Of course, it's appropriate to, research viruses and microbes so that we are ready to respond to a pandemic regardless of whether it's naturally occurring or manmade.
But extending that research into gain of function research, is a totally different level of risk. My understanding is that there was an HHS sorry, an NIH ban on gain of function research that I believe the Obama administration lifted or weakened, during its last weeks before leaving. Obviously, there is evidence that, efforts were made by various scientists to evade even the rules that It does look like, NIH money made its way into some gain of function research. And, if if so, that strikes me as completely inappropriate and something you should work on.
You also mentioned, desktop generation of, of genes. That is a concern. Overall, I think sophisticated technology is mostly gonna be very beneficial, artificial intelligence, machine learning, large language models, neural networks. But, of course, there there's a there is potential danger as well. Regulation might be appropriate. One thing I've noticed with regulation of cutting edge science is the regulation struggles to be as up to date as the technology. So I would like to recruit very excellent technologists into the department in all divisions to ensure that anything we do
to address the risk of gain of function research has up to date technology side as well as regulatory side. Thank you. And and I'll just add this. With quantum computing, AI, essentially three d printing, types of of technologies that are gonna allow us to do some amazing research on health solutions. I just ask that we make sure we're doing all that is possible to ensure that it's not used for nefarious purposes because we have seen what happens when either,
through sinister reasons or through incompetency. It can definitely have a major impact on our world. Thank you, mister chairman. Thank you, senator. Senator Baldwin. Thank you, mister chairman. And, mister Neil, thank you for our opportunity to speak prior to this hearing. I, share the deep concern expressed about health and human services submitting an operating plan, otherwise known as a spend plan to Congress. That includes asterisks,
rather than planned funding levels for over nine or sorry, 530 different programs. This is effectively the Department of Health and Human Services saying that it doesn't need to tell congress and the American taxpayers how it is spending tons of billions of dollars. With that, we are left to assume that the Department of Health and Human Services is intentionally hiding what it's doing and the results of a massive proposed reorganization, firing of tens of thousands of employees,
terminating billions of dollars in grants, and actively delaying billions of dollars in funding. During our meeting, we discussed the importance of transparency. Secretary Kennedy has pledged what he called radical transparency, and that is absolutely not what we have seen. So, mister O'Neil, do you think that the Department of Health and Human Services should tell Congress and the American public how it is spending taxpayer dollars that we have already appropriated? Yes or no? Thank you for the question,
senator. I also enjoyed our meeting. So, I've not seen this, this this plan, that you're referring to, with the asterisks. I can I can I can tell you that it was a long page, asterisk, asterisk, asterisk, no dollar amount, except for a handful of programs? That is not radical transparency in my book. Should, the Department of Health and Human Services tell Congress and the American public, if it is, for example, cutting funding for services through the nine eight eight suicide and, crisis lifeline?
Yes or no? Senator, I'm a former senate staffer. I I know that it's congress that authorizes all the programs at HHS. It's congress that appropriates the money for HHS. Congress absolutely deserves prompt and transparent and accurate information. I I stress the prompt part. And what about how many employees have been fired and the functions that those employees were carrying out? Should that be reported to congress and the American taxpayers? Senator, my understanding of the RIF is that, it was, the decisions of who to lay off were,
I think, I read, made by the heads of the operating divisions who are close Should that be reported to Congress? Senator, yes. I think so. Okay. Should the Department of Health and Human Services tell Congress if it fired, for example, employees administering clinical trials at NIH's, clinical center? Yes or no? Senator, I think, every significant thing the department, does, should be should should be available to congress. So, mister O'Neil, if you are confirmed, I will certainly be following up to ensure that health and human services makes good
on the commitment to transparency. And if these changes would actually enhance the health and well-being of Americans, HHS should be eager to explain how and why instead of what it's doing, which is hiding this information. HHS has delayed funding for research on treatments for deadly diseases and for head start, and childcare programs. It's decimated offices responsible for carrying out critical activities, including addressing lead, poisoning in children. And and let me just give you an example of how HHS,
firings are impacting communities in Wisconsin. The city of Milwaukee requested assistance through the, CDC's childhood lead poisoning prevention surveillance branch to help respond to lead poisoning cases tied to several public school facilities. The request for assistance was denied because of a lack of staff capacity after the entire childhood lead poisoning branch was fired. This is a clear example of HHS firing affecting critical program operations.
And without this support, Milwaukee faces lasting implications of health and well-being of children in the city. If you are confirmed, I will be following up with you on this as I have yet to receive a response from secretary Kennedy. Senator Marshall. Thank you, chairman, and welcome, mister O'Neil. It's good to see you again. I was excited yesterday to see the nomination, professor Trump, of doctor Casey Means to be the surgeon general. And, certainly, she has been an expert on all things Maha and nutrition and metabolism,
importance of mitochondria. And I wanna relate that to you mentioned in your testimony that you're anxious to reform our food system to prioritize health. And just kinda tell me what that vision looks like and how can you work with doctor Means and the other other folks there at HHS. Thank you so much for the question, senator. I really enjoyed our meeting a few weeks ago. You know, I'm I I know that you mentioned the word mitochondria. I've noticed that, three years ago, people didn't know anything about that. They remember from high school biology, oh, yes. Mitochondria, the powerhouse of the cell. But in the past few years,
thanks to a lot of, smart people talking about metabolism much more than in the past, people are starting to be interested. You know, infectious disease is still a very serious challenge for a lot of people, but metabolism, metabolic disorders, chronic diseases are getting more attention. I think that's wonderful. I hope they continue to get attention from researchers, from physicians, from patients. Regarding the food system, the unfortunate situation today is that a lot of families really try hard to be healthier and have healthier habits, and it's not easy. They go to the grocery store,
junk food is much cheaper than healthy food. They're not even sure which food is healthy. Nutrition labels can be confusing. Official government nutrition advice, the dietary guidelines that two departments issue every five years, often seem to lag by decades, actual nutrition science. Real nutrition science is so hard to do because there's so many stakeholders with an interest in particular outcomes. I think it's essential that we have good nutrition research that is free from outside influence. There's a metabolism lab at NIH that I visited where you,
lock people, in a room with their consent for days, measure every calorie that goes in and goes out, exercise. We need more of that. There was there was talk a year ago of shutting that down. I think we should have more of that. Okay. You also mentioned, prioritize health for our children and children, and I wanna just focus for a second on on mental health. I'm not sure if you had the option to read the book The Anxious Generation, but if you haven't, surely would would support recommend that you do that. What role do you think, social media apps have have played in this in the mental health of our children and young adults?
Thank you, senator. That's a great concern. So, companies that develop apps have an interest in maximizing the amount of time that, users spend on the apps, the amount of engagement, try to hook them into it. That's expected given that they're, you know, trying to grow their business. But that's not necessarily what's best for users, especially young users. And so, there's more and more awareness that, social media can be an addiction and that it's it especially could have a profound lasting influence on on young developing brains.
Brains, seem to keep developing until age 25. So, people that don't even think of themselves as children could still be well, adults could also suffer negatively. So, yes. That that is a concern that that that HHS, should have a role in researching and communicating best practices. Great. Certainly adds to the loneliness, as well. Maybe the little time we have left, I just want to emphasize the importance of replicating previous studies. Again, you mentioned that in your testimony. Over twenty years ago, an NIH study on Alzheimer's took us down in the wrong direction, and that study was never replicated.
So what does that look like? I mean, you can't you don't want your your best buddy to do the replication of that surgery. It needs to be another non biased person. So how do you implement that plan? Absolutely. So, there's two ways, a study could lead us down the wrong road. One is outright fraud, which has happened in Alzheimer's research. And the other is, you know, it's kind of bad luck. You do one study. There was no intention of fraud, but the results, you know, were an unusual combination. The stars went to a certain alignment, and it's also not going to replicate. So, you know, there's a lot of talk about the replication crisis in all of science about ten
years ago, and it's still an unsolved problem. I think, NIH should devote and the the problem is no one has a financial interest in replicating studies. So NIH should do that. And I think that would be something that NIH can do best. Whether that should be conducted operationally as one whole division of NIH focused on replication or whether there should be a replication branch in each each, institute, I'm open to arguments both ways. Senator Hassan. Well, thank you, mister chair, and good morning, mister O'Neil. It's good to see you again. Secretary Kennedy has stated that one of his top priorities is to end the fentanyl crisis,
which has devastated countless families in New Hampshire and, as you know, all across the country. One critical tool we have when we are fighting fentanyl is an overdose reversal medication called naloxone. Do you agree that it is important for first responders to have access to naloxone? Thank you. Lovely to see you again, senator. I've very publicly advocated, the approval and legalization of naloxone, for years. And, yes, I believe that, yeah, you never really know when it's going to be needed. When it is needed, you need it right there. And, yes, I think first responders having it makes a lot of sense.
So president Trump has proposed to eliminate a critical program that arms and trains first responders in my state and across the country with naloxone. So you've just made the case for why they need to have it. If confirmed, will you use your position to urge secretary Kennedy and president Trump to reverse their cuts to naloxone funding for first responders? So there are probably a lot of ways to, ensure that naloxone is is deployed locally. I'm not really sure what the best way to do that is. I I can tell you as a former governor, whose state was devastated when the fentanyl crisis first began to hit,
that it was absolutely critical to have that federal partnership to help fund naloxone for first responders. State budgets, can be, sparse, and this is a really important tool. So, I hope you will urge Secretary Kennedy to reverse that or at least work with states in a transparent way to find out what a different way of supporting naloxone supply is. But just to end it without a plan moving forward, I think, will really harm people and may cost us lives. Now I also wanted to turn to another issue that I'm deeply concerned about, which is secretary Kennedy's decision to hire David Guyer,
an individual with a track record of harming children. Mister Geyer was disciplined for practicing medicine without a license on children who have autism. And now secretary Kennedy is paying mister Geyer with taxpayer funds to conduct a study at HHS. Mister O'Neil, if confirmed, would you advise the secretary to fire David Geyer? Senator Flake, thank you for the question. I've never had any communication with this person. I don't know him. I would say that, all research, and research funding decisions and analysis of research should involve multiple people,
ideally with different backgrounds, who are allowed to disagree with each other. Well, I I appreciate that. This is, by the way, the department's website that posts, mister Guyer as an employee. Do you have concerns about the secretary employing an individual who has been found responsible for harming children? Senator, I I think that the secretary, is an excellent judge of, personnel and character. He trusted me, and I I hope to not let him down if confirmed. And, I don't know this person you you mean, so I I can't really commit to What I would like to do is submit,
by unanimous consent for the record. This is the state of Maryland's complaint against mister Geyer for practicing medicine without a lot a license on children with autism, including injecting an 18 year old a eight year old with a testosterone suppressant as some kind of treatment for autism. So it is really concerning, and I hope you will turn your attention, to mister Guyer because, Was that a request to put it in the record? Yes. It was a request to put it in the record. Without objection. Lastly, I guess I'll just finish up this way. I really hope you will look at mister Guyer's record, look at the allegations that were proven in this complaint.
He was disciplined for practicing medicine without a license on children with autism, and it is deeply, deeply concerning. I believe he has no place at the country's premier health agency. Secretary Kennedy also recently made troubling comments about children with autism. His comments reflected that he understands very little about people who are living with disabilities. Instead of taking the time to listen to individuals with disabilities and their families, Secretary Kennedy has moved to shut down programs and fire staff who provide critical support
for these families, and these individuals with disabilities. For example, secretary Kennedy fired staff that run the National Family Caregiver Support Program, a critical resource for people who care for family members with disabilities. Mister O'Neil, will the secretary's actions to gut caregiver support help children with disabilities? Senator, as you may know, the secretary has made it a priority to research autism. We don't know what causes autism. We don't know what causes caused the recent rise in autism. We don't know the best We actually have excuse me. I I'm running out of time. We actually have some really good studies that are leading us to understand the multiple
causes of autism. But doing away with caregiving for these families and these children is not going to help them, in the way they need. And I hope the secretary will reverse course and listen to families. Thank you, mister chair. Thank you, senator. We're gonna take a two minute break, and we'll return subject to the call of the chair. The committee will be back in session, and, senator Hawley is next. Thank you very much, mister chairman. Mister O'Neil, nice to see you. I'm I enjoyed our conversation, our visit the other day. Let me just start with this. You're familiar, I think, with the recent insurance claim study regarding mifepristone.
Is that correct? Yes, Senator. I've not read the study, but I'm familiar with it. This is a study of 865,727 prescribed mifepristone abortions, chemical abortions, between 2017 and 2023. It's the largest such study of mifepristone ever conducted, the only major study conducted now in years. And as I think you know, the results were really quite startling. They showed that ten point nine three percent of women who use the chemical abortion drug experience a major serious adverse health event,
like sepsis infection, hemorrhaging, often necessitating emergency room visits, often leading to life threatening situations. The real dramatic result of this, I mean, I think the takeaway of this is that this is a much, much higher rate of serious adverse health events than what the FDA currently reports, 22 times higher than what the FDA has currently reported. So my question is, in light of this new data, and it is truly, it's an enormous data set, just an enormous data set, isn't it time for the FDA,
number one, to put back in place the reporting requirements of serious adverse health events. As you know, in 02/2016, the FDA eliminated, at the behest of the Obama administration, eliminated the requirement that physicians and others report non life threatening, but yet serious adverse health events. Shouldn't we put those back in place in light of this data? Senator, FDA has responsibility to ensure that all drugs are safe and effective, and sometimes new data comes in and it needs a review. Mifepristone actually has a REMS, meaning it's been designated,
for a long time as something that needs periodic review of safety data. The secretary's pledged to do a safety review of mifepristone, and I strongly support that review. Good. And you'll help him carry out that review, that safety review. Absolutely. And this study that is out just this last week just underscores the need for ongoing safety review and and for a look, I think, a fresh look at all the data. Would you agree with that? It does look that way. Yeah. And would would you also agree that it's it's time for the FDA as part of that thorough top to bottom review to think about reinstating the other long standing safety protocols on this drug until the Biden administration eliminated them,
mifeprostone for twenty plus years had always required physician dispensing, in person dispensing, physician follow-up visits. The Biden administration eliminated all of those things. Now telehealth providers, you don't even have to be in this country now to use, send this drug to prescribe it, quote unquote. You don't have to be a doctor. You don't have to see your patient. You don't have to be in America. You can mail it into states regardless of state law, what state law is, and this is one of the reasons we're seeing such incredibly high adverse health events. Don't you think it's time to reconsider and to revisit imposing,
putting back in place those long standing safety protocols? Senator, a lot of patients have a lot of trouble, getting prescriptions filled across state lines, even even medicines that have much less, safety concerns than this drug. And, of course, every approval, that FDA does or reviews, can, state the appropriate and inappropriate ways of prescribing or dispensing a drug. And so that all of that should be subject to review. Absolutely. Okay. Good. All all of it's subject to review. The the secretary was very clear on this, that he will conduct a full scale safety review. He's required to by law, as you pointed out.
But I think what the what this latest study shows is that the information that is coming into HHS, it's time that you took a serious look at the scope of that information because, again, the FDA in 2016 eliminated the requirement to report much of this. This is why this study is so significant because it looks at all insurance claims, 865,000 of them between 2017 and 2023. So just to be clear, your commitment is you will do a safety review. You will look at this top to bottom. You will take this data into account. Do I have that right? I believe the secretary has already committed to that, and I will I will promise you to fully support that.
Good. Okay. Let me ask you about your work on conscience protections in, in earlier administration. I think in in one of the Bush administrations, the Bush forty three administrations, you worked on conscience protection rules for health care providers. Do I have that correct? Yes. That's correct, senator. Would would you support reinstating and and fully implementing conscience protections for healthcare providers? That would be up to the secretary and the president, but, if, if they decide to go in that direction, I would know exactly how to do it. Would you advise them to do so? I believe I already have, senator. Good. And that should be easy because the secretary, when he sat right where you were sitting,
said unequivocally that he supported conscience protections, that he would put them back into place. The president said he supports conscience protections. In fact, the president had them in place in his first administration. So I'm glad to hear that. We'll hold you to that. Let let me talk to you for just a second here. Well, actually alright, mister chairman. I see I'm out of time, and I'm always I'm always so good about obeying my time limits. Aren't I, senator Kane? I I'll have a few that's a joke. I'll have a few more questions for you for the record, mister O'Deil. Thank you so much. Mister chairman. Yeah. What's the definition of a verification? My Ivy League trained colleague, senator Kane. I appreciate my fellow Rockers High School alum,
Josh Holly, for ceding time to me and not going over. There are two high schools in America that have two US senators, James Madison High School in Brooklyn, Bernie Sanders and Chuck Schumer and Rockhurst High School in Kansas City, Missouri, Josh Holly and Tim Cain. And I think it's the it tells us something about the value of a small c Catholic education that Josh Hawley and Tim Cain could both be graduates of Rockhurst High School. Elephants in the room before I have a question or two for you, Mr. O'Neill, I'm concerned and confused that you're sitting alone at the table today.
This was a hearing that was originally noticed to include the Surgeon General nominee. The circumstances under which she is now not appearing and has had a nomination withdrawn are puzzling. I don't know whether it was at the behest of the committee, the White House or some combination of both. But some news accounts suggest that her nomination was withdrawn because she positively commented about the COVID vaccine that it was a blessing from God. The COVID vaccine development in the first Trump administration was a huge accomplishment. Operation Warp Speed,
the development of that vaccine in such short time relative to other vaccine developments at a time when it was critically needed was a real plus in my view. And the thought that because she praised it at the time that would be a reason to withdraw her nomination, troubles me. I don't know if that was the reason or it was something else, but that's being mentioned as a reason for the withdrawal and that will obviously lead to a lot of questions when the new nominee is before us. Mr. O'Neil, you told the Finance Committee the other day that you supported focusing Medicaid on the
populations it was created to support in the 1960s. And I think everyone on the Committee believes that, but that opens up a pretty big question, which is how about folks who have Medicaid because of the Affordable Care Act and Medicaid expansion. 20 plus million Americans including more than 670,000 Virginians have Medicaid because of the Medicaid expansion component of the Affordable Care Act. As you know, Medicaid expansion is at state option. I think 41 of the 50 states have embraced Medicaid expansion.
Have you made statements, in the past in opposition to the Affordable Care Act? I'm not sure, Senator. Can you recall whether you've ever advocated in opposition to the Affordable Care Act? I don't recall, Senator. Can you recall whether you've ever stated a position upon the about the Medicaid expansion part of the Affordable Care Act? I don't believe I have, senator. Would you agree with me that if there were a proposal to eliminate the Affordable Care Act, including medic Medicaid expansion, that would be a massive and dramatic cut to Medicaid?
I don't know, senator. I haven't looked at the numbers. There was obviously a lot of discussion in president Trump's first term about repealing and replacing, the Affordable Care Act. Repeating. That we we had a vote on a repeal without a replace, and it it failed in the senate because both Republicans and Democrats opposed repeal of the Affordable Care Act without a replacement. But you you acknowledge that 41 states have embraced Medicaid expansion, states that are have Republican governors and Democratic governors, Republican legislatures and Democratic legislatures.
You acknowledge that, correct? I believe that's accurate, Senator. And you would not challenge me when I say more than 20,000,000 Americans, have health insurance through Medicaid expansion. Does that number sound generally in the range, right, Ranger? I believe you, Senator. Have you had conversations either with Secretary Kennedy, President Trump, or any other members of the Trump Administration about repeal of the Affordable Care Act in a second Trump presidential term? I don't believe I have, Senator. Have you had conversations with anyone in the Trump administration, including Secretary Kennedy,
about reductions or repeal of the Medicaid expansion part of the Affordable Care Act? Perhaps very briefly, but I don't recall anything specific. Would it have been full repeal, partial repeal, reduction of the subsidies enabling families to afford Medicaid expansion or do you recall? I recall, general discussions about preserving the core populations of Medicaid and how that's essential and how any changes that Congress, might like to make to the structure of Medicare would be up to Congress, and it would be HHS's responsibility to implement whatever whatever Congress,
legislates. Well, I wanna I wanna dispute the notion that there is a core recipient of Medicaid and a non core recipient of Medicaid. If you're a struggling family and the only way that you can afford health insurance for your family and kids is through Medicaid expansion that's part of the Affordable Care Act, you're not You're not a non core recipient of Medicaid. Medicaid is helping you and your family, and that to me is a core responsibility. I yield back, Mr. Chair. Senator, in my opening statement,
I did point out that many families struggle to afford afford health insurance. That is a continuing problem and the one I like I would like to address, and there are probably multiple ways to address it. And for and for the record, Republicans did have a replace plan. I helped coauthor it, so for the record. So Senator Hickenlooper. Thank you, mister chair. Oh, is this going on? I guess I it's on enough. Thank you, mister O'Neil, for being here. Thank you for your willingness to go deeper into public service. You have experience with companies that are focused on, age related diseases and conditions,
Alzheimer's being, prominent. And certainly I share that interest and I've been particularly interested in some of the research around sugar and ultra processed foods, that could be connected to, dementia, different types of dementia in later life. As you may know, the Trump administration's NIH funding cuts and delays have led to a large amount of confusion, some would call it chaos, particularly at the Alzheimer's disease research centers. And I mean, let's put it this way, are you still interested in further research and understanding into the causes of,
causes of and possible treatments of Alzheimer's? And if so, will you figure out some way to restore funding to the Alzheimer's disease research projects being done at NIH? Senator, that does absolutely remain an interest. There are multiple causes of dementia. Alzheimer's and Parkinson's and Lewy bodies are perhaps the three most well known. There could be others. There could be others that we don't know about. I think it's an open scientific question of how much we should focus research money more downstream, specifically Alzheimer's for these dollars, specifically Parkinson's for these dollars,
specifically Lewy bodies for these dollars, and versus how much we should focus research dollars more upstream on what potential common factors and common causes, all kinds of dementia and all kinds of aging damage has. I don't have a specific answer for that, but it is an area of, like, intellectual, and operational interest for me, and I would I would love to engage in that. Good. Glad to hear that. In Colorado and in a lot of states, we worked hard to make access to green spaces and natural outdoor, environments, recreational opportunities. It was both an economic priority for outdoor recreation,
it's a big part of, most of the Western States, I would say I'd say all the Western States, but also as a public health benefit. And making sure that those who work in outdoor spaces are safe, I think, is a responsibility for all of us and for the federal government. Nearly all the workers at the National Institute of Occupational Safety and Health have been laid off, equally at our at that office, the same office in Denver. The office in Denver specifically focused on occupational health hazards experienced
often uniquely in the West, such as wildfire. If you're fighting wildfires, what does what does that particulate and all those, noxious, smoke and fumes that you inhale, what is what are the consequences of that? If you're confirmed, mister O'Neil, how will you prioritize occupational safety and health, particularly in the West, with a severely feebled staff? In other words, the federal office has been not quite destroyed, but significantly reduced. Thanks, Senator. That is a huge concern. As someone who's lived in Marin County,
California for the last fourteen years, I've had a lot of experience, negative experience with smoke from wildfires, stocked up on N95 masks before the COVID pandemic. Recall, trying to understand the distinction between the N95 masks that were approved by FDA versus the ones that were approved by NIOSH. They seem very similar. I think they are pretty similar. Of course, it's, it's important that, all parts of government, including state governments, do their best to prevent wildfires and and, respond to them. And HHS, of course, has a role. I'm I'm fine with that. And I I guess my question is really, are you gonna fight like hell to make sure you get enough funding so you
can do that basic some of that basic research because it it is ongoing and critical. Last question, and then I'll let you go. As you know, the National Institutes of Health are the largest funders of biomedical research on Earth. Basic research often informs the next big discovery, often done in house at NIH. Many biomedical companies are not incentivized to do this nuts and bolts research, that translates into the the the big deal, and yet we all depend on that research. So if confirmed, deputy secretary, how are you gonna incentivize private companies and institutions to conduct research that historically they
have depended on NIH for, but now are gonna have to do on their own. I I think I agree with the whole premise of your question very strongly, Senator. Companies have a financial incentive to do late stage translational research. They don't have an incentive to do basic research, which is also harder to patent. It's important that NIH do very extensive basic research because almost no one else will. You're gonna have a lot of work to do. Thank you very much. Thank you, senator. I yield. Mister O'Neil, just a follow-up. In my question I ask regarding there's a current effective mandate of CDC if somebody
wishes to become a permanent resident of The United States legally. It is effectively mandated that they receive vaccines. Would knowing your opposition to mandates, would you attempt to rescind that? Senator, I I share a concern about, either legal immigrants or illegal immigrants, coming to the country with an infectious disease, or without, recommended vaccinations. I've not had a chance to discuss, I've I've I've been focused on on most of the vaccine questions on rules for citizens and advice to citizens. I haven't had a chance to discuss, rules for legal immigrants with the secretary,
but I would happy if confirmed to to dig in on that issue. Well, I will have that as my, question for the record, if you could respond to that before, next week. Then for any other senator wishing to ask additional questions, questions for the record will be to do at 5PM tomorrow, May 9. Thank you again to mister O'Neil for being here. The committee stands adjourned. Thank you.