Sen. Shelley Moore Capito, R-W.Va., questions witness Health and Human Services Secretary Robert F. Kennedy Jr., during a Senate Committee on Appropriations subcommittee hearing to examine proposed budget estimates for fiscal year 2026 for the Department of Health and Human Services, on Capitol Hill, Tuesday, May 20, 2025, in Washington. (AP Photo/Manuel Balce Ceneta)

CHARLESTON — U.S. Sen. Shelley Moore Capito urged Robert F. Kennedy Jr., the cabinet secretary of the U.S. Department of Health and Human Services, to consider keeping National Institute for Occupational Safety and Health whole in his federal budget proposal.

Kennedy presented his budget proposal Tuesday morning for fiscal year 2026 beginning Oct. 1 to the Labor, Health and Human Services, Education, and Related Agencies Subcommittee of the Senate Appropriations Committee. Capito, R-W.Va., chairs the subcommittee.

“I know that we all share the goal of improving the health of Americans,” Capito said to Kennedy. “This hearing is an important opportunity for the subcommittee to hear from you on the HHS’s budget proposal and better understand your priorities for fiscal year 2026.”

Kennedy and the White House have proposed a $94 billion budget for Health and Human Services – a nearly 25% decrease in discretionary spending from the current fiscal year.

This request comes as Kennedy cut 20,000 employees at HHS – nearly a quarter of the workforce – for the current fiscal year from 82,000 employees to 62,000 employees. According to Kennedy, employment at the department increased by 40% under former President Joe Biden. The department has also identified $13 billion in contract savings.

Kennedy told the subcommittee that the fiscal year 2026 budget request would reduce duplication of programs and services and increase accountability, while working with state and local governments to improve flexibility. HHS restructuring during fiscal year 2026 could save taxpayers an estimated $1.8 billion annually through shrinking the workforce, he said.

Kennedy said the department’s 28 divisions would shrink to 15 and 10 regional offices would be consolidated into five, while preserving Medicare, Medicaid and Head Start, which serves 750,000 children. Kennedy said he would also create a new Administration for a Healthy America to better coordinate programs targeted to improve chronic care, disease prevention and other health resources.

“The United States remains the sickest developed nation, despite the fact that we spend $ 4.5 trillion annually on health care, two to three times more per capita than comparable nations. Clearly, something is structurally wrong,” Kennedy said. “All the money that we’ve been pouring into these programs for years has not resulted in better health for Americans.

“Furthermore, health care costs are steadily increasing at a rate of 2% greater than the economy,” he continued. “If we don’t staunch this unsustainable hemorrhage, we will ransom our children to bankruptcy, servitude and disastrous health consequences.”

During her opening remarks, Capito addressed the ongoing issues with the National Institute for Occupational Safety and Health. Last week, the U.S. District Court for the Southern District of West Virginia issued a preliminary injunction on behalf of a coal miner ordering that reductions in force for the NIOSH Respiratory Health Division be halted and employees reinstated.

Capito and other members of West Virginia’s congressional delegation have also worked toward reinstatement of NIOSH employees at its Morgantown facility, with 100 recently being returned to full-time status. HHS had cut approximately 900 NIOSH jobs, leaving just 10% of NIOSH’s workforce remaining.

“You and I have talked about the importance of the NIOSH coal programs to West Virginia and how the work conducted by NIOSH in Morgantown is unique across the federal government,” Capito said. “I am pleased that you brought some of these specialized NIOSH employees back to work earlier this month and then, just last week, reversed their RIFs so that their return to the office will not be temporary.

“While your action last week was a good first step, there are other divisions within NIOSH with specialized staff who conduct essential, unique work. I support the president’s vision to rightsize our government, but as you and I have discussed, I do not think eliminating NIOSH programs will accomplish that goal. I encourage you to look closely at all of NIOSH’s offices and bring back additional critical staff.”

Later, Capito asked Kennedy about potential cuts to clinical trial programs for pharmaceuticals and other treatments. Some of these programs take place in conjunction with higher education institutions, providing National Institutes for Health funding to colleges and universities.

“These clinical trials often lead to getting life-saving drugs to the market,” Capito said. “I’ve heard from West Virginia University and Marshall University, which receive smaller amounts, but I’ve heard from everybody across the country in terms of the research.”

“We are not cutting any clinical trials. … We’re not cutting drug development. We’re cutting administrative costs,” Kennedy said. “We’re paying some of these universities up to 78% (on indirect costs). That money was not going to research.

“We’re looking at a series of different ways that we can fund those … but not through the independent, indirect cost structure, which loses all control … of how that money is spent,” he continued.

Kennedy has also proposed folding the Substance Abuse and Mental Health Services Administration into the new Administration for a Healthy America agency. Kennedy said the goal is to eliminate funding for substance use disorder programs that duplicate block grant funding or whose impact is questionable.

Capito and other members of the subcommittee raised concerns about eliminating programs addressing the substance use disorder crisis, such as state opioid response grants.

“Substance abuse challenges also continue to be a real problem facing West Virginia and the nation,” Capito said. “SAMHSA grant funding has played an important role in West Virginia, and I want to understand how the budget proposal will impact my state.”

“Your budget proposes eliminating SAMSHA entirely and consolidating critical substance use and mental health block grants under a vague framework that’s not at all clear to me,” said Sen. Jeanne Shaheen, D-N.H. “Will you commit to preserving the state opioid response grant program and working with this committee … to ensure that states, like New Hampshire, that are suffering with high rates of addiction, receive the funding and support they need?”

“This is an issue that is very close to my heart. I lost a brother to this disease. I’ve lost other family members. I’ve lost a niece, who was essentially a daughter to me. … I have my own 14-year struggle with heroin addiction,” Kennedy said. “It’s always been a priority, and it will continue to be a priority for me. I think all of the interventions you mentioned are interventions we’re going to support.”

“I appreciate and understand why you’d be sympathetic to this challenge. That’s why it’s so hard for me to understand why you would be considering programs that have been working, like the state opioid response grants,” Shaheen said. “That’s why I am so troubled by the idea that you would eliminate the entity that makes those grants available.”

“We will continue to support the most effective ways of ending the opioid epidemic,” Kennedy said. “We have not done a good job at that in the past. We can do a lot better. We need outcome-based care. … I have to look at that particular grant. If it is working, we want to support it.”