[Pages S952-S953]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  NOMINATION OF ROBERT F. KENNEDY, JR.

  Mr. MERKLEY. Mr. President, my colleague from Connecticut is here 
past midnight. Why is he here past midnight? Because the health and 
welfare of our children and our families are at stake. That is why I am 
here, too--because it matters. It matters that you have someone in 
charge of Health and Human Services who has some at least basic 
understanding of the issues and basic experience managing a Department 
or managing an organization. But the candidate, the nominee, RFK, Jr., 
fails--fails on experience, fails on ethics, fails on qualifications. I 
must say the diagnosis is grim in each of these three areas.
  Let's talk a little about his experience running an agency or his 
medical experience. In fact, when Mr. Kennedy was asked during his 
confirmation hearings about some of the Agencies he would oversee, he 
got his facts completely wrong about just the core basics--about 
Medicare, a critical healthcare program for seniors throughout our 
Nation.

  It has these parts--A, B, and C--and people in the medical world all 
know every detail about this. When he was asked about it, he kind of 
just guessed, and he said: Well, Part A covers primary care, Part B 
covers physicians, and Part C is a full menu of healthcare services.
  Well, not even close--not even close. Part A covers inpatient 
hospital services; part B, outpatient and home health services; and 
Part C, Medicare Advantage. I don't know if he could have explained 
what Medicare Advantage is.
  Everyone who works in the field of providing healthcare through 
Medicare understands these core, basic foundations, as well as lots of 
other details.
  Senator Cassidy talked about another piece of the healthcare puzzle. 
We have Medicare. We also have Medicaid. Medicaid in Oregon is the 
Oregon Health Plan. It provides healthcare to families who are 
struggling, who are not yet fully into the middle class.
  He said that all of Medicaid is fully paid by the Federal Government. 
No. No, it is not. In fact, in Oregon, the State picks up two-fifths of 
the tab, and there are different categories and different ratios.
  Maybe one could say that these details--one doesn't need to know 
every aspect of it, but the architecture of our healthcare system, the 
basic architecture, just the simplest, most fundamental pieces, he has 
no idea about.
  These are incredibly important programs in our States, Medicare and 
Medicaid. Forty-four percent of the births in Oregon are covered by 
Medicaid.
  You know, Oregon is a very rural State. We have some big cities, but 
we have a lot of rural areas. Medicaid coverage rates are higher in 
rural areas because incomes are lower and more people qualify.
  Medicaid is incredibly important in the counties that are very rural 
in my State. In my 36 counties, a good two-thirds of them or three-
fourths of them would be considered extremely rural.
  It is important to people in rural America that you have a leader who 
understands and cares about the healthcare program for rural America, 
but that individual is not RFK, Jr.
  Not only that, it is vital that the Health and Human Services 
Secretary understands which ideas don't work.
  Once again, our Republican colleagues are pushing to impose work 
requirements on Medicaid enrollees. Now, every developed country but 
the United States fully backs the idea that healthcare is a right. It 
is not a privilege that comes out of your wealth. They understand that 
in order to be able to work, you have to have healthcare so you can be 
well enough to work. That is every other country. But here, the elite 
across the aisle only want healthcare for the rich. They want to cut 
down Medicaid. They want poor people to struggle and never be able to 
get wealth so they can never get a job so they can keep talking about 
how lazy people are. Well, that is just absurd and wrong in every 
possible way.
  Ninety-one percent of Medicaid enrollees who aren't disabled are 
either employed, in school, or caring for family members. Yet, every 
few years, my colleagues across the aisle trot out this myth, and every 
few years, it gets debunked, and then they bring it back. Just in a 
cycle, like sunspots or something, it comes around every few years.
  We actually have facts on what has happened when this misbegotten 
idea is undertaken.
  In 2018, when Arkansas implemented new work requirements during the 
first Trump administration, to maintain their health insurance, 
Arkansas Medicaid enrollees had to fill out a mountain of paperwork 
every month. Many of these folks worked part time. Many worked hourly 
jobs. Some worked several jobs to make ends meet. Not surprisingly, it 
is very hard, when you are struggling with making multiple jobs fit, to 
have the time to do massive paperwork all the time. They are working 
their jobs, and they are taking care of their families.
  So what happened? Other Medicaid enrollees were working but could not 
reliably meet the required number of hours given the normal 
fluctuations of low-wage and hourly work. If you ever, ever have lived 
in a blue-collar community--and I live in a blue-collar community--
people who are patching together various part-time jobs--the managers 
change the schedules continuously. So now your schedule for one job 
conflicts with the schedule for the other job.
  Anyway, it is very stressful and it is very challenging to be getting 
minimum wage or near minimum wage and conflicting schedules and 
managers changing those schedules and still trying to deal with raising 
kids and being there when you need to be there.
  Roughly 18,000 people lost health insurance in Arkansas before a 
Federal judge halted the new work requirements for violating the 
intended purpose of the Medicaid Program.
  Well, there was another State that tried this out--Georgia. They 
implemented work requirements in 2023. Not wanting their work 
requirements to be struck down by the courts, Georgia lawmakers lowered 
the requirements for Medicaid enrollment, thereby technically expanding 
coverage to fulfill the purpose of the program.
  In doing so, the State of Georgia estimated that another 175,000 
people would enroll in the program. They estimated 175,000, and only 
6,500 people enrolled. The State of Georgia spent $60 million in 
administrative fees tracking compliance with the work requirements--$60 
million; 6,500 people; $10,000 for a Medicaid enrollee in Georgia just 
on administrative overhead, not providing healthcare. The costs just 
kept piling up.
  Uninsured people still need to see a doctor, but instead of seeing 
their doctor and getting care early, uninsured people wait to get care 
until they wind up in the emergency rooms.
  There is an old but accurate saying: ``An uninsured patient is the 
most expensive patient.'' So anyone with half a brain would want people 
to be insured. They will get care earlier. They don't end up in the 
emergency room. It will save money. People are healthier. They are more 
likely to work. And it costs less. It is a win-win on every level.
  Well, if you strike down the support for Medicaid here, States have 
to figure out if they can pick up the difference. Picking up the 
difference means they have to wrestle with whether to raise taxes.
  Why do my colleagues across the aisle in other States have to raise 
taxes to provide basic healthcare?
  Oh, my goodness, yeah, impose that burden on families trying to get 
on their feet and be able to thrive.
  According to the Congressional Budget Office, every Medicaid dollar 
spent today reduces future deficits by $2. That is a pretty good 
return. That is an investment we can't afford not to make. And the loss 
of Medicaid coverage hits rural communities particularly hard.
  As I have noted, most of my home State is rural. A couple of weeks 
ago,

[[Page S953]]

we saw what happened when Medicaid funding was frozen after Donald 
Trump's dead-of-night directive to cut off funding for programs that 
families depended on. Critical access hospitals, rural clinics, 
federally qualified health centers were terrified that they would have 
to lay off staff or shut their doors. Any loss of Medicaid funding for 
these communities would threaten what are often the only hospitals or 
clinics in these rural areas. They are always struggling.
  But when Medicaid was expanded, when Oregon seized that opportunity, 
a lot of patients who were never able to pay a bill could now pay the 
bill because they had insurance, and that meant a much stronger 
foundation for rural healthcare. Don't we want a stronger foundation 
for rural healthcare?
  It is critical to have a Secretary for Health and Human Services who 
understands these issues, and that individual is not RFK, Jr.
  He is, however, something else: one of the world's best-known 
purveyors of conspiracy theories about the alleged harm that comes from 
effective vaccines. That is, he is a conspiracy theorist who says these 
effective vaccines that everyone else knows are effective, he is going 
to tell you something different. He is going to tell you that HPV and 
measles and tetanus and flu and polio and chickenpox vaccines don't 
work.
  His conspiracy theories have been debunked time and time again. They 
have been repudiated time and time again, including the big one--and 
that is that vaccines cause autism. This is a straightforward thing 
that has been studied time and time and time again. And it is a 
powerful conspiracy theory if you happen to have a child who has autism 
and if it starts appearing about the same time that you are giving a 
lot of childhood vaccines. You could believe that maybe that is the 
cause. So it has been studied time and time again in children who have 
vaccines, who don't have vaccines. The vaccines do not cause autism.
  And yet, what has he done? He says: I believe autism comes from 
vaccines.
  In the middle of a 2017 measles outbreak in Minnesota's Somali-
American community, he falsely told parents the following:

       Africans and African Americans may be particularly 
     vulnerable to vaccine injuries including autism.

  He also falsely claimed that the global decline in measles was caused 
by ``nutrition and clean water,'' not the measles vaccine, and that 
children in California were getting measles ``from the vaccine or . . . 
from somebody who got the vaccine.''
  In other words, he stood it on its head and said those who are 
getting sick--who are getting sick because they did not have the 
vaccine--were getting sick because they had the vaccine.
  All of this misinformation does real harm.
  He even raised doubt over flu shots, claiming that ``there is zero 
evidence that the flu shot prevents any hospitalizations or any 
deaths.'' This is completely untrue. This is wrong. A lot of people in 
America die every year from the flu, so this has been extensively 
studied.
  Now, I didn't get flu shots until the COVID epidemic came and my 
wife, who was a nurse, said: While you are getting that COVID shot, get 
your flu shot. I had never gotten a flu shot before. I never worried 
about it. I didn't think about it. It never occurred to me. Lots of 
people didn't. So it was very easy to study those who get flu shots and 
those who don't.
  And what RFK, Jr., did was not be honest with people--in fact, to 
tell people information he undoubtedly knew was untrue. And the result 
is more people get sick, more people die.
  Finally, Kennedy also referred to the COVID vaccine as ``the 
deadliest vaccine ever made.'' Well, we know how many people were dying 
before we had the COVID vaccine, and we now know how much safer things 
are. We are not sitting here on the floor tonight with a mask over our 
face. Our accompanying staff do not have masks over their face. The 
folks in the elevator today didn't have a mask because the threat of 
COVID has receded because we have a COVID vaccine.
  This misinformation isn't just some harmless fun. These conspiracy 
theories are not some harmless fun. They do real harm. They do real 
harm.
  I want to read to you a letter from Josh Green. He is the current 
Governor of Hawaii, and he is a physician. He wrote the following. I am 
going to quote it extensively:

       Mr. Kennedy has spent years undermining one of the greatest 
     public health achievements in history: vaccines. His rhetoric 
     directly contributed to the tragic 2019 measles epidemic in 
     Samoa, which infected thousands and killed 83 people, 
     primarily children.

  He goes on to say--the Governor of Hawaii, current Governor, a 
physician:

       I witnessed this personally. As Hawaii's Lieutenant 
     Governor at the time--

  This is the Governor now--

       and a practicing physician at the time, I led an emergency 
     medical team to Samoa to administer life-saving vaccinations 
     after misinformation--much of it spread by Mr. Kennedy and 
     his network--led to a collapse in immunization rates.
       We saw firsthand the devastating consequences: grieving 
     parents, overwhelmed hospitals, and a nation in crisis.
       The impact of Mr. Kennedy's reckless actions extends beyond 
     Samoa. He has spread vaccine misinformation globally, leading 
     to preventable disease outbreaks that have infected countless 
     people.

  That is the letter from the Governor of Hawaii, also a physician, who 
went on an emergency medical trip to Samoa and witnessed firsthand 
people--children--dying because of the lies from RFK, Jr.
  That is not a person you bring in to lead your healthcare system, and 
every one of my colleagues across the aisle knows it. They know they 
are hurting people by putting him into this office.
  So I ask them: Rethink your responsibility to serve the people of the 
United States. That is your responsibility as a Member of this U.S. 
Senate. You have constituents in your home State. The President is not 
your constituent. The President has platinum-plated healthcare. We are 
not worried about the President getting the best healthcare. We are 
concerned about our constituents.
  I could tell you a lot more because I have a lot of information here. 
My colleague from California is here, and I am looking in his direction 
to see if he is ready to speak. If he is, I am going to wrap up.
  I am particularly struck by the letter written to us by Caroline 
Kennedy, first cousin to RFK, Jr. I will just summarize it and say, it 
is not complimentary. She says in the most dramatic terms that we are 
making a massive mistake to put him in charge; that he has served his 
wallet, he has served without ethics, he has served in a way that has 
hurt people time and time again, and he does not belong in office.
  Mr. President, we are here, as my colleague was before me, Chris 
Murphy from Connecticut, as my colleague from California is now--we are 
all here after midnight. We are here after midnight because this 
matters, because more people will suffer and die across this country, 
more children will die because of the incompetence and the full lack of 
ethics of the individual being considered to head up our healthcare 
system.
  Let's not make this mistake when we vote on his final nomination.
  The PRESIDING OFFICER. The Senator from California.

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