Republicans in the U.S. Senate are moving quickly to advance the nomination of Robert F. Kennedy Jr. to lead the Department of Health and Human Services (HHS), the cabinet-level federal agency that includes the Indian Health Service (IHS).

On Sunday, Sen. Mike Crapo (R-Idaho) announced that the Senate Committee on Finance will consider Kennedy’s nomination to serve as Secretary of Health and Human Services. The meeting on Tuesday morning comes after two confirmation hearings that took place last week.

“You have been accessible to the members and staff on both sides of the aisle throughout a rigorous process, and I want the whole world to know that you spent hours in meetings answering questions outside of this hearing, and providing documents and responses on issue after issue,” Crapo told Kennedy after the Finance committee’s hearing last Wednesday.

“You have gone through the most thorough vetting process that any committee in this Congress puts anybody through, and I think that you have come through well and deserve to be confirmed,” Crapo said at the conclusion of the hearing, during which Kennedy testified and answered questions for less than three hours.

As part of the process, members of the committee submitted written questions on slew of issues at HHS. A number of them touched on IHS and Indian health.

In most cases, Kennedy responded with generic answers that did not directly address health programs for American Indians and Alaska Natives. He also provided the same word-for-word responses to some questions.

“If confirmed, I will take the steps needed to end the chronic disease epidemic and make all Americans healthy again,” Kennedy said in repeated responses to questions about disparities affecting Native maternal health.

Kennedy’s responses on the record were released by the committee in three parts in a document dated January 29. Responses to follow-up questions from Sen. Ron Wyden (D-Oregon), the Democratic ranking member, and other Democratic lawmakers were also provided in documents dated on the same day.

What follows are the questions and responses from Kennedy about Native people. The text is drawn from the three-part document. The follow-up responses did not contain information about Indian health.

AHRQ found that life expectancy in the US for non-Hispanic White Americans is six years longer than for Black Americans, and 11 years longer than for Native American populations. What specific steps would you take to address this problem?
Response: If confirmed, I will take the steps needed to end the chronic disease epidemic and make all Americans healthy again. [Page 28, Part 1]

Why do you believe Black, Hispanic, and Native American people in the United States are more likely to die from cancer than their white counterparts?
Response: If confirmed, I will take the steps needed to end the chronic disease epidemic and make all Americans healthy again. [Page 29, Part 1]

What are your plans to address disparities in cancer rates?
Response: If confirmed, I will take the steps needed to end the chronic disease epidemic and make all Americans healthy again. [Page 29, Part 1]

As we confront the persistent and pervasive health inequities faced by Black, Hispanic, Native American populations in the United States, what specific structural barriers do you believe are driving these inequities?
Response: If confirmed, I will take the steps needed to end the chronic disease epidemic and make all Americans healthy again. [Page 29, Part 1]

What is the role of HHS in addressing these structural barriers?
Response: If confirmed, I will take the steps needed to end the chronic disease epidemic and make all Americans healthy again. [Page 29, Part 1]

Will you commit to directing HHS to support existing programs aimed at addressing the maternal health crisis, and especially these disparities in maternal health outcomes among Black, Indigenous, and rural Americans?
Response: If confirmed, I look forward to addressing the nation’s maternal care and ensuring that we make all Americans healthy again. [Page 44, Part 1]

The U.S. is facing a maternal health crisis, with disproportionately high rates of maternal mortality, particularly among Black, Indigenous, and rural populations. You highlighted this crisis during your time on the Presidential campaign trail, tying it to a high prevalence of chronic disease among Black Americans, largely caused by systemic poverty, the long impact of redlining, and racism. Is it still your belief that these root causes are contributing to the high maternal mortality rate?
Response: If confirmed, I look forward to addressing the nation’s maternal care and ensuring that we make all Americans healthy again. [Page 44, Part 1]

How does Indian Country benefit from Medicaid?
Response: I care very deeply about Native American issues and have spent much of my career working to support tribal nations. If confirmed, I would work closely with the President to determine how we can best meet the needs of Native Americans on Medicare and Medicaid. These populations deserve better health outcomes and quality of care. [Page 51, Part 1]

The Vaccines for Children program provides immunization for children aged 18 and under who are eligible for Medicaid, are Native American or Native Alaskan, are uninsured or are underinsured. The program has been extremely successful in making sure that all children can get the same care, regardless of where they live or whether they have wealthy parents. In fact, in 2023 alone, VFC distributed over 74 million vaccines to participating health care providers to administer to their patients. Do you agree that this program is essential in our nation’s efforts to keep the most vulnerable children safe from harmful, preventable infectious diseases? If confirmed, do you commit to working with Congress to ensure that this program receives proper funding?
Response: If confirmed, I look forward to working with Congress to better understand and evaluate this program. [Page 32-33, Part 2]

Note: The following is a multi-part question from Sen. Maria Cantwell (D-Washington). The full exchange is provided.
Congressional Republicans have proposed cutting over $2 trillion in federal Medicaid funding by implementing per capita caps and work requirements, while lowering federal Medicaid contributions to pay for President Trump’s expiring tax cuts.

1. Last time we met, you told me that you supported reauthorizing the 100% federal Medicaid match for Urban Indian Health Clinics. I believe it is because that you understand federal Medicaid contributions are critical to health care organization’s financial stability.
a. Will you also support upholding existing federal Medicaid contribution levels?
2. In 2024, hospitals in my state faced a financial shortfall of almost $400 million. Congressional Republicans’ Medicaid cuts would cause people to lose coverage, further reducing revenue for hospitals and could cause some in rural areas to close maternity wards or shut down completely.
a. You said that you will work to increase access to health care, especially in rural areas. How is cutting Medicaid funding consistent with your goal to “Make America Healthy Again?”
3. Medicaid funds important home and community-based services, including the Money Follows the Person program.
a. Will you commit to continuing the Money Follows the Person program and providing adequate Medicaid funding for it?
Response 1-3: I am committed to improving healthcare quality and outcomes for all Americans, and Medicaid is an important program to support that goal. While decisions about funding levels are set by Congress, if confirmed, I would work with states as HHS Secretary to ensure that the Medicaid program is well administered, effective, and available for the most vulnerable beneficiaries, and that the states are given the flexibility to pursue innovative approaches that fit the needs of their citizens. [Page 49-50, Part 2]

Tribal health facilities serve 2.5 million Native Americans a year, historically, Indian Health Services (IHS) has suffered from a 25% vacancy rate. I have worked across the aisle with my Senate colleagues to rectify this issue. Do you commit to ensuring these Tribal health care services are adequately staffed, receive funding, and can recruit and retain Tribal health care doctors?
Response: I will work with you, this Committee, and your colleagues on the Senate Committee on Indian Affairs to find innovative solutions to the staffing shortages and service delivery issues impacting IHS, tribal communities, and rural America as a whole. [Page 60, Part 2]

Many Native American Tribes face unique challenges when it comes to accessing health care, including the use of Medicare and Medicaid. What steps would you take to ensure that Tribal nations have equitable access to these programs and how would you address any barriers that prevent these communities from receiving the full benefits they are entitled to?
Response: The 574 federally recognized tribes in the United States reside in some of the most rural and underserved parts of the country. Health access in these areas can be a pervasive challenge and it is unacceptable. I will work with you, this Committee, and other internal and external partners to find innovative solutions whether that includes access to technology, ways to encourage workforce expansion, or other unexplored and novel ideas. [Page 60, Part 2]

The health care needs of Native American communities are often underserved, and Indian Health Services (IHS) faces significant challenges in delivering adequate health care. What steps would you take to strengthen health care services for Native Americans and do you commit to upholding the federal trust responsibility that the U.S. Government has to Native American Tribes to provide adequate health care?
Response: If confirmed, I intend to uphold the Department’s legal, social, and moral obligations for the health services promised to American Indian and Alaska Native communities. [Page 60, Part 2]

As of 2022, there were 76 approved Tribal TANF programs, serving over 285 federally recognized Tribes – more than half of all federally recognized Tribes. Five Tribes in Minnesota have Tribal TANF programs. If confirmed, will you protect these programs, as many Tribes depend on these for career training and job placement?
Response: If confirmed, I intend to explore efficiencies across all HHS programs. I look forward to working with this Committee on this important topic. [Page 34, Part 3]

New Mexico faces one of the nation’s most severe health care workforce shortages, with 32 of our 33 counties designated as Health Professional Shortage Areas. Rural and tribal communities are particularly impacted, struggling to attract and retain health care providers. What specific policies would you propose to address these shortages? In particular, how would you balance immediate needs for health care workers with long-term solutions for building a sustainable health care workforce pipeline in underserved communities?
Response: If confirmed, I will work closely with IHS and Congress to propose novel solutions to the chronic workforce shortages in tribal communities to improve care delivery to underserved populations. [Page 36, Part 3]

You have been a vocal supporter of advocating Native American rights and have acknowledged the intersections between climate and health, how will you support the well-being of indigenous communities through improving access to health care? How will you work with the Indian Health Service (IHS) to promote Native health?
Response: Throughout my career, I have always supported American Indians and Alaska Natives and the federal trust responsibility for health care. If confirmed, I will work tirelessly to improve health services to Tribal nations, honor Tribal sovereignty and fulfill our obligations to Native Americans across our department. This means striving to improve services at IHS. This includes working to staff IHS and accepting only the highest quality of care. We will also work to make sure that all of HHS is responsive to the unique needs of Tribal nations. [Page 38, Part 3]

Native American women have the second highest maternal mortality rate, second to Black women in the U.S. and are 2 to 3 times more likely to die from pregnancy-related complications compared to white women. One major contributing factor to this outcome is limited access to health care services. How do you intend to work to expand care to those living in rural and remote areas?
Response: I agree that we must do better to ensure that American Indian and Alaska Native women have access to health services and improved pre and postnatal services. It is critical to improve staffing at the IHS across these specialties and leverage already existing programs like the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program to ensure that Native moms and families are getting the culturally appropriate care that they need. [Page 39-40, Part 3]

With the roll back of Diversity, Equity, Inclusion language, and programming, how do you intend to protect Native American women from experiencing racial bias, discrimination, and mistreatment in health care settings, which contributes to maternal mortality?
Response: IHS staff currently receive cultural training to ensure that they are able to serve their patients in an appropriate manner. We have no intention of rolling back this long-standing practice at IHS. [Page 40, Part 3]

Responses To Questions For The Record To Robert F. Kennedy, Jr. Part 1 (January 29, 2025)
Responses To Questions For The Record To Robert F. Kennedy, Jr. Part 2 (January 29, 2025)
Responses To Questions For The Record To Robert F. Kennedy, Jr. Part 3 (January 29, 2025)
Further Responses To Questions For The Record To Robert F. Kennedy, Jr. (January 29, 2025)
Further Response To Senator Wyden Question For The Record To Robert F. Kennedy, Jr. (January 29, 2025)
Robert F. Kennedy, Jr. Opening Statement at Confirmation Hearing (January 29, 2025)

Hearing to consider the nomination of Robert F. Kennedy, Jr., of California, to be Secretary of Health and Human Services (January 29, 2025)