Vax Beliefs of HHS Deputy Secretary Nominee Probed at Hearing

Chris Klomp, President Donald Trump’s nominee for deputy HHS secretary, declared his support for the measles, mumps, and rubella (MMR) vaccine at a Senate Finance Committee confirmation hearing Tuesday, but that wasn’t good enough for one of the Democratic senators on the committee.

Klomp, who currently serves as HHS chief counselor, told Sen. Ron Wyden (D-Ore.), the committee’s ranking member, that “Unquestionably, the MMR vaccine is the single most effective public health tool that we have against measles. It’s 97% effective after two doses [in] preventing transmission, and this is the single best thing that we can do to eradicate” the disease, Klomp said.

He added, however, that on the question of whether the vaccine causes autism, “I do not believe, based on the preponderance of evidence I have seen, that MMR vaccines cause autism. But we also don’t know what causes autism, and as a country, that should concern us greatly.”

Wyden was not happy with Klomp’s testimony. “We’ve had a real word salad on the vaccine issue,” Wyden said as the hearing concluded. “You’ve been all over the map, and you have this view and that view. And the president is a good guy, and you like Kennedy. But people are still going to be confused.”

“We’ve got the highest [measles] rates now in decades, and you aren’t giving people any clear statement about what you would do if you’re confirmed,” Wyden continued. “So I want to announce today I’m going to oppose your confirmation. I’m going to oppose it vigorously because of the confusion and the bedlam you created on the vaccine issue this morning.”

Committee chairman Sen. Mike Crapo (R-Idaho) took the opposite view. “You have met all of the requirements and standards of this committee in vetting a nominee, and you are completely and well qualified to be deputy secretary at the Department of Health and Human Services,” he told Klomp.

Sen. Maggie Hassan (D-N.H.) asked Klomp about Trump’s executive order in August recommending that parents get their children — once they are available — a separate vaccine for each MMR component: one for mumps, one for measles, and one for rubella.

“It is very difficult for me to understand how a president and a secretary of HHS, who said they wanted kids to get fewer jabs, are now recommending that they get more jabs, to separate out an MMR vaccine into three different vaccines when there’s no scientific evidence for it,” Hassan said. “That doesn’t sound to me like kids are going to get more vaccines or have more confidence — it just confuses it.”

She asked Klomp whether he agreed that parents should disregard the president’s executive order and rely on recommendations from medical professionals instead.

Klomp did not answer directly. “I believe that my responsibility in the department is to ensure that we conduct the appropriate research so that we can communicate what is most effective and most honest to all parents,” he said.

Sen. Sheldon Whitehouse (D-R.I.) discussed Medicare physician payment rates, noting that payments in Rhode Island were 20% lower than in neighboring states such as Connecticut and Massachusetts. He thanked Klomp for the “technical assistance” that he provided in trying to solve the problem, which is due to differences in the program’s wage index.

Whitehouse then brought up the issue of prior authorization, specifically in relation to medical practices that participate in value-based care arrangements that reward them financially for providing high-quality care at a low price.

“Once a primary care provider has entered into a value-based reimbursement environment, its economic incentives way better align with that of the insurer,” he said. “It doesn’t make sense for a provider in a shared savings program to run up costs as it might in a fee-for-service program, when running up costs actually puts them on the hook for either less savings or perhaps even penalties.”

Whitehouse proposed that no insurer should be allowed to require prior authorization of any healthcare entity that participates in value-based care — unless the insurer gets express permission first from CMS.

“We should flip the script so that you don’t get to do that unless CMS has cleared it,” he said, adding that he looked forward to having more conversations with Klomp on the issue.

Sen. James Lankford (R-Okla.) expressed concern about pharmacy benefit managers (PBMs) and asked Klomp how he would ensure that PBMs wouldn’t favor brand-name drugs — which they often get rebates from — over generic drugs and biosimilars.

“We know that when suppliers compete openly, fairly, honestly, consumers win,” Klomp replied. “Anything that we can do to increase transparency, so that employers, in particular, understand what they’re spending money on and what they’re getting, will increase competition.”

He mentioned TrumpRx as one example. “TrumpRx had two core goals — number one, to make low-cost drugs available to everyday consumers in the market … and number two, to serve as a single source of truth or transparency for employers, so that they could look and say, ‘Wait a minute! I see a drug available on TrumpRx for $100 but I see that I’m paying $300 through my PBM. Why is that?’ And then demand accountability and spur competition.”

Sen. Steve Daines (R-Mont.) asked about the FDA’s ongoing safety review of the medication abortion drug mifepristone; he criticized what he said was the Biden administration’s “reckless” decision to remove the drug’s in-person dispensing requirement during the COVID pandemic.

Klomp replied that HHS “should not fear questions [or] fear continuous safety studies of any approved medication … so that is what the FDA should be doing.” He confirmed that the FDA will have a status report on its review by Oct. 7 and that the full report should be available by year’s end.