Secretary Kennedy Is Cooking the Books

The public comment process is one of the last guardrails between federal agencies and corporate capture. The idea is simple: Before the government makes a major policy change, it has to ask the public what it thinks. It's not perfect, but it's supposed to mean something.

Secretary Robert F. Kennedy Jr.’s Health Resources and Services Agency is working to make sure it doesn't.

Here's what we know. HRSA asked for public comment on its proposed 340B rebate model — a scheme that would force safety-net hospitals, rural clinics, and federally qualified health centers to pay drug companies full price upfront and then beg for a refund later. The public responded with 5,576 comments. And HRSA has, to date, publicly released fewer than half of them.

That's right. Of the comments received, HRSA has posted only 2,451 to the public docket. The rest? Sitting in an agency review queue, invisible to the public and unavailable for scrutiny. We don't know why. We don't know when they'll be released. This is not transparent rulemaking.

Here’s what we found when we analyzed the comments HRSA did release — and it's the part that should make every member of Congress sit up.

The comments HRSA has made public are 50 percent auto-generated.

We pulled every comment in the public docket directly from regulations.gov and analyzed them. What we found were two coordinated astroturf waves — filing spikes on April 3 and April 13–14 — in which 94 percent and 91 percent of comments, respectively, were word-for-word identical. The same template. The same sentences. Filed by hundreds of different names, in rapid sequence, clearly generated by a pharma-funded patient advocacy group.

We've seen this playbook before. It's the same one Big Pharma used in state contract pharmacy proceedings. Flood the zone with manufactured "patient" voices. Make it look like the public is divided. Then let a captured agency do the rest.

The names on those comments read like a comedy sketch. "Corey Corey." Multiple filings from the same household. Suspicious patterns that should be flagged immediately by anyone applying basic scrutiny. And yet HRSA's own system has not tagged a single one of these comments as a duplicate. The agency’s official mechanism for flagging manufactured submissions shows zero! In Secretary Kennedy’s HRSA, every astroturf letter is being counted as an individual, authentic voice.

Once you strip out the manufactured comments, the math is not close. Of the 1,222 legitimate comments in the public record, 99.8 percent oppose the rebate model. Zero pro-rebate organizational submissions were identified in any filing window outside the astroturf campaign. Not even one patient advocacy group speaking for itself — as opposed to shilling on behalf of its pharma funders. The authentic record is, effectively, unanimous. But no matter. The rebate plan has already been sent to the White House Office of Management and Budget for review.

Secretary Kennedy — who built his brand on being the one guy willing to take on the pharmaceutical industry, who promised to drain a swamp that was making Americans sick — is now running an agency that withholds public comments, declines to flag obvious astroturf as duplicates, and appears poised to count manufactured pharma propaganda as legitimate public input on a policy that will gut funding for rural hospitals and safety-net clinics serving the most vulnerable patients in America.

Don't cook the books, Secretary Kennedy. Release all 5,576 comments. Tag the duplicates. Count the real voices — all 99.8 percent of them. That's the American public telling you that the 340B rebate scheme is wrong.