While lawmakers grilled Robert F. Kennedy about his views on vaccines and abortion, President Trump's nominee to lead the U.S. Department of Health and Human Services was also asked how he'd run the two largest government health insurance programs − Medicare and Medicaid.

The hearing offered the public a glimpse of the Trump administration's plans for Medicaid, a federal-state health program for low income and disabled residents. While Trump vowed during the campaign to protect Medicare, the government insurance program for adults over 65, he hasn't made the same promise about Medicaid, which provides health insurance for about 1 in 5 Americans.

Democrats and Republicans peppered Kennedy with questions about his plans for Medicaid and lowering drug costs. Democrats worry that Congressional Republicans proposed Medicaid cuts would "rip away health care for millions of Americans," and shutter nursing homes and rural hospitals, said Sen. Ron Wyden, an Oregon Democrat.

Here are three takeaways from Wednesday's hearing:

Kennedy wants these Medicaid reforms

Kennedy, an environmental lawyer, said he didn't have a broad proposal for Medicaid but suggested the nation needs to "experiment with pilot programs in each state."

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"Do you think all that money, the $900 billion we're sending to Medicaid every year, has made Americans healthy?" Kennedy said.

When quizzed by Sen. Bill Cassidy, a Louisiana Republican and a doctor, Kennedy said the "ultimate goal" is to transform how the nation pays for Medicaid.

He wants the program to embrace value-based care, which describes paying for outcomes instead of the existing fee-based system that reimburses for each service. Health policy experts argue that fee-based reimbursement encourages more tests, services and procedures for patients rather than focusing on what might make a person healthy.

He also said Medicaid should adopt health cooperatives and encourage health savings accounts, which allow people to set aside pre-tax income in a savings account to pay for health expenses down the road.

Kennedy claimed Americans don't like Medicaid and said premiums and deductibles are too high for most Americans. But most people who take Medicaid qualify because they have low incomes and don't pay premiums or deductibles.

He suggested his proposed reforms would "make people more accountable for their own health."

Priority is to end chronic disease

Kennedy said the U.S. spends more on health care because Americans are sicker with chronic disease compared to other nations. Because Americans are sicker, the nation's Medicaid costs have spiraled and far more Americans died from COVID-19 during the pandemic than comparable nations, he said.

He said fights over money in health care − whether from insurance companies, families or doctors − amounts to "moving deck chairs on the Titanic," unless the nation gets healthier.

"President Trump has asked me and the chronic disease epidemic and make America healthy again," Kennedy said. "And that is what I'm doing."

Will Kennedy commit to lowering drug prices?

Democrats sought a commitment from Kennedy that he would work to lower prescription drug prices.

Sen. Catherine Cortez Masto, a Nevada Democrat, noted Republicans in Congress have worked to repeal the Inflation Reduction Act, the 2022 federal law that empowered Medicare to negotiate drug prices and capped seniors out-of-pocket drug costs at $2,000 this year.

“Are you there to be a rubber stamp to this administration?” Cortez Masto asked.  

Kennedy said the Trump administration would issue an executive order supporting drug price negotiations under the law, but no such order has been issued yet. A Trump spokesperson did not immediately address a question from USA TODAY about Kennedy’s statement.

Kennedy added the president told him the nation needs to lower drug prices for seniors.