Gov. Josh Green reiterated his opposition to Robert F. Kennedy Jr. becoming the next secretary of health and human services as a Senate committee is scheduled to vote today on whether to advance the nomination to the full Senate.

Since then-President-elect Donald Trump nominated anti-­vaccine activist Kennedy to lead the Department of Health and Human Services, which oversees a $1.7 trillion budget, Green has traveled twice to Washington, D.C., in the past month to oppose the appointment.

Green was invited to travel to Washington from Jan. 27 to 29 by the Protect Our Health Coalition, U.S. Sens Brian Schatz, D-Hawaii, Patty Murray, D-Wash., and Lisa Murkowski, R-Alaska — along with other senators who reportedly requested anonymity due to fear of retaliation — to meet with Senate members and provide input on Kennedy’s nomination.

Green also said he expects “a lot more requests for me to go and provide some leadership on national health matters.”

His second trip made him the only governor at the time to travel specifically to oppose Kennedy’s nomination, following his first visit Jan. 5-9.

The governor told the Honolulu Star-Advertiser that he is prepared to make quick, two- day trips as needed to defend Hawaii’s health priorities, particularly regarding Medicaid and Medicare, while offering his unique perspective as the nation’s only physician governor.

“There are tenfold more asks, it seems, already, for me to help people on the Medicaid and Medicare question, to protect that from Democrats and Republicans, because plenty of red states are worried about this, too,” Green said.

If the Senate Finance Committee advances Trump’s nomination of Kennedy to lead the DHHS, the full Senate will vote on confirmation. If confirmed, Kennedy would oversee Medicaid, Medicare and the Affordable Care Act.

Green, who sat in the Senate chamber during last week’s confirmation hearing before the Finance Committee, described Kennedy’s performance as “terrible.”

“By all accounts, Republican and Democrat, except for people who are completely truly partisan, he did not do well at all,” Green said. “He didn’t know the difference between Medicare and Medicaid. He refuses to dial back his anti-vaccine rhetoric. He says he’s pro-vaccine, but then refuses to admit that studies have shown which vaccines are safe and which ones people should be warned about.”On the first day of his second administration, Trump issued several executive orders, including including Executive Order 14009, which aimed to protect and strengthen Medicaid and the Affordable Care Act.

In a previous interview with the Star-Advertiser, Green strongly criticized Kennedy’s nomination, calling it “gross malpractice” and warning that his appointment would cause significant harm if his role is confirmed.

The announcement of Kennedy’s nomination prompted a sharp response from Green, who recalled receiving an urgent call in 2019 from Samoa’s prime minister during a deadly measles outbreak that claimed the lives of over 80 people, mostly children.

Before the outbreak, Kennedy had visited Samoa with his anti-vaccine group, Children’s Health Defense, where he met with local anti-vaxxers and government officials. Amid rising vaccine misinformation, Samoa’s vaccination rates plummeted from 60%-70% to just 31%, setting the stage for the outbreak.

“I don’t have a crystal ball on what will happen, but I can tell you that both parties were very upset with Trump and how he’s behaving because we expect a little bit more sober governance now in a second term, and his political people appear to be running roughshod over priorities.”

Green reiterated that his opposition to Kennedy is not personal, noting he “would likely support him” if he were nominated for secretary of agriculture due to his positions on pesticides and processed food.

“But he’s up for health and human services secretary, where he will destroy our public health system,” Green said.

Green suggested former Surgeon General Jerome Adams, who served under Trump from 2017 to 2021, or U.S. Sen. Bill Cassidy, R-La., a physician, as better candidates to lead HHS.

“They’re both Republican, conservative, but professional and experienced health care officials. Either one of those guys would be completely qualified, and I would support them personally,” he said.

On a broader scale relating to health care, Green called the first week of Trump’s presidency “scary,” expressing concern that Trump’s impoundment of federal funds — freezing or withholding money appropriated by Congress — could be detrimental, especially to programs that help cover medical costs.

“Love or hate the bureaucracy — and I know that some of our MAGA friends hate it — there are very necessary programs they’re not acknowledging that have to continue, like our Medicaid program,” Green said.

In Hawaii, Medicaid, Medicare and the ACA are essential in providing health care coverage.

Medicaid offers coverage to low-income residents, including children, pregnant women, seniors and the disabled, helping to serve Hawaii’s most vulnerable populations.

As of Jan. 4, a total of 406,813 people in Hawaii are enrolled in Medicaid, with over half of the children in the islands enrolled in it, according to the state Department of Human Services.

“We understand the concerns about Medicaid funding. Please know that we, at the Department of Human Services, hear your concerns, and we will continue to provide you with as much clarity as possible,” DHS Director Ryan Yamane wrote in an email to the Star- Advertiser. “At this time, we want to assure you that if you are covered by QUEST (Medicaid), your health coverage remains in place. Based on the information we have, we fully expect this to continue. If anything changes, we will communicate that information quickly to all impacted residents and their healthcare providers. In the meantime, please continue to access the healthcare serv­ices you need.”

Additionally, as of August, more than 300,000 Hawaii residents were enrolled in Medicare, providing support for people 65 or older, younger people with disabilities and those with permanent kidney failure by helping cover medical costs.

According to U.S. Sen. Mazie Hirono, the ACA — commonly known as Obamacare — has had a significant impact in Hawaii, reducing the number of uninsured people by nearly half. By 2022 over 45,000 residents gained coverage through the ACA.

The law expanded Medicaid eligibility in Hawaii and established health insurance marketplaces where residents can purchase subsidized plans. It also prohibits insurers from denying coverage due to preexisting conditions and mandates that insurance plans cover essential health benefits.

Green acknowledged that to offset the costs of Trump’s tax cuts for the rich, reductions in other areas of the budget, including health care, are likely. He reassured the state that if resources and important programs like Medicaid are cut, he will work to ensure Hawaii covers any resulting shortfalls.

“I can tell you that governors are going to fight for resources for their people, red- or blue-state governors, and so that may be, ultimately, where the policy divide lies,” he said.

While acknowledging that elections have consequences, Green emphasized his commitment to doing his best with the resources available to Hawaii and pushing for additional resources to bring into the state.

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Star-Advertiser staff writer Dan Nakaso contributed to this report.