Opinion
Article
Author(s):
Robert F. Kennedy Jr, a prominent antivaccine activist and former independent presidential candidate, has been nominated to lead HHS, where he would oversee significant aspects of the nation’s public health policy.
President-elect Donald Trump has announced his nomination of Robert F. Kennedy, Jr for HHS Secretary.1 Kennedy, a prominent antivaccine activist and former independent presidential candidate, would oversee significant aspects of the nation’s public health policy. His controversial stances—ranging from opposition to vaccines and water fluoridation to support for alternative treatments like hydroxychloroquine—signal potential upheavals in long-standing public health initiatives.
Kennedy’s nomination marks a departure from traditional HHS candidates, with Trump opting for a figure who has publicly criticized federal health agencies. His views have drawn criticism from scientists and lawmakers, including Senate Finance Committee Chair Ron Wyden (D, Oregon), who called Kennedy’s positions “disturbing” and signaled intense scrutiny during the confirmation process.
Although Kennedy has pledged reforms to the FDA and HHS, and advocated tying drug prices to European standards, his broader health policy agenda remains uncertain, particularly regarding issues like the Affordable Care Act and Medicaid. So far, Kennedy's nomination appears to reflect his strong stances on the key aspects of health he's broadcasted and Trump's unorthodox approach, setting the stage for contentious Senate hearings.
Trump has promised that Kennedy’s leadership will focus on combating chemicals, pollutants, and additives that he claims contribute to chronic disease in the US.1 Kennedy is known for touting healthier diets, discouraging seed oils and pesticide-heavy agriculture, and advocating for raw milk, despite health risks associated with unpasteurized dairy.2 His potential influence on dietary recommendations would likely face challenges in balancing industry interests with public health goals.
On Fox & Friends, Kennedy explained that improving food quality in the US is "easy to fix," citing that many ingredients used in foods are not permitted in European countries.3 "The reason for that is corruption," he said. "The food industry and big agriculture producers control the FDA, and so they're not worried public health; they're worried about advancing the mercantile interests of those corporations."
Ending the chronic disease epidemic was a prominent platform of Kennedy's previous independent presidential campaign. Now, as part of Trump's administration, he plans "to see measurable results in 2 years," at the president-elect's request.4 Kennedy has brought up concerns about the role chronic disease played in the US mortality rate during the COVID-19 pandemic, comparing it with that of other nations and blaming the lack of efficiency of the CDC. He often underscores that the prevalence of chronic diseases, such as diabetes and autism, among others, was much lower when he was younger, and now, "we have the sickest children in the world."
"When I was a kid, the autism rate among American children, and in 70-year-old men today in my generation, is 1 in 10,000," Kennedy said on Fox & Friends. "In my children's generation, it's 1 in every 34 kids, in every 22 boys." However, he fails to acknowledge that the reason for this is unknown, and there are various factors that could contribute to this increase. Although autism may have been documented by fringe psychiatrists in the early 1900s, it wasn't recognized as a disorder or included in Diagnostic and Statistical Manual of Mental Disorders-III until the 1980s.5
Kennedy has used personal anecdotes frequently while speaking about the current state of health in the country by comparing it with his perspective of growing up.3 Although it's true that current health care spending is at an all-time high,6 especially vs his uncle President John F. Kennedy's time in office, Kennedy has repeatedly made claims about fixing this based primarily on experience bias, lacking the nuance in considering other possible factors.
Kennedy is critical of the FDA’s approach, especially regarding its regulation of alternative treatments like psychedelics, stem cells, and certain supplements.2 He described the FDA as resistant to health innovations and claimed that the "FDA's war on public health is about to end," according to a post from his X account from October. He wrote that employees involved in what he described as a "corrupt system" should preserve their records and prepare to be ousted.
While Kennedy’s rhetoric has questioned FDA-approved products, spanning antidepressants—connecting the increase in the treatment's use with the country's rise in mass shootings—to vaccines, experts argue that substantial changes would be difficult. The FDA's lengthy longstanding framework involves rulemaking processes and extensive collaboration, making the reality of these changes ripe with significant legal and procedural hurdles.
Kennedy is an outspoken vaccine skeptic, claiming that no vaccine is entirely safe and effective and linking vaccines to autism—a claim disproven by scientific research.2 He suggests reviewing vaccine safety and informing the public more comprehensively. He's assured that those who want to be vaccinated will still be able to do so, stating that his stance is "you oughta know the safety profile and the risk profile and the efficacy of that vaccine, and that's it."7
However, experts worry that his influence could erode vaccine coverage and heighten the risk of preventable diseases.2 While leading HHS, which includes the FDA and CDC, he might push for changes, although federal structures and regulatory practices make rapid adjustments challenging.
Kennedy opposes adding fluoride to drinking water, arguing that it’s an unnecessary and ineffective way to deliver the mineral, now available in toothpaste.2 He asserts that high fluoride levels may harm children's IQ, although the CDC and expert panels maintain there’s no convincing evidence of adverse effects from community water fluoridation. However, this policy is primarily a state and local decision.
Kennedy’s positions reflect a broader skepticism of established medical and scientific consensus, drawing concern from experts who warn that his influence could weaken public trust in health recommendations.2 Despite Republicans controlling both houses of Congress with the incoming term, Kennedy's health initiatives will likely warrant scrutiny in a Senate confirmation hearing.1
The fate of the Affordable Care Act, Medicare drug price negotiations, 340B reform, pharmacy benefit manager transparency, or other legislative priorities is still uncertain. Although Trump has historically employed extensive efforts to dismantle the Affordable Care Act, he's offered little clarification on his plans for federal health policies in his new term.8 Yet, Kennedy has provided even less insight into his position on these components, leaving many questions about the country's future health policies unanswered at this time.
References
1. Mattina C. Trump announces RFK Jr as HHS Secretary pick. AJMC®. November 14, 2024. Accessed November 15, 2024. https://www.ajmc.com/view/trump-announces-rfk-jr-as-hhs-secretary-pick
2. Miller K. Trump is praising RFK Jr.'s Make American Health Again' plan. Scientists are worried. Fortune Well. November 13, 2024. Accessed November 15, 2024. https://fortune.com/well/article/rfk-jr-maha-plan-health-policies-trump/
3. Fox & Friends #MAHA. Kennedy MAHA. October 31, 2024. Accessed November 15, 2024. https://www.mahanow.org/fox-friends-maha-video
4. President Trump has asked me to do three things. Kennedy MAHA. November 12, 2024. Accessed November 15, 2024. https://www.mahanow.org/three-things-video
5. Rosen NE, Lord C, Volkmar FR. The diagnosis of autism: from Kanner to DSM-III to DSM-5 and Beyond. J Autism Dev Disord. 2021;51(12):4253-4270. doi:10.1007/s10803-021-04904-1
6. Grossi G. US health spending hits $4.8 trillion, insurance coverage peaks in 2023 projections. AJMC. June 12, 2024. Accessed November 15, 2024. https://www.ajmc.com/view/us-health-spending-hits-4-8-trillion-insurance-coverage-peaks-in-2023-projection
7. My take on vaccines. Kennedy MAHA. October 16, 2024. Accessed November 15, 2024. https://www.mahanow.org/take-on-vaccines-video
8. Grossi G. Harris defends ACA while Trump calls for "much better" health plan during debate. AJMC. September 11, 2024. Accessed November 15, 2024. https://www.ajmc.com/view/harris-defends-aca-while-trump-calls-for-much-better-healthc-plan-during-debate