Robert F. Kennedy Jr Confirmed as HHS Secretary, Nearly Along Party Lines

In a 52-48 vote Thursday, the US Senate made Robert F. Kennedy Jr the nation’s top health official as secretary of HHS.¹ The vote comes after intense confirmation hearings and tense committee votes in which it appeared some Republicans were struggling with the choice, but the majority party has now thrown their support behind the longtime vaccine skeptic, critic of processed foods, and initiator of the Make America Healthy Again agenda.

The lone Republican holdout was Sen Mitch McConnell (R, Kentucky), a polio survivor who has taken issue with Kennedy’s decades of opposition to vaccines. McConnell has also voted against confirming some other nominees in the new administration, including Tulsi Gabbard as director of national intelligence and Pete Hegseth to lead the Department of Defense.

President Donald Trump’s initial announcement of Kennedy as his pick to lead HHS was met with both support and skepticism.² Proponents are enthusiastic about his pledges to promote healthier foods, tackle pollution, address root causes of chronic disease, and ban prescription drug ads. Mainstream public health voices, however, have raised concerns about his long history of false statements about vaccines and touting of raw milk and unproven COVID-19 “cures.”

The path to Kennedy’s confirmation was rocky, with Democrats drawing attention to his financial disclosures, which included stakes in lawsuits against vaccine makers including Merck.³ He resigned from his nonprofit, Children’s Health Defense, which is known for its antivaccine efforts, and during the confirmation hearings agreed to cede his stake in fees from litigation against Merck over the human papillomavirus vaccine.⁴ When vaccines were brought up during the hearings, Kennedy maintained that he is not antivaccine, but rather calling for greater transparency around the safety and effectiveness of vaccines.⁵ Still, he pushed back on widely accepted meta-analyses that show the safety of vaccines and instead cited papers with flawed methods purporting to show associations between vaccines and neurodevelopmental disorders.⁶

Kennedy’s answers to probes on Medicare and Medicaid during his hearings also garnered criticism.⁷ He acknowledged not yet having a specific plan for aligning Medicare and Medicaid funding structures, and at times appeared to misstate key facts, including making the incorrect statement that Medicaid is “fully paid for by the federal government.”⁵ He also painted a picture of Medicaid as having premiums and deductibles that are too high; premiums and deductibles are generally limited in Medicaid,⁸ although enrollees report barriers to accessing care, such as finding providers who will take their insurance.⁹

Both Democrats and Republicans took issue with Kennedy’s shifting stances on abortion, which were rehashed throughout the confirmation hearings.⁵ Democratic senators brought up that as recently as March 2024, he had said he supported a woman’s right to choose abortion “throughout the pregnancy,” and accused him of ceding his beliefs for political gain. Meanwhile, some conservatives including former Vice President Mike Pence aimed to defeat Kennedy’s nomination due to these past statements,¹⁰ but Republican senators largely did not press the issue during the hearings. When questioned about abortion by Democrats, Kennedy repeated his current stance: “I agree with President Trump that every abortion is a tragedy. I agree with him we cannot be a moral nation if we have 1.2 million abortions a year. I agree with him that the states should control abortion.”¹¹

During the hearings, Sen Bill Cassidy (R, Louisiana) asked Kennedy tough questions about his history of vaccine skepticism and embrace of flawed science claiming links between vaccination and autism.⁵ Cassidy, a physician, admitted that he was grappling with whether to advance Kennedy’s nomination, but ultimately decided to move him forward to the full Senate vote, stating, “With the serious commitments I’ve received from the administration and the opportunity to make progress on the issues we agree on, like healthy foods and a pro-American agenda, I will vote yes.”¹²

Now, with Kennedy officially confirmed to head HHS, he will be handed a portfolio of thorny issues ranging from compliance with clinical trial diversity guidance¹³ to ensuring health care access¹⁴ to overseeing the administration’s policies on drug pricing,¹⁵ pharmacy benefit managers,¹⁶ and more. His tenure as HHS secretary portends a status quo shakeup that will be closely watched by both sides of the aisle.

References

1. US Senate 2025-02-13. C-Span. Accessed February 13, 2025. https://www.c-span.org/event/us-senate/us-senate/430935
2. Joszt L. Support and skepticism emerge as reactions to Robert F. Kennedy Jr’s HHS nomination. AJMC^®. November 15, 2024. Accessed February 13, 2025. https://www.ajmc.com/view/support-and-skepticism-emerge-as-reactions-to-robert-f-kennedy-jr-s-hhs-nomination
3. Bonavitacola J. Kennedy reveals key decisions in ethics report as confirmation hearing looms. AJMC. January 23, 2025. Accessed February 13, 2025. https://www.ajmc.com/view/kennedy-reveals-key-decisions-in-ethics-report-as-confirmation-hearing-looms
4. Jewett C, Craig S. Kennedy says he will not keep fees from HPV vaccine litigation. New York Times. January 30, 2025. Accessed February 13, 2025. https://www.nytimes.com/2025/01/30/health/rfk-jr-hpv-vaccine-lawsuits-fees.html
5. Steinzor P. 5 key takeaways from RFK Jr’s confirmation hearings. AJMC. January 31, 2025. Accessed February 13, 2025. https://www.ajmc.com/view/5-key-takeaways-from-rfk-jr-s-confirmation-hearings
6. Steier J. Anatomy of a failure: why this latest vaccine-autism paper is dead wrong. Unbiased Science. January 25, 2025. Accessed February 13, 2025. https://theunbiasedscipod.substack.com/p/anatomy-of-a-failure-why-this-latest
7. Grossi G. RFK Jr fails to offer a clear Medicaid, Medicare strategy. AJMC. January 29, 2025. Accessed February 13, 2025. https://www.ajmc.com/view/rfk-jr-fails-to-offer-a-clear-medicaid-medicare-strategy
8. Cost sharing. Medicaid.gov. Accessed February 13, 2025. https://www.medicaid.gov/medicaid/cost-sharing/index.html
9. Hest R. Assessing physician acceptance of Medicaid patients using State Health Compare. State Health Access Data Assistance Center. August 25, 2022. Accessed February 13, 2025. https://www.shadac.org/news/14-17-physician-Mcaid-SHC
10. Stolberg SG. Pence wages lonely crusade against Kennedy as abortion opponents avoid fight. New York Times. January 24, 2025. Updated January 31, 2025. Accessed February 13, 2025. https://www.nytimes.com/2025/01/24/us/politics/pence-kennedy-abortion.html
11. Watch: ‘every abortion is a tragedy,’ RFK Jr says. PBS. January 29, 2025. Accessed February 13, 2025. https://www.pbs.org/newshour/politics/watch-every-abortion-is-a-tragedy-rfk-jr-says
12. Munz K. RFK Jr confirmation for HHS secretary advances to full Senate after committee votes. AJMC. February 4, 2025. Accessed February 13, 2025. https://www.ajmc.com/view/rfk-nomination-advances-to-full-senate
13. Grossi G. FDA quietly removes draft guidance on diversity in clinical trials following executive order on DEI. AJMC. January 31, 2025. Accessed February 13, 2025. https://www.ajmc.com/view/fda-quietly-removes-draft-guidance-on-diversity-in-clinical-trials-following-executive-order-on-dei
14. Bonavitacola J. Americans claim health care access is top priority in public health. AJMC. February 6, 2025. Accessed February 13, 2025. https://www.ajmc.com/view/americans-claim-health-care-access-is-top-priority-in-public-health
15. Steinzor P. Trump reverses some Biden drug pricing initiatives, potentially impacting Medicare costs. AJMC. January 22, 2025. Accessed February 13, 2025. https://www.ajmc.com/view/trump-reverses-some-biden-drug-pricing-initiatives-potentially-impacting-medicare-costs
16. Klein HE. FTC report highlights prescription drug price markups by PBMs. AJMC. January 14, 2025. Accessed February 13, 2025. https://www.ajmc.com/view/ftc-report-highlights-prescription-drug-price-markups-by-pbms