On Wednesday, Robert F. Kennedy Jr. is set to appear before the Senate Finance Committee for the first of two confirmation hearings as President Donald Trump’s nominee for secretary of the Department of Health and Human Services.
If confirmed, Kennedy would have sweeping control over a suite of 18 agencies, including the Centers for Disease Control and Prevention, the Food and Drug Administration, the National Institutes of Health, and the Centers for Medicare and Medicaid Services.
“This is the most important hearing of all of Trump’s Cabinet picks,” said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University. “The HHS secretary has enormous power over domestic health care, global health and directly oversees tens of thousands of scientists, doctors and nurses.”
The hearing is expected to be contentious due to Kennedy’s controversial views, including his repeated false claims linking vaccines to autism — a theory debunked by decades of scientific research.
In a financial disclosure dated Tuesday, Kennedy said that, as of December, he’s no longer serving as chairman or chief legal counsel for Children’s Health Defense, an anti-vaccine nonprofit that he founded. The group has filed lawsuits against the federal government, including one challenging the authorization of the Covid vaccine for children.
Kennedy will continue to collect fees over ongoing litigation over Gardasil, a vaccine from Merck that protects against HPV, according to the disclosure. The HPV vaccine prevents cervical and other cancers. In a statement to NBC News, Merck said in part, “The plaintiff’s allegations have no merit, and we remain committed to vigorously defending against these claims.”
A spokesperson for Kennedy declined to comment.
Wednesday’s hearing will be followed Thursday with a hearing in front of the Senate Committee on Health, Education, Labor and Pensions.
Here are 5 key health topics to watch for during Kennedy’s hearings.
Vaccines
Kennedy’s nomination to lead HHS comes as childhood vaccination rates are falling. According to KFF, a nonprofit group that researches health policy issues, less than 93% of kindergarteners had received all of their state-required vaccines in the 2023-2024 school year, compared with 95% in the 2019-2020 school year.
Parents are more hesitant than ever to get their children vaccinated, Dr. Paul Offit, a vaccine expert at the Children’s Hospital of Philadelphia, said Tuesday during a roundtable on vaccines hosted by Sen. Bernie Sanders, I-Vt.
“The problem is not only that we’ve largely eliminated these diseases, we’ve eliminated the memory of these diseases,” Offit said, “and for that reason, parents are now more scared of the safety of vaccines, real or imagined, than the diseases they prevent.”
At the roundtable, Sanders, the ranking member of the Senate HELP Committee, noted the “danger” of reversing decades of progress on public health. He hasn’t yet publicly said whether he would support Kennedy’s nomination.
Kennedy’s long history of anti-vaccine activism, experts worry, could mean significant changes to childhood immunization policies.
As health secretary, Kennedy would have influence over the CDC’s Advisory Committee on Immunization Practices, an independent group of health experts that helps the agency make recommendations for states and insurers on what vaccines to cover, including childhood vaccinations.
Senators have stated that they’ve spoken with Kennedy about vaccines, highlighting the topic’s importance. Shortly after the election, Kennedy told NBC News that he won’t “take away anybody’s vaccines.”
“Let us be clear, there is an overwhelming consensus in the scientific community that vaccines have saved millions of lives, prevented massive human suffering and stopped the spread of infectious diseases like polio, smallpox and measles,” Sanders said.
Public health advocacy groups, including the Committee to Protect Health Care, expressed alarm about Kennedy’s views on the topic. Earlier this month, the committee posted a letter online, signed by more than 15,000 doctors, urging senators to vote against his confirmation.
Obamacare
“While vaccines will probably get a lot of the attention, RFK Jr.’s ability to affect people’s health insurance coverage in some ways looms much larger,” said Larry Levitt, executive vice president of health policy at KFF.
In addition to Medicare and Medicaid, HHS, through the Centers for Medicare and Medicaid Services, oversees the implementation of the Affordable Care Act. Taken together, the three programs provide insurance for roughly 168 million people — more than half the American population, Levitt said. The department also does outreach, ensuring people have access to information about their insurance options and provides funding to states to improve their insurance coverage, particularly for the uninsured.
Republicans have signaled support to let expire the subsidies that make Obamacare premiums more affordable, and they have also expressed interest in imposing work requirements for Medicaid eligibility — an unpopular provision. Trump’s nominee to run the Centers for Medicare and Medicaid Services, Dr. Mehmet Oz, has previously expressed support for privatizing Medicare.
Trump vowed during the campaign to replace the ACA, but Kennedy has offered little insight on his views on the program or insurance generally.
“What does he think about Medicaid work requirements? The Affordable Care Act? Enhanced financial aid?” Levitt asked. “He oversees an agency that affects all those things.”
Bird flu
Kennedy could take the reins as the H5N1 bird flu virus is ripping across the country.
As of Jan. 16, an estimated 928 herds of dairy cattle in 16 states have been infected, according to the Agriculture Department. There have been at least 67 cases in people, most of whom are farmworkers. One person, an older adult in Louisiana who had a backyard flock, died from the virus.
Experts worry that bird flu has the potential to set off another pandemic if it were to mutate to spread easily among people. There have been no documented instances of human-to-human transmission of bird flu in the United States so far.
“This is a disease we need to take very seriously, and to leave it to a vaccine skeptic to lead the response is dangerous,” Gostin of Georgetown University said.
Kennedy would oversee the CDC, which has managed much of the outbreak and tracked the risk to humans, as well as the Administration for Strategic Preparedness and Response, an HHS agency responsible for managing the nation’s stockpile of flu vaccines, which currently includes two bird flu vaccine candidates. He’d have authority over the FDA, which would need to authorize the vaccines before they could be used in people.
In December, Biden administration officials said they had no plans to authorize the stockpiled bird flu vaccines, leaving it up to health officials in the Trump administration, possibly including Kennedy, to decide whether they’ll be needed.
“That worries me a great deal,” Gostin said, “because I don’t think RFK Jr. is going to speed delivery of an avian influenza vaccine where it’s needed.”
Food guidelines
Kennedy has made it a priority to advocate for safer food, vowing to crack down on additives and dyes that have been tied to health problems.
That’s something on which lawmakers on both sides of the aisle will likely support Kennedy, experts say. (Earlier this month, the FDA, under the Biden administration, banned Red No. 3, an artificial dye used in thousands of foods but has been linked to cancer in lab rats.)
Marion Nestle, professor emerita of nutrition, food studies and public health at New York University, said that where Kennedy could get questioned on is the development of the 2025 dietary guidelines for Americans — if Republicans in Congress are willing to press him on it.
“You might think the Republicans would worry about the effects of his proposed actions on food, fishing and the dairy industries, but they seem willing to go along with whatever Trump wants,” Nestle said.
The dietary guidelines, which HHS is responsible for overseeing with the Agriculture Department, will be in place for the next five years.
Last month, a committee issued its proposal, recommending that people eat more beans, peas and lentils as protein sources and decrease the consumption of processed and red meat.
Kennedy can decide whether or not to adopt some or all of the recommendations.
Gostin also said that he hopes lawmakers will press on what Kennedy is going to do to take on the food industry.
“He talks a good game in terms of nutrition,” Gostin said, “but what are exactly his plans?”
Weight loss drugs
In November, the Biden administration proposed a rule requiring Medicare and Medicaid to offer coverage of the drugs for weight loss — a move that would dramatically expand access to the medications. Currently, they’re only covered for diabetes, heart disease risk and sleep apnea. A two-decade-old rule blocks the programs from covering drugs for weight loss.
However, Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, noted that the rule will need to be finalized under the Trump administration.
“I do think that’s an important and consequential policy action that would affect many people and spending on Medicare and Medicaid in a very substantial way,” she said.
The significant government spending on Ozempic and Wegovy earned them a spot in this year’s Medicare drug pricing negotiations — another matter on which Kennedy has remained silent.
Kennedy has been critical of the extremely popular weight loss drugs such as Ozempic and Wegovy, telling Fox News’ Greg Gutfeld in October that companies are “counting on selling it to Americans because we’re so stupid and so addicted to drugs.”
He seemingly walked those statements back later: Speaking to CNBC in December, Kennedy said “the first line of response should be lifestyle, it should be eating well, making sure that you don’t get obese, and that those GLP drugs have a place.”
“My casual impression is that he’s more of a diet and exercise and clean up food supply type of guy,” Dusetzina said. “That’s going to be one I try to keep an eye out for.”