Robert F. Kennedy Jr. delivers his testimony during the Senate Finance Committee’s confirmation hearing on January 29. He was confirmed as Secretary of the Department of Health and Human Services by a vote in the full Senate on Thursday.
Chen Mengtong/VCG via Getty Images
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Chen Mengtong/VCG via Getty Images

In spite of the significant financial opposition from various groups to his nomination, the Senate confirmed Robert F. Kennedy Jr. as the new Secretary of the Department of Health and Human Services.

Kennedy encountered resistance from the left due to his long history of promoting conspiracy theories regarding vaccines, while some conservatives opposed him for his previous advocacy for abortion rights. For weeks, there were doubts about whether he would secure enough support from senators. Following protests from Democratic senators who spoke out late into the night, he ultimately received the necessary votes for confirmation, with a final tally of 52 to 48. Notably, Sen. Mitch McConnell, a former Republican majority leader and a polio survivor, voted against Kennedy.

Numerous queries remain concerning the future of Medicare, vaccines, and medical research. Here’s a closer look at five critical issues to monitor as Kennedy steps into his leadership role at this vast health agency in the upcoming weeks:

1. Potential Medicaid and Medicare Cuts

Kennedy has remained relatively silent about the outlook for Medicaid and Medicare, and during his confirmation hearings, he struggled with basic questions related to these programs. However, he now holds authority over these essential programs, which combined provide insurance to approximately 140 million Americans.

From the moment the 119th Congress convened, Republican leaders initiated discussions on potential Medicaid spending cuts. This program, which supports low-income individuals, is funded jointly by the federal government and states. Historically, Medicaid has enjoyed substantial public support; a recent KFF survey indicated that 71% of Americans wish to see the program maintained largely as it is.

While contemplating potential spending reductions, President Trump stated that his administration would “love and cherish” Medicare, Medicaid, and Social Security, asserting that any cuts would target waste rather than beneficiaries. Nevertheless, cuts beyond merely addressing waste could be forthcoming to redirect funds towards Trump’s priorities, such as tax reforms and border enforcement. Conservative factions and GOP lawmakers have frequently claimed that Medicaid is overly expansive—enrollment had surged to 80 million during the pandemic. House Republicans are proposing to find $880 billion in reductions to Medicaid funding, which could lead to states scaling back benefits and tightening eligibility. Medicare may also face its own set of potential cuts.

Dr. Mehmet Oz, a heart surgeon and media personality who previously ran for a Senate seat in Pennsylvania, is Trump’s choice to lead the Centers for Medicare & Medicaid Services, which operates under HHS. A date for his confirmation hearing has yet to be determined.

2. The Future of Vaccine Policy Amid Confusion

As senators cast their votes to confirm Kennedy, a measles outbreak was ongoing in Texas. According to reports from Marfa Public Radio, nine individuals have been hospitalized amid at least 24 measles cases in Gaines County, which has one of the nation’s lowest vaccination rates. All affected individuals are unvaccinated, with many being children.

Kennedy is a highly visible opponent of vaccinations. Throughout his confirmation hearings, he insisted he is neither anti-vaccine nor opposed to the established vaccine schedule, affirming that he supports certain vaccines, like the polio vaccine. However, he dismissed the thoroughly disproven theories linking vaccines with autism.

Kennedy secured his confirmation primarily due to commitments made to Sen. Bill Cassidy, R-La., who is a physician and chairs the Senate’s health committee. These commitments include assurances that he would refrain from interfering with existing vaccine policies and provide Cassidy with oversight on certain decisions made at HHS.

Sen. Patty Murray, D-Wa., former chair of the committee, expressed skepticism regarding the credibility of these commitments during a recent press conference. “The Republicans are choosing to act as if it’s believable that RFK Jr. will refrain from utilizing his newfound authority to pursue his long-standing goal: undermining vaccinations,” she stated.

Kennedy’s authority could greatly impact vaccinations, enabling him to appoint advisors, steer NIH research, and alter public health messaging regarding vaccine significance. Public health advocates are closely monitoring his actions in this arena.

3. Changes on the Horizon for HHS

The DOGE initiative, which aims to dismantle government agencies through furloughs, dismissals, and suspension of operations, might extend to HHS.

Currently, HHS operates with a budget of nearly $2 trillion and employs around 90,000 individuals. A significant portion of this budget addresses Medicare and Medicaid, the health programs catering to seniors and low-income individuals, respectively. Staff members associated with DOGE have reportedly interacted with the Centers for Medicare and Medicaid Services in recent weeks.

Other vital health agencies falling under the HHS umbrella include the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH).

The Heritage Foundation’s Project 2025 outlines sweeping reforms for HHS, including proposals to separate the CDC into two distinct entities and abolish the Head Start program. Kennedy has shared limited insights regarding his intentions for these agencies, other than indicating he would dismiss 600 NIH researchers and redirect the agency’s focus from infectious diseases to address chronic diseases’ underlying causes.

4. Turmoil in Science Communication and Research

Even without Congress imposing cuts or DOGE advancements, changes instigated by the Trump Administration have already caused significant disruptions within American science.

Several executive orders related to “ideology” have led federal health agencies to eliminate numerous databases and web pages that included terms viewed as problematic. This has alarmed many in public health and medicine, especially following the abrupt removal of essential resources that healthcare professionals typically rely on for patient care. The complexities surrounding research involving marginalized groups, such as transgender individuals, have simultaneously become obscured.

Biomedical research, historically a symbol of bipartisan unity and national pride, is also facing challenges. NIH’s financial support for research institutions has been targeted for extensive cuts, a move currently stayed by a federal court. Several Republican senators, including Cassidy, Susan Collins of Maine, and Katie Britt of Alabama, have voiced concerns regarding the potential detrimental impact of this sweeping policy on major research universities. Collins noted that Kennedy assured her he would “reassess” the funding strategy upon his confirmation.

5. MAHA and Its Policy Implications

Kennedy articulated a vision during his confirmation hearings, describing his unique understanding of healthcare agencies cultivated through decades of lawsuits aimed at them. He asserts that these organizations have strayed from their original purpose, evident in the low life expectancy and prevalence of chronic diseases among Americans.

However, he has yet to delineate specific policy strategies or how he might leverage his leadership role to “realign America’s health priorities.” He expressed an interest in food programs outside HHS’ jurisdiction, hinting at possible collaboration with the Department of Agriculture on initiatives like SNAP.

Significant industries, particularly Big Food and Big Pharma, may resist some of his objectives, as NPR has previously reported. Additionally, public health researchers are questioning the feasibility of such extensive reforms within a Republican-controlled government that is often resistant to regulations.