Trump nominee for HHS secretary RFK Jr. faces Senate scrutiny in first confirmation hearing

Robert F. Kennedy Jr. faced sharp questioning from senators Wednesday in his first confirmation hearing as nominee for Secretary of the U.S. Department of Health and Human Services (HHS), a position for which his controversial views on vaccines and public health have drawn scrutiny from both sides of the political aisle.

The hearing, before the Senate Finance Committee, was a demonstration of partisan divides over his nomination, with Republicans praising his stances on “radical transparency” and chronic disease prevention, while Democrats questioned his credibility on vaccine science and female reproductive rights.

Kennedy, an environmental attorney and former independent presidential candidate in the 2024 presidential election, is the son of late U.S. Attorney General, Robert F. Kennedy Sr., and the nephew of the late 35^th president of the United States, John F. Kennedy. He was nominated by President Donald J. Trump in late 2024 for the position of HHS secretary.

Kennedy’s opening statement focused on tackling America’s chronic disease epidemic, citing rising rates of obesity, diabetes and autoimmune disorders as indicators of a failing health care system.

“Today, over half of our countrymen and women are chronically ill,” Kennedy said. “Should I be so privileged as to be confirmed, we will make sure our tax dollars support healthy foods. We will scrutinize the chemical additives in our food supply. We will remove financial conflicts of interest from our agencies… we will reverse the chronic disease epidemic and put the nation back on the road to good health.”

However, his nomination has been met with fierce opposition. Ranking Member Sen. Ron Wyden (D-Ore.), delivered a scathing critique, citing Kennedy’s history of promoting vaccine skepticism.

“In a review of his records, the receipts show that Mr. Kennedy has embraced conspiracy theories, quacks, charlatans, especially when it comes to the safety and efficacy of vaccines,” Wyden said. “… This is the profile of someone who chases money and influence wherever they lead, even if that may mean the tragic deaths of children and other vulnerable people.”

Wyden pointed to Kennedy’s past statements questioning vaccine safety and efficacy, in addition to his role in fueling a measles outbreak in Samoa, which left 83 Samoans dead.

Kennedy defended his record, stating that he is not anti-vaccine or anti-industry, but he is pro-safety. “I worked for years to raise awareness about the mercury and toxic chemicals in fish, and nobody called me ‘anti-fish,’” he said.

Kennedy also pointed to the fact that all of his own children are vaccinated, although Sen. Wyden countered that, during a podcast interview in 2020, Kennedy said he “would do anything, pay anything, to go back in time and not vaccinate [his] kids.”

Priorities as HHS secretary

Kennedy’s policy proposals centered on reshaping federal health care to emphasize chronic disease prevention and nutrition-based interventions. He pledged to overhaul HHS’s approach to health care spending, arguing that the current system incentivizes treatment over prevention. He also promised “radical transparency” within the department.

Citing several rising health concerns, Kennedy said that “The United States has worse health than any other developed nation, [even though] we spend more on health care—at least double, and in some cases triple, that of other countries. Last year, we spent $4.8 trillion, not counting the indirect costs of missed work. That’s almost a fifth of [our gross domestic product (GDP)]. It’s tantamount to a 20% tax on the entire economy.” He proposed stricter regulation of food additives and an expansion of integrative medicine within Medicare and Medicaid.

On reproductive health care, Kennedy faced pressure to clarify his stance on abortion access. Although he had previously voiced his support for women’s autonomy, Democrats highlighted past statements indicating his openness to restricting abortion medication access, with some suggesting that Kennedy abandoned his long-held personal values to support those of the president.

He also faced scrutiny over past statements on selective serotonin reuptake inhibitors (SSRIs), with some senators criticizing him for linking them to school shootings and questioning their safety. He defended his position, emphasizing the need for additional research into potential contributing factors, including SSRIs, social media and video games. Kennedy referenced black-box warnings on SSRIs regarding suicide risk but acknowledged that many patients benefit from these medications.

In discussions about Medicare, Medicaid and Medicare Advantage, Kennedy outlined his vision for a transition to a value-based care (VBC) model, rather than the current fee-for-service system. He suggested that Medicare Advantage offers strong benefits, though it remains unaffordable for many. He emphasized the need for pilot programs in state Medicaid systems to experiment with cost-saving strategies while improving patient health outcomes.

However, Sen. Bill Cassidy, MD, (R-La.), a physician-turned-politician, and Sen. Mark Warner (D-Va.) challenged his understanding of how these programs are funded and structured, pointing to inaccuracies in his descriptions of Medicaid financing and integration with Medicare.

• Cassidy pressed Kennedy on the integration of Medicare and Medicaid for dual-eligible beneficiaries, pointing out that Kennedy appeared uncertain about key funding mechanisms.
• Warner criticized Kennedy’s claims that most Americans dislike Medicaid, countering that millions rely on it for essential health care services.

Health care reform

For primary care physicians, Kennedy’s confirmation carries potential implications for health care reimbursement, rural health access and physician autonomy, as he expressed support for expanding telehealth services and reforming Medicare’s physician payment model.

Another key topic was the physician shortage, particularly in underserved, typically rural areas. Kennedy endorsed increasing federal support for graduate medical education (GME) to train additional primary care physicians and expanding addiction and behavioral health treatment services.

Referencing his own history with addiction, Kennedy said “I hear the stories every day… about denial of [care], or the barriers to access to care, and we need to improve that… I think we can do that through GME, too.”

Kennedy’s confirmation remains uncertain, with Democratic senators signaling opposition. However, Republican support, coupled with endorsements from health care transparency advocates, may be enough to secure his confirmation.

The hearing underscored broader tensions in U.S. health care policy, from vaccine mandates to Medicaid reform. For primary care physicians, Kennedy’s potential confirmation as HHS secretary could indicate shifts in reimbursement models, renewed emphasis on chronic disease prevention and debates over the role of government in public health interventions.

The Finance Committee will vote on Kennedy’s nomination today, with a second hearing scheduled before the Senate Health, Education, Labor and Pensions (HELP) Committee on Thursday, January 30, at 10 a.m.