Robert F. Kennedy Jr. is now in charge of the nation’s health agencies. His plans to upend them could make Elon Musk’s budget-cutting spree look modest by comparison.
Kennedy won Senate confirmation on Thursday even after vowing to take nutrition and health programs in a radical new direction, and despite his long history of criticizing the safety of scientifically proven vaccines.
“We will make sure our tax dollars support healthy foods. We will scrutinize the chemical additives in our food supply. We will remove the financial conflicts of interest in our agencies,” he told the Senate Finance Committee in describing his goals. “We will create an honest, unbiased, science-driven HHS, accountable to the president, to Congress, and to the American people.”
The Senate confirmed Kennedy in a 52-48 vote to lead the 80,000-employee Department of Health and Human Services. Only former Republican Leader Mitch McConnell of Kentucky broke from the party line, joining Democrats in opposition. A polio survivor, McConnell has criticized Kennedy’s anti-vaccine activism. Kennedy will be sworn in Thursday afternoon in the Oval Office, according to two people granted anonymity to discuss the planning — a sign of President Donald Trump’s personal investment in installing Kennedy as the nation’s top health official.
Republicans’ assent represents a major shift for a party once aligned with the health care industry and food manufacturers, both of which Kennedy plans to target.
Kennedy focused on attacking chronic disease by regulating food additives and chemicals in the environment during his own presidential run, before he dropped out of the race and endorsed Trump. The issues will likely remain at the top of his agenda, according to two people familiar with his internal discussions, who were granted anonymity to speak freely.
Kennedy and his aides have spent the past several days drawing up a list of actions that he will prioritize, the two people said, though one of them cautioned that his plans remained in flux just 24 hours out from his confirmation amid debate over how quickly he should move to put his stamp on the administration’s health agenda.
Kennedy laid out an aggressive plan even before Trump named him to lead HHS, vowing an overhaul of HHS’ Food and Drug Administration, which approves drugs and medical devices, in a post to X in October. He said it was “corrupt” and accused it of conspiring with pharmaceutical companies to suppress inexpensive alternatives to high-cost drugs.
Kennedy has long advocated banning direct-to-consumer pharmaceutical ads, his advisers said, a politically popular yet legally thorny policy initiative that he’s expected to pursue in some form as health secretary.
In November, Kennedy targeted the National Institutes of Health, which oversees billions in health research grants to universities, saying he planned to purge hundreds of employees. Kennedy believes the agency has overemphasized infectious diseases and underemphasized chronic ones — a position that has alarmed public health experts worried about his claims about vaccines. Kennedy published a book in 2021 painting then-NIH official Anthony Fauci as a servant of the pharmaceutical industry.
Kennedy’s former colleagues in the anti-vaccine movement have continued to push for him to take expansive action on vaccines, including ramping up scrutiny of new and existing vaccines and overhauling the way the federal government recommends and talks about standard childhood immunizations.
Kennedy for years led an advocacy group that challenged scientific consensus that vaccines are safe, promoting disproven theories that they cause autism. During his confirmation hearings, Kennedy refused to disavow what he’d said but promised to keep an open mind and not to take away anyone’s vaccines.
Others in his camp have urged Kennedy to stick to those vows not to undermine confidence in vaccines, part of a broader dialing back of the aggressive rhetoric of his presidential campaign. Still, Kennedy told senators he thinks the U.S. health care system is broken because it spends too much money and prioritizes the wrong things.
He will start work at HHS a few weeks into the Trump administration that’s already moved to cut federal health agency staff, take down certain public health information from federal websites, and seize control of federal health care data with the help of Musk and DOGE, the commission Trump created by executive order in January 2025.
Musk’s DOGE staffers are already at the HHS division that oversees Medicare, the health insurer for elderly people, and Medicaid, which covers those with low incomes. Combined the two account for about $1.5 trillion in federal spending. Musk seeks to root out billions lost to fraud.
The vote to confirm Kennedy was political theater of a rare sort. Democrats voted in unison to reject Kennedy, the scion of a famous Democratic family whose father and two uncles were Democratic senators.
His anti-vaccine views and alliance with Trump were more important, they said.
“People are alarmed. My phone lines are ringing off the hook with constituents who understand the stakes here and want us to stand up for science and for their health and safety,” Sen. Patty Murray (D-Wash.) told reporters Tuesday. “Because the health secretary has real power over whether Americans can get the basic information and care they need.”
Apart from McConnell, their longtime leader, Republicans voted to confirm Kennedy, putting aside reservations about his support for food and environmental regulation, his anti-vaccine claims and past advocacy of abortion rights.
It reflected their deference to Trump and desire to bring Kennedy’s formidable “Make America Healthy Again” movement into the Republican coalition. Kennedy’s MAHA supporters filled the Senate hearing rooms and jammed phone lines to wavering Republican senators.
Pharmaceutical, hospital, insurance and doctors’ groups — Kennedy targets that were previously thought to be nearly omnipotent in Washington — have largely remained silent on his confirmation, believing they couldn’t affect the outcome and fearing the backlash that could ensue if they spoke out. Some groups are even working to recast their goals in a MAHA-friendly light.
But while MAHA’s backing and DOGE’s help could propel Kennedy after he’s sworn in, his lack of managerial experience and lack of familiarity with the intricacies of HHS’ various programs could limit his reach.
A former senior Trump HHS official, granted anonymity to speak frankly, told POLITICO Kennedy’s influence will come down to his circle.
“Personnel is policy. That’s incredibly true of the Trump administration,” the official said. Kennedy, the person said, will need to rely on people with institutional knowledge to make the changes he wants to make — within the applicable constructs to avoid judicial challenges.
Already, federal judges have hit the pause button on the Trump administration’s plans to cut health research grants and to offer hundreds of thousands of federal employees early resignations. A federal judge also ordered the White House to restore webpages of public health agencies that Trump officials had taken down.
“He is going to need to rely on people who do understand how he could successfully be a disruptor,” the former official said. “You’ve got a lot of disruptors, but there may be ways to do so faster and more successfully than others.”
