Robert F. Kennedy Jr., President Donald Trump’s pick to lead the Department of Health and Human Services, could soon control the nation’s agencies and programs governing health care, vaccine approvals and cancer research.
He testified before the Senate on Wednesday. If confirmed, the frequent vaccine critic, raw milk advocate and Covid-19 conspiracy theorist would oversee agencies critical to supporting Americans’ health, including the Food and Drug Administration, Centers for Disease Control and National Institute of Health.
The 71-year-old, who has no medical background, has promised to “Make America Healthy Again” while also vowing to upend some of the HHS’s agencies and policies.
At the FDA, he has suggested that entire departments “have to go.” He has said he plans to immediately replace 600 NIH employees and “give infectious disease a break for about eight years.” He once claimed that the CDC was a "cesspool of corruption” that harms children similar to “Nazi death camps.”
What agencies does it oversee?
HHS, which boasts a nearly $2 trillion budget, has more than 80,000 employees.
The department has 13 operating divisions, including 10 public health service agencies and three human services agencies.
These include the FDA, CDC, NIH, Administration for Children and Families, Centers for Medicare & Medicaid Services, Substance Abuse and Mental Health Services Administration, and the Health Resources and Service Administration.
The department also oversees federal programs, including child care, Head Start, Alzheimer’s, cancer research grants, the Affordable Care Act marketplace, Medicare and Medicaid.
Seventeen staff offices also support the HHS secretary. These include the Office of the Secretary, Office of Civil Rights, Office of the Inspector General and the Office of the General Counsel.
What can and can’t the HHS Secretary do?
Trump once promised to let RFK Jr. “go wild” on health, food and medicine.
The HHS Secretary has “fairly significant power” over these programs, KFF Health News journalist Julie Rovner told NPR.
The secretary can influence how those programs are implemented, can hire and fire employees and issue guidance and regulations, she said.
However, his power is limited.
Kennedy announced his plans to gut the FDA’s nutrition departments and replace hundreds of NIH scientists. While he has some authority over hiring and firing decisions without Congressional approval, some experts say that he could run into some speed bumps.
Ashish Jha, MD, dean of the Brown University School of Public Health, told MedPage Today: "He can definitely reorganize ... but it's going to be hard to shut entire agencies down.”
Some employees may choose to leave on their own accord. Last week, Trump ordered a federal hiring freeze and an in-person work requirement; his administration has also offered seven-month buyouts to federal employees should they opt to quit by February 6.
Kennedy has also promised major changes to the FDA. In October, he ominously wrote on X: “FDA’s war on public health is about to end.”
He has authority to overrule some of the FDA’s approvals. For example, during the Barack Obama administration, the HHS Secretary overruled the FDA’s decision to make Plan B emergency contraception available over the counter.
Trump has already executed part of his anti-abortion agenda. If confirmed, Kennedy could further it by potentially imposing restrictions on mifepristone, one drug in a two-drug regimen for medication abortions, abortion advocates have warned.
“There’s a possibility that RFK could take pretty dramatic steps on mifepristone, even without the approval of FDA,” Mary Ziegler, a professor at the University of California, told Time.
The FDA approved the drug 25 years ago, but lawsuits targeting the abortion pill are already underway. More challenges could ensue if RFK Jr. decides to revoke or restrict the long-standing drug due to the FDA’s requirements for taking medicines off the market, the Associated Press reported.
