President-elect Donald Trump announced on Thursday that he is nominating Robert F. Kennedy Jr. ― an anti-vaccine conspiracy theorist who formerly competed against Trump for the White House ― to lead the U.S. Department of Health and Human Services.
“I am thrilled to announce Robert F. Kennedy Jr. as The United States Secretary of Health and Human Services (HHS),” Trump wrote on social media. “For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health.”
Under Kennedy, Trump wrote, HHS “will play a big role in helping ensure that everybody will be protected from harmful chemicals, pollutants, pesticides, pharmaceutical products, and food additives.”
Kennedy’s nomination will need to be confirmed by the Senate.
Kennedy, who ran as an independent against Trump and Vice President Kamala Harris before suspending his campaign and endorsing Trump, is an environmental lawyer who espouses fringe, disproven claims that vaccines cause autism and a range of other medical conditions.
Earlier this month, he said on social media that the Trump administration would advise all U.S. water systems to remove fluoride from public water, falsely claiming that it’s linked to “arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.”
Experts say the amount of fluoride in water systems does not pose any of the health threats Kennedy claims. A 2017 study found that fluoride in water systems saves Americans more than $6 billion a year in dental costs.
Trump has suggested he’ll let Kennedy oversee a major overhaul of American health guidelines.
“I’m going to let him go wild on health. I’m going to let him go wild on the food. I’m going to let him go wild on the medicines,” Trump said at a campaign rally last month.
The HHS encompasses the Centers for Disease Control and Prevention and the Food and Drug Administration, both of which oversee the approval and distribution of vaccines and the public messaging about them. In a New York Times interview on Wednesday, CDC director Dr. Mandy Cohen said Kennedy’s mere presence in the federal government would be alarming.
“Even without changing one regulation or one piece of guidance,” she said, “the sharing of misinformation from a place of power is concerning.”
For decades, Kennedy has been one of the most prominent anti-vaccine voices in American politics, pushing false information about vaccine efficacy and disproven assertions about supposed links to autism ― and simply changing his claims when the evidence to the contrary becomes overwhelming.
His anti-vaccine advocacy has had grim side effects. In one striking example, a 2019 measles outbreak in Samoa killed 83 people, mostly children, after Kennedy visited the island and bolstered anti-vaccine sentiment there.
Overall, vaccination rates among children in the United States have markedly declined since the COVID-19 pandemic, in part because of the sort of anti-vaccine sentiment expressed by Kennedy and others.
As noted in an October publication from the CDC, which could soon be under Kennedy’s control: “From the 2019-20 to the 2022-23 school year, national kindergarten coverage with state-required vaccinations declined from 95% to approximately 93%.” The percentage of kindergarteners with more than one vaccine exemption, the report said, “increased to 3.3% (the highest percentage ever reported), increased in 41 jurisdictions, and exceeded 5% in 14.”
For Kennedy to head up the Department of Health and Human Services could also prove a nightmare for trans youth trying to access gender-affirming care, which has already been heavily restricted in various states.
On the campaign trail this year, Kennedy called gender-affirming care a “nonexistential issue,” but he has signaled his support for banning certain kinds of care, such as puberty blockers and hormone replacement therapy for minors. He has also used rhetoric frequently repeated by conservatives to deliberately mischaracterize care for minors as “castration” and “mutilation,” and peddled conspiracies that chemicals in the environment could be turning children gay or transgender ― a claim that has no basis in science.
Trump’s courtship of Kennedy began while they were still both competitors for the presidency. In one July call between the pair, Trump ranted about vaccines as Kennedy listened. Eventually, Trump appeared to make an overture to Kennedy, promising him that something they’d discussed previously would be “so big for you.”
The following month, Kennedy suspended his campaign and endorsed Trump, launching a new slogan ― “Make America Healthy Again,” or “MAHA” ― that quickly spread among Trump supporters.
The full extent of Kennedy’s portfolio at HHS would be vast, given the enormous size and scope of the department. One priority he expressed on the campaign trail was stopping the National Institutes of Health’s study of infectious disease.
But Kennedy’s specific plans aren’t well known. And at least some of them are linked to conspiracy theories. In August, for example, Kennedy pledged to someone on social media that “we are going to stop this crime.”
He was talking about chemtrails.
Kennedy’s views on issues like vaccines and fluoridation are what have made him such a notorious and controversial figure. But immunisations and additives to food or water represent just one small part of HHS’s purview ― and just some of the ways its business affects Americans’ lives.
The department has an annual budget of more than $1.8 trillion, more than any other Cabinet agency, including the Department of Defense. The reason that amount is so high is because it includes payments in the massive federal health insurance programmes Medicare and Medicaid. HHS also has responsibility for overseeing the Affordable Care Act, aka “Obamacare.”
In all, somewhere between a third and half of all Americans get health insurance through a programme that HHS runs or manages, which means that overseeing them would be among Kennedy’s official duties.
The future of those programmes is very much up in the air, given the long history of Trump and other Republicans trying to repeal or at least scale them back. Whether Kennedy had any role in those deliberations would depend entirely on how much the Trump White House decided to consult him.
But beyond the big policy debates over the size and shape of these programmes are countless smaller decisions about how to run them ― decisions that will involve considerations about personnel, organisational structure and internal agency budgets. Responsibility for those decisions would lie with Kennedy if he gets the job.
And poor decision-making can have big, real-world effects ― like it did in late 2013, when HHS was in charge of creating the Obamacare federal website. The system collapsed and took weeks to repair, making it difficult for millions of people to get coverage and very nearly unraveling the entire programme.
The website runs smoothly now. But Kennedy would be in charge of other, newer programmes. That includes the negotiation of prices for certain expensive drugs in Medicare, something that HHS just started doing thanks to an initiative that Democrats passed and President Joe Biden signed into law two years ago.
Conservatives have generally opposed giving the federal government power to reduce drug prices. So has the pharmaceutical industry, which stands to make less money if the government forces down their prices. But while Republicans have spoken out against it, repealing that power could be difficult politically, because the idea is quite popular.
Opponents might instead focus on looking for ways to undermine or at least weaken the negotiating power through HHS ― which would mean, in theory, going through Kennedy.
Kennedy has a history of attacking the drug industry, so it’s not clear how he would respond ― or whether, given his lack of experience running a large agency, he’d be able to assert his will at all.
Lil Kalish contributed to this report.