Robert F. Kennedy, Jr., longtime Democrat, has found an unlikely ally in a man well known for his love of Diet Cokes. And Trump has promised to let RFK “go wild” once he is confirmed.
Vaccines
Kennedy has spent the better part of two decades questioning the safety and efficacy of vaccines, chairing Children’s Health Defense, a nonprofit that helped produce films like Plandemic: The Hidden Agenda Behind Covid-19.
He has repeated information that’s been widely refuted by the medical establishment, saying last year on Fox News that he believes autism is caused by vaccines.
More recently, he’s said that the Covid vaccine is the “deadliest vaccine ever made,” and that “there’s no vaccine that is safe and effective.” But he’s also said, “I’ve never been anti-vaccine.”
If confirmed, what can Kennedy do as the Secretary of Health and Human Services?
The vaccine approval process is generally a long one. Vaccines, like other drugs, are developed by pharmaceutical companies.
Before it’s approved, a drug company must submit an application to the FDA which includes information on clinical trials on its effectiveness, potential side effects, and manufacturing processes.
Once approved by the FDA, the CDC’s Advisory Committee on Immunization Practices (ACIP), composed of medical and public health experts, examines the vaccine. The panel looks at how safe and effective the vaccine is for all ages, how serious the disease is that the vaccine would prevent, and how many people would get the disease if there wasn’t a vaccine.
Once that panel recommends the vaccine, the CDC director has the final say in whether or not it's approved.
Current FDA Commissioner Dr. Robert Califf said Kennedy could decide to stop vaccines from being approved, even if FDA scientists back them. "It's totally within the law for the president or the HHS secretary to overrule the entire FDA,” he said.
It’s possible RFK could try to remove already existing vaccines from the market, but only for some kind of credible reason. And even then, any kind of action like this would be tied up in very expensive and lengthy legal wrangling. So, no, no single individual can just wave a wand and delete vaccines with no oversight.
RFK Jr said earlier this month, "If vaccines are working for somebody, I’m not going to take them away. People ought to have choice, and that choice ought to be informed by the best information.”
Another way RFK could impact vaccines is their widespread availability. Currently, insurance companies are required to cover routine vaccinations. Which vaccines are part of this routine schedule is based on determinations from a panel of experts at the CDC. If Kennedy is confirmed, he would have a lot of say in who is on that panel, and by extension, he has a lot of influence over which vaccines are covered by insurance companies.
Then there’s the question of immunity for drug manufacturers. Currently, anyone claiming to be a victim of an injury due to a vaccine cannot sue the drug company that made the vaccine. Instead, they must go through the federal government’s National Vaccine Injury Compensation Program.
Congress passed this law in 1986 giving vaccine manufacturers reprieve from liability after several lawsuits led to vaccine shortages. In order to qualify for compensation, people who say they were injured must apply and go through an approval process.
This is something that Kennedy points to when saying he believes vaccine manufacturers get a pass. Changes to the law would require Congressional approval, but Ana Santos Rutschman, a law professor who specializes in health care law, said it is possible for Kennedy to remove vaccines from the list covered in the Vaccine Injury Compensation program.
If those vaccines are removed, drug companies could stop making them because they would be potentially liable for lawsuits.
Make America Healthy Again
RFK Jr has repeatedly said he wants to “Make America Healthy Again” through better food, exercise, and to by reversing the chronic disease epidemic in the US.
He says the drug and food industries have too much power, and have been able to make record profits at the expense of America's health. He points to ultra-processed foods, poor nutrition, food additives like dyes and preservatives, and pesticides as the culprit.
And it’s a popular message, especially with parents. But it’s easier said than done.
Yes, the FDA regulates about 80% of the food supply, including overseeing rules that allow packaging to include words like “healthy” or “low fat.” But it doesn’t have the authority to just ban “ultra-processed” foods.
Kennedy and his advisors have suggested they will target FDA regulations on ingredients in processed foods, including additives that are referred to as GRAS (generally recognized as safe). Currently, the FDA says an additive is GRAS if “the scientific data and information about the use of a substance must be widely known and there must be a consensus among qualified experts that those data and information establish that the substance is safe under the conditions of its intended use.”
But how companies determine what is GRAS is often up to them. (The process of labeling something GRAS was designed so that common food ingredients like vinegar or baking soda didn’t have to go through the food additive confirmation process.)
According to the FDA, food manufacturers using GRAS may notify the FDA about the use through a self-reporting system. The FDA’s website says, “This notification is not mandatory; however, the FDA strongly encourages manufacturers to contact the agency and follow the available procedures for our oversight of GRAS conclusions by submitting a GRAS notice.”
That’s because of the 1958 Food Additives Amendment to the Federal Food, Drug, and Cosmetic Act. Under that amendment, food additives had to be approved by the FDA before hitting the market, unless they were GRAS.
Because GRAS were established by congressional legislation, it would take an act of Congress to overturn the law. A bill was introduced in the Senate in 2023 to “direct the Secretary of Health and Human Services to update and clarify its rule on substances generally recognized as safe and to establish within the Food and Drug Administration the Office of Food Chemical Safety, Dietary Supplements, and Innovation, and for other purposes.” So far, that bill has not gone anywhere.
Another hurdle for Kennedy may be money.
Yes, the FDA has a large budget. Part of that money comes from drug manufacturers. Federal law allows the FDA to collect “user fees” from companies to supplement the money given to the agency by Congress. This money helps get products approved more quickly, and provides funding to ensure the safety of clinical trials.
This is not unique to the FDA, by the way. Airlines pay the Federal Aviation Administration. Wall Street banks pay the Securities and Exchange Commission. This means American taxpayers don’t have to pay to regulate companies making billions of dollars in profit – the companies can pay for that themselves, rather than asking taxpayers to bear the burden.
But food is regulated differently than drugs are, and the division of the FDA that oversees food safety has a very small budget that comes directly from Congress.
Out of the FDA’s billion dollar budget, only $25 million of that goes to nutrition. Jerold Mande, who held high level positions at the FDA and the Agriculture Department told NBC, “there’s almost no money for it, and that is the No. 1 barrier: they don’t have the budget or staff to do anything.”
So even if there are changes to rules surrounding additives that are Generally Regarded as Safe, enforcement will be a serious issue, absent new funding schemes from Congress.
Fluoride in drinking water
Kennedy said on X, “On January 20, the Trump White House will advise all U.S. water systems to remove fluoride from public water.”
Fluoride was added to water in the United States in 1945 to help improve oral health. As of 2022, according to the CDC, 72% of the country had received water with fluoride in it. State and local governments are the ones who decide whether or not to add fluoride to water.
The CDC says water fluoridation has led to a large reduction in tooth decay, and by extension, things like infections and abscesses. RFK says that fluoride does not need to be consumed in water, and that using fluoridated toothpaste is sufficient.
But RFK would not have the power to ban fluoride in America’s water supply.
If the Trump administration wants to move forward with removing fluoride from all of the country’s water, the most likely path is through the Environmental Protection Agency.
The Safe Drinking Water Act gives the EPA the authority to regulate chemicals and contaminants in drinking water. If fluoride can be reclassified as a “contaminant” or other substance that is regulated, it’s possible that the administration could seek to remove it from water nationwide using the regulatory process. There are also other federal laws, like the Toxic Substances Control Act, that could give the EPA the authority to act.
None of this would directly fall under RFK’s jurisdiction, but if the administration as a whole is committed to removing fluoride, which RFK says is a risk to human health, it could happen.
Medicare Reform
There is one area where RFK Jr might get support from both Republicans and Democrats, and that’s with Medicare reform.
According to sources who spoke to the Washington Post, Kennedy is considering an overhaul to the way Medicare payouts are made to doctors. Kennedy says the current system incentivizes surgeries over preventative and primary care.
There are thousands of billing codes used to determine how much Medicare will pay for specific visits and procedures. Critics say the coding system rewards doctors with more money for surgeries, and pushes them into specialty medical fields instead of primary care.
These rates are largely determined by a panel at the American Medical Association. The AMA is a lobbying organization that represents hundreds of thousands of physicians. The panel at the AMA studies how much time physicians spend on various activities to make recommendations about reimbursements, which are generally adopted.
Some physicians say these studies about how they spend their time are not accurate, and politicians have expressed skepticism about the idea that the AMA should be able to essentially set their own reimbursement rates.
How these reimbursement rates are set could be overhauled, but there will be a high degree of pushback. As a country that has a large for-profit healthcare sector, anything that could alter the current system is going to be met with significant resistance from lobbying groups, medical groups, and pharmaceutical companies, who are often large donors to members of Congress.
These deep pockets are also incentivized to fight back against changes. So while there is a foundation of support for some of these ideas, don’t expect there to be a quick and easy fix.
Will Kennedy be confirmed?
It’s likely that many of Kennedy’s controversial comments will be examined during his confirmation hearings. Here are some of the things he’s said that you’ll probably hear during televised proceedings:
The CIA runs the media. At a fundraiser in April, RFK Jr claimed, "The new head of NPR is a CIA agent” and that it’s part of a “systematic takeover of the American press, particularly the liberal media." He has also said the CIA had a secret program to recruit journalists to brainwash Americans, and that the program is “alive and well.”
School shootings can be linked to antidepressant use. He told Elon Musk last year that, “Prior to the introduction of Prozac, we had almost none of these events” and said scientists need to “see if there is a connection to some of the SSRI [antidepressant] and psychiatric drugs people are taking, whether there is connections to video games.”
Covid is “ethnically targeted” to certain races of people. “Covid-19 is targeted to attack Caucasians and black people. The people who are most immune are Ashkenazi Jews and Chinese.” You can see the video here.
Chemicals in water can make kids transgender. Kennedy pointed to chemicals found in plastics and pesticides, saying, “the capacity for these chemicals that we are just raining down on our children right now to induce these very profound sexual changes in them is something we need to be thinking about as a society.”
AIDS is not caused by HIV. Kennedy has said that AIDS is caused by a “gay lifestyle” in which people were addicted to recreational drugs, specifically “poppers,” and that he’s never actually “found any evidence that HIV kills a T-cell.”
RFK Jr is also facing sexual assault allegations from a former babysitter, Eliza Conney, who said he groped her when she was 23 years old working for his family.
After coming forward, Cooney said Kennedy texted her, saying, “I have no memory of this incident, but I apologize sincerely for anything I ever did that made you feel uncomfortable or anything I did or said that offended you or hurt your feelings. I never intended you any harm. If I hurt you, it was inadvertent. I feel badly for doing so.”
It’s hard to know how all of this will play out in the Senate because of another reason: his stance on abortion.
Kennedy has long been a supporter of abortion rights. His campaign said he does not back a federal abortion ban, and that he agrees that abortion should be legal up until the point of fetal viability.
Several Republican Senators have said they want to hear more from Kennedy on his stance on abortion, agriculture, and vaccines. Sen. Lankford, for one, said abortion is “a big deal for me.”
Republicans are planning to meet with Kennedy ahead of his confirmation hearings, and will be pushing him on all of these topics. But unlike Matt Gaetz who gave up his attorney general nomination after vocal opposition, so far no Republicans have outwardly opposed Kennedy.