RFK Jr.’s second confirmation hearing: Committee chairman ‘struggling’ with nomination

Robert F. Kennedy Jr.

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Robert F. Kennedy Jr., President Donald Trump’s nominee for Secretary of the U.S. Department of Health and Human Services (HHS), endured a tense and often combative second Senate confirmation hearing on Thursday before the Health, Education, Labor and Pensions (HELP) Committee.

The hearing followed his appearance before the Senate Finance Committee on Wednesday, where several of the same senators—Sens. Bill Cassidy, MD, (R-Louisiana), Bernie Sanders (I-Vermont), Roger Marshall, MD, (R-Kansas) and Maggie Hassan (D-New Hampshire)—examined his positions on key health care issues. Sen. Tim Scott (R-South Carolina) was absent from the Finance Committee’s hearing in favor of questioning Kennedy during today’s HELP session.

The committee is expected to vote on his confirmation next week.

Physician politicians clash over vaccine policy

Relatively early in the hearing, an exchange between Sen. Cassidy, the HELP Committee chairman and a gastroenterologist, and Sen. Rand Paul (R-Kentucky), an ophthalmologist, framed the day’s debate over vaccine safety.

Sen. Paul chose not to pose any questions during his allotted five minutes, instead speaking to the importance of questioning science. Specifically, he indicated that he believes mothers should not be expected to vaccinate their one-day-old infants against hepatitis B. Sen. Cassidy, who specialized in liver disease, countered that infants receive the vaccine because of the high probability of them contracting the disease from their mothers.

During their opening remarks, Sen. Cassidy pressed Kennedy to affirm that the measles and hepatitis B vaccines do not cause autism, citing a robust body of research.

Kennedy, resisting a direct yes-or-no answer, stated that “if you show me the data, I will be the first person to assure the American people that they need to take those vaccines… Not only will I do that, but I will apologize for any statements that misled people otherwise.”

Sen. Sanders repeatedly questioned Kennedy about the COVID-19 vaccine, which President Trump has called “one of the great miracles of the ages,” according to Sen. Sanders. Despite estimations that the vaccine saved three million lives, Kennedy is on record as calling it “the deadliest vaccine ever made.”

When asked if he disagrees with the scientists who say that the COVID-19 vaccine saved lives, Kennedy said he’s “agnostic, because we don’t have the science to make that determination.”

Throughout the hearings, Kennedy has insisted that he supports vaccines, but emphasized concerns over safety and transparency, an argument that many senators found troubling given his past rhetoric.

Kennedy pressed on Medicare, Medicaid

During her questioning, Sen. Hassan confronted Kennedy on his understanding of Medicare, questioning his grasp of the program’s funding and operations. When Kennedy stumbled over details of Medicare’s structure during a series of rapid-fire questions, Sen. Hassan rebuked: “You want us to confirm you to be in charge of Medicare, but it appears that you don’t know the basics of the program.”

Policymakers also pressed him on Medicaid, particularly whether he would support cuts proposed by the Trump administration. Kennedy claimed his goal was to “make Medicaid better,” but stopped short of committing to protect its funding, reinforcing concerns about potential impacts on low-income patients and physicians who treat Medicaid-reliant populations.

Drug pricing

Prescription drug costs emerged as a key issue, with Kennedy vowing to confront pharmaceutical industry price hikes. He expressed support for expanding Medicare’s ability to negotiate drug prices, but offered few specifics about how he would implement cost-reduction strategies.

Sen. Christopher Murphy (D-Connecticut) pushed Kennedy to clarify whether he would uphold Biden administration efforts to rein in drug prices, or whether he would pursue alternative solutions. Kennedy reiterated his, and the Trump administration’s, intent to address pricing disparities, but he lacked a clear policy outline. It’s unclear how his conformation as HHS Secretary would affect reimbursement structures and general patient affordability.

Responsibilities as HHS Secretary

Sen. Lisa Blunt-Rochester (D-Delaware) challenged Kennedy on his overall grasp of HHS responsibilities.

“I am deeply concerned and shocked by your apparent lack of understanding of, frankly, some of the basic responsibilities of the department,” she said. “It’s one of the largest, most complex and vitally important [departments]. Yesterday, during your Finance [Committee] hearing, you confused details about Medicare and Medicaid, you didn’t know what authorities you have under the Emergency Medical Treatment and Labor Act known as EMTALA and you made false claims about the safety of mifepristone.”

Sen. Blunt-Rochester also pressed Kennedy about the health of minorities in light of President Trump’s order for federal agencies to end Diversity, Equity and Inclusion (DEI) programs. Kennedy expressed his interest in helping all people who are vulnerable, saying he wants to “eliminate the shocking, unacceptable disparities in minority health.”

The future of HHS?

If confirmed, Kennedy would hold significant influence over the U.S. health care system. His push to streamline administrative processes and modify regulatory requirements within HHS could significantly alter regulatory compliance and reporting, which could, in turn, impact insurance reimbursements and federal funding. His grasp of Medicare and Medicaid also raised questions among policymakers about his ability to effectively oversee the critical programs that millions of Americans rely on for health care coverage.

In a position with such power and influence, Kennedy’s history of vaccine skepticism and what some policymakers consider "conspiracy theories," as repeatedly referenced throughout the hearings, could result in a greater loss of trust in health care providers, science and vaccines.

With the committees’ votes imminent following the hearings, Kennedy’s confirmation is no guarantee. Although Republicans have the majority, there was still some hesitancy surrounding his nomination, namely from Sen. Cassidy.

“Does a 71-year-old man, who spent decades criticizing vaccines, and who’s financially vested in finding fault with vaccines, can he change his attitudes and approach now that he’ll have the most important position influencing vaccine policy in the United States?” Cassidy posed the questions in his closing statement. “Will you continue what you have been, or will you overturn a new leaf?”