RFK Jr. Is Handling Things Just About as Bad as Imaginable

Summary

Bulwark Takes: RFK Jr. Is Handling Things Just About as Bad as Imaginable
Release Date: April 6, 2025

In this episode of Bulwark Takes, hosted by Sam Stein and featuring guest Jonathan Cohn, author of The Breakdown, the discussion centers on the recent significant workforce reductions at the Department of Health and Human Services (HHS), the administration's handling of these cuts, and the consequent impact on critical public health programs. The episode also delves into the controversial leadership of RFK Jr. at HHS, particularly his stance on vaccines, and the resulting public health crises, including a recent measles outbreak.

---

1. Introduction

Sam Stein opens the discussion by highlighting the major news of HHS implementing a 20% workforce cut across the board. He emphasizes that while much of the media focused on the potential impacts on scientific research and programs like smoking cessation, the effects on initiatives for children in poverty were largely overlooked.

“We were watching it unfold throughout the week. HHS has this incredible across the board cut, 20% of its workforce... not enough, frankly, was on the effect it's going to have on some of the initiatives that HHS oversees for children in poverty.”
[00:00] Sam Stein

---

2. HHS Workforce Cuts

a. Impact on Child and Family Programs

Jonathan Cohn provides an in-depth explanation of the divisions within HHS that focus on children and families. He specifically mentions two substantial programs:

1. Head Start: A program originating from the Great Society era, offering enriched preschool and early childhood care for children in poverty, free of charge.
2. Subsidized Child Care Program: Provides state funds to offer affordable child care to qualifying low-income families.

Cohn underscores the critical role these programs play in supporting working low-income families and ensuring early developmental interventions for children.

“There's Head Start... which provides... curriculum, preschool and early childhood care for children growing up in poverty... and then there is a second program that gives the state's money, and then the states can use that to provide subsidized child care for families that qualify based on their incomes.”
[00:46] Jonathan Cohn

Sam Stein adds that early interventions are crucial for a child’s development, particularly for those in poverty, as the lack thereof can have long-term detrimental effects.

“Scientific research is basically that interventions age 2 to 3, maybe 4, are really critical for a child's development... you're much more likely not to have those early interventions.”
[01:58] Sam Stein

b. Lack of Transparency and Communication

The discussion highlights the lack of detailed information provided by HHS regarding the layoffs. The administration released minimal details, leading to confusion and frustration among both employees and the public.

“This is the federal government. They're supposed to tell us that, like that's public information... it's not like, you know, we're trying to get the names of CIA operators.”
[03:40] Jonathan Cohn

Sam Stein expresses frustration over internal HHS employees learning about the cuts through unofficial channels like Reddit, pointing out potential legal violations given existing union contracts.

“But it's also, it's insane because the people internally don't really know everything... they're like, 'I, no one told us this.'”
[03:40] Sam Stein

c. Specific Examples of Impact

Cohn provides specific examples of the workforce reductions, such as the child care program office cutting staff from approximately 120 to 60 employees, effectively halving its workforce. He emphasizes that such cuts severely impair the agency’s ability to function effectively.

“The agency that oversees all... about a 40% cut, it sounds like... one example... from about 120 people, roughly, to about 60 people.”
[05:00] Jonathan Cohn

Sam Stein criticizes the administration's approach as haphazard and poorly planned, questioning the rationale behind cutting half the staff without considering operational continuity.

“You could just as easily argue that actually they were understaffed, given what they.”
[05:33] Sam Stein

---

3. Critique of Administration’s Handling

a. Haphazard Implementation

The rapid and poorly coordinated implementation of workforce cuts is a central critique. Cohn shares an anecdote illustrating the chaos within HHS, where an ongoing inquiry into a serious incident was abruptly disrupted by the firing of the responsible officer without any plan for continuity.

“There was a report... the person in charge of that inquiry was fired. Nobody knows what's going to happen with the case because there was no arrangement made for someone else to take over the file.”
[08:14] Jonathan Cohn

Sam Stein parallels this with other instances of administrative missteps, suggesting a lack of strategic planning and oversight.

“This sort of important role... and then you have an anecdote in your story that was like shocking to me.”
[08:01] Sam Stein

---

4. RFK Jr.'s Leadership and Vaccine Policies

a. Handling of Vaccine Policies

The conversation shifts focus to RFK Jr., who at the time serves as the head of HHS. Both hosts criticize his approach to vaccine policies, arguing that his dogmatic anti-vaccine stance is detrimental to public health.

Sam Stein remarks on the unlikelihood of any tempering in RFK Jr.'s approach, given his steadfast beliefs.

“He's dogmatic about it and you cannot... someone who's dogmatic about an issue ever does like, you're not going to like have a conversion overnight.”
[11:15] Sam Stein

Jonathan Cohn cites the firing of Peter Marks, a respected figure in vaccine safety, as evidence of RFK Jr.'s aggressive anti-vaccine agenda.

“He was a little more careful... scratch that. He was a little more careful. Right. You wouldn't like firing, pushing out Peter Marks... he is just going to go to Anti Vax here... which is not like what most Americans want.”
[10:25] Jonathan Cohn

b. Public Health Implications

The hosts argue that RFK Jr.'s leadership is not only ineffective but actively harmful. His policies and public statements are seen as escalating anti-vaccine sentiments, undermining public trust in vaccines.

“Maybe Twitter... fire and then aim.”
[09:34] Jonathan Cohn

---

5. Measles Outbreak and Anti-Vaccine Sentiment

a. Details of the Outbreak

The episode discusses a measles outbreak in West Texas, resulting in a second death. This situation is directly linked to the rise in anti-vaccine sentiments fueled by RFK Jr.'s influence.

“We have a second death from measles. The measles outbreak in West Texas in this case... almost certainly going to be a child who is unvaccinated.”
[11:24] Sam Stein

b. RFK Jr.'s Role and Impact

RFK Jr.'s involvement in the outbreak is critiqued, especially his decision to attend the funeral, which the hosts deem inappropriate and insensitive given his role in exacerbating the situation.

“RFK Jr. Is going to go to the funeral, which, boy, it seems totally inappropriate...”
[11:24] Sam Stein

Moreover, Cohn highlights the worsening impact of RFK Jr.'s advocacy, noting increased cases of vitamin A poisoning and delayed medical treatments as parents follow alternative therapies he promotes.

“...hospitals in Texas are saying they're seeing patients, kids included,... showing up with liver problems and vitamin A poisoning because he's talked up vitamin A.”
[12:23] Jonathan Cohn

---

6. Conclusion

Sam Stein emphasizes the critical importance of vaccination, urging listeners to rely on proven medical practices to prevent outbreaks like measles.

“Don’t just get a vaccination... We eradicated measles, basically. Now it's back. Don’t do cod liver oil. Get the vaccination.”
[13:14] Sam Stein

The episode concludes with a call to action for continued vigilance and advocacy for public health measures, recognizing the severe consequences of mismanagement and misinformation.

“Thank you for doing this, Jonathan. Really appreciate that. As always, subscribe to the feed, we'll be in touch. Take care.”
[13:14] Sam Stein

---

Notable Quotes

• Sam Stein [00:00]: “HHS has this incredible across the board cut, 20% of its workforce... effect it's going to have on some of the initiatives that HHS oversees for children in poverty.”

• Jonathan Cohn [00:46]: “There's Head Start... and then there is a second program that gives the state's money... subsidized child care for families that qualify based on their incomes.”

• Sam Stein [01:58]: “Interventions age 2 to 3, maybe 4, are really critical for a child's development... you're much more likely not to have those early interventions.”

• Jonathan Cohn [05:00]: “About a 40% cut... the office that deals strictly with that childcare program... from about 120 people, roughly, to about 60 people.”

• Jonathan Cohn [08:14]: “Person in charge of that inquiry was fired... no arrangement made for someone else to take over the file.”

• Sam Stein [09:34]: “No good company would do this... fire and then aim.”

• Jonathan Cohn [12:23]: “Hospitals in Texas are saying they're seeing patients... showing up with liver problems and vitamin A poisoning because he's talked up vitamin A.”

---

This episode of Bulwark Takes provides a comprehensive and critical examination of the recent HHS workforce cuts and RFK Jr.'s leadership, highlighting the profound and potentially disastrous impacts on public health programs and vaccine confidence in the United States.

Transcript

[Sam Stein]

Hey, guys, it's me, Sam Stein, managing editor at the Bulwark. I'm joined by Jonathan Cohn, author of the Breakdown, one of our new newsletters. He's got a great new edition out this morning. Jonathan, thanks so much, man. So your edition this morning is about. We were watching it unfold throughout the week. HHS has this incredible across the board cut, 20% of its workforce. And like, the predominant focus was on how it's going to affect scientific research and then how it's going to affect some of these programs like smoking cessation and other programs that administers little attention and not enough, frankly, was on the effect it's going to have on some of the initiatives that HHS oversees for children in poverty. Unwrap what you were writing, what you wrote about, and how you ended up kind of stumbling upon these cuts.

[Jonathan Cohn]

Yeah, yeah. So there is a division inside HHS that deals with children and families. It's got its own menu of programs. So there's two really substantial ones, and a lot of people have heard of them. There's Head Start, which, you know, dates back to the Great Society. It's a program that sort of provides enriched, you know, carefully sort of, you know, designed curriculum, preschool and early childhood care for children growing up in poverty. It's free. And then there is a second program that gives the state's money, and then the states can use that to provide subsidized child care for families that qualify based on their incomes. And they're different programs, but they kind of serve a common purpose, which is this recognition that first of all, low income families, you know, they're working. Childcare is super expensive. So this is a way to provide a kind of quality child care to families that need it. But on top of that, we know that kids growing up in poverty, the conditions, the turmoil kids can really set them behind, can really make, you know. Right.

[Sam Stein]

I mean, like scientific research is basically that interventions age 2 to 3, maybe 4, are really critical for a child's development. And if you grow up in poverty, you're much more likely not to have those early interventions to stimulate your brain and your mind in ways that will benefit you in the long run.

[Jonathan Cohn]

Yeah, yeah. And so, you know, in talking to people at hhs, as we were reporting, you know, we're talking about the cdc, we were talking about, you know, what's going on in the agency running Medicare. And people kept saying, hey, you should look at Head Start, you should look at the child care program because, you know, there's a lot of Work being done. And those offices really got decimated.

[Sam Stein]

All right, what is decimated? Like, because everything got decimated. But what is decimated in this case? Because the hhs, I just want to be clear for the people watching, HHS has put out like the bare minimum on what they cut. They, they put out some fact sheets, I believe, but it wasn't really descriptive. They didn't list the positions. A lot of what we know is just because people internally have said, oh my God, entire department has gone, oh my God, this incredible leader at this place has been axed. And so it's not like they were saying, hey, we cut these Head Start programs. So how did you find out?

[Jonathan Cohn]

Yeah, yeah, no, I mean, and, and keep in mind there's been two separate rounds, right? We had the, the layoffs in February, you know, the probationary.

[Sam Stein]

Right, right, right. That was the probationary employees. And these were the reduction in forces.

[Jonathan Cohn]

Right. And you know, and their courts have sort of ordered some people back, but then some people, some people actually did come back to work, but mostly they were put on in. So just, there's no like precise official which can we just tell, you know, viewers. That's insane. Like this is the federal government. They're supposed to tell us that, like that's public information. The idea, this is like some secret. We're trying, you know, it's not like, you know, we're trying to get the names of CIA operators.

[Sam Stein]

But it's also, it's insane because the people internally don't really know everything. Like you talk, I've talked to a number of HHS employees who are like, they're finding out this stuff because they're reading the Reddit, the Fed news page on Reddit and they're like this, I, no one told us this. And then the riffs, this is another story. But the rifts itself, like, they're like, some of this is just blatantly illegal. We have union contracts. Like they completely abandoned any idea, any, any principle around the contract that they were going to abide to buy it. Putting that aside. So you figured out through reporting basically that they're cutting what, five of the 10 regional offices for Head Start.

[Jonathan Cohn]

Yeah, yeah. Now the regional office, they did say, but they didn't say how many people. And the way I, I, I found this out was, you know, just in former officials, it turned out a number of them were like, we should try to make a tally. So they basically group sourced it, you know, on their own. And they're pretty confident because they've been able to, you know, check their numbers. They're pretty close. And so the agency that oversees all the sort of child, you know, the Children and family, which includes these two programs, about a 40% cut, it sounds like. And even within that, there's some variation. So one example I was given was the office that deals strictly with that childcare program. So this is the one that gives money to the states. They've come down from about 120 people, roughly, to about 60 people. So half.

[Sam Stein]

Half, yeah.

[Jonathan Cohn]

Okay.

[Sam Stein]

Even I can do that math.

[Jonathan Cohn]

It's, it's, it's, you know, we could talk about administrative bloat. There's, there's, you know, redundancy or whatever. I mean, there's just not a unit. And people told me there is just not a universe where you're cutting half the staff and you're not going to cut their ability to do their jobs. We can argue there was redundancy and not every position made sense, but you could just as easily argue that actually they were understaffed, given what they.

[Sam Stein]

Well, and then on the Head Start front, so they cut these regional offices. And as I understand, correct me if I'm wrong, I mean, they're there to both communicate latest studies and practices that have been studied to the people who are administering Head Start, and they're there to also hear from local ministers, administrators, the problems that they're having, the needs that they need have. Obviously, the facilitation of finances and money to make sure that they're operational is important, you would imagine. I guess what strikes me about this all is that how quickly this all happened. And by that, I mean, you and I have talked about this. But conservatives have philosophical differences with Head Start. They believe that it doesn't produce the results that, you know, studies show that you're not getting a bang for your buck, that it's basically subsidized child care. There's an argument legitimate, if you, if you're a conservative to be made, that the program needs to be reformed dramatically. But this is not a thoughtful reform process. This is a ax just being applied. And we know that because Kennedy's out there saying things like, well, you know, we're going to hire these people back. This is always the intention that we're going to do this. And then privately, administration officials are actually, no, no, no. This is actually what we're going to do, and so on and so forth. So I guess I have been sort of like, shocked a little bit about how quickly and how haphazardly this all felt.

[Jonathan Cohn]

Quick and haphazard. And, you know, the best evidence of that, I think, something that I heard, and again, we've seen this in other parts of the federal government as well. But, you know, it happened so quickly. You know, it was like the notices went out in the morning and they had like, you know, all their access to their files and even like the sort of managers didn't know who in there, like, you know, you know, division, Right. Getting fired. So as a result, you were just describing, right, this sort of important role these regional offices, these like, staff play in terms of having this sort of contacts with the individual Head Start providers, right? Now, you know, these are the people, you know, if you're a Head Start provider. These are the people you go to if there's a payment problem. They're also the people you give feedback to to sort of say, hey, this is working. This isn't, you know, if you want to get guidance on like, hey, what is the latest sort of best practices and how to design all of that.

[Sam Stein]

Yeah, yeah.

[Jonathan Cohn]

So every person in the, in the regional office has like a kind of list. Right. They're kind of, they're, they're, they're people, they're, they're, they're providers. Right. And there's this on guard. Well, if you're going to fire half of them at the very least. Right. Aren't you going to want to make sure that who, you know, the people, the, you know. Right.

[Sam Stein]

Losing contacts are in place. Case. Case is closed. Make sure that this transition is smooth. None of that happened. You had an anecdote in your story that was like shocking to me. Can you explain that one? Because this actually really exemplifies.

[Jonathan Cohn]

Yeah.

[Sam Stein]

What we're talking about.

[Jonathan Cohn]

So, I mean, one of the responsibilities if you're a regional officer is that you are, you know, if there's a, if there's some kind of problem, there's a violation of a kind of safety conduct. Whatever one of these programs does something, you know, is reported, there's a. Reported something bad happened. You're the one who's going to sort of, you know, take charge of sort of investigating what happened. Coming up, you know, what, what, what, what needs to be done in response, what kind of remedial action, et cetera. So there was a report in one of these programs that an instructor had actually struck a child to try to discipline them. Something that happens very rarely, by the way. I mean, you know, I mean, they document these things and, and, but there was a report and so you had, there was an ongoing Inquiry into this. The person in charge of that inquiry was fired. Nobody knows what's going to happen with the case because there was no arrangement made for someone else to take over the file. And this, you know, this is, this is what's going on there. And it's just, you know, like, who plans things like that? I mean, no, you know, I'd like, you know, you always hear from the conservatives. Well, if the private sector, you know, ran this, operated like this.

[Sam Stein]

Yeah.

[Jonathan Cohn]

No, no private sector company, you know, no, they would. No, no good company would do this.

[Sam Stein]

Maybe Twitter. Maybe Twitter.

[Jonathan Cohn]

Let's, let's. That's, you know, let's be serious, right? I mean, this is how Twitter, kind.

[Sam Stein]

Of how they did it. Yeah. Fire and then aim. Let's talk about RFK a little bit. He's, you know, I don't know how far in, but, you know, roughly two months. No, a little less than that. We had pretty low expectations, I think it's fair to say. The optimistic version of RFK would have been that he would have been sequestered on the issue of health. He would have been checked on the issue of vaccines and on the issue of administration, he would have had seasoned hands at the wheel. He has not been checked on the issue of vaccines. It appears, as we just acknowledge, that the seasoned hands aren't on a wheel with respect to administration or if they are, they're not doing a very good job. The issue of health, tbd, I think it's probably been about as, you know, bad as the skeptics warned. What's your take?

[Jonathan Cohn]

Yeah, I'd say as bad as the skeptics were warned. Maybe worse. You know, I mean, worse. Yeah, I think worse. I think worse because I think I expected. Well, I don't know what I expected, but I mean, I could have imagined a world where, if only for political appearances. Right. There was a little bit, you know, they were a little. He was a little more careful. Right. You wouldn't like firing, pushing out Peter Marks, who's this sort of, you know, revered figure in vaccine safety. You know, that's such an overt act to just sort of say, screw you, I am just going to go to Anti Vax here, which is not like what most Americans want. Most Americans believe in vaccines, you know, but not him.

[Sam Stein]

And he's. And he's. And he's dogmatic about it and you cannot. The idea that he was ever going to sort of temper that impulse, I mean, it's so silly. But you don't.

[Jonathan Cohn]

That.

[Sam Stein]

That's not what, you know, someone who's dogmatic about an issue ever does like, you're not going to like have a conversion overnight. So here we are.

[Jonathan Cohn]

Here we are.

[Sam Stein]

That brings us to the other story today, which is we have a second death from measles. The measles outbreak in West Texas in this case, I believe. Not sure if it's confirmed, but it's almost certainly going to be a child who is unvaccinated. The shocking thing though, and this is from NBC and I have not seen a secondary confirmation, so grain of salt, but this is what they reported. RFK Jr. Is going to go to the funeral, which, boy, it seems totally inappropriate, at least as I read it. And I'm really genuinely surprised that they're doing this because the problem is caused by anti vaccine sentiment, plain and simple.

[Jonathan Cohn]

Yeah, I mean, you know, this is a guy who spent his career, you know, reinforcing and spreading anti vaccine sentence, probably as responsible as any other single.

[Sam Stein]

Well, and then you, we were talking about this too, is like it's not just that he's spreading the anti vaccine sentiment, he's actually actively worsening the situation because he's suggesting all these alternative remedies and therapies that are now getting people sick.

[Jonathan Cohn]

Yeah, yeah. I mean we're seeing, the hospitals in Texas are saying they're seeing patients, kids included, you know, showing up with liver problems and vitamin A poisoning because he's talked up vitamin A. And I, I saw this morning an account, I think it was in the New York Times that in addition to that they are worried now that parents are delaying bringing their children in for medical attention because they believe in the alternative therapies that Kennedy has been talking up. So yes, not just not helping, he's making the problem worse.

[Sam Stein]

Yes. I just, if anyone is watching, I'm sure they're not watching the bulwark. But don't just get a vaccination. It's been proven by history. We eradicated measles, basically. Now it's back. Don't do cod liver oil. Get the vaccination. It's important. All right, well, we'll be watching that. I'm sure we'll be talking about it. And why don't we just make sure that you keep writing about it too? Because it's vital. And thank you for doing this, Jonathan. Really appreciate that. As always, subscribe to the feed, we'll be in touch. Take care.