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.