What would RFK Jr. mean to HHS?

Summary

Consider This from NPR: What Would RFK Jr. Mean to HHS?

Release Date: January 29, 2025

In this episode of NPR's "Consider This," host Scott Detrow delves into the potential implications of Robert F. Kennedy Jr.'s confirmation as the Secretary of Health and Human Services (HHS). The discussion centers on Kennedy's controversial stance on vaccinations, his policy positions, and the broader impact his leadership could have on key health programs like the Vaccines for Children (VFC) program. Through expert insights and notable quotes from the confirmation hearings, the episode provides a comprehensive analysis for listeners seeking to understand the stakes involved.

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1. The Significance of the Vaccines for Children Program

Scott Detrow opens the episode by highlighting the historical context of the Vaccines for Children (VFC) program:

"[...] the VFC provides no cost vaccines to kids who lack health insurance or whose families can't afford the cost of the vaccination." [00:01]

Sarah Rosenbaum, an emeritus professor of health law and policy, underscores the program's impact:

"The first was to make sure that the coverage that Medicaid agencies provided for vaccines met the standard set by public health experts. And to accomplish that, the VFC program covers the entire cost of vaccine." [00:35]

Detrow emphasizes the federal government's role in funding these vaccines:

"That means the federal government foots the entire bill for pediatric vaccinations, something that amounts to billions of dollars today." [00:57]

Rosenbaum further explains the program's success in increasing vaccination rates among low-income children:

"So it's been one of Congress's most effective programs for preventive health. And of course, it's a central achievement of the Medicaid program for children." [01:55]

The VFC program has delivered over 71.5 billion doses of pediatric vaccines to more than 37,000 providers, showcasing its extensive reach and effectiveness.

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2. Robert F. Kennedy Jr.'s Confirmation Hearing

As the potential Secretary of HHS, Robert F. Kennedy Jr.'s views on vaccinations have come under intense scrutiny. During his Senate confirmation hearing, Kennedy faced rigorous questioning about his long-standing skepticism towards vaccines.

Senator Michael Bennett voiced concern over Kennedy's history:

"What is so disturbing to me is that out of 330 million Americans, we're being asked to put somebody in this job who has spent 50 years of his life not honoring the tradition that he talked about at the beginning of this conversation, but peddling in half truths, peddling in false statements, peddling in theories that, you know, create doubt about whether or not things that we know are safe are unsafe." [02:22]

Kennedy has been a prominent figure in the anti-vaccination movement, promoting debunked theories linking vaccines to autism and challenging the established science behind vaccine safety.

Sarah Rosenbaum expresses her apprehensions:

"What we may face is somebody who isn't just skeptical about vaccines. I mean, who has really denied their efficacy for children and raised false questions about their safety in charge of the entire enterprise, which is a very bitter pill to swallow." [03:23]

Rosenbaum fears that Kennedy's leadership could undermine decades of public health achievements, particularly in pediatric vaccination.

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3. Key Moments from the Confirmation Hearing

During the hearing, several pivotal exchanges shed light on Kennedy's positions and the concerns of his opponents.

Maggie Hassan, a Democratic Senator from New Hampshire, confronted Kennedy on his shifting political affiliations and his approach to vaccine policy:

"He did not hear him say at any point that he had been wrong with all the past statements that people were running by him. He just tried to walk this tightrope that for decades of urging people to skip vaccinations despite all that, that wouldn't influence his approach to the job of overseeing federal vaccine policy and recommendations." [05:36]

The hearing also featured Senator Bernie Sanders, who challenged Kennedy's commercial interests in the anti-vaccine movement by highlighting merchandise from Kennedy's former organization:

"One of them is titled Unfaxed Unafraid, Next One. And they sold for 26 bucks apiece, Next One is no vax." [06:16]

Kennedy attempted to distance himself from the merchandise, stating:

"He said he didn't control the merchandise they sell." [06:27]

On the topic of abortion, Kennedy faced tough questions regarding his alignment with Republican administration policies despite his previous support for abortion rights.

Selena Simmons Duffin notes the consistency of Kennedy's stance:

"He made it clear that is not going to be the case." [07:09]

Kennedy affirmed his commitment to the president's policies on abortion, reinforcing his alignment with the Republican agenda.

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4. Policy Priorities and Broader Implications

When discussing his vision for HHS, Kennedy outlined several priorities:

"He would move the focus of scientific research away from infectious diseases like the flu and towards things like the root causes of chronic diseases like diabetes." [07:49]

However, Maggie Hassan criticized Kennedy's understanding of critical programs like Medicare and Medicaid:

"At one point, he got the word Medicare and Medicaid confused, it seemed like. And he said that they not popular programs, while they're very, extremely popular across the political spectrum." [08:25]

This confusion raised concerns about his capability to manage significant aspects of HHS, including the Affordable Care Act and major healthcare programs.

Selena Simmons Duffin adds context about Republican support amidst internal party dynamics:

"He can only lose three Republican senators and still get confirmed if all Democrats oppose him." [10:25]

Despite opposition from figures within the Kennedy family, efforts are underway to secure his confirmation, including financial backing from influential allies.

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5. Conclusion: The Future of HHS Under RFK Jr.

The episode concludes by weighing the potential consequences of Kennedy's leadership at HHS. With his history of vaccine skepticism and alignment with conservative health policies, public health advocates like Sarah Rosenbaum worry about the reversal of important health initiatives.

Kennedy's confirmation could signify a significant shift in U.S. health policy, impacting everything from vaccine distribution to chronic disease research. The political maneuvering surrounding his nomination underscores the deeply polarized views on health governance in the current climate.

As NPR's "Consider This" aptly highlights, the decision to appoint Robert F. Kennedy Jr. to HHS will have profound implications for the nation's public health infrastructure and the trust placed in federal health programs.

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Notable Quotes:

• Michael Bennett [02:22]: "We're being asked to put somebody in this job who has spent 50 years of his life... peddling in half truths... that create doubt about whether or not things that we know are safe are unsafe."

• Sarah Rosenbaum [03:23]: "Who has really denied their efficacy for children and raised false questions about their safety in charge of the entire enterprise..."

• Maggie Hassan [05:36]: "He just tried to walk this tightrope... that wouldn't influence his approach to the job of overseeing federal vaccine policy and recommendations."

• Senator Bernie Sanders [06:16]: "One of them is titled Unfaxed Unafraid... Next One is no vax."

• Selena Simmons Duffin [07:44]: "He will implement his policies when it comes to abortion."

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Produced by: Briana Scott and Jordan Marie Smith
Edited by: Christopher Intagliata, Courtney Dorning, Diane Weber, Kelsey Snell, and Nadia Lansing
Executive Producer: Sammy Yannigan

For more insights and updates, visit NPR's Consider This at plus.npr.org/considerthis.

Transcript

[Scott Detrow]

In 1994, the Vaccines for Children program was implemented. The VFC provides no cost vaccines to kids who lack health insurance or whose families can't afford the cost of the vaccination.

[Sarah Rosenbaum]

I'm Sarah Rosenbaum. I am an emeritus professor of health law and policy at the Milken Institute School of Public Health at George Washington University.

[Scott Detrow]

Rosenbaum played a key role in helping then President Bill Clinton develop a national vaccine initiative. And the Vaccines for Children program, which was made part of Medicaid, addressed two key issues.

[Sarah Rosenbaum]

The first was to make sure that the coverage that Medicaid agencies provided for vaccines met the standard set by public health experts. And to accomplish that, the VFC program covers the entire cost of vaccine.

[Scott Detrow]

That means the federal government foots the entire bill for pediatric vaccinations, something that amounts to billions of dollars today. Rosenbaum says the second thing the program did was to address what she saw as the single greatest impediment to properly vaccinating children. Once again, it came down to money.

[Sarah Rosenbaum]

What Vaccines for Children did was to empower the HHS secretary to negotiate with the manufacturers directly, and then the manufacturers literally deliver, ship and deliver the vaccines right to the doctor's office. So other than having to bill for the administration fee, there is no charge to the doctors.

[Scott Detrow]

Under the vfc, childhood vaccination rates, particularly those from low income backgrounds, soared. The VFC has provided more than 71.5 death billion doses of pediatric vaccines to more than 37,000 vaccine providers.

[Sarah Rosenbaum]

So it's been one of Congress's most effective programs for preventive health. And of course, it's a central achievement of the Medicaid program for children.

[Scott Detrow]

It is also a program that Robert F. Kennedy Jr. Would oversee if he's confirmed as Secretary of Health and Human Services. Exactly what Kennedy believes about vaccinations was something lawmakers questioned him about repeatedly today during his Senate confirmation hearing.

[Michael Bennett]

What is so disturbing to me is that out of 330 million Americans, we're being asked to put somebody in this job who has spent 50 years of his life not honoring the tradition that he talked about at the beginning of this conversation, but peddling in half truths, peddling in false statements, peddling in theories that, you know, create doubt about whether or not things that we know are safe are unsafe.

[Scott Detrow]

That's Colorado Democratic Senator Michael Bennett. Over the years, Kennedy has pushed the disproven theory that vaccines cause autism, and another time has floated other baseless claims like that AIDS is not caused by HIV. There's also the anti vaccination nonprofit formerly chaired by RFK Jr called Children's Health Defense. And Rosenbaum, like many other public health advocates, worries that Kennedy will undo work that she believes has kept children in America safe for more than three decades.

[Sarah Rosenbaum]

What we may face is somebody who isn't just skeptical about vaccines. I mean, who has really denied their efficacy for children and raised false questions about their safety in charge of the entire enterprise, which is a very bitter pill to swallow.

[Scott Detrow]

Consider the Vaccines for Children program is just one part of a massive system overseen by the Secretary of Health and Human Services. So what have we learned about how Robert F. Kennedy, Jr. Would run it? From NPR, I'm Scott Detrow. It's consider this from NPR. Robert F. Kennedy, Jr. Faced senators today in a contentious confirmation hearing to serve as Health and Human Services secretary under President Trump. Kennedy is a former Democrat turned independent now turned Trump loyalist. Democrats like New Hampshire Senator Maggie Hassan questioned how he would square his positions with his politics.

[Maggie Hassan]

When was it that you decided to.

[Bernie Sanders]

Sell out the values you've had your whole life in order to be given power by President Trump?

[Scott Detrow]

Kennedy is the leader of the so called Make America healthy again movement. NPR's Selena Simmons Duffin and Susan Davis covered the hearing. And join me now. Hey there.

[Selena Simmons Duffin]

Hey, Scott.

[Maggie Hassan]

Hi, Scott.

[Scott Detrow]

Selena, I want to start with you and I have to start with vaccines. Kennedy's advocacy against vaccine mandates and questioning the safety of vaccines is the main reason the opponents say he should not have this job. How did he defend himself?

[Maggie Hassan]

Well, today he said many times he is not anti vaccine. He said all his kids are vaccinated. He supports the childhood vaccine schedule. What he said is that he wants good science and he wants to make sure vaccines are safe, which, you know, sounds good, but there is this implication that there isn't good science now, which there is, and that vaccines aren't safe now, which they are. I did not hear him say at any point that he had been wrong with all the past statements that people were running by him. He just tried to walk this tightrope that for decades of urging people to skip vaccinations despite all that, that wouldn't influence his approach to the job of overseeing federal vaccine policy and recommendations.

[Scott Detrow]

But again, he has a very long track record here. So I'm curious what kind of pushback he got when he said that.

[Maggie Hassan]

Well, Democrats on the committee really hammered him on the way he has profited from his anti vaccine work from lawsuits against drug makers, for example, books, speeches. His disclosures that became public this week shows he has made millions of dollars in this activity. And he's just been also very influential in the anti vaccine movement. One memorable way this came up in the hearing was when independent Senator Bernie Sanders of Vermont brought out posters showing the onesies being sold on the website of Children's Health Defense. That's the group Kennedy is closely affiliated with, but and used to lead.

[Bernie Sanders]

One of them is titled Unfaxed Unafraid, Next One. And they sold for 26 bucks apiece, by the way. Next One is no vax.

[Michael Bennett]

No problem.

[Maggie Hassan]

Kennedy responded by distancing himself from the group. He said he didn't control the merchandise they sell. But we should note that they streamed the hearing on that website today.

[Scott Detrow]

Sue, I'm gonna turn to you in another big political topic. Most of his life, Kennedy has supported abortion rights. He now wants to serve in a Republican administration. How did that issue play at today's hearing?

[Selena Simmons Duffin]

Probably the sharpest exchange was with Senator Hassan. She noted this contradiction of his lifelong advocacy of body autonomy when it comes to vaccines, but wouldn't commit to viewing abortion under that same autonomy. Kennedy also made it clear in a separate exchange with Republican Senator James Lankford of Oklahoma that on this issue, he would not seek to counter the White House in any way.

[Bernie Sanders]

I agree with President Trump that every abortion is a tragedy. I agree with them that we cannot be a moral nation if we have 1.2 million abortions a year. I agree with them that the states should control abortion.

[Selena Simmons Duffin]

A quick note, Scott, that Kennedy does have a condition that affects his voice, but in that statement, he went on to say explicitly he serves at the pleasure of the president and he will implement his policies when it comes to abortion. And this is key because Kennedy has faced some skeptical, skepticism on the right from conservative abortion activists that he could somehow be more of a maverick on this issue. He made it clear that is not going to be the case.

[Scott Detrow]

Selena, more broadly, what has Kennedy said his top priorities would be if he is confirmed?

[Maggie Hassan]

Well, he talked a lot about how President Trump has given him a mandate to to get the health of Americans back on track. He said in his generation, he is 71 years old, Americans used to be healthier. And he claimed that they could be healthy again with his out of the box thinking and leadership. He said he would move the focus of scientific research away from infectious diseases like the flu and towards things like the root causes of chronic diseases like diabetes.

[Scott Detrow]

A huge part of HHS and its budget is Medicare and Medicaid. Also the Affordable Care Act. These are all programs that touch a lot of people's minds, that are always politically top of mind. How did Kennedy address those?

[Maggie Hassan]

So on those topics, at times, Kennedy seemed to not know his way around those issues very well. At one point, he got the word Medicare and Medicaid confused, it seemed like. And he said that there not popular programs, while they're very, extremely popular across the political spectrum. And this is an important issue because Republicans in Congress are looking to possibly trim these programs in an effort to balance the budget.

[Scott Detrow]

Sue, Republicans have the majority in the Senate. How did Republicans approach Kennedy and navigate his complicated history?

[Selena Simmons Duffin]

Look, to put a fine point on it, he's been accused for a long time of being a conspiracy theorist, particularly in how he frames this intersection of government and science. One Republican senator, Thom Tillis of North Carolina, seemed to try to give him some oxygen to defend himself.

[Scott Detrow]

I got a real quick question for you. Are you a conspiracy theorist?

[Bernie Sanders]

That is a pejorative, Senator. That's applied to me mainly to keep me from asking difficult questions of powerful interest.

[Selena Simmons Duffin]

Scott, I don't think you can discount how much the COVID pandemic transformed the way the Republican Party views these government health agencies as almost a hostile force, a view that Kennedy Times has shared, which I think explains why there is so much conservative support for him in this political moment.

[Scott Detrow]

Yeah, at this point, there really does not seem to be much resistance at all to Trump's nominees. Is Kennedy on track to be confirmed?

[Selena Simmons Duffin]

You know, nothing is certain in the Trump administration, but it seems likely members of the Kennedy family are out there advocating against him, including his cousin, Caroline Kennedy, the daughter of former President Kennedy. She released a letter this week she sent to senators calling him a, quote, predator and saying he should be defeated. This carries a lot of weight with Democrats, but this is really about keeping the Republican Party unified. He can only lose three Republican senators and still get confirmed if all Democrats oppose him. And I would note here, Scott, that his former running mate, billionaire Nicole Shanahan, publicly this week said she will personally fund primary challenges to any of the key senators who oppose him or threaten to take down his nomination.

[Scott Detrow]

That is NPR's Susan Davis along with Selena Simmons Duffin. Thanks to both of you.

[Selena Simmons Duffin]

You're welcome.

[Maggie Hassan]

Thank you.

[Scott Detrow]

This episode was produced by Briana Scott and Jordan Marie Smith. It was edited by Christopher Intagliata, Courtney Dorning, Diane Weber, Kelsey Snell and Nadia Lansing. Our executive producer is Sammy Yannigan. It's consider this from npr. I'm Scott Detrowed.