How much of RFK Jr.’s health care agenda could he deliver in Trump’s Cabinet?

When Robert F. Kennedy Jr. first joined Donald Trump’s campaign team as a high-profile surrogate in the late stages of the 2024 race, he punctuated the move by offering his own spin on the GOP’s “Make America Great Again” slogan, promising instead to “Make America Healthy Again.” The benign-sounding platitude builds off RFK Jr.’s decades of conspiratorial public health skepticism and anti-vaccine advocacy.

Fast forward to today and Kennedy is no longer a Trump campaign ally. Instead, he has been tapped as the president-elect’s nominee to run the Department of Health and Human Services for the incoming administration. If confirmed by the Republican Senate majority, Kennedy would find some of the most consequential public health policy decisions in his hands. It’s a prospect that has terrified many public health advocates, who point to his disparagement of vaccines, SSRIs, and fluoride as foreshadowing an effort to dramatically reshape the relationship between Americans and their bodies for the worse. Supporters, meanwhile, have cheered on Kennedy’s broadsides against the medical establishment, framing them as a much-needed realignment against a malicious, profit-driven pharmaceutical complex.

Most observers agree that Kennedy’s nomination is a fundamentally radical one, standing out even against the backdrop of Trump’s extremist slate of Cabinet picks. Less clear, however, is the degree to which RFK Jr. can deliver on his promised agenda should he be confirmed next year.

What did the commentators say?

One of Kennedy’s main goals is to limit vaccine availability by accessing public health data “so he can say these things are unsafe,” Trump transition team co-chair and Commerce Secretary nominee Howard Lutnick said in October. “He says, ‘if you give me the data, all I want is the data and I’ll take on the data and show that it’s not safe.’ And then if you pull the product liability, the companies will yank these vaccines right off of the market.” But, said Vox, “undoing the approval of an already approved vaccine would require submitting evidence of harm that meets the FDA’s standards,” which “simply doesn’t exist.”

Moreover, Kennedy’s insistence that he wants the Food and Drug Administration to use stricter vaccine review policies runs counter to the fact that the U.S. has “one of the most rigorous review processes for vaccine safety and effectiveness” on Earth, making it “unclear what he wants changed or what data would be considered sufficient,” said Dr. Katelyn Jetelina, an expert in epidemiology and public health, to “PBS NewsHour.” Still, “more data or more review processes could delay new vaccines.” More directly, Kennedy could also “change which vaccines federal employees are required to take and could influence U.S. military vaccine protocols,” Business Insider said.

Kennedy has similarly promised that the Trump White House will “advise all U.S. water systems to remove fluoride from public water” — a dramatic reversal of more than half a century of public health policy. However, “there’s no federal mandate to put fluoride in water,” Axios said. As such, his proposed advisory would be nothing more than that, although “most state and local municipalities follow the federal government’s recommendation.”

For Kennedy, “sowing distrust does not require Senate confirmation, a vast budget, or structural change,” Vanity Fair said. “It just takes a government megaphone.”

“It will likely be difficult for Kennedy to change the drug approval process,” said CNBC. But with a high-profile government role, he could “politicize certain treatments he opposes and tout others that aren’t proven to be safe and effective.” He could also appoint FDA and CDC officials who “share his debunked anti-vaccine views and could try to slow, restrict, or revoke vaccine approvals,” Time said. “In principle,” The Associated Press said, Kennedy as HHS secretary could also “overturn almost any FDA decision,” something that has only happened in “rare cases” in previous administrations.

What next?

One major question about Kennedy’s effectiveness could become apparent as early as his confirmation process, particularly regarding pharmaceuticals and vaccines. “It’s unclear how the industry and its lobbying groups will respond during the Senate confirmation process,” said Politico. Similarly, when it comes to his focus on nutrition through the removal of certain chemical additives and dyes, “many of Kennedy’s public-health priorities conflict with Project 2025, which calls for deregulating much of the food industry,” Business Insider said.

Ultimately, “most Republican senators appear ready to support Kennedy Jr. to the influential Cabinet position,” said USA Today, “even as they are being hounded about how they’ll vote for even more controversial nominees.”