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Robert F. Kennedy, Jr., faced a barrage of questions from U.S. senators today during his confirmation hearing for his nomination for secretary of the Department of Health and Human Services. The hearing focused on views Kennedy, an environmental lawyer with no medical training, has expressed on several important issues facing Americans’ public health today, including vaccines, chronic disease, and federal health care programs such as Medicaid. Kennedy’s responses could reveal how he would lead the government’s vast health and medical apparatus should he be confirmed.

“The hearing was a reminder of just how sprawling the Department of Health and Human Services is and just how far reaching the areas of health care that the secretary has their hand on,” says Jason Schwartz, an associate professor of health policy at the Yale School of Public Health, who specializes in vaccines and vaccination policy. “I was struck by, under questioning from both Republican and Democratic senators, the areas where there’s clearly not a great deal of familiarity on Kennedy’s part regarding major components of the HHS portfolio.”

Kennedy has made unsupported and dangerous claims about fluoridation, raw milk, and other topics. In the hearing, Democratic Senator Michael Bennet of Colorado also brought up Kennedy’s unsubstantiated past statement that Lyme disease was a bioweapon. Perhaps most notably, Kennedy has frequently promoted false or misleading claims about vaccines, though he tried to distance himself from some of them during today’s hearing.

“As the [hearing’s] questions pointed out, there’s been almost no one who’s been a more expansive critic of vaccines in his work for such a long time,” Schwartz says.

Here are five takeaways from the hearing that reveal what Kennedy’s leadership of HHS might look like.

Vaccines

Kennedy has a long record of antivaccine activism, despite the fact that his own children are vaccinated. He has falsely linked vaccines to autism and has benefitted financially from efforts to revoke the approval of certain vaccines. Despite this history, Kennedy stated in the hearing that he is “not antivaccine” but rather “prosafety.” Democratic senators begged to differ. Senator Ron Wyden of Oregon pointed to Kennedy’s visit to Samoa in 2019, which occurred months before a measles outbreak that killed 83 people, many of them children. Vaccination rates were already low following a tragic incident the previous year, when two nurses accidentally combined the MMR vaccine against measles, mumps, and rubella with a muscle relaxant, leading to the deaths of two children. Kennedy met with antivaccine advocates during his visit and later wrote a letter to the country’s prime minister inaccurately suggesting that a “defective” vaccine could have caused the infections. In the confirmation hearing, Kennedy denied responsibility for any role in the deadly outbreak, however.

During the COVID pandemic, Kennedy sought to revoke the approval of the lifesaving COVID vaccines just six months after their rollout. In the hearing, he said he was against the vaccines’ use in six-year old children and cited a misleading claim that that age group does not get severely ill from COVID. Yet health experts acknowledge the vaccines likely saved millions of lives, including children’s.

“The data clearly show that there has been plenty of risk of COVID in young children, and while it’s not as common a cause of serious illness or death as it is in older individuals, no one would argue that it isn’t still a significant health concern, and there’s a very good reason to continue to recommend vaccination in young children,” Schwartz says.

Medicaid

During the hearing, Kennedy was asked about his views on Medicaid, the government insurance program that supports nearly 80 million low-income Americans. (The program was plunged into uncertainty yesterday when the Trump administration announced a federal funding freeze that roughly coincided with the Medicaid portal temporarily going offline, which meant that people could not check enrollment status or submit claims.) Kennedy at times appeared to confuse Medicare and Medicaid in the hearing, Schwartz says; the nominee claimed that most people are dissatisfied with the latter program, despite clear evidence to the contrary. When questioned about whether he would cut Medicaid, he gave indirect answers stating he would follow President Donald Trump’s desire to reform it.

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