Now that he’s got the job, Robert F. Kennedy Jr. may struggle to navigate his new position as secretary of Health and Human Services as the agency contends with potential job cuts and the administration works to pursue President Donald Trump’s agendas, experts say.
The high-profile anti-vaccine activist, , was confirmed by the Senate in a on Thursday. (Sen. Mitch McConnell, R-Ky., was the only Republican to break with his party and vote no.) His sparked outrage within the scientific community, with many fearing his appointment could undermine decades of public health — particularly vaccination efforts — in the U.S.
However, as HHS secretary, Kennedy may find himself at a disadvantage, as the Department of Government Efficiency, , moves to cut down the size of the federal workforce and reduce spending. Last month, the administration the option to resign but be paid through the end of September. On Wednesday, a federal judge .
With the possibility of limited resources and manpower, Kennedy could have a hard time pushing forward his own priorities — including and eliminating unhealthy foods, according to Dorit Reiss, a vaccine policy expert at the University of California, San Francisco.
“Cutting staff is one challenge Mr. Kennedy will face,” Reiss said. “That challenge will be exacerbated by his lack of expertise about the department’s general functions, something in which an expert staff could help him with.” Kennedy’s background is in environmental law.
What’s more, experts have interpreted Sen. Bill Cassidy’s, R-La., recent comments about Kennedy partly as an effort to curb the secretary’s potentially problematic actions and shield Trump from embarrassment. Cassidy, who is a doctor, chairs the Senate Committee on Health, Education, Labor and Pensions, a panel that oversees HHS.
During to advance Kennedy’s nomination, Cassidy said that Kennedy made several promises to him, including agreeing to regular meetings and that he would give prior notice to the Senate before implementing changes to certain vaccine programs.
“I think the general wrap has been that RFK Jr. is going to be the big bad bear,” said Drew Altman, the president and CEO of KFF, a nonprofit group that researches health policy issues. “On the contrary, I think his challenge is going to be to carve out the territory where he can actually operate.”
Kennedy’s responsibilities will include overseeing Medicare, Medicaid and the Affordable Care Act, which altogether provide health insurance coverage for roughly half the U.S. population.
But Trump has vowed , said Adrianna McIntyre, an assistant professor of health policy and politics in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health, and any potential cuts to Medicaid — as has been suggested by the administration — would largely be handled by Congress.
“It’s not obvious to me that RFK Jr. has specific ideas of his own for Medicare and Medicaid, considering that of both during his confirmation hearings,” McIntyre said.
Kennedy will also have to navigate the bird flu outbreak that experts fear could spiral into a pandemic.
At least 68 people have been infected, most of whom had direct contact with infected animals, according to the Centers for Disease Control and Prevention.
During his confirmation hearings, Kennedy said that he would support the development and distribution of bird flu vaccines — a comment that was seen as a step in a positive direction by experts.
Kennedy will still face challenges when it comes to fighting the bird flu, however, said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University.
The nation’s “ability to prevent an avian flu pandemic and to respond to it will be severely weakened,” Gostin said, if expected cuts to the CDC and to grants to state health departments are carried out. Withdrawing from the World Health Organization and dismantling USAID also hinders America’s response, he said.
“Our preparedness for bird flu will collapse under Kennedy,” Gostin said.
Still, “the HHS secretary wields huge power and influence and can literally shape most public health policy in the federal government,” he said.
The safest place for Kennedy to make changes seems to be around food and childhood chronic disease, Altman, of KFF, said. Kennedy has dubbed this effort “Make America Healthy Again.”
“I think Trump would be perfectly fine if [Kennedy] focuses on chronic disease and on food,” Altman said. “I think he will not be fine if he creates a lightning rod and creates controversy that is, one, a problem for the administration, and two, something that seizes the limelight from Trump.”
But fewer resources — whether because of DOGE’s meddling or because of cuts passed by Congress — certainly won’t make it easier for him to tackle chronic diseases, McIntyre said. The food division of the Food and Drug Administration, an agency within HHS, .
“If DOGE’s efforts mean that these programs see shrinking budgets and fewer staff, RFK Jr. is likely to be held to account for any problems that arise,” McIntyre said. “Congress can summon department and agency leaders to oversight hearings without a subpoena — an authority that does not extend to Elon Musk or his subordinates at DOGE.”
How much progress Kennedy makes may depend on how much support he has within the agency, Reiss, of the University of California, San Francisco, said.
“It’s the secretary, not the president, who gets to appoint a layer of inferior officers with no oversight,” Reiss said. “But the president seems to be intent on close control of the administrative state.”
