One year ago, Robert F. Kennedy Jr. was confirmed as the Secretary of Health and Human Services (HHS), marking a turning point in U.S. health policy. The vote, 52-48 along party lines, highlighted the deep political divisions surrounding his appointment. Kennedy’s tenure has been marked by dramatic reversals of previous commitments, extensive personnel changes, and controversial policy shifts. This article details the key developments of his first year, the underlying forces driving them, and the potential consequences for public health.
Initial Pledges and Subsequent Reversals
At his confirmation hearing, Kennedy made several explicit promises to the Senate: maintaining scientific integrity, supporting existing vaccine schedules, ensuring transparency at HHS, and upholding “good science.” However, over the past year, these pledges have been largely abandoned.
The U.S. childhood vaccine program has been reduced from 17 to 11 recommended shots, thousands of public servants (including scientists) have been dismissed, and scientific standards at the CDC, FDA, and NIH have been replaced with what critics call dishonest practices. Judges have already blocked some of these funding cuts as illegal. HHS and Kennedy himself did not respond to requests for comment.
The “Make America Healthy Again” (MAHA) Agenda
Kennedy’s primary goal, as stated before Congress, is to move the U.S. from a “sick care” system to a “true health care” system focused on tackling chronic disease at its roots. This “Make America Healthy Again” (MAHA) agenda has become closely aligned with President Trump’s “Make America Great Again” movement, creating a coalition built on distrust of science, skepticism towards medicine, and a deep-rooted animosity towards the food industry. Recent surveys indicate that approximately 40% of parents support the MAHA movement.
“Who can argue with the foundational goal of ‘Making America Healthier Again’? We want parents to want healthier lives for their children,” says Sandro Galea, dean of the Washington University in St. Louis School of Public Health. However, Galea cautions that some of the MAHA movement’s ideas could be harmful, specifically predicting inevitable outbreaks due to Kennedy’s vaccine decisions.
The Role of HHS and the Status Quo
HHS oversees massive social insurance programs like Social Security, Medicare, and Medicaid, as well as key regulatory agencies such as the FDA, CDC, and NIH. Despite the disruptive changes under Kennedy, the agency continues to function in many ways: monthly benefit checks still reach 75 million Americans, Medicaid covers one in five citizens, and the Affordable Care Act remains in place despite previous cuts.
In February, Kennedy announced a $100 million pilot program to support homeless individuals and those with substance use disorders, a move that garnered bipartisan support. However, this initiative followed layoffs at the Substance Abuse and Mental Health Services Administration (SAMHSA) and the cancellation/restoration of $2 billion in funding for its programs.
Firings, Controversial Statements, and Policy Shifts
Kennedy’s first year has been defined by tumult. He fired his own CDC chief, linked Tylenol to autism with limited evidence, and urged farmers to allow bird flu to spread unchecked. More than 17,000 civil servants have been fired or resigned, including numerous scientific leaders at the FDA, CDC, and NIH. HHS officials defended these cuts as necessary to eliminate “bloated bureaucracies.”
In a September Senate hearing, Kennedy accused a critical lawmaker of “crazy talk” and dismissed his concerns while scrolling on his phone. When Senator Bill Cassidy questioned his vaccine policies, Kennedy brushed off his concerns, further demonstrating his disregard for expert opinions.
The Vaccine Opposition and its Consequences
Kennedy has a long history of vaccine opposition, serving as chairman of the antivaccine nonprofit Children’s Health Defense (formerly World Mercury Project) until 2024. At his confirmation hearing, he refused to disavow links between vaccines and autism, a debunked theory widely promoted by antivaccine groups.
In March, FDA’s top vaccine official, Peter Marks, resigned, accusing Kennedy of prioritizing misinformation over truth. By May, Kennedy removed COVID vaccines from recommended lists for pregnant adults and children without consulting CDC experts, then fired those experts and replaced them with vaccine opponents. He also cut $500 million in funding for mRNA vaccine research, falsely claiming these vaccines had become ineffective.
In December, his reconstituted vaccine panel voted to stop recommending hepatitis B vaccination for newborns, a decision that contradicts global health recommendations. HHS then reduced the number of recommended childhood vaccines from 17 to 11, citing the example of Denmark, a country with a smaller, more homogenous population and universal healthcare.
The Wellness Industry and MAHA Synergy
Kennedy’s rhetoric aligns closely with the trillion-dollar wellness industry, which embraces unproven cures, unpasteurized milk, unfluoridated water, and dubious supplements. This movement’s distrust of conventional medicine resonates with his own skepticism towards vaccines and pharmaceuticals. In May, Kennedy called for an end to genetic research on autism, instead suggesting that “environmental toxins” are the cause, a claim echoed by wellness influencers.
HHS also revised nutrition guidelines to favor “real food” (such as beets, strawberries, and beans) over processed alternatives, while promoting whole milk and red meat despite decades of research linking saturated fat to heart disease.
The Political Alignment with Trump
Kennedy has publicly endorsed President Trump, framing the MAHA agenda as a means of “making America healthy again.” He has echoed Trump’s claims about Tylenol causing autism, despite weak evidence, and has accused pharmaceutical companies of corruption.
Conclusion
Robert F. Kennedy Jr.’s first year at HHS has been marked by radical policy shifts, extensive personnel changes, and a deepening alignment with anti-science sentiment. The long-term consequences of these actions remain to be seen, but the dismantling of established scientific practices and the promotion of unproven ideologies pose a significant threat to public health. The future trajectory of U.S. health policy under his leadership appears increasingly unpredictable.
