Robert F. Kennedy Jr. nears likely Senate confirmation, but it’s not a lock

After clearing a key hurdle last week, Robert F. Kennedy Jr. is close to becoming the next U.S. Secretary of Health & Human Services.

The Senate is expected to vote this week on Robert F. Kennedy's nomination to lead the U.S. Department of Health & Human Services.

The Senate is expected to vote to confirm Kennedy this week, the Associated Press reports. The Senate Finance Committee narrowly advanced Kennedy last week with a 14-13 vote along party lines.

Sen. Bill Cassidy, a Louisiana Republican and a physician, cast the deciding vote at last week’s committee hearing. Cassidy said he was “struggling” with his vote, citing Kennedy’s past critical statements on vaccines and his reluctance to publicly state that vaccines are safe. But he said he would vote after having some concerns addressed in conversations with Kennedy and the White House.

Cassidy could provide a decisive vote once again this week when the full Senate casts its vote on Kennedy’s confirmation. Democrats have spoken out against President Trump’s nomination of Kennedy and said he’s unqualified to be the next health secretary. And they’re vowing not to give up.

Robert Andrews, the CEO of Health Transformation Alliance and a former member of Congress, said he expects Kennedy will be confirmed. He also made that projection even before the Senate Finance Committee cast its vote to advance Kennedy’s bid to the full Senate.

“The president is a force of nature within the Republican Party,” Andrews said, adding, “I do think he's going to be the secretary of HHS.”

Republicans hold a 53-47 edge in the Senate, making Kennedy’s confirmation likely, but not a lock.

• Read more: Medical schools, colleges blast NIH cutting billions in aid

Cassidy’s critical vote

Just before the Senate Finance Committee vote, Cassidy said he would vote to advance Kennedy. While most Republicans have backed Kennedy enthusiastically, Cassidy expressed his concerns about Kennedy’s vaccine statements repeatedly at a hearing before the Senate Health, Education, Labor and Pensions Committee.

The chairman of the committee, Cassidy said he wondered if a man “who spent decades criticizing vaccines and who's financially vested in finding fault with vaccines, can he change his attitudes and approach now that he'll have the most important position influencing vaccine policy in the United States?”

Cassidy appeared on the Senate floor last week and offered a detailed explanation of his vote for Kennedy. He said he’d received assurances from the White House that vaccine protocols wouldn’t be changed unless there was overwhelming scientific evidence. He also said he’d be regularly meeting with Kennedy if he is confirmed.

“Mr. Kennedy and the administration committed that he and I will have an unprecedentedly close collaborative working relationship if he is confirmed,” Cassidy said on the Senate floor. “We will meet or speak multiple times a month. This collaboration will allow us to work well together and therefore to be more effective.”

Cassidy also said Kennedy and the administration pledged that if he is confirmed, the health department will provide 30 days notice before making any changes in vaccine safety monitoring programs.

“He has also committed that he would work within the current vaccine approval and safety monitoring systems, and not establish parallel systems,” Cassidy said. “If confirmed, he will maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices without changes. CDC will not remove statements on their website pointing out that vaccines do not cause autism.”

Cassidy expressed confidence that Kennedy would work in partnership, and said he supported Kennedy’s views on focusing on chronic diseases, ultra-processed foods and reforms within the National Institutes of Health. Cassidy also said that he’d be keeping a close eye on vaccine policies.

“If Mr. Kennedy is confirmed, I will use my authority as Chairman of the Senate Committee with oversight of HHS to rebuff any attempts to remove the public’s access to life-saving vaccines without ironclad, causational scientific evidence that can be defended before the mainstream scientific community and before Congress,” Cassidy said. “I will carefully watch for any effort to wrongfully sow public fear about vaccines between confusing references of coincidence and anecdote.”

Battle isn’t over

Kennedy isn’t likely to get many Democratic votes, and he may not get any.

Every Democrat on the Senate Finance Committee voted against Kennedy, and those lawmakers hammered Kennedy’s conflicting stance at the hearings with his past views. Other Democrats have signaled their unwillingness to support him.

Sen. John Fetterman, a Democrat of Pennsylvania, said he would be voting against Kennedy’s confirmation. Fetterman has shown more willingness to consider Trump’s picks than other Democrats.

Sen. Chris Koons, a Democrat from Delaware, offered a succinct summary of his opposition to Kennedy.

“I wouldn’t let RFK Jr. give me a band aid, let alone run American health care.⁣ I’m a no,” Koons posted on X.

Many healthcare leaders have assailed Kennedy’s nomination, owing to his long record of disparaging comments of the safety of vaccines and his lack of experience managing a large health organization.

If Democrats are united, Kennedy could only lose three Republican votes and still be confirmed, and even in that scenario, Vice President Vance would have to cast the tie-breaking vote. But the Senate has yet to reject any of Trump’s nominees.

Sen. Mitch McConnell, R-Ky., the former Senate majority leader, represents one of the most important votes. McConnell had polio as a child, and lawmakers grilled Kennedy over past remarks on a podcast when he said the polio vaccine has led to cancers that have killed many more Americans than polio.

Republican Sen. Susan Collins of Maine has indicated she'll vote to confirm Kennedy, CNN's Manu Raju reported Monday. If she does, that gives Kennedy another key vote toward confirmation.

Protect Our Care, an advocacy group that has been pushing to block Kennedy’s bid, isn’t conceding his confirmation, said Brad Woodhouse, the group’s executive director.

“This fight is not over. Not by a long shot,” Woodhouse said in a statement. “RFK Jr. is a dangerous anti-science, anti-vaccine, and anti-public health grifter and conspiracy theorist whose radical views have preyed on parents and cost people their lives, and he would be an unmitigated disaster in any role related to public health.”