Why some are optimistic about Robert F. Kennedy Jr. as health secretary

Six months ago, it seemed unfathomable that Robert F. Kennedy Jr. would serve as the nation’s top federal health officials.

Robert F. Kennedy Jr. won Senate approval to be the U.S. Secretary of Health & Human Services. Many have worried about his long anti-vaccine record, but some hope he could make progress on chronic diseases and obesity.

But Kennedy is now the U.S. Secretary of Health & Human Services. The Senate narrowly voted to confirm Kennedy Thursday.

Many physicians and healthcare leaders spoke out against putting Kennedy in that position, citing his long record of vaccine skepticism and misinformation and his lack of experience running a health organization. And some expressed alarm about Kennedy taking over the health department.

Republicans, including some that weren’t comfortable with his many past statements on vaccines, cited Kennedy’s plan to focus more attention on chronic diseases, obesity and processed foods.

Ash Shehata, KPMG’s U.S. sector leader for healthcare, told Chief Healthcare Executive® in a recent interview that some healthcare businesses could see opportunities with Kennedy leading the health department.

Citing Kennedy’s focus on obesity, Shehata says, “If he really is focused on health and wellness, is there going to be an opportunity for a health and wellness economy to start taking off in our industry?”

Shehata says more Americans are focused on eating healthier and want to see less processed food. He adds there could be “some of the incentives we've been trying to drive in healthcare.”

“I always say to people if you can find the positive in it, there'll be great opportunity to help advance the healthcare agenda overall. And I think that's what people are hopeful to hear in the months to come,” Shehata says.

Robert Andrews, CEO of the Health Transformation Alliance, also sees areas where there can be progress with Kennedy leading the health department. A former Democratic congressman from New Jersey, Andrews acknowledges Kennedy’s baggage but says he could do some good if he focuses on chronic diseases.

“Kennedy is a very controversial figure, but he said some things about chronic health, chronic disease and wellness,” Andrews tells Chief Healthcare Executive®.

“I think there's very broad support for focusing on diet, exercise, behavior as ways to deal with chronic disease," he says. "I think there's a lot of people who agree with that, and I think it's possible that his work as secretary could become less controversial than we think, less focused on vaccines, where he's, frankly, in a minority of people, and more focused on ways to tilt spending toward prevention and wellness.”

Andrews points to one mechanism that could promote wellness: allowing Medicare Advantage plans to offer multi-year contracts. Those plans would have more ability to invest in programs to keep people healthy if they knew they had customers for more than a year, he says.

“It pretty radically changes the economics in Medicare Advantage towards wellness and prevention, which is what he's talking about,” Andrews says. “So one thing I think is a possible narrative here, is that Kennedy emerges as a force that supports wellness and different approaches to chronic disease, is able to get some things done which become widely popular and help the system.”

To be clear, Democratic lawmakers urged their colleagues against confirming Kennedy and bemoaned that he got the post. Sen. Elizabeth Warren, D-Mass., said Kennedy is not qualified to lead the health department.

"Putting Kennedy in charge of the nation’s public health is a huge mistake,” Warren said in a statement. “When dangerous diseases resurface and people can’t access life-saving vaccines, all Americans will suffer. And thanks to his serious, unresolved conflicts of interest, RFK Jr.’s family could continue getting richer from his anti-vaccine crusade while he’s in office.”

Sen. Mitch McConnell, R-Ky., the former Senate majority leader, cast the only Republican vote against Kennedy’s confirmation. A polio survivor, McConnell cited Kennedy’s long record of statements against vaccines.

“A record of trafficking in dangerous conspiracy theories and eroding trust in public health institutions does not entitle Mr. Kennedy to lead these important efforts,” McConnell said in a statement.

McConnell also pointed to the Trump administration’s success in developing COVID-19 vaccines. He said the health department needs a leader who understands the value of vaccines and “can demonstrate an understanding of basic elements of the U.S. healthcare system.

“Mr. Kennedy failed to prove he is the best possible person to lead America’s largest health agency,” McConnell said. “As he takes office, I sincerely hope Mr. Kennedy will choose not to sow further doubt and division but to restore trust in our public health institutions.”

Sen. Bill Cassidy, a Louisiana Republican and the chairman of the Senate Health, Education, Labor, and Pensions Committee, cast a key vote that helped assure Kennedy’s confirmation. Cassidy cast a decisive vote to advance his nomination to the full Senate, and voted to confirm him Thursday.

A physician, Cassidy acknowledged Kennedy's troubling record on vaccines and said he’d be working to make sure he wouldn’t make sweeping changes in vaccine policy. But Cassidy pointed to areas where he thought Kennedy would make a difference in a speech on the Senate floor last week.

“I want Mr. Kennedy to succeed in making America healthy again,” Cassidy said on the Senate floor. “His success will be tied to the health of our nation. He has the opportunity to address the most pertinent issues affecting Americans’ health.”