RFK Jr. confirmed as HHS secretary

Noted vaccine skeptic and food wellness advocate Robert F. Kennedy Jr. took the helm of the complex and sprawling federal healthcare bureaucracy after the Senate confirmed him as Health and Human Services secretary Thursday.

Despite skeptical utterances from a few Republicans ahead of the vote, all GOP senators backed President Donald Trump's nominee except Sen. Mitch McConnell (Ky.). Every Democrat voted no, leaving the final tally at 52-48. Supreme Court Justice Neil Gorsuch swore in Kennedy later Thursday.

Related: Washington healthcare world steels itself for RFK Jr.’s HHS

Kennedy takes his spot atop the powerful department and its myriad agencies despite the alarm his selection sparked among many physicians and public health experts who campaigned against him, citing his lengthy history of spreading falsehoods about vaccines.

But the attorney, scion of a Democratic dynasty and former independent presidential candidate, won over a handful of dubious Republicans by publicly and privately pledging not to interfere with standard federal vaccine policies or science.

As HHS secretary, Kennedy oversees the Centers for Medicare and Medicaid Services, which dispenses $1.5 trillion a year. He also has authority over agencies such as the Food and Drug Administration, the National Institutes of Health and the Centers for Disease Control and Prevention, where Democrats cautioned he could improperly meddle.

Kennedy's unorthodox background, and his career disseminating misinformation about vaccines, seemed to be impediments to his confirmation, as even some Republicans appeared ready to reject Trump's nominee.

Key among those was Sen. Dr. Bill Cassidy (R-La.), the chair of the Senate Health, Education, Labor and Pensions Committee and a member of the Finance Committee, which advanced Kennedy's nomination last week.

In a key hearing before the HELP Committee last month, Cassidy, who is a gastroenterologist and founded a vaccine clinic before entering politics, pressed Kennedy to renounce claims against settled science on vaccines. Kennedy declined to do so. Cassidy decided to back him anyway, saying in a Senate floor speech last week that Kennedy had pledged to abide by established federal policies, and that Kennedy would grant Cassidy significant input on his actions at HHS.

Kennedy won over a pair of other GOP skeptics, Sens. Susan Collins (Maine) and Lisa Murkowski (Alaska). McConnell survived polio as a child and has been critical of Kennedy's vaccine positions.

Some Republicans, especially former Vice President Mike Pence, also raised concerns about Kennedy's past support for abortion rights, but GOP senators appeared mollified after the nominee promised to follow Trump's lead.

Democrats never relented in their opposition, casting Kennedy as dangerous. They did manage to convince Kennedy to update his ethics agreement concerning future income from vaccine lawsuits on which he worked as an attorney.

Kennedy had intended to keep earnings from some ongoing cases, but now says those earnings will go to his son, Conor Kennedy, who is an attorney at Wisner Baum, the personal injury law firm representing the plaintiffs. Democrats said that is still unacceptable, arguing the HHS secretary should not occupy a position that could benefit his family should he take action that might aid in a vaccine lawsuit.

More broadly, Democrats emphasized that Kennedy demonstrated little understanding of the mammoth agencies and programs he will manage, and that he had done nothing to ease their anxiety about his influence over public health.

"The fact that we're here right now, that we're even here right now, voting on this wildly unqualified conspiracy theorist to trust with one of the most life or death jobs, HHS Secretary, charged with protecting the health of every single American, should be an affront to every senator and the millions of Americans that will be impacted by this horrific nomination," Senate Minority Leader Chuck Schumer (D-N.Y.) said on the floor before the vote Thursday.

"He showed a complete lack of understanding of the basics of Medicaid and how it functions. I personally believe it shouldn't be too much to ask for the future CEO of Medicaid to understand how important it is to provide affordable coverage for millions of families," Finance Committee ranking member Ron Wyden (D-Ore.) said Thursday. "Their ultimate objective is to take away Medicaid from as many people as they can, colleagues. So much for making America healthy again."

Republicans said Kennedy would make good on Trump's pledges to root out fraud and abuse, slash spending, and focus on basic health and preventive care while providing unprecedented transparency into departmental operations.

"He will bring a fresh perspective to healthcare, prioritizing consumer choice, information, transparency and early interventions to strengthen the well-being of all Americans," Finance Committee Chair Mike Crapo (R-Idaho) said Thursday. "Mr. Kennedy stated we have a generational opportunity to bring together the greatest minds in science, medicine, industry and government to put an end to the chronic disease epidemic facing Americans. I agree with him. We've got to get into the business of making America healthy again."

Republicans were also pleased by Kennedy's pledges to focus on rural health.