Chaos is an option: What RFK Jr. and Trump mean for health care
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President-elect Trump has selected vaccine skeptic Robert F. Kennedy Jr. to lead the nation's top health care agency, which would give him power over food and drug regulation, Medicare and Medicaid policy, the federal public health system and national health care research money.
Why it matters: We're now in the Wild West in a way we never were during Trump's first presidency, at least when it comes to health care.
- The pick is a radical departure from both mainstream science and Republican orthodoxy, and even before we know if Kennedy will be confirmed, the fallout is sending shockwaves through health care markets.
- "Kennedy likely will lead to significantly more volatility in health markets, making navigating policy risks far more challenging," Raymond James analyst and former Trump administration health official Chris Meekins wrote yesterday in an investor note.
- "If Kennedy is confirmed, it is hard to bookend risks for investors as his views are so outside the traditional Republican health policy orthodoxy."
What they're saying: "For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health," Trump posted on X, announcing the decision.
- "Mr. Kennedy will restore these Agencies to the traditions of Gold Standard Scientific Research, and beacons of Transparency, to end the Chronic Disease epidemic, and to Make America Great and Healthy Again!"
Between the lines: Kennedy's views on vaccines and the need to revamp health agencies are well-known at this point. But his views on more traditional health care topics — like Medicare Advantage or the Affordable Care Act subsidies — are much less clear.
- And on some topics, especially the value of the pharmaceutical industry, Kennedy has starkly different views than most Republicans — including those who may be staffing the administration in other health care roles.
- On the other hand, his appointment is likely to set the tone for other top health care appointees, like FDA commissioner or CMS administrator — and potentially scare away would-be contenders who don't share his views.
- Kennedy's appointment is likely to amplify fears of top government scientists fleeing health agencies.
Yes, but: Kennedy still probably has to get confirmed by the Senate, though there's been a lot of talk lately about Trump pushing for the use of recess appointments to skirt around the confirmation process. (Here's a good Semafor explainer of why that is easier said than done.)
- Regardless of how Senate Republicans react, a confirmation process would be brutal.
- "Mr. Kennedy's outlandish views on basic scientific facts are disturbing and should worry all parents who expect schools and other public spaces to be safe for their children," Senate Finance Committee Chair Ron Wyden said in a statement after the announcement.
- "When Mr. Kennedy comes before the Finance Committee, it's going to be very clear what Americans stand to lose under Trump and Republicans in Congress."
The big picture: By elevating Kennedy to such a position of power, Trump has lent credence to a messenger who distorts and misrepresents basic facts or concepts that have been rigorously proven.
- The post-pandemic years have shown how easy it is for seeds of doubt to translate into reduced vaccination rates and, in the case of measles, the outbreak of a disease that was declared eliminated in the U.S. in 2000.
Go deeper: What a Trump-empowered RFK Jr. could do on health care
