Senators who haven't committed on Robert F. Kennedy Jr.'s nomination for HHS secretary say he'll have to lay out a cogent public health vision in twin confirmation hearings that start tomorrow, Peter reports.

Why it matters: Kennedy has alarmed public health experts with his years of vaccine criticism. The hearings in the Finance and HELP committees will show which senators still are concerned and which are giving more credence to his recent efforts to soften his views.

What they're saying: "He's got to have a good hearing, address some of the concerns we all know, like vaccine, couple other things like that," Sen. Thom Tillis, who sits on Finance, told reporters yesterday.

• "And he has the distinction of having to go through two committees, so we'll see how he does on Wednesday and Thursday," he added.
• The Finance hearing is tomorrow and the HELP hearing is Thursday. Only Finance votes on whether to advance the nomination.

Driving the news: All signs point to a close vote in the full Senate. Kennedy can afford to lose only three Republican senators, assuming Democrats are united in opposition.

• Some GOP senators have said Kennedy's recent efforts to downplay his vaccine criticism have been convincing, but Sen. Lisa Murkowski, a key moderate vote who sits on HELP, said she has questions.
• "I'm certainly concerned about it," she said when asked about his vaccine views. "I know others have other points of concerns that they want to drill down on and try to get some public commitments from him on. Vaccines are important. Get them."
• Sen. Bill Cassidy, who sits on Finance and chairs the HELP Committee, is another closely watched senator.
• He's declined to answer questions about Kennedy in recent days, referring reporters to his office. "Chairman Cassidy is looking forward to the hearings this week," a spokesperson said.

The other side: Some Senate Democrats are issuing harsh warnings about what confirming Kennedy could mean for public health. Yet others haven't ruled out voting for him, in part given his views on encouraging healthful foods.

• Sens. Tammy Baldwin and Chris Murphy are holding a press conference the morning of the Finance hearing with Hawai'i Gov. Josh Green, a physician who helped respond to a 2019 measles outbreak in Samoa following a visit from Kennedy, during which he met with anti-vaccine figures.
• Baldwin told reporters she is seeking to "make sure that not only other senators but the public are educated on what happened, because he's tried to back off from what actually happened."

Between the lines: Sen. Bernie Sanders, the ranking member of the HELP Committee, is among the Democrats who hasn't shown his hand. "I look forward to Mr. Kennedy answering a number of very important questions about his views [at the hearings]," Sanders told reporters yesterday.

• Sen. Sheldon Whitehouse, a Democrat not usually known for bucking his party, has also not committed.
• "I have not been inclined to telegraph my vote before someone has even had their hearing, so people just need to kind of chill on that a bit," Whitehouse told the Providence Journal, which noted that Kennedy and Whitehouse know each other from law school.

Finance Ranking Member Ron Wyden wouldn't predict whether any Democrats will break for Kennedy.

• "I think on issue after issue, there are potential questions about compromising public health, public safety," Wyden said. "And those are issues that are our breadbasket. I think members feel very strongly about it, it's going to be an important hearing, and we're prepping for it."

Victoria Knight contributed.

An OMB freeze on grants and other forms of federal funding that takes effect today could challenge Congress' ability to disburse billions of dollars in health spending, Victoria reports.

Why it matters: The two-page memo that surfaced late yesterday asserts the power to temporarily freeze appropriated funds and potentially squelch Congress' power of the purse, per Georgetown law professor Steve Vladeck.

What's inside: The memo specifically said that each agency must "complete a comprehensive analysis of all of their federal financial assistance programs to identify programs, projects and activities that may be implicated by any of the president's executive orders."

• Programs or activities that could be impacted include "financial assistance for foreign aid, nongovernmental organizations, DEI, woke gender ideology, and the green new deal," per the memo.
• The order becomes effective at 5pm ET today, and agencies must submit program information to OMB by Feb. 10.

Between the lines: Although the order appears to exclude funds paid directly to individuals, a number of state agencies today reported difficulty accessing funding portals for Medicaid, community health centers and other sources of federal funding.

• House Democratic Whip Katherine Clark wrote on X that community health centers and Head Start programs in Massachusetts couldn't access money and that the Medicaid payment system was shut down.
• Illinois Gov. JB Pritzker's office reported that the state was shut out of Medicaid as of this morning, the Chicago Sun Times reports.
• CMS didn't respond to a request for comment by Axios' deadline.

What they're saying: Democrats immediately slammed the order, stating that its unprecedented scope takes away congressional authority to determine federal spending.

• Minority Leader Chuck Schumer told reporters he has talked to New York attorney general Letitia James about suing over the OMB order "right away."
• Senate Democrats also said they are asking for a two-week delay for OMB director-designate Russ Vought's confirmation vote — an idea Senate Budget Chair Lindsey Graham's office shot down.
• Senate Appropriations Chair Susan Collins said that although there's justification to take a hard look at some programs, "this is far too sweeping" and could disrupt a lot of programs and services.

Threat level: The National Family Planning and Reproductive Health Association is concerned at how the order may impact Title X family planning clinics.

• Other programs that could be affected include Head Start, Meals on Wheels, medical research institutions and homeless shelters that serve veterans.

The bottom line: "We're in uncharted waters here," Erik Fatemi, a principal at Cornerstone Government Affairs and a former Senate Appropriations Democratic staffer, told Axios.

• "Everyone who follows federal appropriations expected some sort of constitutional challenge from the new administration about who holds the power of the purse … but no one predicted anything as sweeping as this."
• Fatemi added that this order could have implications for appropriations negotiations going forward because "if an executive branch can essentially ignore the spending levels that Congress agrees on, then whichever party is not in power will have to ask themselves, what's the point?"

1. Defunding trans care: The Trump administration may take a multipronged approach to block federal funds for any transgender care, Axios' Tina Reed reports.
2. Trust in Trump & Co.: A KFF poll finds that most Americans don't trust health recommendations from President Trump and his health nominees, but Republicans are about as likely to trust them as they are their own doctors, Axios' Maya Goldman reports.
3. NIH freeze: Rep. Jamie Raskin and Sens. Chris Van Hollen and Angela Alsobrooks urged the acting HHS secretary to lift a freeze on communications and some work at NIH, citing disruptions to research.