HHS Secretary-designate Robert F. Kennedy Jr. faced fiery exchanges with Democrats and struggled with policy questions from both sides in his first confirmation hearing today, Peter reports.

Why it matters: There were few surprises, but the exchanges underscored questions about Kennedy's qualifications ahead of what's expected to be a close vote on the nomination.

What they're saying: Democrats on the Finance panel pressed Kennedy on his vaccine views. "Are you lying to Congress today when you say you are pro vaccine?" asked Ranking Member Ron Wyden, pointing to comments Kennedy has made repeatedly in the past.

• Kennedy again said that he is "not anti-vaccine" but "pro safety."
• Still, he did not renounce a petition he filed with the FDA in 2021 seeking to stop the COVID-19 vaccine.
• "COVID vaccines are inappropriate for 6-year-old children.… That's why I brought that lawsuit," Kennedy said.
• He did say he supports the measles and polio vaccines and would "do nothing" to stop them as HHS secretary.

Between the lines: Sen. Bill Cassidy, a closely watched GOP vote on Kennedy, provoked one of the most telling exchanges with questions about Medicaid and Medicare policy.

• Kennedy stumbled at times, at one point incorrectly stating that the federal government pays the full cost of Medicaid.
• He shed some light on his Medicaid views by criticizing its expansion under the Affordable Care Act, saying it "robbed" the poorest Americans.
• Sen. Thom Tillis had been viewed as a potential swing vote, but he asked supportive questions of Kennedy, starting off by stating: "You came prepared and I'm glad that you did."

The intrigue: On the Democratic side, Sen. Sheldon Whitehouse has provoked interest as a law school classmate of Kennedy's.

• But the Rhode Island senator had some tough words for Kennedy, calling for a "clear and trustworthy recantation" of what he has said on vaccines.
• Sen. Bernie Sanders has also been a question mark. He found some common ground in his questions with Kennedy, who agreed that the U.S. should not be paying 10 times more than other countries for prescription drugs.
• But Sanders had a fiery exchange with Kennedy over vaccines, displaying photos of baby onesies bearing the logo "unvaxxed, unafraid" that the group Kennedy founded, Children's Health Defense, is selling.
• Facing sharp questioning, Kennedy did not renounce the message, instead saying he no longer controls the group and is "supportive of vaccines."

Of note: There was not much discussion of Medicare drug price negotiation under the IRA, but Kennedy said that "we need lower prices" and referred to an "executive order" on carrying it out. It was not immediately clear what he was referring to.

• CMS did put out a statement on incorporating "lessons learned" in the next round of negotiations.

The bottom line: Kennedy's controversial views mean the Senate floor vote on his nomination will likely be close. More key GOP senators will be on the dais tomorrow for a second confirmation hearing with the HELP Committee.

Kennedy showed an openness to changing dispensing or safety reporting requirements for the widely used abortion pill mifepristone at the Senate Finance hearing, Victoria reports.

Why it matters: Antiabortion groups already are pressing the Trump administration to reverse policies that expanded the time frame in which mifepristone could be used and allowed it to be prescribed without an in-person visit.

What they're saying: Sens. James Lankford and Steve Daines both asked Kennedy about his willingness to look into the safety of mifepristone, which the FDA originally approved in 2000 and has a long-established safety and efficacy record.

• Lankford asked if Kennedy would be willing to change how side effects are reported for mifepristone, and whether FDA will "move to actually give transparency to the American people and say this drug is no different than any other drug."
• Kennedy responded: "We need to know what adverse events are. We need to understand the safety of every drug, mifepristone and every other drug. President Trump has made it clear to me that one of the things he hasn't taken a detailed position on is mifepristone."
• "But he has made it clear to me that he wants to look at safety issues. And I'll ask NIH and FDA to do that."

Daines followed up by asking about policies around mifepristone, such as adverse event reporting and sending the pills through the mail.

• "Will you commit to working with the FDA commission review to look at the deregulatory actions that are threatening the safety of women?" Daines asked.
• Kennedy repeated his previous statements that he was serving under Trump and that he would implement his policies.

The other side: Sen. Maggie Hassan also pulled out signs that had past quotes from Kennedy declaring that he was "pro-choice" and that the government doesn't have any business telling women what to do with their bodies.

• Hassan asked Kennedy to affirm if he had made those past statements, and he did.
• She questioned whether Kennedy would follow Trump's orders without question despite his past statements supporting abortion rights.
• "Regardless of what values you have, if President Trump tells you to do something, you're going to do it.… [If he] orders you to take action to make it harder for women to get direly needed health care, you'll follow his order?" Hassan asked.

The bottom line: As a lifelong Democrat who previously had liberal views on abortion, Kennedy has to tred a fine line in order not to alienate uncommitted Republican senators.

1. Funding freeze: Trump's now-canceled federal funding freeze paralyzed state Medicaid agencies and some health providers until a federal judge issued an injunction, Axios' Maya Goldman and Tina Reed report.
2. Arkansas Medicaid: Gov. Sarah Huckabee Sanders said the state will seek federal approval to require Medicaid recipients to work or volunteer to keep their benefits, Axios' Worth Sparkman reports.
3. Opioid alternative: A long-awaited non-opioid pain medication is up for FDA approval this week, refocusing attention on a field that has hit roadblocks, PharmaVoice reports.