What We’re Watching for in the Senate Confirmation Hearings to Consider Robert F. Kennedy, Jr. to be Secretary of HHS

The confirmation hearings for Robert F. Kennedy, Jr. to lead the Department of Health and Human Services kick off at 10 am on January 29 and promise to have a packed agenda. With oversight over FDA, the Centers for Medicare & Medicaid Services, the National Institutes of Health, and the Centers for Disease Control and Prevention, if confirmed, Kennedy’s portfolio would be vast. Aside from his many high profile claims about vaccines, what he perceives as corruption at FDA, and the President’s license for him to go “wild” on health, Kennedy’s specific policy views about how FDA should administer its day-to-day oversight of drugs, medical devices, food, dietary supplements, cosmetics, and tobacco have not been publicly detailed.

The Senate Finance Committee will hold the first day of hearings, which will then move over to the Health, Education, Labor and Pensions Committee on Thursday. Only Finance will vote to send his nomination to the full Senate.

We don’t know if the hearings will get into management of FDA. In addition to Kennedy’s anti-vaccination stances, controversial takes on nutrition, and his own potential conflicts, Kennedy is likely to face questions about the sudden freeze on federal spending and proposed federal employee buyouts. Before the events of the last week, perhaps the best preview of the questions Kennedy is likely to face came from Sen. Elizabeth Warren, who sent him a letter with 175 questions designed to probe his policy positions.

In addition to the hot-button topics, Warren’s letter asks Kennedy to be ready to address more nuanced, FDA-specific issues. As HHS Secretary, Kennedy would not have day-to-day FDA responsibilities. The President has nominated Dr. Marty Makary, to be FDA Commissioner, a position that also requires Senate confirmation. Those hearings have not yet been scheduled. That said, given Kennedy’s public statements, how he might affect FDA is certainly confirmation hearing-worthy. For example, she asks Kennedy if he’ll “interfere in any FDA decision regarding review or approval of vaccines,” or if he would “overrule the FDA if you disagreed with its determination that a drug or vaccine was safe and effective.” Questions like this might offer insight we haven’t seen yet into how FDA might operate under a Kennedy-led HHS.

Other FDA-specific questions from Warren may also come up. In her letter, Warren posed these questions to Kennedy:

1. How will you ensure that food and medicine are safe for consumption given your plans for deregulation?
2. Do you still plan to fire FDA employees as you alluded to in your October social media post? To the extent you intend to fire any FDA employees, what will be your standard for doing so?
3. What “gold standard” of scientific review do you have planned for the FDA?
4. What is your plan to protect the independent scientific decision making of agencies like the FDA from political interference?

Kennedy may also face questions about the basis for his assertion that the agency is part of a “corrupt system.” Kennedy has been critical of FDA’s reliance on user fees to fund its mission, saying they give Big Pharma too much influence. Will Kennedy try to overturn the user fee system that’s been in place since 1992? Will he wait until the next PDUFA reauthorization in 2027 to instill additional changes at the agency? A better question still may be whether the Senators get that far down on their list of questions to Kennedy, diving into the minutiae of policy and funding when so many other splashy topics accompany this particular nominee.

We’ll see if the hearings move beyond the numerous political talking points into the specific nitty-gritty of how he would manage FDA’s statutory mission to protect public health and safety. Much more to come on this.