What does HHS do? What to know as RFK confirmed as Trump's health secretary

Robert F. Kennedy Jr. was confirmed as President Donald Trump’s health secretary Thursday, but what exactly does the Health and Human Services Department do and what is his role?

As secretary, Kennedy will be responsible for food and hospital inspections, providing health insurance for millions of Americans and researching deadly diseases.

The sprawling $1.7 trillion agency is responsible for a huge part of the nation’s economy — overseeing insurance for nearly half the country, funneling billions of dollars to the states for Medicaid and providing health insurance for the nation’s older Americans through Medicare.

Among the agencies under the Health and Human Services Department are the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes for Health.

Here's what to know:

What does the HHS Department do?

HHS is a massive Cabinet agency that oversees everything from drug, vaccine and food safety to medical research and the social safety net programs Medicare and Medicaid.

"The mission of the U.S. Department of Health and Human Services (HHS) is to enhance the health and well-being of all Americans, by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services," the department's website reads.

Which agencies are under HHS?

• Administration for Children and Families (ACF)
• Administration for Community Living (ACL)
• Advanced Research Projects Agency for Health (ARPA-H)
• Administration for Strategic Preparedness and Response (ASPR)
• Agency for Healthcare Research and Quality (AHRQ)
• Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC)
• Agency for Toxic Substances and Disease Registry (ATSDR)
• Assistant Secretary for Administration (ASA)
• Assistant Secretary for Financial Resources (ASFR)
• Assistant Secretary for Health (ASH)
• Assistant Secretary for Legislation (ASL)
• Assistant Secretary for Planning and Evaluation (ASPE)
• Assistant Secretary for Public Affairs (ASPA)
• Center for Faith-Based and Neighborhood Partnerships (CFBNP)
• Centers for Disease Control and Prevention (CDC)
• Centers for Medicare & Medicaid Services (CMS)
• Departmental Appeals Board (DAB)
• Food and Drug Administration (FDA)
• Health Resources and Services Administration (HRSA)
• Immediate Office of the Secretary (IOS)
• Indian Health Service (IHS)
• National Institutes of Health (NIH)
• Office for Civil Rights (OCR)
• Office of Global Affairs (OGA)
• Office of Inspector General (OIG)
• Office of Intergovernmental and External Affairs (IEA)
• Office of Medicare Hearings and Appeals (OMHA)
• Office of the General Counsel (OGC)
• Substance Abuse and Mental Health Services Administration (SAMHSA)

Who voted for and against RFK?

Nearly all Republicans fell in line behind Trump despite hesitancy over Kennedy views on vaccines, voting 52-48. Democrats unanimously opposed Kennedy.

Kentucky Sen. Mitch McConnell, who had polio as a child, was the only “no” vote among Republicans, mirroring his stands against Trump's picks for the Pentagon chief and director of national intelligence.

“I’m a survivor of childhood polio. In my lifetime, I’ve watched vaccines save millions of lives from devastating diseases across America and around the world," McConnell said in a statement afterwards. “I will not condone the re-litigation of proven cures, and neither will millions of Americans who credit their survival and quality of life to scientific miracles.”

What has Kennedy said of his plans for the department?

With Trump's backing, Kennedy insisted he is “uniquely positioned” to revive trust in those public health agencies, which include the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes for Health.

Sen. Thom Tillis, R-N.C., said he hoped Kennedy “goes wild” in reining in health care costs and improving Americans' health. But before agreeing to support Kennedy, potential holdout Sen. Bill Cassidy, R-La., a doctor who leads the Senate Health, Education, Labor and Pensions Committee, required assurances that Kennedy would not make changes to existing vaccine recommendations.

Kennedy will take over the agency in the midst of a massive federal government shakeup, led by billionaire Elon Musk, that has shut off — even if temporarily — billions of taxpayer dollars in public health funding and left thousands of federal workers unsure about their jobs.

On Friday, the NIH announced it would cap billions of dollars in medical research given to universities and cancer being used to develop treatments for diseases such as cancer and Alzheimer's.

Kennedy, too, has called for a staffing overhaul at the NIH, FDA and CDC. Last year, he promised to fire 600 employees at the NIH, the nation's largest funder of biomedical research.

Kennedy has also threatened to slash FDA regulations on a host of unproven treatments, including stem cells, psychedelics and discredited COVID-era treatments like ivermectin.

Kennedy has also said he'll give his son all of the referral fees in legal cases against vaccine makers. Kennedy made more than $850,000 last year from an arrangement referring clients to a law firm that has sued the makers of Gardasil, a human papillomavirus vaccine that protects against cervical cancer.

What are some of Kennedy's views?

His has been a flexible ideological journey, part liberal Democrat, part libertarian, and now, an adherent of the MAGA agenda after dropping out of the race last year to back Trump.

Vaccines

Kennedy's numerous remarks, anti-vaccine nonprofit and lawsuits against immunizations are likely to haunt him.

Over many years, Kennedy has been clear about his beliefs on vaccines in dozens of interviews, podcasts and social media posts.

He's headed up a nonprofit that has sued the government over its authorizations of vaccines. He's said there is “no vaccine that is safe and effective” and repeatedly called for further study of routine childhood vaccinations, despite decades of research and real-world use that proves they've safely prevented disease.

He's rejected the anti-vaccine label, instead casting himself as a crusader for “medical freedom” who wants more research. He and Trump have vowed not to “take away” vaccines. To defuse criticism, he resigned from the Children’s Health Defense, his nonprofit that has filed dozens of lawsuits against vaccines, including the government authorizations of some of them.

But critics have argued that his work advocating against vaccine use has cost lives. Democrats are poised to home in on his social media campaigns and work in Samoa, the island nation in the Pacific Ocean where doctors say he and his anti-vaccine acolytes seized on a tragedy to campaign against childhood inoculations. Later that same year, a measles epidemic killed dozens of infants and children.

In sometimes heated exchanges during his hearings last week, Kennedy denied that he is anti-vaccine. But Kennedy, who pointed out that his children are vaccinated, acknowledged he has asked “uncomfortable questions” about vaccinations.

“I believe that vaccines play a critical role in health care,” Kennedy told the Senate Finance Committee.

Agriculture

Kennedy had previously promised a ban on corn syrup or pesticides. If confirmed, Kennedy would oversee the Food and Drug Administration, which has the power to enact restrictions.

Kennedy indicated before the election that he would be keen to end the Food and Drug Administration's “aggressive suppression” of raw milk. The FDA and the Centers for Disease Control and Prevention have called raw milk one of the “riskiest” foods people can consume because of the possibility for contamination.

Processed foods

One of Kennedy's proposals has been to remove some chemicals from processed foods. Kennedy has vowed to ban certain food additives and crack down on ultra-processed foods that are tied to obesity and diabetes rates.

In his hearings, Kennedy mentioned the number of ingredients in U.S. foods and suggested ultraprocessed foods are contributing to chronic disease.

“We need to fix our food supply and that’s number 1,” he said.

Ultraprocessed foods have been linked to a host of health problems, including obesity, diabetes, heart disease and more.

But those studies have shown associations, not causes, and experts say more research is needed to confirm exactly how these foods can lead to poor health outcomes.

Kennedy tried to assure senators that he would not seek widespread bans on vaccines or food, saying he wants to provide more information to people.

“I don’t want to take food away from anybody," he said. "If you like a cheeseburger – a McDonald’s cheeseburger and a diet Coke like my boss — you should be able to get them.”

Abortion

Other conservatives have questioned Kennedy's abortion views, after he said last year that it should be legal for full-term pregnancies. His campaign later clarified that he supports abortion rights until fetal viability, around 22 to 24 weeks.

In meetings with some senators, he's promised to follow Trump's directive on the issue.

Republican Sen. Josh Hawley of Missouri, for example, said he was convinced after talking to Kennedy that he would be a strong anti-abortion advocate.

But skepticism remains, with former Vice President Mike Pence's advocacy group highlighting his abortion views in an ad campaign.

“RFK Jr. has made certain overtures to pro-life leaders that he would be mindful of their concerns at HHS, there is little reason for confidence at this time," his group said in a letter sent to senators.

During his confirmation hearings, Kennedy repeatedly leaned on the phrase, “I have always believed abortion is a tragedy.”

“I’ve never seen any major politician flip on that issue quite as quickly as you did when Trump asked you to be HHS secretary,” said Sen. Bernie Sanders of Vermont.

Sen. Steve Daines of Montana questioned Kennedy about his views on access to the abortion pill mifepristone. The FDA approved mifepristone in 2000 as a safe and effective way to end early pregnancies, yet access to the drug and its FDA approval has been threatened in legal battles.

“President Trump has asked me to study the safety of mifepristone,” Kennedy said. “He has not yet taken a stand on how to regulate it. Whatever he does, I will implement those policies.”

Fluoride

Even before Trump was elected, Kennedy said he would recommend water agencies stop adding fluoride to drinking water, although fluoride levels are mandated by state and local governments.

Fluoride strengthens teeth and is viewed as one of the biggest public health successes of the past century as the addition of the material has been cited as leading to improved dental health. While it can be toxic in large doses, health experts say those levels are hard to reach.

"Fluoride reverses early decay and remineralizes your tooth enamel. While fluoride can be harmful in large quantities, it’s difficult to reach toxic levels due to the low amount of fluoride in over-the-counter products like toothpastes and mouth rinses," the Cleveland Health Clinic reported.

Others

Kennedy has previously discussed making school lunches healthier and banning certain food additives.

Making major changes to the federal program involves coordination between the Agriculture Department, the Department of Health and Human Services and dozens of state educational programs. Even seemingly smaller goals like banning potentially harmful food additives would require new regulations and staffers at FDA — which Kennedy has vowed to “clear out.”

Kennedy has also made a variety of claims not backed by science, such as questioning whether HIV causes AIDS and suggesting antidepressants lead to school shootings.

What to know about RFK Jr.

Who is RFK Jr?

A scion of a famous Democratic dynasty, Kennedy made a name in his own right as an environmental attorney who successfully took on large corporations including DuPont and Monsanto.

He first challenged President Joe Biden for the 2024 Democratic presidential nomination. He then ran as an independent but abandoned his bid over the summer after striking a deal to endorse Trump, a Republican, in exchange for a promise to serve in a health policy role during a second Trump administration.

Trump selected Kennedy in November as his nominee to head DHS, shortly after he won the presidential election, saying Kennedy would “end the Chronic Disease epidemic” and “Make America Great and Healthy Again.”

Five of RFK Jr.'s siblings released a statement on X calling his decision to endorse Trump a "betrayal."

Family history

Kennedy hails from one of the nation’s most storied political families.

His father was Attorney General Robert F. Kennedy, brother of President John F. Kennedy. Both men were assassinated.

His voice

RFK Jr. has spasmodic dysphonia, which, according to Johns Hopkins, is a voice disorder that "causes involuntary spasms in the muscles of the voice box or larynx."

"This causes the voice to break and have a tight, strained or strangled sound," the medical group said.

He was diagnosed in 1996 at the age of 42, he said.

"It makes my voice tremble," he said during a political event last year.

He has spoken publicly about his condition, saying "it makes it problematic for people to listen to me."

He has previously noted that he does not listen to himself on TV because of it.