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This is a MedPage Today story. President Trump said he would take health agencies in a new direction on the campaign trail and has chosen some controversial nominees to help him achieve his goal, including Robert F. Kennedy Jr., Trump’s pick for HHS secretary. However, it remains unclear how much could actually change if Kennedy were to be confirmed. To answer that question, MedPage Today spoke with legal experts, former CMS and White House officials, and others who worked alongside health agencies to gauge the potential for substantial reforms across HHS and its sub-agencies. Can Kennedy Terminate Employees at FDA, Other Agencies? In October, Kennedy posted on X that "FDA’s war on public health is about to end." He criticized the agency’s "aggressive suppression" of a number of unproven therapies, including ivermectin and hydroxychloroquine, and warned, "If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack…

This is a MedPage Today story. As President Donald Trump’s picks to lead federal health agencies await confirmation hearings, there are now acting directors in place at HHS and its key sub-agencies. Here is what is known about who is currently running the show at these sprawling and influential entities. HHS Acting Secretary: Dorothy Fink, MD Fink is deputy assistant secretary for women’s health and director of the Office on Women’s Health in the Office of the Assistant Secretary for Health at HHS. She is board certified in endocrinology, internal medicine, and pediatrics. Soon after her appointment as acting secretary, she told agency staff leaders in a memo that an "immediate pause" had been ordered on communications, such as regulations, guidance, announcements, press releases, social media posts, and website posts, until they had been approved by a political appointee. In a subsequent statement issued this week, Fink noted that the Office for Civil Rights at HHS would…

This is a MedPage Today story. Robert F. Kennedy Jr.’s statements before the Senate Finance Committee on Wednesday revealed a concerning lack of knowledge about the major health programs he’d oversee, should he be confirmed as HHS secretary. On several occasions during the 3.5-hour hearing, Kennedy seemed to conflate Medicare, Medicaid, and Medicare Advantage, and appeared to mistakenly refer to the Affordable Care Act health exchanges. "Medicaid is not working for Americans, and it’s specifically not working for the target population," he said in response to questions from Sen. Bill Cassidy, MD (R-La.), a physician, who asked him in what ways he would improve the healthcare delivery system. "I’m on Medicare Advantage and I’m very happy with it," Kennedy replied. "Most people who are on Medicaid are not happy. The premiums are too high, the deductibles are too high, the networks are narrow." In fact, Medicaid plans generally do not have premiums, or if they do, under federal law…

This is a MedPage Today story. Sen. Bill Cassidy, MD (R-La.), said he received numerous pledges from Robert F. Kennedy Jr. and the Trump administration to protect medicine and science — particularly regarding vaccines — that clinched his support for the HHS secretary nominee. Cassidy said Kennedy and the administration promised an "unprecedentedly close collaborative working relationship" that includes the two of them meeting or speaking "multiple times a month." They also said that Kennedy could appear before the Senate Health, Education, Labor and Pensions (HELP) Committee — which Cassidy currently chairs — quarterly if requested. Most of the pledges revolved around vaccines, including that Kennedy will work within current approval and safety monitoring systems, and not establish parallel systems. He’ll also maintain recommendations from CDC’s Advisory Committee on Immunization Practices (ACIP) without changes, and statements that vaccines don’t cause autism won’t be…