Democrats in Congress fought tooth and nail to pass the Affordable Care Act, and when they did, they gave the secretary of health and human services an enormous amount of discretionary power to implement the law moving forward.
While some of what they hoped the law would achieve has come to pass — millions of Americans were able to access health insurance who hadn’t before — they did not anticipate that someone like Robert F. Kennedy Jr. could eventually lead the department.
President-elect Donald Trump has been vague about his plans for the law in his second term. Repeal efforts during his first time in office failed — a sore point for many congressional Republicans. But now Kennedy — who questions vaccine safety, opposes fluoride and has promoted unproven COVID-19 treatments — could hold the keys to the department that many Republicans continue to argue has too big of a federal role.
Kennedy, if confirmed, would oversee 13 public agencies, including the Food and Drug Administration, the Centers for Disease Control and Prevention, the National Institutes for Health and the Centers for Medicare and Medicaid Services. He’d be in charge of many aspects of health insurance and be able to make sweeping changes with Trump’s input. Congressional Democrats who pushed for the law faced strong resistance from opponents who argued it would be too costly and give the government too much control. So do these Democrats, who fought for the ACA, now think the HHS secretary will have too much power?
“Good question,” Sen. Bernie Sanders told NOTUS. He then took a breath and added, “Let me not answer it right now.”
The former third-party presidential candidate needs to be confirmed by the Senate in order to serve the post, and whether he’d actually get the votes remains uncertain. Rep. Marcy Kaptur, told NOTUS she hopes that senators “probe and bring forth qualifications” in their vetting process.
The congresswoman, one of the most senior members in the House, wouldn’t directly answer whether she could have anticipated someone like Kennedy heading HHS, but said that “he just doesn’t seem to have all the requisite talents for someone in that position.”
Rep. Joe Courtney said that he doesn’t “really have real buyer’s remorse” about the ACA even with Kennedy potentially running federal health decisions. Instead, he said that Democrats are already used to dealing with picks like Kennedy because of “you know, four years of Trump 1.0.”
“There’s certain key, you know, junctures and decisions that we have to watch like a hawk,” Courtney said. But, “we’ve been through this once before.”
Sen. Mazie Hirono, who was serving in the House at the time the ACA was being debated, said that Democrats “would not have anticipated someone who thinks vaccines are ineffective” to head HHS. But she said, resigned, that this was just another person that President-elect Trump wanted in the administration to “run the government into the ground.”
Overall, lawmakers said they didn’t have regrets over the ACA because the possibility of someone like Kennedy taking over never crossed anyone’s mind.
“I would not have seen that coming. Ever. Not just back then,” said Sen. Ben Cardin, who at the time was two years into his first term as a senator.
Rep. Jim McGovern told NOTUS that it’s not just about Kennedy: In general, “to be honest, I couldn’t anticipate anything like we’re seeing develop before our very eyes with the picks that Trump is making.” During the interview, the congressman let out an uncomfortable laugh when told about the recently appointed Mehmet Oz to lead Medicare and Medicaid.
“I thought it was a joke at first, but now I’m told it’s real,” he said.
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Oriana González is a reporter at NOTUS.