The slow-motion humiliation of RFK Jr
HHS is in chaos and the MAHA movement looks like a spent force.
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Last week, Trump’s Food and Drug Administration just about tore itself apart in a paroxysm of confusion and chaos.
First, Commissioner Dr. Martin Makary resigned. He was replaced by Kyle Diamantis, a crony of Donald Trump Jr. who has no medical qualifications. Makary was soon followed to the exit by administrator Dr. Tracy Beth Hoeg, an anti-vax crank aligned with the rolling public health disaster that is Health and Human Services Secretary Robert F. Kennedy Jr.
The turmoil at the FDA is a sign of the administration’s deeply unserious and incoherent approach to public health. That is not, obviously, something to celebrate.
Trump’s catastrophically inadequate response to covid helped kill 1.2 million people in the US. In his second term he seems determined to ensure that the US is even more unprepared to face any and every public health crisis than it was in 2020.
At the same time, the instability at US public health agencies underlines the precarity of the Make America Healthy Again (MAHA) movement, with all its snake-oil, fatphobia, and eugenic woo woo. MAHA never had a solid constituency on the right, and its support appears to have eroded further the longer the nation has stared into Kennedy’s beady, fanatic eyes.
The fall of Makary
The immediate cause of Makary’s departure was his opposition to fruit-flavored vapes, which he believed would encourage children to become addicted.
MAHA’s emphasis on natural lifestyles is an uncomfortable fit with vaping, to say the least, and Kennedy’s senior spokesperson Richard Danker also resigned last week over the issue. Trump, though, appears to have been swayed by industry lobbying — an example of corporate cronyism overruling ideology.
In addition to irritating the right’s corporate wing, Makary also enraged anti-abortion advocates by refusing to aggressively target and regulate the abortion drug mifepristone. Mifepristone is “safe, effective, and widely used” per the Guttmacher Institute. But abortion opponents want it banned whatever the research; Sen. Josh Hawley was enraged that Makary “froze out pro-life leaders” when they wanted to meddle in scientific decisions.
Actions like this earned Makary some praise from Democrats. Sen. Dick Durbin, for example, said that he hoped Makary would “inspire others” to say no to Trump on issues of conscience.
The problem, though, is that Makary’s conscience is a MAHA conscience, which means that it is profoundly broken. He, Hoeg, and Dr. Vinay Prasad — the FDA vaccine chief removed in March — pushed junk science anti-vax claims that 10 children died from the covid vaccine. Epidemiologist Elizabeth Jacobs said that Prasad, Makary, and Hoeg were guilty of “lying to the American people.”
Makary also abandoned the FDA’s independent expert review by creating ad hoc panels staffed with cranks who shared Kennedy’s antipathy to antidepressants and fluoride — or with industry advocates pushing therapies for treatments like estrogen-based medications for menopause. Genevieve Kanter, a health policy expert at USC, told the AP that the panels “seem designed … to put a stamp of approval on predetermined opinions.”
Whether dealing with vapes, abortion drugs, antidepressants, or vaccines, Makary followed the MAHA playbook — which is to say, he consulted his own prejudiced intuitions and then tried to find evidence that coincided with his views. While this can sometimes look sort of principled, as in his resistance to endorsing vaping, in the long run it undermines scientific process and public health, not least by kneecapping trust in government officials and recommendations.
The lack of respect for procedure and science is part and parcel of the Trump administration’s gutting of public health capacity. Kennedy fired some 3,500 FDA workers last year, belatedly realized that in fact the FDA is a vital agency and can’t run without employees. He’s now trying to hire 3,200 replacements, but without much luck, because who on earth would want to work for RFK Jr.?
Unsurprisingly, experts worry that the weakened, rudderless FDA — and similar cuts at the Department of Agriculture and the Centers for Disease Control — have made US food supplies significantly less safe.
The decline of MAHA
Makary and Hoeg were not ejected because of their anti-vax and anti-science garbage, but that garbage didn’t save them either. On the contrary, Republicans inside and outside the Trump administration have become increasingly nervous about the anti-vax MAHA agenda and its relationship to their coalition.
It’s worth remembering that Kennedy was a lifelong Democrat until he realized the party was never going to give him the opportunities he craved to gut child vaccine schedules or spread lies about and insult autistic people. His endorsement of Trump was opportunistic, as was Trump’s appointment of him.
Covid turned a rabid portion of the right against the public health establishment, and Kennedy seemed like a good way to channel that energy. But he doesn’t have deep relationships with other portions of the conservative movement. And as Trump’s approval plunges, Kennedy is beginning to look like he might be more of a hindrance than a help.
Despite MAHA’s best efforts, vaccines remain popular. A December poll by Trump pollster Tony Fabrizio found “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts;” 86 percent of voters believe vaccines save lives. In a February poll, 54 percent of US adults said that Kennedy’s vaccine schedule changes would harm children’s health; only 26 percent said it would be a positive change.
Kennedy’s anti-vax cronyism has also caused major headaches for Trump with the Senate. Republican senators, including physician and childhood vaccine advocate Bill Cassidy, disgracefully confirmed Kennedy to placate Trump. But since then, they’ve been quietly but consistently pushing back on Kennedy-aligned appointees.
Lisa Murkowski, Susan Collins, and Cassidy were involved in killing the nomination of Kennedy stooge David Weldon to head the CDC in March 2025. Instead, they confirmed Susan Monarez — who Kennedy fired when she wouldn’t go ahead with his attack on childhood vaccinations.
The acting director who replaced Monarez, Jim O’Neill, was more compliant. But a judge blocked Kennedy’s changes to the vaccine schedule, and O’Neill has been replaced by Jay Bhattacharya — another Kennedy ally and covid denialist, who is stretched thin because he’s also the head of NIH.
In an effort to end the revolving door chaos, Trump has finally nominated another director, Dr. Erica Schwartz, a supporter of vaccines who is trusted by the public health community. Kennedy has said publicly he was not consulted about her appointment. That probably means the White House wants the Senate to know Kennedy wasn’t involved, because nominees associated with him are DOA.
Last month, Trump was again forced to withdraw a Kennedy-aligned nominee. This time the failed apparatchik was Casey Means, a wellness influencer who has no medical license and whose brother is a top Kennedy aide.
Means did not impress during her confirmation hearing, and Trump pulled her in favor of Nicole Saphier, a Fox News contributor who has more conventional experience and views, though she’s also pushed false claims about children’s deaths from MMR vaccines.
It’s not clear whether Saphier will be confirmed. Cassidy just lost his Senate primary, and without reelection worries, he may become a more spineful opponent of Kennedy’s homicidal nonsense.
Healthcare pls
In theory, Republicans don’t want to lose MAHA voters. So they are trying to downplay the anti-vax messaging and instead talk about lowering drug pieces (they actually are up under Trump) and regulating food (gutting the FDA was not a good way to ensure food safety).
In practice, Trump regularly chooses industry over MAHA, whether that means approving fruit-flavored vapes or trying to increase production of weedkiller linked to cancer. Kennedy rarely pushes back, because his first and really only commitment is to deeply unpopular attacks on vaccines. Polling shows MAHA voters themselves are motivated more by healthcare costs than by vaccines or other MAHA hobby horses. That’s bad news for Republicans, since Trump has record-high disapproval on healthcare issues.
The MAHA-GOP marriage of convenience looks increasingly inconvenient. Trump may or may not be considering whether to push Kennedy out after the midterms. But he is certainly taking steps to marginalize him and his anti-vax agenda.
Trump’s brave fight for cancer-causing weed killer and fruit-flavored vapes is hardly something to admire. Still, the exit of Makary, Hoeg, Prasad, and other MAHA ghouls is a good thing. Trump is the main force for evil in his own administration. But Robert F. Kennedy Jr. is also a singularly malevolent presence in American public life. His humiliation, and the complete humiliation of his ugly, dangerous movement, is necessary, and cannot happen soon enough.
That’s it for this week
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Thanks for reading, and have a great weekend.
Robert F. Kennedy Jr. can't be embarassed. Like Trump he's a extreme NARCISSIST.
That was informative and depressing. What's wrong with letting apolitical experts run things? I'd have thought health was a pretty technical thing that most people aren't heavily invested in. (Note that vaccines remain popular)...I suppose it all comes down to the bribe that Trump paid Kennedy giving him his position to ensure that he didn't stand and bleed of a very small but politically important part of loony right.