RFK Jr.'s frenzied first months send health industry scrambling

Robert F. Kennedy Jr.'s tenure as the nation's top health official is becoming increasingly known for abrupt policy pronouncements based on limited or sketchy evidence that perplex health care providers, industries and patients. Why it matters: While Kennedy has branded himself as a change agent bringing "radical transparency" to a bloated federal bureaucracy and promoting "gold standard" science, the results have at times been chaotic, even exposing rifts between President Trump's circle and Kennedy's own base.State of play: The Kennedy-led Make America Healthy Again Commission report on causes of childhood illness became a focus last week for a series of erroneous and fabricated references, first reported by NOTUS. The White House had to quickly correct those errors. New policies that Kennedy rolled out over the preceding two weeks that limited access to COVID vaccines also evidenced what some critics characterize as an on-the-fly approach, and delivered contradictory messages on whether healthy kids and pregnant women should get the shots. While Health and Human Services cited a lack of evidence in favor of annual COVID booster strategy for healthy people, public health experts said the administration provided scant evidence for switching from the current system. The commentary announcing the change includes just eight citations, one of which is an opinion piece from current Food and Drug Administration commissioner Marty Makary. What they're saying: HHS spokesperson Andrew Nixon said Kennedy is "doing what previous administrations would not" in going against the policymaking status quo. "His approach is deliberate — not traditional for Washington, but urgently needed for a nation that has lost trust in public health institutions," Nixon told Axios in an email. "By leveraging direct communication tools like social media, Secretary Kennedy is modernizing how HHS engages with the public, reaching Americans where they are, and with the radical transparency they deserve." Yes, but: Health industry players have been left wondering what the actual rules of the road are, and how to implement policies that could change day by day."There's a new inconsistency every day," said Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy. "For many of us, what we're concerned about is that this is all merging into one anti-vaccine message, and it also is merging into [the administration thinking] 'We can do whatever we want from a regulatory oversight standpoint,'" he said. The false citations in the MAHA Commission report are an example of how even pieces of Kennedy's health care agenda with broader appeal are being carried out "in a way that is unserious," said Chris Meekins, a managing director at Raymond James and health official in the first Trump administration. Zoom out: The pace of the changes and the sometimes abrupt way they're communicated mirrors other parts of the Trump administration. Many recent announcements out of HHS come directly from Kennedy and appear on social media before they're reflected on official government webpages. It's not dissimilar to how President Trump has taken to announcing tariff policies on social media. A Truth Social post from the president can send financial markets spiraling.Reality check: While public health policy shifts abruptly and outside the typical channels, other HHS hallmarks like Medicare payment rules are moving through their typical processes under Kennedy, at least so far. What we're watching: Whether Kennedy's aggressive policymaking eventually undermines his agenda by angering stakeholders who are even closer to Trump than he is."At the end of the day, they're going to do what they believe and what they want to do," Meekins said. "How they go about executing the agenda, I think, is very much in play."

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