WASHINGTON — In a contentious confirmation hearing to be the nation’s top health official, Robert F. Kennedy Jr. struggled to answer questions about how he would reform Medicaid or Medicare, the government health care programs used by millions of disabled, poor and older Americans.

Republican Sen. Bill Cassidy of Louisiana, a physician and key vote Kennedy needs to win, repeatedly pressed the nominee on Wednesday to share ways he plans to reform Medicaid, a multibillion-dollar taxpayer-funded program that covers health care for about 80 million people, including children. Republicans have said they might need to make deep cuts to Medicaid to fund President Donald Trump’s proposals.

“I don’t have a broad proposal for dismantling the program,” Kennedy said.

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Misstatements and Privatization Suggestions

Kennedy also inaccurately claimed that Medicaid is fully paid for by the federal government — it’s not; states and federal taxpayers fund it. He also said most Americans have purchased a Medicare Advantage plan, when only about 1 in 10 Americans have.

His misstatements about the program were peppered in between suggestions that he would seek to push privatization of the programs, repeatedly saying that most Americans like private insurance and that they dislike the government run versions of the programs.

Kennedy is seeking to lead a $1.7 trillion department of Health and Human Services agency that will oversee vaccine recommendations as well as food inspections, hospital oversight and funding for hundreds of community health clinics.

Vaccine Controversy

In sometimes heated exchanges on Wednesday, 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.

Republicans did not ask Kennedy about his vaccine views during the first hour of the hearing.

But Democrats homed in, with Sen. Ron Wyden of Oregon pointing out that Kennedy has previously claimed there’s “no safe” vaccine, initiating a back and forth between him and Kennedy. Wyden also quoted from Kennedy’s books, which say that parents have been “misled” on the measles vaccine.

“You have spent years pushing conflicting stories about vaccines,” Wyden said.

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.

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Other Topics and Political Background

Republicans narrowed in on questions about agriculture, food and the abortion pill, which many women access over telehealth.

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.”

Kennedy hails from one of the nation’s most storied political families and is the son of the late Attorney General Robert F. Kennedy and the nephew of President John F. Kennedy. 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, shortly after he won the presidential election, saying Kennedy would “end the Chronic Disease epidemic” and “Make America Great and Healthy Again!” As one of the most prominent anti-vaccine activists in the world, Kennedy’s nomination immediately alarmed some public health officials.