What we're learning about RFK Jr and Trump's health agenda

Also: I went on the Slate Political Gabfest!

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“Personnel is policy.” It’s a saying that you hear a lot around Washington — that the people you choose for key roles shape whether your policies get implemented.

We’re starting to learn the personnel that President-elect Donald Trump and his ally, Robert F. Kennedy Jr., want in key health positions. It’s still TBD on whether these choices will get confirmed by the Senate — and whether the plans sketched out by Trump and particularly by Kennedy come to fruition.

Last night’s announcements included:

• Marty Makary, Trump’s pick to run the Food and Drug Administration, the regulatory agency that oversees everything from additives in our food to the medicines we put in our bodies

• Dave Weldon, his pick to run the Centers for Disease Control and Prevention, which played such a key role in the covid-19 fight

• Janette Nesheiwat, his pick to be America’s surgeon general, the nation’s top doctor

My colleague Rachel Roubein and I dug into Trump’s latest picks.¹ As we wrote, you can see Kennedy’s influence on two of them.

Makary, a Johns Hopkins surgeon and the choice for FDA commissioner, has been an ally on Kennedy’s “Make America Healthy Again” agenda.

Weldon, a former GOP lawmaker and the pick to run CDC, has been a vaccine skeptic who’s worked with Kennedy in the past.

Both Makary and Weldon have conservative bona fides that should satisfy the Republican base, too. Makary has experience advising the first Trump administration on health policy; Weldon pushed restrictions on federal abortion funding when he was in Congress.

The picks also ran the gamut from “duh” to “who?”

Makary had been the presumptive FDA choice for a while; I wrote five weeks ago that he was on RFK Jr’s shortlist. Weldon was a blast from the past; the former congressman has been out of office for more than 15 years and hadn’t been floated in media coverage on CDC’s next director, at least that I’d seen. And the choice to be the nation’s top doctor, Nesheiwat, caught a lot of people by surprise. Perhaps it shouldn’t have; she’s been a Fox News commentator and has some family connections to the Trump administration, a path to prominence that we’ve seen again and again under Trump.

Anyway: read our latest story for more.

Trump picks Marty Makary to lead FDA, Dave Weldon to run CDC

One name we already knew before Friday night: Mehmet Oz, the TV doctor and former GOP senator candidate who’s been selected to run the Centers for Medicare and Medicaid Services, I wrote earlier this week. That could end up being a key appointment if Kennedy and his team try to overhaul Medicare payment; more on that below.

One notable name not yet announced: whoever Trump wants to lead the National Institutes of Health. As I wrote last week, Stanford’s Jay Bhattacharya has been in contention for that job, though it hadn’t been sewn up when I talked to sources about it earlier this week.

A theme that’s emerged: Trump wants camera-ready officials. Oz, Makary and Nesheiwat all have plenty of TV experience, with Oz hosting his own show and Makary and Nesheiwat serving as Fox News contributors. If Trump taps Bhattacharya, who’s also skilled on TV, he’d fit in too.

The trade-off: these aren’t people with experience leading large, bureaucratic organizations. That kind of expertise has historically been helpful, and often crucial, for Washington success.

That’s rarely stopped Trump, who’s repeatedly picked agency critics to run them. It remains to be seen whether his latest choices will tame the health care bureaucracy — or the bureaucracy will defeat them.

It’s also not clear whether Kennedy himself will survive Senate confirmation. Rachel and I hit Capitol Hill earlier this week, quizzing senators about how they’re going to vote on Trump’s pick to be HHS secretary.

It could be an interesting, complicated confirmation battle. Kennedy is a former Democrat who has staked out past stances on abortion, pharma and food that threaten GOP allies and donors. There’s a world where just a handful of Republicans end up saying, sorry RFK Jr, you’re not a true conservative, and that’s enough to kill his nomination.

Our early read: some of Kennedy’s biggest potential critics are willing to signal their concerns but not yet willing to go beyond that — more in our story.

Meanwhile, Kennedy’s vaccine skepticism made him a non-starter with virtually every Democrat that talked to us, even if no one wants to officially rule him out until the formal confirmation process begins. (Sen. Chris Coons (D-Del.) is “gravely concerned,” he reiterated to me.) But several Democrats gave Kennedy credit for his agenda to tackle unhealthy eating and its causes; Sen. Cory Booker (D-N.J.) went on a long riff about Kennedy’s food ideas and why he shares those policy goals.

One policy idea that could further complicate the political dynamics here: Kennedy and his team are kicking around changing what Medicare pays doctors — specifically, wanting to shift the financial incentives away from specialty care and more toward primary care. If they actually try to do this, it would be a big deal and provoke a messy fight with the medical industry.

It also might win support from Democrats.

I was in New York City for about 24 hours this week to moderate a city health department event. One takeaway: it was interesting to hear many liberal doctors and policy experts talk about their antipathy toward Kennedy … but how they thought his potential idea to change physician payments would be a good move.

There have been a lot of questions about RFK Jr’s agenda, and my colleagues and I have been trying to answer them, discussing The Post’s reporting on a variety of programs.

It’s a very busy time, but it’s important for reporters to say yes to these requests: podcasts are policy, too.

One awesome appearance: I went on the Slate Political Gabfest this week to talk with hosts Emily Bazelon, John Dickerson and David Plotz about RFK Jr’s early moves and what Republicans could do next year.

It was a lot of fun, and if you listen to the episode, I hope my joy comes through.

I could blather for hours about my love for Slate, the Internet’s first truly great web magazine, and how much it meant to me. Its writers’ willingness to ask contrarian questions — perhaps you’ve heard of the Slate pitch — shaped my thinking as a teenager and college student; early podcasters like Emily, John and David got me excited about policy and politics in my 20s. It’s a career achievement to share the air with them, even for a few minutes.²

Slate is also how I got familiar with

Mike Pesca

, who co-hosted Slate’s great sports show for years. Mike now has his own oft-provocative podcast, The Gist, and I joined him on a pair of episodes this week to discuss our recent reporting on Bhattacharya and the team being assembled at HHS. He’s a quick thinker and pushed me with questions involving years’ worth of pandemic decisions; I appreciate how he embraces nuance in a world that often refuses it.

1. Any of those three picks would be big stories on their own. However, Trump announced his choices in three emails across 18 minutes on Friday night, as I struggled to put my toddler in his pajamas and get him to bed.

(It’s the latest reminder: “Trump time” often means there’s no time to catch your breath in a frenetic news cycle.)

2. I was so excited for my 8:30 am taping for the Gabfest, I could barely sleep.