(The Hill) – Robert F. Kennedy Jr. has spent decades as an outsider railing against federal health authorities.

Kennedy’s entire Make America Healthy Again movement is based largely on undermining the scientific and public health messaging from the federal government, along with overhauling the status quo in the food and drug industries.

But after being confirmed by the Senate and sworn in as Health and Human Services secretary Thursday, Kennedy is now in charge of those agencies.  

Here are five pressing questions he will face: 

Will RFK Jr. disrupt the food and pharmaceutical industries?

Kennedy has vowed to tackle obesity and chronic disease through major changes to federal food programs. Republicans who were left uneasy about Kennedy’s vaccine comments following his confirmation hearings praised his focus on chronic conditions and unhealthy eating. 

Kennedy said he’d like to overhaul dietary guidelines and end subsidies for junk food and sugary drinks currently available through federal programs such as SNAP  

“How are we going to tackle obesity? That is his biggest bipartisan opportunity, and to the extent that he can approach that thoughtfully, comprehensively, holistically … that would be positive for the country,” said Anand Parekh, chief medical adviser at the Bipartisan Policy Center. 

Kennedy has also attacked the pharmaceutical industry, accusing it of poisoning Americans to make them sicker for profit, and of spending millions of dollars to corrupt the health agencies he is now running.  

Despite Kennedy’s rhetoric, the pharmaceutical industry did not publicly lobby against his confirmation. Companies and trade groups have issued statements congratulating him and expressing optimism about working together.  

Kennedy will need to balance working in a pro-business administration that generally opposes regulation, while also trying to cut costs.  

On the food side, any efforts to ban types of foods or ingredients will likely face lawsuits, especially if he tries to remove sugary beverages and ultra-processed foods from public nutrition programs. 

On the drug side, Kennedy has called for an end to direct-to-consumer advertising for prescription drugs. 

Will Robert F. Kennedy Jr. follow through on firing hundreds at NIH and FDA?

Shortly after the election, Kennedy touted a plan to fire hundreds of staffers at the National Institutes of Health (NIH). He somewhat backed off that pledge during his confirmation hearings, when he promised not to fire people who were doing their jobs 

In an interview Thursday on Fox News, Kennedy told Laura Ingraham “I have a list in my head,” of specific people to remove.  

Kennedy said that lower-level federal employees were “public-spirited, good public servants, good American patriots, and hardworking people” who shouldn’t be afraid of losing their jobs.

“If you’ve been involved in good science, you have got nothing to worry about,” Kennedy said.  

But the Trump administration is in the process of trying to substantially slash the federal workforce, including thousands of employees across health agencies.  

Downsizing the agencies will have a significant impact on what the administration will be able to accomplish.  

Kennedy will also need to boost agency morale in the wake of the Trump administration’s open disdain for the federal workforce. He will need the expertise of federal workers if he wants to be a successful HHS leader, said Parekh of the Bipartisan Policy Center. 

“He can bring in as many advisors or loyalists, or anything he wants, but to understand the technical aspects of [the agency], he is going to need to partner with the career civil servants,” Parekh said.  “I mean, he’s now in charge. He’s the boss, so it behooves him to inspire and motivate them, because without their efforts, his agenda will not be successful.” 

How will RFK Jr. handle the booming weight loss drug industry?

HHS faces a key decision deadline in the coming months about whether to expand Medicare coverage for weight loss drugs. 

Kennedy thinks the drugs are a scam, and the solution to obesity is to eat better and live healthier.

In an interview with Greg Gutfeld on Fox News in October, Kennedy suggested weight loss drugs were being pushed on to gullible Americans by foreign pharmaceutical companies that wouldn’t even market the drugs in their home countries.  

Foreign companies are “counting on selling it to Americans because we’re so stupid and so addicted to drugs,” Kennedy said.   

“If we just gave good food, three meals a day, to every man, woman and child in our country, we could solve the obesity and diabetes epidemic overnight,” he added.  

It’s unclear what President Trump thinks, but expanding Medicare coverage would be extremely popular. However, it also comes with a price tag in the tens of billions of dollars, as anti-obesity drugs cost upward of $1,000 per month an amount seemingly at odds with the mandate to cut federal spending. 

However, Trump also put Kennedy in charge of a new Make America Healthy Again commission. Concerningly for some health experts, the commission was tasked with assessing “the prevalence of and threat posed by the prescription of” weight-loss drugs, along with anti-depression drugs, antipsychotics, mood stabilizers and stimulants. 

Kennedy has long warned of the dangers of anti-depression drugs called selective serotonin reuptake inhibitors (SSRIs), which he said during comfirmation hearings are harder to quit than heroin a claim contradicted by research.

Will RFK Jr. make it harder to access abortion medication?

One of the promises Kennedy made to Republican senators was to faithfully implement any Trump administration anti-abortion policies, despite his past support for abortion access.

During his Senate Finance Committee confirmation hearing, Kennedy indicated the administration was likely to closely scrutinize the abortion drug mifepristone because of “safety’ concerns.  

“President Trump has asked me to study the safety of mifepristone,” Kennedy said at the hearing. “He has not yet taken a stand on how to regulate it. Whatever he does, I will implement those policies.” 

The Food and Drug Administration approved mifepristone in 2000 to terminate pregnancies up to seven weeks. The drug is taken in conjunction with misoprostol, a two-medication regimen that constitutes the majority of abortions in the country.  Scientists and top medical groups contend it has been studied extensively and proven to be safe. It’s been used by millions of women with minimal side effects. 

But sowing doubt about the safety of the drug suggests an alignment with Trump, and the potential for national restrictions on a major method of abortion. He could also order new studies and revisit the drug’s approval. 

During his interview with Fox after being sworn in, Kennedy said there would be safety studies conducted. But he didn’t say whether he thinks access to the pills needs to be tightened. 

Will Robert F. Kennedy Jr. seek to get rid of fluoride in water systems?

Just days before the election, Kennedy said on X the Trump administration would “advise all US water systems to remove fluoride” on its first day due to alleged health risks like IQ loss and neurodevelopmental disorders. 

Water fluoridation is a local government decision, and it’s unclear if Kennedy could compel municipalities to do away with the cavity-fighting chemical. There are no federal laws that require water fluoridation, though some government agencies provide limits and recommendations on how much fluoride can or should be in drinking water.   

Still, Kennedy could withdraw fluoridation guidance that the Public Health Service issued in 2015. And Kennedy’s influence could prompt more states to propose limits or outright bans on community fluoridation. 

Kennedy’s November social media post was followed by an anti-fluoridation advisory from Florida’s surgeon general. In addition, lawmakers in four states have introduced bills to ban adding fluoride to public water systems. Legislation in at least four other states would make fluoride optional or put limits on the amount.