Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. has experienced a series of setbacks in recent months, diminishing his influence within the Trump administration. These challenges center around his “Make America Healthy Again” (MAHA) agenda and have created tension with both White House officials and some Republican senators.

Surgeon General Nomination Stalled

President Donald Trump’s nominee for surgeon general, Casey Means, has been unable to secure private meetings with Senators Lisa Murkowski and Susan Collins, who hold the power to sink her nomination. Senator Murkowski stated in mid-March she was “not enthusiastic about her.” This skepticism has effectively stalled Means’ candidacy, a significant blow to Kennedy and his MAHA initiative.

A Proxy Battle Over Kennedy

The vote on Means’ confirmation is increasingly viewed as a proxy battle over Kennedy himself, particularly his recent policy changes regarding vaccines. One source familiar with internal discussions noted that senators are using the nomination process as leverage to slow down Kennedy’s agenda. President Trump acknowledged the possibility of withdrawing Means’ nomination, stating, “We certainly have a lot of great candidates for the job.”

Internal Tensions at HHS

Inside HHS, Kennedy and his team are navigating a difficult balance between a White House tightening control over policy and MAHA advocates pushing for the fulfillment of campaign promises. This tension has become public, with some allies expressing frustration with dysfunction within the agency.

Vaccine Policy Reversals and Panel Resignations

In March, a Massachusetts judge blocked Kennedy’s revised childhood vaccine recommendations and suspended most of his appointees to the Advisory Committee on Immunization Practices. Dr. Robert Malone, a biochemist and vaccine critic, resigned from the panel following the ruling, stating the situation was a “hot mess” and the government’s defense was “horrid.” Malone also revealed Kennedy personally asked him to remain on the panel.

White House Reasserts Control

The White House has recently taken steps to increase its influence over HHS, installing senior officials focused on drug pricing and access. Administration officials are prioritizing the president’s successes in this area, such as prescription drug pricing initiatives, over vaccine policies in the lead-up to the midterm elections. This shift reflects growing concern that Kennedy’s vaccine actions are alienating voters.

Declining Popularity and MAHA Backlash

Kennedy’s popularity has declined since taking office, with a KFF poll in October showing nearly 60% of Americans disapproved of his performance. However, MAHA advocates argue they represent a crucial voting base and are being sidelined. Michael Caputo, a former HHS assistant secretary, emphasized that Means represents a demographic – “MAHA moms” – essential for Republican success in the midterms.

Pesticide Concerns and Policy Conflicts

Further aggravating MAHA advocates are Trump’s actions supporting pesticide manufacturers and a pending Supreme Court case regarding potential health damages. Kennedy and Means have long argued that pesticides like glyphosate can contribute to health problems, a position that clashes with the administration’s current messaging and support for the agricultural industry. Kennedy publicly expressed his unhappiness with the administration’s decision on glyphosate, stating, “It’s not something that I was particularly happy with.”

Senate Deadlock on Surgeon General

The confirmation of a surgeon general, typically a straightforward process, has become contentious. During Means’ hearing, Senator Bill Cassidy pressed her on vaccine policy, while Senator Murkowski raised concerns about HHS efforts regarding hepatitis B vaccination. Cassidy, a physician, has not indicated how he will vote, but has been a vocal critic of Kennedy’s vaccine actions.