President Trump's bombshell executive order aimed at lowering U.S. drug prices is a step toward a worst-case scenario for the pharmaceutical industry. Some critics say the industry could have done more to avoid it, even though Trump's policies are causing turmoil in almost every sector of the economy.

Why it matters: Trump's announcement could be the start of enormous global disruption for the pharmaceutical industry — or it's the least-bad version of what was on the table, depending on who you ask.

• But the continued risk of a "most favored nation" policy that pegs U.S. drug prices to those paid in other developed nations is a massive threat to drugmakers' bottom lines, especially coming on top of the pharmaceutical tariffs Trump has said he wants to impose.
• The big questions are whether it ever comes to fruition, and whether drugmakers could have done more to avoid getting to this place at all, especially given Trump's laser focus on drug prices and the populist leanings within the GOP.

What they're saying: "The biopharmaceutical industry is working with President Trump and Capitol Hill on solutions to help patients access and afford the treatments they need," Alex Schriver, senior vice president of public affairs at the trade group PhRMA, said in a statement.

• "We remain committed to finding areas of alignment with policymakers to support making America healthy."

The big picture: Yesterday's announcement was sparse on details about how the administration plans to harmonize what the U.S. and other countries pay for drugs, meaning there's no way to know exactly how much trouble the pharmaceutical industry is in.

• The announcement also took a deep swipe at drug "middlemen," who the pharmaceutical industry faults for drug affordability issues.
• But the predicament drugmakers find themselves in marks a fall from grace for an industry that was recently considered among the most powerful in Washington.
• Trump's latest effort comes amid turmoil at the Food and Drug Administration, the administration's slashing of biomedical research funding and the appointment of the nation's most prominent vaccine critic, Robert F. Kennedy Jr., as the nation's top health official.

And all of that follows the passage of the Inflation Reduction Act, which gave Medicare the power to negotiate the prices of certain drugs — a policy the industry had been fighting for decades.

• "This is a 10-year screwup; they've been targeting the PBMs and they've done nothing but lose ground," said one source close to both the drug industry and the White House. "I think they have totally misplayed their hand."

Yes, but: Pharma is far from alone in being on the losing side of Trump's economic policies, and is joined by industries that have bent over backward to curry favor with the administration.

• Trump, however, has bemoaned U.S. drug prices since his first term and has long adopted the kind of anti-pharma language once exclusive to Democrats.
• "This egregious imbalance is orchestrated through a purposeful scheme in which drug manufacturers deeply discount their products to access foreign markets, and subsidize that decrease through enormously high prices in the United States," Trump's executive order states.

Between the lines: The drug industry's critics include health officials from Trump's first administration. Some said PhRMA's primary mistake was not making more concessions after he was sworn in for a second term.

• "When this administration notices that it intends to do something, the only way you get to the table is to be proactive. Look at the agriculture lobby coming into alignment with MAHA — proactivity is your biggest friend in this administration," said David Mansdoerfer, a senior health official in the first Trump administration.
• "Pharma was caught flat-footed and wasn't able to muster a substantive defense," he added. "Of course, trying to explain to an 'America first' president why Americans were paying substantively more for the same drug was always going to be an uphill battle."

The other side: Some analysts argue there may not have been much more that the industry could have done.

• The industry was already trying to fight for relief from the Democrats' drug pricing law, and Trump's focus on global price disparities is a long-standing one.
• Pharmaceutical interests have so far avoided industry specific tariffs, kept most-favored-nation pricing policies out of the GOP's massive reconciliation bill on the Hill, and kept a spotlight on pharmacy benefit managers as the reason drug prices are high.
• "Trump has not hidden how he feels on the issue and he won," said one drug industry lobbyist. "So I wouldn't criticize pharma too much on their lobbying — what are they supposed to do?"

There's also a narrow window of opportunity for the industry: If the U.S. can successfully convince other wealthy countries to pay more for drugs, even if Americans pay less, that could be a win — or at least a wash — for manufacturers.

• "The Administration is right to use trade negotiations to force foreign governments to pay their fair share for medicines. U.S. patients should not foot the bill for global innovation," PhRMA President and CEO Stephen Ubl said yesterday in a statement.

"There are words on a page, but not much substantive there," Raymond James analyst Chris Meekins, a health official in Trump's first administration, wrote in an investor note after the release of the executive order. "It reminds us of how in President Trump's first term he was 'all bark, no bite' on drug pricing."

• But Meekins published a separate note in anticipation of the announcement with a scathing critique of the industry's approach to Trump 2.0.
• "The pharmaceutical industry thought if they just ate with Trump enough and hung out at the White House enough, President Trump would not act on his long held views," he wrote.

Robert F. Kennedy Jr.'s short time leading America's health agencies has already destabilized the uneasy alliance that vaulted him into President Trump's Cabinet.

Why it matters: The "Make America Healthy Again" movement — a loose umbrella of vaccine skeptics, wellness influencers, and anti-pharma crusaders — was envisioned as a revolution against the medical establishment.

• But its attempt to integrate with the federal health apparatus — and the MAGA purists who comprise the backbone of Trump's base — has so far proven deeply dysfunctional.

The big picture: The anti-establishment takeover of Health and Human Services — a sprawling agency that accounts for the largest share of domestic federal spending — has become one of the most chaotic experiments of Trump's second term.

• Trump has already been forced to pull two major health nominations — former Rep. Dave Weldon for Centers for Disease Control and Prevention director and Fox News contributor Janette Nesheiwat for surgeon general — after scrutiny of their records.
• The Food and Drug Administration's top vaccine regulator, Peter Marks, abruptly resigned in March in protest of Kennedy's "misinformation and lies" about vaccines.
• As a measles outbreak spread in Texas, the White House became so frustrated by the lack of clear and fast communications by HHS that it set up a parallel press shop, as Axios scooped last month.

Between the lines: Kennedy's top health picks include contrarians who are critical of the medical establishment — but unwilling to fully embrace the MAHA movement's more conspiratorial views on vaccines.

• National Institutes of Health director Jay Bhattacharya and FDA commissioner Marty Makary were brought in as high-profile critics of COVID-era orthodoxy who boast mainstream academic credentials.
• But neither man fully endorses Kennedy's most controversial positions, particularly on childhood vaccines and autism — making them targets for the anti-vaccine purists who view them as insufficiently radical.

Zoom in: Trump's nomination of nutrition influencer Casey Means to be surgeon general last week has become the latest flashpoint in the unraveling of the MAHA coalition.

• Means and her brother, White House adviser Calley Means, became key faces of Kennedy's movement after authoring a New York Times best-seller that railed against the food and pharmaceutical industries.
• Their message — that metabolic dysfunction and chronic illness stem from institutional corruption — helped popularize the MAHA brand among wellness influencers and libertarian-minded reformers.

But Casey Means' nomination to be the face of public health messaging has drawn fire from all sides.

• Anti-vaccine activists argue she isn't sufficiently committed to Kennedy's views on vaccine safety, especially the more fringe beliefs he espoused before leading HHS.
• Kennedy's running mate, Nicole Shanahan, claimed she was promised that the Means siblings wouldn't get jobs inside HHS — and that "someone" is "controlling" Kennedy's decisions.

The intrigue: Far-right conspiracy theorist Laura Loomer, who successfully lobbied Trump to fire national security adviser Mike Waltz and much of his team, has trained her eyes on the Means siblings.

• Loomer has openly mocked Casey Means as a "woo woo woman" who "literally talks to trees and spiritual mediums" — drawing backlash from Calley Means, who suggested Loomer was taking money from the medical industry.
• Kennedy has vigorously defended Means' qualifications, arguing that her popularity among "MAHA moms" poses "an existential threat to the status quo interests, which profit from sickness."

The other side: Other top MAGA influencers, including Charlie Kirk, Donald Trump Jr. and Megyn Kelly, have praised Casey Means' appointment and emphasized the need for coalition harmony.

• "If you merge MAHA and MAGA, it's like 1932," former Trump chief strategist Steve Bannon said on his "War Room" podcast, predicting a political realignment on par with FDR's New Deal coalition.
• "You govern forever."

The bottom line: HHS will be at the center of major policy debates over Medicaid cuts, abortion access, vaccine policy, medical research and the future of public health infrastructure.

• But the deep divisions within its Frankenstein coalition are threatening to tear MAHA apart before those battles can even begin.

UnitedHealth Group is bracing for scrutiny from the Trump administration over the way it and other Medicare Advantage insurers bill the government, along with other cost-related topics, an executive at the health company told Axios.

Why it matters: Mehmet Oz's characterization of the Medicare Advantage system as "upside down" during his Senate confirmation hearing to become Centers for Medicare and Medicaid Services administrator on Friday may have surprised those who assumed he'd enter office as a champion for the program.

Driving the news: Oz pointed to the way the U.S. pays more for Medicare Advantage than traditional Medicare and specifically discussed the practice of "upcoding," in which insurers categorize patients as sicker in order to get higher payments.

• "I pledge if confirmed, I will go after it," he said.
• Oz also brought up prior authorization in MA, saying it could be streamlined and is a "pox on the system," Axios Pro reported.
• He floated limiting the number of procedures subject to prior authorization by insurers at 1,000, and said reviews should happen more rapidly, including through the use of AI tools.

State of play: A growing chorus of MA critics, including a federal watchdog, has been calling for more scrutiny of the program.

• UnitedHealth, the biggest MA insurer, has specifically been accused of gaming the system in order to extract high payments from the federal government. The company has denied the accusations.
• Health insurer trade group AHIP says it will engage with the new administration on MA, which now cares for more than half of all Medicare beneficiaries.
• "More than 34 million Americans choose Medicare Advantage because it provides them better care at lower costs than fee-for-service. We look forward to working with the administration and Congress to protect and strengthen Medicare Advantage," Mike Tuffin, CEO of AHIP, said in a statement.

What they're saying: "We're excited to have a conversation" about whether to continue the push for value-based care or to "stay stuck in fee-for-service, which is volume-based and which is doing nothing to actually improve people's health," a UnitedHealth Group executive said at an Axios event sponsored by the company, hours after Oz's remarks. The executive was granted anonymity so they could speak freely about the breaking news.

• "Part of that conversation is about coding, and diagnosing whether patients are sick and if so, what can we do about it?" the executive said.
• The executive referred to a recent special master's ruling that the Justice Department failed to prove a long-running claim that UnitedHealth Group exaggerated how sick MA patients were, leading to more than $2 billion in overpayments to the insurer.
• "That's probably our best example of, let's have this conversation about Medicare Advantage," the executive said.

On Monday, the Better Medicare Alliance launched a video ad urging President Trump to "secure and protect" Medicare Advantage, a further signal that some industry players see threats to the program looming ahead.

• "We share Dr. Oz's goal of strengthening Medicare Advantage for seniors and taxpayers, and we look forward to working with him on policy solutions to accomplish this," Mary Beth Donahue, CEO of the group, told Axios in a statement after Friday's hearing.
• The first major test of the administration's stance toward the program will occur in the coming weeks, when it will finalize MA payment rates for next year.

The big picture: The entire health care sector should prepare not only for heavy scrutiny, but also for a flurry of activity from the Trump administration, the UnitedHealth executive said.

• Citing reports that HHS Secretary Robert F. Kennedy Jr. is interested in overhauling the way Medicare pays physicians, the executive said big ideas shouldn't be dismissed as too difficult to actually happen. So far, the administration doesn't "seem challenged by prior constraints."
• "I think everything's on the table for a lot of different industries in the health care sector," the executive added. "And so I think we are now about to live the future of health care."

The White House is withdrawing the nomination of Dave Weldon to be the director of the Centers for Disease Control and Prevention (CDC), per a source close to Senate health committee and another source familiar.

Why it matters: The former Florida congressman was scheduled to appear before the committee this morning for a since-cancelled confirmation hearing. But his views questioning certain vaccines have garnered attention since he was nominated months ago and were sure to play a prominent role in questioning.

• HHS Secretary Robert F. Kennedy Jr. himself said Weldon wasn't ready, per one of the sources.

Background: Weldon is an internal medicine doctor who served in the House of Representatives from 1995 through 2009. While in Congress, he was one of the sponsors of a bill that would have banned mercury from vaccines.

• In a 2007 statement on a different bill he sponsored, Weldon wrote that "legitimate questions persist regarding the possible association between the mercury-based preservative, thimerosal, and the childhood epidemic of neurodevelopmental disorders (NDDs), including autism."
• Thimerosal has been used as a preservative in vaccines, although it was taken out of childhood vaccines in 2001, per the CDC. Many studies have found no evidence of harm of thimerosal in low doses in vaccines.
• Studies have also found no evidence of a connection between vaccines and autism.

Sen. Patty Murray (D-Wash.) said Weldon repeated debunked claims about vaccines in a meeting they had last month. She called on the administration to pick a nominee "who at bare minimum believes in basic science and will help lead CDC's important work to monitor and prevent deadly outbreaks."

In nearly three weeks as Health and Human Services secretary, Robert F. Kennedy Jr. certainly hasn't allayed concerns that he'll bring his vaccine criticism — most if not all of it unfounded — into his role as the nation's top health care official.

Why it matters: Several of Kennedy's vaccine-related actions have stoked fears that the anti-vaccine movement has gained a powerful foothold within the federal government in the midst of a worsening measles outbreak in Texas, one of the worst flu seasons in more than a decade and a circulating bird flu virus that has pandemic potential.

Driving the news: Kennedy drew attention last week during a Cabinet meeting, when he described measles outbreaks as "not unusual" after one now hitting west Texas and New Mexico resulted in the first U.S. death from the virus since 2015 and almost half of the cases seen last year.

• He then wrote in a Fox News op-ed over the weekend that vaccines protect individuals and communities from the disease but also that "all parents should consult with their healthcare providers to understand their options to get the MMR vaccine," and that "[t]he decision to vaccinate is a personal one."

The lukewarm support for measles vaccines came after a tumultuous few weeks in vaccine policy, including the Food and Drug Administration's cancellation of a March 13 meeting of a federal advisory panel to discuss the composition of next season's flu shot.

• Earlier this month, a Centers of Disease Control and Prevention advisory panel on vaccines was told that a February meeting on updating vaccination guidelines had been postponed indefinitely.
• The administration is also reviewing whether to pull $590 million in funding that Moderna received in the final days of the Biden administration to develop an mRNA vaccine for bird flu, reportedly as part of a bigger examination of spending on mRNA-based shots.
• "In isolation each of these actions have their own tolerable explanation, but taken collectively they raise the specter that RFK's trial-lawyer antipathy to any and all vaccinations continues to reign supreme," a person who worked on Kennedy's confirmation told Axios.

The big picture: Everything could still turn out fine, and the U.S. may resume business as usual when it comes to vaccines after a bumpy transition period. But it's hard to ignore the series of unusual vaccine-related decisions made over the last couple of weeks against the backdrop of Kennedy's decades of anti-vaccine activism prior to his government role.

• Kennedy said during his confirmation hearing that he wouldn't take away people's vaccines, but didn't disavow past anti-vaccine statements.
• The Trump administration clearly relishes disruptions to the status quo. It's plausible that these past few weeks are just the beginning of a brand-new, less transparent approach to vaccine policy under Kennedy's leadership — an approach that deeply alarms scientists and public health experts.

Kennedy's actions so far are "significant things, and I think it's just the tip of the iceberg," said Richard Hughes, a professor of vaccine law at George Washington University and a partner at Epstein, Becker & Green.

• "This is a man who was one of the most pivotal leaders in the anti-vaccine movement," he added. "It's not like he woke up one day and said, 'You know what, I feel different about vaccines.'"

The other side: "RFK has a mandate, under the MAHA movement, to allow for all of science to be critiqued and challenged," said David Mansdoerfer, a former senior HHS official in the first Trump administration.

• "These actions don't represent the rise of an anti-vaccine movement, they instead represent a return to science being able [to be] rigorously discussed in the public square," he said.

What they're saying: Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia and a member of the FDA's advisory committee, told Axios that the cancellation or postponement of meetings, combined with recent workforce reductions at health agencies, reflects "just a gradual sort of dismembering of the public health service."

• Offit said he didn't know the reasoning behind cancellation of the meeting on flu vaccine but that HHS officials said that they are going to make the decision about the vaccine internally within the FDA.
• "The irony to me is that Robert F Kennedy Jr. talks endlessly about transparency, and now you have meetings being canceled and decisions being made behind closed doors," Offit said.

Some advocacy groups were especially alarmed at the cancellation of the flu vaccine discussions, considering the severity of the current flu season and possibly delays formulating next year's shots.

• "Cancelling essential health advisory committee meetings without promptly rescheduling them is appalling," said Public Citizen Health Research Group director Robert Steinbrook.

Officials haven't said why the advisory panel's meeting on flu vaccines was canceled, but an HHS spokesperson said the FDA will "make public its recommendations to manufacturers in time for updated vaccines to be available for the 2025-2026 influenza season."

• HHS and CDC said in identical statements that the meeting on updating vaccination guidelines for infectious diseases was postponed "to accommodate public comment in advance of the meeting," adding that advisory working groups had met as scheduled.
• Addressing the review of federal funding of mRNA vaccines, an HHS spokesperson told Axios: "While it is crucial that the U.S. Department and Health and Human Services support pandemic preparedness, four years of the Biden administration's failed oversight have made it necessary to review agreements for vaccine production."

What to watch: Kennedy has considerable discretion to put his stamp on vaccine policy, drug approvals and any number of other issues.

• Some critics expect more requests for vaccine safety data and the appointment of like-minded individuals to advisory panels that could influence coverage of drugs, services and devices.
• His leadership could also result in a shift of federal health funding to chronic disease or unproven cures, and away from infectious diseases.

Tina Reed contributed to this story.

After watching 6-plus hours of Robert F. Kennedy Jr. testifying before two Senate committees, I have no idea whether he'll be confirmed as HHS secretary — I could see it going either way.

• Yes, but: It was still incredibly interesting to watch Kennedy reintroduce himself after decades in the public eye, hear more about how he'd govern and, in some cases, read between the lines of what he wasn't saying.

Here are some major takeaways from the hearings:

He's not declaring himself an entirely new man — on vaccines, on abortion or on many of his Democratic views.

Kennedy didn't deny several of his outlandish past statements, although he frequently tried to add context or explanation. He also began his testimony by saying that "news reports have claimed I am anti-vax or anti-industry. I am neither."

• But he refused to acknowledge that vaccines don't cause autism, saying only that he wouldn't take any preconceived notions into the office with him and would look at the data.
• The problem with that, as several senators pointed out, is that reams of studies have existed for years that find no link between vaccines and autism.

He also made no attempt to convince them he'd had a personal change of heart about abortion policies, saying repeatedly instead that he would implement President Trump's policies and that "every abortion is a tragedy."

• He didn't run away from other liberal positions, either, saying at one point that he and Trump have "agreed to disagree" on climate change.

Deference to Trump — both by Kennedy and GOP senators — may make none of that matter.

That's not to say Kennedy doesn't have any true fans, and he was vocally supported and praised by several GOP senators. Many on both sides of the aisle found points of agreement with him.

• But on abortion, one of his diciest issues, his repeated commitment to follow Trump's lead seemed to satisfy ardent anti-abortion members, although several Democrats did their best to remind those colleagues that Kennedy's personal values have been in stark contrast with their own.
• It's "great that my Republican colleagues are so open to voting for a pro-choice HHS secretary," Sen. Maggie Hassan, a New Hampshire Democrat, said at one point.

He's unfamiliar with the basics of how the federal health programs work.

This first became apparent during Louisiana Republican Sen. Bill Cassidy's first round of questioning on Wednesday, when he asked a series of Medicaid-related questions. Kennedy's answers contained factual errors about the program and suggested a lack of familiarity with federal health programs.

• Hassan then went in for the kill yesterday, asking him to explain what each of the four major parts of the Medicare program cover. Kennedy fumbled his responses.

If Kennedy is confirmed — or maybe even if he isn't — pharma is probably in trouble.

The hearings yielded very little information about what Kennedy would want to do as secretary outside of public health and vaccine policy. But he did have a few illuminating comments on drug pricing.

• In an exchange with Sen. Bernie Sanders (I-Vt.) about how much more the U.S. often pays for pharmaceuticals compared with other countries, Kennedy said that "we should end that disparity" and that he's spoken with Trump about it.
• He told Sen. John Hickenlooper (D-Colo.) that "I've spoken to President Trump about negotiations. He's absolutely committed to negotiating lower drug prices."
• And in a fiery back-and-forth with Sanders, Kennedy made clear his disdain for the pharmaceutical industry's influence in Washington.
• "Almost all the members of this panel — including yourself — are accepting millions of dollars from the pharmaceutical industry and protecting their interests," Kennedy said.

Where it stands: For the handful of senators truly on the fence about Kennedy's nomination, he may not have made the decision much easier for them. As a reminder, Kennedy can only lose three Republicans if every Democrat votes against him.

• At the end of yesterday's hearing, Cassidy told Kennedy that he is "struggling with your nomination."
• Does someone "who has spent decades criticizing vaccines and who is financially vested in finding fault with vaccines — can he change his attitudes and approach now that he'll have the most important position influencing vaccine policy in the United States?" Cassidy asked.
• "Will you continue what you have been, or will you overturn a new leaf at age 70?"

What the White House is saying: "After two days and over six hours of testimony in two Senate Committees, we are fully confident [Kennedy] will be confirmed by the U.S. Senate, 🇺🇸" confirmation spokesperson Katie Miller posted on X.

Almost everyone I talked to thinks this is ultimately going to be a nail-biter, including both Kennedy supporters and critics.

• If he is confirmed, it's also hard to predict which version of himself he'll bring to the job as the nation's top health official.

The success of Robert F. Kennedy Jr.'s first confirmation hearing Wednesday "kind of depends on which Bobby Kennedy shows up," as one Trump administration source working on his nomination put it.

Why it matters: Whether Kennedy becomes the next Health and Human Services secretary likely hinges on his ability to convince a handful of Republican senators that he's not the version of himself that was on public display only a few months ago — or at least that he can hold those instincts back once confirmed.

The big picture: The Kennedy who made his personal fame — and some of his fortune — around challenging the safety of vaccines and embracing other positions well outside the GOP mainstream has largely disappeared from public view since President Trump nominated him in mid-November, replaced by a more buttoned-down persona.

• The question is which version appears in potentially heated exchanges with senators from both parties. Kennedy can only afford to lose three Republican votes, assuming Democrats are united in opposition.
• "He's got to have a good hearing, address some of the concerns we all know, like vaccine, couple other things like that," Sen. Thom Tillis told reporters this week, Axios Pro's Peter Sullivan reported Tuesday.

Between the lines: Beyond being one of the nation's most prominent vaccine skeptics, Kennedy has also been a lifelong Democrat with liberal views on issues like the environment and abortion — until he teamed up with Trump late in the campaign.

• His personal life is littered with controversy and scandal, including new accusations by his cousin Caroline Kennedy in a letter to senators in which she called him a "predator." The letter was first reported by the Washington Post.
• "His basement, his garage, his dorm room were the centers of the action where drugs were available, and he enjoyed showing off how he put baby chickens and mice in the blender to feed his hawks. It was often a perverse scene of despair and violence," she wrote of Kennedy.

State of play: Kennedy's vulnerabilities haven't changed much in the months since his nomination was announced. A spokesperson didn't respond to a request for comment for this story.

• One tightrope Kennedy will have to walk is abortion, a subject that even lifelong foes of the procedure have struggled to navigate politically since the Supreme Court ended the federal right to abortion.
• "I think the challenge is his personal beliefs versus Trump's personal beliefs versus what GOP senators need to hear," said the source working on the confirmation.
• Treading that line "requires finesse and humility. Neither are characteristics he has in great abundance," the source added.

Although most anti-abortion groups have held their fire against Kennedy despite his prior pro-choice views, Advancing American Freedom — a group led by former Vice President Mike Pence — has voiced full-throated opposition to his nomination.

• A new ad from the group features a video of Trump himself from last year calling Kennedy a "radical left Democrat," and urging senators to vote against his nomination.

Where it stands: So far, he's not convincing major conservative editorial boards that he's moderated enough to be qualified for the position.

• "Senators would be wise to believe RFK Jr.'s career of spreading falsehoods rather than his confirmation conversions," the Wall Street Journal editorial board recently wrote.
• "[N]othing has changed about Kennedy from last spring. He's still a radical left lunatic who is anti-energy, a 'big time' taxer and completely incoherent about our nation's health," the NY Post editorial board wrote. "No Republican can vote for this guy. No senator should."

What we're watching: The only audience that matters, of course, are the 100 senators, half of whom Kennedy must convince to back him. The more Kennedy can stick to safe answers around topics like vaccines and abortion, the better off he'll be with members who are still on the fence.

• Some GOP lawmakers have said Kennedy's recent statements that he won't take away the polio vaccine are reassuring, but others are looking to this week's hearings, Peter reports.
• "I'm certainly concerned about it," Sen. Lisa Murkowski said when asked about his vaccine views. "I know others have other points of concerns that they want to drill down on and try to get some public commitments from him on."

Seed oils are being targeted by Robert F. Kennedy Jr. and influencers claiming they are linked to chronic illness and other health concerns, but many health experts say the oils are simply caught up in the real problem: Americans' diet and overconsumption.

Why it matters: The debate over seed oils ultimately ties back to Americans' over-reliance on processed foods and other, broader dietary habits that many people want the government to help address.

Driving the news: Online influencers and the RFK-led health movement alike share a skepticism of seed oils and their impact on people's health.

• Oils made from seeds including canola, soy and sunflower have been dubbed the "Hateful Eight."
• RFK has said Americans are being "unknowingly poisoned" by them and claimed beef tallow is a healthier option.
• "To turn the page on our chronic disease crisis, the new administration should initiate a thorough, science-based review of seed oil," author Nina Teicholz recently wrote in the Washington Examiner.

But many nutritionists say seed oil concerns are overblown, lack context or just aren't based in science. Studies have repeatedly found they are safe to consume and may even be associated with lower risks of cardiovascular disease, cancer and Type 2 diabetes, per the NYT.

• Nutritionists say they're also much healthier than other sources of fat, like butter and lard, the NYT reported last month.
• Seed oils are mainly made up of unsaturated fats, and are high in heart-healthy omega-6 fatty acids and low in omega-3 fatty acids.
• "Many ultra-processed foods are lower in nutrient density, but the oil itself has really been demonized," Judy Simon, a registered dietitian nutritionist at the University of Washington Medical Center, told Verywell Health.

The latest: A recent study found ultra-processed foods high in seed oils may increase the risk of developing colon cancer, which is rising among younger people.

• An excess amount of omega-6 fatty acids found in ultra-processed foods may be to blame, Scientific American reports. Seed oils are used in a lot of packaged and processed food.
• It's not that omega-6 is bad for you; it's that Americans tend to eat too much of it.
• "Omega-6 is an essential fatty acid. You've got to have it — but...it's like everything else: it should be in moderation," Timothy Yeatman, a co-author of the study and a professor of surgery at the University of South Florida, told Scientific American. "But the problem is we've massively overdone the amount of seed oil in foods."

What they're saying: Although seed oils themselves are typically processed, "even worse than that...is they're usually used to make ultra-processed foods — think fast food burgers and fries and anything you'd eat at a state fair or get in a package in the grocery store," the Cleveland Clinic writes in a blog post.

• "Outside of your own home, you're most likely to consume seed oils when you're eating something that's already pretty bad for your health — something that's also full of fat, sugar and sodium," the blog post adds.

The bottom line: Using seed oils — in moderation — to cook healthy meals at home is probably fine. The real takeaway is that eating fast food and heavily processed foods all the time isn't.

Unflattering stories about Robert F. Kennedy Jr.'s personal life and influential criticisms of his public health stances are already starting to pile up — more than a month and a half before President-elect Trump takes office and can even officially nominate him to lead Health and Human Services.

Why it matters: Kennedy can only afford to lose three Republican senators' votes, assuming all Senate Democrats vote against him. The question is how much the handful of wavering members will accept.

Driving the news: News stories published over the past few days highlight Kennedy's key vulnerabilities, including the wildcard presented by his colorful past.

• A deeply reported piece by the New York Times discusses his "drug addiction, compulsive sexual behavior and deep dives into conspiracy theories," including his arrest and conviction for heroin possession and a journal he kept documenting sexual encounters with more than three dozen women in one year.
• Kennedy was accused of sexual assault in the late 1990s by a woman who interned at his law clinic and babysat for his family. The woman has said she's willing to testify before the Senate, the Wall Street Journal reports. Kennedy didn't comment on the claims.

What they're saying: Trump's transition team is working to address concerns about Kennedy's abortion-related positions, CNN reports.

• A Trump transition spokesperson told CNN "this is President Trump's administration that Robert F. Kennedy has been asked to serve in and he will carry out the policies Americans overwhelmingly voted for in President Trump's historic victory."

Zoom in: Kennedy has in the past used the word "fascism" to describe the Centers for Disease Control and Prevention's vaccine division and compared an alleged widespread cover-up of vaccine harms — for which there is no evidence — to the Catholic Church's cover-up of child sexual abuse, NBC reports. Neither Kennedy nor the Trump transition team responded to requests for comment from NBC.

• Kennedy ally Del Bigtree, CEO of the MAHA Alliance PAC, suggested on X that Kennedy's opinions haven't changed: "Bobby didn't get dragged through the mud for over a decade just so he could compromise his values once he finally got inside the castle."

The intrigue: Although criticism is nothing new for Kennedy, a powerful voice has joined in: Trump's former FDA commissioner Scott Gottlieb, who is widely respected in GOP circles and beyond.

• Gottlieb said Friday on CNBC that he has "deep concerns" about Kennedy's intentions, especially related to childhood vaccines.
• "What I worry about is we're at a tipping point, that we're going to start seeing epidemics of diseases that have long been vanquished," Gottlieb said.
• "I think if RFK follows through on his intentions — and I believe he will, and I believe he can — it will cost lives in this country," he added.

President-elect Trump has selected vaccine skeptic Robert F. Kennedy Jr. to lead the nation's top health care agency, which would give him power over food and drug regulation, Medicare and Medicaid policy, the federal public health system and national health care research money.

Why it matters: We're now in the Wild West in a way we never were during Trump's first presidency, at least when it comes to health care.

• The pick is a radical departure from both mainstream science and Republican orthodoxy, and even before we know if Kennedy will be confirmed, the fallout is sending shockwaves through health care markets.
• "Kennedy likely will lead to significantly more volatility in health markets, making navigating policy risks far more challenging," Raymond James analyst and former Trump administration health official Chris Meekins wrote yesterday in an investor note.
• "If Kennedy is confirmed, it is hard to bookend risks for investors as his views are so outside the traditional Republican health policy orthodoxy."

What they're saying: "For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health," Trump posted on X, announcing the decision.

• "Mr. Kennedy will restore these Agencies to the traditions of Gold Standard Scientific Research, and beacons of Transparency, to end the Chronic Disease epidemic, and to Make America Great and Healthy Again!"

Between the lines: Kennedy's views on vaccines and the need to revamp health agencies are well-known at this point. But his views on more traditional health care topics — like Medicare Advantage or the Affordable Care Act subsidies — are much less clear.

• And on some topics, especially the value of the pharmaceutical industry, Kennedy has starkly different views than most Republicans — including those who may be staffing the administration in other health care roles.
• On the other hand, his appointment is likely to set the tone for other top health care appointees, like FDA commissioner or CMS administrator — and potentially scare away would-be contenders who don't share his views.
• Kennedy's appointment is likely to amplify fears of top government scientists fleeing health agencies.

Yes, but: Kennedy still probably has to get confirmed by the Senate, though there's been a lot of talk lately about Trump pushing for the use of recess appointments to skirt around the confirmation process. (Here's a good Semafor explainer of why that is easier said than done.)

• Regardless of how Senate Republicans react, a confirmation process would be brutal.
• "Mr. Kennedy's outlandish views on basic scientific facts are disturbing and should worry all parents who expect schools and other public spaces to be safe for their children," Senate Finance Committee Chair Ron Wyden said in a statement after the announcement.
• "When Mr. Kennedy comes before the Finance Committee, it's going to be very clear what Americans stand to lose under Trump and Republicans in Congress."

The big picture: By elevating Kennedy to such a position of power, Trump has lent credence to a messenger who distorts and misrepresents basic facts or concepts that have been rigorously proven.

• The post-pandemic years have shown how easy it is for seeds of doubt to translate into reduced vaccination rates and, in the case of measles, the outbreak of a disease that was declared eliminated in the U.S. in 2000.

Go deeper: What a Trump-empowered RFK Jr. could do on health care