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Americans keeping close track of political news may have been toggling their screens today between Senate confirmation hearings: the second day of Robert F. Kennedy Jr.’s for secretary of Health and Human Services, and the first for Tulsi Gabbard’s for director of national intelligence and Kash Patel’s for FBI director. But each of those three hearings deserves the public’s full attention: Donald Trump’s nominees offered new glimpses into their approaches to policy, truth, and loyalty to the president.

Robert F. Kennedy Jr., Day Two

Ahead of Kennedy’s first day of hearings, our colleague Nicholas Florko noted that the HHS nominee is no stranger to conspiracist statements: “RFK Jr. has insinuated that an attempt to assassinate members of Congress via anthrax-laced mail in 2001 may have been a ‘false flag’ attack orchestrated by ‘someone in our government’ to gin up interest in the government preparing for potential biological weapon threats. He has claimed that COVID was ‘targeted to attack Caucasians and Black people,’ and that 5G is being used to ‘harvest our data and control our behavior.’ He has suggested that the use of antidepressants might be linked to mass shootings.”

“If Republican senators skirt around [Kennedy’s] falsehoods during today’s confirmation hearings,” Nicholas wrote, “it will be evidence of their prevailing capitulation to Trump. And it also may be a function of Kennedy’s rhetorical sleights … He’s capable of rattling off vaccine studies with the fluency of a virologist, which boosts his credibility, even though he’s freely misrepresenting reality.” But Kennedy’s sleights didn’t serve him quite as well today as he might have hoped.

At several points, senators encouraged Kennedy to acknowledge that vaccines are not the cause of autism, but instead of confirming what numerous studies have shown to be true, Kennedy insisted that he would need to “look at all the data” before coming to any conclusions. “The room went silent today during Senator [Bill] Cassidy’s closing questions,” Nicholas noted when we spoke this afternoon. “Cassidy was practically begging Kennedy to recant his previous statements on vaccines. Kennedy, like everyone else in the room, had to know this was a make-or-break moment for his confirmation. But despite the potential fallout, Kennedy refused, promising only that he would look at any studies presented to him disproving a link between vaccines and autism.”

The nominee for HHS secretary also showed, for the second day in a row, his lack of understanding about basics of the Medicare system, fumbling his answers to a series of rapid-fire questions from Senator Maggie Hassan, a Democrat from New Hampshire. Hassan also shared that she is the mother of a 36-year-old with cerebral palsy, and accused Kennedy of relitigating settled science on the fact that vaccines do not cause autism. “It’s the relitigating and rehashing and continuing to sow doubt so we can’t move forward, and it freezes us in place,” she argued.

Cassidy, whose vote could prove key to whether RFK Jr. is confirmed, said after today’s hearing that he is “struggling” over whether to confirm Kennedy.

Tulsi Gabbard

Gabbard came into her confirmation process with a history that raises questions about her commitment to national security (she has, among other things, met with former Syrian President Bashar al-Assad and expressed sympathetic views toward Russian President Vladimir Putin). As our colleague Tom Nichols wrote in November, “Gabbard has every right to her personal views, however inscrutable they may be. As a private citizen, she can apologize for Assad and Putin to her heart’s content. But as a security risk, Gabbard is a walking Christmas tree of warning lights. If she is nominated to be America’s top intelligence officer, that’s everyone’s business.”

The topic that ultimately received much attention in her confirmation hearing today was her refusal to say whether Edward Snowden is a traitor. Despite pressure from Democratic and Republican senators, Gabbard refused to answer the question, repeating that Snowden had broken the law and that she would take steps to make sure whistleblowers know how to properly make a complaint. Gabbard also revealed that she was unable to extract any concessions in her 2017 meeting with Assad. “I didn’t expect to,” she said.

Gabbard’s potential confirmation will depend on how her somewhat incoherent set of policy views sits with Republican senators. Last week, our colleague Elaine Godfrey explored the one through line—besides ambition—that has guided Gabbard’s otherwise inconsistent political career.

Kash Patel

Donald Trump is not always clear about what he means when he refers to “DEI,” but presumably it involves how someone’s identity is taken into consideration during the hiring process. In this morning’s press conference addressing the tragic plane crash last night, Trump asserted, without evidence but crediting his “common sense,” that DEI hiring at the Federal Aviation Administration was at fault.

It was odd, then, that a few hours later, Republican senators used Patel’s confirmation hearing to highlight his identity: Senator Lindsey Graham of South Carolina asked about examples of racism Patel has experienced, and Senator Mike Lee of Utah acknowledged the struggles Patel and his father must have faced as racial minorities in the United States and Uganda, respectively. Senator Thom Tillis of North Carolina, as if he were reading from a book report about the Gujarati people, lauded the religious diversity in Gujarat, India, where Patel’s family is originally from, omitting the state’s extreme tensions and violent history. Patel opened his own remarks by acknowledging his family’s journey from abroad. He invoked the phrase Jai Shri Krishna, a standard greeting for a sect of Hindus seeking blessings.

Patel was calm and still—he became riled up only when questioned by Senator Amy Klobuchar about his past suggestion that he would “shut down the FBI Hoover Building on day one and reopen it the next day as a museum of the ‘deep state.’” But he was walking a tightrope. Today’s hearing may be the rare instance when Patel has publicly broken with Trump, to whom he has otherwise been unequivocally loyal. He refused to explicitly state that Trump lost the 2020 election, but he also said, “I do not agree with the commutation of any sentence of any individual who committed violence against law enforcement.”

Overall, Patel seemed to be trying to carefully toe a line, answering questions about the culture-war issues that Trump and congressional Republicans care about—Senator Marsha Blackburn, for example, asserted during the hearing that the FBI prioritizes DEI and “counting Swiftie bracelets” over conducting investigations—while attempting not to alienate the employees he hopes to lead. Pressed by Blackburn, Patel made a vague statement about the “high standards” FBI employees must meet.

Related:

RFK Jr. has a lot to learn about Medicaid. What everyone gets wrong about Tulsi Gabbard

Here are four new stories from The Atlantic:

The memo that shocked the White House The near misses at airports have been telling us something. Donald Trump is just watching this crisis unfold. Jonathan Lemire: “What I saw at Trump’s first press conference”

Today’s News

Officials announced that there are no survivors in the crash last night between a U.S.-military Black Hawk helicopter and a regional American Airlines passenger jet landing at an airport near Washington, D.C. Three soldiers were aboard the helicopter, and 64 people were on the flight from Wichita, Kansas. Donald Trump appointed Christopher Rocheleau as the acting administrator of the Federal Aviation Administration. The agency had not had an administrator since the start of Trump’s new term. Eight hostages were released from Gaza by Hamas, and Israel released 110 Palestinian prisoners.

Dispatches

Time-Travel Thursdays: Don Peck interviews Nicholas Carr about h​​ow online life has rewired our brains.

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More From The Atlantic

“The ‘exciting business opportunity’ that ruined our lives” Trump’s war on meritocracy If Iranian assassins kill them, it will be Trump’s fault, Tom Nichols writes. Don’t politicize aviation safety. The return of snake oil Why Meta is paying $25 million to settle a Trump lawsuit

Evening Read

Illustration by Ben Kothe / The Atlantic. Source: Getty.

Your FOMO Is Trying to Tell You Something

By Faith Hill

I feel deeply haunted by the thought that if I don’t go to the party or the dinner or the coffee stroll, my one wild and precious life will be void of a joyful, transformative event—one I’d surely still be thinking about on my deathbed, a friend at my side tenderly holding my hand and whispering, Remember? That time we went bowling and the guy in the next lane over said that funny thing? Every year, my New Year’s resolution is to keep one night of the week free from social plans. Almost every week, I fail.

Read the full article.

Culture Break

Illustration by The Atlantic. Source: Jamie McCarthy / Getty.

Listen. In the latest episode of Radio Atlantic, the MSNBC host Chris Hayes speaks with Hanna Rosin about how bad the war for your attention has really gotten.

Read. The Stranger Things effect is coming for the novel, Mark Athitakis writes.

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Stephanie Bai contributed to this newsletter.

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In a Massachusetts cellar in 1873, Lydia Pinkham first brewed the elixir that would make her famous. The dirt-brown liquid, made from herbs including black cohosh and pleurisy root, contained somewhere between 18 and 22 percent alcohol—meant as a preservative, of course. Within a couple of years, Pinkham was selling her tonic at $1 a bottle to treat “women’s weaknesses.” Got the blues? How about inflammation, falling of the womb, or painful menstruation? Lydia E. Pinkham’s Vegetable Compound was the solution. Pinkham’s matronly smile, printed on labels and advertisements, became as well known as Mona Lisa’s.

Lydia E. Pinkham’s Vegetable Compound was one of thousands of popular and lucrative patent medicines—health concoctions dreamed up by chemists, housewives, and entrepreneurs—that took the United States by storm in the 19th and early 20th centuries. These products promised to treat virtually any ailment and didn’t have to reveal their recipes. Many contained alcohol, cocaine, morphine, or other active ingredients that ranged from dubious to dangerous. Dr. Guild’s Green Mountain Asthmatic Compound was available in cigarette form and included the poisonous plant belladonna. Early versions of Wampole’s Vaginal Cones, sold as a vaginal antiseptic and deodorizer, contained picric acid, a toxic compound used as an explosive during World War I. Patent-medicine advertisements were unavoidable; by the 1870s, 25 percent of all advertising was for patent medicines.

After the Pure Food and Drug Act was passed in 1906, the newly created Food and Drug Administration cracked down on miracle elixirs. But one American industry is still keeping the spirit of patent medicine alive: dietary supplements. In the U.S., vitamins, botanicals, and other supplements are minimally regulated. Some can improve people’s health or address specific conditions, but many, like the medicines of old, contain untested or dangerous ingredients. Nevertheless, three-quarters of Americans take at least one. Some take far more. Robert F. Kennedy Jr., the longtime conspiracy theorist and anti-vaccine activist who’s awaiting Senate confirmation to run the Department of Health and Human Services, has said he takes a “fistful” of vitamins each day. Kennedy has in recent years championed dietary supplements and decried their “suppression” by the FDA—an agency he would oversee as health secretary. Now he’s poised to bring America’s ever-growing supplement enthusiasm to the White House and supercharge the patent-medicine revival.  

The newly created FDA eventually required all pharmaceutical drugs—substances intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease—to be demonstrably safe and effective before they could be sold. But dietary supplements, as we call them now, were never subject to that degree of scrutiny. Vitamins were sold with little interference until the “megadosing” trend of the late 1970s and ’80s, which began after the chemist Linus Pauling started claiming that large amounts of vitamin C could stave off cancer and other diseases. The FDA announced its intention to regulate vitamins, but the public (and the supplement industry) revolted. Mel Gibson starred in a television ad in which he was arrested at home for having a bottle of Vitamin C, and more than 2.5 million people participated in a “Save Our Supplements” letter-writing campaign. Congress stepped in, passing the 1994 Dietary Supplement Health and Education Act, which officially exempted dietary supplements from the regulations that medications are subject to.

Since then, the FDA has generally not been responsible for any premarket review of dietary supplements, and manufacturers have not usually had to reveal their ingredients. “It’s basically an honor system where manufacturers need to declare that their products are safe,” says S. Bryn Austin, a social epidemiologist and behavioral scientist at the Harvard T. H. Chan School of Public Health. The agency will get involved only if something goes wrong after the supplement starts being sold. As long as they disclose that the FDA hasn’t evaluated their claims, and that those claims don’t involve disease, supplement makers can say that their product will do anything to the structure or function of the body. You can say that a supplement improves cognition, for example, but not that it treats ADHD. These claims don’t have to be supported with any evidence in humans, animals, or petri dishes.

In 1994, the dietary-supplement industry was valued at $4 billion. By 2020, it had ballooned to $40 billion. Patent-medicine creators once toured their products in traveling medicine shows and made trading cards that people collected, exchanged, and pasted into scrapbooks; today, supplement companies sponsor popular podcasts, Instagram stories are overrun with supplement ads, and influencers make millions selling their own branded supplements. The combination of modern wellness culture with lax regulations has left Americans with 19th-century-like problems: Pieter Cohen, an associate professor of medicine at Cambridge Health Alliance, has found a methamphetamine analogue in a workout supplement, and omberacetam, a Russian drug for traumatic brain injuries and mood disorders, in a product marketed to help with memory.

Last year, Kennedy accused the FDA of suppressing vitamins and other alternative health products that fall into the dietary-supplement category. But “there is no truth about the FDA being at war on supplements over the last several decades,” Cohen told me. “In fact, they have taken an extremely passive, inactive approach.” Experts have repeatedly argued that the FDA needs more authority to investigate and act on supplements, not less. And yet, Kennedy continues to champion the industry. He told the podcaster Lex Fridman that he takes so many vitamins, “I couldn’t even remember them all.” Kennedy has vocally opposed additives in food and conflicts of interest in the pharmaceutical industry, but has failed to mention the dangerous additives in dietary supplements and the profits to be made in the supplement market. (Neither Kennedy nor a representative from the MAHA PAC responded to a request for comment.)

In an already permissive environment, Kennedy’s confirmation could signal to supplement manufacturers that anything goes, Cohen said. If the little regulation that the FDA is responsible for now—surveilling supplements after they’re on the market—lapses, more adulterated and mislabeled supplements could line store shelves. And Americans might well pour even more of our money into the industry, egged on by the wellness influencer charged with protecting our health and loudly warning that most of our food and drug supply is harmful. Kennedy might even try to get in on the supplement rush himself. Yesterday, The Washington Post reported that, according to documents filed to the U.S. Patent and Trademark Office, Kennedy applied to trademark MAHA last year, which would allow him to sell, among other things, MAHA-branded supplements and vitamins. (He transferred ownership of the application to an LLC in December. Kennedy’s team did not respond to the Post.)

A truly unleashed supplement industry would have plenty of tools at its disposal with which to seduce customers. Austin studies dietary supplements that make claims related to weight loss, muscle building, “cleansing,” and detoxing, many of which are marketed to not just adults, but teenagers too. “Those types of products, in particular, play on people’s insecurities,” she told me. They also purport to ease common forms of bodily or mental distress that can’t be quickly addressed by traditional medical care. Reducing stress is hard, but ordering the latest cortisol-reducing gummy on TikTok Shop is easy. Your doctor can’t force vegetables into your diet, but a monthly subscription of powdered greens can.

Judy Z. Segal, a professor emerita at the University of British Columbia who has analyzed patent-medicine trading cards from the 19th and 20th centuries, told me that supplement-marketing strategies “have not changed that much since the patent-medicine era.” Patent medicines appealed to ambient, relatable complaints; one ad for Burdock’s Blood Bitters asserted that there were “thousands of females in America who suffer untold miseries from chronic diseases common to their sex.” And the makers of patent medicine, like many modern supplement companies, used friendly spokespeople and customer testimonials while positioning their products as preventive care; according to one ad for Hartshorn’s Sarsaparilla, “The first deviation from perfect health should receive attention.”

In 1905, the muckraker Samuel Hopkins Adams lamented that “gullible America” was so eager to “swallow huge quantities of alcohol, an appalling amount of opiates and narcotics, a wide assortment of varied drugs ranging from powerful and dangerous heart depressants to insidious liver stimulants; and, far in excess of all other ingredients, undiluted fraud.” Compounds and elixirs go by different names now—nootropics, detoxes, adaptogens—but if Adams walked down any supplement aisle or browsed Amazon, he’d still find plenty of cure-alls. He could even pick up a bottle of Lydia E. Pinkham’s Herbal Supplement, which is sold as an aid for menstruation and menopause. Pinkham’s face smiles at buyers from the label, though its advertised benefits are now accompanied by a tiny disclaimer: “This statement has not been evaluated by the FDA.”

Yesterday, the United States suffered the first fatal crash of a U.S. airliner in 16 years. American Airlines Flight 5342, a regional jetliner, originated in Wichita, Kansas. Just before landing at Ronald Reagan Washington National Airport in northern Virginia, it collided with a military helicopter over the Potomac River. Scores of people were feared dead late Tuesday. Authorities haven’t yet determined the cause of the collision. The National Transportation Safety Board will lead an investigation, hoping to determine what happened and prevent any similar accidents in the future.

There is no reason to believe that the dramatic changes to the federal government made by the Trump administration, or the chaos they introduced, played any role in this tragedy. But the success of regulators in improving the safety of commercial aviation is among the great triumphs of the last half-century. And in its first week in office, the Trump administration did take one unrelated step that suggests a cavalier disregard for the consequences of politicizing those efforts: it dismissed all of the members of the federal Aviation Security Advisory Committee, a body which advised the Transportation Security Administration.

“The aviation security committee, which was mandated by Congress after the 1988 PanAm 103 bombing over Lockerbie, Scotland, will technically continue to exist but it won’t have any members to carry out the work of examining safety issues at airlines and airports,” the Associated Press reported last week. “Before Tuesday, the group included representatives of all the key groups in the industry — including the airlines and major unions — as well as members of a group associated with the victims of the PanAm 103 bombing. The vast majority of the group’s recommendations were adopted over the years.”

My colleague James Fallows, a longtime pilot who has reported on aviation for decades, noted yesterday that dismantling the committee one week ago “wasn’t part of tonight’s tragedy,” but argued that it is a thoughtless destruction of a taken-for-granted institution that will erode safety over time, when the United States should instead be conserving the gains of recent decades. Pointing his readers to a list of the board’s former members, Fallows wrote that it “was collaborative; it combined public, private, military, civilian, academic, and other institutions to pool knowledge; it avoided blame; but it focused relentlessly on lessons learned.”

I favor a smaller federal government, and will likely cheer some cuts that the Trump Administration makes. My hope is for a bureaucracy that does fewer things and does them well.

But aviation safety in America is the envy of the world––it’s among the few things that was working well, having improved significantly in recent decades under a status quo that Trump is disrupting. To what end? Perhaps the Trump administration has some compelling rationale that it hasn’t shared for disbanding the Aviation Security Advisory Committee. If so, it should speak up.

Instead, a Department of Homeland Security official offered a vague and unpersuasive statement to Aviation International News: “The Department of Homeland Security will no longer tolerate any advisory committee which pushes agendas that attempt to undermine its national security mission, the President’s agenda, or Constitutional rights of Americans,” he said.

Congress should demand better answers, for the sake of the due diligence that airline safety warrants, and because stripping a mandated board of all its members would seem to thwart its legitimate power with a technicality. If Congress judges that the board is still useful, it should use the power of the purse to force its restoration, rather than giving in to the president.

Will Republicans, who hold a majority in the House and the Senate, jealously guard the legislature’s powers and diligently discharge its oversight responsibilities? Perhaps not. Deferring to presidents from one’s own party is a bipartisan sin, however derelict it makes legislators in their duties. While Trump undoubtedly has a popular mandate for aspects of his agenda, however, no voter sent him to Washington to end an aviation safety committee. He is owed no deference on that move.

Trump is making a lot of changes very quickly. If GOP legislators won’t probe this one to see if it is arbitrary or ill-considered, it’s hard to imagine what will spur them to exercise their oversight responsibilities––after all, most members of Congress are frequent flyers.

President Donald Trump intended his flood of executive orders to shock and awe his opponents. But on Monday night, a memo from the Office of Management and Budget instead shocked the Trump White House.

That memo, with its call for a “temporary pause” to all federal-government grants and loans, set off widespread panic and confusion within the federal government and among the millions of individuals and institutions reliant on federal funds. But it was released without going through the usual White House approval processes.

The memo was produced by the budget office alone, which failed to get proper sign-off from the White House, according to a senior White House official and a second person familiar with the memo. The team headed by Trump’s deputy chief of staff for policy, Stephen Miller, had requested to see the memo before it went out, but OMB never sent it over, these people said.

As a result, the White House was caught off guard as the memo sparked the sort of chaos that Trump’s team had hoped would be a vestige of his first term. Within 48 hours, OMB was forced to rescind the memo.

After the memo was initially released, White House staffers—knowing they faced a communications problem, if not also a policy one—prepared White House Press Secretary Karoline Leavitt to handle questions on the funding freeze at her inaugural briefing yesterday.

As anticipated, reporters peppered her with questions about which federal programs might be affected by the freeze. “I have now been asked and answered this question four times,” a slightly exasperated Leavitt said. “To individuals at home who receive direct assistance from the federal government: You will not be impacted by this federal freeze.”

In response to the confusion, OMB sent out a clarification memo yesterday, insisting that the pause did “not apply across-the-board” and was intended to affect programs from the Biden administration that were not in sync with Trump’s day-one executive orders, such as DEI initiatives and “the green new deal”—which Republicans use as a catchall term for climate programs.

But if the OMB memo was not properly vetted, it should not have come as a complete surprise. A slide deck labeled “Office of Management and Budget” that outlines priorities and goals in line with Trump’s agenda—marked “confidential,” bearing the seal of the executive office of the president, and dated January 2025—has been circulating on Capitol Hill. The presentation, focused on what it calls “regulatory misalignment,” presents columns of problems paired with actions intended to address them.

The Impoundment Control Act of 1974, for instance, is listed as a problem because it undermines the president’s ability “to ensure fiscal responsibility.” The suggested action is restoring “impoundment authority” by challenging the act’s constitutionality in court. Both Trump and Russell Vought, his nominee to lead the budget office, have argued that the Watergate-era law—which generally prevents the executive branch from spending less than what Congress has appropriated for various programs and purposes—is unconstitutional.

Another problem, according to the presentation, is that “existing legal interpretations protect entrenched bureaucratic practices.” To solve that, it calls for the appointment of “a bold General Counsel at OMB with a mandate to challenge outdated legal precedents that protect the status quo.”

An OMB spokesperson, Rachel Cauley, told me that, despite outlining in detail many steps that Trump actually took once in office, the slide deck was not the work of Trump’s incoming team. “Trump officials have never seen this document before and it’s pretty apparent it was generated before Trump was in office,” Cauley wrote to me in a text message.

But whatever its origin, the slide deck seems to have been oddly prophetic. The source familiar with the OMB memo that touched off so much controversy this week said that it had been drafted by Mark Paoletta, who was appointed by Trump as the agency’s general counsel. OMB declined to comment on that claim.

Even after OMB rescinded its Monday memo, confusion reigned. This afternoon, Leavitt tried to clarify things with a post on X: “This is NOT a rescission of the federal funding freeze,” she wrote. “It is simply a rescission of the OMB memo.”

Her post did little to resolve the lingering questions surrounding federal funds, but made it perfectly clear how the White House now feels about the memo.

Put on the spot, a lot of Americans might hesitate over the difference between Medicaid and Medicare. People who aren’t affected by one of these programs, which together enroll about 150 million people in the U.S., don’t generally have a need to be well versed in their intricacies, and the two programs sound quite similar. The names don’t really hint that Medicare is a federal program that covers older Americans and Americans with disabilities, and that Medicaid covers low-income people in the United States.

Most Americans, though, are not nominated to become secretary of the Department of Health and Human Services. Robert F. Kennedy Jr. is. And yet today, at his confirmation hearing before the Senate Finance Committee, he made clear that he also does not know very much about Medicare and Medicaid.

As HHS secretary, Kennedy would oversee a suite of government agencies, including the FDA, CDC, and National Institutes of Health, that are focused on improving American health. He also would oversee the Centers for Medicare and Medicaid Services, which, as the name implies, manages those two programs. HHS services, in other words, touch the lives of every American—and Medicaid and Medicare are, in particular, two of the most common ways for people to directly benefit from the government’s services.

During the three-and-a-half-hour hearing, in which the Senate committee pressed Kennedy on a range of issues—his anti-vaccine views, endorsements of conspiracy theories, stance on abortion, potential financial conflicts—senators grilled Kennedy on various aspects of the two government programs. In his new role, Kennedy could be charged with overseeing substantial changes to one of them. Donald Trump has pledged to preserve Medicare. He has made no such promise about Medicaid, which health-policy experts anticipate may be targeted for spending cuts. (On Tuesday, Medicaid reimbursement portals abruptly stopped working after the Trump administration ordered a freeze on federal grants and loans; states have since regained access to the portals.) Some Republicans have argued that an increased focus on public-health insurance in the U.S. won’t make Americans healthier, and Kennedy appeared to echo that viewpoint today when he criticized Medicaid, saying “our people are getting sicker every single year,” and lamented the program’s expansion to people with higher incomes. “The poorest Americans are now being robbed,” he said.

But Kennedy also seemed to mix up the two programs when he described them. Part of the issue with Medicaid, he said, is that “the premiums are too high, the deductibles are too high.” The majority of people enrolled in Medicaid don’t pay premiums or deductibles; federal law actually prohibits premiums for the program’s lowest-income enrollees. (He did seem better versed in Medicare Advantage, a program that provides private insurance coverage for older Americans and that he himself is enrolled in.)

To be fair, Kennedy was in a high-pressure situation. But being HHS secretary is a high-pressure job. Kennedy had time to prepare in advance of today’s hearing. If confirmed, he won’t need to master every minute detail of Medicare and Medicaid, but he will need to be able to navigate both programs—their differences, their weaknesses, and how they might evolve. People who are eligible for both programs, for instance, have created sticking points in the health-care system, in part because coordinating coverage between the two is difficult and can complicate care. When pressed by Senator Bill Cassidy of Louisiana on how to deal with that issue, Kennedy suggested that the programs should be “consolidated” and “integrated”—but when asked how that might happen, said, “I’m not exactly sure.”

Kennedy struggled with other policy specifics, too. One of his goals, Kennedy said, is to fulfill Trump’s directive to improve the quality of care and lower the price of care for all Americans. But he was vague on any plans to reform Medicaid, explaining that he’d “increase transparency” and “increase accountability.” When pushed by Cassidy to clarify, Kennedy said, “Well, I don’t have a broad proposal for dismantling the program.”

Nor did Kennedy have a clear sense of how he would approach one of the more contentious and legally sensitive health questions of the past few years: whether women whose lives are threatened by pregnancy should be able to receive emergency abortions under EMTALA, the law that requires emergency rooms that receive Medicare funding to provide care to anyone in a life-threatening situation. The Biden administration argued that this federal law supersedes state abortion bans, and in 2024, after the Supreme Court demurred on the issue, the administration made clear to doctors, in a letter co-authored by Health and Human Services Secretary Xavier Becerra, that abortions could qualify as emergency treatment. Kennedy admitted this morning that he didn’t know the scope of the authority he’d have to enforce the law in his new job.

Jacinda Abdul-Mutakabbir, a clinical pharmacist at UC San Diego, told me that Kennedy's apparent failure to understand the intricacies of the two programs wasn’t just a harmless fumble. If the health secretary is not well versed in the programs he’s tasked to run, he might not appreciate the impacts of his decisions. Should health coverage for some of the most vulnerable Americans be altered—perhaps even taken away—then health disparities in this country would likely widen. And if any part of his agenda does include increasing transparency, as Kennedy described in today’s hearing, expertise will have to be a prerequisite. “You can’t increase transparency on something you don’t have clarity on,” Abdul-Mutakabbir told me. (Kennedy’s press team did not immediately return a request for comment on his performance at today’s hearing.)

During the hearing, Kennedy’s more radical views on vaccines and infectious disease did come up. He copped to describing Lyme disease as “highly likely a militarily engineered bioweapon.” (The bacterium, which has been around for at least tens of thousands of years, is not.) He stood by his assertion that the measles vaccine killed two children in Samoa in 2018. (The vaccine did not; those children died following the administration of an improperly mixed vaccine by two nurses who were ultimately sentenced to five years in prison for the act.) He said that young children are at “basically … zero risk” from COVID-19. (Young children are at risk, especially babies under six months of age, who have similar hospitalization rates from the disease as adults 65 to 74 years old.) Kennedy’s falsehoods about infection and immunity were already well known, though. What the country learned today was that he may lack basic competency in some of the most wide-reaching aspects of his future job—and didn’t take the time to prepare answers for Congress, which he’ll ultimately have to answer to.

The great federal-grant freeze of 2025 is over, but don’t expect it to be gone for good.

The Office of Management and Budget, which issued a memo freezing grants on Monday, has revoked it, The Washington Post first reported. The whole thing went so fast that many people may have never had a chance to sort out what was happening. Yesterday, amid widespread confusion about what the order did or didn’t do, White House Press Secretary Karoline Leavitt was unable to answer specific questions about it. State and local officials of both parties were bewildered, and yesterday afternoon, a federal judge blocked the order. Today, OMB folded—at least for now. The White House says that it has withdrawn the grant freeze in the memo, but not the executive orders mentioned in it, some of which assert a freeze on spending. Part of the goal appears to be to short-circuit court proceedings that might produce an unfavorable ruling.

This episode resembles the incompetent fumbling of the first Trump administration, especially its earliest days. But this was no fluke and no ad hoc move. It’s part of a carefully thought-out program of grabbing power for the executive branch, and this week’s drama is better understood as a battle over priorities within the Republican Party than as unmanaged chaos.

The abortive grant freeze is an example of the second Trump administration’s strategy to drastically deploy executive power as part of a bigger, and somewhat paradoxical, gambit to shrink the federal government as a whole. “The great challenge confronting a conservative President is the existential need for aggressive use of the vast powers of the executive branch to return power—including power currently held by the executive branch—to the American people,” the current OMB head, Russell Vought, wrote in Project 2025, the blueprint for a conservative administration convened by the Heritage Foundation, a Trump-aligned right-wing think tank. The strategy is to seize power and dare both Congress and the courts to stop it. This tactic is unpredictable, as this week’s misadventures show, but it’s also relatively low-risk. The ideologues inside the administration want to see what they can get away with, and if it doesn’t work, so be it.

[Read: ‘It’s an illegal executive order. And it’s stealing.’]

But the administration has other staffers who are more responsive to politics. President Donald Trump, for example, has relatively weak ideological commitments. The court injunction yesterday was a nuisance, but what really seems to have done in the freeze was the backlash—not so much from the public, but from state and local officials, including many Republicans, who were outraged about the withdrawal of funds and lack of communication. The political team won this round over the ideologues, but there will be more.

At a mechanical level, the fight over the freeze was a battle over impoundment, the power of the executive branch to not spend money appropriated by Congress. Federal law on this is as settled as any: A law passed in 1974 prevents impoundment, except in cases where the president seeks permission from Congress. But Trump and some of his aides argue that that law is unconstitutional.

In a letter to Congress in the last days of the first Trump administration, Vought (then the head of OMB) wrote that the law “is unworkable in practice and should be significantly reformed or repealed.” In September, the attorney Mark Paoletta co-wrote a report for Vought’s nonprofit, the Center for Renewing America, arguing that the power of impoundment was constitutional; Trump has now appointed Paoletta the general counsel of OMB, a position he also held in Trump’s first administration. And as my colleague Russell Berman reported yesterday, Vought refused to commit to abiding by the Impoundment Control Act during his confirmation hearings. And Vought and his allies had a plan for how to knock it down.

“President Trump will take action to challenge the constitutionality of limits placed on the Impoundment Power,” the Trump presidential campaign said—in other words, he planned to disobey the law, litigate any challenges, and hope to get a favorable ruling from the Supreme Court. It’s worked in the past.

This all goes to show that sometimes the chaos has a strategy behind it. Things just didn’t shake out the way Vought’s crew had hoped this time.

One curiosity is why the administration wouldn’t just try to go through Congress to rescind funding passed during Joe Biden’s presidency. After all, Republicans now control both the House and Senate. The White House might have a few reasons for wanting to do it on its own. First, legislation is slow, and Trump prefers to show results fast. Second, Republican margins are narrow, and although GOP elected officials and voters favor cuts in the abstract, they don’t always favor cuts to particular things that voters like, so the White House might struggle to get even the requisite simple majority to rescind some of the spending it tried to freeze this week. Third, impoundment per se is not the only goal—it’s also a means to the ideological end of seizing power for the executive branch.

In Project 2025, Vought laments that Congress has yielded too much power to the presidency. “The modern conservative President’s task is to limit, control, and direct the executive branch on behalf of the American people. This challenge is created and exacerbated by factors like Congress’s decades-long tendency to delegate its lawmaking power to agency bureaucracies,” he wrote. Paradoxically, his plan for limiting the executive branch is to give it more muscle.

[Jonathan Chait: Trump’s second term might have already peaked]

As if to prove Vought’s point about congressional deference, Speaker Mike Johnson has backed the White House thus far. Just a decade ago, conservatives were furious that then-President Barack Obama was using executive orders to do things that congressional Democrats had failed or declined to do. Now the use of much more radical executive orders is the first recourse of the Republican president.

Because this effort is core to the ideological agenda of Project 2025 principals such as Vought, the revocation of this executive order likely won’t be the last effort we see along these lines. And having to back down for political reasons tends to make the internal battles only fiercer. Trump’s attempts to decimate the civil service and clear out career bureaucrats are well known, but Project 2025’s authors reserved special animus for those whom they expected to be on their side during the first Trump administration.

“I had a front-row seat on many of these issues and importantly [saw] how bad thinking would end up preventing what we were trying to accomplish, from less-than-vigorous political appointees who refused to occupy the moral high ground, particularly in the first two years of the president's administration,” Vought said in a 2023 speech. He has no intention of letting that happen again.

The first 10 days of Donald Trump’s presidency have seen such an onslaught of executive orders and implementing actions that Steve Bannon’s strategy to “flood the zone with shit” seems apt. But that characterization is incomplete, and it obscures a more frightening truth: The Trump administration’s actions have been not just voluminous but efficient and effective. Though Trump himself may not appreciate the depth of detail that has gone into these early days, his allies do appear to understand what they are doing, and they seem to have his unquestioning consent to do whatever they like.  

And what they want is very clear: to take full control of the federal government. Not in the way that typifies every change of administration but in a more extreme way designed to eradicate opposition, disempower federal authority, and cause federal bureaucrats to cower. It is an assault on basic governance.

A great deal of thought has gone into this effort already. The executive orders and sundry administrative directives and guidance that have been issued reflect a profound understanding of the federal government and exactly where the weak spots within the bureaucracy might lie.

Read: The strategy behind Trump’s policy blitz

Consider, as a first example, the order that reassigned 20 senior career lawyers within the U.S. Department of Justice. Because of their career status, they could not be unilaterally fired, but Trump’s team did the next best thing by reassigning them to a newly created “Sanctuary Cities” task force. With one administrative act, the senior leaders of public-integrity investigations, counter-intelligence investigations, and crypto-currency investigations—individuals with immense experience in criminal law—were taken off the board and assigned to a body that is, apparently, tasked with taking legal actions against cities that do not assist in Trump’s immigration crackdown. Their former offices were effectively neutered.

As my friend, the former federal prosecutor Randall Eliason, put it: “These are career people. They are not political. They are people who have been in these positions often many, many years or even decades. They have developed a real expertise, and that’s a great resource for the government.” A resource that is now lost.

But this is not merely an attack on expertise. This maneuver has a further effect: to disable opposition. Career employees with this degree of expertise and experience are exactly the type who would embody institutional norms and, thus, exactly the sort who could be expected, in their own way, to form a bulwark of institutional resistance to Trumpian excess. Moreover, three of the prosecuting sections of the DOJ that have been disrupted—public integrity (an anti-corruption unit), counterintelligence (combatting foreign influence), and crypto crime—are precisely the three units whose oversight might interfere with Trump’s activities, or those of his allies.

The same playbook was also used last week to hamstring environmental enforcement, by reassigning four senior environmental lawyers at the DOJ to immigration matters. The leaders of these four litigating sections are four of the most experienced environmental lawyers in the nation. Additionally, the Trump administration has frozen action on all cases handled by the Justice Department’s Environmental Enforcement Section, with substantial practical disruption. Once again, expertise has been lost and the functionality of government institutions has been significantly impaired, with the inevitable result that companies subject to environmental regulation (including Trump’s big corporate supporters) will be less policed.

One could continue with a number of other examples, whether the wholesale reassignment of 160 staffers at the National Security Council (responsible for coordinating crucial national-security matters at the White House), the reassignment of DOJ civil-rights leadership (enforcing DEI mandates), or the appointment Ed Martin (a January 6 denier) as the United States attorney for the District of Columbia. But the themes are always the same: Long-standing expertise is discarded and institutional effectiveness diminished.  

[Read: Trump can’t escape the laws of political gravity]

More to the point, however, these actions are a “deep cut” reflecting significant planning and intent. The chiefs at DOJ’s public-integrity or environmental-enforcement sections are by no means household names. Nobody outside their immediate ambit of authority would know who they are. And yet the extent of knowledge demonstrated by Trump’s team in reassigning them is extensive. Trump’s team knows which high-value targets might offer internal resistance, and it has removed them.

A second pillar of Trump’s effort to take over the government can be seen in his steps to eliminate any independent oversight of his actions.

Here, the headline is his attempted purge of at least a dozen inspectors general.  Inspectors general, as an institution, are perhaps not so little-known as the DOJ section chiefs who were dismissed, but as individuals, they are mostly anonymous. IGs serve as an internal check on waste, fraud, and abuse at federal agencies. They were created by Congress in the 1970s as a semi-independent authority intended to be insulated from presidential control. They routinely report to Congress and the public about misconduct that they identify for corrective action.

Indeed, Congress so highly values the independence, objectivity, and nonpartisanship of IGs that, following Trump’s first presidency, it passed a law strengthening that independence and limiting a president’s removal authority. No doubt recognizing the threat that independent oversight might pose to his planned actions, Trump’s (possibly illegal) removal order is a frontal assault on the careful monitoring Congress has sought to build into the government

To similar effect, the Trump administration has moved to eliminate the Pentagon’s Civilian Protection Center of Excellence. That relatively obscure office (with a budget of only $7 million and 30 staff), little noticed outside the Army, is intended to study ways of reducing civilian harm during combat. But Trump’s secretary of defense, Pete Hegseth, thinks that “restrictive rules of engagement” make defeating the enemy harder, but the protection of civilians is all about careful rules of engagement. Again, the Trump administration’s action reflects both a substantive desire to diminish oversight and a depth of bureaucratic knowledge that is extensive.

That depth can also be seen in Trump’s announced intention to fire three Democratic members of the Privacy and Civil Liberties Oversight Board. The PCLOB is an independent bipartisan oversight board reviewing executive-branch law-enforcement and intelligence surveillance activities. Yet, despite its crucial internal importance, the PCLOB is hardly a well-known institution. Save for those, like me, who work in that field, few, if any, outside observers could likely define the board’s role or name its members.

[Jonathan Chait: Trump’s second term might have already peaked]

And still, Trump’s team knew enough to identify an ingenious way of neutering the board. As an independent, statutorily created agency, it could not be eliminated. But the board does require a quorum to operate, and by firing three of its five members this past Monday, Trump effectively eliminated its oversight. As Senator Ron Wyden put it: “By purging the Democratic members of the Privacy and Civil Liberties Oversight Board, Trump is kneecapping one of the only independent watchdogs over government surveillance who could alert Congress and the public about surveillance abuses by his administration.” And he is doing so in a highly sophisticated manner.

Along with large-scale actions to reform government, Trump’s orders included a plethora of small-bore, petty-minded actions designed to implement his personal prejudices and desire for revenge. For example, he has stripped Anthony Fauci of his federal security detail. He has also dismissed Admiral Linda Fagan of the Coast Guard, the only woman who has ever led a military branch, on a transparently inaccurate claim of ineffectiveness. Likewise, he has stripped security protection from Mike Pompeo and John Bolton (both of whom are under affirmative threat from Iran). His administration’s ban on “activist” flags at U.S. embassies would be almost comical if it did not exemplify the coldhearted efficiency at the core of Trump’s new presidency. These actions are petty, but they also reflect the comprehensive nature of his purpose and the extent of his team’s planning.

Were it not so dangerous to democratic norms, the efficiency of these early days would almost be admirable, in the same way that one might admire a well-run play by an opposing football team. But politics is not a game, and this nation’s basic security and functioning are at risk. Those who oppose Trump’s actions do not have an incompetent opponent; Trump’s team is savvy and has been planning for this for years. They came ready.

These days in Washington, D.C., among a class of Extremely Beltway types—the name droppers, the strivers, the media gossips—Donald Trump’s threats to exact revenge on his enemies have turned into a highly specific (and highly absurd) status competition.

Olivia Troye has heard the joke so many times that she already has a well-worn comeback prepared. When nervous journalists and teasing D.C. types crack to Troye—a lifelong Republican who served as former Vice President Mike Pence’s homeland-security adviser before becoming an outspoken Trump critic—that they might end up in adjoining Guantánamo Bay cells, she responds: “I had the Gitmo portfolio, so I can give you some tips.”

In a moment of deep uncertainty in the nation’s capital, where Trump took office promising vengeance but where the scope of his intentions remains nebulous, many of Trump’s known critics have unofficially divided into two adjacent camps: those, like Troye, who have real reason to be alarmed by the president’s threats and are quietly taking steps to protect themselves and their family, and those who are loudly—and often facetiously—chattering about how Trump and his posse might throw them in a gulag. (There are also those in Trump’s orbit who are joking, one hopes, about whom they might throw in the hypothetical gulag.)

Whereas many of those branded most prominently with the scarlet R of Resistance are now eager to stay out of Trump’s sight line, other figures in Washington are actively self-identifying as could-be Trump targets, in a very D.C. show of importance. And often the people talking openly about getting thrown in a gulag likely aren’t even important enough for the gulag.

At one of the many swanky parties in the run-up to Trump’s second inauguration, a White House reporter confessed to me that during a recent meeting in outgoing White House Chief of Staff Jeff Zients’s office, the reporter had—mainly in jest—asked to get on the list for a preemptive pardon. In his final The Late Show episode during the Biden administration, Stephen Colbert also played with the gag, telling his audience, “The next time you all see me, Donald Trump will be president. And you may not see me! Next four years—next four years, we’re taking this one day at a time.”

If the classic “D.C. read” is scanning a book’s index for one’s own name and frantically flipping to the listed pages, then even a mention in Appendix B (“Executive Branch Deep State”) of Government Gangsters, written by Trump’s pick for FBI chief, Kash Patel, can serve as a status symbol in certain circles.

[Read: The sound of fear on air]

“For a lot of people, it’s a joke that is a thinly disguised flex—it’s joking about how important you are,” Tommy Vietor, a co-host of Pod Save America who has been on the receiving end of such jokes many times, told me. “It’s sort of become a standard greeting in a lot of circles: ‘See you in the gulags.’ ‘I hope we get the nice gulag.’”

“Then every once in a while,” he added, “someone makes that joke to someone who is actually scared or has hired a lawyer, and it’s not so funny.”

Tim Miller, a former Republican turned ardent Trump critic who writes for The Bulwark, told me that he not only regularly hears the joke but also sometimes finds himself “reflexively making it,” the way remarking on the weather is an almost involuntary conversational crutch. “And then after I do, just clarifying that I don’t actually think I’m going to the gulag and that there are people who are at real risk from this administration, and we should probably focus on that,” he said.

On Inauguration Day, President Joe Biden issued a handful of preemptive pardons that included five members of his family, lawmakers on the January 6 House committee, and people Trump had threatened, including Anthony Fauci, the nation’s top public-health expert during the coronavirus pandemic, and retired General Mark Milley, whom Trump floated the idea of executing after The Atlantic published a profile of him. Others who have attracted Trump’s ire have both publicly and privately lamented that they were not on Biden’s pardon list.

Rachel Vindman, the wife of Lieutenant Colonel Alexander Vindman—who testified before Congress about a 2019 call between Trump and the Ukrainian president during which Trump asked him to investigate Biden’s son Hunter—posted on social media after Biden’s pardons emerged, “Whatever happens to my family, know this: No pardons were offered or discussed. I cannot begin to describe the level of betrayal and hurt I feel.” Her husband appears in Patel’s appendix.

[Read: In praise of mercy]

In the early weeks of his second presidency, Trump has spoken ambiguously about plans to punish his perceived enemies, though he has already taken steps to root out those in the government he believes are part of the anti-Trump “deep state.” In some ways, the list in Patel’s book is instructive. The appendix mentions prominent figures whom Trump has already put on notice or begun targeting: Biden (“the funny thing—maybe the sad thing,” Trump noted in his first post-inauguration interview, with the Fox News host Sean Hannity, is that Biden failed to pardon himself); Trump’s former national security adviser John Bolton (within hours of taking office, Trump pulled U.S. Secret Service protection from Bolton, who faces threats on his life from Iran); and Fauci (last week Trump also terminated Fauci’s security detail). Yet the list also mentions people such as Elizabeth Dibble and Nellie Ohr, alleged deep staters who are hardly household names and whose alleged offenses are too complicated and obscure to quickly explain.

Patel also previously shared on social media a meme that featured him wielding a chainsaw and buzzing off chunks of a log emblazoned with images of alleged enemies, ranging from “Fake News,” CNN, and MSNBC to people such as Biden, the former Republican lawmaker Liz Cheney, and Representative Nancy Pelosi, the former Democratic House speaker.

Just before Election Day, the longtime Trump fundraiser Caroline Wren shared an X post from an Arizona reporter, writing, “He should be the first journalist sent to the gulag.” She later said she was joking. Mike Davis, one of Trump’s most vocal outside legal defenders, has led the unofficial social-media brigade threatening to toss reporters and other perceived enemies into the “gulag,” statements he described to The Washington Post as a “troll” to nettle the left.

But now that Trump, back in the Oval Office, continues to display a willingness to punish those who have crossed him, this sort of declaration from Trump allies can take on a more menacing edge. On Inauguration Day, Davis unleashed more than a dozen posts on X that, depending on the perspective, could be read as trolls or threats. “Dear Congress: We need a supplemental to feed the Vindmans in federal prison,” he wrote in one. “Dear Tony Fauci: Roll the dice. Decline the pardon. And see what happens,” read another. And in a third, using a format he repeated for many of Trump’s enemies, he addressed Biden’s former Homeland Security secretary by name, writing, “Dear Alejandro Mayorkas: No pardons for you and your staff?”

“Nobody is above the law,” Davis said, when I called to ask him about his public posts. “If they’ve done nothing wrong, they have nothing to worry about, and if they’ve done nothing wrong, why did they need a pardon?”

Some of those squarely in the sights of Trump and his allies have begun taking steps to protect themselves. Troye, for instance, has retained a lawyer, and recently made sure that she and her family members had up-to-date passports. Rachel Vindman, meanwhile, told me that she and her family moved from Virginia to Florida two years ago—uprooting their daughter in the middle of sixth grade—in part because they “wanted to live somewhere a little bit more anonymous.” (She was also, she added, ready to leave the D.C. bubble and eager for a “fresh start.”)

[Read: Trump’s first shot in his war on the ‘deep state’]

In many ways, the fear that the mere prospect of retribution has struck in Trump’s opponents—prompting them to hire personal security or nervously bluster about the gulags—could be victory enough for MAGA world. After winning reelection, Trump posted on social media a list of out-of-favor individuals and groups—including “Americans for No Prosperity,” “Dumb as a Rock” John Bolton, and Pence, his former vice president—and said that prospective administration hires should not bother applying if they had worked with or were endorsed by anyone on the list.

“That’s the financial gulag,” one person told me, speaking anonymously because he has worked for three of the people or entities on Trump’s list, and doesn’t want his business to be blackballed. “It’s not quite a gulag, but it does have a chilling effect.”

Similarly, those who did not receive pardons from Biden worry about the financially daunting task of protecting themselves. “Did you not think of the people who are about to get destroyed, who defend themselves, who have no congressional coverage, who are not politicians, who are not millionaires, who don’t have dozens of PACs that are protecting them?” Troye asked. “There are people who worked on government salaries.” (A Biden spokesperson declined to comment on Biden’s relatively selective set of pardons.)

Vindman, who lived in Russia for several years, said that although no one knows exactly what to expect in Trump’s second term, her experience in Moscow might offer a glimpse: Colleagues policed themselves, and other Russians proactively took actions they believed would please Russian President Vladimir Putin.

“It was never a direct ask,” she told me. “It was a more tacit thing.”

[Read: Trump targets his own government]

Vindman, who has friends who regularly check in on her, said she spent Election Night wide awake. Her husband was in Virginia with his twin brother, Eugene Vindman, a Democrat the state’s suburban voters elected to the House, and the task of telling her daughter that Trump had won fell to her. “The hardest part of that was laying in bed awake, worrying,” she said. “She’s in eighth grade, and maybe the last four years of her with us will be marred by that, by this harassment.”

When, over the Thanksgiving holiday, Trump’s close ally Elon Musk accused Alexander Vindman of “treason,” warning that “he will pay the appropriate penalty,” Rachel Vindman told me that her immediate concern was for her in-laws and her 98-year-old grandmother, who heard the comment and worried on her family’s behalf.

But personally, Vindman said she is working to find daily joy and maintain a sense of normalcy for herself and her family. Her husband recently turned his masters thesis into a book, The Folly of Realism, coming out at the end of February. When I asked her if she ever considered urging him not to publish, because it would thrust their family back into public view, she was emphatic: “Do you just say no to it because it might anger them or put you in the spotlight?” she asked. “It’s that kind of quiet defiance of living your life.”

“It could be a mistake. I guess we’ll never know.” She paused, then added, “Well, I guess we will know.”

Shortly after birth, newborns in the United States receive a few quick procedures: an Apgar test to check their vitals, a heel stick to probe for genetic disorders and various other conditions, and in most cases, a hepatitis B vaccine. Without that last one, kids are at risk of getting a brutal, and sometimes deadly, liver condition. Senator Bill Cassidy of Louisiana happens to know quite a lot about that. Before entering Congress in 2009, he was a physician who has said he was so affected by an 18-year-old patient with liver failure from the virus that he spearheaded a campaign that vaccinated 36,000 kids against hepatitis B.

Cassidy, a Republican, will now play a major role in determining the fate of Robert F. Kennedy Jr., Donald Trump’s pick for health secretary, whose confirmation hearings begin today on Capitol Hill. Kennedy has said that the hepatitis B vaccine is given to children only because the pharmaceutical company Merck colluded with the government to get the shot recommended for kids, after the drug’s target market (“prositutes and male homosexuals,” by Kennedy’s telling) weren’t interested in the shot. Kennedy will testify in front of the Senate Finance Committee, where Cassidy and 26 other senators will get the chance to grill him about his views. Though it might seem impossible for an anti-vaccine conspiracist to gain the support of a doctor who still touts the work he did vaccinating children, Cassidy has not indicated how he will vote. Similar to the Democratic senators who have come out forcefully against Kennedy, Cassidy, in an interview with Fox News earlier this month, said that RFK Jr. is “wrong” about vaccines. But he also said that he did agree with him on some things. (Cassidy’s office declined my request to interview the senator.)

That Kennedy even has a chance of winning confirmation is stunning in its own right. A longtime anti-vaxxer with a propensity for far-fetched conspiracy theories, RFK Jr. has insinuated that an attempt to assassinate members of Congress via anthrax-laced mail in 2001 may have been a “false flag” attack orchestrated by “someone in our government” to gin up interest in the government preparing for potential biological weapon threats. He has claimed that COVID was “targeted to attack Caucasians and Black people,” and that 5G is being used to “harvest our data and control our behavior.” He has suggested that the use of antidepressants might be linked to mass shootings. Each one of these theories is demonstrably false. The Republican Party has often found itself at war with mainstream science in recent years, but confirming RFK Jr. would be a remarkable anti-science advance. If Republican senators are willing to do so, is there any scientific belief they would place above the wishes of Donald Trump?

A number of Republicans have already signaled where they stand. In the lead-up to the confirmation hearings, some GOP senators have sought to sanewash RFK Jr., implying that his views really aren’t that extreme. They have reason to like some of what he’s selling: After the pandemic, many Republicans have grown so skeptical of the public-health establishment that Kennedy’s desire to blow it up can seem enticing. And parts of RFK Jr.’s “Make America Healthy Again” agenda do in fact adhere to sound scientific evidence. His views on how to tackle America’s epidemic of diet-related diseases are fairly well reasoned: Cassidy has said that he agrees with RFK Jr.’s desire to take action against ultra-processed foods. Kennedy appears to have won over the two other Republican doctors on the committee, Senators Roger Marshall of Kansas and John Barrasso of Wyoming. Marshall has been so enthusiastic about Kennedy’s focus on diet-related diseases that he has created a “Make America Healthy Again” caucus in the Senate. Although Barrasso hasn’t formally made an endorsement, he has said that Kennedy would provide a “fresh set of eyes” at the Food and Drug Administration. (Spokespeople for Barrasso and Marshall did not respond to requests for comment.)

[Read: Everyone agrees Americans aren’t healthy]

Meanwhile, Kennedy appears to have gone to great lengths to sand down his extremist views and present himself as a more palatable candidate. “He told me he is not anti-vaccine. He is pro–vaccine safety, which strikes me as a rational position to take,” Senator John Cornyn of Texas told Politico. He has also done more to drum up unnecessary fear about COVID shots than perhaps anyone else in the country. Nearly four years ago, Kennedy petitioned the federal government to revoke authorization for the shots, because “the current risks of serious adverse events or deaths outweigh the benefits.” (COVID shots are highly safe and effective. A spokesperson for Kennedy did not respond to a request for comment.)

Especially on the right, Kennedy’s conspiracy theories have not consumed his candidacy: With concerns about conflicts of interest, his support of abortion, and generally strange behavior (such as dumping a dead bear in Central Park), there is much to debate. If Republican senators skirt around his falsehoods during today’s confirmation hearings, it will be evidence of their prevailing capitulation to Trump. And it also may be a function of Kennedy’s rhetorical sleights. As Benjamin Mazer recently wrote in The Atlantic, Kennedy is not simply a conspiracy theorist, but an excellent one. He’s capable of rattling off vaccine studies with the fluency of a virologist, which boosts his credibility, even though he’s freely misrepresenting reality.

[Read: RFK Jr. is an excellent conspiracy theorist]

During his recent appearance on Joe Rogan’s podcast, Kennedy claimed that thimerosal, a preservative containing mercury used to protect vaccines from contamination, was found to cause “severe inflammation” in the brain of monkeys. Kennedy was able to quickly name the lead author and introduce the methods as if he has read the study hundreds of times. But Kennedy’s central claim—that the brains of monkeys given thimerosal were severely inflamed—is a “total misrepresentation” of the study, its lead author, Thomas M. Burbacher, told me. The problem is that Kennedy gets away with these claims because very few listeners are going to log onto PubMed to track down the study Kennedy is referencing, let alone read through the entire thing.

In theory, senators should be equipped to push back on his schtick. RFK Jr.’s positions are hardly a mystery, and senators have advisers to help them prepare for such hearings. Regardless of Kennedy’s pseudoscientific beliefs, some Republicans may support him simply because they are wary of bucking their president. Before Kennedy even makes it to a full vote from the Senate, he has to receive approval from the Senate Finance Committee: Given the tight margins in the committee, Kennedy can’t afford to lose a single vote from Republicans sitting on that panel, assuming that no Democrats support his nomination. I reached out to the offices of seven Republican senators on the committee who haven’t already backed Kennedy for clarity on where they stand; none of them gave me a straight answer on how they’d vote.

In all likelihood, the first big decision in Kennedy’s nomination will fall to Cassidy. He has proved willing to oppose Trump before. Cassidy was one of seven Republicans who voted to convict Trump during his second impeachment proceedings. That led Louisiana’s Republican Party to formally censure him, and has drawn him a primary challenger for his 2026 reelection bid. Although Cassidy criticized Trump during the 2024 campaign, he now seems eager to support him. “Today, the American people start winning again,” Cassidy wrote in a statement on Inauguration Day.

Perhaps Cassidy will still dissect Kennedy’s views with the precision of a surgeon’s scalpel. He likes to dive deep into health-care minutiae any chance he gets. (I would know: He once pulled out his iPad and lectured me and other reporters about some arcane drug-pricing policy.) But if today’s meeting is full of softball questions, it could put RFK Jr. on his way to confirmation. That would send a message that, science-wise, the Senate is willing to cede all ground. Trump could pursue the most radical parts of the Project 2025 agenda, such as splitting up the CDC, or Kennedy could launch a full-blown assault on vaccines—and the Senate would be in a much less powerful position to stop it even if it wanted to. If senators hand the keys of a nearly $2 trillion health-care agency to a known conspiracy theorist, anything goes.

Buried within one of the dozens of executive orders that President Donald Trump issued in his first days in office is a section titled “Terminating the Green New Deal.” As presidential directives go, this one initially seemed like a joke. The Green New Deal exists mostly in the dreams of climate activists; it has never been fully enacted into law.

The next line of Trump’s order, however, made clear he is quite serious: “All agencies shall immediately pause the disbursement of funds appropriated through the Inflation Reduction Act of 2022 or the Infrastructure Investment and Jobs Act.” The president is apparently using “the Green New Deal” as a shorthand for any federal spending on climate change. But the two laws he targets address much more than that: The $900 billion IRA not only funds clean-energy programs but also lowers prescription-drug prices, while the $1.2 trillion bipartisan infrastructure law represents the biggest investment in roads, bridges, airports, and public transportation in decades. And the government has spent only a portion of each.

In one sentence, Trump appears to have cut off hundreds of billions of dollars in spending that Congress has already approved, torching Joe Biden’s two most significant legislative accomplishments. The order stunned even some Republicans, many of whom supported the infrastructure law and have taken credit for its investments.

And Trump didn’t stop there. Yesterday, the White House ordered a pause on all federal grants and loans—a move that could put on hold an additional tens of billions of dollars already approved by Congress, touching many corners of American life. Democrats and government watchdogs see the directives as an opening salvo in a fight over the separation of powers, launched by a president bent on defying Congress’s will. “It’s an illegal executive order, and it’s stealing,” Representative Rosa DeLauro of Connecticut, the top Democrat on the House Appropriations Committee, told me, referring to the order targeting the IRA and infrastructure law.

Withholding money approved by Congress “undermines the entire architecture of the Constitution,” Democratic Senator Chris Van Hollen of Maryland told me. “It essentially makes the president into a king.” Last night, Senate Minority Leader Chuck Schumer said that Trump’s freeze on federal grants and loans “blatantly disobeys the law.”

The Constitution gives Congress the so-called power of the purse—that is, the House and the Senate decide how much money the government spends and where it goes. Since 1974, a federal law known as the Impoundment Control Act has prohibited the executive branch from spending less than the amount of money that Congress appropriates for a given program or purpose. During Trump’s first term, the nonpartisan Government Accountability Office found that the administration had violated that law by holding up aid to Ukraine—a move that became central to Trump’s 2019 impeachment.

[Jonathan Chait: Trump’s second term might have already peaked]

Trump has argued that the Impoundment Control Act is unconstitutional, and so has his nominee for budget director, Russell Vought, who had the same job at the end of the president’s first term. Vought also helped write Project 2025, the conservative-governing blueprint that attracted so many attacks from Democrats that Trump disavowed it during the campaign.

In his Senate confirmation hearings this month, Vought repeatedly refused to commit to abiding by the impoundment act even as he acknowledged that it is “the law of the land.” “For 200 years, presidents had the ability to spend less than an appropriation if they could do it for less,” he told senators at his first hearing. During his second appearance, when Van Hollen asked him whether he would comply with the law, Vought did not answer directly. “Senator, the president ran against the Impoundment Control Act,” he replied. His defiance astonished Democrats. “It’s absolutely outrageous,” Van Hollen told me.

The pause on funds for the Biden-signed laws did not draw as much attention as other moves Trump made on his first day back in the White House, especially his blanket pardons for January 6 defendants. Nor was it the only one that appeared to test the limits of his authority. A separate executive order froze nearly all foreign aid for 90 days, while others targeted birthright citizenship and civil-service protections for federal employees.

But the order cutting off spending for the IRA and the infrastructure law could have far-reaching implications. State and municipal governments in both Democratic and Republican jurisdictions worry that they may not be able to use investments and grants that the federal government promised them. “It’s creating chaos,” DeLauro said. “I honestly don’t think the people who are dealing with this know what they are doing.” She listed a range of popular and economically significant programs that appear to be on pause, including assistance for home-energy bills and money to replace lead pipes that contaminate drinking water.

“It was alarming,” Representative Don Bacon of Nebraska told me. Bacon, a Republican who narrowly won reelection in a district Trump lost, called the White House after reading the text of last week’s executive order to seek assurance that money he’d secured for Nebraska—including $73 million to upgrade Omaha’s airport—wouldn’t be stopped.

The immediate confusion became so intense that a day after Trump signed the order, the White House issued a memo seeking to clarify its scope that seemed to slightly narrow its impact and open the door for some spending to continue. Bacon told me that he was assured the directive applied mostly to Biden’s electric-vehicle mandate, which Trump railed against on the campaign trail and is part of the IRA. DeLauro, however, said the memo offered little clarity: “Everything is at risk.”

Yesterday’s memo extending the funding pause to all federal grant and loan programs set off another frenzy. The directive sought to exempt Medicare and Social Security recipients, as well as other direct aid to individuals. But according to a copy of the memo published by The Washington Post, it explicitly targets “financial assistance for foreign aid, nongovernmental organizations, DEI, woke gender ideology, and the green new deal.”

Whether the funding pause constitutes an illegal impoundment is unclear. The executive branch does have some latitude in how it spends money. And yesterday’s memo instructs federal agencies to halt funding only “to the extent permissible under applicable law.” Describing last week’s order targeting the IRA and infrastructure law, Vought told senators that it was merely a “programmatic delay,” a term that arguably falls within what federal departments are allowed to do.

More broadly, executive orders are frequently less consequential than they appear, Nicholas Bagley, a law professor at the University of Michigan and occasional Atlantic contributor, told me about last week’s directive. “It’s one thing to try to get a really nice headline for cutting back on government spending. It’s another thing altogether to decline to spend money that people are expecting you to spend,” Bagley said. “I would not be surprised if rhetoric does not match reality.”

To Charlie Ellsworth, a senior adviser with the nonprofit watchdog Congressional Integrity Project, Trump’s executive order on clean energy unmistakably oversteps the law. “They could have done this legally, but they didn’t,” Ellsworth, a former Schumer aide, told me. A new administration, for example, could have justified a pause in spending to ensure that a program was being funded in accordance with the law. But the order instead instructs agencies to ensure that the spending aligns with new policies set by the Trump administration. Ellsworth said that the order is “self-evidently” illegal.

The fight is almost certain to wind up in the courts, which have repeatedly ruled against the president’s ability to withhold funds appropriated by Congress. Indeed, Vought’s Senate testimony seemed to invite a legal challenge that could lead the Supreme Court, now with a 6–3 conservative majority and three Trump-appointed justices, to reconsider the question. “That seems to be their game plan,” Ellsworth said. “They want to get sued. They want to go to the Supreme Court.”

Van Hollen told me that he believes the Court would rule against Trump but that preferably the dispute won’t get that far. “You would hope that Republicans in Congress recognize they have an institutional interest in protecting Article I [of the Constitution] and the power of the purse, which is clearly congressional,” Van Hollen said.

[David A. Graham: It’s already different]

Beyond the question of legality, Van Hollen warned that Trump’s orders would jeopardize virtually all negotiations over spending on Capitol Hill, because Democrats would not be able to trust the administration to keep its end of any agreement. Although Republicans have majorities in both the House and the Senate, they will need to strike deals with Democrats to avert government shutdowns and a catastrophic default on U.S. debt.

There were early signs of GOP pushback on last week’s spending freeze, but it fell well short of a revolt. Senator Rand Paul of Kentucky, the chair of the Homeland and Governmental Affairs Committee, said at one of Vought’s hearings that he disagreed with the administration’s view on spending and impoundments. “I think if we appropriate something for a cause, that’s where it’s supposed to go, and that will still be my position,” Paul said. And Senator Lindsey Graham of South Carolina, the chair of the Budget Committee, said at a second Vought hearing that he, too, had “concerns” about impoundment. But neither of them planned to stand in the way of the nominee who has argued for the president to wrest control of spending from Congress. “When you win, you get to pick people,” Graham told Vought. “And I’m glad he picked you.”

On the Republican side, the fight might be left to lawmakers such as Bacon, who has some protection from presidential retribution because he represents a purple district where voters might reward him for standing up to Trump. The GOP, he said, should go after policies it opposes through legislation, not executive order. “You just can’t determine what laws you want to execute and what you don’t,” Bacon said of Trump. Executive orders, he added, “have gotten out of hand” from presidents in both parties. “You can’t change the law,” Bacon said. “I think Republicans should stay true to that notion.”