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The Great Surrender

The Atlantic

www.theatlantic.com › newsletters › archive › 2025 › 02 › trump-cabinet-rfk-confirmation-tulsi-gabbard › 681693

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The single greatest success of Donald Trump’s second term so far might be his Cabinet. Today, senators confirmed Robert F. Kennedy Jr. to lead the Department of Health and Human Services, one day after confirming Tulsi Gabbard as director of national intelligence. The nomination of Kash Patel to lead the FBI is headed to a floor vote, and Linda McMahon—chosen to lead and apparently dismantle the Department of Education—is testifying to senators today.

Many parts of Trump’s agenda are deceptively fragile, as the journalist Ezra Klein recently argued. Courts have stepped in to block some of his executive orders and impede Elon Musk’s demolition of broad swaths of the federal government as we know it. Republicans in Congress still don’t seem to have a plan for moving the president’s legislative agenda forward. But despite clear concern from a variety of Republican senators about Trump’s Cabinet picks, it now seems possible that Trump will get every one confirmed except for Matt Gaetz—an indication of how completely Senate Republicans have surrendered their role as an independent check on the president.

The initial rollout of nominees was inauspicious. Gaetz, whom Trump reportedly chose spontaneously during a two-hour flight, lasted just eight days before withdrawing his nomination, after it became evident that Republicans would not confirm him. The rest of the slate was weak enough that at least one more casualty was likely, though I warned in November that a uniformly bad group might perversely make it harder for Republicans to take down any individual. How could they say no to one and justify saying yes to any of the others?

Pete Hegseth had no clear qualifications to run the Defense Department, serial infidelities, and allegations of a sexual assault and alcohol abuse. (He has denied both allegations, and settled with the sexual-assault accuser out of court. Prosecutors have said that they did not have sufficient evidence to pursue charges.) Gabbard not only lacked any intelligence experience but also brought a history of views antithetical to many Republican senators, an affinity for deposed Syrian dictator Bashar al-Assad and Russian President Vladimir Putin, and evidence of dishonesty. Patel was, in the view of many of his former colleagues in the first Trump administration, simply dangerous. Kennedy was, um, Robert F. Kennedy Jr.

Now all seem likely to take up their posts. Sure, it’s taken a while. Democrats have done what they can to slow down many of these nominations, and they voted unanimously against Hegseth, Kennedy, and Gabbard (a former Democratic House member!). Republicans objected when the administration tried to drive nominees through without FBI background checks, and damaging information about each of these nominees has continued to emerge; earlier this week, Democratic Senator Dick Durbin accused Patel of orchestrating a political purge at the FBI, despite promises not to do so. Yet none of that has mattered to the results.

Getting this done has required the White House to do some deft maneuvering. Trump allies publicly bullied Joni Ernst, an Iowa Republican who is a veteran and an outspoken advocate for victims of sexual assault, into backing Hegseth. According to The Wall Street Journal, they privately bullied the Republican Thom Tillis, a North Carolinian who has sometimes bucked Trump and faces a tough reelection campaign next year, after he indicated that he’d vote against Hegseth; he ultimately voted in favor. They horse-traded with Bill Cassidy, a Louisiana medical doctor who sounded very skeptical of Kennedy during hearings, giving him undisclosed reassurances in exchange for his support. As Politico reported, Trump dispatched J. D. Vance to absorb the grievances of Todd Young, an Indiana senator, about Gabbard; the vice president called off attacks from Trump allies and won Young’s vote.

One lone Republican voted against all three: Kentucky’s Mitch McConnell, the man responsible for keeping GOP senators lined up behind Trump during his first four years in office. The rest have various justifications for voting more or less in lockstep. They say they were reassured by what they heard in meetings—as though they’ve never seen a nominee fib, and as though that outweighed long histories. They say that presidents deserve to have the advisers they want. Behind closed doors, they might lay out a different calculation: Voting no on Cabinet members is a good way to tick Trump off while gaining little more than symbolism; better for them to keep their powder dry for real policy issues where they disagree with him.

These rationalizations might have made sense for a distasteful nominee here and there, but what Trump has put forward is likely the least qualified Cabinet in American history. In 2019, the Senate deep-sixed John Ratcliffe’s nomination as DNI (though it did confirm him a year later); this time around, when nominated for director of the CIA, he was seen as one of the more sober and qualified picks. Putting people like Trump’s nominees in charge of important parts of the federal government poses real dangers to the nation. Tom Nichols has explained how Hegseth exemplifies this: He seems more interested in bestowing trollish names on bases and giving contradictory messages about Ukraine than the tough work of running the Pentagon. That’s bad news in the immediate term and worse news when a crisis hits.

The idea of waiting to push back on Trump later might be more convincing if no one had ever seen him in action, as I discussed yesterday. Successfully ramming through this slate of nominees will only encourage the president. If Republican members wanted to, they could exert unusual leverage over the White House because of the narrow 53–47 margin in the chamber; Kyrsten Sinema and Joe Manchin showed during the Biden presidency how a tiny fraction of the Democratic caucus could bend leadership to its will. But if Trump managed to get senators to vote for Gabbard and Kennedy, two fringe nominees with some far-left views, why should he expect them to restrain him on anything else?

The real reason for these votes is presumably fear. Republicans have seen Trump’s taste for retribution, and they fear his supporters in primaries. The irony is that in bowing to Trump, senators may actually be defying voters’ preferences. A CBS News poll published Monday found that six in 10 GOP voters would prefer to see congressional Republicans stand up to Trump when they disagree with him. By knocking down some of the worst nominees, senators might have made the Cabinet better and served the country well. But if that wasn’t enough to persuade them, perhaps the chance for political gain could.

Related:

Kash Patel will do anything for Trump. The perverse logic of Trump’s nomination circus (From November)

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By Nancy Walecki

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DC plane crash: What we know about the victims and ongoing investigation

Al Jazeera English

www.aljazeera.com › news › 2025 › 1 › 31 › dc-plane-crash-what-we-know-about-the-victims-and-ongoing-investigation

Young figure skaters Spencer Lane and Jinna Han were on the American Airlines flight that collided with the Black Hawk.

RFK Jr. Has a Lot to Learn About Medicaid

The Atlantic

www.theatlantic.com › health › archive › 2025 › 01 › rfk-jr-hearing-medicaid › 681504

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.