Discontent and Lack of Trust Swirls Around RFK Jr

By: Ranier Simons, ADAP Blog Guest Contributor

Public health affects all Americans, regardless of their political ideology, religious beliefs, or socioeconomic background. The vast majority of the public also lacks an extensive medical or scientific background. Thus, citizens look to established institutions and entities for guidance on best health practices as they go about their busy lives. Consequently, the instability caused by the current state of upheaval in the U.S. Department of Health and Human Services (HHS) and the Centers for Disease Control & Prevention (CDC) is a public health hazard. The trust gap the average American has with RFK Jr. should not be trivialized, as it is having ripple effects throughout public discourse and the medical establishment.

Photo Source: STAT News

RFK Jr. has a very high-profile stance that many describe as being anti-vaccine. Although he does not hold a medical degree and has no prior experience as an environmental attorney, he has characterized the historically internationally respected CDC as a corrupt institution that has failed the American public (Soucheray, 2025). This sentiment is especially notable in his characterizations of COVID-19 vaccines and childhood vaccinations. Scientific data show that COVID-19 vaccinations worldwide prevented approximately 2.5 million deaths between December 2020 and October 2024 (John et al., 2025). Statistics such as this significantly damage his credibility.

A recent poll, conducted by The Economist and YouGov and surveying 1,691 adults, indicated that only one in four Americans trusts RFK Jr. with medical advice (Crisp, 2025). Approximately 51% of respondents stated they still trust CDC guidance, and 79% stated they trust the medical recommendations of their personal physicians (Crisp, 2025). Notably, 45% expressed disapproval of Kennedy’s job as HHS secretary.

Experienced career staff at HHS have also raised questions about RFK Jr.’s trustworthiness. A recent shooting at the CDC resulted in six CDC buildings sustaining damage and one police officer being killed (Fields, 2025). 

In response, on August 20th, over 750 current and former HHS staff members issued a letter addressed to HHS Secretary Kennedy and Congress asking him to stop spreading inaccurate health information. The letter expressed that, “The attack came amid growing mistrust in public institutions, driven by politicized rhetoric that has turned public health professionals from trusted experts into targets of villainization—and now, violence…Health and Human Services Secretary Robert F. Kennedy, Jr., is complicit in dismantling America’s public health infrastructure and endangering the nation’s health by repeatedly spreading inaccurate health information…”.

Photo Source: STAT News

On September 3rd, over 1000 current and former HHS staff released another letter asking him to resign. The public cannot foster trust in the head of HHS when internal members of HHS are calling for his resignation.

Even amidst the recent outbreak of measles, RFK Jr.'s stance on childhood vaccines is fostering conflicting messaging and confusion. Recently, Florida’s Surgeon General announced that the state would be the first to end all vaccine mandates, including those for schoolchildren (Kearney, 2025). For years, all 50 states and the District of Columbia have had laws requiring school children to be vaccinated against diseases such as polio and measles. Despite the Florida Surgeon General’s announcement, a recent survey conducted by The Washington Post and the Kaiser Family Foundation (KFF) indicates 82% of Florida parents support public schools requiring vaccines for measles and polio, with some health and religious exemptions. Comparatively, 81% of parents nationwide also support school vaccine requirements.

In June of this year, HHS Secretary Kennedy fired all 17 members of the Advisory Committee on Immunization Practices (ACIP) (Stone, 2025). This committee helps develop vaccine policy and recommendations for the CDC. Kennedy stated that he removed all the members because he felt they all had conflicts of interest, as indicated in a government report (Huang, 2025). However, it has been documented that Kennedy’s interpretation of the report is inadequate, given that it is almost twenty years old, dating back to 2009. Dr. Tom Frieden, CDC director from 2009 to 2017, publicly stated Kennedy was giving “a total misrepresentation of a 20-year-old report, about a process that was already being improved before that report was issued” (Huang, 2025). Secretary Kennedy subsequently replaced the old members with several individuals who had previously expressed anti-vaccine sentiments.

Out of grave concern for public health, the American Academy of Pediatrics (AAP) recently published its own 2025 recommended schedule for child and adolescent immunization, which differs from the current CDC's ACIP (Gerlach, 2025). The AAP is outwardly challenging the current CDC guidelines, stating its recommendations are evidence-based. Susan J. Kressly, MD, AAP president, said in a statement, “The AAP will continue to provide recommendations for immunizations that are rooted in science and are in the best interest of the health of infants, children, and adolescents” (Gerlach, 2025). She added, “Pediatricians know how important routine childhood immunizations are in keeping children, families, and their communities healthy and thriving” (Gerlach, 2025). Among the significant divergences from CDC ACIP guidance, the AAP recommends universal COVID-19 vaccination for children aged 6 to 23 months and risk-based immunization for children aged 2 to 18 years, such as those who are medically vulnerable or living with high-risk individuals (Gerlach, 2025).

Photo Source: ABC30

Some Democrat-led states are also pushing back against the current CDC ACIP advisories. Massachusetts recently became the first state to issue its own vaccine rules. Governor Maura Healey announced that health insurers doing business in Massachusetts will be required to cover vaccines recommended by the state health department, regardless of whether the CDC recommends them or not. Blue Cross Blue Shield of Massachusetts and the Massachusetts Association of Health Plans support the policy (Goldman, 2025 Sept.4) California, Oregon and Washington have formed what is being called the West Coast Health Alliance to issue their own vaccine recommendations to battle the politicization of the CDC (Goldman, 2025 Sept.3). New Mexico recently through its health department issued and order that all its residents can obtain COVID-19 vaccinations even though Kennedy announced they should be restricted to high-risk patients (Goldman, 2025, September 5).

Just this week, PlusInc – an organization promoting health equity – issued a strongly worded rebuke of RFK Jr's assertion that there is a definitive link between Tylenol and autism. The statement, in part, reads: "Monday’s disorganized pronouncement was made with either complete unawareness or discounting of findings from a study published just last year in JAMA Network that found no link between the use of acetaminophen and children’s risk of autism, attention-deficit/hyperactivity disorder (ADHD), or any intellectual disabilities."

Distrust in RFK Jr’s leadership is adversely disruptive to public health and problematic for the evidence-based established infrastructure of medical science. Moreover, since states have the legal latitude to create their own health policies and guidance, the result could lead to a patchwork quilt of public health protections that vary from state to state. The public will ultimately be left with apprehension regarding health decisions, and states may face retaliatory funding responses from the federal government. The trust gap between RFK Jr. and the American public is not merely an issue of political theater, but a threat to the lives of citizens.

[1] Crisp, E. (2025, September 3). 1 in 4 Americans trust RFK Jr. with medical advice. Retrieved from https://thehill.com/policy/healthcare/5484579-kennedy-poll-medical-advice/

[2] Fields, A. (2025, August 12). 500 shots fired in CDC attack in Atlanta. Retrieved from https://thehill.com/homenews/state-watch/5447797-gunman-cdc-headquarters/

[3] Gerlach, A. (2025, August 21). American Academy of Pediatrics Releases 2025 Child, Adolescent Immunization Recommendations. Retrieved from https://www.pharmacytimes.com/view/american-academy-of-pediatrics-releases-2025-child-adolescent-immunization-recommendations

[4] Goldman, M. (2025, September 4). Massachusetts becomes first state to impose its own vaccine coverage rules. Retrieved from https://www.axios.com/2025/09/04/massachusetts-vaccine-coverage-rules

[5] Goldman, M. (2025, September 3). 3 western states form vaccine alliance to counter feds. Retrieved from https://www.axios.com/2025/09/03/cdc-vaccine-washington-california-oregon-guidelines-recommendations

[6] Goldman, M. (2025, September 5). Blue states eye rival health rules to defy RFK Jr.. Retrieved from https://www.axios.com/2025/09/05/rfk-vaccine-rule-states-democrats-vaccine-rules

[7] Huang, P. (2025, March 11). RFK says most vaccine advisers have conflicts of interest. A report shows they don't. Retrieved from https://www.npr.org/sections/shots-health-news/2025/03/11/nx-s1-5323771/rfk-jr-vaccine-advisers-conflicts-interest

[8] John, Pezzullo, A. M., Cristiano, A., & Boccia, S. (2025). Global Estimates of Lives and Life-Years Saved by COVID-19 Vaccination During 2020-2024. JAMA Health Forum, 6(7), e252223–e252223. https://doi.org/10.1001/jamahealthforum.2025.2223

[9] Kearney, A. (2025, September 4). Most Parents Nationally and in Florida Want Schools to Require Vaccines. Retrieved from https://www.kff.org/quick-take/most-parents-nationally-and-in-florida-want-schools-to-require-vaccines/

[10] Soucheray, S. (2025, September 4). In heated Senate committee meeting, RFK Jr says fired CDC chief lied about ouster. Retrieved from https://www.cidrap.umn.edu/anti-science/heated-senate-committee-meeting-rfk-jr-says-fired-cdc-chief-lied-about-ouster#:~:text=During%20the%203%2Dhour%20meeting,see%20today's%20CIDRAP%20News%20story).

[11] Stone, W. (2025, June 9). RFK Jr. boots all members of the CDC's vaccine advisory committee. Retrieved from https://www.npr.org/sections/shots-health-news/2025/06/09/nx-s1-5428533/rfk-jr-vaccine-advisory-committee-acip#:~:text=boots%20all%20members%20of%20the%20CDC's%20vaccine%20advisory%20committee,-Listen%C2%B7%203:25&text=Secretary%20of%20Health%20Robert%20F,issue%20statements%20denouncing%20the%20move

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.   

Feds Tell States to Cover Hep C Medications, Regardless of Substance Use

By: Ranier Simons, ADAP Blog Guest Contributor

The right to health is a human right recognized in many international human rights documents, such as the 1966 International Covenant on Economic, Social, and Cultural Rights and the World Health Organization’s (WHO) Constitution.[1,2] According to the WHO, “Countries have a legal obligation to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination.”[1] To that end, in recent history, the United States Departments of Justice (DOJ) and Health and Human Services (HHS) have found it necessary to intervene in order to protect citizens’ right to health. 

Photo Source: U.S. Department of Justice

The DOJ Civil Rights Division issued a letter to state Medicaid administrators on January 24, 2024, reminding them of their obligation to ensure that their programs allow people who have both Substance Use Disorder (SUD) and Hepatitis C (HCV) to access direct-acting antivirals (DAAs).[3] In the letter, the DOJ and HHS reiterate Medicaid agencies are required to grant this access under the Americans with Disabilities Act (ADA). Under the Act, states cannot discriminate against people with disabilities, which includes SUD. SUD qualifies as a disability because it “substantially limits one or more major life activities and interferes with the operation of key bodily functions.”[5]

In 2022, the DOJ reached a settlement agreement with Alabama Medicaid after an investigation of its Medicaid policy. It was denying access to DAAs for people who had consumed drugs or alcohol six months prior to starting treatment and denying payment if they used any drugs during their treatment. The DOJ accused Alabama Medicaid of “imposing non-medically indicated sobriety restrictions for HCV treatment, in violation of the Americans with Disabilities Act (ADA).”[4] There was no scientifically evidence-based reasoning for the restriction. 

Alabama Medicaid agreed to multiple stipulations and reporting requirements as part of the settlement. They were required to reverse their sobriety policy for HCV treatment and agree not to create any further restrictions, such as requirements for drug or alcohol counseling.[4] Additionally, Alabama Medicaid had to notify Medicaid providers of the change and inform the  Alabama Board of Medical Examiners and the Alabama Department of Public Health.[4] One notable requirement was notification of all Medicaid recipients of the change, thus informing them of their rights. Interestingly, in the settlement, Alabama Medicaid denied any acknowledgment of any violation of the ADA but framed their cooperation as an amicable negotiated resolution to the matter.[4]

Photo Source: Arkansas Medical Society

The DOJ utilized the ADA in 2020 to reach a settlement with Massachusetts General Hospital.[6] Massachusetts General Hospital denied a cystic fibrosis patient access to be listed on the lung transplant list because he was taking suboxone, a drug used to treat dependence on opioids. The cystic fibrosis damaged his lungs so severely that he needed a lung transplant to live. As part of the settlement, Massachusetts General Hospital paid $170,000 to the patient and $80,000 to his mother.[6] The hospital additionally agreed to give ADA training to its staff and end its discriminatory policy. The patient ended up receiving a lung transplant at the University of Pennsylvania.[6] Selma Medical, Charwell Operating Nursing Facility, Athena Health Care Systems, Alliance Health, New England Orthopedic Surgeons, and King’s Daughters Medical Center are other providers that reached settlements with the DOJ after violating the ADA by denying healthcare to patients taking medication for SUD.[6] 

Utilizing the ADA to ensure health protections for people with SUD is a robust tool. However, under the ADA, protections against discrimination only extend to “a person in recovery who is no longer engaging in the current illegal use of drugs.”[7] Protections from being denied healthcare services is an exception or ‘carve-out’: “A person who is currently engaging in the illegal use of drugs can’t be denied healthcare or rehabilitation services because of their current use if they would otherwise qualify for these services.”[7] 

That is why the letter issued by the DOJ and HHS is important. Amplifying attention to the matter is a way to prevent harm before it happens since widespread understanding of the exception is lacking policy-wise and programmatically. Although people with SUD have rights, having to fight for their rights when denied care results in treatment delays and poor health outcomes. It is better to address and change policy before issues occur. The letter is guidance and an indication to entities that the DOJ can and will actively seek remedy against infractions. Optimistically, the threat of litigation is enough of a deterrent for entities to examine and modify their policies.

[1] World Health Organization. (2023, December 1). Human rights. Retrieved from https://www.who.int/news-room/fact-sheets/detail/human-rights-and-health#:~:text=The%20right%20to%20health%20and,of%20physical%20and%20mental%20health.

[2] Office of the United Nations High Commissioner for Human Rights. n.b. The Right to Health. Retrieved from https://www.ohchr.org/sites/default/files/Documents/Publications/Factsheet31.pdf

[3] Department of Justice. (2024, January). Letter to State Medicaid Administrators. Retrieved from https://www.justice.gov/d9/2024-01/dear_colleague_letter-state_medicaid_coverage_for_people_with_hcv_and_sud.pdf

[4] Settlement Agreement between the United States of America and the State of Alabama's Medicaid Agency. (2022, December 5). Retrieved from https://www.justice.gov/opa/press-release/file/1555501/download

[5] U.S. Department of Justice Civil Rights Divison. (2022, April 5). The ADA and Opioid Use Disorder: Combating Discrimination Against People in Treatment or Recovery. Retrieved from https://www.ada.gov/resources/opioid-use-disorder/#2-does-an-individual-in-treatment-or-recovery-from-opioid-use-disorder-have-a-disability-under-the-ada

[6] Rahim, H. (2023, Decemeber 26). Does the ADA protect people with substance use disorder from health care discrimination? Retrieved from https://blog.petrieflom.law.harvard.edu/2023/12/26/the-ada-as-protection-from-health-care-discrimination-towards-persons-with-substance-use-disorder/

[7] ADA National Network. (2020). The Americans With Disabilities Act, Addiction, and Recovery for State and Local Governments. Retrieved from https://adata.org/factsheet/ada-addiction-and-recovery-and-government

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

Ryan White HIV/AIDS Program AIDS Drug Assistance Program (ADAP) Annual Client-Level Data Report

By: Ranier Simons, ADAP Blog Guest Contributor

Effective population health monitoring, program evaluation, and decision-making requires quality data. To that end, in September 2023, the Division of Policy and Data, HIV/AIDS Bureau (HAB) under the Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services published the Ryan White HIV/AIDS Program AIDS Drug Assistance Program (ADAP) Annual Client-Level Data Report.[1] The current iteration of this annual publication covers the years 2017 through 2021. The client-level data includes information such as demographics, socioeconomic status/factors, and service utilization.

ADAPs are in each of the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and six U.S. territories, receiving funding from Part B of the Ryan White HIV/AIDS Program (RWHAP). Eligibility for ADAP services requires one to have a diagnosis of HIV, be of low income, defined as a percentage of the federal income poverty level, and meet residency requirements based on a particular state’s ADAP structure. The report includes a multitude of metrics grouped by age, race/ethnicity, gender, federal poverty level, and healthcare coverage status. What follows is an overview of some of the data. To view the report in its entirety, please click here.

According to the report, clients served numbers are on an upward trend. From 2017 to 2021, the client base grew from 268,174 to 289,289. These numbers describe those who specifically receive ADAP services and do not include clients who only receive non-ADAP RWHAP direct health care and support services. However, some ADAP clients partake of those services as well. Increasing yearly numbers indicate that ADAP programs are needed, and ongoing funding is necessary. Additionally, research shows that ADAP programs are cost-effective, and policies that stifle them are detrimental to the health and well-being of those dependent upon them and society overall.[2]

Photo Source: NASTAD

A few gender-related observations stand out as well. Most of the ADAP clients are male. In 2021, 78.6% were cis-gender male. This percentage and the overall gender ratio of male, female, and transgender patients served has remained consistent over the 2017-2021 timeframe. In 2021, the data shows a difference in poverty based on gender. There were more cis-gender female/transgender female ADAP clients than cis-gender male/transgender males living at or below 100% of the federal poverty level, though as a whole, half of all ADAP clients were below. The comparison was 54.1% cis-gender female and 65.6% transgender female in contrast to 44.7% cis-gender male and 51.4% transgender male. Gender differences were also noted in the status of healthcare coverage. In 2021, 36.5% of ADAP clients were entirely without health care insurance coverage. However, of that subgroup, 36.6% were male, and 34.95 were female. The numbers for transgender clients were higher, with 49.8% of transgender males and 51.2% of transgender females lacking any healthcare coverage. Complete lack of coverage means they did not even have Medicaid.

The report indicated a few standout metrics regarding race as well. The majority of ADAP clients are non-White. In 2021, seven out of ten were racial or ethnic minorities, with white clients comprising 30% of the client total. A further breakdown of the racial data indicates that in 2021 over half, 55%, of female ADAP clients were African American. By comparison, 24.1% were Hispanic/Latina, 18.1% were White, and less than 2% identified as Asian, mixed-race, American Indian/Alaska Native or Native Hawaiian/Pacific Islander. In contrast, 33.6% of male clients were African American, 33.3% were White, and 29.9% were Hispanic/Latino. A very notable racially varied metric involved age. Ethnic/minority ADAP clients are younger than White clients. In 2021, 62.1% of white clients were 50 years of age or older. This contrasts with the statistics of 39.9% being African American, 48.9% being American Indian/Alaska Native, 38.6% Hispanic/Latino, and 36.0% Asian. 

The observations are just a few of the many data points described in the report. Continued reporting of this nature is necessary for accountability in terms of the billions spent on ADAP each year and to continue to improve the services and the lives of those dependent on ADAP services. Whether examining the breakdown of various service utilization or how the distribution of services differs based on geographical region, continuing to create a robust repository of data is the best way to improve the health outcomes of the vulnerable ADAP population.

[1] Health Resources and Services Administration. (2023, September). Ryan White HIV/AIDS Program AIDS Drug Assistance Program (ADAP) Annual Client-Level Data Report 2021. Retrieved from https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/hrsa-adap-data-report-2021.pdf

[2] McManus, K. A., Strumpf, A., Killelea, A., Horn, T., Hamp, A., & Keim-Malpass, J. (2022). Economic benefits of the United States' AIDS drug assistance Program: A systematic review of cost analyses to guide research and policy priorities. Preventive medicine reports, 29, 101969. https://doi.org/10.1016/j.pmedr.2022.101969

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.

Missouri Governor Issues Proclamation on HIV/AIDS

By: Sarah Hooper,  intern, ADAP Advocacy Association, and rising senior at East Carolina University

In a recent proclamation by Republican Missouri Governor Michael L. Parson, the month of April was designated HIV Awareness Month. He is the first governor to issue a proclamation acknowledging the national "Ending the HIV Epidemic: A Plan for America." The Missouri proclamation references testing (diagnosis), treatment and prevention.

The Ending the HIV Epidemic ("EHE") plan - announced in 2019 - was developed by agencies across the U.S. Department of Health and Human Services (Offices of Infectious Disease). EHE provided 57 geographic focus areas where HIV transmission occurs at a high rate, and Missouri is one of only seven entire states that is a jurisdiction of focus. The goal of the EHE is to reduce new HIV infections by 75% by 2025 and by at least 90% by 2030 by focusing on four pillars: prevention, diagnosis, treatment, and outbreak response by working with programs, resources and the infrastructure of HHS agencies and offices nationwide (Offices of Infectious Disease).

Nationally, HIV/AIDS Awareness Month is usually recognized in December, but Governor Parson chose to hold the month of recognition in April. Missouri has 447 annual HIV diagnoses as of 2018 and estimates 12,529 total people living with diagnosed HIV. However, only 87% have knowledge of their HIV status, leaving many more individuals who may be living with the virus and completely unaware (CDC).

When left undiagnosed, HIV positive individuals can transmit to others unknowingly and the virus may progress within their own bodies to the point of serious consequences. Governor Parson addresses diagnosis in his proclamation as one of the four pillars vital to addressing the HIV epidemic in America.

A resolution in support of the HIV Viral Load Suppression in Improving Health Outcomes and Reducing Transmission was adopted by many members of the National Lieutenant Governors Association ("NLGA") in March of 2019. State governors who sponsored the resolution included Wisconsin, Hawaii, Delaware, Missouri, Virgin Islands, Kansas and Vermont.

The sponsorship of Missouri’s Lt. Governor Mike Kehoe may have helped to push the Missouri Governor’s recent proclamation to light and stressed the importance of HIV awareness. The NLGA resolution reads, in part:

“Whereas, over 1.2 million people living in the United States are infected with HIV, and one in eight is unaware of the infection… Whereas, viral load suppression not only improves individual health, but it also reduces HIV transmission on a population level.” (2019, March)

By addressing the HIV epidemic on a state level and national level, progress will begin to accelerate in each state. Missouri’s Governor has set a great example to other states on how to begin addressing the HIV Epidemic and bring awareness to a virus that had such a “taboo” stigma surrounding it for many years. Many advocates believe this proclamation will save lives and help de-stigmatize HIV for those who still may hold certain negative views around the virus and those who are living with it.

Since 1981, more than 700,000 Americans have lost their battle to HIV (Offices of Infectious Diseases). While the numbers of infections and deaths have declined over the years with the increase of HIV education, the issue remains: those who may spread the virus without knowledge. I truly believe that both the Missouri and National plan to stop the spread of HIV and better educate the general public on the virus will help to destigmatize the disease and help lower the number of cases nationwide.

References:

• Geographic Priorities. (2020, May 21). Retrieved from https://www.cdc.gov/endhiv/priorities.html?CDC_AA_refVal=https://www.cdc.gov/endhiv/data.html
• Office of Infectious Disease. (2020, May 8). Overview. Retrieved from https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview
• Resolution In Support of HIV Viral Load Suppression in Improving Health Outcomes and Reducing Transmission. (2019, March). Retrieved from https://nlga.us/wp-content/uploads/Resolution-In-Support-of-HIV-Viral-Load-Suppression-in-Improving-Health-Outcomes-and-Reducing-Transmission-2.pdf

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.