Robert F Kennedy Jr’s testimony was a “through the looking glass” moment for some senators, as lawmakers questioned one of the nation’s most influential vaccine critics for a job as the top US health official.

The hearing was a testament to how quickly Republicans have integrated “Make America Healthy Again” rhetoric into their own, lauding Kennedy, who was called a “predator” only hours earlier in a letter by his own cousin, as the correct man to head the Department of Health and Human Services (HHS).

That letter alone, which described how Kennedy put baby chicks and mice into a blender for the birds of prey he keeps as pets, might have been disqualifying in earlier political eras.

But as the Trump administration dominates headlines with nominees, executive orders and new laws, Kennedy’s hearing on Wednesday was one more spectacle where thunderous Democrats attempted to hold a mirror to the nominee, only for him to step right through.

“We are truly through the looking glass this morning in the Senate here,” said the Colorado Democratic senator Michael Bennet. He later added: “Unlike other jobs we’re confirming around this place, this job is life and death.”

If confirmed, Kennedy would helm HHS, an agency with a $1.8tn budget that oversees the world’s leading pharmaceutical regulatory agency (the Food and Drug Administration), public health agency (Centers for Disease Control and Prevention), the world’s largest publicly funded biomedical research branch and directly insures 145 million people on Medicare and Medicaid alone, including tens of millions of children.

Kennedy is a long-time environmental lawyer and scion of a political dynasty. He led the Children’s Health Defense, a nonprofit that is recognized by experts as one of the world’s leading spreaders of vaccine misinformation, before running for president – first as a Democrat, later as an Independent – in 2024. He ended his campaign and endorsed Trump before the November election.

Republicans, such as Ron Johnson of Wisconsin, lauded Kennedy for his ability to “set aside” political differences to work on the nation’s challenges. Kennedy ran as a Democrat. The nominee’s supporters cheered from the gallery at multiple such assertions.

“Thank you for your decades-long advocacy for a clean environment, for children’s health,” said Johnson on Wednesday, who, like Kennedy, has been criticized for spreading vaccine misinformation. “I can’t say I’m surprised by their hostility on the other side – I’m highly disappointed by it,” the senator said.

Democrats, meanwhile, questioned how the American people could trust someone who so recently ran for president only to U-turn on at least one critical issue – abortion – and display obsequious deference to the new administration.

“We have no shortage of challenges to confront, and I even agree with Mr Kennedy on some of the diagnoses,” said Bennet, who said he observed young people with worry as a Denver public schools superintendent.

“What is so disturbing to me is out of 330 million Americans, we are being asked to put somebody in this job who spent 50 years of his life… peddling in half-truths, peddling in false statements, peddling in theories that create doubt about whether or not things that we know are safe are unsafe. And he says it with such conviction you believe him!”

Bennet’s next line of questioning was emblematic of the hearing: “Did you say Lyme’s disease is highly likely a militarily engineered bioweapon?”

“I probably did say that,” said Kennedy.

“Did you say exposure to pesticides causes children to be transgender?” asked Bennet.

“No, I never said that,” said Kennedy, when he did, in fact, link gender identity to pesticide exposure without evidence on several occasions.

“Did you write in your book that it’s undeniable that African Aids is an entirely different disease than western Aids?”

“I’m not sure,” said Kennedy.

“Did you say on a podcast, and I quote, ‘I wouldn’t leave it abortion to the states. My belief is we should leave it to the woman. We shouldn’t have the government involved – even if it’s full term,’” asked Bennet.

“Senator, I believe every abortion is a tragedy,” said Kennedy.

And so it went for nearly four hours, as Kennedy repeated that he would seek to bring American scientific institutions back to “gold standard” science if he had the “privilege of being confirmed”, even as he expressed support for investigating issues seen as long settled in the scientific community.

“We need to understand the safety of every drug – mifepristone and every other drug,” Kennedy said about the medication abortion drug, adding he had been asked to “to look at the safety issues” by the administration.

Mifepristone has been extensively studied for safety, and it is found to have fewer adverse outcomes than acetaminophen (paracetamol), a common over-the-counter pain reliever. Key studies that supported a recent supreme court case have been retracted.

Kennedy also repeatedly confused Medicare and Medicaid, the programs that provide health insurance for seniors and the low-income respectively.

“Medicaid is not working for Americans and is not working for the target population,” said Kennedy. “Most people on Medicaid are not happy, the premiums are too high, the deductibles are too high, the networks are too narrow.”

Cost-sharing in Medicaid is strictly limited. Most patients pay little or nothing because the program is specifically designed for the low-income. The Minnesota Democrat Tina Smith would later remark on social media that Kennedy did not “understand the basics of the program”.

Most Americans, Kennedy later said, “would prefer to be on private insurance”, an assertion many would likely dispute given the recent outpouring of grievance about private insurance.

Perhaps most revealing was the way he answered a question by Senator Bernie Sanders.

“Is healthcare a human right?” said the Vermont independent.

“In the way free speech is a human right?” said Kennedy. “I would say it’s different because free speech doesn’t cost anybody anything, but in healthcare if you smoke cigarettes for 20 years, you are now taking from the pool. So are you guaranteed the same rights and duties?”

The implication: maybe not.

Sanders, limited to five minutes, moved on, but the cohesion was clear: limited government now lives side-by-side with a call to end the chronic disease epidemic. Only now, the chronic disease will be framed as a matter of personal responsibility, with policies to match.

Medicaid could be reformed to “help pay for President Trump’s priorities but to improve outcomes,” Kennedy said. It’s Medicaid that has poor outcomes – not poverty.

The youth mental health crisis is a global challenge experts tie to “neoliberalism, where everything is a commodity”, with an acute shortage of providers and notoriously spotty insurance coverage in the US. However, to Kennedy the problem is one of over-prescribing.

“I know people, including members of my family, who’ve had a much worse time getting off SSRIs [anti-depressants] than they’ve had getting off heroin,” Kennedy told Smith during the hearing, to her dismay.

What about ultra-processed food? The new Republican MAHA caucus celebrated the Biden administration’s decision to ban red dye number 3 – a change some food policy experts might have seen as an opportunity to increase industry regulation. But the lever to pull in Kennedy’s estimation is one of public benefits.

“We shouldn’t be spending 10% of the Snap program on sugared drinks,” said Kennedy, in support of a conservative proposal to limit the types of food public assistance beneficiaries can buy. Snap is better known by its colloquial name, “food stamps”.

Kennedy, if confirmed, could rejuvenate Republican health policy. Yet, available evidence shows Americans are unlikely to be healthier for it.