If the Senate confirms President-elect Donald Trump’s pick of Robert F. Kennedy Jr. to be secretary of health and human services, it would be a monumental disaster.

A lot of attention in the coming weeks will be focusing on RFK Jr.’s opposition to vaccines and other oddball stances such as his warnings about fluoride in the water, which is to be expected. After all, in this role he would be put in charge of the FDA, CDC, and NIH.

But let us not forget that HHS is the largest department in the federal government, with more than one out of every four dollars in the budget flowing through its doors. Medicare, Medicaid, and Obamacare are all controlled by HHS, and Obamacare delegated a massive amount of regulatory power to the secretary. 

It is through HHS that Republican presidents have the ability to influence abortion policy, but RFK Jr. earlier this year defended the right to “full-term abortion.” After backtracking, he still said he supported abortion until viability. 

HHS would also be the agency through which Republicans could try to loosen the government’s regulatory grip on American health care, but in RFK Jr., Trump has named somebody who has envisioned a sort of single-payer system akin to the government-run public option that was rejected during the Obamacare debate for being a step toward socialized medicine. He said, “My highest ambition would be to have a single-payer program,” which he described as one “where people who want to have private programs can go ahead and do that, but to have a single program that is available to everybody.” In the original version of Obamacare, the hope of progressives was that over time, people would gravitate toward a government-run program that would eventually evolve into a fully single-payer system.

If Republican senators do their jobs, they should reject both the nomination of Matt Gaetz to be attorney general and the nomination of RFK Jr. to be HHS secretary. But if I could only persuade them to reject one, I would get them to replace RFK Jr. My reasoning is that any AG pick is going to be a Trump toady. But RFK Jr. is the only pick for HHS who would be pro-abortion and pro-government health care.