WASHINGTON >> Robert F. Kennedy Jr. battled his way through his second Senate confirmation hearing, defending his views on vaccination during a raucous three-hour session Thursday that featured shouting matches, angry accusations and a senator in tears, and also exposed the deep misgivings of a key Republican who could hold Kennedy’s future in his hands.

The hearing, before the Senate Committee on Health, Education, Labor and Pensions, was an extraordinary spectacle, even by the standards of today’s bitter partisanship in Washington. It also revealed the power of Kennedy’s “Make America Healthy Again” movement — legions of women he calls “MAHA moms” — as well as the platform he would have if confirmed as health secretary.

At one point, Kennedy suggested that Black people should adhere to different immunization schedules. At another, a Republican senator suggested that American children are overmedicated and recalled the days when parents disciplined their children with a belt. Sen. Maggie Hassan, D-N.H., cried while talking about her son. Kennedy yelled at Sen. Bernie Sanders, I-Vt., who yelled back.

Doctor’s misgivings

In the middle of it all was Sen. Bill Cassidy, who is a doctor and the committee chair. Cassidy, R-La., is on the fence about Kennedy. He opened the hearing by declaring that he was deeply troubled by Kennedy’s “past of undermining confidence in vaccines.” By the end, he wondered aloud whether Kennedy, 71, could change.

“Will you continue what you have been or will you overturn a new leaf?” Cassidy asked, adding that Kennedy, with his devoted fan base, could have an “incredible impact” were he to declare vaccines safe.

“That’s your power,” Cassidy said. “So what’s it going to be? Will it be using your credibility to support” vaccination, “or will it be using credibility to undermine? I’ve got to figure that out for my vote.”

Cassidy also serves on the Senate Finance Committee, which interviewed Kennedy on Wednesday and will determine whether Kennedy’s nomination receives consideration from the full body. The finance panel, which is likely to vote next week, has 14 Republicans and 12 Democrats. If Cassidy votes against Kennedy, causing the committee to deadlock, the Republican leader, Sen. John Thune of South Dakota, could use a procedural tactic to force the nomination to the floor.

In a narrowly divided Senate, Kennedy can afford to lose only three Republican votes if he is to win final confirmation, provided all Democrats oppose him. Sen. Lisa Murkowski, R-Alaska, also expressed misgivings about Kennedy’s views on vaccines Thursday. And Sen. Mitch McConnell, R-Ky., who is a polio survivor, has not said how he will vote.

Unfamiliar territory

For the second straight day, Kennedy appeared to have little familiarity with the sprawling health programs he would oversee if confirmed to run the Health and Human Services Department. Pressed by Hassan, he was unable to correctly identify the different components of Medicare, the health insurance program for tens of millions of older Americans. On Wednesday, he had stumbled through a response to questions about Medicaid, the program for low-income people.

Kennedy on Thursday committed to a broad anti-abortion agenda, despite past comments supporting abortion rights. A former heroin user, Kennedy also promised to support the distribution of opioid addiction medicine to address a crisis still claiming roughly 100,000 lives every year.

But the bulk of the hearing was devoted to whether Kennedy was willing to accept consensus in scientific research. Kennedy frequently asserted that if lawmakers were to show him vaccine data that proved him wrong, he would apologize. Democrats fired back, telling Kennedy that the research he was asking to see had long been public.

GOP support

Republicans on the panel mostly defended Kennedy’s approach, saying that scientific knowledge was volatile and rarely settled.

“We’re so consensus-driven that the science says this,” Sen. Rand Paul of Kentucky, who is also a doctor, said, criticizing the government’s role in encouraging vaccination. “Well, science doesn’t say anything. Science is a dispute, and 10 years from now we could all be wrong.”

There were a number of times when emotions ran high.

Kennedy and Sanders shouted at each other after Kennedy, addressing Sanders as “Bernie,” accused the senator of taking money from pharmaceutical manufacturers. A furious Sanders acknowledged that $1.5 million of the $200 million he had received during his 2020 presidential race had come from drug companies. “I had more contributions from workers all over this country!” Sanders said angrily, adding, “Not a nickel from corporate PACs!”

At another point, Hassan broke down in tears while talking about her 36-year-old adult son, who has cerebral palsy. She said that when the first study about autism and vaccines came out — referring to research by a now-discredited doctor, Andrew Wakefield, that has been retracted and debunked — “it rocked my world.”

Her voice breaking, Hassan said not a day had gone by when she did not think about what she did when pregnant with her son that might have caused his condition. “So please do not suggest that anybody in this body of either political party doesn’t want to know what the cause of autism is,” she said.

All about vaccines

But it is Cassidy, the soft-spoken physician from Louisiana, whose decision will ultimately be critical. He opened the hearing by recounting the story of a patient who needed a liver transplant; caring for her, he said, was the “worst day of my medical career” because he knew a vaccine could have prevented her fate.

“My phone blows up with people who really follow you, and there are many who trust you more than they trust their own physician,” Cassidy told Kennedy as the hearing began. “And so the question I need to have answered is, what will you do with that trust?”

The hearing made clear that Democrats believe their strongest tactic is to hammer away at Kennedy’s views on vaccination. In response to a question from Sen. Angela Alsobrooks, D-Md., who is one of two Black women on the panel, Kennedy defended his previous assertion that Black people should be on a different vaccine schedule than white people, saying there was research suggesting that Black people needed fewer antigens, the components of vaccines that provoke an immune response.

Alsobrooks cut him off. “Mr. Kennedy, with all due respect, that is so dangerous,” she said. “Your voice would be a voice that parents would listen to.”

Allies of Kennedy’s have expressed concern that the focus on vaccines could derail his confirmation; they would much rather he talk about issues that have bipartisan support, such as encouraging healthy eating and reversing the nation’s chronic disease epidemic. But Kennedy did not shy away from the vaccine debate.

His supporters were thrilled with his performance Thursday. Zen Honeycutt, the founder of Moms Across America, an advocacy group that promotes healthy eating, said Kennedy’s exchange with Sanders exposed that “corruption in the system was not just in the system,” but within Congress, too.