Robert F. Kennedy Jr. overcame a significant obstacle on Tuesday when a Senate panel voted to advance his nomination for health and human services secretary to the full chamber. In a tight 14-13 vote divided along party lines, the Senate Finance Committee approved Kennedy’s nomination after addressing concerns raised by Senator Bill Cassidy of Louisiana.

Cassidy, a doctor, played a pivotal role as a potential swing vote on the panel. He had previously expressed reservations about Kennedy’s qualifications to lead the massive agency, admitting to being “struggling” with his decision after questioning Kennedy in two confirmation hearings. As the chair of the Health, Education, Labor, and Pensions Committee, Cassidy’s opinion carried significant weight in the decision-making process.

In the days leading up to the vote, Cassidy engaged in intense discussions with Kennedy and the White House. He specifically thanked Vice President JD Vance for his guidance and support, citing commitments from the administration and shared priorities such as promoting healthy foods and advancing a pro-American agenda as factors influencing his decision to vote in favor of Kennedy’s nomination.

One of Cassidy’s key requirements for supporting Kennedy was a clear statement that vaccines do not cause autism and a commitment to follow established scientific evidence on the matter. Despite these conditions, it remained uncertain whether Kennedy had unequivocally made that assertion.

Kennedy, a member of the prominent Democratic family, had previously run for president in 2024 before withdrawing from the race to endorse former President Trump. During his campaign, he championed a “Make America Healthy Again” initiative, focusing on criticizing food manufacturers and advocating for improvements in the nation’s diet.

However, Kennedy faced significant challenges during the confirmation process, particularly in addressing basic questions about Medicaid, a critical aspect of the health secretary’s role. Democratic senators raised concerns about potential conflicts of interest that could arise if Kennedy were to be confirmed, including financial benefits from pending litigation against a vaccine manufacturer under his regulatory purview.

Despite these issues, the most contentious point of contention revolved around Kennedy’s controversial stance on vaccines. Cassidy, in particular, challenged Kennedy’s rejection of scientific evidence disproving a link between vaccines and autism. The clash highlighted a fundamental disagreement between Kennedy’s approach, which Cassidy criticized as selective evidence, and the scientific consensus on the issue.

Autism advocacy groups expressed alarm over Kennedy’s nomination, fearing that his unfounded claims linking vaccines to autism could impede progress in understanding and addressing the complex condition. The emphasis on debunked theories surrounding autism and vaccines, they argued, diverted attention and resources from genuine research efforts.

Pressure mounted on Cassidy from both supporters and opponents of Kennedy’s nomination, with anti-vaccine groups lobbying intensely for his confirmation and advocacy organizations urging Cassidy to vote against Kennedy. Amidst the competing influences, Cassidy found himself at the center of a contentious debate that underscored the stakes involved in confirming Kennedy as health secretary.

As the confirmation process unfolded, Kennedy’s supporters mobilized to rally behind his nomination, flooding Cassidy’s office with calls and emails. The anti-vaccine movement, spearheaded by Kennedy, demonstrated a fervent commitment to securing his confirmation, leveraging their influence to sway Cassidy’s decision.

In a political landscape fraught with division and conflicting interests, the fate of Kennedy’s nomination hung in the balance, with Cassidy emerging as a key figure in determining the outcome. The clash of perspectives, from scientific evidence to political maneuvering, encapsulated the complexities surrounding Kennedy’s bid for health secretary.

Natasha Korecki, Kate Santaliz, and Brandy Zadrozny, senior journalists with NBC News, provided comprehensive coverage and analysis of the unfolding drama surrounding Kennedy’s nomination. Their insights shed light on the intricate dynamics at play and the broader implications of the contentious confirmation process.

As the Senate Finance Committee’s vote loomed, the nation awaited the final decision with bated breath, keenly aware of the far-reaching consequences of confirming Robert F. Kennedy Jr. as the next health and human services secretary.