Kennedy, who was to sit before the Senate’s health committee later in the day, appeared at a House appropriations hearing to defend the White House’s requested budget for his agency. The request includes a $500 million boost for Kennedy’s “Make America Healthy Again” initiative to promote nutrition and healthier lifestyles while making deep cuts to infectious disease prevention, medical research maternal health, low-income heat assistance and preschool programs.

Kennedy described his downsizing of the sprawling $1.7 trillion-a-year agency — from 82,000 workers to 62,000 — as necessary cost-cutting measures that have reduced redundancies. He argued that he’s merely consolidating several existing offices that work on women’s health, minority health and sexually transmitted disease prevention.

“When we consolidate them, Democrats say they’re eliminating them,” Kennedy said.

But Democrats argued that some of that consolidation will ultimately impact the work that the federal government is doing to reduce overdose deaths, study causes of cancer or offer suicide prevention services to LGBTQ+ teens.

Rep. Madeline Dean, a Democrat from Pennsylvania, pressed Kennedy on his plans to shutter the Substance Abuse and Mental Health Services Administration, an agency that oversees a national suicide hotline, surveys Americans on their drug use annually and provides funding and guidance for addiction treatment centers. Kennedy plans to fold it into his new Administration for Healthy Americans.

“We call that shift and shaft,” Dean said of Kennedy’s plans.

Several Republicans, too, sprinkled hints of concerns about Kennedy’s approach to the job throughout the hearing.

Rep. Chuck Fleischmann of Tennessee praised Kennedy for his work but raised concerns about whether the secretary has provided adequate evidence that artificial food dyes are bad for diets. Removing those food dyes would hurt the “many snack manufacturers” in his district, including the makers of M&Ms candy.

Rep. Mike Simpson, a dentist from Idaho, said Kennedy’s plan to remove fluoride recommendations for drinking water alarms him. The department’s press release on Tuesday that announced the Food and Drug Administration plans to remove fluoride supplements for children from the market wrongly claimed that fluoride “kills bacteria from the teeth,” Simpson noted. He explained to Kennedy that fluoride doesn’t kill bacteria in the mouth but instead makes tooth enamel more resistance to decay.

“I will tell you that if you are successful in banning fluoride … we better put a lot more money into dental education because we’re going to need a lot more dentists,” Simpson added.

Democrat Bonnie Watson-Coleman of New Jersey asked “why, why, why” Kennedy would lay off nearly all the staff that oversees the Low Income Home Energy Assistance Program, which provides $4.1 billion in heating assistance to needy families. The program is slated to be eliminated from the agency’s budget.

Kennedy said that advocates warned him those cuts “will end up killing people” but that President Donald Trump believes his energy policy will lower costs. If that doesn’t work, Kennedy said, he would restore funding for the program.

Kennedy heads next to to the Senate, where many eyes will be on his dialogue with Republican Sen. Bill Cassidy of Louisiana, who extracted a number of guarantees from Kennedy about his approach to vaccines.

Cassidy, a doctor, harbored a number of concerns about Kennedy’s history of promoting conspiracy theories or misspeaking about vaccines, he said during a confirmation hearing earlier this year.

“Can I trust that that is now in the past?” Cassidy asked Kennedy at the time.

Kennedy has since delivered a mixed message on vaccines that public health experts have said are hampering efforts to contain a measles outbreak now in at least 11 states. He’s offered endorsements of vaccinations but continued to raise questions about their efficacy or safety. He’s said the childhood vaccine schedule will be examined in a study of autism’s causes. He’s called the measles, mumps and rubella vaccine — a shot given to children to provide immunity from all three diseases — “leaky,” although it offers lifetime protection from the measles for most people. He’s also said they cause deaths, although none has been documented among healthy people.

At the agency, too, he’s made moves that support the anti-vaccine movement. He hired a man who has published research that suggests vaccines cause developmental delays to oversee a study on autism. And he’s terminated some research and public health funds dedicated to vaccines.

Kennedy, who has rejected the anti-vaccine label, has regularly said that he is “pro-safety” and wants more research on vaccines, although decades of real-world use and research have concluded they safely prevent deadly diseases in children.

“His longstanding advocacy has always focused on ensuring that vaccines, and other medical interventions, meet the highest standards of safety and are supported by gold-standard science,” Health and Human Services said in a statement. “As he did during confirmation, Secretary Kennedy is prepared to address questions surrounding this topic.”