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In a starkly partisan vote, the Republican-controlled Senate Finance Committee advanced Kennedy’s nomination 14-13, sending his bid to oversee the $1.7 trillion Department of Health and Human Services for a full vote on the Senate floor.

Meanwhile, Tulsi Gabbard’s nomination to be President Donald Trump’s director of national intelligence cleared a key Senate committee Tuesday despite concerns raised about her past comments sympathetic to Russia and a meeting with Syria’s now-deposed leader.

A former Democratic congresswoman, Gabbard is one of Trump’s most divisive nominees, with lawmakers of both parties also pointing to her past support for government leaker Edward Snowden. But the Senate Intelligence Committee advanced her nomination in a closed-door 9-8 vote, with the committee’s Democrats voting no.

Full Senate votes on the nominees have yet to be scheduled. Given strong Democratic opposition and thin Republican margins, Gabbard and Kennedy will need almost every GOP senator to vote yes to win confirmation.

Kennedy's path

All Democrats on the Senate Finance Committee opposed Kennedy, whose family name was synonymous with their party for generations before he aligned with President Donald Trump during the 2024 presidential campaign. They sounded an alarm on Kennedy’s work to sow doubt around vaccines and his potential to profit off lawsuits against drugmakers.

With Cassidy’s vote no longer in doubt, Kennedy’s nomination is likely to succeed absent any last-minute vote switches.

Cassidy publicly detailed his personal struggle, as a doctor who has seen the lifesaving ability of vaccines, with Kennedy’s confirmation. Yet when it came to his vote Tuesday, he advanced Kennedy with a simple “aye.�

Cassidy, who is up for reelection next year and could face a primary challenge, later described "intense conversations" with Kennedy and Vice President JD Vance that started over the weekend and continued into Tuesday morning, just before the vote. Those conversations yielded “serious commitments� from the administration, Cassidy said.

Cassidy said in a speech later on the Senate floor that, in exchange for his support, Kennedy promised not to make changes to existing vaccine recommendations that have been made by a federal advisory committee and has agreed not to scrub the Centers for Disease Control and Prevention of statements that clarify vaccines do not cause autism.

In addition, Cassidy said Kennedy will consult with him on new hires for the agency and appear if asked quarterly before the Senate's health committee, which Cassidy chairs. A 30-day notice will be sent to the committee if Kennedy seeks to make changes federal vaccine safety monitoring programs.

Cassidy said Kennedy's formidable following waged a maximum pressure campaign, bombarding his office with thousands of messages daily.

Pediatricians reached out, too, expressing fears of rampant disease outbreaks and deaths among children if a man who has a history of denigrating inoculations is installed as the nation's health secretary, he said.

Republican Sens. Susan Collins of Maine, Lisa Murkowski of Alaska and Mitch McConnell of Kentucky have also been seen as potentially unsecured votes, because they voted against Trump's defense secretary nominee and have expressed concerns about Kennedy's anti-vaccine work. Kennedy could lose support from all three of those senators and still become the health secretary.

Democrats, meanwhile, continued to raise alarms about Kennedy's potential to financially benefit from changing vaccine guidelines or weakening federal lawsuit protections against vaccine makers.

“It seems possible that many different types of vaccine-related decisions and communications — which you would be empowered to make and influence as Secretary — could result in significant financial compensation for your family,� Democratic Sens. Elizabeth Warren of Massachusetts and Ron Wyden of Oregon wrote in a letter sent over the weekend to Kennedy.

As secretary, Kennedy would be responsible for food and hospital inspections, providing health insurance for millions of Americans and researching deadly diseases.

Gabbard's path

After a contentious confirmation hearing last week, where some senators questioned Gabbard harshly, GOP support for her fell into place following a pressure campaign over the weekend unleashed by Trump supporters and allies, including Elon Musk.

Though some Republicans have questioned Gabbard's past views, they support her calls to overhaul the Office of the Director of National Intelligence, which coordinates the work of 18 federal agencies focused on intelligence collection and analysis. GOP lawmakers have also taken aim at the office, saying it's grown too large and politicized.

Senate Intelligence Chairman Tom Cotton, an Arkansas Republican, said Tuesday that he looked forward to working with Gabbard to “bring badly needed reforms� to ODNI.

Gabbard is a lieutenant colonel in the National Guard who deployed twice to the Middle East and ran for president in 2020. She has no formal intelligence experience, however, and has never run a government agency or department.