As of today, it seems likely that the nation’s next surgeon general will, at the very least, have an active medical license. President Trump announced that he was rescinding his nomination of Casey Means, a health lobbyist who left his surgical residency in 2018, in a Community Truth post this afternoon. The move is the latest setback for Health and Human Services Secretary Robert F. Kennedy Jr.’s campaign. of Make America Healthy Again, which has embraced Means’ criticism of the medical establishment as well as his love of raw milk and the mentally disabled. His book, Good Energyit could also be a MAHA bible. Vani Hari, the activist and influencer better known as the Food Babe, told me recently that if Means is not confirmed, “it will destroy the spirit of MAHA.”
Earlier this month, the White House appeared to still believe Means could be confirmed. The President invited him to a round table for several MAHA lobbyists. (Among them was Kelly Ryerson, who told me that the group made it clear to administration officials that Means’ controversial appointment was killing MAHA’s activist status.) But when I spoke with Means this afternoon, shortly after Trump’s announcement, he told me that it had become clear, in the past week, that he would not be the next surgeon general. In our conversation, Means insisted that he remained happy about MAHA, but was clearly confused by what he repeatedly described as a triumph of the situation. His nomination had been stalled in the Senate since February, and three Republicans—Bill Cassidy, Lisa Murkowski, and Susan Collins—appeared to have deep doubts about him. Means called them “disgruntled senators who don’t fully understand the extraordinary movement taking place in our culture right now.”
Skepticism of senators is understandable. As he tells his story, Means was trained as a doctor only to decide that the medical system was not doing enough to deal with chronic diseases. Since then, however, he has been adopted several external opinions. Means has declared that Americans’ chronic health problems are part of a “spiritual crisis,” recounted his use of psychiatric drugs, and said that pesticides and hormonal birth control all show “disrespect for life.” (During his Senate hearing, Means said he had been referring to certain women with a medical history that could increase their risk of side effects from taking birth control.) He has opposed seed oil because of its unproven, purportedly harmful health effects and advises it. Good Energy Readers avoid all conventionally grown foods. During a 2024 appearance on Tucker Carlson’s podcast, he questioned the birth dose of the hepatitis-B vaccine. His close relationship with Kennedy, a longtime anti-vaccine activist, doesn’t help either.
Means emphasized when we spoke this afternoon that vaccine safety is not one of his primary concerns and that his message is instead “about empowerment and about fixing the broken incentives for health care.” During his Senate confirmation hearing, he actually struck a moderate tone, telling Cassidy he believes that “vaccines are an important part of any public health strategy for infectious diseases.”
But Means’ endorsement of the vaccine movement seems insufficient. He believes, based on his conversations with Murkowski and Collins, that concerns about the anti-vaccine coalition in the MAHA movement helped in his selection, he told me. In another Social Truth post today, Trump blamed Cassidy, who chairs the Senate health committee, for blocking Means’ nomination, accusing the senator of playing “political games”; in an email, a White House spokesman doubled down on blaming Cassidy and added that the president “remains committed to the MAHA agenda.” Means’ brother, Calley, is a senior White House adviser and co-author Good Energyhe was even harsher, writing on X that Cassidy is “a mindless avatar for his sponsors.” (In response to a request for comment, Cassidy’s office sent a link to an X post from Republican members of the Senate health committee, which said that Means clearly “didn’t have a vote in committee or on the floor.”)
The newly appointed chief physician is Nicole Saphier, a radiologist and Fox News contributor. A number of his views are consistent with Kennedy’s and are not outside the public health consensus. In 2021, for example, he published a book saying that the United States touched the coronavirus epidemic for political reasons. He has also endorsed Kennedy’s inverted food pyramid and emphasized its merits for whole milk, which has received mixed reviews from nutritionists. But Saphier is more popular than MAHA’s loudest activists. As a radiologist at Memorial Sloan Kettering (and head of breast imaging for her clinic in Monmouth, New Jersey), she advocates for conventional cancer treatment. He has argued that the evidence purporting to link vaccines to autism is flawed, has spoken out in support of measles and polio vaccinations, and questioned Defense Secretary Pete Hegseth’s recent decision to cancel the order for flu shots in the military. (Saphier did not respond to a request for comment.)
Means’ defeat comes at a time when MAHA seems to be losing its momentum. Last month, a judge issued a preliminary decision against several of Kennedy’s anti-vaccine measures at HHS. The White House has reportedly told Kennedy to stop talking about the topic, fearing it could hurt Republicans in the midterms. (Kennedy instead has been promoting uncomplicated plans(including a program to improve military food.) The administration has also orchestrated a series of staff changes at the CDC, including the appointment of a new director who has common public health beliefs. In February, Trump signed an executive order that could provide liability protection for manufacturers of glyphosatea herbicide that some studies have linked to cancer and that MAHA activists have denounced; then, this morning, the House removed the liability protection from the Farm Bill, which is now on its way to the Senate.
At the end of his 2024 campaign, Trump promised to release Kennedy from “disordered health” if he won the presidency. But now the White House and congressional Republicans seem to be at odds over how far they will tolerate Kennedy’s MAHA movement. Apparently, having Means as the nation’s top doctor was more than they were willing to go.
