Means’ surgeon general nomination is stalled as senators question her experience and vaccine stance
NEW YORK (AP) — Wellness influencer Dr. Casey Means’ nomination to be U.S. surgeon general is stalled a month after senators of both major political parties grilled her on vaccines and other health topics during a tense confirmation hearing, deepening doubts about her ability to secure the votes she needs for the role.
The nomination has languished despite ongoing efforts from the White House and Make America Healthy Again activists to convince lawmakers to carry it forward, revealing how intractable rifts over health policy can be even when Congress has shown deference to President Donald Trump’s agenda.
Means, a 38-year-old Stanford-educated physician who became disillusioned with traditional medicine and did not finish her surgical residency program, has faced scrutiny for her lack of experience and potential conflicts. Another sticking point has been her close alignment with Health Secretary Robert F. Kennedy Jr., whose efforts to dramatically pull back vaccine recommendations have faced criticism from both Republican and Democratic lawmakers and a wide swath of the medical community.
To advance to a full Senate vote, Means likely needs every Republican on the Senate Health, Education, Labor and Pensions Committee to support her nomination. But after last month’s hearing, two of them — Sens. Lisa Murkowski of Alaska and Susan Collins of Maine — told reporters they still had questions for her.
Murkowski told reporters Tuesday that “I’m just in the same spot” when it comes to her hesitations over advancing Means’ nomination. Collins and Republican committee chairman Sen. Bill Cassidy, a physician from Louisiana who interrogated Means about vaccines during the hearing, didn’t respond to multiple inquiries about the delay.
White House spokesman Kush Desai said in a statement that the Trump administration has been having “productive conversations with the Senate” to advance Means. He added that her “elite academic credentials, research background and advocacy on America’s chronic disease epidemic will make her a critical asset for President Trump’s push to Make America Healthy Again.”
Kennedy spokesman Andrew Nixon reinforced the Republican administration’s support for Means. He said Means has “communicated a vital public health message that people voted for, that we need to fundamentally transform our health care system” to promote healthier lifestyle choices rather than “sick care.”
Contentious hearing set the stage for a tough path to confirmation
Means is an enthusiastic speaker and author who promotes ideas popular with the MAHA movement, including that Americans are overmedicalized and that diet and lifestyle changes should be at the center of efforts to end widespread chronic disease.
But she has faced criticism for having an inactive medical license, for at times failing to disclose financial relationships with health-adjacent brands she promotes and for some of her past comments on health topics.
On top of those concerns, senators asked her during her hearing to address Kennedy’s wide-ranging actions to scale back vaccine guidance and how she would speak to the public about them if confirmed.
Murkowski and Cassidy both pressed Means about her past doubts about the birth dose of the hepatitis B vaccine, which the U.S. Centers for Disease Control and Prevention stopped recommending for all children late last year in a move that was later temporarily blocked by a federal judge. Means called the hepatitis B vaccine important and lifesaving but said parents should make their own decisions in consultation with their doctors.
Cassidy also asked Means whether she would advise Americans to vaccinate against the flu and measles amid outbreaks across the country. She didn’t make that commitment, instead emphasizing the importance of informed consent.
Collins asked Means about her past advocacy for the therapeutic use of psychedelic mushrooms. Means, who has spoken positively of her own experience with the drugs, said that her comments as a private citizen were different from what she would say as a public health official and that she wouldn’t recommend psychedelics for the public.
Kennedy’s supporters put pressure on hesitant senators
Once it appeared Murkowski and Collins were undecided, MAHA activists orchestrated a push to support Means’ bid by surging phone calls to the two senators.
“Please call both of them. Call them time after time. Get your friends to call them,” Tony Lyons, head of the Kennedy-aligned group MAHA Action, said on a call with supporters earlier this month. “This is critical. We need to get this done.”
But throughout the monthlong delay, others have been vocal in opposing Means’ nomination. Dr. Jerome Adams, Trump’s first-term surgeon general, has repeatedly taken to social media to call her unqualified for her lack of an active medical license. He said in an interview that Republicans in Congress and in the Trump administration have told him they disapprove of the pick but see it as Kennedy’s choice.
“What I keep hearing from folks is, ‘This is what Bobby wants,’” he said.
While no federal law requires surgeons general to have a medical license, they are required to be part of the U.S. Public Health Service Commissioned Corps, a group of health professionals that requires up-to-date licenses for membership.
Means said during her confirmation hearing that she had voluntarily placed her Oregon medical license into inactive status because she wasn’t seeing patients and that Adm. Brian Christine, who runs the Commissioned Corps, had testified that she was eligible to serve in the role.
Even if Means advances out of committee, she might have difficulty securing confirmation by the full 100-member Senate, where she can only afford to lose support from three Republicans if all Democrats vote against her. Republican Sen. Thom Tillis of North Carolina, who has said he won’t seek another term, told The Associated Press that he’s leaning against voting for Means if her nomination reaches the Senate floor.
“Her resume already puts me on alert — and then I don’t think she did herself any favors in the hearing,” Tillis said.
Means’ confirmation delay is unusually long
At nearly 300 days since her nomination in May, Means’ confirmation process has taken almost twice as long as the average presidential pick in Trump’s second term, according to data from the nonprofit Partnership for Public Service. The group’s data shows that in the first 400 days, the average time between nomination and confirmation for Trump’s nominees was 157 days.
Sometimes the process has gone far more quickly. Markwayne Mullin, the new Department of Homeland Security secretary sworn in on Tuesday, had his confirmation hearing, floor vote and swearing-in all within a weeklong period.
One reason for Means’ drawn-out nomination is the birth of her son, which happened last October on the day she was initially scheduled to take part in her confirmation hearing. Her hearing wasn’t rescheduled until four months later, in February.
But Chris Piper, manager of public policy and stakeholder engagement at the Partnership for Public Service, said the length of time that has passed since Means’ rescheduled confirmation hearing also is unusual. He said candidates are often voted out of committee within a week of their hearing.
“A monthlong delay following a hearing is atypical for most nominations, particularly at this level of position,” he said.
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Associated Press writers Joey Cappelletti and Stephen Groves in Washington contributed to this report.