The Trump Administration Casts Out the ‘Soul’ of MAHA

As of today, it seems likely that the nation’s next surgeon general will, at least, have an active medical license. President Trump announced that he was pulling his nomination for Casey Means, a wellness influencer who dropped out of her surgical residency in 2018, in a Truth Social post this afternoon. The move is the latest setback for Health and Human Services Secretary Robert F. Kennedy Jr.’s Make America Healthy Again movement, which has embraced Means’s criticism of the medical establishment along with her fondness for raw milk and psychedelics. Her book, Good Energy, might as well be MAHA’s bible. Vani Hari, an activist and influencer better known as the Food Babe, told me recently that if Means wasn’t confirmed, it would “ruin the soul of MAHA.”

Earlier this month, the White House seemed to still believe that Means could be confirmed. The president invited her to a roundtable for several MAHA influencers. (Among them was Kelly Ryerson, who told me that the group made clear to administration officials that Means’s troubled nomination was killing the mood of MAHA activists.) But when I spoke with Means this afternoon, shortly after Trump’s announcement, she told me that it had become obvious, over the past week, that she would not become the next surgeon general. In our conversation, Means emphasized that she remained upbeat about MAHA, but she was clearly frustrated by what she repeatedly described as a victory for the status quo. Her nomination had been stalled in the Senate since February, and three Republicans—Bill Cassidy, Lisa Murkowski, and Susan Collins—appeared to have strong reservations about her. Means called them “disgruntled senators who don’t fully understand the incredible movement that’s happening in our culture right now.”

The senators’ skepticism is understandable. As she tells her story, Means had trained as a physician only to decide that the medical system wasn’t doing enough to combat chronic disease. Since then, however, she has adopted some decidedly out-there views. Means has declared that Americans’ chronic health problems are part of a “spiritual crisis,” recounted her use of psychedelics, and argued that pesticides and hormonal birth control both indicate a “disrespect of life.” (During her Senate hearing, Means said that she had been referring to certain women with medical histories that might increase their risk of side effects from taking birth control.) She has decried seed oils for their unproven, supposedly ill effects on health and advises her Good Energy readers to avoid all conventionally grown foods. During a 2024 appearance on Tucker Carlson’s podcast, she questioned the universal birth dose of the hepatitis-B vaccine. Her close association with Kennedy, a longtime anti-vaccine activist, doesn’t help either.

[Read: America’s would-be surgeon general says to trust your ‘heart intelligence’]

Means insisted when we spoke this afternoon that vaccine safety isn’t one of her primary issues and that her message is instead “about empowerment and about fixing broken health-care incentives.” During her Senate confirmation hearing, she indeed struck a moderate tone, telling Cassidy she believes that “vaccines are a key part of any infectious-disease public-health strategy.”

But Means’s lukewarm endorsement of immunization seems to have been insufficient. She believes, based on her conversations with Murkowski and Collins, that concerns about the anti-vaccine coalition in the MAHA movement helped tank her nomination, she told me. In another Truth Social post today, Trump blamed Cassidy, who chairs the Senate’s health committee, for blocking Means’s nomination, accusing the senator of playing “political games”; in an email, a White House spokesperson doubled down on blaming Cassidy and added that the president “remains committed to the MAHA agenda.” Means’s brother, Calley, a senior White House adviser and her co-author on Good Energy, was harsher, writing on X that Cassidy is a “mindless avatar for his donors.” (In response to a request for comment, Cassidy’s office sent a link to an X post from the Republican members of the Senate’s health committee, which said that Means clearly “did not have the votes on committee or on the floor.”)

The new surgeon-general nominee is Nicole Saphier, a radiologist and Fox News contributor. A number of her views align with Kennedy’s and fall outside the public-health consensus. In 2021, for example, she published a book arguing that the United States overreacted to the coronavirus pandemic for political reasons. She has also endorsed Kennedy’s upside-down food pyramid and echoed his praise for whole milk, both of which have received mixed reviews from nutrition experts. But Saphier is far more mainstream than the loudest MAHA activists. As a radiologist at Memorial Sloan Kettering (and the head of breast imaging for its clinic in Monmouth, New Jersey), she advocates for conventional cancer treatments. She has argued that the alleged evidence connecting vaccination with autism is inconclusive, has spoken in favor of the shots for measles and polio, and questioned Defense Secretary Pete Hegseth’s recent decision to repeal the flu-vaccine mandate in the military. (Saphier did not respond to a request for comment.)

Means’s defeat comes at a time when MAHA seems to have lost much of its momentum. Last month, a judge issued a preliminary ruling against several of Kennedy’s most anti-vaccine moves at HHS. The White House has reportedly told Kennedy to stop talking about that topic, for fear that it could hurt Republicans in the midterms. (Kennedy has instead been touting less controversial initiatives, including a plan to improve military food.) The administration has also orchestrated a series of staff changes at the CDC, including the nomination of a new director who has conventional public-health bona fides. In February, Trump signed an executive order that could give liability protection to manufacturers of glyphosate, an herbicide that some studies have linked to cancer and that MAHA activists have railed against; then, this morning, the House removed liability protections from the Farm Bill, which is now on its way to the Senate.

[Read: A new level of vaccine purgatory]

At the end of his 2024 campaign, Trump promised to let Kennedy “go wild on health” if he won the presidency. But now the White House and Republican lawmakers seem conflicted about just how much they’ll tolerate Kennedy’s MAHA movement. Apparently, having Means as the nation’s top doctor was further than they were willing to go.