The nascent Make America Healthy Again movement got one of its biggest wins last spring: Casey Means was selected to be the nation’s top doctor.
But more than 10 months later, the controversial surgeon general pick has yet to assume the position advising Americans on how to improve their health. Her nomination has stalled as some Republicans question her stance on vaccines, her medical credentials and her pushes against the medical establishment.
Means probably cannot afford to lose the support of a single Republican on the Senate Health committee, which has yet to schedule a vote to advance her nomination to the full Senate. The panel’s chairman, Sen. Bill Cassidy (R-Louisiana), repeatedly pressed Means on her views on immunizations during a late February hearing — questions she largely dodged — and Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska) afterward publicly said they still have questions.
Murkowski earlier this month told reporters she still has “strong reservations” about Means’s nomination. On Friday, Murkowski said she didn’t “have anything new.”
The stagnation sets up a test of the political power of the MAHA movement and its champion, Health Secretary Robert F. Kennedy Jr. Means wrote the book widely considered the bible of the MAHA movement, “Good Energy” with her brother, Calley Means, a top White House adviser on health issues.
While she honed her message on the importance of healthy food — talking points that Kennedy has tried to amp up as the midterms approach — she is getting tangled in his prior controversial stances on vaccines and other aspects of the MAHA movement, which has tried to galvanize supporters to call on reticent senators.
If her nomination makes it out of committee, she can only afford to lose the support of three Republicans on the floor with every Democratic senator likely to oppose her and all senators voting. Sen. Thom Tillis (R-North Carolina), who is not seeking reelection this year, told The Washington Post that he was leaning toward voting against her.
“I don’t think she performed particularly well in the hearing,” he said Wednesday, noting that while he likes “disrupters,” he was “not impressed with her background.”
Means’s confirmation hearing was postponed after she went into labor the day senators were initially scheduled to question her in late October. She came before the panel nearly four months later.
Despite the lack of momentum on Capitol Hill, the White House is standing behind its nominee.
“Dr. Casey Means’s 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,” White House spokesperson Kush Desai said in a statement. “The Administration continues to have productive conversations with the Senate to advance Dr. Means as our next surgeon general, and the White House looks forward to her swift confirmation.”
An official from the Department of Health and Human Services echoed those sentiments, saying the agency is working “closely with the Senate to secure her swift confirmation.”
Means has come under fire for the status of her medical license, which she has voluntarily placed in inactive status in Oregon, meaning she cannot practice medicine in the state, according to the state medical board. Means left her surgical residency in its final year and went on to pursue functional medicine and decry the medical establishment, while building a large social media following and becoming a health technology entrepreneur.
As a core part of her message, she has written that “the ability to prevent and reverse” a variety of ailments, such as infertility and Alzheimer’s, “is under your control and simpler than you think.” Medical experts say there is significant evidence that diet and exercise can lower the risk and slow the progression of some chronic diseases, but they have cautioned that she goes too far when she states that many can be reversed.
During her hearing, she did not explicitly recommend all Americans receive the measles and flu shots — a stance many public health experts said was previously unimaginable for the nation’s top doctor.
She instead said all patients should speak with their physicians and that vaccines save lives.
Despite expressing how his views on food overlapped with Means at the hearing, Sen. Bernie Sanders (I-Vermont), the panel’s ranking minority-party member, went on to beg her to combat Kennedy’s and President Donald Trump’s misinformation about vaccines. He told a Post reporter on Friday that he would not support Means’s nomination.
She also took fire from both sides of the aisle about pesticides, an issue that has animated the MAHA movement. Though members of the movement argue a popular weed killer is poisoning Americans, Trump has moved to protect its active ingredient glyphosate in an executive order.
MAHA’s political advocacy arm, MAHA Action, has been trying to rally its supporters, including on a weekly video call this week that flashed Collins’s and Murkowski’s office phone numbers on the screen.
“Get everybody you know to call her,” MAHA Action head Tony Lyons said about Collins, whom the group had also drawn attention to in an email to supporters calling for Maine constituents to contact the “key holdout.”
“The nomination of Dr. Casey Means for Surgeon General remains stalled in the Senate, with key Republican votes from Susan Collins and Lisa Murkowski in play,” Lyons told The Post. “The MAHA movement needs a truth-teller, not a puppet for the broken system.”
Cassidy, a physician who cast the key vote in Kennedy’s nomination but has become an antagonist to the secretary over vaccine issues, has not publicly said how he will vote.
When asked Friday about the status of Means’s nomination, he said, “No change.”
Vani Hari, an author, activist and Kennedy ally who also writes under the name the Food Babe, pointed to Cassidy as a potential holdup.
“I think the decision lies with Bill Cassidy at this point,” she said. “And he’s going to be in a world of hurt if he decides to oppose Casey Means because he will basically be opposing every single MAHA mom in the country.”
Lyons has pledged his groups will spend a million dollars to support Cassidy’s primary opponent, Rep. Julia Letlow (R-Louisiana), whom Trump has endorsed.
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