President Trump has swapped Surgeon General nominees again, pulling Dr. Casey Means and naming Dr. Nicole Saphier, while publicly blaming Senator Bill Cassidy for blocking Means and sparking a heated response from HHS Secretary Robert F. Kennedy Jr. and Means’ camp. The back-and-forth has exposed factional fights over vaccine policy, MAHA-aligned health reform, and confirmation-timing controversy, and it keeps the Surgeon General post unfilled well into the administration.
On March 29, a reporter aboard Air Force One asked President Donald Trump whether he would consider withdrawing Dr. Casey Means and picking someone else for Surgeon General. Trump answered that he was looking at other options while focused on foreign policy, and that swapping nominees “would be possible.”
Well, we’re looking at a lot of different things. I don’t know how she’s doing in the nomination process, I’m more focused on Iran. But, you know, something like that would be possible. We have a lot of great candidates for that.
Exactly one month later, Trump announced on Truth Social that Dr. Nicole B. Saphier would be his new nominee for Surgeon General. The post praised her clinical work in breast cancer care and her communication skills, promising she would help “MAKE AMERICA HEALTHY AGAIN.”
Trump’s Truth Social announcement read:
I am pleased to announce that I am nominating Dr. Nicole B. Saphier to be the next SURGEON GENERAL OF THE UNITED STATES OF AMERICA. Nicole is a STAR physician who has spent her career guiding women facing breast cancer through their diagnosis and treatment while tirelessly advocating to increase early cancer detection and prevention, while at the same time working with men and women on all other forms of cancer diagnoses and treatments. She is also an INCREDIBLE COMMUNICATOR, who makes complicated health issues more easily understood by all Americans. Dr. Nicole Saphier will do great things for our Country, and help, “MAKE AMERICA HEALTHY AGAIN.” Congratulations Nicole, our Country has long been waiting for you! President DONALD J. TRUMP
Dr. Saphier is a practicing radiologist at Memorial Sloan Kettering in New York and a familiar voice on cable news. Her nomination appears to be less combustible than prior picks, though MAHA supporters and others have not formally weighed in yet.
The exit of Dr. Casey Means was swift after months of scrutiny. Means, a high-profile advocate for metabolic health and author of Good Energy, faced questions about her vaccine-related remarks and other positions that made some senators wary during her HELP Committee review.
This administration still lacks a confirmed Surgeon General nearly a year and a half in. The first nominee, Dr. Janette Nesheiwat, was withdrawn amid opposition related to her pandemic-era positions. That set the stage for a troubled nomination process that produced two subsequent picks and fierce political fights over health messaging and policy direction.
Trump formally nominated Means in May 2025, but her confirmation timeline was messy. Her initial hearing was delayed by childbirth, and when she finally faced the Senate HELP Committee in February, she met resistance from both parties, including HELP Chairman Sen. Bill Cassidy of Louisiana.
Some senators raised concerns about Means’ stance on informed consent around vaccines and her admitted past use of psychedelics for trauma healing, topics she wrote about in Good Energy. Those concerns stalled her committee movement and ultimately kept her from reaching the full Senate for a confirmation vote.
On the same day Saphier was announced, President Trump publicly blamed Sen. Cassidy for blocking Means’ path and attacked his loyalty and past votes. The post framed Cassidy as obstructing a MAHA-forward pick and accused him of siding with entrenched interests.
For months, Senator Bill Cassidy (of the GREAT State of Louisiana!), a very disloyal person whose “TRUMP” Endorsement got him elected, but later voted to impeach “President Trump” on what has now proven to be a total Hoax and Scam, has stood in the way of Robert F. Kennedy Jr.’s Nominee, Casey Means, for the important position of U.S. Surgeon General. I nominated Casey, a strong MAHA Warrior, at the recommendation of Secretary Kennedy, who understands the MAHA Movement better than anyone, with perhaps the possible exception of ME! Nevertheless, despite Senator Cassidy’s intransigence and political games, Casey will continue to fight for MAHA on the many important Health issues facing our Country, such as the rising childhood disease epidemic, increased autism rates, poor nutrition, over-medicalization, and researching the root causes of infertility, and many other difficult medical problems. Casey, thank you for your service to our Nation! President DONALD J. TRUMP
HHS Secretary Robert F. Kennedy Jr. amplified the criticism, calling Means a leading voice for MAHA and accusing Cassidy of helping protect the status quo in health care. Kennedy framed the stalled appointment as evidence of entrenched interests resisting reform.
President Trump’s Surgeon General nominee, Casey Means, stands as one of the MAHA movement’s most powerful evangelists. Her book Good Energy, which exposed the nation’s catastrophic decline in metabolic health, has become a bible for the MAHA movement.
After graduating first in her class at Stanford Medical School, Casey walked away from her medical practice because she no longer wanted to be part of a sick-care system. She has committed her life to transforming American health care.
By sabotaging this appointment, Bill Cassidy once again did the dirty work for entrenched interests seeking to stall the MAHA movement and protect the very status quo that has made America the sickest nation on earth.
Casey Means will remain an important leader and a close partner as we uncover the root causes of the chronic disease epidemic and Make America Healthy Again.
Casey Means’ brother and other allies joined the chorus of criticism, and Means herself was outspoken about what she described as deliberate scheduling tactics by senators aimed at undermining her confirmation during her pregnancy. Her camp accused Cassidy of orchestrating delays that affected her hearings.
I am so proud of Casey, and the way she conducted herself during this process.
I am also proud to work for the Trump admin, who has marshaled the disruptive MAHA message and driven victories against dark forces personified by Bill Cassidy.
At every step, Casey’s message of hope and empowerment was thwarted by Bill Cassidy.
Bill Cassidy is a mindless avatar for his donors and a blind defender of the status quo system that is profiting from American sickness.
At every turn during Casey’s confirmation, Bill Cassidy worked to delay her and smear her.
For several months last year, Bill Cassidy knew Casey’s due date. He demanded to schedule her hearing on her due date, and at the last minute scheduled it two days later. He could have scheduled it weeks before. Casey ended up having her baby the hour her first hearing was scheduled.
Bill Cassidy worked with Mike Pence’s pharma-funded group to smear Casey in the media as not sufficiently pro-life – when anyone who has a rudimentary understanding of Casey’s message knows it is grounded in a deep respect and awe for the miracle of life.
To Casey’s assertion that Americans should consult with their doctor before taking any medical product, he worked to smear her as “anti-vaccine” for not saying every American should submit their children to mandatory injections without parental or medical input (which is his view).
Bill Cassidy will lose his re-election and immediately work for the pharmaceutical industry who funded his political career. He will be remembered as an inconsequential figure who tried to stop the important and disruptive MAHA conversation President Trump and RFK unleashed.
Because of his constant delay tactics, Casey is being pulled from consideration.
I am so proud of her and the historic change the Trump admin is pushing for against broken and corrupt defenders of the status quo like Bill Cassidy.
For now, Saphier steps into the spotlight and Means steps away, and the political fight over health policy and nominations continues. The story remains active as both sides press their narratives and seek advantage ahead of future confirmation fights.
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