Casey Means’ nomination to become the next U.S. surgeon general has stalled as senators pressed her on vaccines, her experience and license status, and her views on other health topics during a confirmation hearing that carried sharp partisan and policy tension, according to the Associated Press.
The delay, the AP reported, has left Means’ path to a full Senate vote uncertain as lawmakers weigh whether she can secure enough support from the Senate Health, Education, Labor and Pensions Committee. The nomination has languished despite efforts by the White House and groups aligned with the “Make America Healthy Again” push, which has helped define the administration’s broader health-policy agenda.
Means, described by the AP as a 38-year-old Stanford-educated physician who became disillusioned with traditional medicine and did not finish her surgical residency, has faced scrutiny over a lack of experience and potential conflicts. Senators have also focused on her close alignment with Robert F. Kennedy Jr., whose efforts to pull back vaccine recommendations have drawn criticism from lawmakers and medical groups.
To move ahead to a full Senate vote, the AP said Means likely needs support from Republican senators on the committee—particularly from lawmakers whose questions were not resolved after last month’s hearing. After the hearing, two Republicans, Sen. Lisa Murkowski of Alaska and Sen. Susan Collins of Maine, told reporters they still had questions for Means.
On Tuesday, Murkowski told reporters she was “in the same spot” regarding her hesitations. Collins and Republican committee chairman Sen. Bill Cassidy, a physician from Louisiana who questioned Means about vaccines during the hearing, did not respond to multiple inquiries about the nomination delay, the AP reported.
The White House said it is still working to advance the nomination. White House spokesman Kush Desai said in a statement that the Trump administration has been having “productive conversations with the Senate” to advance Means, adding 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,” according to the AP. Kennedy’s spokesman Andrew Nixon also reinforced the administration’s support and praised Means’ message about healthier lifestyle choices over what he described as “sick care,” the AP reported.
During the hearing, senators challenged Means’ vaccine positions and other health-related views. Murkowski and Cassidy pressed her 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 before a move was later temporarily blocked by a federal judge, the AP reported. Means called the vaccine important and lifesaving but said parents should make their own decisions with their doctors, according to the AP.
Cassidy also questioned Means about whether she would advise Americans to vaccinate against the flu and measles amid outbreaks across the country. The AP reported that she did not make that commitment and instead emphasized the importance of informed consent.
Collins asked Means about her past advocacy for the therapeutic use of psychedelic mushrooms. The AP reported that Means, who has spoken positively about her own experience with the drugs, said she would not recommend psychedelics for the American public.
Outside the committee room, the nomination has also drawn organized advocacy from both supporters and opponents. With Murkowski and Collins appearing undecided, MAHA activists orchestrated a phone-call push to support Means’ bid, the AP reported, citing Tony Lyons, head of the Kennedy-aligned group MAHA Action, who urged supporters to “Please call both of them. Call them time after time. Get your friends to call them.”
Opponents, the AP reported, have also argued that Means is not qualified. Dr. Jerome Adams, Trump’s first-term surgeon general, has repeatedly called her unqualified due to her lack of an active medical license. He said in an interview that Republicans in Congress and in the Trump administration disapprove of the pick but view it as Kennedy’s choice, according to the AP.
The AP reported that surgeons general are not required by law to have an active medical license, but they are required to be part of the U.S. Public Health Service Commissioned Corps, a group of health professionals that says members should have up-to-date licenses. Means told senators during her confirmation hearing that she voluntarily made her Oregon medical license inactive and that Adm. Brian Christine, who runs the Commissioned Corps, testified she was eligible to serve, the AP reported.
Even if Means advances from committee, the AP reported that she could face additional resistance in the full Senate. Republican Sen. Thom Tillis of North Carolina, who is not seeking another term, told the AP he is leaning against voting for Means, saying her resume puts him “on alert” and that he did not think she “did herself any favors in the hearing.”
The AP also said the delay is unusually long. Nearly 300 days after Means’ nomination in May, the confirmation process has taken almost twice as long as the average time for Trump’s nominees in his second term, according to data from the nonprofit Partnership for Public Service. The group found that in the first 400 days, the average time between nomination and confirmation for Trump’s nominees was 157 days, the AP reported.
The AP noted that in some cases the timeline can move quickly: it pointed to Markwayne Mullin, the new Department of Homeland Security secretary sworn in Tuesday, whose confirmation hearing, floor vote and swearing-in all occurred within a week. The AP said one reason for Means’ extended timeline was the birth of her son last October on the day of her originally scheduled confirmation hearing. But Chris Piper, manager of public policy and stakeholder engagement at the Partnership for Public Service, told the AP that a monthlong delay following a hearing is “atypical for most nominations, particularly at this level of position,” adding that candidates are often voted out of committee within a week of their hearing.