President Trump on Thursday pulled the nomination of Casey Means to be U.S. surgeon general, directly accusing Senator Bill Cassidy of Louisiana of sabotaging the process. In a blistering post on Truth Social, Trump wrote that Cassidy had engaged in “political games” that ultimately forced his hand, and he warned Louisiana Republicans that he would work to unseat the senator in the upcoming primary.
Trump announced he would replace Means with Nicole Saphier, a former Fox News contributor. Both Trump and White House senior adviser Calley Means, who is Casey Means’s brother, placed the blame squarely on Cassidy for the nomination’s failure.
Trump’s attack on Cassidy
In his post, Trump described Cassidy as a “very disloyal person” who had been elected only because of Trump’s endorsement, later voting to impeach him over what Trump called a “total Hoax and Scam.” He accused Cassidy of obstructing Means, whom he had nominated at the recommendation of Health and Human Services Secretary Robert F. Kennedy Jr. “I nominated Casey, a strong MAHA Warrior, at the recommendation of Secretary Kennedy,” Trump wrote, adding that despite Cassidy’s “intransigence and political games,” Means would continue to fight for the Make America Healthy Again movement. He concluded with a direct threat: “I hope Louisiana voters will be voting Bill Cassidy OUT OF OFFICE in the upcoming Republican Primary.”
Calley Means took to X to accuse Cassidy of working to “delay” and “smear” his sister as anti-vaccine. He predicted Cassidy would lose reelection and “immediately work for the pharmaceutical industry who funded his political career,” calling him an “inconsequential figure” trying to halt the MAHA conversation Trump and Kennedy had unleashed. The Hill has reached out to Cassidy’s office for comment.
Cassidy’s concerns and primary pressure
During Means’s confirmation hearing before the Senate Committee on Health, Education, Labor, and Pensions, which Cassidy chairs, the Louisiana Republican expressed reservations about her views on vaccines. Other GOP panel members, including Senators Lisa Murkowski of Alaska and Susan Collins of Maine, also raised concerns about her positions on vaccines and psychedelics. Cassidy has previously shown exasperation with the turnover of Trump health nominees; when former CDC director Susan Monarez was fired less than a month after her confirmation, Cassidy suggested it was a poor use of Senate Republican support. With two Cabinet members recently removed, Senate Republicans may be seeking nominees who are likely to last longer and avoid repeat confirmation battles.
Cassidy is currently facing primary challenges from Louisiana Treasurer John Fleming and Representative Julia Letlow, and a recent Emerson College poll shows him trailing both. The surgeon general’s role is relatively small in federal health policy—issuing recommendations rather than drafting policies—and some Republicans appear comfortable leaving the position vacant.
This episode adds to a growing list of Trump administration personnel clashes. In a separate development, Trump’s attacks on judges have raised concerns about judicial independence, while Speaker Johnson weighs a DHS funding bill as the administration faces a cash crunch. The broader political landscape remains volatile, with King Charles’s visit and House turmoil adding to Washington’s chaotic week.
