President Donald Trump on Thursday abruptly withdrew the nomination of Casey Means to be surgeon general, a move that followed mounting opposition from Republican senators. In a post on Truth Social, Trump announced that his new choice for the post is Dr. Nicole Saphier, a radiologist and Fox News contributor who will leave her network role if confirmed.
Trump praised Saphier as a “STAR physician” who has dedicated her career to guiding women through breast cancer diagnosis and treatment, while also advocating for early detection and prevention across all cancer types. He called her an “incredible communicator,” signaling a shift toward a more conventional pick after two previous nominees failed to secure Senate GOP support.
Saphier is Trump’s third nominee for surgeon general. His first pick, Fox News contributor Janette Nesheiwat, also failed to advance. Means, a physician and the sister of senior White House adviser Calley Means, had been seen as a strong contender given her family ties to Health and Human Services Secretary Robert F. Kennedy Jr. But her confirmation hearing before the Senate Health, Education, Labor and Pensions Committee revealed deep reservations among Republicans, particularly over her stance on vaccines.
Senators Bill Cassidy (R-La.) and Lisa Murkowski (R-Alaska) voiced concerns that Means did not offer a full-throated endorsement of routine childhood immunizations, including those for measles and hepatitis B. Though Means stated she believed the vaccines were safe and effective, she stopped short of the ringing endorsement Cassidy and others sought. With no Democratic support likely, losing just a handful of Republican votes doomed her chances.
In his Truth Social post, Trump blamed Cassidy for the collapse of Means’s nomination, accusing him of “intransigence and political games.” He added that Means would continue to work on health issues such as childhood disease, autism rates, poor nutrition, and infertility research, under the banner of the Make America Healthy Again (MAHA) movement.
Calley Means, who serves as a senior White House adviser, did not hold back in his criticism of Cassidy. “I am so proud of Casey, and the way she conducted herself during this process,” he wrote on social media. “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.” He called Cassidy a “mindless avatar for his donors” and accused him of delaying the confirmation hearing to coincide with his sister’s due date.
The episode underscores the ongoing tension within the Republican Party over health policy, particularly around vaccine skepticism and the influence of Kennedy’s MAHA agenda. Trump’s decision to pivot to Saphier, a Fox News regular, suggests he is seeking a nominee who can navigate Senate confirmation while maintaining a high media profile.
For more on Trump’s health policy moves, read our coverage of Saphier’s nomination and Trump’s warning to Cassidy about a primary challenge.
