The nomination of wellness influencer Dr. Casey Means to serve as U.S. surgeon general has stalled, a month after a contentious confirmation hearing saw senators from both major parties grill her on vaccines and other health topics. The delay deepens doubts about her ability to secure the necessary votes for the role.
Despite ongoing efforts from the White House and “Make America Healthy Again” (MAHA) activists, the nomination has languished, highlighting persistent divisions over health policy, even when Congress has shown deference to President Donald Trump. This marks the latest setback for Health Secretary Robert F. Kennedy Jr.’s agenda, following two legal challenges last week.
Dr. Means, a 38-year-old Stanford-educated physician, became disillusioned with traditional medicine and did not complete her surgical residency. She has faced scrutiny over her limited experience and potential conflicts of interest. Her close alignment with Secretary Kennedy, whose push to significantly reduce vaccine recommendations has drawn criticism from lawmakers and medical groups, is another significant hurdle.
To advance to a full Senate vote, Dr. Means likely requires the support of every Republican on the Senate Health, Education, Labor and Pensions Committee. However, following last month’s hearing, two key Republicans – Alaska Senator Lisa Murkowski and Maine Senator Susan Collins – indicated they still had unanswered questions.
Senator Murkowski stated on Tuesday that she remains in “the same spot” regarding her hesitations. Senator Collins and Republican committee chairman Senator Bill Cassidy, a Louisiana physician who questioned Dr. Means extensively on vaccines during the hearing, did not respond to inquiries about the delay.
White House spokesman Kush Desai affirmed the Trump administration is engaged in “productive conversations with the Senate” to advance Dr. Means’ nomination. He added 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.”
Kennedy spokesman Andrew Nixon reiterated the Republican administration’s backing for Dr. Means, praising her message advocating for healthier lifestyle choices over what he termed “sick care.”
The contentious hearing underscored the difficult path to confirmation. Dr. Means promotes ideas popular within the MAHA movement, including the belief that Americans are overmedicalized and that diet and lifestyle changes are central to combating widespread chronic disease.
However, she has been criticized for holding an inactive medical license, for sometimes failing to disclose financial relationships with brands she promotes, and for certain past health-related comments.
During her hearing, senators questioned her approach to public communication regarding vaccines. Senators Murkowski and Cassidy pressed Dr. Means on her past skepticism about the birth dose of the hepatitis B vaccine. While the U.S. Centers for Disease Control and Prevention recently paused its recommendation for all children – a move later temporarily blocked by a federal judge – Dr. Means acknowledged the vaccine’s importance but stressed parental decision-making with doctors.
Senator Cassidy also inquired if she would advise Americans to vaccinate against the flu and measles amidst ongoing outbreaks. She avoided a direct commitment, instead emphasizing the importance of informed consent. Senator Collins questioned Dr. Means about her past advocacy for the therapeutic use of psychedelic mushrooms. Dr. Means, who has spoken positively about her own experiences, stated she would not recommend psychedelics for the general American public.
As Senators Murkowski and Collins appeared undecided, MAHA activists launched a campaign to support Dr. Means’ bid, urging supporters to inundate the senators with phone calls. “Please call both of them. Call them time after time. Get your friends to call them,” Tony Lyons, head of the Kennedy-aligned group MAHA Action, instructed supporters earlier this month.
Conversely, others have vocally opposed Dr. Means’ nomination. Dr. Jerome Adams, who served as Surgeon General during President Trump’s first term, has repeatedly deemed her unqualified due to her inactive medical license. He noted in an interview that Republicans in Congress and the Trump administration privately disapprove of the choice but view it as Secretary Kennedy’s prerogative.
“What I keep hearing from folks is, ‘This is what Bobby wants,’” Dr. Adams said.
While an active medical license is not legally mandated for the Surgeon General, the U.S. Public Health Service Commissioned Corps, which members are required to join, states that its health professionals should possess up-to-date licenses. Dr. Means testified during her hearing that she voluntarily made her Oregon medical license inactive, and that Adm. Brian Christine, who leads the Commissioned Corps, had confirmed her eligibility to serve.
Even if Dr. Means clears the committee, securing confirmation by the full 100-member Senate remains challenging. Republican Senator Thom Tillis of North Carolina, who is not seeking re-election, told The Associated Press he is leaning against voting for her.
![‘[Means] resume already puts me on alert — and then I don’t think she did herself any favors in the hearing,’ Senator Tillis remarked.](http://static.independent.co.uk/2026/03/25/15/54/GettyImages-2262971677.jpg)
“Her resume already puts me on alert — and then I don’t think she did herself any favors in the hearing,” Senator Tillis remarked.
Dr. Means’ confirmation delay is unusually protracted. At nearly 300 days since her nomination in May, her process has taken almost twice as long as the average presidential pick in President Trump’s second term. Data from the nonprofit Partnership for Public Service indicates that the average time between nomination and confirmation for Trump’s nominees was 157 days within the first 400 days.
Some processes have moved much faster. Markwayne Mullin, the new Department of Homeland Security secretary, had his confirmation hearing, floor vote, and swearing-in all within a single week.
One factor contributing to Dr. Means’ drawn-out nomination was the birth of her son last October, which coincided with her initially scheduled confirmation hearing. However, Chris Piper, manager of public policy and stakeholder engagement at the Partnership for Public Service, noted that the length of time since her rescheduled hearing is also atypical. He explained that candidates are often voted out of committee within a week of their hearing.
“A monthlong delay following a hearing is atypical for most nominations, particularly at this level of position,” Piper concluded.
