Trump’s Surgeon General Pick Faces Mounting Gop Opposition

A new wave of attacks from conservatives is further imperiling President Donald Trump’s pick for surgeon general — and testing the power of Health Secretary Robert F. Kennedy Jr.’s Make America Healthy Again campaign to combat chronic disease.

Casey Means’ nomination was already stalled in the Senate over concerns she’s insufficiently supportive of vaccines, and now Republican factions from anti-abortion activists to anti-drug warriors are starting to pile on.

The Ethics and Religious Liberty Commission, the policy arm of the Southern Baptist Convention, which is the largest and most influential protestant denomination, urged senators on the Senate Health Committee earlier this month to vote against Means because of remarks she made about the abortion medication mifepristone during her confirmation hearing.

When pressed about whether an in-person doctor’s visit should be required for a mifepristone prescription — one of abortion opponents’ top federal policy demands — Means largely deflected, calling the question “out of the purview of the surgeon general's office.”

The Southern Baptists also took issue with Means’ embrace of psychedelics, calling out her “blatant flaunting of prior illicit drug use.” Means’ book, "Good Energy," encouraged the “intentional, guided” use of psilocybin — the active compound in magic mushrooms — as a tool for improving mental health, and she has talked about her positive personal experiences with the substance, which is illegal to take or possess under federal law.

As MAHA advocates push top White House officials to strongarm her nomination through, and Kennedy uses his marathon run of congressional hearings to give Means a rousing endorsement, her rejection would call into question the movement’s influence within the Republican party. The fight over who should serve as the nation’s top doctor also spotlights tensions within the coalition that Trump believes fueled GOP victories in 2024, pitting newer MAHA arrivals against social conservatives that have long been a pillar of the GOP.

"If Dr. Means has any chance of saving her nomination, she must come out against mail-order abortion and show congressional leaders and the American public that she is willing to take the office seriously,” Gavin Oxley, a spokesperson for Americans United for Life, told POLITICO.

Another anti-abortion leader, granted anonymity to discuss private conversations, said an anti-Means lobbying campaign is happening under the radar on Capitol Hill, with activists telling senators in private meetings that Means is too soft on their policy priorities. Yet the activists haven’t approached the White House with their concerns, given the increasingly strained relationship between abortion opponents and the Trump administration.

"There’s definitely discontent and hesitation about someone with her background, beliefs and lack of commitment to the values the pro-life movement sees as important," the leader said. “But the complicating factor is that some of the louder groups, including the Heritage Foundation and Students for Life, have tried to ally with MAHA in various ways and so are worried about burning that newly-constructed bridge."

Means’ views on drugs have also sparked outcry.

She and Kennedy, plus many other Republicans, have touted psychedelics as a promising mental health treatment and called for making them easier to access, drawing backlash from the party’s law-and-order wing. Trump signed an executive order on Saturday that directed federal agencies to fast-track research and FDA approval of certain psychedelic drugs, such as ibogaine.

Advancing American Freedom, founded by former vice president Mike Pence, has spent months working to sink Means’ nomination in part because of her use of psychedelics.

“Even in an age of therapeutic experimentation, this should give senators pause,” wrote Marc Short, the Pence group’s chair and a former director of legislative affairs for Trump during his first term, in an op-ed in The Washington Post last month. “Many Americans still look to the surgeon general for serious, evidence-based guidance on everything from opioid abuse to mental health.”

Her brother and Kennedy adviser, Calley Means, said he thinks Republicans "will do the right thing" for her nomination, while speaking at the POLITICO Health Summit Tuesday. But the pro- and anti-Casey Means factions of the GOP are currently at an impasse.

Three Republican senators on the Health, Education, Labor and Pensions Committee handling Means’ nomination — Bill Cassidy of Louisiana, Lisa Murkowski of Alaska and Maine’s Susan Collins — have declined to say they’ll support Means since her confirmation hearing. And Cassidy, the committee’s chair, hasn’t scheduled a vote to advance her to the full Senate.

Murkowski said she’s concerned about equivocal responses Means gave during the hearing about promoting vaccination. Collins questioned her sharply about her use of psychedelics. Cassidy has declined to comment.

Yet a Republican Senate aide, granted anonymity to discuss private conversations, said Means’ problems extend beyond those three members. While Sen. Thom Tillis (R-N.C.) has said publicly that he is leaning against Means, the aide said several others are similarly opposed but see no reason to risk the administration or MAHA’s wrath by speaking up while the nomination remains in limbo.

“If Republicans had the votes they would have voted already,” the aide said. “The reason the HELP committee hasn't acted yet is because Means lacks the votes on the floor.”

When Rep. Julia Letlow, Cassidy’s primary opponent, brought up the fight over Means at a House hearing last week, Kennedy called the surgeon general nominee “the most articulate, eloquent and erudite evangelist of the MAHA movement.”

“She's going to help our country, and the only thing that would prevent that is the kind of lack of integrity, lack of courage and the tribalism that is polarizing and destroying our country,” Kennedy said.

Letlow has also repeatedly cited Cassidy’s refusal to schedule a vote on Means as she campaigns against him ahead of their May 16 primary.

Meanwhile, as the Senate stalemate continues, the Trump administration is sending mixed signals about its dedication to pushing Means’ nomination through.

Last month, the president appeared open to pulling her nomination, saying there were many other “great candidates” for the job. Yet the White House walked back that statement a few days later and in April invited several MAHA leaders to the White House.

Influencer Kelly Ryerson, known as “Glyphosate Girl” online, said she made it clear in that gathering that failure to get Means confirmed would be “not great for MAHA morale” at a time the movement was already upset with Republicans.

MAHA advocacy groups have asked their followers to call senators and pressure them to confirm Means. But the GOP Senate aide said that wave has yet to materialize.

“Those calls have been far outnumbered by people concerned about other issues, primarily the war in Iran,” the staffer said.