WASHINGTON — The Trump administration has dropped its nomination of Casey Means to be the next surgeon general, opting instead for Nicole Saphier, a radiologist and Fox News contributor.
The move is a blow to the Make America Healthy Again movement’s months-long push to get Means confirmed. But Saphier shares some commonalities with MAHA, including an interest in personal wellness and a skepticism of vaccine mandates.
It also signals the limits of President Trump’s power to achieve Senate approval, especially after months of concerns from lawmakers about his health agenda. The administration has nominated a health official to lead the Centers for Disease Control and Prevention who is also awaiting Senate review.
Trump announced the change on social media and blamed Sen. Bill Cassidy (R-La.) for blocking Means. Cassidy leads the committee tasked with nominees for surgeon general. He called the senator, a physician who has expressed deep concerns with Robert F. Kennedy Jr.’s vaccine policies, “disloyal.”
“Nevertheless, despite Senator Cassidy’s intransigence and political games, Casey will continue to fight for MAHA on the many important Health issues facing our Country,” Trump wrote.

Kennedy also blasted Cassidy in a social media post for “sabotaging” Means.
“Bill Cassidy once again did the dirty work for entrenched interests seeking to stall the MAHA movement and protect the very status quo that has made America the sickest nation on earth,” he wrote.
Cassidy declined to comment on Trump’s remarks when asked by reporters, Samantha Handler of Punchbowl News wrote on social media. The Senate’s health committee said it declined to hold a vote on Means because she didn’t have the support to be confirmed.
Cassidy is facing a difficult primary contest, with Trump and the national MAHA movement backing one of his opponents.
Means, who completed medical school but dropped out of residency, drew criticism for her lack of a medical license or experience treating patients.
Saphier is a practicing physician at the Memorial Sloan Kettering Cancer Center and director of breast imaging at MSK Monmouth in New Jersey, where she lives. She’s married to a physician and has three children, including a child she became pregnant with at 17.
What to know about Saphier
On Thursday afternoon, Trump signed the orders swapping the nominations and praised Saphier.
“She’s with Fox — was with Fox,” Trump said. “She’s great. ”
An aide noted to the president that Saphier is also with Sloan Kettering and an “outstanding doctor.”
Saphier has credited her own mother with supporting her as she became a parent, encouraging her to pursue college and medical school.
She graduated from the Ross University School of Medicine in Barbados and was a resident at Valleywise Health, formerly Maricopa Integrated Health System, in Phoenix.
According to Ross, she completed an oncological imaging fellowship at Mayo Clinic in Arizona and later advocated for the state to pass a law requiring doctors to inform patients if they have dense breast tissue, which can make detecting cancer harder. She has similarly advised the state of New Jersey on notifying patients about dense breast tissue.
According to her biography on AAE Speakers, she has served on the CDC’s Advisory Committee on Breast Cancer in Young Women, though she is not currently listed as a member.
On vaccines, an issue that has become something of a litmus test because of Kennedy’s history as an anti-vaccine advocate, Saphier appears to to oppose mandates while remaining firm that vaccination has positive impacts.
As a regular contributor to Fox Business, she has said that the overwhelming majority of “good research” disputes the notion that vaccines are linked to autism, and she has encouraged the use of the MMR vaccine.
She has previously said higher rates of autism in the U.S. may be attributed to environmental exposures, including chemicals from agricultural and pharmaceutical products. Still, she encouraged further research into safety signals in vaccines, saying she hoped it would restore confidence in the shots.
Some MAHA leaders appear to be getting behind the change. Mary Talley Bowden, founder of Americans for Health Freedom, said on social media that Saphier had “recently reached out” with “kind words” and hoped the new nominee would bring reason to public health policy, despite acknowledging the two didn’t see eye-to-eye during the pandemic.
“She seems to have changed her views from our communications,” Bowden said of Saphier.
On a recent episode of her podcast, Wellness Unmasked, Saphier said she is uncertain about the recent decision by Defense Secretary Pete Hegseth to drop a mandatory flu vaccination policy for troops.
She is the author of the book “Make America Healthy Again: How Bad Behavior and Big Government Caused a Trillion-Dollar Crisis,” which advocates for Americans to take better care of themselves to improve the country’s health.
Saphier was critical of the Biden administration’s handling of Covid — and supportive of Trump’s pandemic policies. She appeared during the early days of the pandemic, along with Mehmet Oz, now a top administration health official, at a Fox Covid town hall with Trump himself and other administration officials, where she praised the president’s decision to close the country’s borders.
Means, other Trump nominees failed to win over senators
Cracks in Means’ confirmation hopes showed during her hearing before the Senate’s health committee. She dodged multiple questions on vaccines, repeatedly calling for more research rather than endorsing universal immunization. Her past use of psilocybin also raised eyebrows, as did her lack of a medical license and her business ventures.
After the hearing, Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska), along with Cassidy, declined to pledge their support for Means. She likely would have needed the backing of every Republican on the committee to advance.
Trump has been forced to pull a number of other nominees for health care roles.
Last year, Janette Nesheiwat, then-surgeon general nominee and a former Fox News contributor, had her nomination pulled. The White House withdrew her after questions about where she earned her medical degree and opposition from Trump ally Laura Loomer.
Former Florida GOP Rep. Dave Weldon saw his nomination to lead the Centers for Disease Control and Prevention scuttled after his skepticism on vaccines raised concerns from key Republican senators.
This article has been updated with additional information about Saphier.

