Trump’s atypical surgeon general pick faces Senate scrutiny: Key takeaways

The Hill · Feb 25, 2026 · Collected from RSS

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After months of delay, President Trump’s nominee for U.S. surgeon general, Casey Means, appeared before the Senate, facing intense questions over her qualifications, personal health care practices and career as a social media influencer. Means appeared before the Senate Committee on Health, Education, Labor and Pensions (HELP) on Wednesday, about four months after her initial hearing was rescheduled when she went into labor just hours before it was meant to begin. Trump picked Means, a graduate of Stanford University School of Medicine, to be his surgeon general more than half a year ago after the qualifications of his first pick, Janette Nesheiwat, came under question. Means would be an unprecedented pick, not having completed her medical residency or having an active medical license. She is the sister of White House senior adviser Calley Means, one of Health Secretary Robert F. Kennedy Jr.’s top advisers, and a prominent “Make America Healthy Again” influencer in her own right. Former surgeons general have spoken out against her nomination. Trump’s former Surgeon General Jerome Adams said of Means, “I feel strongly that the person who is leading America’s Public Health Service should be held to the same standard as the people he or she is leading.” Here are five key takeaways from Means’s confirmation hearing. Refuses to urge vaccines As with many of Trump’s health nominees, senators on both sides of the aisle zeroed in on Means’s views on vaccinations. Means sought to characterize her previous rhetoric about vaccines to be more about informed consent rather than questioning vaccine efficacy. Sen. Bill Cassidy (R-La.), chair of the HELP Committee, asked whether Means would encourage mothers to get their children vaccinated against measles, given the ongoing measles outbreaks across the country and the U.S. poised to lose its measles elimination status. “Like you, I’m a physician. I believe vaccines save lives. I believe that vaccines are a key part of … any infectious disease public health strategy,” Means said. “I’m supportive of vaccination. I do believe that each patient, mother or parent needs to have a conversation with their pediatrician about any medication they’re putting in their body and their children’s body.” When pressed by Cassidy, however, Means declined to say if she’d encourage other mothers to get their children vaccinated against measles. A highly contentious moment occurred when Sen. Tim Kaine (D-Va.) challenged Means to contradict Health and Human Services Secretary Robert F. Kennedy Jr., who claimed last month there is no evidence that flu vaccines prevent hospitalizations or deaths among children. Means repeatedly tried to avoid answering whether she agreed with that statement, first saying she believed vaccines save lives and then saying she hadn’t seen that interview. When Kaine pressed her further, she eventually said she supports CDC guidance on the flu vaccine and believed it was effective at a population level, but again said families should consult their physicians. Federal guidance recommends everyone six months and older get the annual flu shot unless they have a condition contraindicated to the injection. Sen. Angela Alsobrooks (D-Md.) brought up a past social media post in which Means said the hepatitis B birth dose was a “crime.” Means argued “that is not the full tweet,” though the rest of the post did not refute or clarify her claim. Hepatitis B vaccinations are an issue close to Cassidy’s heart, the senator having been a physician specializing in liver conditions. He used the last few minutes of the hearing to press Means on whether she would recommend the immunization. Means skirted around the issue at first, only noting that the vaccine is still available and that parents should have “autonomy over the decision,” which Cassidy noted they already do. After several minutes of this, Means agreed a hepatitis shot for children “at some time in their youth” would be an “important recommendation.” Social media stardom takes center stage Means, 38, would be the first millennial surgeon general if confirmed and has shared many of her thoughts and opinions online as an influencer, which provided HELP Committee members with plenty of fodder for questioning. Across her accounts on Instagram and the social platform X, Means has more than 1 million followers, along with a large readership through her weekly “Good Energy” newsletter. “She is a proven communicator. She’s appeared on over 200 podcasts. She’s a faculty course director at Stanford. She’s been featured in articles in The Wall Street Journal, Forbes, New York Times. She inspires, educates on complex health issues,” Sen. Roger Marshall (R-Kansas) said when introducing Means. However, Democrats focused on potential cases of conflict of interest and questionable endorsements on these platforms. Sen. Chris Murphy (D-Conn.) noted there is currently a pending complaint against Means over her alleged failure to abide by Federal Trade Commission (FTC) policies regarding online endorsements. Agency guidelines require that people making endorsements online disclose their financial ties with the company selling the product. “You routinely violated this policy, and that in fact, in the majority of your posts for many of the products we recommend, you did not transparently reveal your financial connection,” Murphy said. Means shot back, “That’s false.” Sen. Tammy Baldwin (D-Wis.) pressed Means about her promotion of another health care company, Genova Diagnostics, which agreed to pay up to $43 million in 2020 to settle allegations about improperly submitted claims to Medicare. “Frankly, I was not familiar with that settlement,” said Means. “There’s a particular test that they make about nutrient quality that I find very compelling, because I do think we need to understand a little bit more transparently about how the nutrients from our food are affecting our health.” According to Baldwin, Means earned $10,000 for her promotion of Genova, more than $300,000 since 2024 through endorsing supplements, as well as nearly $50,000 for “wellness teas and elixirs.” “Just to be very clear, I’ve spent the last several months working with the Office of Government Ethics to be fully compliant with this process,” Means told Murphy. Defends professional qualifications A recurring point of contention in Means’s nomination is her qualifications to be surgeon general, a job dubbed America’s “top doctor” and historically reserved for practicing physicians. Sen. Andy Kim (D-N.J.) sought clarification on whether Means, who left her residency program before completion, had an active medical license. “I have not been seeing patients over the last several years. And so I currently, with the status of my license that I voluntarily put on inactive status, which I’m sure what you’re getting at, cannot prescribe a prescription right now,” Means said. She added that while it would be “possible” to get her license reactivated, she has no plans to do so. Trump also nominated Means to be Medical Director in the Regular Corps of the Public Health Service, which Kim noted requires “keeping professional licensure and certification up to date.” He asked Means how she plans to reconcile that requisite with her inactive license. “I do have a medical license right now. It is voluntarily placed on inactive status because I’m not actively seeing patients at this time, the HHS and Admiral Brian Christine have testified in front of this committee that I am eligible to serve as the medical director of the HHS,” Means said. Collins asks about magic mushrooms Sen. Susan Collins (R-Maine) drew concerns about Means from her book “Good Energy,” in which she detailed her use of psychedelic psilocybin mushrooms. “I am concerned that in your book on ‘Good Energy’ that you urge readers to consider psilocybin-assisted therapy,” said Collins. “You also said that you were inspired to try psychedelics in what I can only describe as an internal voice that whispered, ‘It’s time to prepare.’ Illicit drug use remains a huge problem in this country, and this didn’t happen in your teen years. According to your book, in 2021 you began using illicit psychedelic mushrooms.” Collins asked if Means stood by the advice given in her book. “I would start by just saying that I believe what I would say as a private citizen is in many cases different than what I would say as a public health official,” Means responded, adding that she believes the “science is still emerging” when it comes to using psychedelic therapy for mental health. “It would certainly not be a recommendation to the American people to do that under no circumstances,” added Means. Collins pressed her on the “internal voice” she heard whispering to her. Means said her mother was diagnosed with pancreatic cancer about a week after her experience with psilocybin and she believed that the voice was an indication “something ominous was coming.” Copyright 2026 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.