President Donald Trump announced on April 30, 2026, that he is withdrawing the nomination of Dr. Casey Means for U.S. surgeon general and instead nominating Dr. Nicole B. Saphier for the position. The switch follows months of stalled confirmation for Means in the Senate, with Trump attributing the delay to opposition from Senator Bill Cassidy.
Trump made the announcement in two posts on his Truth Social platform, first defending Means and accusing Cassidy of blocking her nomination. Means, a Stanford-trained physician associated with the MAHA (Make America Healthy Again) Movement, had faced difficulty securing enough Senate support after her confirmation hearing in February 2026.
Shortly after, Trump introduced Saphier as his new nominee. Saphier is a radiologist and breast imaging director at Memorial Sloan Kettering Cancer Center Monmouth. She is also a former Fox News medical contributor and the author of Make America Healthy Again: How Bad Behavior and Big Government Caused a Trillion-Dollar Crisis, published in 2020.
“Nicole is a STAR physician who has spent her career guiding women facing breast cancer through their diagnosis and treatment,” Trump wrote, emphasizing her advocacy for early cancer detection and prevention. He also highlighted her communication skills, stating she makes complex health issues more understandable for the public.
Saphier has been a vocal critic of the COVID-19 pandemic response from public health authorities. In 2022, she drew controversy for tweeting about a rumored vaccine mandate for schoolchildren—a claim later debunked by The Washington Post. Beyond her medical practice, she founded DropRx, a company selling natural supplements aimed at improving focus and relaxation, with products marketed as physician-formulated though not FDA-reviewed for efficacy.
Means’ Stalled Confirmation
Dr. Casey Means’ confirmation encounter raised concerns among Senate members. During her February hearing, she refrained from unequivocally endorsing childhood vaccinations, responding ambiguously to questions about vaccines’ safety and links to autism. Cassidy, a practicing physician himself, stressed vaccine importance throughout the proceedings.
Means, who does not hold an active medical license, also disclosed past experimentation with psychedelic drugs. Her confirmation process faced additional delays due to the birth of her child in October 2025. Trump first nominated Means in May 2025, but her advancement on the Senate floor remained stalled, prompting her withdrawal.
Why it matters
The surgeon general serves as a leading spokesperson on public health issues for the federal government. The stalled confirmation of Means and subsequent replacement with Saphier signals Trump’s continued effort to install nominees aligned with his health policy views. Saphier’s public profile as a critic of some mainstream COVID-19 responses and a health entrepreneur adds complexity to the role amid ongoing debates over pandemic management and health communication.
Sources
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