Trump Withdraws Casey Means Nomination, Names Nicole B. Saphier Surgeon General Replacement

President Donald Trump on Thursday withdrew Dr. Casey Means’s surgeon general nomination and announced Dr. Nicole B. Saphier as his replacement, ending a process that had stretched nearly a year.

“In a series of social media posts Thursday, President Trump withdrew his nomination of Make America Health Again influencer Casey Means to be surgeon general, lashed out at Sen”

Ars Technica

The Washington Post reported that Trump’s announcement “putting an end to Casey Means’s nomination process that had stretched nearly a year,” and said the choice of Saphier was Trump’s “third attempt to fill the job of the nation’s top doctor.”

Ars Technica

In a Truth Social post, Trump declared, “I am pleased to announce that I am nominating Dr. Nicole B. Saphier to be the next SURGEON GENERAL OF THE UNITED STATES OF AMERICA,” and called her “a STAR physician” and “an INCREDIBLE COMMUNICATOR.”

Multiple outlets tied the change directly to Senate math and stalled momentum: NBC News said “She didn’t have the votes to pass,” quoting Sen. Bill Cassidy telling NBC News, while The Guardian said Means’s nomination had been “stalled since a bruising February confirmation hearing.”

The New York Times described the withdrawal as a response to opposition “including from some Republicans,” and said Trump announced the new nominee in a social media post on Thursday.

The Associated Press reporting carried by PBS similarly said Trump’s decision followed “questions about her experience and her stance on vaccines,” and that the nomination had “stalled in the Senate.”

Across the coverage, Saphier’s professional identity was consistent: she is described as a radiologist and director of breast imaging at Memorial Sloan Kettering Cancer Center’s Monmouth facility, with the New York Times adding she is “the director of breast imaging at MSK Monmouth in New Jersey.”

The withdrawal of Means’s nomination was framed by Trump and echoed by other reporting as tied to Sen. Bill Cassidy’s opposition and to questions about vaccines.

NBC News reported that Trump said Thursday on Truth Social that “Sen. Bill Cassidy, R-La., had stood in the way of Means' nomination and called him 'a very disloyal person,'” and it quoted Cassidy saying, “The White House has known for a while she didn’t have the votes to pass.”

BBC

The Guardian described the same dynamic, saying Trump stated Means would continue to fight for “MAHA” “despite opposition from Bill Cassidy,” and it quoted Trump: “Despite Senator Cassidy’s intransigence and political games, Casey will continue to fight for MAHA on the many important Health issues facing our Country.”

PBS, drawing on Associated Press reporting, said Means’s path forward stalled “over questions about her experience and her stance on vaccines,” and it described the nomination as languishing “since her confirmation hearing in late February.”

The Los Angeles Times said senators questioned Means about “her vaccine stance and nontraditional medical background,” and Rolling Stone said Means faced “headwinds of more basic expectations for America’s top doctor.”

The New York Times added that Means’s confirmation was stalled “amid opposition, including from some Republicans, over her views on vaccines,” and it reported that Trump withdrew her nomination after that opposition.

The NBC News account also detailed the vaccine focus, saying Means was repeatedly asked about “the birth dose of the hepatitis B vaccine,” and it noted that the Centers for Disease Control and Prevention “stopped recommending for all children late last year.”

In a separate thread of the same controversy, Rolling Stone said Means’s nomination collapse reflected “her refusal to express plainspoken support for childhood vaccinations,” while NPR said Means told The Associated Press her nomination fell apart after a “yearlong smear campaign against me.”

Trump’s new nominee, Dr. Nicole Saphier, was presented as both a mainstream clinician and a political fit for the Make America Healthy Again agenda.

“Radiologist and former Fox News opinion contributor Dr”

Deadline

The New York Times said Trump described Saphier as “a STAR physician who has spent her career guiding women facing breast cancer” and “an INCREDIBLE COMMUNICATOR, who makes complicated health issues more easily understood by all Americans.”

Rolling Stone reported that Trump called her “a “STAR physician” and “INCREDIBLE COMMUNICATOR”” and described her as “a longtime Fox News contributor and radiologist at Memorial Sloan Kettering Cancer Center.”

The Los Angeles Times said Saphier is director of breast imaging at Memorial Sloan Kettering Monmouth and that she has a doctor of medicine degree from Ross University School of Medicine in Barbados, along with fellowships at the Mayo Clinic.

But the coverage also highlighted that Saphier’s views do not fully mirror the most prominent MAHA messaging.

Rolling Stone quoted Saphier from last year, saying, “Do I think it is the end-all be-all and going to save the health care system? No, I don’t.”

It also quoted her on MAHA’s critique of the system: “when they’re not [working inside] it, day after day” like she has been, and she said, “I would not want to be in any other health care system,” while adding, “You can be a supporter of the MAHA movement but not agree with every facet of it.”

NPR and PBS both described a similar divergence on Tylenol messaging during pregnancy, with PBS quoting Saphier’s email to Associated Press: “Advising moderation was sound; delivering it in a patronizing, simplistic way was not.”

At the same time, the New York Times said Saphier “rejects vaccine mandates and wants the childhood vaccine schedule to be flexible enough to allow some parents to delay giving infants their shots,” and it quoted her asking during a 2025 podcast, “Can we change the timeline?” and “Does every single child need all of these vaccines?”

Beyond the nomination itself, Rolling Stone and other outlets connected Saphier to the MAHA brand through her writing and attempts to claim ownership of its signature phrase.

Rolling Stone said Saphier “may have expressed some skepticism that MAHA is a panacea for all that ails American medicine,” but it also reported that she “tried to claim ownership of the phrase “Make America Healthy Again.””

Fox News

The magazine said that in April 2020, Saphier published a book entitled “Make America Healthy Again: How Bad Behavior and Big Government Caused a Trillion Dollar Crisis,” and that she attempted to trademark the phrase in June 2019.

It reported that the United States Patent and Trademark Office suspended her application in August 2019 due to a “prior-filed potentially conflicting pending application(s),” and it identified the competing filing as coming from “Gildardo Fullen, who works in California for a construction company.”

Rolling Stone said Fullen’s trademark application lapsed, but that Saphier’s application was “abandoned in September 2021, due to her failure to file the required paperwork.”

The outlet also included Saphier’s own explanation for the paperwork lapse, quoting her: “With the Covid pandemic underway and absolute mayhem, [with] three kids, it wasn’t on my to-do list.”

It added another quote from Saphier about the meaning of the phrase: “Would I have liked a little shoutout? RFK Jr. may be known as the father [of MAHA], that would make me the mother.”

The Guardian similarly described Saphier as the author of a “bestselling 2020 book titled Make America Healthy Again: How Bad Behavior and Big Government Caused a Trillion-Dollar Crisis,” and it said the book argues that “socialized medicine isn’t necessary for lower medical costs when you instead have healthy eating habits.”

In the same thread, NBC News said the title of Saphier’s 2020 book “Make America Healthy Again” became the slogan for Health Secretary Robert F. Kennedy Jr.’s agenda, linking her writing to the administration’s broader messaging.

The nomination switch sets up a new confirmation fight and underscores how the surgeon general role is being used amid broader public health leadership instability.

“Trump pulls Casey Means’ stalled surgeon general nomination”

Los Angeles Times

The Guardian reported that “Now, Saphier is the third person Trump has nominated to the post,” and it said the appointment comes as “the wider public health apparatus remains in disarray,” including that the CDC “has been without a permanent, Senate-confirmed leader since August 2025.”

Los Angeles Times

The Guardian further said “there were months-long gaps in leadership at the National Institutes of Health,” and that “the CDC alone has cycled through four directors or acting directors since Trump took office,” while “80% of the top positions at the agency remain vacant.”

In the immediate political aftermath, NBC News said the Means nomination had stalled in the Senate health committee where Cassidy chairs the HELP Committee, and it quoted Cassidy explaining that “She didn’t have the votes to pass,” while also saying “The White House has known for a while she didn’t have the votes to pass.”

The Washington Post described the broader pattern of Trump’s surgeon general staffing: it said Trump’s announcement represented his “third attempt to fill the job of the nation’s top doctor,” after he first nominating and then withdrawing Janette Nesheiwat last year.

Rolling Stone described the Means withdrawal as a “blow to the MAHA movement,” saying Means’s nomination could not overcome “headwinds of more basic expectations for America’s top doctor,” and it said Saphier’s alignment with MAHA remains a question even as she has tried to claim the phrase.

Meanwhile, NPR reported that Means said her nomination fell apart after a “yearlong smear campaign against me,” and it said she would continue to help “with progress on this movement how I can.”

Looking ahead, the New York Times said Saphier “rejects vaccine mandates” and wants flexibility in the childhood schedule, and it quoted her asking, “Can we change the timeline?”—a stance that could become central in any new Senate scrutiny.

For the White House, the messaging is explicit: Trump called Saphier “a STAR physician” and “an INCREDIBLE COMMUNICATOR,” and he wrote that she “will do great things for our Country, and help, ‘MAKE AMERICA HEALTHY AGAIN.’”