Dr. Casey Means, the president’s nominee for surgeon general, believes the US is a “nation with a broken heart” reckoning with unprecedented quantities of continual sickness and psychological sickness. But throughout a prolonged confirmation hearing on Wednesday, she mentioned vaccine coverage wouldn’t be her precedence.
At one level, she sparred with a senator over the advantages of flu vaccination, dodging repeated questions on whether or not she thinks it’s efficient in opposition to hospitalization and loss of life.
Means was interrogated by senators from either side of the dais about her positions on vaccines, abortion and contraception and pesticides. She additionally fielded questions on her {qualifications}, conflicts and even her private use of psychedelic mushrooms.
Means, a best-selling author, wellness influencer and Stanford medical graduate, testified for more than two hours earlier than the Senate Health, Education, Labor and Pensions Committee on Wednesday, almost 4 months after her preliminary hearing was postponed for the delivery of her baby.
She was an early ally of now-Health and Human Services Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” marketing campaign and has a number of essential backers throughout the Trump administration.
Along along with her brother Calley, who serves as an adviser to Kennedy on the US Department of Health and Human Services, Means has championed wholesome consuming, restricted pharmaceutical use and various treatments. Means can be a co-founder of a health tech company, Levels, that connects glucose displays to a well being monitoring app on customers’ telephones.
Means’ affect made the 38-year-old a recognizable early advocate of the MAHA movement. President Donald Trump chosen Means to be surgeon general in May, the identical day the White House withdrew its nomination of Dr. Janette Nesheiwat.
In her opening remarks Wednesday, Means described the “unraveling” of psychological and bodily well being” within the United States and “a society losing its mind” to dementia and melancholy.
“As a physician, I have always been inspired that the root of the word healing means to return to wholeness,” she advised senators. “Nothing is more urgent than restoring wholeness for Americans, physically, mentally and societally.”
Means mentioned she would push to deal with root causes of continual sickness by means of vitamin, steering away from “frankenfoods made in factories,” and mentioned she desires to focus the well being care system on understanding “why we are sick and not just reactive sick care.”
Advocates and a few former officers have criticized Means’ nomination as a result of the surgeon general is often a doctor with medical expertise; Means dropped out of her medical residency program, and her Oregon medical license is inactive. Means acknowledged on Wednesday that her license is just not energetic and she or he can not write a prescription. She mentioned she has no plans to reactivate her license.
Here are highlights from the roughly two-and-a-half hour hearing.
Means’ vaccine views have been a standard theme all through the hearing, with each Democrats and Republicans questioning her stance on the childhood vaccine schedule and sure immunizations below new scrutiny by Kennedy appointees, such because the hepatitis B vaccine.
The nominee had a tense backwards and forwards with Virginia Democratic Sen. Tim Kaine over the advantages of flu vaccination.
Kaine requested repeatedly whether or not Means, a Stanford-trained doctor, would agree that flu vaccination reduces the danger of hospitalization and loss of life.
Means appeared unwilling to touch upon the precise benefits of flu immunization, stating as an alternative that she believes “vaccines save lives” and “I support the CDC guidance on the flu vaccine.” The US Centers for Disease Control and Prevention’s childhood vaccine schedule lately modified to say that flu vaccination must be primarily based on “shared clinical decision-making,” which implies individuals who need one should seek the advice of with a well being care supplier.
Kaine pressed repeatedly: “This is an easy one, doctor.”
Means finally mentioned that “at a population level, I certainly think that [flu vaccines could reduce risk].”
This yr’s record-breaking flu season has the very best rates of doctors’ visits within the US in additional than twenty years.
Several senators together with Republicans Bill Cassidy, chairman of the committee, and Lisa Murkowski questioned Means’ stance on the hepatitis B vaccine, which had been advisable for all infants at delivery till latest modifications by the Trump administration.
“I think it is an important vaccine, a lifesaving vaccine. I also think that parents’ autonomy needs to be respected,” Means advised Cassidy.
However, she additionally sought to guarantee the chairman that vaccine coverage wouldn’t be a precedence for her as surgeon general.
“I wanted to back up and broadly just reassure you that this is not an issue that I intend to complicate, or bring an agenda on vaccines. This is not the core of my issue,” Means mentioned.
Ongoing controversy over the Trump administration’s actions on pesticides, and Means’ stance on it, was evident within the hearing Wednesday.
Last week, Trump signed an executive order to guard the nationwide provide of glyphosate, a extensively used herbicide generally referred to as Roundup. The determination infected many MAHA advocates who’ve pressed for extra stringent regulation and even bans.
Means, like Kennedy, has lengthy recommended that publicity can result in well being points.
The nominee was first questioned on the subject by Ohio Republican Sen. Jon Husted, who argued, subsequent to a big poster board picture of an ear worm destroying an ear of corn, that decreasing glyphosate use would hurt the nationwide meals provide.
The nominee mentioned she understands that it is a complicated problem and that widespread pesticide use can’t be modified in a single day. Farmers, she mentioned, are in an “impossible situation.”
Later within the hearing, Massachusetts Democrat Sen. Ed Markey interrogated her conviction to pesticide motion, arguing that Trump’s order represented a reversal for advocates like Means and Kennedy.
“I am not in any way backing away from this issue. It is a core passion my life,” Means replied. “We must study these chemicals to understand their effect. I’m very gravely concerned about the health impacts of these chemicals.”
She added that she believes the administration is appearing in “good faith” to scale back pesticide utilization and that she understands the chief order to be about nationwide safety, or utilizing US provide of the chemical somewhat than imports.
As surgeon general, Means wouldn’t have authority over pesticides. But surgeons general can fee experiences on the analysis surrounding well being points, as previous officers have accomplished on tobacco, alcohol and psychological well being challenges.
Means declined early within the hearing to take a agency stance on limiting the abortion tablet mifepristone to in-person prescribing by a physician.
Senate Republicans have called on the Trump administration to reverse a Biden-era determination to permit mifepristone prescriptions by means of telehealth. The coverage change allowed physicians to ship the tablet by means of the mail, generally circumventing restrictive state abortion bans.
Cassidy, who led a hearing on the subject final month, pressed the nominee on whether or not she believes mifepristone must be prescribed remotely.
Means advised the committee that mifepristone coverage was exterior the purview of the surgeon general’s workplace.
“But I do believe that every patient needs to have a very thorough conversation with their doctor before taking any medication,” Means mentioned. “Unfortunately, in our current health care system, because of how overburdened doctors are, this often doesn’t happen, whether it’s in person or online.”
Democrats, in the meantime, questioned the nominee on her stance on contraception, which she has characterised in podcast interviews as probably dangerous to long-term well being.
Means mentioned she believes contraception must be extensively accessible however repeated that sufferers ought to talk about dangers and advantages with their docs.
“I want those women, and I know you do too, to be able to have a thorough conversation with their doctor and know whether they are at higher risk for side effects,” she mentioned.
Credentials and conflicts of curiosity
Democrats additionally repeatedly questioned the nominee’s medical expertise and her potential conflicts of pursuits.
Means dropped out of her medical residency program months earlier than completion, a choice she has described as disillusionment with the well being care system and its incentives.
On Wednesday, Democrats questioned the standing of her medical license. Means mentioned that it’s inactive as a result of she is just not at the moment seeing sufferers however that she has distinctive experiences to carry to the surgeon general function.
“I have completed extremely thorough medical training, and I have the ability to use these experiences to communicate excellent public health information,” she mentioned.
As a wellness author and influencer, Means had endorsed various wellness products together with nutrient assessments, smoothies and dietary supplements.
Those included ENERGYbits, a complement firm that sponsored her now-dormant e-newsletter, and Daily Harvest, a smoothie subscription service that marketed a collection curated with Means.
Wisconsin Sen. Tammy Baldwin, a Democrat, additionally requested Means about accepting $10,000 from Genova Diagnostics, which markets merchandise to check private nutrient ranges. Means appeared in a Genova video posted in October, months after her nomination to function surgeon general.
Baldwin identified that in 2020, the corporate agreed with the US Justice Department to pay $43 million for charging pointless assessments.
Means mentioned that she was unfamiliar with that settlement however that “there’s a particular test that they make about nutrient quality that I find very compelling.”
Means advised the committee she has labored intently with authorities ethics officers to eradicate conflicts of curiosity and has all the time been clear about when she was paid to endorse a product.
The surgeon general and psilocybin
Maine Republican Sen. Susan Collins questioned Means about her stance on psychedelic drugs, drawing from a passage in Means’ 2024 e book, “Good Energy,” the place she mentioned utilizing psilocybin, or psychedelic mushrooms, throughout her mom’s sickness and subsequent loss of life from pancreatic most cancers.
“When it comes to psychedelic therapies for mental health issues, I think science is still emerging,” Means mentioned, emphasizing that she would comply with the proof. “I do believe that there is exciting work being done in this area that needs to continue, on psychedelic therapies for PTSD in veterans, for mental health issues.”
Kennedy has additionally proven curiosity within the potential of psychedelic therapies and final yr within the HHS general counsel workplace employed a lawyer who has labored on entry to psychedelics and hashish for medical analysis.
Yet Collins appeared most involved about what Means’ stance may imply for illicit drug use.
“What I would say as a private citizen is in many cases different than what I would say as a public health official, joining a team where the purpose of this role is to communicate, absolutely, the best evidence-based science to the American people,” Means mentioned.
Correction: A earlier model of this story incorrectly recognized Sen. Tammy Baldwin’s state.