President Donald Trump’s new nominee for surgeon general is exposing divisions in the Make America Healthy Again (MAHA) movement, the health-focused coalition elevated inside the administration by Health and Human Services Secretary Robert F. Kennedy Jr.
“The new surgeon general nominee, Dr. Nicole Saphier, may have a great pro-life testimony, but she gets an F when it comes to all things MAHA,” said Turning Point USA health and wellness podcaster Alex Clark — a comment shared by other MAHA activists like Kelly Ryerson, an anti-pesticide advocate also known online as “Glyphosate Girl.”
“DOGE the Surgeon General!!! We want medical freedom!!!! If not Casey – we take no one!” added Vani Hari, also known online as “Feed Babe” and a prominent figure inside the MAHA movement.
She recently told The Atlantic that failing to confirm Means would “ruin the soul of MAHA.”
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After Trump’s initial pick for surgeon general, Dr. Janette Nesheiwat, was withdrawn in 2025, Trump selected Casey Means, a Stanford-trained physician, wellness author and entrepreneur, and vocal MAHA proponent who was close to Kennedy as he helped develop the Trump administration’s health agenda.
Means’ nomination was withdrawn Thursday, and she was replaced with radiologist and former Fox News contributor Dr. Nicole Saphier amid a stalled confirmation process leading up to the eventual pivot.
Trump announced that Means’ nomination would be withdrawn from his Truth Social platform Thursday and replaced with Saphier amid the stalled confirmation process, in part caused by Means’ pregnancy during the process and the need for extensive vetting, a source familiar with the nomination told Fox News Digital.
Minutes before Trump announced the pivot to Saphier on his social media platform Truth Social, Trump called Means “a strong MAHA Warrior, at the recommendation of Secretary Kennedy, who understands the MAHA Movement better than anyone.”
Kennedy also praised Means as news was coming down that she would be replaced by Saphier.
Meanwhile, the pair also lambasted moderate U.S. Sen. Bill Cassidy, R-La., Chairman of the Senate’s powerful health committee in charge of getting the surgeon general nomination approved, for allegedly sabotaging Means’ nomination.
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Delays and concerns about Means’ qualifications and views on vaccines, among other things, slowed down the process, until, according to a source familiar with the confirmation process, it was determined that not enough support would be garnered to secure Means’ appointment.
Saphier has been described by Trump as “an INCREDIBLE COMMUNICATOR” who “will do great things for our Country,” and Kennedy has also publicly supported Saphier’s nomination. But MAHA activists became alarmed by the decision to withdraw Means’ nomination.
Clark described Saphier as a “catastrophic mistake” at a time when the MAHA coalition is “very fragile.”
“She is one of the most pro-vaccine advocates in medicine, even defending Hep B on the first day of life,” Clark wrote on X. “My position isn’t to replace Dr. Saphier. It’s to completely DOGE the Surgeon General role. If we don’t, we risk accelerating the loss of one of the most activated voting blocs the GOP is already watching slip away.”
“Doge the SG!!!!” Hari said in a post on X Sunday, lamenting that the pivot is just “more of the same.”
“We’re seeing a system that protects itself,” she added, according to The Washington Post. “A system that says it wants change but recoils the moment real change shows up.”
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“I am so proud of Casey, and the way she conducted herself during this process,” her brother, Calley Means, another early leader within the MAHA movement said on X before laying into Cassidy. “I am also proud to work for the Trump admin, who has marshaled the disruptive MAHA message and driven victories against dark forces personified by Bill Cassidy.”
Fox News Digital reached out to Saphier for comment on the criticism that she is not skeptical enough of vaccines, but did not hear back.
White House spokesperson Kush Desai said Saphier has been “an outspoken voice” against “intrusive COVID-19 mandates, the politicization of science, and the federal government’s role in America’s chronic disease epidemic.”
“She will be a powerful asset … to deliver on every facet of (the president’s) MAHA agenda.”
Others aligned with the MAHA world appeared less concerned with Means’ departure, such as the Independent Medical Alliance, which is anti-pesticide, promotes questions about vaccine efficacy and supported two of Kennedy’s picks for the Centers for Disease Control and Prevention’s vaccine advisory panel.
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Dr. Joseph Varon, the group’s president and chief medical officer, said Saphier was “exactly who America needs,” describing her as “a real doctor, treating real patients, who has the spine to tell the truth even when it’s unpopular.”
Dr. Robert Malone, a leading contrarian to COVID-19 vaccine mandates and lockdown measures and a supporter of the broader MAHA movement, described Saphier as “moderate-MAHA” in a blog on his Substack.
Malone also attempted to assuage fears Saphier is too pro-vaccine.
“This is the part MAHA readers care about most, and it is the part where Saphier’s record is most genuinely mixed,” Malone wrote on his blog.
“She is pro-individual-vaccine on the merits. She is supportive of parental autonomy on schedule. She is critical of universal pediatric mandates absent benefit data. She is explicitly sympathetic to MAHA’s vaccine-safety-surveillance reform agenda,” he continued. “She is not, in any reading I can construct from the documentary record, an anti-vaccine voice in the medical-freedom register that, say, Children’s Health Defense operates in. She is also not, in any reading I can construct, a CDC-establishment-defending voice of the kind Cassidy is looking for.”
Kennedy, known for being a vaccine skeptic, faced backlash when he attempted to make formal changes to the U.S. childhood vaccine schedule — changes ultimately blocked by the courts.
Fox News Digital reached out to MAHA Action, whose founder Tony Lyons fought against moderate GOP Senators, like Sen. Susan Collins, R-Maine, and Lisa Murkowski, R-Ak., who were not supportive of Means’ nomination, but did not receive a response in time for publication.