Trump’s surgeon general pick, Casey Means, still lacks votes for confirmation

Casey Means, President Donald Trump’s pick for surgeon general, does not yet have the votes for confirmation following a testy Senate health committee hearing on her nomination Wednesday.

Senators of both parties pressed Means on her views about vaccines at the hearing. Means did not commit to promoting them and now has to convince at least two skeptical Republicans to back her nomination: Susan Collins of Maine and Lisa Murkowski of Alaska, who told POLITICO they haven’t decided how they’ll vote.

Winning the approval of the Health, Education, Labor and Pensions Committee is almost certainly a prerequisite for confirmation. The panel is split between 12 Republicans and 11 Democrats, so any one Republican could sink Means’ chances if Democrats, as expected, vote against.

The Republican-controlled Senate has turned back few of Trump’s nominees. But one of the first was Trump’s pick to lead the Centers for Disease Control and Prevention, which like the surgeon general serves within the health department. The White House withdrew the nomination of former Florida GOP Rep. Dave Weldon last March after Murkowski and Collins raised concerns about his vaccine views.

The surgeon general is the nation's top doctor and a high profile spokesperson on public health.

The Senate last year did confirm Robert F. Kennedy Jr. as secretary of the Health and Human Services Department, despite his longstanding skepticism about vaccine safety. The Finance Committee handled that nomination and voted to approve him on a partyline vote.

Murkowski said on Wednesday it was too soon to say whether she supports Means' confirmation.

“These issues are important to me,” she said of Means’ positions on vaccines. “Last year when the secretary was going through his confirmations, he made certain assurances about vaccines that in fairness I am not seeing have been kept.”

Collins told POLITICO on Thursday that she has “not yet made a decision,” adding she has more questions for the nominee.

The committee chair, Bill Cassidy (R-La.), would not comment on his vote when asked Thursday. At the Wednesday hearing, Cassidy, a liver doctor, pressed Means on her views about vaccines.

Cassidy was the key vote on Kennedy’s nomination. Cassidy pressed Kennedy about his vaccine views at a confirmation hearing and then secured commitments from Kennedy that he would not upend the country’s vaccine safety and approval systems. Kennedy has since flouted some of those promises, angering Cassidy.

Means has secured the support of most Republicans on the Senate health committee.

Roger Marshall of Kansas, Tommy Tuberville of Alabama, Josh Hawley of Missouri, Jim Banks of Indiana, Markwayne Mullin of Oklahoma and Jon Husted of Ohio told POLITICO they planned to vote to approve her. Tim Scott of South Carolina and Ashley Moody of Florida declined to comment.

At the Wednesday hearing, Means, a wellness influencer and a doctor without an active medical license, dodged questions about whether she would recommend shots against measles, hepatitis B and the flu.

Weldon’s controversial vaccine views, including his endorsement of unproven claims linking vaccines and autism, were enough to sink him.

The White House told Weldon he didn’t have the votes and withdrew his nomination, Weldon said in a statement at the time. Weldon said he’d expected his nomination to die in the health committee because of opposition from Cassidy or Collins. Murkowski had also told the White House she was troubled by the nominee’s vaccine views.

Amanda Friedman, Robert King and David Lim contributed to this report.