By SUZANNE DOWNING
April 30, 2026 – Sen. Lisa Murkowski played a pivotal role in blocking the advancement of President Donald Trump’s nominee for US Surgeon General. The White House withdrew the nomination this week of Casey Means.
Trump instead named Nicole Saphier, a radiologist at Memorial Sloan Kettering Cancer Center and a longtime Fox News medical contributor, as his new pick to serve as the nation’s top doctor.
The collapse of Means’ nomination comes after months of gridlock in the Senate Health, Education, Labor and Pensions Committee, where Murkowski’s refusal to back the nominee effectively halted progress. Without near-unanimous Republican support on the committee, Chairman Bill Cassidy did not bring the nomination forward for a vote, leaving it stalled for nearly a year. Means had been nominated on May 7, 2025.
Murkowski never cast a formal “no” vote on the Senate floor. Instead, she used her position on the committee to withhold support, a move that proved decisive given unified Democratic opposition.
At the center of Murkowski’s concerns were Means’ past statements on vaccines, particularly regarding the hepatitis B vaccine administered to newborns.
During a February confirmation hearing, Murkowski pressed Means on her views, citing Alaska’s long-standing success in reducing liver disease through aggressive vaccination efforts. Means responded that vaccines are important but emphasized parental choice in consultation with doctors, rather than strong universal recommendations.
Following the hearing, Murkowski publicly maintained she had unresolved questions and remained undecided. She reiterated that position for weeks, aligning with Maine Sen. Susan Collins as one of the key Republican holdouts. Their hesitation prevented the nomination from advancing, as Republicans could not afford defections in committee.
Means is a Stanford-trained physician who did not complete a residency and does not hold an active medical license. She has been a prominent figure in the “Make America Healthy Again” movement and closely aligned with Health and Human Services Secretary Robert F. Kennedy Jr. Means advised his 2024 presidential campaign.
Supporters of Means, including activists tied to the MAHA movement, mounted fruitless pressure campaigns targeting Murkowski and Collins in an effort to force movement on the nomination. Those efforts failed.
With no clear path forward, Trump formally withdrew Means’ nomination on Thursday and moved quickly to replace her.
Murkowski’s role in the outcome is a victory for her and her quest to get the better of the president who she does not support.
