Key Takeaways
- •Casey Means (Nominee for Surgeon General, U.S. Public Health Service) pledged to prioritize metabolic health and combat chronic disease by targeting ultra-processed foods during her Senate confirmation hearing.
- •Means testified that the nation must shift from "reactive sick care" to addressing root causes of illness, specifically citing the dangers of ultra-processed foods and metabolic dysfunction.
- •Sen. Murphy (D-CT) challenged Means over alleged failures to disclose financial ties to companies she promoted online, though Means asserted she followed all federal ethics guidelines.
- •Republicans praised her focus on preventive nutrition, while Democrats questioned her past comments on birth control safety and her refusal to definitively rule out vaccine links to autism.
- •If confirmed, Means will lead the U.S. Public Health Service and spearhead the administration’s efforts to reform national dietary guidelines and address the escalating chronic disease epidemic.
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Hearing Analysis
Overview
A hearing to examine the nomination of Casey Means Committee: Senate Health, Education, Labor, and Pensions Hearing Date: 2026-02-25
Extended Summary: The Senate Committee on Health, Education, Labor, and Pensions (HELP) convened on February 25, 2026, to consider the nomination of Dr. Casey Means to serve as the Surgeon General of the U.S. Public Health Service. The hearing, presided over by Chairman Bill Cassidy (R-LA), focused on Dr. Means’ platform to address the nation’s chronic disease epidemic through the "Make America Healthy Again" (MAHA) initiative. Dr. Means, a Stanford-trained physician and co-founder of the metabolic health company Levels Health, presented a vision centered on shifting the American healthcare system from "reactive sick care" to "proactive healthcare" by addressing the root causes of illness, such as ultra-processed foods, environmental toxins, and metabolic dysfunction.
Key Testimony
In her testimony, Dr. Means emphasized that the United States is the most chronically ill high-income nation, with rising rates of obesity, diabetes, and mental health disorders despite trillions in annual spending. She proposed a systemic overhaul that includes reforming medical education to prioritize nutrition, closing the "Generally Recognized as Safe" (GRAS) loophole at the Food and Drug Administration (FDA) to increase oversight of food additives, and aligning federal procurement—such as the National School Lunch Program—with whole-food standards. Dr. Means cited her background in biomedical research at the National Institutes of Health (NIH) and her entrepreneurial experience as evidence of her ability to lead the United States Public Health Service Commissioned Corps (Commissioned Corps) toward addressing chronic disease.
Overview
The hearing featured sharp partisan divisions regarding Dr. Means’ past statements and public health philosophy. Republican members, including Sen. Roger Marshall (R-KS) and Sen. Markwayne Mullin (R-OK), praised her focus on metabolic health and her willingness to challenge the status quo of the healthcare industry. Sen. Marshall highlighted her best-selling book, "Good Energy," as a roadmap for preventive medicine. Conversely, Democratic members raised significant concerns regarding her views on vaccines, reproductive health, and potential financial conflicts of interest.
Key Testimony
A major point of contention involved Dr. Means’ stance on vaccines. While she stated that "vaccines save lives," she repeatedly declined to offer a definitive "yes" or "no" when asked by Chairman Cassidy and Sen. Bernard Sanders (I-VT) if she would unequivocally encourage the measles, mumps, and rubella (MMR) or flu vaccines. Instead, she emphasized the importance of "informed consent" and private conversations between patients and doctors. She also faced questioning regarding the link between vaccines and autism; while acknowledging evidence showing no link, she suggested that "science is never settled" and supported further study of environmental factors.
Notable Exchanges
Sen. Patty Murray (D-WA) challenged Dr. Means on her past comments describing hormonal birth control as a "disrespect of life" and claiming it carried "horrifying health risks." Dr. Means defended her statements by arguing that many women are prescribed contraception without adequate discussion of risks like blood clots or stroke. Similarly, Sen. Susan M. Collins (R-ME) questioned Dr. Means’ past use and promotion of illicit psychedelics for therapy, as mentioned in her book. Dr. Means clarified that while she finds the emerging research promising for conditions like PTSD, she would not recommend illicit drug use as a public health official.
Overview
The hearing also delved into Dr. Means’ financial ties and professional conduct. Sen. Tammy Baldwin (D-WI) and Sen. Christopher Murphy (D-CT) questioned her for accepting payments to promote companies like Genova Diagnostics, which previously settled False Claims Act allegations, and for allegedly failing to disclose financial relationships in social media posts for brands like Daily Harvest, Zen Basel, and WeNatal. Sen. Murphy cited a pending Federal Trade Commission (FTC) complaint regarding these disclosures. Dr. Means maintained that she has worked closely with the Office of Government Ethics (OGE) to resolve any conflicts and would divest from relevant holdings if confirmed.
Organizations & Entities
Several organizations were central to the discussion. The Department of Health and Human Services (HHS) was discussed regarding its ongoing implementation of the MAHA strategy and recent changes to the Dietary Guidelines for America. The Centers for Disease Control and Prevention (CDC) was referenced both for its vaccine guidance and in the context of recent budget cuts to smoking cessation and maternal health programs, which Sen. Tim Kaine (D-VA) criticized. The American Medical Association (AMA) was cited by Sen. Sanders regarding its firm stance that vaccines do not cause autism. Finally, Sen. Andy Kim (NJ-D) questioned Dr. Means’ eligibility to lead the Commissioned Corps given that her medical license with the Oregon Medical Board is currently on "inactive" status. Dr. Means argued that an inactive status is standard for physicians not currently seeing patients and does not preclude her from serving as Surgeon General.
Overview
The hearing concluded without a definitive timeline for a committee vote, though Chairman Cassidy indicated the committee would continue to review her record. If confirmed, Dr. Means would oversee 5,000 uniformed officers in the Commissioned Corps and serve as the primary spokesperson for public health in the Trump administration.
Transcript
The Senate Committee on Health, Education, Labor, and Pensions will please come to order. Hi, Dr. Means. You came in just as I walked away, so greetings. I'm sorry to have missed shaking your hands down there. Thanks for appearing before the committee and for your willingness to serve the people of the United States in this administration. And by the way, congratulations on your baby.
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