Bill Cassidy

As a physician and former U.S. surgeon general, I have always believed that health should never be partisan. That conviction is precisely why I am reluctant to speak out during the heat of a political campaign. Yet I do so now because I fear America is drifting toward a dangerous precedent: one in which competence and merit no longer determine who holds critical government roles, and where the Senate may abdicate its constitutional duty to protect American families.

As President Donald Trump’s first (and so far only confirmed) surgeon general, I saw daily how much our nation’s health depends on having qualified, science-driven leaders. Each day, we make decisions that touch every American household.

And that is precisely why I respect Sen. Bill Cassidy’s thoughtful approach. As a physician and chairman of the Senate Health, Education, Labor and Pensions Committee, he has shown the kind of responsible oversight the Senate’s constitutional “advice and consent” role requires. His reluctance, and that of other HELP Committee members, to advance the nomination of Casey Means as surgeon general was not an obstruction. It was prudent vetting that ultimately contributed to the nomination being withdrawn.

Means did not complete her residency training, nor does she hold an active medical license. When pressed under oath at her confirmation hearing, she repeatedly demurred on supporting measles vaccines — in the midst of a worst-in-decades national measles outbreak. These are foundational requirements for a role that relies on credibility and the public’s trust that its occupant can function as an actual doctor, much less serve as the nation’s doctor.

America is already paying the price for weakening that standard, as vaccine-preventable diseases are roaring back. Louisiana data show MMR vaccination rates among kindergartners fell from 96% in the 2020-21 school year to 91.65% in the 2024-25 school year, well below the 95% threshold needed for community protection. Nationally, the Centers for Disease Control and Prevention reports 2,288 confirmed measles cases in 2025, with major outbreaks in South Carolina, Texas and Utah. Already in 2026, the United States has recorded 1,792 cases through late April, putting us on track to far exceed last year’s total.

Even a few cases can trigger expensive, disruptive responses: contact tracing, quarantines, school exclusions and medical care. Exposed children who are not fully vaccinated may miss up to 21 days of class. Those who contract measles must isolate for four days after the rash appears. The classroom time lost, the family stress, the community disruption — these are real costs measured in missed learning, lost wages and preventable illness.

The financial toll is equally stark. One recent measles outbreak in South Carolina, nearly 1,000 cases with just 20 hospitalizations, carried an estimated public-health response cost of $35.5 million, roughly 6.7% of the state’s entire public health budget. Vaccinating that same population would have cost between $66,000 and $134,000. In plain terms, every dollar spent on prevention could have saved more than $500. Those numbers translate into higher taxes, strained hospitals and, most heartbreakingly, suffering that families should never have to endure.

The reality is that the advise and consent process worked as designed: The committee exercised independent judgment, Means lacked the necessary qualifications and support and the White House withdrew the nomination. This is precisely how the Constitution says the Senate is supposed to function — not as a rubber stamp but as a safeguard.

Fortunately, we have now seen positive movement with more qualified nominees. Erica Schwartz, a former deputy surgeon general with extensive public health experience, has been nominated to lead the CDC. And Nicole Saphier, a practicing radiologist at Memorial Sloan Kettering Cancer Center with clinical expertise and clear credentials, has been named as the new surgeon general nominee. After earlier missteps, these new appointees are being met with excitement — and appreciation for Trump — as both better meet the standards of competence and experience our nation’s health leadership demands.