Bill Cassidy

WASHINGTON – President Donald Trump on Wednesday called U.S. Sen. Bill Cassidy “very disloyal” for not scheduling a confirmation vote for Casey Means, the controversial MAHA influencer, as the nation’s surgeon general.

Trump then withdrew Means’ nomination and tapped Dr. Nicole B. Saphier. The third nominee for the post, Saphier is a radiologist in New York and a Fox News contributor.

On Truth Social, Trump called for Louisiana voters to defeat Cassidy in the May 16 closed party primary. Trump has endorsed U.S. Rep. Julia Letlow, R-Baton Rouge, in Cassidy's effort to win a third six-year term — early voting starts Saturday. Letlow is also backed by the MAHA movement.

“Hopefully all of the Great Republican People of Louisiana, which I won, BIG, three times, will be voting Bill Cassidy OUT OF OFFICE in the upcoming Republican Primary!” Trump wrote on Truth Social.

“I nominated Casey, a strong MAHA Warrior, at the recommendation of Secretary Kennedy, who understands the MAHA Movement better than anyone, with perhaps the possible exception of ME!,” Trump wrote in another Truth Social post, referring to Department of Health & Human Services Secretary Robert F. Kennedy Jr. and the Make America Healthy Again movement the secretary has trumpeted for years.

The president wrote about 20 minutes later on another Truth Social post that he was nominating Saphier.

Cassidy’s campaign did not respond to a request for comment, and the Baton Rouge Republican has repeatedly refused to talk about Means. But, as chair of the Senate Health, Education, Labor & Pensions committee, Cassidy has not scheduled a vote on Means’ confirmation, even though her hearing took place in February.

Means reportedly did not have enough Republican votes on the committee to forward her confirmation to the full Senate as all the Democratic members oppose. With 12 Republicans and 11 Democrats, one GOP member voting "no" would have ended Means’ chances.

Senators raised questions about Means' writings and past positions.

During her Senate Health confirmation hearing, Means did not embrace the use of vaccinations. While agreeing that vaccinations save lives, she wouldn't expressly support shots to combat measles. She appeared to back Kennedy’s policies that support his long-held vaccine skepticism.

Means also was opposed by prominent conservative bloggers and the Ethics & Religious Liberty Commission, which sets public policy for the 13 million Southern Baptists.

This is not the first time that Trump has gone after Cassidy on social media. In April 2024, Trump posted a two-page entry that read, in part: “One of the worst Senators in the United States Senate is, without question, Bill Cassidy, A TOTAL FLAKE, Republican though he may be.”

Cassidy became one of seven Republican senators to convict Trump of inciting insurrection in the 2021 impeachment trial that followed the Jan. 6, 2021 sacking of the U.S. Capitol by Trump supporters trying to disrupt the official certification that Joe Biden won the 2020 presidential election. Cassidy was the only member of Louisiana's Republican delegation in Congress to support impeachment; he also was the only GOP member from the state who voted to certify the electors from every state.

The Louisiana Republican Party censured Cassidy and its more conservative members have belittled him since. Several leading Louisiana conservatives spent the last few years flirting with challenging Cassidy. He drew two major elected officials as opponents – Letlow and State Treasurer John Fleming.

Once a doctor from Minden, Fleming is a founder of the far-right Freedom Caucus in the House and worked in the administration during Trump’s first administration.

Cassidy has spent much time trying to make amends with Trump. He is largely responsible for Kennedy becoming the nation’s health chief despite fundamental disagreements on vaccinations. As a practicing physician and medical researcher for 30 years prior to elective office, Cassidy ardently supports vaccinations. Kennedy has spent years questioning whether certain vaccines work.