On February 25, 2026, the Senate Health, Education, Labor, and Pensions (HELP) Committee held a hearing to consider the nomination of Dr. Casey Means to be Surgeon General of the Public Health Service. The committee covered the topics of vaccines, nutrition, mental health, substance use, and women’s health. The next step in the confirmation process is for the Senate HELP Committee to hold an Executive Session to vote on the nomination. Assuming the Committee advances her nomination, it would next go to the Senate floor for a vote on confirmation.
OPENING STATEMENTS
WITNESS TESTIMONY
- Dr. Casey Means, Nominee to be US Surgeon General – Testimony
MEMBER DISCUSSION
Vaccines
The most prominent topic of conversation was Dr. Means’ views on vaccines. There was bipartisan questioning of whether Dr. Means views vaccines, such as those for the flu, measles, mumps and rubella (MMR), respiratory syncytial virus (RSV) and Hepatitis B (Hep B), as safe and effective for children. Dr. Means stated multiple times that she believes vaccines are key for public health. She also expressed support for the practice of shared clinical decision making and gaining informed consent from patients before administering vaccines. When pressed by Chairman Bill Cassidy (R-LA) about what additional steps pediatricians should take to obtain informed consent, Dr. Means did not have a concrete answer.
Nutrition
One of Dr. Means’ stated priorities is to improve nutrition and reduce consumption of ultra-processed foods. Many senators shared their support, including Ranking Member Bernie Sanders (I-VT), and Sens. Tommy Tuberville (R-AL), Roger Marshall (R-KS), and Ed Markey (D-MA). Sen. Marshall was curious about how Dr. Means expected to accomplish this goal, as many Americans do not have access to nutritious food options. Dr. Means acknowledged that if whole foods are not a sustainable choice, then many Americans will not change their behaviors. To help with this, Dr. Means highlighted the recent change in dietary guidelines encouraging procurement of food sources and her desire to encourage more federal research about food additives and pesticides.
Sen. Jon Husted (R-OH) shared concerns that changing views on pesticides could be detrimental for American farmers. Dr. Means responded that she greatly respects farmers but wants to change agricultural practices so that they are not as dependent on toxic chemicals.
Mental Health and Substance Use
Sens. Husted and Marshall were interested in understanding Dr. Means’ thoughts on the link that smartphones and social media have to adolescent mental health. Dr. Means shared that she is also concerned about the effects of technology on mental health and is committed to working with various public and private sectors to protect children from the harms of smartphones and social media.
Sen. Susan Collins (R-ME) raised concerns about Dr. Means past statements promoting illicit drug use, given the rise in substance use disorders. Dr. Means reassured the senator that she would not make similar statements while in office, as the science is still emerging about the use of various drugs to treat health conditions.
Women’s Health
Chairman Cassidy and Sen. Patty Murray (D-WA) asked about the use of oral contraception, such as Mifepristone pills, and both hormonal and non-hormonal birth control options. Sen. Murray questioned whether Dr. Means supports their approval by the Food and Drug Administration (FDA) due to past comments about their “horrifying health risks for women.” Dr. Means expressed the view that these medications should only be prescribed after an in-depth conversation with a physician and after gaining informed consent about possible risks and side effects. Chairman Cassidy asked if these medications should only be prescribed after an in-person doctor’s visit to which Dr. Means stated that such a requirement is outside of the purview of the Surgeon General’s office.
Sens. Jim Banks (R-IN), Tim Kaine (D-VA), and John Hickenlooper (D-CO) were curious about Dr. Means’ approach to In-Vitro Fertilization (IVF). Dr. Means shared that she is supportive of access to IVF treatments but wants to emphasize the positive effects of lifestyle changes in supporting increased fertility, especially for Polycystic Ovary Syndrome (PCOS).
Vision for the Role
Dr. Means shared that her overall vision as US Surgeon General would be to improve health outcomes through better nutrition and the consumption of whole food and encouraging the healthcare system to focus on the root causes of disease, rather than addressing symptoms and providing sick care. Dr. Means also plans to champion research on environmental exposures that cause disease. Dr. Means believes that her interdisciplinary background allows her to approach the position in a unique way. She hopes to be a messenger and champion solutions to reduce healthcare spending in the United States.