Republican Senators Divide Over Confirmation of Trump’s Surgeon General Nominee

By Sam Barron | Thursday, February 26, 2026 10:05 PM EST

Two Republican senators said they remain undecided on voting to confirm Dr. Casey Means, President Donald Trump’s nominee for surgeon general.

Senators Susan Collins of Maine and Lisa Murkowski of Alaska both stated they have not decided how they would vote following a confirmation hearing in which she was questioned about her views on vaccines and other health matters.

If all Democrats on the Health, Education, Labor, and Pensions Committee vote against Means—as expected—any single Republican could block her from advancing out of committee and receiving full Senate confirmation.

“These issues are important to me,” Murkowski said about Means’ skepticism regarding vaccines. “Last year when the secretary was going through his confirmations, he made certain assurances about vaccines that in fairness I am not seeing have been kept,” Murkowski added, referring to Health and Human Services Secretary Robert F. Kennedy Jr., who was confirmed by the Senate last year.

During the hearing, Means did not rule out a connection between autism and vaccines. She stated: “We do not know what, as a medical community, causes autism. We should not leave any stones unturned.”

Overall, Means expressed support for vaccines, saying they save lives. “Every patient, mother, parent needs to have a conversation with their physician,” she said at the hearing.

Collins said she has “not yet made a decision” and told the report she has more questions for her.

During the hearing, Collins questioned Means about her past use of psychedelic drugs and a book in which she urged people to “consider psilocybin-assisted therapy.”

“I’m concerned,” Collins told Means.

Sen. Bill Cassidy, R-La., chair of the committee and a physician himself, declined to comment on his vote.

Republicans on the committee including Roger Marshall of Kansas, Tommy Tuberville of Alabama, Josh Hawley of Missouri, Jim Banks of Indiana, Markwayne Mullin of Oklahoma, and Jon Husted of Ohio said they support Means and would vote to confirm her.

Sens. Tim Scott of South Carolina and Ashley Moody of Florida did not comment for the report.