Trump's Third Surgeon General Pick Faces Senate Panel After Two Nominations Collapsed

The Senate Health, Education, Labor and Pensions Committee spent Wednesday morning questioning three of President Trump's nominees to senior posts at the Department of Health and Human Services, with the bulk of the scrutiny falling on Dr. Nicole Saphier, a radiologist and former Fox News contributor who is the president's third attempt in this term to fill the office of surgeon general.

The panel, chaired by Sen. Bill Cassidy of Louisiana, also considered the nominations of Chris Klomp to be deputy secretary of HHS and Dr. Timothy Westlake to lead the Substance Abuse and Mental Health Services Administration. But it was Saphier's hearing, held in the Dirksen Senate Office Building, that carried the most political weight, coming after two previous surgeon general picks collapsed in the same room.

The numbers

The office of surgeon general has sat empty since January 2025, when Dr. Vivek Murthy departed at the end of the Biden administration, meaning the country has gone roughly twenty months without a Senate-confirmed "nation's doctor." Saphier is the third person Trump has put forward for the job, after an academic-credentials controversy sank his first choice and a second nominee's confirmation effort stalled without a committee vote.

Saphier's own financial disclosure, filed with the committee on September 7, shows holdings in health insurers and food companies including Coca-Cola, Yum Brands, Hershey and Philip Morris, along with an ownership stake in DropRx, a company that sells unregulated tinctures containing kava kava root, an ingredient the Food and Drug Administration has warned can cause severe liver injury. She has told the committee she will resign from DropRx and its parent, Empower MD LLC, and divest holdings that conflict with the office if she is confirmed. The committee's current roster gives Republicans a 12-11 edge, meaning Saphier's path depends far less on Democratic votes than on whether Cassidy and his GOP colleagues stay unified.

How the seat went unfilled for twenty months

Trump's first choice, Dr. Janette Nesheiwat, was withdrawn after questions surfaced about her medical training. His second, wellness entrepreneur Dr. Casey Means, saw her own confirmation hearing postponed when she went into labor, then endured a contentious rescheduled session in February in which senators pressed her on vaccine safety and her lack of a completed residency or active medical license. Support for Means never coalesced, and the committee never brought her nomination to a vote.

Saphier arrives with a different résumé problem. She holds a medical degree from Ross University School of Medicine in Barbados and completed a fellowship at the Mayo Clinic before becoming director of breast imaging at Memorial Sloan Kettering Monmouth in New Jersey. She has no formal public health credentials, but unlike Means she has not drawn a unified wall of Democratic opposition, and Dr. Jerome Adams, who held the job during Trump's first term, predicted earlier this year that she would ultimately be confirmed.

Who is affected

The surgeon general has little direct policymaking authority but functions as the government's most visible messenger on public health, a role that has taken on outsized importance amid the administration's disputes with mainstream medical guidance on vaccines and prenatal care. Saphier has questioned whether every infant needs a hepatitis B vaccine at birth, a position that puts her at odds with longstanding pediatric guidance the Public Health Service's uniformed corps she would formally lead has historically promoted.

The other two nominees carry consequences of their own. Westlake would take over an agency, SAMHSA, that has already absorbed deep staffing reductions under Secretary Robert F. Kennedy Jr. and canceled a round of federal grant programs that had funded comprehensive opioid treatment, addiction care for homeless populations, reentry support for people leaving prison, and HIV and hepatitis C prevention services, according to an accounting of the cuts published earlier this year. Klomp, who has run Medicare's federal insurance program since April 2025, would move into a deputy secretary post overseeing the department's day-to-day operations, including whatever direction SAMHSA and the surgeon general's office take on vaccine messaging and grant policy.

Reaction

Cassidy, a hepatologist by training, has spoken in the past about patients he treated who died of hepatitis B, and lawmakers on both sides of the dais have signaled that Saphier's comments on the newborn vaccine schedule would draw close questioning. She has not been a reliable ally of the administration's more skeptical health voices, either. Saphier broke publicly with the White House this year over its warnings to pregnant women about acetaminophen, telling the Associated Press that the messaging oversimplified the science.

Trump's caution to pregnant women against taking Tylenol was "patronizing," Saphier told the Associated Press, and overlooked the risk of leaving a fever or severe pain untreated during pregnancy.

That independent streak has complicated efforts to characterize her simply as a loyalist pick, even as she has also pushed back publicly at critics, at one point posting on social media that pregnant women should not "weaponize" their pregnancies to make a political point about the president. Sen. Bernie Sanders of Vermont, the committee's ranking member, has used past hearings on this same seat to press nominees on vaccine science and industry ties, and is expected to focus similarly on Saphier's investment holdings and her past writing, including a 2020 book she titled "Make America Healthy Again," years before Kennedy adopted the phrase as a movement slogan.

What happens next

The committee has not scheduled a vote on any of the three nominations. If Saphier clears the panel, her confirmation would then require a simple majority on the Senate floor, where Republicans hold the majority needed to move nominees largely along party lines absent defections. The committee's official hearing record will remain open for senators to submit written follow-up questions, a routine step that in Means's case preceded her nomination's quiet collapse. Cassidy has given no public indication he intends to block Saphier, but his personal history with hepatitis B means his private questioning, more than any Democratic objection, may be the clearest signal of whether this third nomination fares better than the two before it.

Klomp's and Westlake's nominations are moving on a similar, if lower-profile, track. Neither has generated the kind of controversy attached to the surgeon general seat, and coverage of Wednesday's session suggested both are likelier to reach the floor without the delays that have twice sunk the administration's surgeon general choice. For now, the post that Adams once held and Murthy left vacant some twenty months ago remains, formally, unfilled.