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Senators question Trump's picks for top health positions, including surgeon general

Dr. Nicole Saphier, Trump's nominee for surgeon general.
John Lamparski
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Getty Images
Dr. Nicole Saphier, Trump's nominee for surgeon general.

The Senate committee on health meets this morning to consider three of the Trump administration's picks for top jobs at the Department of Health and Human Services, including deputy secretary and surgeon general.

If you're having deja vu, that's because there was a similar hearing seven months ago on the nomination of Dr. Casey Means for surgeon general. After a last-minute cancellation of her first confirmation hearing because she went into labor, and a contentious hearing in February, support for her nomination fell apart and the committee never voted.

Means was the second nominee for the position. President Trump's first choice, Fox News medical contributor Dr. Janette Nesheiwat, was dropped after questions were raised about her academic credentials. On Wednesday, senators will consider Trump's third pick, Dr. Nicole Saphier, a radiologist, for the surgeon general position.

Also testifying before senators Wednesday is Chris Klomp, a former health tech executive who's been running much of the day-to-day operations of HHS since February. He's the nominee to serve as deputy secretary of HHS. Klomp is not a media personality or politician, but since joining the Trump administration initially as the director of the Center for Medicare, he's risen through the ranks with a reputation as a pragmatic and effective leader. If Tuesday's confirmation hearing in the Senate Finance Committee is any indication, senators will grill Klomp on measles, abortion medication, drug prices, and vaccines.

The third nominee up for consideration is Dr. Timothy Westlake, a Wisconsin-based emergency medicine physician, who's been nominated to serve as assistant secretary for Mental Health and Substance Use.

The elephant in the room will be Health Secretary Robert F. Kennedy Jr., whose relationship with Congress, and with this committee in particular, is strained. Kennedy made many promises during his own confirmation hearing that he has subsequently broken. His appearances before the committee have been infrequent, and when they happen, they've been chaotic and combative.

Third time's the charm?

America has not had a surgeon general since President Biden left office in January 2025 — Trump has not been able to get a nominee through the senate this term.

Like Trump's initial pick, Dr. Nicole Saphier is also a former Fox News Channel contributor with a medical degree from a Caribbean university. She's a radiologist and the director of breast imaging at Memorial Sloan Kettering Monmouth in New Jersey.

Although she lacks a public health background, Saphier's nomination has not been met with the wall of opposition that Means faced, and it's unclear what reception she will receive from senators. Dr. Jerome Adams, who served as surgeon general in the first Trump administration, told NPR in May that he expects Saphier to be confirmed.

Kennedy complimented Saphier's nomination in April on social media, calling her "a long-time warrior for the MAHA movement." She, in fact, wrote a book titled "Make America Healthy Again" published in 2020, years before Kennedy began promoting the slogan during the 2024 presidential election.

A key issue during the hearing will likely be Saphier's views on vaccines. She has criticized COVID-19 vaccine booster requirements and questioned whether every child needs to get the hepatitis B vaccine at birth. Those latter comments may draw the attention of Republican Sen. Bill Cassidy, a liver doctor and chair of the committee, who has spoken emotionally in past hearings about treating patients who died of hepatitis B.

At times, though, Saphier has defended vaccines in the context of the debunked link with autism. In an op-ed last spring, Saphier criticized Kennedy's decision to look for the root cause of rising autism diagnoses by hiring anti-vaccine activist David Geier.

"If we want lasting change in how we diagnose, treat and perhaps prevent autism, it must be built on a foundation of rigorous science, not controversy and conspiracy theories," she wrote.

She also told The Associated Press last fall that Trump's suggestion that pregnant women should avoid Tylenol because of the risk of autism was oversimplistic and "patronizing."

HHS number 2

A less public-facing but arguably more powerful position will also be considered on Wednesday: deputy secretary of HHS.

The man nominated for that job is Chris Klomp. If confirmed, Klomp would be second-in-command to Secretary Kennedy. Klomp has served as Medicare director since April 2025, and in February was elevated to become "chief counselor" to Kennedy.

Republican senators on the Finance committee were friendly to Klomp during a hearing on Tuesday and questioned him about issues like drug pricing and Medicaid fraud. Democratic senators pushed him on HHS' response to ongoing measles outbreaks across the country. Despite the doubts sown by Kennedy and Trump about the efficacy and safety of the MMR vaccine, Klomp forcefully spoke in support of children getting the MMR to help stop the spread of measles

Finally, Dr. Timothy Westlake, currently serving as chief of staff at the Substance Abuse and Mental Health Services Administration, or SAMHSA, has been nominated to serve as assistant secretary for Mental Health and Substance Use. SAMHSA has had massive staff cuts since Kennedy took over as secretary, and his restructuring plan — which is currently on ice after legal challenges — would have eliminated the agency.

Copyright 2026 NPR

Rachel Carlson
Rachel Carlson is an associate producer at Short Wave.
Selena Simmons-Duffin reports on health policy for NPR.
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