The Great MAHA Makeover: Casey Means Goes Mainstream

Can someone who talks to trees become America's top doctor?

Casey Means seemed determined to find out today, but not in the way you'd expect. The woman who once called natural disasters "communication from God" and denounced birth control as cultural "disrespect of life" underwent what can only be described as a complete rhetorical makeover during her surgeon general confirmation hearing.

Gone were the psychedelic anecdotes. Absent were the raw milk endorsements. Instead, the longtime health entrepreneur emphasized her Stanford medical degree—conveniently omitting that she lacks an active medical license—and searched desperately for common ground with skeptical senators.

The Art of Political Shapeshifting

The transformation was remarkable. This is the same person who, in her 2024 book Good Energy, advised readers to avoid tap water and conventionally grown food while trusting themselves over their doctors. She recommended "one cumulative hour of very hot heat exposure" weekly and pushed glucose-monitoring devices from Levels Health, a company she co-founded.

Yet when Senator Patty Murray pressed her on previous anti-birth control comments, Means pivoted smoothly: she was only referring to "particular women whose medical history might increase risk." On vaccines—a lightning rod issue for the MAHA (Make America Healthy Again) movement—she declared that "vaccines save lives" and are "a key part of any infectious-disease public-health strategy."

The contrast was jarring. Just months ago, Means was posting on X that "pesticides are a slow-motion extinction event." Today, when asked about President Trump's executive order boosting glyphosate production—a move that MAHA leaders considered a betrayal—she was suddenly diplomatic: "changes need to be made thoughtfully, with full respect for American farmers."

The MAHA Movement's Identity Crisis

Means's makeover reflects a broader struggle within the MAHA movement. Recent polling shows that RFK Jr.'s plan to dismantle childhood vaccine schedules is his least popular priority, while battling the food industry enjoys broad support. The White House reportedly wants Kennedy to downplay vaccines ahead of the midterms, focusing instead on more palatable targets like ultra-processed foods.

This strategic pivot creates tensions. Anti-vaccine activists won't be satisfied with half-measures, yet the administration needs broader appeal for electoral success. Means found herself threading this needle, offering measured vaccine support while avoiding specific endorsements that might alienate the movement's base.

When asked about the measles vaccine, she said she was "absolutely supportive" but declined to actually recommend it to parents—a careful dance that satisfied neither public health experts nor hardcore vaccine skeptics.

Trust and Credibility Questions

The hearing also exposed credibility issues. Senator Chris Murphy cited analysis showing Means frequently failed to properly disclose financial relationships with companies she promoted in her newsletter. Her defense—that the data was "done intentionally to create these claims"—sounded more like deflection than accountability.

Despite claiming months of work with the Office of Government Ethics, Means is still listed as chief medical officer on Levels Health's blog. Her financial entanglements raise questions about whether her health advice serves patients or profit margins.

Peter Lurie of the Center for Science in the Public Interest didn't mince words, calling Means "a virtual PEZ dispenser for RFK Jr.'s misinformation." Dozens of health organizations have opposed her nomination, questioning whether someone who dropped out of surgical residency and promotes unproven wellness theories should lead America's public health messaging.