2026-04-01T10:00:56.048Z / 美国有线电视新闻网（CNN）
作者：萨拉·奥弗莫勒、亚当·坎ryn
发布于2026年4月1日，美国东部时间早上6:00
内森·霍华德/路透社/档案照片
一个多月以来，唐纳德·特朗普总统提名的卫生局局长候选人凯西·米恩斯一直在寻求与两名威胁否决其提名的共和党参议员进行私下会面。
但据两名知情人士透露，这些会面始终未能成行，丽莎·穆尔科斯基和苏珊·柯林斯两位参议员仍未表明其投票意向。
穆尔科斯基在3月中旬告诉CNN，她“对凯西·米恩斯并不热衷”。
两位参议员的质疑实际上已使米恩斯的提名陷入停滞，这对大力支持她获任的卫生与公众服务部部长罗伯特·F·肯尼迪 Jr.及其“让美国再次健康”（MAHA）议程来说，是一次重大打击。
这是肯尼迪近期遭遇的又一次批评。过去数月来，他接连遭遇一系列挫折，削弱了他在共和党人中的影响力，也让他在本届政府中的地位有所下降——一些官员认为，他本人及其有关疫苗的政策，可能会在即将到来的中期选举中成为政府的潜在负担。
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近日，一名联邦法官推翻了肯尼迪最具影响力的儿童疫苗政策调整，而针对疾控中心（CDC）新任主任的搜寻工作也已超期，原因在于外界质疑谁能顺利通过参议院确认程序，以及CDC在当前环境下将面临的挑战。与此同时，长期支持MAHA议程的倡导者们抱怨称，本届政府已经放弃了他们的核心目标，并承诺将在中期选举中采取报复性投票行动。
当前的局面与肯尼迪上任最初几个月时截然不同。当时他被视为特朗普的得力盟友，拥有广泛自主权来推进其政策优先事项，他宣扬所谓的自闭症病因，并承诺扭转儿童慢性病发病率上升的趋势。
如今，米恩斯的提名投票越来越像是一场针对肯尼迪本人的代理战。过去一年来，肯尼迪在疫苗政策上的激进调整，已经激怒了不少不同派系的共和党人。
“他们对抗肯尼迪的唯一手段，就是试图阻挠这些提名人选，至少是拖延进程，”一名了解内部讨论的人士说道。
这场看似陷入僵局的提名，也引发了外界猜测特朗普可能会撤回对这位健康领域作家、肯尼迪长期盟友的提名。特朗普周日告诉记者，这一举措“有可能”。他补充道：“我们当然还有很多优秀的候选人来担任这一职位。”
2026年2月25日，美国卫生局局长候选人凯西·米恩斯在参议院卫生、教育、劳工与养老金委员会的确认听证会上作证。
布伦丹·斯米亚洛夫斯基/法新社/盖蒂图片社
白宫发言人卡罗琳·利夫特周一在一份声明中重申了对米恩斯的支持，并表示参议院应“不再拖延”，迅速推进对米恩斯的确认程序。
卫生与公众服务部的一名发言人表示，米恩斯“传递了选民们支持的重要公共卫生信息”，并且“我们期待她能迅速获得确认”。
收紧MAHA议程
在卫生与公众服务部内部，肯尼迪与其核心圈子正努力在日益收紧政策与信息管控的白宫，与敦促肯尼迪兑现竞选承诺的MAHA议程支持者之间寻求平衡。
这种紧张关系已经公开化，一些MAHA议程的盟友公开抱怨联邦卫生机构内部的运作混乱。
马萨诸塞州一名法官在3月实际上叫停了肯尼迪缩减后的儿童疫苗建议清单，并暂停了这位部长任命的免疫实践咨询委员会的大部分成员。该委员会是为相关决策提供建议的联邦专家小组。
生物化学家、新冠疫苗批评者罗伯特·马龙博士在该法官裁决后辞去了委员会职务，而政府尚未就这一裁决提起上诉。
“说实话，几个月来我一直在寻找退出的机会。这整件事就是一团乱麻，”马龙在3月底参加德尔·比格特主持的《高压线》节目时说道。德尔·比格特是肯尼迪的长期盟友，一直倡导反疫苗立场。
“可以肯定的是，政府在为肯尼迪的疫苗政策辩护时表现得极为糟糕，”马龙说道。
马龙还表示，肯尼迪曾致电他，请求他继续留在疫苗咨询委员会。卫生与公众服务部的一名发言人拒绝就此置评。
2025年12月4日，罗伯特·马龙博士在亚特兰大举行的CDC免疫实践咨询委员会会议上出现在屏幕上。
伊莱贾·努瓦拉格/盖蒂图片社/档案照片
去年6月，肯尼迪任命马龙等人进入该委员会时，称他们是一群“资质过硬的科学家、顶尖公共卫生专家以及美国部分最杰出的医师”。
近几个月来，白宫试图加大对卫生与公众服务部的管控力度，于今年2月任命了四名在药品定价与可及性领域有经验的高级官员。
政府官员急于强调总统在该领域的政绩，例如处方药“最惠国”定价政策以及特朗普直接面向消费者的药品平台TrumpRx，而非在即将到来的中期选举中提及疫苗政策。
这一策略与日益增长的担忧有关：肯尼迪颇具争议的疫苗政策正在疏远普通选民。肯尼迪曾是特朗普内阁中支持率最高的官员，如今其整体支持率有所下滑：根据KFF的一项民调，到他上任8个月后的10月，近60%的美国人表示不认可这位卫生部长的工作。
但另一方面，MAHA议程的倡导者警告称，他们代表着关键的选民基础，而这一群体正被传统共和党人边缘化。
“凯西·米恩斯以及她——不仅仅是她的医疗经验，她还是一位新晋妈妈——代表着对共和党中期选举成功绝对至关重要的群体：MAHA妈妈们，”迈克尔·卡托说道。他是一名生物技术创始人，曾在特朗普第一届政府期间担任卫生与公众服务部公共事务助理部长。
这一群体因特朗普近期支持农药制造商的举措，以及最高法院即将审理的有关这些化学品制造商能否因健康损害被起诉的案件而更加不满。
肯尼迪及其包括米恩斯在内的盟友长期以来一直认为，草甘膦（农达）等常用农药可能会引发癌症和其他健康问题。制造商和几个主要农业组织则表示，没有证据表明存在这种关联，限制农药使用可能会破坏美国的粮食供应。
就目前而言，后者的观点占据了舆论上风：肯尼迪主导的慢性病应对战略并未呼吁禁止或限制农药使用。这位卫生部长今年在为特朗普下令增加草甘膦国内生产的决定辩护时，也呼应了稳定粮食供应的论点。
但他也公开承认对这些举措感到沮丧。
“这并不是我特别乐意看到的事情。这么说吧，只是稍微有些不满，”他在2月接受播客主持人乔·罗根采访时说道。
2026年2月26日，德克萨斯州奥斯汀市“吃真正的食物”集会上的“让美国再次健康”帽子。
乔丹·冯德哈/彭博社/盖蒂图片社
参议院僵局
卫生局局长作为公共卫生宣传员并无政策制定权，他们的提名很少陷入投票争议。在大多数情况下，他们都会在参议院全院一致通过的“赞成”声中走马上任，成为美国最高级别的医师。
但米恩斯在2月参议院卫生、教育、劳工与养老金委员会举行的紧张确认听证会，暴露了温和派共和党人与MAHA议程支持者之间的分歧。
委员会主席、来自路易斯安那州的比尔·卡西迪立刻就疫苗政策提出问题，向米恩斯追问其相关观点。随后穆尔科斯基对卫生与公众服务部推迟乙肝疫苗接种的举措表示担忧，民主党人则对这位斯坦福大学毕业的医生的个人立场提出质疑。
米恩斯告诉卡西迪：“这不是一个我打算复杂化的问题。”
同为医生的卡西迪尚未表明他将如何对米恩斯的提名投票，也未透露他计划何时举行委员会投票。但他一直是共和党中对肯尼迪疫苗政策批评最激烈的议员之一，他在2月启动米恩斯的提名听证会时，也提及了这些担忧。
“卫生局局长需要成为高效且诚实的宣传员，在如今许多人出于各种原因散布不信任与混乱的时刻，成为冷静、理性的声音，拥有沉稳的经验，”卡西迪说道。“米恩斯医生，你的使命——以及每一位卫生与公众服务部官员的使命——都应该是恢复稳定，向美国民众保证，保护健康是首要任务。”
How RFK Jr.’s MAHA agenda keeps hitting roadblocks
2026-04-01T10:00:56.048Z / CNN
By Sarah Owermohle, Adam Cancryn
PUBLISHED Apr 1, 2026, 6:00 AM ET
Secretary of Health and Human Services Robert F. Kennedy Jr. is seen at the Health and Human Services headquarters in Washington, DC, on February 23, 2026.
Nathan Howard/Reuters/File
For more than a month, President Donald Trump’s pick for surgeon general, Casey Means, has sought private meetings with the two Republican senators threatening to sink her nomination.
But those meetings haven’t happened, two people familiar with the matter said, with Sens. Lisa Murkowski and Susan Collins remaining noncommittal about their votes.
Murkowski told CNN in mid-March she’s “not enthusiastic about her.”
The senators’ skepticism has effectively stalled Means’ candidacy, dealing a major blow to the man who championed her rise, Health and Human Services Secretary Robert F. Kennedy Jr., and his “Make America Healthy Again” agenda.
It’s the latest rebuke for Kennedy, who over the last several months has suffered a series of setbacks that have sapped his influence among Republicans and left him diminished within an administration where some officials view him — and his vaccine actions — as a potential liability in the upcoming midterm elections.
Related article RFK Jr. pledged to fight Lyme disease. Does that include supporting a vaccine? 11 min read
A federal judge recently reversed Kennedy’s most significant childhood vaccine changes, and the administration’s search for a new director of the Centers for Disease Control and Prevention has dragged past deadline amid questions about who can navigate Senate confirmation and the CDC’s challenges in this environment. Longtime MAHA advocates, meanwhile, are lamenting that the administration has abandoned their top goals — and are promising their own retribution with midterm votes.
The current environment is a far cry from Kennedy’s first months on the job, when he was seen as a powerful Trump ally who enjoyed broad latitude to carry out his priorities, touting a supposed cause of autism and promising to reverse rising chronic illnesses in children.
Increasingly, the Means vote looks like a proxy battle over Kennedy himself, who over the past year has plunged ahead on vaccine policy changes that have rankled some Republicans across the spectrum.
“Their only leverage [against him] is trying to stop these nominees, or at least slow them down,” said one person familiar with the internal discussions.
The seeming deadlock has also fueled speculation that Trump would pull his nomination of the wellness author and longtime Kennedy ally. The president told reporters Sunday that step “would be possible.” He added, “We certainly have a lot of great candidates for the job.”
Casey Means, nominee for US surgeon general, testifies during a Senate Health, Education, Labor and Pensions Committee confirmation hearing on February 25, 2026.
Brendan Smialowski/AFP/Getty Images
In a statement Monday, White House spokesperson Karoline Leavitt reiterated support for the nominee and said the Senate should move quickly to confirm Means “without further delay.”
An HHS spokesperson said that Means “has communicated a vital public health message that people voted for” and that “we look forward to her swift confirmation.”
Reining in MAHA
Inside HHS, Kennedy and his inner circle are struggling to strike a balance between a White House increasingly tightening its grip on policy and messaging, and MAHA advocates pressing for Kennedy to keep his campaign promises.
The tension has tipped into public view, with some MAHA allies openly venting about dysfunction at the federal health agency.
A Massachusetts judge in March effectively blocked Kennedy’s narrowed list of childhood vaccine recommendations and suspended most of the people the secretary had appointed to the Advisory Committee on Immunization Practices, a federal panel advising those decisions.
Dr. Robert Malone, a biochemist and Covid-19 vaccine critic, resigned from the panel following the judge’s ruling, which the government has yet to appeal.
“The truth is that I have been looking for an exit for months. This thing is a hot mess,” Malone said in late March on “The Highwire,” a weekly show hosted by Del Bigtree, a longtime Kennedy ally who has advocated against vaccination.
“All you can say for sure is the government did a horrid job” defending Kennedy’s vaccine actions, Malone said.
Malone also said Kennedy called him and asked him to stay on at the vaccine advisory panel. An HHS spokesperson declined to comment.
Dr. Robert Malone is seen on a monitor during a meeting of the CDC Advisory Committee on Immunization Practices in Atlanta on December 4, 2025.
Elijah Nouvelage/Getty Images/File
Kennedy, when appointing Malone and others to the committee last June called them a group of “highly credentialed scientists, leading public-health experts, and some of America’s most accomplished physicians.”
The White House has tried in recent months to assert more influence over HHS, this February installing four senior officials with experience in drug pricing and access.
Administration officials are keen to emphasize the president’s wins in that arena, such as “Most Favored Nation” pricing for prescription drugs and the direct-to-consumer drug platform TrumpRx, rather than vaccine policies in the upcoming midterm election.
The strategy is tied to mounting concern that Kennedy’s controversial vaccine actions are alienating average voters. Kennedy, once polling as Trump’s most popular Cabinet secretary, has seen his broader popularity slip: By October, eight months into Kennedy’s tenure, nearly 6 in 10 Americans said they disapproved of the health secretary, according to a KFF poll.
But on the other side, MAHA advocates warn they represent a pivotal voting base that is being sidelined by traditional Republicans.
“Casey Means and her — not just her health experience, but she’s a new mom — represents a demographic that is absolutely essential to successful Republican midterms: MAHA moms,” said Michael Caputo, a biotech founder and former assistant HHS secretary for public affairs during the first Trump administration.
That cohort has been further aggravated by recent Trump action to support pesticide manufacturers and a looming Supreme Court battle over whether those chemical makers can be sued for health damages.
Kennedy and his allies, including Means, have long argued that commonly used pesticides such as glyphosate, or Roundup, can fuel cancer and other health problems. Manufacturers and several prominent agricultural groups have said there is no evidence of this link and that restricting pesticide use could destabilize the American food supply.
For now, the latter camp has won the messaging: A Kennedy-led strategy to address chronic disease skipped calls for pesticide bans and restrictions. And the health secretary this year echoed the argument about a stable food supply when defending Trump’s decision to order more domestic production of glyphosate.
But he also publicly admitted frustration with the moves.
“It’s not something that I was particularly happy with. Let me put it that way, mildly,” he told podcast host Joe Rogan in February.
“Make American Healthy Again” hats during an “Eat Real Food” rally in Austin, Texas, on February 26, 2026.
Jordan Vonderhaar/Bloomberg/Getty Images
Senate deadlock
Surgeons general — public health messengers with no policymaking authority — are rarely mired in voting controversy. Most are waved into their role as the nation’s top doctor with a chorus of “ayes” on the Senate floor.
But Means’ tense confirmation hearing before the Senate Health, Education, Labor and Pensions Committee in February exposed fault lines between moderate Republicans and MAHA advocates.
Committee Chairman Bill Cassidy of Louisiana almost immediately brought up vaccine policy, pressing Means on her views. He was followed by Murkowski expressing alarm about HHS efforts to delay hepatitis B vaccination, and Democrats questioning the Stanford-trained physician’s personal stance.
Means told Cassidy that “this is not an issue that I intend to complicate.”
Cassidy, a physician himself, has not signaled how he will vote on Means’ nomination — or when he intends to hold the committee vote. But he has been one of the most vocal GOP critics of Kennedy’s vaccine actions, concerns he nodded to when he kicked off Means’ hearing in February.
“The surgeon general needs to be an effective and truthful communicator, a calming voice of reason, a steady-handed experience at a time when so many, for whatever reason, sow distrust and confusion,” Cassidy said. “Dr. Means, it should be your mission — and the mission of every HHS official — to restore stability and assure Americans that protecting health is the top priority.”
