2026年5月7日 美国东部时间上午6:30 / 美国有线电视新闻网（CNN）
作者：亚当·坎ryn、萨拉·奥沃莫勒
约翰·兰帕尔斯基/盖蒂图片社
去年5月，当唐纳德·特朗普总统需要提名新一任卫生局局长时，他向卫生与公众服务部部长小罗伯特·F·肯尼迪寻求建议。
“博比（肯尼迪的昵称）真的觉得她很棒，”特朗普在选择凯西·米恩斯的次日对记者表示，米恩斯是肯尼迪的亲密盟友，也是“让美国再次健康”（MAHA）运动的核心人物。“我并不认识她，我听从了博比的推荐。”
但近一年后，当米恩斯的提名陷入停滞，特朗普最终选择妮可·萨皮尔接替她时，肯尼迪几乎没有参与相关讨论。
据知情人士透露，萨皮尔是白宫官员列出的一系列候选人之一。这位放射科医生、福克斯新闻撰稿人与肯尼迪此前并无实质性交集，且长期批评肯尼迪及其部分政策。
这最新迹象表明，正如特朗普在大选前承诺的那样，在放任肯尼迪“在医疗议题上自由发挥”一年后，总统及其高级助手在中期选举临近之际收紧了对其的约束，即使可能疏远他带入共和党的大量追随者，也会对卫生与公众服务部部长施加更严格的政治限制。
这种动态变化加剧了白宫与2024年大选期间基本支持特朗普的MAHA选民之间的关系紧张。同时，特朗普团队内部也引发了新的疑问：他必须在多大程度上迎合这场运动？如今有人开始怀疑，该运动是否如其所称，会成为共和党内部一支重要的全国性政治力量。
“我不愿这么说，但我认为他们被高估了一点，”一位特朗普顾问表示，“在某种程度上，MAHA一直就是纸老虎。”
MAHA与MAGA阵营的裂痕
最近几周，白宫选择了医疗背景更传统的候选人担任疾控中心主任和卫生局局长，背离了肯尼迪上任初期试图让亲密盟友和反建制怀疑论者担任卫生与公众服务部高层职位的做法。
特朗普助手还限制了卫生与公众服务部有争议的疫苗政策重塑和医疗研究改革计划，转而转向更具广泛吸引力的议题，如降低药品价格和改善医疗保险。在一次造成负面影响的事件中，特朗普站在大型农业企业一边，反对肯尼迪和MAHA活动人士，推动加快一种有争议除草剂的国内生产。
这种中期选举前的政策调整引发了肯尼迪亲密盟友的担忧，他们认为自己正被政府边缘化，这在新兴的MAGA-MAGA联盟内部制造了新的裂痕。
肯特·西岛/法新社/盖蒂图片社
美国卫生与公众服务部部长小罗伯特·F·肯尼迪于5月5日在华盛顿白宫椭圆形办公室，在唐纳德·特朗普总统签署一项公告前发表讲话。
一方面，部分特朗普助手和顾问 increasingly 对MAHA影响力人士在人事和政策决策上的要求感到不满。这些盟友认为，MAHA拖累了填补关键职位空缺和推进中期选举关键议题的工作。他们特别指责肯尼迪及其盟友推动有争议的疫苗政策，损害了政府与部分共和党议员的关系，且在公众中普遍不受欢迎。
反过来，MAHA运动的领导人则公开警告白宫，如果不能优先考虑他们的关切，可能会在11月的选举中失去一个有影响力的选民群体。上周，众议院议员在一项综合性农业法案中删除了一项实际上会让农药生产商免受健康相关诉讼的条款，这为他们的主张提供了支持。
农药的所谓危害一直是MAHA选民的热点问题，上个月促使数十人在最高法院前集会。这也是米恩斯长期以来的优先议题。
“这是一个由家长、农民和健康倡导者组成的快速发展、充满活力的联盟，我们正在以华盛顿不习惯的方式组织起来，”以“食品宝贝”博客闻名的健康影响人士瓦尼·哈里在反农药集会上表示，“在中期选举前忽视这一点不仅是错误的，在政治上也是短视的。”
白宫的平衡术
白宫驳斥了有关肯尼迪被边缘化或其对MAHA优先事项的承诺有所削弱的说法。
“让美国再次健康一直是特朗普总统上任第一天的优先事项，肯尼迪部长继续在特朗普政府为实现总统MAHA议程而开展的全政府努力中发挥核心作用，”发言人库什·德赛表示，并承诺将“继续为美国人民兑现并宣传MAHA的胜利”。
尽管如此，这已成为一场日益微妙的平衡行动。特朗普上个月在椭圆形办公室会见了一批MAHA影响力人士，旨在缓解他推动除草剂草甘膦生产引发的紧张局势。
这一举措似乎奏效了；MAHA团体离开白宫时认为他们的不满得到了倾听。但这也凸显了另一个棘手局面：米恩斯提名卫生局局长的进程停滞。米恩斯出席了与总统及其顾问的会面。
“转折点美国”播客主持人、MAHA核心声音亚历克斯·克拉克后来告诉CNN，她直接向特朗普提及了米恩斯的确认斗争，总统给予了热情回应。她表示，肯尼迪后来还拥抱并感谢她提出了这一问题。
“她确实是MAHA的代言人，”克拉克在椭圆形办公室会议后谈到米恩斯时说，“如果她能担任这个职位，我认为这将大大缓解许多人的焦虑。”
几周后，特朗普撤回了米恩斯的提名，并用萨皮尔取而代之。
克拉克此后抨击了这一决定，在X平台上写道，萨皮尔的当选是“灾难性的错误”，且“在所有与MAHA相关的事情上都得不及格”。哈里也公开反对这一举措，辩称如果无法确认米恩斯，政府应该让卫生局局长职位空缺。
一些人推测，MAHA选民可能不仅会在11月的选举中弃权，还可能主动倒戈——他们指出，像新泽西州参议员科里·布克这样的民主党人支持该运动对抗农药的斗争。
“我认为，无论是民主党人还是共和党人，只要候选人能传达出他们想听的信息，就能赢得MAHA选民的支持，”亚利桑那州共和党策略家巴雷特·马森表示。
特朗普政府官员和其他参与相关进程的人士表示，撤回米恩斯的提名与其说是放弃，不如说是务实的转变，此前数周他们曾多次尝试为米恩斯争取足够的支持，但均未成功。
“在某个节点，他们必须做出决定，”一位知情人士表示，“我们已经花了一年半的时间试图确认一位卫生局局长提名人选。”
萨皮尔的困境
白宫此后试图强调萨皮尔自身的MAHA资质，包括她反对新冠疫情时期的疫苗强制令，以及在“让美国再次健康”成为政治运动之前就使用该标签的一本书。
“她非常符合MAHA的模式，”一位白宫官员表示，“从理念上讲，我认为没有太大分歧。”
但也不能保证萨皮尔能获得确认。据一位熟悉内部审议情况的人士透露，特朗普过渡团队在2024年大选后不久就考虑过由她担任卫生局局长。当时由于她没有美国医学学位，以及她的诊断放射学专业是否足以让她直接接触患者的疑问，她被否决了。
如果萨皮尔能通过参议院的考验，她将面临一项艰巨的任务：赢得政府内外肯尼迪的MAHA盟友的支持。据CNN报道，萨皮尔在过去一年中曾多次批评肯尼迪，指责他的疫苗政策造成“混乱”，并猜测政府是否隐瞒了麻疹病例。她还公开批评过米恩斯，曾表示希望她“少参与一点MAHA的事务”。
但在中期选举还有六个月之际，特朗普团队中的一些人认为，她的候选资格对MAHA运动来说是一次关键的政治考验：它是否会做出必要的妥协，以成为共和党联盟中更强大的一部分——还是会继续作为政治边缘的派系分支存在？
“她是MAHA，但可以说是‘理智的MAHA’，”一位特朗普顾问在谈到萨皮尔时说，“MAHA支持很多东西，比如更清洁的食品——这确实很受欢迎。但我也认为疫苗非常受欢迎，白宫必须在这些问题上采取坚定、务实的立场。”
Trump’s new surgeon general pick deepens MAHA-MAGA rift
2026-05-07 06:30 AM ET / CNN
By Adam Cancryn, Sarah Owermohle
Dr. Nicole Saphier interviews Johnny Joey Jones, author of Fox News Books’ “Unbroken Bonds of Battle,” at “Outnumbered” at Fox News Studios on June 27, 2023 in New York City.
John Lamparski/Getty Images
When President Donald Trump needed a new pick for surgeon general last May, he turned to Health and Human Services Secretary Robert F. Kennedy Jr. for advice.
“Bobby really thought she was great,” Trump told reporters the day after choosing Casey Means, a close Kennedy ally and outsized voice in the Make America Healthy Again movement. “I don’t know her. I listened to the recommendation of Bobby.”
But nearly a year later, when Means’ candidacy stalled and Trump eventually selected Nicole Saphier to replace her, Kennedy played little role in the conversation.
Instead, Saphier came up as one of a host of options drawn up by White House officials, people familiar with the process said. The radiologist and Fox News contributor has no prior substantial relationship with Kennedy and a lengthy history of criticizing him and some of his policies.
It’s the latest sign that, after a year of letting Kennedy “go wild” on health care, as Trump promised ahead of the election, the president and his top aides are shortening the leash in the run-up to the midterms — and imposing tighter political constraints on the HHS secretary even at the risk of alienating the legion of followers he brought into the Republican Party.
The shifting dynamics have strained the White House’s relationship with MAHA voters who largely sided with him in the 2024 election. And they have raised fresh questions within Trump’s orbit about how far he must go to please a movement that some now doubt has lived up to its claim that it would be a major national political force within the GOP.
“I hate to say it, but I think they’re a little bit overrated,” said one Trump adviser. “To some extent, MAHA has always been a paper tiger.”
The MAHA-MAGA rift
The White House in recent weeks chose candidates with more conventional health backgrounds to run the Centers for Disease Control and Prevention and serve as surgeon general, departing from Kennedy’s efforts at the beginning of his tenure to fill HHS’ top ranks with close allies and anti-establishment skeptics.
Trump aides have also reined in HHS’ controversial efforts to remake vaccine policies and overhaul medical research in favor of shifting to broader-appeal topics like lower drug prices and improving health insurance. In one damaging episode, Trump sided with major agricultural corporations over Kennedy and MAHA activists by seeking to accelerate domestic production of a controversial weedkiller.
That recalibration ahead of the midterms has raised fears among Kennedy’s close allies that he is being marginalized inside the administration, opening a fresh rift within the nascent MAGA-MAHA alliance.
US Secretary of Health and Human Services Robert F. Kennedy Jr. speaks before President Donald Trump signs a proclamation in the Oval Office of the White House in Washington, DC on May 5.
Kent Nishimura/AFP/Getty Images
On one side, some Trump aides and advisers have increasingly bristled over the demands from MAHA influencers on personnel and policy decisions. Those allies contend that MAHA has complicated efforts to fill key vacancies and make headway on issues critical to the midterm elections. They blame Kennedy and his allies in particular for advancing controversial vaccine policies that damaged the administration’s standing with some GOP lawmakers and proved broadly unpopular with the public.
Leaders of the MAHA movement, in turn, are vocally warning the White House that it risks losing an influential bloc of voters in November if it fails to prioritize their concerns. Their case got a boost last week, when House lawmakers scrapped a provision in a sweeping agricultural bill that would have effectively shielded pesticide makers from health-related lawsuits.
The alleged harms of pesticides have been a flashpoint with MAHA voters, one that prompted scores of people to rally before the Supreme Court last month. It’s also been a longtime priority for Means.
“This is a fast-growing, highly energized coalition of parents, farmers, and health advocates and we’re organizing in ways Washington isn’t used to,” said Vani Hari, a wellness influencer known for her “Food Babe” blog, who spoke at the anti-pesticide rally. “Ignoring that heading into the midterms is not just wrong, it’s politically shortsighted.”
White House balancing act
The White House disputed suggestions that Kennedy was being sidelined, or that its commitment to MAHA priorities had diminished in any way.
“Making America Healthy Again has been a Day One priority for President Trump, and Secretary Kennedy continues to play a central role in the Trump administration’s whole-of-government effort to deliver on the President’s MAHA agenda,” spokesman Kush Desai said, pledging to “continue to deliver and tout MAHA victories for the American people.”
Still, it’s become an increasingly delicate balancing act. Trump last month hosted a contingent of MAHA influencers in the Oval Office aimed at easing tensions over his effort to boost the weedkiller glyphosate.
The gambit appeared to work; the MAHA group emerged from the White House feeling their grievances had been heard. But it also served to emphasize another thorny situation: Means’ stalled nomination for surgeon general. Means attended the meeting with the president and his advisers.
Alex Clark, a Turning Point USA podcaster and leading MAHA voice, directly pressed Trump about Means’ confirmation battle, Clark later told CNN, and the president responded enthusiastically. Kennedy hugged and thanked her afterward for raising the point, she said.
“She really is the spokesperson for MAHA,” Clark said of Means following the Oval meeting. “If she were to be in that position, I think that it would just really soothe a lot of this anxiety.”
Weeks later, Trump pulled Means’ nomination and replaced her with Saphier.
Clark has since blasted the decision, writing on X that Saphier’s selection is “a catastrophic mistake” and that “she gets an F when it comes to all things MAHA.” Hari also publicly opposed the move, arguing that the administration should leave the surgeon general position vacant if it can’t confirm Means.
And some theorize that MAHA voters may not just sit at home come November but could actively switch sides — noting that Democrats like Sen. Cory Booker of New Jersey supported the movement’s battle against pesticides.
“I think the right candidate, either a Democrat or Republican, could win MAHA voters with a message that they would want to hear,” said Barrett Marson, an Arizona GOP strategist.
Trump officials and others involved in the process said pulling Means’ nomination was less an abandonment than a pragmatic pivot that came after weeks of long-shot attempts to win her sufficient support.
“At some point, they had to make a decision,” said one person familiar with the process. “We’ve now burned a year and a half trying to get a surgeon general nominee confirmed.”
Saphier’s struggle
The White House has since sought to highlight Saphier’s own MAHA credentials, including her opposition to Covid-era vaccine mandates and a book that used the “Make America Healthy Again” moniker before it became a political movement.
“She’s very much in the MAHA mold,” said one White House official. “Philosophically, I don’t think there’s much daylight.”
There’s no guarantee that Saphier will get confirmed either. Trump transition advisers weighed her for surgeon general shortly after the 2024 election, according to a person familiar with the internal deliberations. She was dismissed at the time due to concerns about her lack of a US medical degree, the person said, as well as questions about whether her diagnostic radiology specialty had put her in direct-enough contact with patients.
Should Saphier survive the Senate gauntlet, she’ll likely face a tall test in winning over Kennedy’s MAHA allies both inside and outside the administration. Saphier criticized Kennedy several times over the last year, CNN has reported, accusing his vaccine policies of causing “chaos” and speculating over whether the administration was hiding measles cases. She also took public aim at Means, saying at one point she wished she were “a little bit less involved with MAHA.”
But six months out from the midterms, some in Trump’s orbit argued that her candidacy represents a key political test for the MAHA movement: Will it make the compromises necessary to become a stronger part of the GOP coalition — or remain a factional offshoot on the political fringe?
“She’s MAHA, but it’s like, sane MAHA,” the Trump adviser said of Saphier. “There’s a lot of stuff that MAHA supports, like cleaner food — that’s really popular stuff. But I also think that vaccines are very popular, and the White House has to take a good, strong, common-sense position on this stuff.”
