By Adam Cancryn, Sarah Owermohle, CNN
(CNN) — 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.
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 pestic