MAHA's messy marriage
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Illustration: Maura Losch/Axios
Robert F. Kennedy Jr.'s short time leading America's health agencies has already destabilized the uneasy alliance that vaulted him into President Trump's Cabinet.
Why it matters: The "Make America Healthy Again" movement — a loose umbrella of vaccine skeptics, wellness influencers, and anti-pharma crusaders — was envisioned as a revolution against the medical establishment.
- But its attempt to integrate with the federal health apparatus — and the MAGA purists who comprise the backbone of Trump's base — has so far proven deeply dysfunctional.
The big picture: The anti-establishment takeover of Health and Human Services — a sprawling agency that accounts for the largest share of domestic federal spending — has become one of the most chaotic experiments of Trump's second term.
- Trump has already been forced to pull two major health nominations — former Rep. Dave Weldon for Centers for Disease Control and Prevention director and Fox News contributor Janette Nesheiwat for surgeon general — after scrutiny of their records.
- The Food and Drug Administration's top vaccine regulator, Peter Marks, abruptly resigned in March in protest of Kennedy's "misinformation and lies" about vaccines.
- As a measles outbreak spread in Texas, the White House became so frustrated by the lack of clear and fast communications by HHS that it set up a parallel press shop, as Axios scooped last month.
Between the lines: Kennedy's top health picks include contrarians who are critical of the medical establishment — but unwilling to fully embrace the MAHA movement's more conspiratorial views on vaccines.
- National Institutes of Health director Jay Bhattacharya and FDA commissioner Marty Makary were brought in as high-profile critics of COVID-era orthodoxy who boast mainstream academic credentials.
- But neither man fully endorses Kennedy's most controversial positions, particularly on childhood vaccines and autism — making them targets for the anti-vaccine purists who view them as insufficiently radical.

Zoom in: Trump's nomination of nutrition influencer Casey Means to be surgeon general last week has become the latest flashpoint in the unraveling of the MAHA coalition.
- Means and her brother, White House adviser Calley Means, became key faces of Kennedy's movement after authoring a New York Times best-seller that railed against the food and pharmaceutical industries.
- Their message — that metabolic dysfunction and chronic illness stem from institutional corruption — helped popularize the MAHA brand among wellness influencers and libertarian-minded reformers.
But Casey Means' nomination to be the face of public health messaging has drawn fire from all sides.
- Anti-vaccine activists argue she isn't sufficiently committed to Kennedy's views on vaccine safety, especially the more fringe beliefs he espoused before leading HHS.
- Kennedy's running mate, Nicole Shanahan, claimed she was promised that the Means siblings wouldn't get jobs inside HHS — and that "someone" is "controlling" Kennedy's decisions.
The intrigue: Far-right conspiracy theorist Laura Loomer, who successfully lobbied Trump to fire national security adviser Mike Waltz and much of his team, has trained her eyes on the Means siblings.
- Loomer has openly mocked Casey Means as a "woo woo woman" who "literally talks to trees and spiritual mediums" — drawing backlash from Calley Means, who suggested Loomer was taking money from the medical industry.
- Kennedy has vigorously defended Means' qualifications, arguing that her popularity among "MAHA moms" poses "an existential threat to the status quo interests, which profit from sickness."
The other side: Other top MAGA influencers, including Charlie Kirk, Donald Trump Jr. and Megyn Kelly, have praised Casey Means' appointment and emphasized the need for coalition harmony.
- "If you merge MAHA and MAGA, it's like 1932," former Trump chief strategist Steve Bannon said on his "War Room" podcast, predicting a political realignment on par with FDR's New Deal coalition.
- "You govern forever."
The bottom line: HHS will be at the center of major policy debates over Medicaid cuts, abortion access, vaccine policy, medical research and the future of public health infrastructure.
- But the deep divisions within its Frankenstein coalition are threatening to tear MAHA apart before those battles can even begin.

