Why it Matters

Chair Bill Cassidy (R-LA) recessed the Senate Health, Education, Labor and Pensions Committee markup on Sept. 24 without a final vote on the No Aid for Ghost Students Act after the committee adopted an amendment prohibiting the federal government from garnishing Social Security benefits to collect defaulted student loans.

The committee also postponed votes on five Trump administration nominees, including Dr. Nicole Saphier, the administration's third nominee for surgeon general. The Surgeon General's Office has been without a Senate-confirmed leader since the start of the Trump administration, while the country's measles outbreak and disagreements over federal vaccine policy have heightened scrutiny of Saphier's nomination.

The Big Picture

The administration's previous surgeon general nominees, Dr. Janette Nesheiwat and Dr. Casey Means, were both withdrawn before confirmation, making Saphier Trump's third choice. Saphier's Sept. 16 confirmation hearing came amid the country's worst measles outbreak in decades. Cassidy said during the hearing that Pennsylvania coroners had confirmed measles as the cause of three deaths, with another death still being evaluated.

The markup of S.4428, the No Aid for Ghost Students Act, was prompted by concerns about fraud involving applicants using false or stolen identities to obtain federal student aid. The legislation would require the Education Department to use an identity fraud detection system to screen Free Application for Federal Student Aid applications and require additional identity verification for applications flagged as potentially fraudulent.

What They're Saying

During Saphier's confirmation hearing, Cassidy pressed her for unequivocal answers about vaccine safety and efficacy. Saphier told the committee she did not believe the measles, mumps, and rubella vaccine to be lethal and called it "our greatest tool for combating measles." She also said she did not believe childhood vaccines cause autism and described vaccines as "one of the strongest tools in our arsenal" for public health.

Sen. Bernard Sanders (I-VT) announced opposition to the three Department of Health and Human Services nominees considered at the Sept. 16 confirmation hearing and delivered a blunt verdict on Saphier, saying, "Dr. Saphier is not that person," after raising concerns about her record on vaccines.

The sharpest clash during the Sept. 24 markup came when Sanders introduced an amendment to prohibit federal garnishment of Social Security benefits for student loan repayment. Cassidy asked him to withdraw it, citing the lack of a Congressional Budget Office score. Sanders refused and demanded an immediate vote. The amendment passed 12-11, with Sen. Susan M. Collins (R-ME) joining Democrats and Sanders in support. Cassidy subsequently pulled the bill from consideration pending additional budget analysis.

Sen. Ashley Moody (R-FL), a sponsor of the legislation, argued for stronger protections against fraudulent student aid applications.

Political Stakes

Saphier's nomination has drawn opposition from the Center for Science in the Public Interest, which called her "unfit to serve as Surgeon General" and criticized her investments in Philip Morris International. Saphier's ethics agreement says she would divest her interests in Philip Morris and other identified companies within 90 days of confirmation.

Her nomination also follows a dispute within the Republican Party and the Make America Healthy Again movement over Trump's previous nominee, Means. When Trump withdrew Means' nomination in April, Health and Human Services Secretary Robert F. Kennedy Jr. accused Cassidy of undermining it, while Cassidy said Means lacked sufficient committee support to advance.

At her Sept. 16 confirmation hearing, Saphier said she did not believe the measles, mumps and rubella vaccine was lethal and called it "our greatest tool for combating measles." She also endorsed universal hepatitis B vaccination and said universal birth-dose vaccination had proved safe and effective in the United States.

Mary Lazare's nomination as assistant secretary for aging would place her in a senior federal role overseeing aging policy. Lazare currently serves as principal deputy administrator of the Administration for Community Living.

The Bottom Line

The committee has rescheduled consideration of Saphier, Timothy Westlake, Lazare, Loren Sweatt and Douglas Ralph for a Sept. 30 executive session. The No Aid for Ghost Students Act is not included on the new agenda, leaving the legislation pending after Cassidy pulled it from consideration following adoption of Sanders' amendment.

The Surgeon General vacancy remains unresolved as Saphier's nomination moves toward another committee vote amid continued debate over federal vaccine policy and the administration's public health agenda. Track the committee's next steps at Legis1.com.

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