The opulent ballroom of the Willard InterContinental Hotel is a regular stop on the high-dollar circuit of industry conferences that populate downtown Washington.
But on a recent morning, mingling among the marble columns was an eclectic group of outsiders new in town. Food influencers, organic farmers and anti-vaccine advocates were among those gathered for the official launch of the MAHA Institute, the latest incarnation of the Make America Healthy Again movement that has become a key facet of Washington in the second Trump administration.
Speakers took the stage to discuss medical freedom, school lunches, vaccine exemptions and above all, chronic illness. Farmers chatted about the importance of local produce but also the dangers of chemtrails in the sky. College students pitched a health startup built around the importance of “touching grass.”
Speaking from the stage, Calley Means, a longtime ally of Health and Human Services Secretary Robert F. Kennedy Jr.’s who is now advising the White House, noted the oddity of pairing the people and ideas behind MAHA with those in Donald Trump’s MAGA movement.
“There’s a lot of organizations, a lot of people in this room who four to eight years ago, would have thought it was crazy to vote for President Trump,” Means said. “And I think many of those same people in 2024 felt like their vote for President Trump was the most important vote of their life.”
With Trump came Kennedy, who nearly three months into the job as HHS secretary has finally built out his leadership team filled with Covid-19 contrarians and self-styled “renegades.” Together, with the added influence of Elon Musk’s Department of Government Efficiency, or DOGE, they’ve begun a massive overhaul of the nearly $3 trillion agency — implementing deep cuts in medical research and sweeping layoffs that have led to the departure of some of the most highly trained specialists working in the federal government.
But agency shake-ups and new appointees have also begun to splinter the alliance between traditional Trump world allies and Kennedy’s MAHA acolytes. Though it’s early days, there is friction between the MAHA and MAGA camps, according to more than half a dozen current and former officials and people familiar with the conversations who declined to be named because they weren’t authorized to speak on behalf of the health agency, or who feared retribution.
The White House bristled over the way Kennedy’s team handled the measles outbreak in Texas and elsewhere this year. Meanwhile, Kennedy’s powerful principal deputy chief of staff, Stefanie Spear, has cracked down on the way agency officials communicate publicly, insisting that she personally review statements and reports.
Cracks have also opened up within the MAHA movement itself. Tension spilled into public view this month as high-profile MAHA supporters railed against Trump’s new pick for surgeon general, Calley Means’ sister, Dr. Casey Means.
The holistic doctor has railed against the health care system’s handling of chronic illnesses. But she has not discussed vaccine safety, and specifically Covid-19 vaccines, enough for some MAHA supporters.
Looming large is what many MAHA supporters — and Kennedy himself — have publicly described as years of dismissal and ostracization by the mainstream medical and scientific community. Now that they are in charge, their suspicion of the establishment has not abated.
“The number of actual, true MAHA supporters at the top of these agencies is maybe 75 people across an agency that has 60,000 employees,” Mark Gorton, MAHA Institute co-president and a tech entrepreneur, told the Willard ballroom. “Their job is unbelievably daunting because these bureaucracies are highly resistant to change.”
But change is happening, buoyed by Kennedy’s close circle of agency leaders and MAHA appointees.
According to one former official familiar with conversations inside HHS, despite being outnumbered, there is no question that it’s the MAHA advocates who are now fully in charge of the government’s health agencies.
“Anyone in power, who has any kind of control, is a MAHA person,” the former official said.
HHS did not respond to a request for comment.
RFK Jr.’s band of ‘renegades’
To hear Kennedy describe it, there has never been unity like this among the country’s top health officials.
“We’re friends. We go to lunch together; we stay at each other’s homes; we vacation together,” Kennedy told Fox News this month, flanked by the heads of three of the biggest health agencies: Dr. Marty Makary, Food and Drug Administration commissioner; Dr. Jay Bhattacharya, National Institutes of Health director; and Dr. Mehmet Oz, Centers for Medicare and Medicaid Services administrator.
“We’re aligned in our vision. Friendship is based upon shared values, and that’s the strongest bond that holds people together,” the secretary said. “You got, sitting here, four people who are all canceled during Covid. The entire leadership of this agency is renegades, juggernauts against convention, and who are trying to look for truth, no matter what the cost.”
Oz, known better by his TV moniker Dr. Oz, was already a public figure and adviser to Trump when the pandemic struck. He soon campaigned for reopening schools and touted hydroxychloroquine, without evidence, as an effective treatment for Covid-19 infection.
Bhattacharya was an early advocate of ending broad shutdowns, co-authoring an October 2020 paper that argued most young, healthy people could safely mingle and achieve herd immunity against the virus.
And while surgeon and author Makary supported certain public health measures during the pandemic, including early shutdowns and masking, his public opposition to vaccine mandates and skepticism of booster shots increasingly brought him into the circle of Covid-19 critics.
Each has been tasked with reorganizing their respective agencies and reorienting them toward a MAHA vision while satisfying cuts directed by DOGE, a sometimes discombobulated combination that has resulted in eliminating programs, research and staff.
Makary launched FDA initiatives to remove certain food dyes and reassess vaccine reviews. Bhattacharya is charged with leading Kennedy’s massive autism research effort but also reworking the $48 billion NIH into merged groups with less funding. Oz has taken up the campaign for more artificial intelligence in health care outreach and defended potential Medicaid access requirements.
Friction over surgeon general pick
Yet outside the jovial unity of the country’s top health officials, tensions are brewing about the assembly’s commitment to MAHA goals. The debate broke open this month when Trump pulled Dr. Janette Nesheiwat for surgeon general, and tapped Casey Means to fill the role.
“The new Surgeon General has never called for the Covid shots to be pulled off the market. That’s why she was picked,” Dr. Mary Talley Bowden, founder of Americans for Health Freedom, wrote on X. “Kennedy is powerless.”
Nicole Shanahan, Kennedy’s former running mate in his 2024 independent presidential bid, also questioned the choice, suggesting on X that the HHS secretary may be “reporting to someone regularly who is controlling his decisions (and it isn’t President Trump).”
More recently, Shanahan took more precise aim at Kennedy’s MAHA moves thus far, targeting food dyes but not — in her mind — putting sufficient pressure on issues including Covid-19 vaccines. “Sure, we can make Fruit Loops great again, but let’s not overlook the bigger issues—glyphosate and mRNA,” she wrote on X.
The blowback has led Kennedy himself to step in and defend Means, a holistic medicine doctor who rose to prominence after she and her brother linked up with the MAHA movement and Kennedy’s presidential campaign.
“Appointing Casey Means as US Surgeon General is like appointing someone who dropped out of West Point as Chairman of the Joint Chiefs of Staff,” Steve Kirsch, an anti-Covid vaccine advocate and tech entrepreneur, wrote on X the afternoon of May 10.
Five hours later, Kirsch posted his change of heart: “I’ve talked to RFK and now support her despite my initial reservations.”
Divisions inside HHS
Outside of layoffs and reassignments at HHS, droves of federal employees have left the agency, several citing frustrations with the new leadership and Kennedy’s chief of staff, Spear, a former environmental journalist who joined Kennedy’s presidential campaign as press secretary.
Spear told staff in meetings that all external communications, including responses to press but also routine reports such as the Centers for Disease Control and Prevention’s weekly mortality updates or articles submitted by the NIH to research journals, would need to be reviewed by her, according to four people familiar with the meetings.
Spear also controls the communications and information that Kennedy receives, according to those people.
“She’s probably one of the biggest challenges of him getting feedback of any kind, information from the team,” said a former official who recently left the agency. “Everything is filtered through her.”
The slowdown on communications left White House officials frustrated with HHS’ early response to the ongoing measles outbreak, that person and others familiar with the conversations said.
White House officials would call HHS staff asking about the measles response, only to be told that Spear was handling it, the former officials said. There are now more than 1,000 measles cases across 30 states, according to CDC figures. Kennedy told congressional committees last week that “we’ve handled this measles outbreak better than any other nation.”
Frustrations with Kennedy’s assembled leadership and the health agency overhaul have only exacerbated the flood of experts leaving HHS.
For instance, so many people have left the agency’s legal office that there is anxiety about whether HHS has the staff to man the looming battles with Harvard University over frozen research grants, the former official and another person familiar said.
It is “an utter disaster,” said the person familiar.