Sen. Bill Cassidy (R-LA) is facing his latest dilemma over President Donald Trump’s nominees, this time with the candidate for surgeon general, as the fate of his political future draws near.

The Senate health committee chairman is wrestling with Casey Means’ quest to become the nation’s next top doctor over her vaccine views, just as he did before supporting her ally, Robert F. Kennedy Jr., despite deep misgivings over the health and human services secretary’s vaccine stances. But now, the prospect of Trump’s endorsement no longer hangs over Cassidy.