Washington, Jun 10 (AP) Calley Means has built a following within the “Make America Healthy Again” movement by railing against the failings of the US health system, often pinning the blame on one issue: corruption.

Means, a top aide to Health Secretary Robert F. Kennedy Jr., was hired as a White House adviser in March. He has used that perch to attack the nation's leading physician groups, federal agencies and government scientists, claiming they only protect their own interests in the nation's USD 4.9 trillion-a-year industry.

In recent interviews, speeches and podcasts he has called the American Medical Association “a pharma lobbying group”, labelled the Food and Drug Administration “a sock puppet of industry", and said federal health scientists have “overseen a record of utter failure”.

Means, however, has his own financial stake in the sprawling health system. He's the co-founder of an online platform, Truemed, that offers dietary supplements, herbal remedies and other wellness products. Some of the vendors featured on Truemed's website are supporters of Kennedy's MAHA movement, which downplays the benefits of prescription drugs, vaccines and other rigorously tested medical products.

Kennedy has pledged to run the Department of Health and Human Services with “radical transparency”, but Means has never had to publicly disclose his own financial details or where exactly they intersect with the policies he's advancing.

“It reeks of hypocrisy,” said Dr. Reshma Ramachandran, a health researcher at Yale University. “In effect, he is representing another industry that is touting nonregulated products and using his platform within the government to financially benefit himself.” In a written statement, Means said his government work has not dealt with matters affecting Truemed and has focused on issues like reforming nutrition programs and pressuring companies to phase out food dyes.

“Pursuing these large-scale MAHA goals to make America healthy has been the sole focus in my government work,” Means said.

Truemed helps users take tax-free money out of their health savings accounts, or HSAs, to spend on things that wouldn't normally qualify as medical expenses, such as exercise equipment, meal delivery services and homeopathic remedies — mixtures of plants and minerals based on a centuries-old theory of medicine that's not supported by modern science.

The business model caught the attention of the IRS last year, which issued an alert: “Beware of companies misrepresenting nutrition, wellness and general health expenses as medical care.” Truemed co-founder and CEO, Justin Mares, said in a statement the company is “in full alignment” with IRS guidelines.

“Truemed enables patients to work with providers to use medical funds for root cause interventions like exercise and vitamin D to reverse disease under current law,” Mares said.

The full extent of Means' potential conflicts — including his personal investments — are unclear because of his status as a special government employee.

Unlike presidential appointees and other senior officials, special government employees are temporary staffers who do not have to leave companies or sell investments that could be impacted by their work. Also, their financial disclosure forms are shielded from public release.

“It's a big problem,” says Richard Painter, a former White House ethics lawyer under George W. Bush now at the University of Minnesota. Painter and other experts have raised alarms over a whirlwind of Trump administration actions to dismantle the government's public integrity guardrails.

Still, part-time government employees are subject to the same law that bars all federal staffers from working on issues that could directly benefit their finances. When such cases arise, they must recuse themselves or risk criminal penalties.

Means regularly opines on matters before HHS, including rethinking the use of drugs for depression, weight loss, diabetes and other conditions. Recently he's been promoting a new government report that calls for scaling back prescription medications in favour of exercise, dietary changes and other alternatives.

“If we rely less on our medical system, less on drugs, it necessitates the spiritual, cultural conversation about what we're doing to our children's bodies,” Means said in a recent podcast appearance.

Experts note that government ethics rules are intended to both prevent financial conflict violations, but also the appearance of such conflicts that might undermine public trust in government.

“If I were running the ethics office over at HHS, I sure as heck wouldn't want anybody going around giving interviews and speeches about government matters that could have an effect on their own financial interests,” Painter said.

A rising star in the MAHA movement Means' rapid rise reflects the seeming contradictions within the MAHA movement itself, which urges followers to distrust both big corporations and the government agencies which regulate them.

Means rails against big pharma and food conglomerates, two industries that he says he spent years working for as a consultant in Washington.

Means has no medical training. A graduate of Harvard Business School, he previously ran a bridal gown startup with his wife. On Wednesday, he's scheduled to be the keynote speaker at FDA's annual science forum, according to a copy of the program shared with The Associated Press.

He traces his passion for health care reform to the death of his mother from pancreatic cancer in 2021. Shortly thereafter, Means and his sister, Dr. Casey Means, took psychedelics together and had “a mind-blowing, life-changing experience,” which led them to co-author a wellness book, launch separate health startups and begin appearing on podcasts.

Casey Means was recently nominated to be surgeon general and has faced scrutiny over her qualifications, including an unfinished medical residency.

Asked about her nomination, President Donald Trump said: “Bobby thought she was fantastic,” adding that he did not know her.

Meanwhile, her brother has stepped up his rhetoric for the MAHA agenda, recently declaring that Kennedy has “a spiritual mandate to reform our broken system".

While promoting the administration's accomplishments, Means does not shy away from plugging his own brand or those of his business partners.

When asked to offer health advice to listeners of a sports podcast, Outkick The Show, in April, Means said: “Read our book, Good Energy.'” He also recommended blood tests sold by Function Health, which provides subscription-based testing for USD 500 annually. The company was cofounded by Dr. Mark Hyman, a friend of Kennedy and an investor in Truemed, which also offers Hyman's supplements through its platform. Casey Means is also an investor in Hyman's company.

“If you're sick, most likely you have some kind of nutrient deficiency, some kind of biomarker that you can actually then target with your diet and your supplements,” Calley Means said.

Like dietary supplements, the marketing claims on laboratory tests sold by Hyman are not approved by the FDA. The agency has warned for years about the accuracy of such tests and tried to start regulating them under President Joe Biden.

Experts say MAHA entrepreneurs like Hyman are following a playbook common to the wellness industry: Identify a health concern, market a test to diagnose it and then sell supplements or other remedies to treat it.

“It ends up favouring these products and services that rest on flimsy grounds, at the expense of products that have actually survived a rigorous FDA approval process,” said Dr. Peter Lurie, a former FDA official who is now president of the Centre for Science in the Public Interest.

Many of the items sold via Truemed, including sweat tents, cold plunge tanks and light therapy lamps, wouldn't typically qualify as medical expenses under rules for HSAs, tax-free accounts created by Congress to manage medical costs.

The IRS generally states that HSA purchases must help diagnose, cure, treat, mitigate or prevent disease.

Truemed allows users to request a “letter of medical necessity” from a doctor, stating that the product in question could have medical value for them. Like other telehealth services, there's usually no real-time communication with the patient. The physician reviews a “simple survey solution,” filled out by the Truemed user, according to the company's website.

Industry representatives say customers should be careful.

“You need to be prepared to defend your spending habits under audit,” said Kevin McKechnie, head of the American Bankers Association's HSA council. “Companies are popping up suggesting they can help you manage that process and maybe they can — so the debate continues.” Americans have an estimated USD 147 billion in HSA accounts, a potential windfall for companies like Truemed that collects fees for transactions made using their platforms.

Means sees an even bigger opportunity — routing federal funds out of government programs and into more HSAs.

“The point of our company is to steer medical dollars into flexible spending,” Means told fitness celebrity Jillian Michaels, on her podcast last year. “I want to get that USD 4.5 trillion of Medicare, Medicaid, everything into a flexible account.” Who benefits most from HSAs? Means' pitch for expanding HSAs echoes two decades of Republican talking points on the accounts, which were created in 2003 to encourage Americans in high-deductible plans to be judicious with their health dollars.

But HSAs have not brought down spending, economists say. They are disproportionately used by the wealthiest Americans, who have more income to fund them and a bigger incentive to lower their tax rate.

Americans who earn more than USD 1 million annually are the group most likely to make regular HSA contributions, according to an analysis by the nonprofit Centre on Budget and Policy Priorities. More than half Americans with HSAs have balances less than USD 500.

Trump's “One Big Beautiful Bill” would further expand HSA purchases, making gym memberships and other fitness expenses eligible for tax-free spending. That provision alone is expected to cost the government USD 10 billion in revenue.

“These are really just tax breaks in the guise of health policy that overwhelmingly benefit people with high incomes,” said Gideon Lukens, a former White House budget official during the Obama and Trump administrations, now with the Centre on Budget and Policy Priorities.

Expanding HSA eligibility was listed as a goal for a coalition of MAHA entrepreneurs and Truemed partners, founded by Means, which lobbied Congress last year, according to the group's website.

Means said in a statement that the group focused only on broad topics like “health care incentives and patient choice — but did not lobby for specific bills”.

In total, the HSA expansions in Trump's bill are projected to cost the federal government USD 180 billion over the next 10 years. As HSAs expand to include more disparate products and services, Lukens says the US government will have fewer dollars to expand medical coverage through programs like Medicaid.

“We have a limited amount of federal resources and the question is whether we want to spend that on health and wellness products that may or may not be helpful for wealthy people,” Lukens said. (AP) PY