There are plenty of reasons Republicans could justify denying him the position. And if they don't want him in HHS, why would they vote for a recess so Trump can make a recess appointment?

He'd have to both be nominated (already kinda iffy) AND THEN either get confirmed by the Senate (practically impossible), or have Trump put him in as acting (fairly unlikely)

@Marnix No longer fully confident there are enough people willing to stop him. My mother's all in on him. I think he's going through.