President-elect Donald Trump nominated Oz to oversee the federal program on Tuesday, sparking a move from Fetterman to break from the Democratic Party and express his possible support for the physician. 

Responding to negative reactions from Democrats on Friday, Fetterman slammed the “freakouts” and explained that if he voted to confirm Oz in the Senate, his move likely wouldn’t affect the results as Republicans hold the majority in the upper chamber. 

Saying he just wanted an “open dialogue” and mocking the “hot takes online,” the senator said in a post to X: “Math is math: GOP has 53 votes and Oz has a new job. … He doesn’t have to give a s*** about Dem votes, and same for the remaining nominees.

Fetterman and Oz were onetime rivals during Pennsylvania’s 2022 Senate race. After the two engaged in an intensely personal campaign, during which Fetterman faced a flood of scrutiny about his health after a stroke, the Democrat ultimately beat his Republican opponent by just under 6 percentage points.

The Pennsylvania senator appeared to bear little animus toward Oz after Trump tapped him to head the CMS.

“If Dr. Oz is about protecting and preserving Medicare and Medicaid, I’m voting for the dude,” Fetterman said on X. 

While conceding Oz may not have been the Democrats’ “first choice,” Fetterman has called his plans to cut waste and fraud in the federal program “a good thing.” 

If Oz was going to make the programs more efficient, “then I’m not going to vote against that,” he told the Independent earlier this week. 

“Our politics are obviously different, and we do have a history, but I don’t have any bitterness. I don’t hold anything against him,” the senator added Tuesday. 

Fetterman has received backlash from former staffers over his bipartisan approach to Oz’s nomination. 

The director of operations for Fetterman’s Senate campaign called the move “a huge personal betrayal,” saying that he said in 2022 that Oz would “gut” Medicare and Medicaid.

“I feel like I’ve been duped and 2 years of working on your campaign was a waste,” Victoria Perrone said in a post. 

Before nominating Oz to head CMS, Trump reiterated promises to protect Social Security and Medicare on the campaign trail, indicating cuts are not on the horizon.

Fetterman did, however, attack Oz for his support for Medicare Advantage, the privately run version of Medicare, during his campaign and suggested that the physician supported a Republican plan that he worried would “destroy Social Security + Medicare.” 

The senator’s evolution on Oz comes after he has surprised his party’s left wing several times since he was elected two years ago. 

Fetterman often branded himself as a progressive during his Senate campaign two years ago. But in December 2023, he rejected the label outright, saying that he is “not a progressive.”

He has frequently spurned tribalistic behavior since he was elected to office, taking an approach to illegal immigration and the war in Gaza that is often more in line with Republicans than members of his own party. 

Fetterman has also often criticized factions of his party for alienating right-leaning and centrist voters, telling colleagues to take their message to platforms and people outside of the Democratic bubble. 

His move to express tentative support for Oz comes after he backed Trump’s decision to nominate Sen. Marco Rubio (R-FL) as the next secretary of state earlier this month, calling him a “strong choice.”