Trump’s FDA pick faces Republican doubts as confirmation deadline nears

WASHINGTON — The Food and Drug Administration is set to finish its safety review of the abortion pill mifepristone in March, setting up one of the most politically charged decisions the agency has faced in years. And yet it may not have a permanent leader to oversee it.

Dr. Heidi Overton, President Donald Trump’s pick to run the agency, faces a vote next week before the Health, Education, Labor and Pensions Committee, but key Republicans whose support she needs remain uncommitted, with only weeks before Democrats take control of the Senate.

“I have not taken a position,” said Sen. Susan Collins of Maine in a brief interview on Capitol Hill on Thursday, adding that she needed “to get some answers on various things.” Sen. Lisa Murkowski of Alaska declined to say how she’d vote. During her confirmation hearing in September, Murkowski asked Overton about political pressure surrounding access to mifepristone.

Sen. Bill Cassidy of Louisiana, the health committee’s chairman, also declined to comment. Asked about his decision, he said, “I’m a last-second sort of guy,” laughing as he moonwalked away from reporters.

But Cassidy has been openly skeptical. Before Overton’s confirmation hearing, he wrote on X that he had “strong concerns” about her nomination, saying her lack of managerial experience left her poorly prepared to lead the agency.

In a post Wednesday, Cassidy said he remained undecided, adding he’s had “several frank conversations” with Overton and Jim O’Neill, Trump’s nominee to serve as the director of the National Science Foundation, about “their visions, roles, and the lack of trust that exists due to broken promises and irresponsible decisions from other officials within the Administration.”

The senators could still be won over before the committee vote next Wednesday, and the White House has given no indication that it plans to withdraw her nomination. The White House did not respond to a request for comment.

To advance to the full Senate, Overton needs 11 votes in the 21-member committee, which means she can’t afford to lose a single Republican if all Democrats oppose her. After that, she would need to pass a Senate vote.

Time is also running short. Democrats, who won control of the Senate in the midterm elections, take power on Jan. 3. According to a former congressional aide, if Overton isn’t confirmed by then, her nomination would most likely be returned to the White House and Trump would have to nominate her again before a Democratic-controlled Senate, where her chances would be slim.

Whoever leads the FDA will inherit a series of consequential decisions — from vaccine approvals to a safety review of mifepristone — at an agency that has been without a permanent commissioner since Dr. Marty Makary resigned in May.

Overton, a preventive medicine doctor, is a domestic policy official in the White House. She appeared alongside Trump when he signed an executive order aimed at reducing the number of vaccines routinely recommended for children. At her confirmation hearing in September, Overton appeared to break with Health Secretary Robert F. Kennedy Jr. on vaccines, calling the measles, mumps and rubella vaccine safe and effective.

But her record on abortion has drawn intense scrutiny from Democrats. While working at the American First Policy Institute, a conservative think tank, she called the FDA’s decision to allow mail delivery of mifepristone “dangerous to women.” The agency is now conducting a safety review of the drug, which Overton would oversee as commissioner.

During the hearing, she sidestepped questions on mifepristone, saying only that it had met the FDA’s standards and that she didn’t want to prejudge the agency’s review.