Trump Picks ‘good Soldier’ To Lead Fda Despite Maha, Industry Misgivings

Heidi Overton’s years of loyalty to Donald Trump helped her become his pick to lead the Food and Drug Administration, one of the government’s most powerful regulatory agencies. But that devotion could ruin her chances at Senate confirmation.

As Trump’s deputy assistant for domestic policy, Overton, a physician, has helped bring Trump’s health policies to fruition, most recently helping shepherd an executive order last week that spelled out Trump’s plan to reduce the number of recommended vaccines for children. Sen. Bill Cassidy (R-La.), proponent of vaccination, occasional Trump critic, and chair of the Health, Education, Labor and Pensions Committee, has already signaled that may cost her his vote.

“Dr. Overton’s active role in last week’s nonsensical vaccine executive order calls into question her commitment to standing up for sound science and protecting children’s health. That alone is almost disqualifying,” Cassidy said in a statement Wednesday on X.

Without the support of Cassidy, who’s frequently pushed back on vaccine policies championed by Trump and Health Secretary Robert F. Kennedy, Jr., it would be nearly impossible for her to become commissioner. Cassidy could deny her the committee vote she needs, or simply join Democrats in voting her down there. The Senate would then never get the chance to consider her.

Cassidy isn’t Overton’s only stumbling block. Many in Kennedy’s Make America Healthy Again coalition dislike her for backing Trump’s decision to protect the manufacturing of a weedkiller they believe causes cancer.

Meanwhile, some critics are raising her ties to the FDA’s former commissioner, Marty Makary, whose springtime exit came amid clashes with the drug industry and opposition to Trump's push for flavored vapes. And her limited leadership experience — the 37-year-old was still in her medical residency at Johns Hopkins when she went to work for Trump in 2019 — has people across industry and government questioning her ability to manage one of the most powerful agencies within the Health Department.

“Being seemingly inexperienced and unqualified is fine if you have self-awareness and humility and a strong team around you,” said Chris Meekins, a Raymond James health analyst and former Trump HHS official. “There is evidence she does not understand how systems work.”

The White House maintains that Overton has the skills and the resume to do the job.

“As Deputy Assistant to the President for Domestic Policy, Dr. Heidi Overton has spent the last year and a half coordinating an interagency policymaking process with senior officials across HHS, FDA, CDC, USDA, and other agencies to deliver on President Trump’s MAHA agenda. Dr. Overton has been integral to ensuring that the Administration’s policies are correct, consistent, and grounded in Gold Standard Science, and will play a similar role at the FDA as its next Commissioner,” White House spokesman Kush Desai said in a statement.

One person familiar with the commissioner search, speaking on condition of anonymity, said Overton’s “loyalty to the White House” is her biggest selling point. She’s played significant behind-the-scenes roles in shepherding some of Trump’s biggest priorities — from a most-favored nation drug pricing deal with a fertility drug manufacturer to last week’s executive order encouraging a slimmed-down and spaced-out childhood vaccine schedule.

"She'll be a good soldier,” the person said. “She'll voice the opinion of doctors — she's a mainstream doctor — but ultimately she's a staffer.”

A second person familiar with the FDA candidate search echoed that Overton will execute on Trump’s priorities and has the upside of understanding clinical research, which underpins the agency’s biggest decisions on whether to approve drugs and vaccines. But she has “no regulatory track record,” the person noted.

Still, drugmakers and medical device manufacturers are keen on maintaining relations with Overton even if they are unsure of her potential leadership. Should she be confirmed, Overton will come on board as the agency, industry and Congress wrap up negotiations around the user fees that fund about half of the FDA’s product review work.

“In the past few months, interim FDA leaders have demonstrated excellent governance and have done important work to stabilize the agency and meet the needs of patients,” a spokesperson for the Biotechnology Innovation Organization said. “Our hope is that a new commissioner will continue in this direction and further strengthen the FDA.”

Makary, a Johns Hopkins surgeon before taking the FDA commissioner job last March, also lacked management experience. His struggle to run the 16,000-plus-employee FDA led to frustrations among senior HHS officials. Some worry Overton could run into similar challenges.

Her anti-abortion record and her work for and against several Make America Healthy Again policy initiatives have also won her detractors across Washington. Two Republican supporters of abortion rights, Lisa Murkowski of Alaska and Susan Collins of Maine, would have to vote to advance her from the Senate Health Committee.

Murkowski’s office didn’t respond to a request for comment Wednesday, and a Collins spokesperson said the Maine Republican’s “longstanding policy” is to wait for the confirmation process to play out in the chamber before deciding how to vote.

Democrats are already pledging to oppose her nomination.

“Heidi Overton is a far-right, anti-abortion extremist who has no business leading the FDA,” Sen. Patty Murray (D-Wash.) wrote on X. “The American people deserve someone who will put science and facts FIRST, not another Trump sycophant who will make it their mission to attack medication abortion.”

Some current and former FDA career staff were lukewarm to Overton’s selection.

“[I don’t know] why they’re going for Marty 2.0,” said Chanapa Tantibanchachai, a former FDA spokesperson who worked with both Makary and Overton at Johns Hopkins and lost her agency job amid last year’s Department of Government Efficiency-led firings.

An agency employee granted anonymity echoed that view and expressed reservations about Overton’s lack of experience managing a large organization.

“We are hoping Cassidy does the right thing” and opposes her, the staffer said.

The pick infuriated MAHA advocates, who have seen Overton as someone who consistently disagrees with their goals on health, food and agriculture, outside of last week’s vaccine executive order.

“If I was going to point to one person that would be a massive red flag for MAHA moms, I would say it's Heidi,” said Alex Clark, a MAHA influencer who hosts a wellness podcast produced by the conservative group Turning Point USA.

Kelly Ryerson, a MAHA activist whose primary focus is eliminating pesticide use and moving toward regenerative agriculture, said she first interacted with Overton at a White House meeting to patch up major fissures between the administration and the movement after the president signed an executive order protecting the supply of glyphosate, the main component of the herbicide Roundup.

MAHA advocates like Ryerson saw the order as a win for the pesticide industry and a loss for their movement, which considers pesticides a toxin and wants to reduce farmers’ reliance on them.

“In my one conversation with her, she knew all of Bayer's talking points,” Ryerson said, referring to the chemical company that produces Roundup. “So to me that said everything I need to know. I don't think she deserves to have a place at the head of the FDA. It's a sad day for the American population.”

Vani Hari, known in the MAHA world for her healthy food activism, also criticized Overton’s industry ties.

“At this point they should just double down and make it a joint position — CEO of Pepsi and CEO of Pfizer,” Hari said in a text message.

The segment of the GOP base that is most excited about Overton’s nomination appears to be the anti-abortion movement, which continues to demand the FDA take action to roll back access to the drug used in more than two-thirds of abortions.

Conservative activists told POLITICO they are especially encouraged by Overton’s work at the America First Policy Institute, the Trump-aligned think tank where she directed the Center for a Healthy America while Joe Biden was president. There, she authored papers casting the medication mifepristone as dangerous and called on the federal government to ban its distribution by mail. As FDA commissioner, she’d have the power to try to do that.

Her anti-abortion bona fides also include an appearance last year at the annual March for Life on the National Mall, her support for defunding Planned Parenthood, and her praise for the Supreme Court’s 2022 ruling overturning Roe v. Wade, which she called “a huge victory for life.”

“Overton is primed for the job,” said Gavin Oxley, the spokesperson for Americans United for Life, adding that his and other groups are requesting meetings with her “regarding the agency's plans to bring the abortion pill review across the finish line.”

Kristi Hamrick with Students for Life of America was similarly optimistic.

“We appreciate a nominee who has looked at the dangers of chemical abortion pills and likely won’t rubber-stamp a deep-state review,” she said.

That same record, however, could complicate Overton’s path forward on Capitol Hill. Reproductive Freedom for All, Planned Parenthood and other abortion-rights groups plan to pressure the senators most likely to have qualms about her record, such as Murkowski; those who are vulnerable in the upcoming midterms, like Alaska Republican Dan Sullivan; and those in both camps, like Collins.

Democrats are already hammering Collins for her 2018 vote to confirm Brett Kavanaugh to the Supreme Court because Kavanaugh later voted to overturn Roe v. Wade, the 1973 decision that legalized abortion nationwide.

Nora Walsh-Devries, Planned Parenthood’s vice president of political and legislative affairs, told POLITICO the group is currently putting together a plan to make voting for Overton “politically toxic.”

“We are making sure that they're hearing from their constituents that any attack against Planned Parenthood is something that they won't stand for,” she said.

During Trump's first term, when faced with a vacancy atop the FDA, he turned to a traditional pick: Stephen Hahn, a renowned cancer doctor from MD Anderson Cancer Center who won Senate approval in a bipartisan 73-17 vote. That’s not likely to be the case with Overton.

"These people have a knack for making confirmations hard for themselves," said one drug industry lobbyist.