The Senate confirms Trump’s anti-abortion pick to lead the FDA

On Tuesday night, the Senate 56 to 44 voted to confirm Martin Makary as Trump’s Food and Drug Administration (FDA) Commissioner.

Three Democrats—Senators Dick Durbin (D-Ill.), Maggie Hassan (D-N.H.), and Jeanne Shaheen (D-N.H.) —joined Republicans in the confirmation vote to appoint Makary, formerly a surgeon and professor at the Johns Hopkins School of Medicine, to lead the agency’s 18,000 employees and spearhead the regulation of products as vast and varied as food, cosmetics, and medical devices.

As I wrote back in January, as commissioner, Makary will also wield immense power to help facilitate—or stymie—anti-abortion Republicans’ efforts to roll back access to abortion pills, which now account for more than half of all abortions and have helped the total number of abortions increase since the Supreme Court overruled Roe v. Wade in June 2022. The pills have become much easier to access since 2021 when the FDA ruled that mifepristone—the first drug in the two-drug regimen, which also includes misoprostol—could be distributed by mail or at pharmacies instead of requiring that they be obtained in person at a clinic or hospital. 

But Makary has made no secret about his anti-abortion views. As I previously wrote:

The head of the FDA, housed within HHS, could lead the agency’s efforts to reinstate the in-person requirement to access abortion pills—which would prevent them from being legally mailed to patients, creating a massive blow to access—and in the longer term revoke FDA approval of the drugs entirely, as Project 2025 recommends. Makary…has been open about his anti-abortion views. After Dobbs was handed down, Makary joined ex-Fox host Tucker Carlson on-air and described false information about fetuses’ abilities to feel pain in utero, as the Center for Reproductive Rights points out. All this makes it clear why the conservative political advocacy group CatholicVote celebrated Makary as a pro-life pick who could reverse FDA approval of the pills. Reproductive Freedom for All, an abortion rights advocacy group, on the other hand, called Makary “a known anti-abortion extremist” after Trump announced his nomination.

It’s worth noting, though, that if Makary did try to roll back the agency’s approval of abortion pills, he would face an immediate legal challenge under the Administrative Procedure Act, which prevents agencies from acting in ways that are “arbitrary or capricious,” according to Rachel Rebouché, reproductive law scholar and dean of Temple Law School. (A spokesperson for the FDA said the agency would not comment on pending litigation or hypotheticals.)

Attacks on the pills—seeking to both reinstate the in-person requirement and eventually roll back FDA approval of the medication entirely, as both Project 2025 and anti-abortion advocates have outlined—come as more than 100 scientific studies have proven they are safe and effective. One study published last year that confirmed they are also safe and effective when prescribed virtually and mailed to patients.

But this didn’t stop Makary, and some Republican senators, from peddling misinformation suggesting that the pills are dangerous during his March 6 confirmation hearing before the Senate Health, Education, Labor, and Pensions Committee. He refused to commit to upholding FDA approval of medication abortion when asked the question by Sen. Patty Murray (D-Wash.). Instead, his reply was evasive: “You have my commitment to follow the independent scientific review process at the FDA.”

FDA nominee Martin Makary just dodged a simple, straightforward question from @PattyMurray on whether he would uphold nearly TWO DECADES of evidence that mifepristone is safe and effective.

That tells you all you need to know about how he’ll lead the agency if confirmed. pic.twitter.com/kNMsznYdX7

— Reproductive Freedom for All (@reproforall) March 6, 2025

At the March 6 hearing, Hassan—one of the Democratic senators who ultimately voted to confirm Makary—followed up, noting that when they met previously, Makary told her he was not familiar with mifepristone. “Have you reviewed the data, and do you agree that mifepristone is safe and effective?” Hassan asked. “I did read those articles,” Makary replied, adding that he was not unfamiliar with the drug itself, but rather with the evidence regarding its safety and efficacy.

“The concern is whether you are going to unilaterally overrule the data that currently exists for political reasons,” Hassan pressed. Makary again declined to clarify. “Senator, you have my commitment that once I’m in office I will do a review of the data,” he replied, adding, “I have no preconceived plans to make changes to the mifepristone policy.” Hassan concluded her time by stating, “I wish you were hedging a little bit less today.” A spokesperson for Hassan did not immediately respond to a question from Mother Jones about why she voted to confirm Makary in light of her comments, and his responses, during his hearing.

Makary’s response to anti-abortion Sen. Josh Hawley’s (R-Mo.) question about whether he would reinstate in-person requirements for obtaining the drugs inspired less confidence than his claim to Hassan that he has no “preconceived plans” to restrict mifepristone. “I do think it makes sense to review the totality of data and ongoing data,” Makary said. “I know, personally, of OB doctors who prefer to insist…that mifepristone be taken, when necessary, in their office, as they observe the person taking it. And I think their concern there is if the drug is in the wrong hands, it could be used for coercion.”

The reproductive coercion argument has long been discredited, but abortion opponents brought it to the Supreme Court last year when they sought to restrict mifepristone access. As I wrote then of the argument:

And like many arguments from the anti-abortion side, the claim that medication abortion prescribed through telehealth contributes in any significant way to domestic abuse is baseless: Experts told me it’s unsupported by evidence and ignores many of the ways reproductive coercion actually manifests—as well as the many benefits telehealth abortion can provide for people experiencing intimate partner violence.

Meanwhile, legitimate research suggests that increasing numbers of abortion restrictions nationwide are what is driving reproductive coercion.

Unsurprisingly, abortion rights advocates greeted the news of Makary’s confirmation with despair. “Martin Makary’s confirmation jeopardizes two of the most important aspects of the FDA: independence and decision-making rooted in science,” Mini Timmaraju, president and CEO of Reproductive Freedom for All, said in a statement Tuesday night. “Trump just succeeded at giving yet another extremist the green light to chip away at birth control, medication abortion, and more.”

In a statement provided to Mother Jones, Anna Bernstein, principal federal policy advisor at the reproductive research and policy center, the Guttmacher Institute, said that Makary’s confirmation “could further erode abortion access nationwide.”

“Makary’s refusal to acknowledge the well-established safety of mifepristone, one of the two drugs used in a medication abortion regimen, during his confirmation hearing signals a willingness to prioritize political pressures over scientific evidence,” Bernstein added.

Freya Riedlin, senior federal policy counsel at the Center for Reproductive Rights, told Mother Jones that Makary “has indicated he is open to playing politics with medicine and pregnant people’s lives.”

“The FDA needs a leader committed to protecting access to quality health care for everyone—not someone with a documented history of opposing reproductive health care access and spreading inaccurate health information,” Riedlin added.

Responding to his confirmation, Sen. Murray wrote on X: “We need an FDA Commissioner who will put science over politics to protect the health and safety of all Americans. That means opposing far-right efforts to restrict safe & effective medication abortion—at minimum. I voted NO on Dr. Makary to lead the FDA.”