White House ignores demands from pro-life lobby to fire FDA commissioner

The pro-life lobby is calling on President Trump to fire FDA Commissioner Marty Makary after news broke alleging that the agency is slow walking a long-promised review of the abortion drug mifepristone until after the midterms.

For months Makary and his boss, Health and Human Services Secretary Robert F. Kennedy Jr., have promised lawmakers and state attorney generals that a review is under way. But a new report that Makary is deliberately delaying that effort has angered the anti-abortion base, a key Trump constituency.

The White House denies that allegation. “The study is not being ‘slow walked,’” a senior official told RealClearPolitics. “Comprehensive and exhaustive reviews take time.”

All the same, Missouri Sen. Josh Hawley cited the Bloomberg News report and wrote on social media Tuesday morning that “the FDA lied to me and other members of Congress,” before calling on Makary “to stop dithering [and] reinstate the mifepristone safety guardrails. Nothing less is acceptable.”

“It shows they are fundamentally unserious,” one anti-abortion activist told RCP. And now it could create a profound headache for Trump, who often brags that he is “the most pro-life president.”

Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, called on Trump to fire Makary after news broke that the FDA had put the effort on the back burner despite multiple promises to Congress.

“Enough is enough: FDA Commissioner Makary should be fired immediately. The FDA is doing nothing while every single day abortion drugs take the lives of children, put women and girls at serious risk, empower abusers and trample state pro-life laws,” Dannenfelser said in a statement calling on Trump to reinstate policy from his first term that required the drug to be dispensed in person.

“Commissioner Makary is severely undermining President Trump and Vice President Vance’s pro-life credentials and their position that states should have the right to enact and enforce pro-life protections,” she concluded. “Makary must go.”

That message was not well received in the White House. For now, Makary remains in Trump’s good graces.

“FDA Commissioner Marty Makary is working diligently to ensure that Americans have the best possible, Gold Standard Science study of mifepristone. The White House maintains the utmost confidence in Commissioner Makary,” Trump spokesman Kush Desai told RCP in a statement, pointing to “one landmark victory for the American people after another” from his crackdown on artificial food ingredients to the first safety review of baby formula in decades.

“Uninformed attacks against Commissioner Makary from individuals outside the administration will not change these facts,” said Desai.

But food dye and baby formula are not the primary concerns of the pro-life lobby. Their focus is instead on mifepristone. Prescriptions of the drug surged after the Supreme Court overturned the national right to an abortion in 2022 and the total number of abortions has increased nationally year after year. Nearly two-thirds of abortions are now carried out using the medication, which is readily available through the mail after the Biden administration reversed rules requiring an in-person doctor visit in order for a patient to receive a prescription.

The FDA continues to publicly state that mifepristone, a drug which is used to stop the development of a pregnancy, is safe, “when used as directed.” Anti-abortion advocates argue that the drug has been overprescribed, and without proper medical supervision can lead to adverse complications like hemorrhaging, sepsis, and even death.

The Trump administration has promised to conduct a review of the abortion pill. During his Senate confirmation hearing, Kennedy told lawmakers that he was open to limiting access to mifepristone citing “safety issues.” Later in September, the HHS secretary said that the review was in progress and accused the Biden administration of politicizing science. “They actually twisted the data to bury one of the safety signals,” Kennedy told Oklahoma Sen. James Lankford. The next month, the FDA made the drug more available by approving a generic version of mifepristone, infuriating Republicans.

A spokesman for HHS, Andrew Nixon, said in a statement at the time that “the FDA has very limited discretion in deciding whether to approve a generic drug. By law, the Secretary of Health and Human Services must approve an application if it demonstrates that the generic drug is identical to the brand-name drug.”

The explanation left Louisiana Sen. Bill Cassidy, the chairman of the Senate Health, Education, Labor and Pensions Committee, flabbergasted. When he was told the FDA was just following the law by approving the generic, Cassidy told reporters in October that he replied, “Hang on, the Biden admin didn’t do it, and you did? We’ve got to obey the law exactly to the nth degree, and Biden didn’t?”

A spokesman for Lankford told RCP that the senator remains focused on the health and safety of mothers and ensuring FDA decisions follow both the law and sound medical standards,” before adding that “delaying that review only underscores why oversight is needed.”

Abortion has receded from the White House policy portfolio. While the administration took a handful of steps to roll back Biden-era policies and limit funding, Trump has not moved to curtail abortion access. Calls to ban the delivery of the abortion drug through the mail, for instance, have fallen on deaf ears in the West Wing. Anti-abortion activists, who remain some of the president’s most loyal supporters, increasingly feel alienated and ignored.

“Our natural inclination is to try to be allies and supportive of the good work they are doing, but they promised this study, but it’s just been crickets since then,” said one anti-abortion activist in regular contact with the White House. “They are putting us in an impossible position.”

The timing is not lost on many in the pro-life lobby who believe that by delaying the release of a study until after the midterms, Trump is trying to punt the issue to avoid political fallout. But a survey by the president’s own pollster, John McLaughlin, shows that 70% of likely voters approve of policies that require a woman to visit a doctor before receiving a prescription for abortion drugs.

“It’s politics over women,” said Brad Kehr, government affairs director for Americans United for Life. “Votes over safety.”

The White House was already asking anti-abortion activists for patience as they scramble to come up with a plan to extend Obamacare subsidies. Activists have demanded that abortion coverage not be included; the administration asked their pro-life supporters to keep quiet as they come up with a compromise. That constituency may be losing patience. For now, their ire is directed toward the FDA.

“If Dr Makary will not act as head of the FDA to protect children and mothers he should be fired,” Lila Rose, president of Live Action wrote on social media. “Under his watch abortion pills kill preborn children and endanger women and the study he promised is nowhere to be found. End mail order abortion. Ban the abortion pill now!”