BREAKING: Trump's FDA Commissioner Resigns

Summary

Podcast Summary: BREAKING: Trump's FDA Commissioner Resigns

The Bulwark | May 12, 2026
Host: Andrew Egger (White House Correspondent, The Bulwark)
Guest: Jonathan Cohn (Senior National Correspondent, Healthcare Policy, The Breakdown Newsletter)

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Episode Overview

This emergency episode addresses the sudden resignation (or possible firing) of FDA Commissioner Marty Makary from the Trump administration. The conversation dives into Makary’s background, the internal dynamics of the Trump and RFK Jr.-led HHS, and the political and policy controversies that culminated in his exit. The hosts break down the power struggles and policy disputes within the FDA under Makary’s tenure, with a focus on the administration’s fraught handling of issues like vaccines, abortion pills, and vaping regulations.

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Key Discussion Points & Insights

1. Context of Makary’s Departure

• Announcement & Uncertainty: The news just broke; it remains unclear if Makary was fired or resigned. Trump’s public comments are intentionally ambiguous, emphasizing Makary's character but not clarifying the circumstances.
  • Quote (Donald Trump, 00:52):

    "Well, I don't want to say, but Marty's a great guy. He's a friend of mine. He's a wonderful man. And he's going to be off and the assistant, the deputy is taking over temporarily until we... But everybody wants that job. It's a very important job. Marty's a terrific guy, but he's gonna go on and he's gonna lead a good life."

• Significance: Makary was a key player caught in ongoing internal battles within HHS, especially amid competing interests from the administration’s “Make America Healthy Again” (MAHA) and more traditional MAGA constituencies.

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2. Why Marty Makary? His Path to the FDA

• Professional Reputation: Highly credentialed surgeon (cancer and gut surgery), researcher at Johns Hopkins, and a respected name in medical circles.
  • Quote (Jonathan Cohn, 02:17):

    "Makary, he's a surgeon by training, cancer surgery, gut surgery, was at Johns Hopkins, did a lot of research. You know, well-respected guy..."

• COVID-Era Contrarianism: Rose to greater prominence as a critic of certain COVID-19 public health measures. Aligned with a cohort frustrated by mainstream pandemic policies—a group that found political favor in Trump’s second administration and with RFK Jr., who, as HHS Secretary, intentionally staffed key agencies with individuals sharing this sense of grievance.
• Shared Grievances:
  • Many HHS appointees felt ostracized by the mainstream medical community during COVID.
  • The HHS team included both credentialed scientists and more fringe figures, but unified by opposition to perceived public health overreach and establishment exclusion.

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3. Makary’s Tenure: Caught in the Crossfire

• The FDA’s Unique Challenges:
  • The FDA commissioner’s job is unavoidably political, with intense, opposing pressures from industry, public health advocates, and shifting political priorities.
  • Quote (Jonathan Cohn, 06:22):

    "This is not a job where you can have someone who can't make the trains run on time or at least knows what they're doing or somehow credentialed."

• Specific Controversies:
  • Drug Approvals: Makary campaigned against the FDA’s “medical dogma” and for faster approvals, but was criticized by some for going too fast and by others for not fast enough.
  • Vaccine Policy/Tensions with RFK Jr.:
    • Under Kennedy’s vaccine-skeptic HHS, FDA scientists were reportedly forced to withdraw pro-vaccine research.
    • Public health advocates, including many in the GOP, voiced alarm.
  • Abortion Pill (Mifepristone) Debate:
    • The FDA, pressured to restrict access to mifepristone (commonly mailed for medication abortion), delayed a promised review—a sore point with anti-abortion activists in Trump's base.
  • Vaping Regulation:
    • Makary opposed FDA staff recommendations to approve certain flavored vapes with age controls, seeking to ban them out of concern for youth usage, despite White House pressure to accommodate the vaping industry.
    • Crucial Insight: This vaping standoff may have been the final straw leading to his ouster.
    • Quote (Jonathan Cohn, 09:40):

      "So McCary was getting squeezed on both sides ... at least some of the reporting suggests that in fact it was the vaping thing that finally got Trump to act on Makary, who, as you said, has been on the hot seat for, I mean, that was a seriously hot seat."

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4. The Politics of the Moment

• Internal Administration Divisions: Tension between RFK Jr.’s anti-establishment approach and more well-credentialed (but still contrarian) figures like Makary.
  • Quote (Andrew Egger, 04:37):

    "It was almost a relief when he would pick one of them for one of these top posts. Like a guy who came by that sort of contrarian streak and built that kind of contrarian reputation honestly, as opposed to just being some guy who came up in, in like vaccine injury circles..."

• Abortion Pill Pressure: Pro-life groups impatient with delays, threatening coalition stability as Trump’s White House tries to "slow pedal" decisive federal moves on abortion since Dobbs.
  • Quote (Andrew Egger, 12:10):

    "Basically the pro-life people have been champing at the bit and kind of getting extremely impatient honestly with ... okay, you say you’re a pro-life administration. When are [you acting] … So it’s just really easy to continue to get abortion pills even if they're illegal in a given state. And they have been pushing the FDA to essentially revoke the ability for doctors to prescribe it without a clinic visit ..."

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Memorable Moments & Notable Quotes

• On the difficulty of the FDA job:

  "Even in the best of circumstances, the most capable FDA commissioner is going to be dealing with these different constituencies."
  —Jonathan Cohn (07:36)

• On Makary’s unique standing in the administration:

  "He really got tripped up on a series of these [controversies]... there were complaints from both. Some who said he was moving too fast on some, some who said he was moving too slow on some."
  —Jonathan Cohn (08:06)

• Trump’s evasive comments on Makary’s status:

  "Marty's a terrific guy, but he's gonna go on and he's gonna lead a good life."
  —Donald Trump (00:52)

• Frustration among activists:

  "Pro-life people have been ... extremely impatient honestly with ... okay, you say you’re a pro-life administration. When are [you acting]?"
  —Andrew Egger (12:10)

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Key Timestamps

• 00:00: Episode begins; Makary’s resignation/firing announced.
• 00:52: Trump responds to questions about Makary's departure.
• 02:16–04:37: Jonathan Cohn details Makary’s background and entry into FDA.
• 06:16–10:23: In-depth review of policy challenges and controversies during Makary’s tenure—drug approvals, vaccine policy, abortion pill, vaping.
• 12:10: Analysis of abortion policy pressures from the conservative base.

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Tone & Language

The hosts employ an analytical, slightly irreverent tone, informed by policy expertise but accessible and frank. There is clear skepticism and weariness around the ongoing churn of Trump administration appointees and the unsolvable cross-pressures within federal health policy.

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Conclusion

Marty Makary’s resignation underscores ongoing turbulence within the Trump administration’s health agencies, reflecting larger struggles over science, ideology, and political loyalty. The episode provides context on why Makary—despite being one of the more credentialed and earnest appointees—could not survive the conflicting demands of Trump, RFK Jr., and the wider coalition of stakeholders contending for control of federal health policy.

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For further coverage and updates, visit thebulwark.com.

Transcript

[Andrew Egger]

All right, I think we are live. Hi, everybody. It is Tuesday afternoon. We are here with a, I guess you'd call it an emergency livestream. I don't know if emergency is quite the news, but we've had another high profile firing or perhaps resignation. It's not 100% clear exactly what has happened, but there's somebody leaving the Trump administration and that somebody is the FDA commissioner, FDA Commissioner Marty Makary, who has been sort of an important secondary player in HHS Secretary Robert F. Kennedy Jr's attempt to maha fi the federal government and the United States of America. Let's play a real quick clip here of the president. He was just asked about this moments ago. Cats out of the bag. Marty Makary leaving the administration. Here's the president. Will you ask Marty McCarry to resign,

[Jonathan Cohn]

sir, or did you fire your evidence?

[Donald Trump]

Well, I don't want to say, but Marty's a great guy. He's a friend of mine. He's a wonderful man. And he's going to be off and the assistant, the deputy is taking over temporarily until we. But everybody wants that job. It's a very important job. Marty's a terrific guy, but he's gonna go on and he's gonna lead a good life.

[Andrew Egger]

He's gonna go on and he is going to lead a good life. All right. This is pretty important political news and pretty important from the point of view. A lot of different fights that are going on in HHS and within the Make America Healthy Again and the Make America Great Again, different constituencies and all this different stuff. Very happy to be here talking about it with policy guru on all health care matters are, I believe senior national correspondent is Jonathan Cohn's title. He writes the receipts or, sorry, the Breakdown newsletter. Katherine Rampel writes receipts. He writes the Breakdown newsletter for us on health care policy and other policy and got a lot to say about Marty Makary and just this weird moment that we're in with Maha in general. So, Jonathan, can you just start by kind of walking us through? I mean, this is not necessarily a household name type guy as far as these various Trump administration figures are. How did he get in here in the first place? And what, when he was in government was kind of his. How did he fit into the, the rfk, you know, dream team that he had going over there?

[Jonathan Cohn]

Yeah, yeah.

So Makary, he's a surgeon by training, cancer surgery, gut surgery, was at Johns Hopkins, did a lot of research. You know, well respected guy. Name somebody very serious academic and practitioner, had done a Lot of work on medical errors, had gotten interested in policy. He was, I would, part of the cohort that during COVID there was a lot of physicians who suddenly became sought after for their expertise. You saw them all the time. And there was kind of a group of them who really kind of became outspoken critics of the public health measures that were being taken. And everyone was different. Maybe they thought there was over aggressive on the masking or

on the social

distancing or maybe thought certainly as time went on, I mean, most of the sort of cred physicians were all in favor of the vaccine. As time went on, I think there were some who were like, should we still be recommending it for everybody? I mean, that's the ongoing debate we're having. Because he was part of that universe. And for various reasons, you know, we can talk about some other time. Like how, you know, how much of that was because of the right wing, how much that was because of the way the left wing reacted, you know, whatever. When Trump got reelected and was looking to staff his administration and he turned to Robert F. Kennedy Jr. Became famously Secretary of Health and Human Services, Kennedy kind of came in with and brought in with him a kind of constellation of people who could run the federal agencies who somehow shared that sort of sense of grievance. And I really think that's important to realize that when you look across the sort of Kennedy round, you know, the Kennedy regime at hhs, there's some variety there. There are people with different backgrounds. Some are pretty well credentialed scientists, some not so much. But if there's one common element, they all have, they have this sense of grievance. They thought the public health measures went too long, and they typically have a sort of sense that they were ostracized. And many of these people became very active online. They were posting all the time on social media. And of course that just reinforced their affinity with Trump land. And so that is how McCarry found his way to become the commissioner of FD, which is a super important job.

[Andrew Egger]

Yeah, yeah. I mean, it's, it's, it's a little strange. I'm curious what you make of this, because when, when, when all these guys were starting to be bandied about, when RFK Jr. Was kind of putting his gaggle of sort of junior HHS top officials together, I almost felt like some of these guys who were just sort of like heterodox Covid types, like, it was almost a relief when he would pick one of them for one of these top posts. Like a guy who came, came by that sort of contrarian streak and built that kind of contrarian rep reputation, honestly, as opposed to just being some guy who came up in, in like vaccine injury circles or something like that. Right. Which there are also a number of people kind of close to Robert F. Kennedy Jr. Or even just, you know, more sort of kooky holistic health types like the means Brother Cat, Callie and Casey Means Callie and Casey, yes, the means, yes, yes. But, but, but. So I, I kind of felt early on like, you know, maybe this is one of these guys we won't have to keep as much of an eye on. And, and I don't know to what extent that has been true. I think, I think he has come under a lot of fire from a lot of different directions. Maybe some for good reasons, some for some, some for bad. But there is no question that, like, this is a firing that has been building for a while just in terms of him constantly finding himself sort of caught between different factions that want the FDA to go in different directions. Can you just walk us through kind of, I don't know, I don't know if you want to go laundry list or, you know, fast money style or whatever, but like, what, what, what were some of the things that, that this guy was having to kind of struggle through and wade through at hhs?

[Jonathan Cohn]

Yeah, yeah.

[Andrew Egger]

Well, first of all, you're right about

[Jonathan Cohn]

sort of, you know, him being one of the more serious, credential, seriously credentialed people. And that's not a coincidence that that

would happen at fda.

You know, fda, it's a regulatory agency, right. They have so much power and so much influence over a very powerful industry, the American drug industry, food industry.

[Andrew Egger]

Right.

[Jonathan Cohn]

I mean, there's this massive amount of money tied there. And so there's.

When, you know, when, if you think

about, you put yourselves in the minds of an administration taking over when you're staffing the fda, when you're picking an FDA commissioner, and this is true for

any administration, you're going to hear from

all these stakeholders and there's going to

be a lot of demands to have someone who's serious who can do that.

This is not a job where you can have someone who can't make the

trains run on time or at least

knows what they're doing or somehow credentialed.

So there, you know, McCary was seen as somebody who was more serious, a bit more of a heavyweight. And the hard part about being FDA commissioner, and again, this is true for every administration, is that all these stakeholders are Constantly pulling at you for wanting different things. The drug, they want faster. The drug industry wants faster approvals, but they want them to be solid approvals. It's in the drug industry's own interest to sort of keep out flawed drugs. Drugs are going to be dangerous because it hurts their own reputation. You have public interest activists pushing on either side. And then of course, you have all

kinds of political issues that intersect the

FDA on everything from, you know, recreational drugs to abortion and all of that. It kind of comes on the FDA commissioner. So even in the best of circumstances, the most capable FDA commissioner is going to be dealing with these different constituencies. In the case of McCary, he really got tripped up on a series of these. So you had a couple. First of all, there was the usual, how fast are the drugs being approved? You know, he kind of. One of his calling cards coming in, one of his slogans was the FDA was too beholden to medical dogma, needed to move more quickly on certain kinds of drugs. And then once in office, there were complaints from both. Some who said he was moving too fast on some, some who said he was moving too slow on some. There has been this ongoing controversy, and we're dealing with it right now in the Supreme Court about the abortion pill. And the FDA has been promising a review of it. That review has now been put off until after the midterms. He was getting a lot of pressure from anti abortion groups that this wasn't moving more quickly, controversy going on. He did intersect and deal frequently with the vaccine agenda from Robert F. Kennedy Jr. There were just reports recently in the New York Times the FDA had forced FDA's own scientists to withdraw publications that have been accepted by peer reviewed journals that has showed vaccines to be safe. And that got him a lot of flack from the large number of people out there who approve of vaccines, which, by the way, is a lot of Republicans. Kennedy's own agenda has now become controversial within the administration. So you had that, and then on top of all that, you had this controversy over vaping, which was kind of, you know, where basically, you know, there's been this push to should they be. Should vaping companies be able to push flavored vaping? There's a concern that that will sort of be alluring to children, get them, you know, minors, get them addicted. And what was so interesting about that, and really typical of how complex this whole situation is that this was a case where the career staff at FDA had basically signed off, said, yeah, we think this is saf. These vaping devices were gonna come with age devices, does this sort of protect against kids using them? And McCary was overruling them and saying, I don't think so. Meanwhile, the White House was pressuring because Trump had, you know, was taking the side of the vaping industry. So McCary was getting squeezed on both sides. And, you know, it's hard to know. I mean, there was so much going on here, there's so many cross pressures. But at least some of the reporting suggests that in fact it was the vaping thing that finally got Trump to act on Makary, who, as you said, has been on the hot seat for, I mean, that was a seriously hot seat. I mean, people have been talking about him being on the way up for weeks. And really in the last two weeks there have been a number of stories that he was basically Trump had signed off on his departure. It just hadn't happened yet, I should say.

[Andrew Egger]

Again, I said it right at the top. Nobody was hardly on the stream yet at that point. I'm Andrew Egger and White House correspondent for the Bulwark. This is Jonathan Cohn writes our Breakdown newsletter on healthcare policy and policy in general. We are talking about the firing or perhaps resignation, a little bit unclear, a little bit woolly in that department today of the Food and Drug Administration Commissioner Marc Cardi Makary, which was just came news of that came out just a little bit ago. So we're here reacting to that. Jonathan, you were just talking about the vaping controversy and him being kind of squeezed, particularly getting himself crosswise with the president on wanting to keep this ban in place on flavored vapes. But I also wanted to go back to another thing that you alluded to, because this was my first reaction when I saw this news. And I'm curious what you make of this, that this had also a lot to do specifically with this abortion fight because we have been seeing a lot of headlines in just the last week or two of the pro life movement, social conservatives who are anti abortion, who have been sort of a really important core component of the president's base, certainly going back to the first term a little less so now there has not been a lot of sort of abortion policy basically since Dobbs, basically since the decision that ended Roe v. Wade restored states rights to ban and regulate abortion within their own states. Since Trump became president in the wake of that decision, he has kind of slow pedaled basically anything that would be like have to have to do with federal abortion policy. But one big exception to that has been this question of this abortion drug. And now that I'm come to say it out loud. I know that I don't know how to type it, but I'm not 100% sure I know how to pronounce it. Mifeprostone or I'm so sorry.

[Jonathan Cohn]

Mifeprostone. Mifemiferprostone.

[Andrew Egger]

Mifeprostone. Okay. It's been controversial. There's this. Basically the pro life people have been champing at the bit and kind of getting extremely impatient honestly with okay, you say you're a pro life administration. When are the use of this drug has exploded, especially since Dobbs. You know, it can be mailed all over the country. It can be mailed into, you know, any of these states that now ban abortion. So it's just really easy to continue to get abortion pills even if you're, even if they're illegal in a given state. And they have been pushing the FDA to essentially revoke the ability for doctors to prescribe it without a clinic visit, without a face to face visit, which is what enables the mailing. Right. It would be much harder to get if you had to go see a specific doctor presumably in your state or at least drive across a state line or something to get those pills. And the White House has not known how to deal with this. Right. They've been trying to kick the can down the road. They've been asking the courts not to rule on it. There's been this reporting that McCary with the White House is blessing.