President Donald Trump has approved a plan to remove Food and Drug Administration Commissioner Marty Makary from his post after months of friction over flavored vaping products, abortion-pill policy, and the broader pace of regulatory action at the agency, Newsmax reported, citing a Wall Street Journal report and people familiar with the matter.
The plan is not final and could still change, those people cautioned. But the reported decision marks the sharpest break yet between the White House and an FDA chief who was confirmed by the Senate just months ago, and who had aligned himself closely with Health and Human Services Secretary Robert F. Kennedy Jr. and the administration's "Make America Healthy Again" agenda.
If Trump ultimately follows through, Makary would become the latest senior health official to leave the administration during Kennedy's tenure leading HHS, extending a pattern of high-profile departures and internal conflict across the federal health apparatus.
Trump nominated Makary, a Johns Hopkins surgeon, to lead the FDA in late 2024. The Senate confirmed him in March 2025. His tenure has been brief and turbulent.
The central flashpoint, according to multiple reports, was flavored vaping products. Makary initially resisted approving fruit-flavored electronic cigarettes, specifically blueberry and mango varieties from Glas, a Los Angeles-based vape manufacturer, because of concerns that fruit flavors could appeal to underage users.
That resistance put him at odds with White House officials who pressed for authorization. Trump himself reportedly grew increasingly frustrated with Makary over what he viewed as delays, a dynamic that the Washington Examiner described as Trump scolding Makary for moving too slowly on the approvals.
The FDA eventually authorized the Glas products, saying they included age-verification safeguards intended to prevent access by minors. The authorization marked the first time the agency had approved fruit-flavored vaping products for sale in the United States.
But the concession did not appear to repair the relationship. Tensions between Makary and administration officials only intensified in recent months as critics questioned his management of the FDA and the pace of regulatory decisions across several fronts.
Vaping was not the only fault line. Makary also drew fire over his handling of mifepristone restrictions and the approval of a new generic version of the abortion pill. Anti-abortion groups and some Republicans publicly demanded his removal over those decisions.
Marjorie Dannenfelser, president of SBA Pro-Life America, was blunt: "FDA Commissioner Makary should be fired immediately," she said, as the Washington Examiner reported. For pro-life organizations that had invested political capital in the Trump administration's health agenda, Makary's actions on abortion drugs were a direct betrayal of expectations.
The criticism was not limited to outside groups. Former U.S. Sen. Rick Santorum wrote on social media earlier this month with a pointed indictment of Makary's leadership:
"I supported his nomination because he spoke truth during COVID. He immediately fired the best leaders at the FDA, replaced them with anti-Trump leftists who hollowed out FDA, harmed patients, stifled innovation & drove bio-tech to China then lied about it."
Santorum's charge, that Makary replaced experienced FDA leaders with personnel hostile to the administration's own goals, echoes a broader complaint from conservatives who watched the agency's direction with growing alarm. Whether that characterization is accurate remains disputed, but the political damage was real.
This is not the first time Trump has moved to shake up his health team. The president earlier withdrew Casey Means' surgeon general nomination and tapped a replacement, signaling a willingness to correct course quickly when nominees or appointees fall short of expectations.
The reported ouster did not come without warning. Administration officials told NOTUS that Makary was on "thin ice" after multiple clashes with Trump and White House staff. Breitbart noted that multiple major outlets reported Trump intends to fire Makary, with UPI reporting that "Trump signed off on the decision to replace Makary as he has clashed with Trump, officials in the Department of Health and Human Services and other officials in the administration."
The breadth of the opposition is striking. Makary faced pressure from inside the White House, from HHS leadership, from pro-life organizations, from conservative media figures, and from industry groups, all at once. That kind of multi-directional fire rarely ends with the embattled official keeping his job.
When reached for comment, White House spokesman Kush Desai offered a statement that neither confirmed nor denied the reported plan:
"President Trump has assembled the most experienced and talented administration in history, an administration that continues to focus on delivering more historic victories for the American people."
Makary did not respond to a request for comment.
The reported move fits a broader pattern in Trump's second term. The president has shown little patience for appointees who drift from his agenda or fail to execute at the pace he demands. That approach has generated persistent shake-up talk across the Cabinet, with officials in multiple departments facing questions about their standing.
The dynamic extends well beyond health policy. Reports have surfaced about possible pressure on other senior officials, and the administration has moved to tighten internal controls, including White House chief of staff Susie Wiles requiring personal approval for Cabinet members' international travel.
In the defense sphere, the same willingness to force change was visible when the Army chief of staff was pushed into immediate retirement, drawing both support and concern from Republican lawmakers.
The Makary situation is different in one respect: the FDA commissioner was supposed to be a reformer. He earned credibility during COVID by challenging public-health orthodoxy. That reputation helped him win confirmation. But credibility earned as an outside critic does not always translate into effective leadership inside a sprawling federal bureaucracy, especially one as entrenched and politically sensitive as the FDA.
Several important questions remain unanswered. No specific date has been reported for when Trump approved the plan. The mechanism for Makary's removal, whether a formal firing, a request for resignation, or some other process, has not been described. No replacement has been publicly named or floated.
The specific FDA decisions involving abortion pills and vaccine policy that drew scrutiny have not been detailed in full. And the "high-profile departures and internal conflicts" among senior FDA officials that preceded this moment remain only loosely defined in public reporting.
What is clear is the trajectory. A commissioner confirmed barely two months ago now faces removal after clashing with the president, the White House staff, the HHS secretary's orbit, pro-life organizations, and conservative allies in Congress, all over decisions that cut to the core of the administration's health agenda.
The FDA is one of the most powerful regulatory agencies in the federal government. It touches every American's life, from the drugs in their medicine cabinet to the food on their table. Getting the wrong person in that chair is not a minor staffing error. It is a policy failure with real consequences.
Makary's supporters will argue he was trying to protect public health by resisting flavored vaping products aimed at young users. His critics will counter that he slow-walked the president's priorities, mismanaged personnel, and made concessions on abortion drugs that no Trump appointee should have made. Both sides have facts to point to.
But the fundamental question is simpler than the policy disputes. When a president nominates someone to run an agency, that person serves at the president's pleasure, and is expected to advance the president's agenda within the bounds of law. If the relationship breaks down this quickly and this completely, the fault may lie with the selection process, with the appointee, or with both. Either way, the taxpayers who depend on the FDA deserve leadership that can actually lead.
In Washington, a confirmation vote is not a lifetime appointment. Makary is learning that the hard way.
