President Donald Trump has signed off on a plan to oust Food and Drug Administration Commissioner Marty Makary, capping months of friction over flavored vaping products, abortion drugs, and the broader pace of federal health regulation, Newsmax reported, citing a Wall Street Journal account based on people familiar with the matter. Those same people cautioned the plan is not final and could still change.
If Trump follows through, Makary would become the latest senior health official to leave an administration that has demanded speed and loyalty from its agency heads, and shown little patience when it doesn't get both.
The falling-out centers on a handful of high-profile regulatory decisions where Makary either moved too slowly for the White House or landed on the wrong side of core conservative constituencies. The result is a commissioner who arrived with strong COVID-era credibility and now faces the door barely a year after Senate confirmation.
The sharpest clash involved Glas, a Los Angeles-based vape manufacturer that had applied for FDA authorization of blueberry- and mango-flavored electronic cigarette products. Makary initially resisted approving the applications because he worried fruit flavors could appeal to underage users, people familiar with the discussions told the Wall Street Journal.
Trump grew increasingly frustrated with the delay. Administration officials pressured the FDA to authorize the products, and the agency eventually did, marking the first time it had approved fruit-flavored vaping products for sale in the United States. The FDA said the products included age-verification safeguards intended to prevent access by minors.
The Washington Examiner noted that the agency announced approval of four new vaping flavors within hours of reports about the president's displeasure, a timeline that speaks for itself about who was really driving the regulatory calendar.
The episode exposed a pattern that had been building for months. A president who prizes decisive action installed an FDA chief who kept pumping the brakes.
Vaping was not the only front. Makary also faced scrutiny over FDA decisions involving abortion pills and vaccine policy, though the specific regulatory actions at issue have not been detailed publicly. Biotechnology firms, rare-disease advocates, and anti-abortion activists all directed criticism at the commissioner, an unusual coalition united mainly by frustration with the agency's direction under his watch.
The breadth of that opposition matters. When a Trump appointee manages to draw fire simultaneously from the pro-life movement, the biotech sector, and patient advocates, the political math inside the West Wing gets simple fast. This administration has shown repeatedly that it will move quickly on personnel changes when a nominee or appointee becomes a liability.
Former U.S. Sen. Rick Santorum captured the conservative frustration in a social media post earlier this month:
"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 accusation, that Makary replaced experienced FDA leaders with personnel hostile to the administration's own agenda, is a claim, not a verified finding. But the fact that a prominent former senator and early Makary supporter is now making it publicly tells you how far the commissioner's standing has fallen on the right.
Trump nominated Makary, a Johns Hopkins surgeon, to lead the FDA in late 2024. The Senate confirmed him in March 2025. At the time, Makary's willingness to challenge COVID-era orthodoxy made him a popular pick among conservatives who wanted an FDA chief unafraid of the agency's entrenched bureaucracy.
He also aligned himself closely with Health and Human Services Secretary Robert F. Kennedy Jr. and the administration's "Make America Healthy Again" agenda. That alignment apparently wasn't enough to insulate him once the policy disagreements stacked up.
In recent months, tensions between Makary and White House officials intensified as critics questioned his management of the FDA and the pace of regulatory decisions. The administration has not been shy about scrutinizing its own health nominees when their records or public statements create complications.
White House spokesman Kush Desai, reached for comment, offered a statement that notably did not defend Makary by name:
"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."
That's the kind of boilerplate a communications shop issues when it has nothing good to say about the person reporters are asking about. Makary himself did not respond to a request for comment.
The potential removal fits a larger picture. Trump has shown no reluctance to challenge officials, inside or outside his own administration, whom he views as obstacles. He recently raised the question of impeachment proceedings against a congressional leader who attacked the Supreme Court's legitimacy, and he has reversed inherited programs he considered misguided.
The FDA situation, though, carries its own stakes. The agency regulates roughly a quarter of every dollar Americans spend. A leadership vacuum, even a brief one, can stall drug approvals, delay device clearances, and rattle the biotech investors whose capital funds the next generation of treatments.
Several open questions remain. Who would replace Makary, and through what process? Which specific abortion-pill and vaccine decisions drew the heaviest fire? And which White House officials drove the internal clashes? None of those details have surfaced publicly.
What has surfaced is a clear verdict from the people closest to the president: Makary talked a good game during COVID, but once he held the regulatory pen, he moved too slowly, hired poorly, and picked fights the administration didn't want.
There's a straightforward takeaway here for every Senate-confirmed official in this administration. A good confirmation hearing does not buy you permanent goodwill. The president expects his agency heads to execute the agenda voters endorsed, not to slow-walk it while building personal fiefdoms inside the bureaucracy.
Makary may yet survive if the plan changes. But the public signal has already been sent, and in Washington, that signal is usually the last one before the exit.
Presidents who hold their own people accountable don't need to apologize for it. The voters who sent Trump back to the White House expected exactly this kind of management, and they're watching to see who's next.
