Food and Drug Commissioner Marty Makary’s planned resignation creates a new opening for anti-abortion activists to push for national restrictions on the procedure — and in particular, limit the availability of a key abortion drug. The move comes as anti-abortion groups became angry over what they viewed as his agency’s failure to curb access to the drug. 

Makary’s planned resignation, which multiple outlets reported Tuesday, followed reports of Trump’s growing dissatisfaction with the commissioner. According to The Wall Street Journal, Trump was frustrated by an FDA decision not to approve multiple flavored vape products, which Makary worried might particularly appeal to children. Trump pressed Makary to approve the products, calling flavored vape availability a key issue for younger supporters. After Trump’s intervention, those products received federal approval.

But Makary had drawn ire from other corners of the conservative movement. Abortion opponents have been pressing the FDA for months to rescind a decision approving the drug mifepristone, which is used in most abortions, to be dispensed without an in-person visit. 

The Supreme Court is now reviewing a case concerning that same FDA approval, which was issued in 2023. The high court has said it will decide by 5 p.m. ET on Thursday how to handle a case seeking to block the drug’s telehealth approval immediately. Research shows that it is safe to dispense without an in-person visit. Abortion opponents say the federal agency should still act regardless of whether or how the court might intervene.

Reports that Makary could be fired from his post emerged Friday, the day Trump was scheduled to meet with anti-abortion activists including Marjorie Dannenfelser, who heads SBA Pro-Life America. When asked to comment on Makary’s possible exit from the administration, Kelsey Pritchard, a spokesperson for the organization, responded by email, “Marjorie had a very constructive meeting at the White House today.”

Last June, Makary wrote to Sen. Josh Hawley, a Missouri Republican and strident abortion opponent, that the FDA was “committed to conducting a review of mifepristone,” per a copy of the letter Hawley shared on social media.  The FDA approved a new generic form of mifepristone — chemically the same as the already-approved brand name drug — in October, sparking outcry among abortion opponents. And in December, Bloomberg Law reported that Makary had requested any review of mifepristone be postponed until after the midterm elections. 

SBA Pro-Life America called for Makary’s firing upon that report’s publication. The organization renewed those calls this month after another Wall Street Journal article suggested that any review of mifepristone might not be underway until the end of 2026 at the earliest.

“Dr. Makary has failed to safeguard public health and safety. He has time to sign off on things like vaping and no awareness of chemical abortion pills that kill preborn babies in the hundreds and thousands,” Kristi Hamrick, the head of policy for the anti-abortion group Students for Life, wrote in a text message to The 19th.

Anti-abortion organizations are now pushing for a successor who might be more amenable to their cause. Kyle Diamantas, a deputy within the agency, is expected to step in as acting commissioner, according to several news outlets. 

“I don’t want to name names. But whoever comes in needs to be ready to do the job when it comes to evaluating chemical abortion pills, including environmental risks,” Hamrick said. 

Mifepristone is one of two drugs used in medication abortions, the most common method of ending a pregnancy. It has become a top target for abortion opponents, who are particularly frustrated because the FDA’s telehealth approval has made abortions easier to attain, including in states with abortion bans. 

Medical providers in a handful of abortion-friendly states, relying on their home states’ laws protecting them, will prescribe mifepristone and misoprostol from their states and  mail them to patients in states with abortion bans. About a quarter of all abortions are done through telehealth, and about half of those are for people in states with abortion bans, per data collected by the Society for Family Planning.

“One sacrificial firing at the FDA does not mean victory for the pro-life movement,” Kristan Hawkins, the head of Students for Life, posted on the social media platform X, adding, “A win is the enforcement of the federal Comstock Act, which would end the shipping of abortion pills, and the banning of these pills from the marketplace.”

A new commissioner — one willing to to move abortion restrictions forward — could be a major victory for the anti-abortion movement. But some opponents still expressed dissatisfaction with the direction of the Trump administration, which many had hoped would take an aggressive stance in implementing national abortion restrictions, despite their unpopularity.

“Social and religious conservatives have been really disappointed with how the FDA has slow-walked responding to their concerns, especially with regards to mifepristone, and it’s possible a new head could be more responsive,” Patrick Brown, a fellow at the Ethics and Public Policy Center, a conservative think tank that opposes abortion, wrote in an email to The 19th. “But it’s also possible that whoever he or she might be, they’d be stuck facing the same political realities — serving in an administration that has so far been very reluctant to stake much political capital on the concerns that animate pro-lifers.” 

One of Makary’s personal priorities within the FDA was expanding access to hormone therapy for cisgender men and women — particularly for women going through menopause and perimenopause. He aggressively pursued this goal, hosting hour-long conversations on the agency’s podcast and seeking experts for panels to advocate for deregulating treatments. The push was successful: Last fall, the FDA removed safety warnings from menopause treatments containing estrogen. 

“I think sometimes there may be no other medication in the modern era besides, say, antibiotics or vaccines, that can improve the health outcomes of women at a population level more than hormone replacement therapy,” he said on the FDA podcast. The agency also sought to get testosterone therapy to more cis men in order to help boost their libido. 

Makary raised his national profile when he increasingly criticized the federal government’s response to the COVID-19 pandemic and opposed vaccine mandates. The surgeon became a staple on Fox News before he was confirmed to the commissioner role in March 2025. Makary eventually aligned his tenure at the FDA with MAHA — the “Make America Healthy Again” movement — appearing alongside media personalities to talk about healthy eating. Among his department priorities became targeting food dyes and ultra-processed foods.

Under Makary’s guidance, the FDA also turned its attention to revamping how vaccines are approved, a move that drew backlash from the medical community. Makary was among the people standing alongside Health and Human Services Secretary Robert F. Kennedy Jr. when he announced last year that the federal government would stop recommending COVID-19 vaccines routinely to pregnant people and healthy children.

There were other growing strains, even as Makary faced criticism for seeking to change how some drugs are reviewed. In February, Politico reported that Makary was forced to reverse course on a flu vaccine application that had been held up. It highlighted tension between Makary and the White House over how ongoing changes to vaccine access could impact support for Republicans in the upcoming midterm election.

Orion Rummler contributed to this report.