The Senate Committee on Health, Education, Labor, and Pensions will vote on the nomination of Dr. Heidi Overton to lead the Food and Drug Administration (FDA) during a markup session scheduled for November 18, committee leadership announced on November 11.
The panel will also consider the nomination of James O’Neill, whom President Donald Trump selected to direct the National Science Foundation, as part of the same session. However, Sen. Bill Cassidy (R-La.), the committee’s Republican chairman, indicated he has not yet decided whether to support Overton or O’Neill’s nominations.
In a post on X (formerly Twitter), Cassidy cited concerns over “broken promises and irresponsible decisions from other officials within the Administration” as factors in his indecision. He emphasized that while he remains undecided, the committee is proceeding with the markup to resolve the nominees’ paths forward before the Republican Senate majority ends in January 2027, when Democrats will assume control.
Cassidy, who lost his primary race to now Senator-elect Julia Letlow (R-La.), added that he has had “frank conversations” with both nominees about their visions and roles. He did not specify which broken promises or officials he was referencing. The Department of Health and Human Services deferred comment to the White House, which did not respond to a request for comment by publication time.
The FDA has operated without Senate-confirmed leadership since Dr. Marty Makary resigned in May 2024. Overton, a former White House adviser, was nominated to the FDA commissioner post in August 2024.
Senate Confirmation Process
Nominees advanced from committee markup require a majority vote to proceed to the full Senate, where a simple majority is needed for confirmation. With Republicans holding a slim Senate majority until January 2027, the timing of the markup may influence the nominees’ chances of confirmation before the power shift.
Context on Nominees
Dr. Heidi Overton, a surgeon and former White House adviser, has not previously held a federal regulatory role. Her nomination has drawn attention amid ongoing debates over FDA policies, including those related to abortion medications and drug approval processes. James O’Neill, a biotech executive and former FDA official, has been nominated to lead the National Science Foundation, a role focused on scientific research funding and policy.
Republican Divisions
Cassidy’s remarks reflect broader tensions within the Republican Party over Trump’s nominees, particularly on issues where party members have expressed skepticism about alignment with traditional conservative priorities. The committee’s decision to proceed with the markup suggests an effort to move forward despite internal disagreements, though the ultimate confirmation remains uncertain.