Sen. Susan Collins (R-Maine) is once again at the center of a political storm over a Trump nominee, with her abortion-rights credentials on the line as Dr. Heidi Overton, the president's pick to lead the Food and Drug Administration (FDA), prepares for her Senate confirmation hearing Thursday.
Overton, a physician and top White House domestic policy adviser on health, is set to appear before the Senate Health, Education, Labor and Pensions (HELP) Committee. If confirmed, she would take over an agency that has seen a wave of senior staff departures and is widely perceived by healthcare leaders as less credible and more politicized than under any previous administration.
The hearing is shaping up as a direct clash between Overton's staunch anti-abortion views and Collins' long-held support for abortion rights. Overton has been a vocal critic of FDA regulations on mifepristone, one of two drugs used in medication abortions, and has called for stricter prescribing rules. She celebrated the Supreme Court's 2022 decision overturning Roe v. Wade, saying it would allow Americans to "reevaluate the value of the potential of every baby in the womb and choose life through a democratic process." She has also urged policymakers to block efforts to expand access to abortion pills via telehealth.
Collins, who is facing a tough reelection fight in Maine, has remained cautious in her public statements about Overton. In a brief interview Wednesday, Collins told The Hill that she raised the abortion issue during a private meeting with Overton. But she also noted other concerns, including vaccine policy and the FDA's slow approval process for treatments for rare diseases. "That's one issue, but another is vaccines and third is the slow pace that FDA approves treatments and medications in cases where there are rare diseases for which there are no medications currently on the market," Collins said. "So these are all issues that I've raised with her in our private meeting in my office, and I'm sure will come up" during Thursday's hearing.
Anti-abortion advocates have cheered Overton's nomination, hoping she will impose new restrictions on mifepristone. Lila Rose, president of Live Action, said in a social media post that Overton should "pull the deadly abortion pill from the market" and "end mail-order abortions." The hearing comes as the FDA conducts a safety review of the drug, a move that abortion-rights groups condemn as politically driven.
Republicans and anti-abortion leaders are pressuring the FDA to reverse a Biden-era rule allowing mifepristone to be prescribed and dispensed via telehealth, and some want the drug pulled from the market entirely, despite decades of safe use. Dr. Rob Davidson, executive director of the Committee to Protect Health Care, said that if Overton becomes FDA chief, the mifepristone decision "likely lands on her desk," and she may not act as a neutral arbiter of science.
Overton's path to confirmation is narrow: she needs every GOP senator's support in the committee if all Democrats vote against her. So far, HELP Committee Republicans have advanced all Trump health nominees who came to a vote, though Casey Means' nomination for surgeon general was withdrawn before a final vote.
For Collins, the stakes are personal. She is running for reelection in a state where abortion is a top issue, and Democrats are working to undermine her reputation as one of the last abortion-rights Republicans. She has faced criticism for her vote to confirm Supreme Court Justice Brett Kavanaugh, who was the deciding vote to overturn Roe, and for supporting numerous Trump-appointed judges who have upheld restrictive state abortion laws. This is her first election since Roe was overturned.
Her Democratic opponent, Troy Jackson, has been endorsed by abortion-rights groups, which are pouring money into the race. Mini Timmaraju, president of Reproductive Freedom for All, accused Collins of "betraying" Americans on abortion access, while Adrienne Kimmell, a strategist with Free & Just, said Overton's position is "black and white" and that a yes vote from Collins would "pretty much end any argument that she is interested in protecting access to reproductive freedom."
Free & Just is running a six-figure digital ad campaign in Maine urging voters to press Collins to oppose Overton, and is also deploying a billboard truck around the Capitol during the hearing. The group's message echoes a familiar warning: "Every woman in Maine remembers what happened the last time Senator Collins took a nominee at their word about Roe."
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