The Senate health committee has scheduled a Nov. 18 vote on Dr. Heidi Overton’s nomination to lead the Food and Drug Administration, but her confirmation is far from guaranteed as Republicans face a narrow window to install President Trump’s picks before Democrats take control next year.
The panel will also vote that day on James O’Neill’s nomination to head the National Science Foundation, according to a committee press release.
Republicans are scrambling to confirm as many of Trump’s nominees as possible following a significant midterm election defeat, but Overton’s path was already precarious before the election. It remains unclear whether the GOP’s loss will persuade hesitant senators to fall in line.
With Republicans holding just a one-vote majority on the committee, a single defection would sink the nomination if all Democrats vote against it.
Committee Chairman Bill Cassidy (R-La.) said he met with Overton on Tuesday but is still undecided on both her and O’Neill. In a post on X, Cassidy appeared to link the nominations to promises Health Secretary Robert F. Kennedy Jr. made to win Cassidy’s support for his own confirmation—promises Cassidy says have been broken.
“Over the last several months, I have had several frank conversations with both Dr. Overton and Mr. O’Neill about their visions, roles, and the lack of trust that exists due to broken promises and irresponsible decisions from other officials within the Administration. I appreciate their ongoing candid conversations,” Cassidy wrote Wednesday.
“While I remain undecided on both of their nominations and am aware that other Republican members of the Committee are undecided as well, the Committee is moving forward with noticing their markup in the hopes of resolving their path forward one way or another this Congress,” he added.
Cassidy, a physician, has previously criticized Overton’s role in the administration’s efforts to roll back childhood vaccination, calling it “almost disqualifying.” He has signaled that Overton would need to repudiate Trump’s comments on vaccines to earn his vote.
The Louisiana senator has repeatedly sought commitments from administration health nominees to uphold scientific standards and not upend vaccine policy, with little success. He cast the deciding vote to confirm Kennedy as HHS secretary.
Overton currently serves as a top domestic policy adviser at the White House and previously worked as chief policy adviser at a conservative think tank. She has been involved in various administration health initiatives, including an executive order aimed at reducing the number of recommended childhood vaccines.
She praised that order as “historic” and stood beside Trump in the Oval Office when he falsely claimed the combined MMR shot could be “quite lethal.”
If confirmed, Overton would oversee the FDA’s safety review of the abortion pill mifepristone. She is openly anti-abortion and has described the 2022 Supreme Court decision overturning Roe v. Wade as “a huge victory for life.” During her September confirmation hearing, she declined to say directly whether she believes mifepristone is safe.
This week, the anti-abortion group Susan B. Anthony Pro-Life America launched a pressure campaign urging GOP senators to oppose Overton unless the administration immediately halts mail-order mifepristone and the FDA corrects its safety review of the drug, which the group calls “wildly off track.”
Overton found herself in the spotlight last week when Calley Means, a former senior HHS adviser and close Kennedy ally, appeared on Joe Rogan’s podcast to criticize administration officials—including Overton—whom he accused of blocking the Make America Healthy Again agenda.
The upcoming committee vote will test whether Cassidy and other Republican skeptics can extract concessions from the administration or whether the GOP’s lame-duck status will force their hand. With just one vote to spare, the outcome remains uncertain.
