Politics
F.D.A. Nominee to Face Grilling Over Cutbacks and Policy Shifts
Dr. Marty Makary may face sharp questions from senators about whether he will defend the Food and Drug Administration against staff cutbacks and industry pressure on Thursday, although he is still expected to sail through his confirmation hearing to become the agency’s commissioner.
Dr. Makary built his reputation as a contrarian in the medical field, gaining widespread notice by speaking out about medical errors. Those close to him have remarked on his willingness to agree with Robert F. Kennedy Jr., the nation’s health secretary, on a variety of issues.
As a pancreatic cancer surgeon and health policy researcher at Johns Hopkins University, Dr. Makary has been viewed by some as a study in contrasts. He has written several books criticizing what he considers flaws in medical orthodoxy that result in recommendations backed by scant evidence.
Yet he also drew attention from the Trump team as a Fox News personality with more controversial views, like his relatively early predictions that Covid would fade as a concern and that widespread immunity would take hold long before it did.
Dr. Reshma Ramachandran, an assistant professor at the Yale School of Medicine, said that it was not clear which is the “true Marty Makary.”
She said that was an important question, given some of Mr. Kennedy’s pronouncements. The health secretary has suggested that the F.D.A. should lift constraints on risky products like raw milk, which can be rife with bacteria, and had embraced hydroxychloroquine, a drug briefly used as a Covid therapy before its risks were deemed to exceed any benefit.
“I’m hoping, and kind of desperately hoping,” she said, “that just a top-line overall priority for him is to maintain the integrity and independence of the agency.”
Mr. Kennedy has already begun to signal shifts in vaccine policy, an area Dr. Makary would also oversee at the F.D.A. Mr. Kennedy has expressed an interest in examining the safety of vaccines that have been on the market for decades and that protect millions of American children and adults against debilitating diseases.
The agency has vast regulatory authority over products including prescription and over-the-counter drugs, medical devices, tobacco and about 80 percent of the food supply.
The F.D.A. has a staff of about 18,000 and a budget of about $7.2 billion. Among its many oversight roles, the agency regulates artificial intelligence software used to scan medical images, an area where the agency has been dismissed as too permissive in its approvals.
If confirmed, Dr. Makary would first encounter tensions among staff members, who have been whipsawed by the Trump administration’s aggressive cost-cutting measures in recent weeks.
The staff endured an initial round of about 700 layoffs, decimating some product-review teams that ensure the safety of medical devices such as surgical robots and systems that deliver insulin to people with diabetes. Those firings were followed by some job reinstatements.
On Tuesday, panic swept through some quarters of the agency when the Trump administration put about two million square feet of the agency’s Maryland office space up for possible sale before backing off. Concern also spread when the lease to a key drug-safety lab in St. Louis was posted as savings on the “Wall of Receipts” advertised by Elon Musk’s so-called Department of Government Efficiency. (The agency said on Wednesday that the lab would remain open.)
Further staff cuts are expected.
“What are the F.D.A. resources going to look like in an environment where it seems like the current approach is slashing and burning, without any kind of thoughtful deliberation?” asked Dr. Aaron S. Kesselheim, a Harvard professor of medicine who has studied the F.D.A.
In documents filed with the Office of Government Ethics, Dr. Makary pledged to step away from millions of dollars in financial interests. Those steps include resigning from his role as co-owner of Global Appropriateness Measures, a company that scans health data for signs of inappropriate medical care with clients including health plans and physician groups. He also said he resigned from positions at Sesame, a telehealth company that provides weight-loss medications, and from MedRegen, a pharmaceutical company, and others.
There are many other issues that Dr. Makary would face, including a new review that Mr. Kennedy pledged to undertake on the safety of abortion pills. Tobacco companies could emerge emboldened after the Biden administration failed to advance cigarette restrictions, and after having heavily contributed to President Trump’s campaign. The president’s decision to impose tariffs could affect the supply of essential medicines from overseas.
He will also be expected to advance Mr. Kennedy’s goal of ending what he has described as corruption in public health agencies, closing the revolving door between the F.D.A. and the industries it regulates. Dr. Makary will be expected to work with the Make American Healthy Again coalition, which is banking on the administration to identify and remove unhealthy food additives.
Those priorities are already appearing to clash, though: The new acting chief of the F.D.A. food division, Kyle Diamantas, comes directly from a law firm where he was defending the maker of infant formula, a regulated product, against claims that it harmed premature babies.
Politics
Video: Democrats Press Noem on Harsh Immigration Tactics
new video loaded: Democrats Press Noem on Harsh Immigration Tactics
transcript
transcript
Democrats Press Noem on Harsh Immigration Tactics
Some Democratic lawmakers pressed Homeland Security Secretary Kristi Noem on the Trump administration’s aggressive immigration enforcement tactics during a hearing on Thursday.
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“Madam Secretary, your incompetence and your inability to truthfully carry out your duties of secretary of Homeland Security — if you’re not fired, will you resign?” “Sir, I will consider your asking me to resign as an endorsement of my work. Thank you very much.” “Secretary Noem, Trump administration — you’re going after the worst of the worst criminals, and we agree with you. The problem is, 70 percent of the people you’ve arrested have no criminal record. You’re going after noncriminal immigrants, U.S. citizens and permanent legal residents.” “Madam Secretary, you and the gentleman from N.C.T.C. referenced the unfortunate accident that occurred with National Guardsmen being killed.” “Do you think that was an unfortunate accident?” “I mean —” “It was a terrorist attack.” “Wait, wait. Look, I’ll get it straight. Then you can —” “He shot our National Guardsmen in the head.” “It was an unfortunate situation, but you blamed it solely on Joe Biden. Trump administration, D.H.S., your D.H.S. approved the asylum application.”
By Jorge Mitssunaga
December 11, 2025
Politics
The Speaker’s Lobby: What Congress’ December script means for healthcare next year
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This December on Capitol Hill appears to follow a familiar script.
There’s a deadline for Congress to act on (insert issue here). And if lawmakers don’t move by Jan. 1, then (insert consequence here). So, everyone on Capitol Hill clamors over pathways to finish (given issue). Lawmakers and staff are at the end of their wits. Everyone is worried about Congress successfully fixing the problem and getting everyone home for the holidays.
There’s always the concern that Congress will emerge as The Grinch, pilfering Whoville of Christmas toys.
But lawmakers often wind up toiling with the diligence and efficiency of Santa’s elves, plowing through late-night, overnight and weekend sessions, usually finishing (insert issue here) in the St. Nick of time.
THE HITCHHIKER’S GUIDE TO THURSDAY’S BIG SENATE VOTES ON HEALTHCARE
This pattern is always the same. With few variations.
This parliamentary dance of the sugar plum fairies frequently centers on deadlines for government funding, the debt ceiling and tax policy. Such was the case when the Senate passed the first version of Obamacare on Christmas Eve morning in 2009. Republicans skated on thin ice to finish their tax reform package in December 2017.
Lawmakers moved expeditiously to approve a defense policy bill in late 2020, then made sure they had just enough time on the calendar to override President Trump’s veto of the legislation before the very end of the 116th Congress in early January 2021.
The deadlines sometimes veer into the political. There was a crush to finish articles of impeachment on the House floor for both presidents Clinton and Trump in December 1998 and December 2019, respectively.
And, so, after everyone got this fall’s government shutdown worked out of their systems, lawmakers were far from prepared to address its root cause. Democrats refused to fund the government unless Congress addressed spiking healthcare premiums. Those premiums shoot up on Jan. 1. And no one has built enough consensus to pass a bill before the end of the year.
Yet.
This December is playing out like many others on Capitol Hill. (Celal Gunes/Anadolu via Getty Images)
But it’s only mid-December. And everyone knows that the congressional Christmas legislative spirit can be slow to take hold. Some of that holiday magic may have officially arrived Thursday afternoon after the Senate incinerated competing Republican and Democratic healthcare plans.
Senate Minority Leader Chuck Schumer, D-N.Y., pushed a three-year extension of the current Obamacare subsidies with no built-in reforms.
“This is going to require that Democrats come off a position they know is an untenable one and sit down in a serious way and work with Republicans,” Senate Majority Leader John Thune, R-S.D., said of the Democratic proposal.
Thune characterized the Democrats’ gambit as “a political messaging exercise.”
MODERATE REPUBLICANS STAGE OBAMACARE REBELLION AS HEALTH COST FRUSTRATIONS ERUPT IN HOUSE
Republicans even mulled not putting forth a healthcare plan at all. It was the group of Senate Democrats who ultimately helped break a filibuster to reopen the government last month that demanded a healthcare-related vote (not a fix, but a vote) in December. So, that’s all Thune would commit to.
“If Republicans just vote no on a Democrat proposal, we’ll let the premiums go up and Republicans don’t offer anything. What message is that going to send?” asked Sen. Josh Hawley, R-Mo. “I know what people in Missouri will think. They’ll look at that, and they’ll say, ‘Well, you guys don’t do anything. You’ve just let my premiums go up.’”
It may yet come to that.
Sen. Josh Hawley, R-Mo., questioned what message “no” votes by his party would send. (Valerie Plesch/Bloomberg via Getty Images)
So, there’s a holiday healthcare affordability crisis.
“People are looking now at exactly what’s ahead for them, and they’re very, very frightened,” said Sen. Ron Wyden, D-Ore., the top Democrat on the Senate Finance Committee.
But most Senate Republicans coalesced around a plan drafted by Senate Finance Committee Chairman Michael Crapo, R-Idaho, and Senate Health Committee Chairman Bill Cassidy, R-La. The bill would not renew Obamacare subsidies. Instead, it would allow people to deposit money into a healthcare savings account and shop around for coverage.
“Our plan will reduce premiums by 1% and save taxpayers money,” boasted Crapo. “In contrast, the Democrats’ temporary COVID bonuses do not lower costs or premiums at all.”
With skyrocketing prices, Republicans are desperate to do something, even if it’s a figgy pudding leaf, as they face competitive races next year.
COLLINS, MORENO UNVEIL OBAMACARE PLAN AS REPUBLICANS SEARCH FOR SOLUTION TO EXPIRING SUBSIDIES
“It has nothing to do with me. It has everything to do with people in Ohio and across America who need to be able to afford access to healthcare,” said Sen. Jon Husted, R-Ohio.
Gov. Mike DeWine, R-Ohio, appointed Husted to succeed Vice President Vance after he left the Senate. So, 2026 will be Husted’s first time on the ballot for the Senate.
There was some chatter that Republicans might allow for a limited extension of the Obamacare aid so long as Democrats agreed to abortion restrictions in exchange.
“Off the table. They know it damn well,” thundered Schumer.
Senate Minority Leader Chuck Schumer, D-N.Y., said abortion restrictions in exchange for a limited extension are “off the table.” (Tom Williams/CQ-Roll Call, Inc via Getty Images)
So, the competing plans needed 60 yeas to clear a procedural hurdle. But that also meant that both plans were destined to fail without solving the problem before the end of the year.
“We have to have something viable to vote on before we get out of here,” lamented Sen. Thom Tillis, R-N.C.
That’s why some Christmas congressional calendar magic often compels lawmakers to find a last-minute solution.
“Every legislator up here would like to be home for Christmas,” said Sen. Roger Marshall, R-Kan. “That pressure is what forces us to come together.”
CONGRESS FACES HOLIDAY CRUNCH AS HEALTH CARE FIX COLLIDES WITH SHRINKING CALENDAR
We’ll know soon if everyone buckles down to harness soaring premiums after days of political posturing.
“This should have been done in July or August. So, we are up against a deadline,” said Hawley.
And procrastination by lawmakers may yet do them in.
“Healthcare is unbelievably complicated,” said Rep. Dusty Johnson, R-S.D. “You’re not going to reform it and bring down costs overnight.”
House Speaker Mike Johnson, R-La., is promising a separate healthcare bill. (J. Scott Applewhite/AP Photo)
House Speaker Mike Johnson, R-La., is now promising a separate, still unwritten healthcare bill for the floor in the coming days.
“You’re going to see a package come together that will be on the floor next week that will actually reduce premiums for 100% of Americans,” said Johnson.
But it’s unclear if Congress can pass anything.
“I think there’s a fear of working with Democrats. There’s a fear (of) taking action without the blessing of the President,” said Rep. Susie Lee, D-Nev.
GOP WRESTLES WITH OBAMACARE FIX AS TRUMP LOOMS OVER SUBSIDY FIGHT
That’s why it’s possible Congress could skip town for the holidays without solving the problem.
“It will be used like a sledgehammer on us a year from now,” said Rep. Don Bacon, R-Neb.
Not a great message for Republicans — especially on affordability — before the midterms.
“If there’s no vote, that’ll run contrary to what the majority of the House wants and what the vast majority of the American people want,” said Rep. Kevin Kiley, R-Calif.
Rep. Kevin Kiley said a no vote runs contrary to the will of the American people. (Scott Strazzante/Pool/Getty Images)
That political concern may be just enough to force the sides to find some Christmas magic and address the issue before the holidays.
That’s one Yuletide script in Congress.
But there’s a script to not fixing things, too.
If Congress leaves town, every communications director on Capitol Hill will author a press release accusing the other side of channeling Ebenezer Scrooge, declaring “Bah humbug!” or dumping a lump of coal in the stockings of voters on Christmas.
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That’s the script.
And every year, it sleighs me.
Politics
Commentary: The U.S. Senate is a mess. He wants to fix it, from the inside
To say the U.S. Senate has grown dysfunctional is like suggesting water is wet or the nighttime sky is dark.
The institution that fancies itself “the world’s greatest deliberative body” is supposed to serve as a cooling saucer that tempers the more hotheaded House, applying weight and wisdom as it addresses the Great Issues of Our Time. Instead, it’s devolved into an unsightly mess of gridlock and partisan hackery.
Part of that is owing to the filibuster, one of the Senate’s most distinctive features, which over roughly the last decade has been abused and misused to a point it’s become, in the words of congressional scholar Norman J. Ornstein, a singular “weapon of mass obstruction.”
Democrat Jeff Merkley, the junior U.S. senator from Oregon, has spent years on a mostly one-man crusade aimed at reforming the filibuster and restoring a bit of sunlight and self-discipline to the chamber.
In 2022, Merkley and his allies came within two votes of modifying the filibuster for voting rights legislation. He continues scouring for support for a broader overhaul.
“This is essential for people to see what their representatives are debating and then have the opportunity to weigh in,” said Merkley, speaking from the Capitol after a vote on the Senate floor.
“Without the public being able to see the obstruction,” he said, “they [can’t] really respond to it.”
What follows is a discussion of congressional process, but before your eyes glaze over, you should understand that process is what determines the way many things are accomplished — or not — in Washington, D.C.
The filibuster, which has changed over time, involves how long senators are allowed to speak on the Senate floor. Unlike the House, which has rules limiting debate, the Senate has no restrictions, unless a vote is taken to specifically end discussion and bring a matter to resolution. More on that in a moment.
In the broadest sense, the filibuster is a way to protect the interests of a minority of senators, as well as their constituents, by allowing a small but determined number of lawmakers — or even a lone member — to prevent a vote by commanding the floor and talking nonstop.
Perhaps the most famous, and certainly the most romanticized, version of a filibuster took place in the film “Mr. Smith Goes to Washington.” The fictitious Sen. Jefferson Smith, played by James Stewart, talks to the point of exhausted collapse as a way of garnering national notice and exposing political corruption.
The filibustering James Stewart received an Oscar nomination for lead actor for his portrayal of Sen. Jefferson Smith in the 1939 classic “Mr. Smith Goes to Washington.”
(From the Academy of Motion Picture Arts and Sciences)
In the Frank Capra classic, the good guy wins. (It’s Hollywood, after all.) In real life, the filibuster has often been used for less noble purpose, most notably the decades-long thwarting of civil rights legislation.
A filibuster used to be a rare thing, its power holstered for all but the most important issues. But in recent years that’s changed, drastically. The filibuster — or, rather, the threat of a filibuster — has become almost routine.
In part, that’s because of how easy it’s become to gum up the Senate.
Members no longer need to hold the floor and talk nonstop, testing not just the power of their argument but their physical mettle and bladder control. These days it’s enough for a lawmaker to simply state their intention to filibuster. Typically, legislation is then laid aside as the Senate moves on to other business.
That pain-free approach has changed the very nature of the filibuster, Ornstein said, and transformed how the Senate operates, much to its detriment.
The burden is “supposed to be on the minority to really put itself … on the line to generate a larger debate” — a la the fictive Jefferson Smith — “and hope during the course of it that they can turn opinions around,” said Ornstein, an emeritus scholar at the American Enterprise Institute. “What’s happened is the burden has shifted to the majority [to break a filibuster], which is a bastardization of what the filibuster is supposed to be about.”
It takes 60 votes to end a filibuster, by invoking cloture, to use Senate terminology. That means the passage of legislation now effectively requires a supermajority of the 100-member Senate. (There are workarounds, which, for instance, allowed President Trump’s massive tax-and-spending bill to pass on a 51-50 vote, with Vice President JD Vance casting the tie-breaker.)
The filibuster gives outsized power to the minority.
To offer but two examples, there is strong public support for universal background checks for gun buyers and greater transparency in campaign finance. Both issues have majority backing in the Senate. No matter. Legislation to achieve each has repeatedly been filibustered to death.
That’s where Merkley would step in.
He would not eliminate the filibuster, a prerogative jealously guarded by members of both parties. (In a rare show of independence, Republican senators rejected President Trump’s call to scrap the filibuster to end the recent government shutdown.)
Rather, Merkley would eliminate what’s come to be called “the silent filibuster” and force lawmakers to actually take the floor and publicly press their case until they prevail, give up or physically give out. “My reform is based on the premise that the minority should have a voice,” he said, “but not a veto.”
Forcing senators to stand and deliver would make it more difficult to filibuster, ending its promiscuous overuse, Merkley suggested, and — ideally— engaging the public in a way privately messaging fellow senators — I dissent! — does not.
“Because it’s so visible publicly,” Merkley said, “the American citizens get to weigh in, and there’s consequences. They may frame you as a hero for your obstruction, or a bum, and that has a reflection in the next election.”
The power to repair itself rests entirely within the Senate, where lawmakers set their own rules and can change them as they see fit. (Nice work, if you can get it.)
The filibuster has been tweaked before. In 1917, senators adopted the rule allowing cloture if a two-thirds majority voted to end debate. In 1975, the Senate reduced that number to three-fifths of the Senate, or 60 members.
More recently, Democrats changed the rules to prevent filibustering most presidential nominations. Republicans extended that to include Supreme Court nominees.
Reforming the filibuster is hardly a cure-all. The Senate has debased itself by ceding much of its authority and becoming little more than an arm of the Trump White House. Fixing that requires more than a procedural revamp.
But forcing lawmakers to stand their ground, argue their case and seek to rally voters instead of lifting a pinkie and grinding the Senate to a halt? That’s something worth talking about.
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