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The Dictatorship

With his choice for drug czar, Trump adds to his team of Fox-affiliated amateurs

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With his choice for drug czar, Trump adds to his team of Fox-affiliated amateurs

Nearly eight years ago, Donald Trump nominated Republican Rep. Tom Marino of Pennsylvania to lead the Office of National Drug Control Policy — a position best known to the public as the nation’s “drug czar.” That did not turn out well.

Following explosive reporting from The Washington Post, which found that the GOP congressman championed legislation that hindered federal agents from going after the Big Pharma firms that flooded the country with addictive opioids, Marino’s nomination collapsed and he withdrew from consideration.

Eight years later, the president has a new drug czar in mind, who’s notable for different kinds of reasons. The Washington Post reported:

President Donald Trump said on Friday that he intends to nominate Sara A. Carter, a Fox News contributor, to serve as director of the White House Office of National Drug Control Policy. “From Afghanistan to our Border, Sarah’s relentless pursuit of Justice, especially in tackling the Fentanyl and Opioid Crisis, has exposed terrorists, drug lords, and sex traffickers,” Trump wrote on his social media platform, Truth Social, misspelling her first name.

One of the reasons the Carter nomination stood out is the growing list of Fox News personalities who’ve landed powerful positions on Team Trump. In January, The New York Times published a tally and found 19 “former Fox News hosts, commentators, on-air medical experts, producers and other personnel” who’d landed jobs in the Republican administration. Soon after, Media Matters published a revised totalputting the new number at 20. (The list did not include Attorney General Pam Bondi, who briefly moonlit as a guest host of a Fox News program while she was serving as Florida’s chief law enforcement official.)

As March got underway, the president also appointed Fox News personalities Laura Ingraham and Maria Bartiromo to the Kennedy Center board, and as March neared its end, Trump added yet another Fox News contributor to his White House operation, tapping Carter to serve as the drug czar.

But complicating matters is the nominee’s resume. As a Stat News report explained, “Carter’s selection comes as a surprise: Her background is not in drug policy, public health, or law enforcement, and she has never served in government.”

Or put another way, Carter will be an amateur, joining Trump’s team of amateurs.

It is not exactly a secret that the incumbent president sees governing expertise and policymaking experience as qualities to be avoided. Indeed, during the Republican’s first term, those with expertise and experience tended to be the people who discouraged the president — the first chief executive in American history to reach the Oval Office without any experience in public office at any level — from taking steps he was eager to take.

As a result, Trump appears to have gone out of his way to lean into his preference for amateurs in a second term, choosing inexperienced and unqualified loyalists for much of the White House Cabinet.

Those who celebrate rookies in positions of influence have reason to celebrate. Those who value qualifications have reason to worry.

Steve legs

Steve Benen is a producer for “The Rachel Maddow Show,” the editor of MaddowBlog and an BLN political contributor. He’s also the bestselling author of “Ministry of Truth: Democracy, Reality, and the Republicans’ War on the Recent Past.”

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The Dictatorship

Trump’s proposed ‘Golden Dome’ estimated to cost $1.2T over 20 years

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Trump’s proposed ‘Golden Dome’ estimated to cost $1.2T over 20 years

WASHINGTON (AP) — President Donald Trump’s plan to put weapons in space — pitched as a “Golden Dome for America” missile defense program — is estimated to cost $1.2 trillion over a 20-year period, according to a new analysis from the Congressional Budget Office, a far heftier sum than the initial $175 billion price tag he gave last year.

The nonpartisan CBO report, published Tuesday, is described as an analysis that reflects “one illustrative approach rather than an estimate of a specific Administration proposal.”

The futuristic system was ordered by Trump in an executive order during his first week in office. He said then that he expected the system to be “fully operational before the end of my term,” which wraps up in January 2029.

“Over the past 40 years, rather than lessening, the threat from next-generation strategic weapons has become more intense and complex with the development by peer and near-peer adversaries of next-generation delivery systems,” Trump said in his executive order, justifying the need for the missile defense system.

The CBO’s estimates are in part based on a lack of details from the Defense Department about what and how many systems will be deployed, “making it impossible to estimate the long term cost” of the Golden Dome system, the report says.

The concept for the missile system is at least partly inspired by Israel’s multitiered defenses, often collectively referred to as the “Iron Dome,” which played a key role in defending it from rocket and missile fire from Iran and allied militant groups as it prosecutes the war on Iran alongside the U.S.

The U.S. Golden Dome is envisioned to include ground- and space-based capabilities able to detect, intercept and stop missiles at all major stages of a potential attack.

Congress has already approved roughly $24 billion for the missile defense initiative through Republicans’ massive tax and spending measure signed into law last summer.

Gen. Michael A. Guetlein, director of the Golden Dome project, testified last month about its costs. He told lawmakers that various groups estimating costs “just take the cost of a legacy system and they multiply it out and they get these really large numbers and they say, well, that must be it.

“That is not what Golden Dome is doing,” the U.S. Space Force general said. “We are laser focused on affordability.”

Sen. Jeff Merkley, D-Ore., who requested the estimate from the CBO, said in response to the report that the missile defense project is “nothing more than a massive giveaway to defense contractors paid for entirely by working Americans.”

Last May, the president said the Golden Dome would cost $175 billion. The CBO last year estimated that just the space-based components of the Golden Dome could cost as much as $542 billion over the next 20 years.

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The Dictatorship

Marty Makary is out as Trump’s Food and Drug Administration head

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Marty Makary is out as Trump’s Food and Drug Administration head

WASHINGTON (AP) — The head of the Food and Drug Administration, Dr. Marty Macaryis resigning after a rocky tenure that drew months of complaints from health industry executives, anti-abortion activistsvaping lobbyists and other allies of President Donald Trump.

News of Makary’s departure Tuesday came just 13 months after he was confirmed to lead the powerful regulatory agency.

A surgeon and health researcher, Makary came to prominence among Republicans as an outspoken critic of public health measures during the COVID-19 pandemic, when he frequently appeared on Fox News Channel. But he struggled to manage the FDA’s bureaucracy and failed to win the confidence of its staff after mass layoffsleadership upheavals and a series of controversies in which the agency’s scientific principles appeared to be overridden by political interests, including those of Health Secretary Robert F. Kennedy Jr.

“He’s a great doctor, and he was having some difficulty,” Trump told reporters outside the White House. “But he’s going to go on and he’s going to do well.”

President Donald Trump talks with reporters as he departs the White House for travel to Beijing, Tuesday, May 12, 2026, in Washington, to meet with China's President Xi Jinping. (AP Photo/Jacquelyn Martin)

President Donald Trump talks with reporters as he departs the White House for travel to Beijing, Tuesday, May 12, 2026, in Washington, to meet with China’s President Xi Jinping. (AP Photo/Jacquelyn Martin)

Trump later confirmed in a social media post that Kyle Diamantas, the agency’s chief for foodsis expected to take over as acting commissioner. Diamantas is an attorney with personal ties to Donald Trump Jr.

In that post, the president included what appeared to be a text message from Makary submitting his resignation. In it, he noted: “I announced 50 major FDA reforms. Joe Biden’s FDA had none.” He thanked Trump for the chance to serve.

The FDA commissioner, as the leader of an agency that regulates billions of dollars in consumer goods and medicines, is often required to juggle competing priorities that straddle science and politics.

Makary faced a unique challenge in balancing calls by Trump and other Republicans to cut red tape at the FDA, while also tending to Kennedy’s interest in scrutinizing the safety of vaccinesdrugs and food additives. The decision to get rid of Makary was made by Kennedy, and then the White House signed off on it, according to an administration official who was granted anonymity because they were not authorized to describe internal dynamics.

Virtually all of the FDA’s senior career officials resigned, retired or were forced out in the first year of the second-term Trump administration, leading to a steady stream of leaks and negative stories in the media cataloging low morale, dysfunction and frustration among staff.

Dr. Marty Makary, commissioner of the Food and Drug Administration, center, speaks while National Institutes of Health Director Dr. Jay Bhattacharya, left, and Health and Human Services Secretary Robert F. Kennedy Jr., right, listen in the Oval Office of the White House, Saturday, April 18, 2026, in Washington. (AP Photo/Julia Demaree Nikhinson)

Dr. Marty Makary, commissioner of the Food and Drug Administration, center, speaks while National Institutes of Health Director Dr. Jay Bhattacharya, left, and Health and Human Services Secretary Robert F. Kennedy Jr., right, listen in the Oval Office of the White House, Saturday, April 18, 2026, in Washington. (AP Photo/Julia Demaree Nikhinson)

AP AUDIO: Trump FDA chief is leaving after angering pharma CEOs, vaping lobbyists and anti-abortion groups

Speaking with reporters, President Trump says he likes Marty Makary.

Makary’s handpicked deputy, Dr. Vinay Prasadwas pushed out of the agency twice in less than a year for running afoul of specialty drugmakers and groups for patients with rare diseases. Makary appeared poised to weather the controversy, despite an ongoing pressure campaign calling on Trump to fire him.

Recent weeks brought fresh criticisms from other interest groups that the White House considers key to Republican chances in November elections.

Anti-abortion groups have accused Makary of slow-walking an internal review of the abortion pill mifepristonewhich has been on the market for 25 years but remains a target for conservative activists. They are seeking to roll back FDA rules that currently allow the pill to be sent through the mail.

“We look forward to a new FDA commissioner who will put an end to the mail-order abortion drug regime,” said Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America.

Vaping executives told Trump that Makary was blocking approval of their products, including new flavored e-cigarettes seen as crucial to the industry’s survival.

Disposable flavored electronic cigarette devices are displayed for sale at a store in Pinecrest, Fla., June 26, 2023. (AP Photo/Rebecca Blackwell, File)

Disposable flavored electronic cigarette devices are displayed for sale at a store in Pinecrest, Fla., June 26, 2023. (AP Photo/Rebecca Blackwell, File)

Last week, the agency abruptly changed course, authorizing the first fruit-flavored e-cigarettes and issuing guidelines that loosened marketing for major manufacturers. But it wasn’t enough to keep Makary in the job.

A permanent replacement for the FDA job will need to be nominated by Trump and confirmed by the Senate.

Faster drug reviews are overshadowed

As a former regular on Fox News, Makary was aggressive about promoting his accomplishments on cable television and podcasts and in online opinion pieces.

A string of initiatives from Makary aimed to speed up or streamline FDA drug reviews, including dropping certain study requirementsincorporating artificial intelligence into drug evaluations and offering expedited reviews to medicines that support “national interests.”

But pharmaceutical executives rely on the predictability and consistency of FDA decisions, even more than speedy reviews. Makary’s efforts on drug reviews were overshadowed by internal conflicts and disputes that created headaches for drugmakers, investors and patients.

More than a half-dozen drugmakers studying therapies for rare or hard-to-treat diseases said they received rejection letters or requests to run additional studies for drugs that had previously been given the go-ahead by FDA staff. Those drugs were primarily overseen by Prasad, who stepped down for a second time from his role as the FDA’s vaccine and biotech chief in April.

The U.S. Food and Drug Administration building is seen behind FDA logos at a bus stop on the agency's campus in Silver Spring, Md., Aug. 2, 2018. (AP Photo/Jacquelyn Martin, File)

The U.S. Food and Drug Administration building is seen behind FDA logos at a bus stop on the agency’s campus in Silver Spring, Md., Aug. 2, 2018. (AP Photo/Jacquelyn Martin, File)

Vaccine moves denounced

Prasad repeatedly overruled vaccine staffers to restrict eligibility for new coronavirus shots. In February, Prasad initially refused to even consider Moderna’s mRNA shot for flu. The FDA was forced to reverse itself after Moderna pledged to formally challenge the decision and called for intervention by the White House.

Some of Makary and Prasad’s most controversial vaccine proposals never came to fruition, despite stoking confusion and anxiety within the FDA and beyond.

In an internal memo in November, Prasad claimed — without publishing evidence — that the FDA had linked COVID-19 shots to the deaths of 10 children. Prasad used that to justify a planned overhaul of the agency’s approach to approving vaccines.

A dozen former FDA commissioners issued a scathing denunciation of the planwarning it would “undermine the public interest” and decimate vaccine development. The FDA has not released its analysis of the deaths or its plan for the vaccine overhaul.

Martin Makary nominated to serve as Commissioner of Food and Drugs at the Department of Health and Human Services, testifies before the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill, March 6, 2025, in Washington. (AP Photo/Jose Luis Magana, File)

Martin Makary nominated to serve as Commissioner of Food and Drugs at the Department of Health and Human Services, testifies before the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill, March 6, 2025, in Washington. (AP Photo/Jose Luis Magana, File)

FDA’s drug center had a revolving door

In the FDA’s drug center, which is the agency’s largest division, Makary oversaw a revolving door of leadership changes. Six people served as director over the course of one year.

Makary’s initial pick for the job, Dr. George Tidmarsh, was forced to resign after allegations that he used his FDA position to pursue a personal vendetta against a former business partner.

His replacement, longtime FDA cancer specialist Dr. Rick Pazdurannounced he would retire after just three weeks on the job, after clashing with Makary on multiple issues surrounding drug reviews.

With Makary’s departure, the fate of many of his fledgling initiatives is uncertain.

Most of the programs Makary introduced have not gone through federal rulemaking required to enshrine them in U.S. law. Democrats in Congress have questioned the legality of some of those efforts, including a program that offers drugmakers expedited reviews for innovative medicines.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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The Dictatorship

Wednesday’s Mini-Report, 5.13.26

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Wednesday’s Mini-Report, 5.13.26

Today’s edition of quick hits.

* Warsh was confirmed with 54 votes: “The Senate voted to install Kevin Warsh as chair of the Federal Reserve on Wednesday, handing the millionaire Trump ally the reins of America’s monetary policy even as he faced skepticism over his ability to remain independent of presidential influence.”

* When Barack Obama visited China in 2009, he was greeted by Xi Jinping himself. Nearly two decades later: “President Trump arrived Wednesday night in Beijing, where he was welcomed by a military band, an honor guard, hundreds of Chinese youth waving flags and China’s vice president, Han Zheng. Such carefully designed receptions for foreign leaders telegraph Beijing’s attitude toward these visits. … This time, they sent someone who is high-level but whose position is mostly that of a figurehead — which could be a way to send a layered message.”

* All the news on inflation is bad: “Wholesale prices in April posted their highest annual increase in more than three years, signaling more nettlesome inflation as pipeline costs intensify. The producer price index rose a seasonally adjusted 1.4% for the month, much higher than the 0.5% Dow Jones consensus forecast and the upwardly revised 0.7% March increase, the Bureau of Labor Statistics reported Wednesday. This was the largest monthly gain since March 2022.”

* The bar is low, but this represents a little progress: “Republican divisions over the Iran war deepened on Wednesday as three GOP senators voted with Democrats to curtail the conflict, signaling greater headwinds for President Donald Trump as he seeks to stem economic impacts that have damaged the party’s political standing. While the Democratic-led measure failed, it was the closest a war powers vote came to advancing in the Senate in the seven attempts since the war began as GOP concerns slowly grow over the path forward.”

* ICE’s newest chief: “The Department of Homeland Security has selected David Venturella, a former private prison executive, to lead U.S. Immigration and Customs Enforcement, the agency at the center of President Donald Trump’s controversial effort to detain and deport millions of undocumented immigrants. Venturella, who has served as a senior ICE adviser since February 2025, will be named acting director following the departure of Todd M. Lyons, DHS spokeswoman Lauren Bis said in a statement Tuesday.”

* In related news: “Ten thousand losses. That’s the Trump administration’s track record in court as federal judges grapple with the way ICE agents have swept through major U.S. cities and detained thousands of people in support of President Donald Trump’s aggressive deportation agenda.”

* It’s always interesting to me when discharge petitions work: “A bipartisan effort to force a vote on legislation sending fresh American security aid to Ukraine has amassed the 218 signatures needed to force a floor vote, the latest in a series of instances of rank-and-file lawmakers wresting control of the chamber’s agenda from Republican leaders.”

See you tomorrow.

Steve Benen is a producer for “The Rachel Maddow Show,” the editor of MaddowBlog and an MS NOW political contributor. He’s also the bestselling author of “Ministry of Truth: Democracy, Reality, and the Republicans’ War on the Recent Past.”

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