It’s been a whirlwind month for the U.S. Department of Health and Human Services (HHS), as the Trump administration scrambles to fill top health leadership posts, steady a battered Food and Drug Administration (FDA), and recalibrate its political messaging ahead of the pivotal November 2026 midterm elections. The shake-up, which has unfolded at breakneck speed, comes on the heels of FDA Commissioner Marty Makary’s dramatic resignation after a stormy 13-month tenure, leaving a trio of senior vacancies at the heart of the nation’s public health apparatus.
Makary’s abrupt exit, confirmed on May 14, 2026, capped a period of near-constant turmoil at the FDA, according to KFF Health News. The agency, already struggling to keep pace with a rapidly evolving health landscape, now finds itself leaderless at a time when public trust in its mission is wavering. Kyle Diamantas, a lawyer with close ties to the Trump family but no medical background, has stepped in as acting director, a move that’s raised eyebrows among career health officials and industry observers alike.
But the FDA isn’t the only agency in flux. The Department of Health and Human Services, led by Secretary Robert F. Kennedy Jr., is also searching for new heads for the Centers for Disease Control and Prevention (CDC) and the surgeon general’s office. All three posts require Senate confirmation, and as Bloomberg News notes, the Senate committee overseeing the process is chaired by Senator Bill Cassidy (R-La.), who’s had a rocky relationship with both Kennedy and President Trump. That dynamic promises contentious hearings as the administration seeks to steady the ship before voters head to the polls.
“It needs a lot of sorting out,” GOP pollster Whit Ayres told CNN about the upheaval at HHS. “It’s not exactly a well-oiled machine.”
The White House, keenly aware of the political stakes, has taken a more hands-on approach to HHS decision-making in recent months. After a period marked by controversial vaccine policies, personnel shake-ups, and a messaging strategy that left many Republicans uneasy, President Trump and his advisers have pushed Kennedy to pivot away from vaccine skepticism and toward more mainstream issues—namely, drug pricing and health insurance affordability. This shift is part of a broader effort to shore up support among swing voters and blunt Democratic criticism ahead of the midterms.
Yet the changes have not come without friction. Kennedy, a longtime vaccine skeptic and leader of the Make America Healthy Again (MAHA) movement, has reportedly been asked by the White House to tone down his public questioning of vaccines. According to The New York Times, Kennedy is nonetheless pressing ahead with a multi-agency review of vaccine science behind the scenes, focusing on unproven links between vaccines, chronic disease, and autism. The review, led by biostatistician Martin Kulldorff and involving officials from the CDC, FDA, and National Institutes of Health, has alarmed some public health experts, who worry it will undermine confidence in proven immunization programs.
“It just demonstrates that no matter what the general tone is about vaccines, whether we talk about them or not, the secretary is going to continue to try and look at the data and analyze it in a way that will help support the conclusions that he’s already made,” Dr. Daniel Jernigan, who oversaw vaccine safety at the CDC until his resignation last August, told The New York Times. “And that, to me, is a real problem.”
Under Kennedy’s leadership, the government has rolled back recommended childhood vaccines, purged a key vaccine advisory board, and ousted the CDC director over vaccine disagreements. While these moves have pleased Kennedy’s MAHA base, they’ve become a political liability for Republicans, with recent polling from KFF showing only about 40% of Americans support the MAHA movement. More than 60% of voters, however, say health costs will have a major impact on their vote this fall—far outpacing concerns about vaccines or food policy.
“Policies related to vaccines and vaccine safety need to be addressed carefully and with nuance,” Todd Lyons, president of the RFK-aligned MAHA Action advocacy group, wrote in a February memo. “That’s because, overall, a slim majority of voters are not convinced there are negative health impacts from vaccines.”
The administration’s recalibration has led to a wave of resignations among senior health officials. Rich Danker, a top HHS spokesman who worked closely with Makary, resigned on May 13, 2026, citing opposition to the administration’s push to allow sales of flavored e-cigarettes—a move that put him at odds with both Makary and Trump. Mitchell Hailstone, HHS Director of Public Strategy, also departed in recent weeks, though his exit preceded Makary’s resignation. As CNN reported, more departures are expected as the administration reviews agency functionality and prepares to install new leadership teams.
Meanwhile, the White House is pushing for swift confirmation of new leaders for the CDC and surgeon general posts. Erica Schwartz, a public health veteran and former deputy U.S. surgeon general, has been tapped as the new CDC nominee, following the ouster of former director Susan Monarez last August over vaccine policy disagreements. The administration abandoned an effort to install Kennedy ally Casey Means as surgeon general after it became clear she could not win Senate confirmation, opting instead for a nominee more supportive of vaccines.
But the path forward is anything but clear. The administration aims to recommend a permanent FDA commissioner to President Trump by early June, but the search is complicated by competing demands from Trump, Kennedy, GOP lawmakers, and a restive MAHA movement still pushing for radical health reforms. “The job is still impossible,” Steven Grossman, a former HHS official and health policy consultant, told CNN. “The most we can hope for is it won’t be badly done.”
Adding to the administration’s headaches are ongoing crises that highlight the stakes of effective public health leadership. The recent hantavirus outbreak on a cruise ship, which left American passengers quarantined and transfixed the globe, has underscored the challenges facing a CDC that’s seen its resources slashed under Trump. Critics argue that the administration’s disengagement from global public health and focus on domestic political battles have left the country less prepared for emerging threats.
Political pressure is mounting from both sides of the aisle. Abortion opponents are demanding a tougher federal crackdown on abortion and the abortion pill, while the administration simultaneously pushes policies to encourage family growth. The fate of telehealth access to the abortion pill mifepristone remains uncertain, as the Supreme Court recently extended its stay on a lower-court order that would have halted access—a decision that could reshape abortion rights nationwide if upheld.
All of this is unfolding against a backdrop of economic anxiety. Polls conducted by CNN/SSRS in late April and early May found that 77% of respondents believe Trump’s policies have driven up the cost of living, with the war in Iran and new tariffs cited as key factors. For many voters, affordability—not vaccines or culture wars—will be top of mind in November.
As the Trump administration races to fill a widening leadership vacuum at HHS, the stakes for public health and the upcoming election couldn’t be higher. Whether the agency can find its footing amid so much upheaval remains to be seen, but one thing is clear: the next few weeks will be crucial for both the nation’s health and its political future.