Senator Elizabeth Warren is urging President Donald Trump’s pick for Deputy Secretary of Health and Human Services to take stronger ethical stances before his confirmation can move forward.
Jim O’Neil, a health policy adviser with deep roots in the biotech and venture capital world, faces scrutiny over his prior connections to healthcare companies regulated by the very agency he’s been nominated to help lead.
In a formal letter reviewed by Reuters, Warren called on O’Neil to recuse himself from any matters involving his former clients or employers for a minimum of four years. She also requested he commit to not seeking compensation from or lobbying on behalf of any companies he regulated while in office for the same duration after stepping down.
“Your relationships with biomedical companies regulated by HHS will raise concerns about your impartiality in this role,” Warren wrote. The Democratic senator, who sits on the Senate Finance Committee overseeing the nomination process, pressed for commitments that exceed legal requirements, noting that previous appointees have voluntarily done so.
O’Neil is known as an ally of tech billionaire and prominent Trump supporter Peter Thiel. Between 2012 and 2019, he managed Thiel’s Mithril Capital Management, which invested in biotech firms—some of which currently have products pending FDA approval. He also held executive roles at the Thiel Foundation and Thiel Capital.
Adding to concerns, O’Neil currently sits on the board of ADvantage Therapeutics, a company developing an Alzheimer’s drug subject to FDA oversight. He has agreed, per legal requirements, to a limited recusal of one or two years depending on bonus compensation, but Warren says that’s not enough.
If confirmed, O’Neil would serve under Health Secretary Robert F. Kennedy Jr., who has openly criticized the “revolving door” between regulatory agencies and industry, and has pledged “radical transparency” at the department.
The nomination now hinges on how O’Neil addresses bipartisan concerns about conflicts of interest—and whether he’ll take additional steps to prove his commitment to impartial public service.
