Senate Committee Approves McClellan as CMS Administrator; Floor Vote Blocked
The Senate Finance Committee on Tuesday voted 18-2 to approve the nomination of FDA Commissioner Mark McClellan to serve as the new CMS administrator, but Sen. Byron Dorgan (D-N.D.) blocked a floor vote on the nomination because opposition by McClellan to the reimportation of lower-cost, U.S.-manufactured prescription drugs from other nations, the Washington Post reports (Connolly, Washington Post, 3/10). In testimony before the committee on Monday, McClellan defended his opposition to the practice but also said that he could support reimportation legislation that would place limits on "the scope and type of drugs that can be imported" and would provide FDA with more authority and funding to track reimported medications (California Healthline, 3/9). Sen. Bob Graham (D-Fla.) voted against the McClellan nomination because he said that the FDA commissioner provided "inadequate answers" to the questions he asked (Schuler, CQ Today, 3/9). Sen. John Kerry (D-Mass.), by proxy, also voted against the nomination; Sen. Blanche Lincoln (D-Ark.) abstained (Rovner, CongressDaily, 3/10).
Although the committee approved the McClellan nomination by an "overwhelming ... vote," Dorgan placed a formal hold on the nomination to prevent a Senate floor vote, the Atlanta Journal-Constitution reports (Mollison, Atlanta Journal-Constitution, 3/10). In recent weeks, Dorgan, Senate Commerce, Science and Transportation Committee Chair John McCain (R-Ariz.) and Sen. Debbie Stabenow (D-Mich.) have announced plans to delay a final vote on the McClellan nomination because of his position on reimportation. McClellan, who has refused invitations to testify about the safety of reimportation before the Senate Commerce Committee, on Monday agreed to testify, but only after his confirmation as CMS administrator (California Healthline, 3/9). Dorgan said that the agreement was "not satisfactory," adding, "I intend to put on hold Dr. McClellan's nomination until he complies with the request of the commerce committee chair to appear and testify" (AP/Dallas Morning News, 3/9). A formal hold allows an individual senator to prevent action on a bill or a nomination by "notifying leadership that he or she may object if it is brought to the floor," CQ Today reports (CQ Today, 3/9).
Kerry said that he supports the decision by Dorgan to place a formal hold on the McClellan nomination, the Post reports. In addition, Senate Minority Leader Tom Daschle (D-S.D.) said that the full Senate may not confirm McClellan "if he does not soften his stance" on reimportation, according to the Post (Washington Post, 3/10). "My guess is he doesn't have the votes necessary to win the nomination unless he is able to move more clearly in the direction that Congress, in a bipartisan way, supports," Daschle said, adding that the reimportation issue "will not go away and it is incumbent upon McClellan to deal with it" (CongressDaily, 3/9). However, Amy Call, spokesperson for Senate Majority Leader Bill Frist (R-Tenn.), said that the Bush administration and Frist "will work with Dorgan to address his concerns," adding that Frist "is committed to trying move McClellan's nomination this week" (CQ Today, 3/9). Frist said, "We have lots of important issues to address in Medicare, Medicaid, in the uninsured. We need a leader in CMS. And I would expect that by the end of the week, I hope people will come around and support him" (CongressDaily, 3/10). Bill Pierce, spokesperson for HHS, said, "We hope that members don't continue to play politics with this. This is a big, important job, and senators have acknowledged he is very qualified." Senate Finance Committee Chair Chuck Grassley (R-Iowa) said that he agrees with Dorgan on the reimportation issue, but he added, "It's not going to help senior citizens to hold up the administration official who's supposed to get the prescription drug discount card and new benefit up and running" (Washington Post, 3/10).
PBS' "NewsHour with Jim Lehrer" Tuesday in the first segment of a two-part series reported on factors contributing to lower prescription drug prices in Canada compared with those in the United States, as well as some senators' "resistance" to McClellan's confirmation because of his opposition to reimportation. The segment includes comments from Tom Brogan, a former Canadian health ministry official who helped establish the Patented Medicine Prices Review Board; Illinois Gov. Rod Blagojevich (D); McCain; McClellan; and Pfizer CEO Hank McKinnell (Dentzer, "NewsHour with Jim Lehrer," PBS, 3/9). The complete transcript is available online. The complete segment is available online in RealPlayer. Expanded PBS coverage, including extended interviews with Blagojevich, Brogan, McClellan and McKinnell, is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.