Senate Approves McClellan as FDA Commissioner

The Senate Oct. 17 on a voice vote unanimously confirmed Dr. Mark McClellan as FDA commissioner, a position that has been vacant since President Bush took office, the Houston Chronicle reports (Lee, Houston Chronicle, 10/17). McClellan, a physician with a doctorate in medical economics, has served as a White House health policy adviser and as a member of the Council of Economic Advisers in the Bush administration. He has represented the Bush administration in negotiations with Congress on a Medicare prescription drug benefit and proposals to extend health coverage to the uninsured. McClellan, a native of Austin, Texas, graduated from the University of Texas with degrees in English and biology. He earned his medical degree from Harvard Medical School and received an economics degree from the Massachusetts Institute of Technology. McClellan practiced as a physician at Stanford University, where he also taught health care economics, before he joined the Bush administration (Kaiser Daily Health Policy Report, 10/8). "Dr. McClellan has the training, the experience and the stature to serve as the head of the country's most important public health regulatory agency," Sen. Edward Kennedy (D-Mass.) said (AP/New York Times, 10/18).

Objections Dropped
The Senate voted to confirm McClellan after Sen. Jeff Bingaman (D-N.M.) on Oct. 17 agreed to lift a hold on his nomination. Bingaman placed the hold on McClellan's nomination to "gain leverage" in negotiations with the Bush administration on a bill to extend CHIP program coverage to pregnant women, the Chronicle reports (Houston Chronicle, 10/17). Last week, HHS Secretary Tommy Thompson said that he no longer supported legislation to extend CHIP coverage to pregnant women. He said that a regulation issued by the administration last month to extend CHIP benefits to fetuses will have the same effect. The rule revises the definition of children to allow states to provide CHIP coverage "from the moment of conception." Under the rule, pregnant women, including undocumented immigrants, can receive prenatal care for their fetuses. Bingaman said that he would hold McClellan's nomination until Thompson explained the administration's decision to drop support for the bill. Thompson on Oct. 15 stated in a letter to senators that the regulation will provide "more comprehensive" coverage for pregnant women than the legislation (Kaiser Daily Health Policy Report, 10/16). Bingaman replied that Thompson's explanation of his support for the rule over the bill did not convince him to lift the hold on McClellan's nomination (Middleton, Dow Jones, 10/17). However, after discussions with the Bush administration yesterday, Bingaman dropped his hold on the nomination, the Chronicle reports (Houston Chronicle, 10/17).

Vacancies Remain
According to the Brookings Institution, Bush has become the "slowest chief executive in four decades in getting his top federal managers into place," the Washington Post reports. Until McClellan's confirmation last night, the FDA had not had a commissioner for about 20 months (Lee, Washington Post, 10/18). At HHS, only the Administration for Native Americans commissioner position remains vacant. Bush in July nominated Quanah Crossland Stamps for the position (Brookings Institute, Presidential Appointee Initiative, 10/18). Paul Light, director of the Center for Public Service at the Brookings Institution, said, "It now takes as long, on average, to get an appointee into office as it does to have a child." However, Light said that "it's not all the Bush administration's fault," the Post reports. The contested 2000 presidential election, the increased number of positions in presidential administrations, "more extensive" background checks and ethics requirements and Democratic control of the Senate have contributed to delays in appointments, the Post reports. White House personnel director Clay Johnson said, "We made nominations to the Senate as fast as any other administration since the introduction of the new ethics laws in the late '70s -- period" (Washington Post, 10/18).