President Joe Biden's nominee to head the Food and Drug Administration does not have the votes in the Senate yet to seal the deal, Politico reported.
More than two months after picking Robert Califf to be FDA commissioner, the confirmation has been stalled by Democrats' concerns about the cardiologist's regulatory track record and an emerging GOP effort to ax the nomination.
Califf's supporters fear his candidacy is faltering and, with the possibility of a setback for Biden and the health agency key to his pandemic response, the White House is calling on its top advisers, including Dr. Anthony Fauci, to rescue it.
Marking the first outward sign of trouble, only four Republicans — Sens. Richard Burr, R N.C.; Susan Collins, R-Maine; Lisa Murkowski, R-Alaska; and Mitt Romney, R-Utah — voted for Califf in committee earlier this month.
"If the vote were held today, he would not have the votes," one person with knowledge of the matter told Politico on Friday.
Permanent political leadership at the FDA has been lacking for a year and the White House tried for months to find a candidate who could win majority support in the evenly divided Senate.
The regulatory body for everything from COVID-19 vaccines to large sectors of the nation's food supply, the FDA is currently reliant on longtime drug regulator Janet Woodcock to run the agency on an acting basis.
Four people familiar with the matter told Politico that five Democrats — Sens. Bernie Sanders, I-Vt.; Joe Manchin, D-W.Va.; Ed Markey, D-Mass.; Maggie Hassan, D-N.H.; and Richard Blumenthal, D-Conn. — are opposed to Califf's nomination, but that even more remain on the fence.
Some lawmakers have expressed concern over Califf's work in the private sector after his last stint at the FDA in 2016, as well as his pharmaceutical industry ties and the FDA's track record regulating opioids.
Thus far, there has been no real talk of scrapping Califf's nomination, and the administration has no backup candidates waiting in the wings. If necessary, Senate Democrats could postpone a confirmation vote for weeks while they work to build enough support.
Some close to the confirmation proceedings blamed the White House for being too detached and said the nominee himself has struggled to make his case to skeptical senators.
"The White House isn't supporting him," someone with knowledge of the matter told Politico. "He's kind of his own one-man PR show."
A White House official disagreed with the portrayal, saying there has been "consistent outreach to members throughout this entire process."
"We are confident Dr. Califf will be confirmed with bipartisan support, and it is critical to have confirmed leadership at the FDA in the midst of a pandemic," White House spokesperson Chris Meagher told Politico.
One GOP lobbyist told Politico, however, that support among Republicans plummeted when the FDA moved forward in December with a plan to allow patients to obtain a mailed prescription for the abortion medication mifepristone through a telehealth appointment.
"At most, he gets three to four GOP votes, so maybe he is short, considering at least five Democrats are a no," the lobbyist said.
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