Senate confirms Biden FDA nominee

The Food and Drug Administration (FDA) has a new permanent leader for the first time in over a year after the Senate on Tuesday voted to confirm Robert Califf.

Califf was confirmed in a vote of 50-46, with Sen. Mike RoundsMike RoundsGOP leaders silent on Trump’s claims that VP could overturn elections McConnell aims to sidestep GOP drama over Trump Budowsky: President Biden leads NATO against Russian aggression MORE (R-S.D.) voting present. Rounds “paired” his vote to offset the absence of Sen. Ben Ray Luján (D-N.M.), who is recovering after suffering a stroke.

The close vote reflected unexpected opposition from both Democrats and Republicans, as the nomination was roiled with debate about abortion and opioids. 

Democratic Sens. Joe ManchinJoe ManchinBiden’s FDA pick clears key Senate hurdle Why congressional Democrats should rethink their universal pre-k plan  Manchin clarifies: He’d oppose second high court nominee right before presidential election MORE (W. Va.), Ed MarkeyEd MarkeyBiden’s FDA pick clears key Senate hurdle This week: Confirmation fight over Biden’s FDA nominee comes to a head Senators introduce a resolution honoring Tom Brady’s career MORE (Mass.), Richard Blumenthal (Conn.) and Maggie HassanMargaret (Maggie) HassanBiden’s FDA pick clears key Senate hurdle This week: Confirmation fight over Biden’s FDA nominee comes to a head Democrats see inflation as growing problem for their agenda   MORE (N.H.), and Independent Sen. Bernie SandersBernie SandersBiden’s FDA pick clears key Senate hurdle Sanders endorses Jessica Cisneros over sitting Democratic lawmaker This week: Confirmation fight over Biden’s FDA nominee comes to a head MORE (Vt.), who caucuses with Democrats, voted against him, as well as almost all Republicans.

Democrats were critical of Califf’s ties to the pharmaceutical industry, as well as the FDA’s record on opioid approvals.

The razor-thin margin was evident Monday, when Democrats were able to shut down debate on the nomination, 49-45, because five Republicans were missing from the vote. 

Ultimately, Califf picked up six Republicans on Tuesday to balance out the Democratic defections: Sens. Roy BluntRoy Dean BluntBiden’s FDA pick clears key Senate hurdle Hawley endorses candidate to succeed fellow Missouri Sen. Blunt On The Money — Inflation hits highest rate since February 1982 MORE (Mo.), Richard BurrRichard Mauze BurrBiden’s FDA pick clears key Senate hurdle This week: Confirmation fight over Biden’s FDA nominee comes to a head On The Money: Border blockade hits US economy MORE (N.C.), Susan CollinsSusan Margaret CollinsBiden’s FDA pick clears key Senate hurdle Manchin clarifies: He’d oppose second high court nominee right before presidential election Trump says he could have ousted ‘atrocious’ Susan Collins in 2020 MORE (Maine), Lisa MurkowskiLisa Ann MurkowskiBiden’s FDA pick clears key Senate hurdle Manchin clarifies: He’d oppose second high court nominee right before presidential election This week: Confirmation fight over Biden’s FDA nominee comes to a head MORE (Alaska), Mitt RomneyWillard (Mitt) Mitt RomneyBiden’s FDA pick clears key Senate hurdle Trump says he could have ousted ‘atrocious’ Susan Collins in 2020 This week: Confirmation fight over Biden’s FDA nominee comes to a head MORE (Utah) and Patrick ToomeyPatrick (Pat) Joseph ToomeyLate-night reports suggest CIA collecting more data on Americans Conservatives are outraged that Sarah Bloom Raskin actually believes in capitalism Meet Washington’s most ineffective senator: Joe Manchin MORE (Pa.).

Califf is a “supremely qualified nominee with bipartisan support,” Burr said prior to the vote. “The FDA has an opportunity to be forever changed for the better, but it needs effective leadership to get there.” 

Califf had slowly been picking up Democratic votes leading up to the vote by making individual pledges to lawmakers, including Sens. Dick DurbinDick DurbinBiden’s FDA pick clears key Senate hurdle The Hill’s Morning Report – World poised for war This week: Confirmation fight over Biden’s FDA nominee comes to a head MORE (Ill.), the No. 2 Senate Democrat, Elizabeth WarrenElizabeth WarrenBiden’s FDA pick clears key Senate hurdle Lina Khan won’t solve inflation Invent here, manufacture here MORE (Mass.) and Senate Finance Committee Chairman Ron WydenRonald (Ron) Lee WydenBiden’s FDA pick clears key Senate hurdle This week: Confirmation fight over Biden’s FDA nominee comes to a head Late-night reports suggest CIA collecting more data on Americans MORE (Ore.). 

Califf, a cardiologist and Duke University researcher, was confirmed to the same post by a vote of 89-4 in 2016 when he was nominated by former President ObamaBarack Hussein ObamaBiden’s FDA pick clears key Senate hurdle Manchin clarifies: He’d oppose second high court nominee right before presidential election Make some policy love this Valentine’s Day MORE. He was widely viewed as a shoo-in for the position this time. 

As a result, the pushback appeared to catch the White House by surprise, and the nomination had been stalled since November. Officials engaged in an intense behind-the scenes effort to shore up the votes for Califf, as conservatives tried to galvanize a handful of expected Democratic “no” votes and sink his confirmation. 

Republicans faced pressure from anti-abortion groups, which have mobilized against Califf. He gained just four GOP votes in a committee vote last month.

The Susan B. Anthony List said it would “key vote” Califf’s nomination as a result of his work on the abortion drug mifepristone during the Obama administration.

Califf has “a track record of putting an extreme agenda before the science,” Sen. Steve DainesSteven (Steve) David DainesPhotos of the Week: Marking COVID-19 deaths, Mt. Etna and Olympic snowboarders Stock trading ban gains steam but splits Senate GOP Amazon launching telehealth service nationwide MORE (R-Mont.) said prior to the vote. 

FDA has been without a confirmed leader for nearly 400 days

The FDA is one of the primary agencies helping shape the nation’s response to the global COVID-19 pandemic that has killed more than 880,000 Americans. It regulates products like masks, lab tests and vaccines, but is also responsible for the nation’s food supply.

The agency is being run in an acting capacity by Janet Woodcock, a career FDA official who previously was in charge of the agency’s drug evaluation unit. Woodcock’s tenure was limited by federal law, and Biden waited until almost the last minute to name a nominee.

Updated at 1:33 p.m.