Biden’s FDA pick clears key Senate hurdle

President Biden’s nominee to lead the Food and Drug Administration (FDA) is headed towards a close confirmation vote after the Senate on Monday voted to shut down debate on his nomination.

The final confirmation vote on Robert Califf, which could come as early as Tuesday, is expected to be even closer than the 49-45 vote to invoke cloture. 

Five Republicans joined with Democrats to invoke cloture and end debate: Sens. Susan Collins (Maine), Lisa Murkowski (Alaska), Richard Burr (N.C.), Mitt Romney (Utah), and Roy Blunt (Mo.).

Prior to the vote, five Democrats had already spoken out against him; Sens. Joe Manchin (D-W.Va.), Sen. Bernie Sanders (I-Vt.), Ed Markey (D-Mass.), Maggie Hassan (D-N.H.) and Richard Blumenthal (D-Conn.) are expected to oppose Califf’s nomination.

Sen. Ben Ray Luján (D-N.M.) is absent after suffering a stroke, so if all Republicans who oppose Califf are present, Democrats will need one more vote in their favor to confirm.

Califf had slowly been picking up Democratic votes leading up to Monday by making individual pledges to lawmakers, including Sens. Dick Durbin (Ill.), the No. 2 Senate Democrat, Elizabeth Warren (Mass.), and Senate Finance Committee Chairman Ron Wyden (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 Obama, but faced unexpected opposition this time.

The pushback appeared to catch the White House by surprise, and 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. 

“At this critical moment we need a trusted hand to lead FDA,” said Sen. Patty Murray (Wash.), the No. 3 Senate Democrat, on the floor just ahead of the vote. 

Manchin has been highly critical of Califf ever since Biden announced his nomination in the fall, both for his industry ties and because of FDA’s role in the opioid crisis while Califf was at the helm.

Manchin also voted against Califf in 2016.

“Nothing that Dr. Califf has said or done leads me to believe he will operate FDA any differently than he did during his previous tenure,” Manchin said on the floor. “I cannot for the life of me understand why this administration is so committed to asking each of us in the Senate to reconfirm a person who had the opportunity to make a difference, but showed us who he really was? Do not expect a different outcome if he is given another opportunity to lead the FDA.” 

At the same time, Republicans are facing pressure from anti-abortion groups, which have mobilized against Califf. He gained just four GOP votes in a committee vote last month.

Anti-abortion groups in particular have been lobbying hard against Califf. 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.