[Congressional Record Volume 150, Number 29 (Tuesday, March 9, 2004)]
[Senate]
[Page S2431]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




NOMINATION OF MARK McCLELLAN AS ADMINISTRATOR, CENTERS FOR MEDICARE AND 
                           MEDICAID SERVICES

  Mr. VOINOVICH. Mr. President, 3 weeks ago President Bush nominated 
Mark McClellan to be Administrator of the Centers for Medicare and 
Medicaid Services, CMS. I rise today to express my deep concern over 
the news that some of my colleagues have threatened to delay his 
confirmation.
  This is happening at a time when CMS has more on its plate than it 
has had in 39 years--since the creation of the Medicare and Medicaid 
programs in 1965. Last November, I proudly joined my colleagues in 
support of a bill to finally provide over 40 million seniors a 
voluntary prescription drug benefit through Medicare. After years of 
having to carry the burden of high prescription drug costs without any 
assistance from Medicare, the bill we passed will provide 1.6 million 
seniors in my State with access to affordable prescription drugs. This 
is long overdue.
  At CMS, steps are already being taken to implement the provisions in 
this bill. In fact, 2 months from now, in May 2004, seniors across the 
Nation will have the opportunity to enroll in a Medicare-endorsed drug 
discount card that is expected to yield an average 10 to 25 percent 
savings on all prescription drug purchases. On top of these discounts, 
the Federal Government will annually purchase the first $600 in 
prescription drug costs for those seniors below 135 percent of the 
poverty level.
  Five weeks ago, on February 5th, CMS announced that over 100 separate 
entities had submitted applications to offer Medicare-approved cards to 
beneficiaries, a response they called a ``robust level of interest'' 
from potential card sponsors. While this is encouraging, this level of 
interest places greater demand on CMS staff as they continue to review 
applications and move forward in announcing their card endorsements 
within the next month.
  Furthermore, former CMS administrators have been quick to point out 
that if the new drug benefit is to commence on time in January 2006, 
rules must be written and finalized no later than October or November 
of 2005. Vital decisions must be made about the administration of the 
benefit in the development stage, which is now--decisions that require 
strong leadership and expertise. Unfortunately, CMS has been without a 
leader since January, when Tom Scully resigned.
  I assure you that the success of Medicare and the prescription drug 
benefit rests with a capable CMS workforce under strong leadership. CMS 
already faces an enormous challenge. Approximately one quarter of its 
workforce will be eligible to retire in the coming years. In fiscal 
year 2003, 30 percent of individuals serving in career Senior Executive 
Service positions at CMS were eligible for retirement. In addition, 20 
percent of CMS's workforce was eligible to retire. The leadership to 
move this vital agency forward is lacking without a confirmed 
administrator.
  Gail Wilensky, administrator of CMS's predecessor, the Health Care 
Financing Administration from 1990 to 1992, describes the task ahead as 
``the largest challenge an administrator has had.'' Similarly, her 
successor, Nancy Ann Min DeParle, who had the demanding task of 
implementing the Balanced Budget Act throughout her tenure from 1997 to 
2000, has correctly stated that implementing the new drug benefit will 
be even more taxing than previous initiatives and will require the 
agency to design a ``new delivery system that does not now exist even 
in the commercial market.''
  I could not agree more. I have concerns about the arduous task ahead 
for CMS and as a result, will be holding a hearing at my Government 
Affairs Subcommittee in the coming weeks to examine CMS' capacity to do 
this job. I expect Dr. McClellan to be at this hearing to discuss his 
plans for leading CMS in this pursuit.
  I cannot think of a more qualified leader for CMS at this critical 
time than Dr. Mark McClellan. His work at the helm of the FDA over the 
past 2 years brought innovation and creativity to the agency, which 
many believe has dismantled bureaucratic barriers and led to quicker 
reviews of drug and other product applications to speed generic drugs 
to the marketplace. I am most appreciative of his work in this area, as 
a few years ago, I was able to secure $400,000 for the FDA to educate 
our nation's seniors about the safety and cost-effectiveness of generic 
drugs.
  Dr. McClellan earned a medical degree from the Harvard University-
Massachusetts Institute of Technology Program in Health Sciences and 
Technology and a doctorate in economics from MIT. He served under 
President Clinton between 1998 and 1999 as Deputy Assistant Secretary 
of the Treasury and served as health policy coordinator and a member of 
President Bush's Council of Economic Advisers before joining the FDA.
  In fact, Dr. McClellan has always enjoyed broad support across party 
lines, and it was no surprise that just last week, Senator Edward 
Kennedy described Dr. McClellan as a superb choice for CMS 
administrator who ``brings to the job a powerful intellect, a deep 
knowledge of the programs and a commitment to public service.''
  What did come as a surprise was the announcement by several Senators 
that, despite Dr. McClellan's outstanding qualifications, they are 
threatening to block his nomination to gain leverage on the issue in 
Congress of re-importing pharmaceuticals from outside of the United 
States.
  As Chairman of the Governmental Affairs Subcommittee on Oversight of 
Government Oversight and Management and the Federal Workforce, I am 
gravely concerned. Delaying this appointment at a time when CMS 
desperately needs leadership will affect the agency's ability to 
effectively implement the prescription drug benefit and even more 
urgently, the drug discount card program.
  This is not fair to the 5,000 dedicated CMS employees who are working 
tirelessly to implement the congressionally mandated prescription drug 
benefit.
  This is not fair to our Nation's seniors. Every American, and 
particularly every senior citizen, should be outraged.
  Now is not the time to play political games. We must make sure that 
CMS has the leadership it needs at this juncture to handle the task at 
hand. I urge my colleagues to reconsider their decision to delay the 
nomination of Dr. Mark McClellan and confirm his appointment to this 
important position.

                          ____________________