The divisive issue of Canadian drug re-importation is expected to dominate his second confirmation hearing today before the Senate Finance Committee. But the chummy bipartisan reception Leavitt got on the Health, Education, Labor and Pension Committee bodes well for a quick confirmation, with a vote reporting his nomination out to the full Senate possible by the end of the week.

"I'm impressed with what you did in your state," Sen. Edward Kennedy, of Massachusetts, the top Democrat on the committee, told Leavitt during questioning about the upcoming reauthorization of welfare program reforms. Just before the start of the two-hour-long hearing, Kennedy shook hands with the outgoing head of the Environmental Protection Agency and told him he would support his nomination.

"That's a real good sign," said Sen. Orrin Hatch, R-Utah, a member of both committees considering Leavitt's nomination and who joined Sen. Bob Bennett, R-Utah, in introducing him to the panel.

"This is a man who's proven he knows how to get things done," Bennett told the committee.

The hearing was dominated by questions about potential cuts to Medicaid, the federal-state health care service that covers 51 million low-income or disabled Americans, including more than 200,000 people in Utah. GOP budget writers are expected to tweak the federal formula for matching state contributions to Medicaid this year as a way of reining in the record deficit.

Leavitt said that while it is vital for the federal government to care for the "truly needy," Medicaid "is not meeting its potential to do good in the lives of the poor." He acknowledged Utah's use of a first-ever federal waiver to scale back some Medicaid benefits and use the savings to serve a broader population did not provide "the kind of health care we'd want them to receive." But Leavitt maintained giving states added flexibility in spending the money would mean basic coverage for more people without additional funding.

"I passionately believe that," he told the committee. "We could and should use Medicaid as part of the transformational movement in the delivery of health care in general."

Only a handful of senators attended Leavitt's confirmation hearing, which was held at the same time and in the same building as the higher-profile vetting of Secretary of State nominee Condoleezza Rice by the Senate Foreign Relations Committee. Those who showed up roundly praised him as the ideal candidate to lead HHS, with the only pointed questions coming from Sen. Judd Gregg, R-New Hampshire.

Gregg tried to extract pledges from Leavitt that a new Food and Drug Administration commissioner would be announced by the end of the month and that he would keep the Medicare prescription drug benefit program costs within the $400 billion estimate Congress had relied upon when they voted, rather than new White House estimates of $532 billion.

Leavitt dodged making any specific promises, saying only that his "sense is" Bush will nominate a new FDA boss soon and to note that "it's been my practice as a manager to operate within my budget."

Using tech-oriented marketing phrases to showcase his vision in the same way he has done throughout his political career, Leavitt told the panel U.S. health care is entering the "age of interoperability," when technology will eliminate excessive paperwork through multi-agency coordination. The world is rapidly moving toward an era of "personalized medicine," Leavitt said, where individuals will own their own health savings accounts, health insurance and health records.

His EPA-signature philosophy of "Enlibra" collaboration never was cited during the hearing, but Leavitt repeatedly said he would work to "find balance" on issues such as ensuring safety of new medicines while promoting innovation and speed to market.

And he called three high-profile HHS agencies - the FDA, Centers for Disease Control and National Institutes of Health - America's "most treasured brands," whose reputation for safety must be protected because "a brand is a promise."

Leavitt also said implementing the new Medicare prescription drug benefit by the end of the year will be "the main event" during his first year as HHS secretary. "There will inevitably be flaws but we will not fail," he said.