ACA Defender Becerra Tapped For Biden’s HHS Chief

Dive Brief:

  • * President-elect Joe Biden on Monday said he would nominate California Attorney General Xavier Becerra to lead HHS in his administration. The move was somewhat of a surprise, as his name had not previously been circulated as among those in contention.
  • * The former House lawmaker has led the coalition of blue states defending the Affordable Care Act against a constitutional challenge most recently heard by the U.S. Supreme Court. He took up the task after President Donald Trump’s administration declined to stand behind the landmark law.
  • * The AG has also voiced opposition to consolidation in the healthcare market in his state, alleging anticompetitive practices by regional powerhouse Sutter Health and denying a merger between Adventist Health and St. Joseph Health in November 2019.

Dive Insight:

The next person to be the nation’s top health official will face a daunting task to say the least, as the COVID-19 pandemic continues to greatly strain the nation’s hospitals and a winter surge of cases is expected.

They will oversee a massive effort in distributing a coronavirus vaccine, the first of which could receive emergency approval in a matter of weeks. The Trump administration has left that task largely to the individual states, but Biden’s plan calls for $25 billion toward manufacturing and administration along with a focus on equitable distribution.

No HHS secretary is likely to get a smooth confirmation in what will likely be a Congress with divided political power. Becerra could see opposition for perceived activism in the courts. He would be the first Latino to hold the position.

Biden named a few other members of his incoming health team, including three people to assist with response to the pandemic. Leading a COVID-19 equity task force will be Marcella Nunez-Smith of the Yale School of Medicine; to coordinate pandemic response will be Jeff Zients, who helped fix the troubled launch of in 2013; and as deputy coordinator of the response, former White House and Pentagon senior adviser Natalie Quillian.

The president-elect has also asked National Institute of Allergy and Infectious Diseases Director Anthony Fauci to continue his role and also serve as chief medical officer to the president on COVID-19.

Rochelle Walensky, chief of infectious diseases at Massachusetts General Hospital, is being appointed to lead the Centers for Disease Control and Prevention.

Prior to becoming attorney general in 2017, Becerra spent 12 terms in the House of Representatives, eventually becoming chair of the House Democratic Caucus and helping to usher passage of the ACA.

He told Healthcare Dive in an interview last summer he views healthcare as a right — one he could not take for granted growing up. “People have gone bankrupt personally because they’ve taken their child to the hospital,” he said. “That doesn’t seem like it belongs in a civilized country like the United States.”

Those considered to be on the short list for Biden’s HHS chief were former U.S. Surgeon General Vivek Murthy, whom Biden will nominate to take up the position once again, New Mexico Gov. Michelle Lujan Grisham and Louisiana’s top health official Rebekah Gee.

The American Hospital Association on Monday applauded the nomination, citing Becerra’s support for the ACA. “He has been a champion for affordable health access and coverage, which the ACA has supported, and he has consistently made people across American and their health a priority,” the group wrote.

Avalere CEO Dan Mendelson on Twitter called the choice of Becerra is “incredibly strategic” because he understands the legislative process and advocates for fighting health disparities. While Becerra has a history of support for single-payer healthcare, he understands the realities of the system and is likely to continue to advocate for incremental expansion of the ACA, Mendelson said.

The Trump administration had two HHS secretaries. Tom Price resigned in 2017 after a scandal involving his personal use of federally funded plane travel. Alex Azar, former Eli Lilly CEO, has had the helm since January 2018.


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