By Amy Goldstein and Paige Winfield Cunningham,
Xavier Becerra, nominated to lead the Department of Health and Human Services, made clear Tuesday he would adhere to President Biden’s goal of expanding health coverage through existing law, jettisoning his own prior enthusiasm for a government-paid health-care system.
With some Senate Republicans assailing him as an unqualified radical, Becerra sought — during the first of two confirmation hearings — to dispel the characterization of him as anything but a loyal foot soldier to the president and an advocate for the nation’s underserved.
“The mission of HHS to enhance the health and well-being of all Americans is core to who I am,” he testified before the Senate Committee on Health, Education, Labor and Pensions. “We must build on what we’ve had with the Affordable Care Act to make it stronger, to provide better quality care at more affordable prices.”
During a 2½ -hour hearing, the only person who mentioned Medicare-for-all, a single-payer system that would replace private insurance, was the committee’s top Republican, Sen. Richard Burr (R-N.C.), who noted that Becerra had supported such proposals during more than 20 years as a congressman from Los Angeles.
Becerra, now the California attorney general, did not refer to that history when it was his turn to speak. “I will look for common cause,” he said, “and I will work with you to improve the health and dignity of the American people.”
His nomination has become a target for some conservative Republicans, who sent a letter Monday to Biden calling Becerra “unfit for any position of public trust, and especially for HHS secretary.” Senate Minority Leader Mitch McConnell (R-Ky.) denounced Becerra on the Senate floor Tuesday, contending that the nominee “has no particular experience or expertise in health” and saying, “I am hard-pressed to see any way such a radical and underqualified nominee should fill such a critical post at this crucial time.”
Still, Becerra is considered likely to be confirmed, given that the Democratic caucus holds a razor-thin Senate majority, and no one in the caucus has signaled an intent to vote against him.
Becerra’s loudest critics do not belong to the HELP committee. And few sit on the Senate Finance Committee, which is scheduled to hold Becerra’s other confirmation hearing Wednesday and will vote whether to forward his nomination to the full Senate.
At Tuesday’s hearing, a few GOP senators picked up on the questioning of Becerra’s qualification.
“I’m not sold yet,” Burr told Becerra. “I’m not sure that you have the necessary experience or skills to do this job at this moment.”
But at least two of the committee’s Republicans, Sens. Susan Collins (Maine) and Lisa Murkowski (Alaska), offered no criticism of Becerra, and Murkowski sounded as if she is preparing to work with him as secretary. When Becerra offered to visit Alaska to see rural health obstacles firsthand, Murkowski replied, “Well, I would encourage that, and I would encourage that visit early.”
Overall, the nominee reflected mainstream Democratic positions as he pledged to address a spectrum of problems with health and health care in the United States, including the price of prescription drugs, inequities in access to care and the year-old coronavirus pandemic that has killed more than 500,000 people nationwide and is dominating American life and the president’s agenda.
Becerra praised steps Biden has taken since he assumed office last month. He singled out the temporary reopening of the ACA’s federal insurance marketplaces for people who cannot get affordable health benefits through a job. He also lauded the formation of an equity task force within HHS to help with the government’s coronavirus response.
“We will have a team . . . that lives and breathes the desire to have health equity,” Becerra said, explaining that the task force will ensure that studies conducted by the National Institutes of Health as well as the work of the Centers for Disease Control and Prevention include “these populations that have often been left behind, so that, when we get results, we get results that are good for everyone.”
With a $1.4 trillion budget, HHS is a sprawling department that contains agencies at the heart of the government’s efforts to defeat covid-19, the disease caused by the novel coronavirus. In addition to NIH and the CDC, they include the Food and Drug Administration and the Centers for Medicare and Medicaid Services.
As Biden has been filling his Cabinet largely with alumni of past Democratic administrations, including people who served with him during his eight years as President Barack Obama’s vice president, Becerra’s selection stood out. Becerra is the first state attorney general nominated to be the nation’s top health official, and he has not worked before with Biden. And he does not have medical expertise — as public health officials were encouraging for the HHS nominee in the midst of the pandemic.
However, Becerra worked on major health-care legislation, including the ACA, during his long tenure in the House. Running the nation’s largest state justice department since 2017, he has led a coalition of Democratic attorneys general defending the ACA from an attempt, in a case now before the Supreme Court, to invalidate the entire health law. He would be the first Latino HHS secretary.
During the HELP committee hearing, Sen. Mitt Romney (R-Utah), an opponent of abortion, asked Becerra why he voted as a House member against a ban on a procedure critics have labeled “partial birth” abortion.
“I understand that people have different, deeply held beliefs on this issue, and I respect that,” the nominee replied. “I have worked . . . for decades, trying to protect the health of men and women, young and old. . . . I understand that we may not always agree on where to go, but I think we can find some common ground on these issues because everyone wants to make sure that, if you have an opportunity, you’re going to live a healthy life.”
To which Romney retorted, “I think we can reach common ground on many issues, but on partial birth abortion, it sounds like we’re not going to reach common ground there.”
Becerra returned to the theme of opportunity when he praised another step Biden favors and congressional Democrats are considering: expanding subsidies for the monthly premiums on health plans sold through ACA insurance marketplaces. That expansion would, among its provisions, end a sharp cutoff of subsidies to people above a certain income level.
“We gotta deal with this cliff so many Americans face,” Becerra testified. “When they’re in middle-class status, when they get a little too high in their income, all of a sudden you find you fall off this cliff when it comes to the tax credits to help afford your insurance plan.”
As he often has done since his nomination, he spoke of his time as a boy, watching families in a neighborhood of Mexican immigrants struggle for health care.
“The last thing I need,” Becerra said, “is to be one who doesn’t address these disparities in an aggressive manner.”
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