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In a Squeaker, Senate Confirms Xavier Becerra as HHS Secretary

— Former California AG gets single Republican vote

MedpageToday
A photo of Xavier Becerra

WASHINGTON -- By a vote of 50-49, the Senate on Thursday narrowly confirmed Xavier Becerra, President Biden's nominee to be secretary of Health and Human Services (HHS).

Becerra, 63, a Democrat, has been serving as attorney general of California. He began that job in 2017 after serving in Congress from 1993 to 2016, representing a district that included downtown Los Angeles. The vote to confirm him was largely along party lines; Sen. Susan Collins (R-Maine) was the lone Republican to vote for Becerra's confirmation. Sen. Mazie Hirono (D-Hawaii) did not vote.

The discussion on the Senate floor prior to the vote reflected the split between Democrats and Republicans on Becerra's nomination. "What this means is after 4 years of going in reverse on health policy, it will be possible to go to drive and actually make progress for the American people in addressing their healthcare needs," said Sen. Ron Wyden (D-Ore.). Central to Becerra's agenda "is going to be the distribution of vaccines, because there are a lot of pieces to the challenge of beating the pandemic, but right at the heart of it is distribution of those vaccines and PPE [personal protective equipment], and bringing together all the people at Health and Human Services and in our country to have a coordinated strategy for dealing with the pandemic. We didn't have that in the past."

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As HHS secretary, Becerra will "actually make progress for the American people" on healthcare issues, said Sen. Ron Wyden (D-Ore.). (Photo courtesy C-SPAN livestream)

In addition, Becerra will need to "move quickly to reverse some of those flawed policies of the Trump administration like junk insurance, barely worth the paper it was written on, the mindless restrictions that were placed on coverage, for example, that made it harder for people to get access to Medicaid," Wyden continued. "Some of what they did just defied common sense, making it tougher for people to enroll in the Affordable Care Act."

Wyden also pointed out Becerra's experience as a member of the House Ways and Means Committee, "the committee of jurisdiction as it relates to these issues, and then he has been in California, taking on monopolies, fighting those who would rip off the healthcare system, sticking up for the Affordable Care Act. So he's had frontline experience on these issues."

But Sen. John Barrasso, MD (R-Wyo.), disagreed. He pointed out that although he had previously voted to confirm Sylvia Burwell, President Obama's nominee for HHS secretary, "that's not the kind of nominee that we have this time. In the middle of a crisis, President Biden has chosen someone who is, in my opinion, both unqualified and unfit for this specific job ... As a doctor, I'm deeply concerned that President Biden has nominated someone with no medical or public health experience. He's not a doctor, not a scientist, not a public health official. He's a trial lawyer and a career politician. A global pandemic is no time for on-the-job healthcare training. The secretary must be ready on day one."

Barrasso also said Becerra was "radically liberal in his positions. Attorney General Becerra is the most left-wing nominee for this job, in my opinion, in history." As an example, Barrasso noted that Becerra "supports Medicare for All, which would ban private health insurance -- 180 million people who get their healthcare through their jobs would lose it." He also cited Becerra's position on abortion. "During his 24 years in Congress, Attorney General Becerra voted against every restriction on abortion ... This record has earned him a 100% rating from Planned Parenthood."

Barrasso pointed out that as California's attorney general, Becerra sued the Trump administration more than 120 times, including nine lawsuits filed on Trump's last day in office. "When you look at the record, it's clear -- Xavier Becerra is out of touch with the views of the American people," Barrasso concluded. "During this pandemic, we need a leader for the Department of Health and Human Services who brings us together as a nation. Instead, the president has chosen a nominee with no public health experience and an extremely partisan record. So I urge my colleagues to reject this unqualified, incredibly liberal nominee."

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Becerra is the most left-wing nominee for HHS secretary in history, said Sen. John Barrasso, MD (R-Wyo.). (Photo courtesy C-SPAN livestream)

These divisions between Republicans and Democrats also played out during Becerra's nomination hearings, especially on the abortion issue. "Could you name one abortion restriction you might support?" Sen. Steve Daines (R-Mont.) asked during Becerra's second nomination hearing, which was held by the Senate Finance Committee. Becerra wouldn't answer directly. "I have tried to make sure that I am abiding by the law, because whether it's a particular restriction or whether it's the whole idea of abortion, whether we agree or not, we have to come to some conclusion, and that's where the law gives us a place to go," he said.

Daines tried several more times to pin Becerra down, asking whether he would support a ban on "lethal discrimination" against fetuses diagnosed with Down syndrome, or a ban on sex-selective abortions, or late-term abortions. "You're asking questions which will touch on aspects that I know have different views," Becerra answered. "I will make sure I'm respecting the law on those issues."

Democrats, meanwhile, had plenty of praise for Becerra. "While the Trump administration ignored crises that impact public health like this pandemic, climate change, and systemic racism, Attorney General Becerra has taken them on," said Sen. Patty Murray (D-Wash.), chairman of the Senate Health, Education, Labor, & Pensions (HELP) committee, at her committee's hearing the day before. "He has held companies accountable for flouting COVID-19 safety rules and putting workers at risk ... And he has worked throughout his career to advocate on behalf of communities of color across health, immigration, education, and more. Overall, his record tells a story that is clear, compelling, and persuasive."

In the end, the Finance Committee split 14-14 -- along party lines -- on favorably reporting Becerra's nomination to the Senate floor, forcing Senate Majority Leader Chuck Schumer (D-N.Y.) to call for a floor vote on the nominee.

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    Joyce Frieden oversees ľֱ’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.