Why Xavier Becerra Is a Smart Pick to Run HHS

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At something of a gallop, the Senate is, after weeks of delay, now holding hearings on Biden’s remaining cabinet nominations. Several of the nominees are, not surprisingly, running into significant GOP opposition.

This week California’s attorney general, Xavier Becerra—who served as a 12-term representative from Los Angeles before being elected to his current position in 2016—has been appearing before Senate committees to answer questions relating to his nomination as secretary of Health and Human Services.

Unlike Neera Tanden, whose nomination as director of the Office of Management and Budget has run into opposition from at least one Democrat as well as Republicans, Becerra is likely to survive the confirmation process. But he may well end up being confirmed on an almost entirely party-line vote. GOP senators have no love for the man. They have attacked him for defending California’s tough coronavirus lockdown policies, and they have critiqued his positions on abortion access and on requiring insurers to provide contraception coverage.

That Becerra would prove to be something of a lightning rod should not be surprising. As California AG, he sued the Trump administration more than 100 times, and as a result emerged as one of the most important politicians in the country in slowing down the worst of Trump’s anti-immigrant, anti-environment, and anti–Affordable Care Act agendas. To highlight just a few of these cases: Becerra’s team fought Trump’s infamous child separation policy at the border; they argued against ending DACA and the Temporary Protected Status program; and they sought to maintain California’s long-standing waivers allowing it to impose on automakers tougher fuel efficiency and emissions standards than those nationally mandated.

But it was Becerra’s dogged efforts to protect the Affordable Care Act—and to maintain California’s ability to bring millions of previously uninsured residents under its umbrella—that pushed him to the fore when Biden was deciding whom to nominate as his HHS secretary.

At a time when conservative states, led by Texas, along with the federal government were urging the US Supreme Court to declare the entire ACA unconstitutional, California—which had used the law and its own insurance exchange to reduce the percentage of its population that was uninsured from upwards of 17 percent to roughly 7 percent—marshaled an alliance of states to aggressively defend the landmark legislation.

Becerra pushed hard to defend contraceptive coverage at a time when the Trump team was seeking to carve out religious exemptions, and to provide legal cover for California’s efforts to bring the undocumented under the social safety net—especially when it came to expanding health care access. In 2019, the state set up a funding system parallel to the federal government’s so that it could include undocumented children and young adults within the Medi-Cal system. And, until the Covid-19 crisis generated massive budgetary uncertainties for the Golden State, legislators were working to expand eligibility to include undocumented seniors and, ultimately, the entire undocumented population.

GOP critics argue that this background is irrelevant at best and harmful at worst—that Becerra doesn’t have enough public health experience to take the HHS helm during an unprecedented pandemic, when it is critical that we control the spread of Covid variants and ensure rapid and wide distribution of vaccines.

In this, though, they miss the point. President Biden has already created an A-team around public health priorities. His administration has from the start listened to and acted on the recommendations of experts in solving the myriad, complex challenges of the pandemic. What Becerra brings to the table isn’t so much a public health background as a strong commitment to using the law and regulatory tools to move the polity forward on issues of social equity and inclusive access to vital parts of the social safety net.

Becerra’s tenure as California AG has overlapped with years in which the state, along with its coastal neighbors Oregon and Washington, led the way nationally in providing safety net protections to poor and undocumented residents. California not only expanded Medi-Cal; it also set up cash assistance programs during the pandemic aimed at undocumented residents and others left out of federal programs. Washington state ratcheted up its unemployment insurance payments during the pandemic and, like California, began sending cash payments to out-of-work laborers who lacked legal status and thus couldn’t claim federal benefits. So, too, Oregon created a $10 million fund for unemployed and undocumented workers.

These are priorities that augur well for Becerra as HHS secretary, in terms of coordinating with the states to gain control over the Covid disaster. We will not snuff out the pandemic until we vaccinate minority communities; expand the ACA so that millions of low-income families are finally provided regular, affordable health care; and ensure health care coverage and vaccination for the millions of undocumented residents who now live in the shadows. West Coast political leaders have realized this. Hopefully the federal government will now also throw its weight behind the notion that public health is part of a broader package of safety net programs—that if you want to have a healthier country, you must not only expand health care coverage but also strengthen the entire social safety net.