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Becerra Confirmed As HHS Secretary in Closest Vote Yet

The radically effective Xavier Becerra. Photo: Greg Nash-Pool/Getty Images

After perhaps the most heated debate involving any of Joe Biden’s Cabinet nominations, California Attorney General Xavier Becerra was confirmed as secretary of Health and Human Services by a 50-49 vote. Every Democrat, plus Republican Susan Collins of Maine, voted for Becerra (Hawaii Democrat Mazie Hirono was back home dealing with a family emergency). Becerra, a famously hard worker, spent seven terms in the U.S. House representing central Los Angeles before being appointed California’s Attorney General by then-Governor Jerry Brown when Kamala Harris was elected to the Senate. The son of Mexican immigrants, he becomes the first Latino to head up HHS.

Many Republicans opposing the confirmation claimed that Becerra lacked a background in health policy. This was a bit specious given his past experience on the House Ways & Means Committee, which has jurisdiction over Medicare — and given the central role health-care issues play in legal conflicts in California and nationally.

It’s likely that Becerra’s political problems on the health care front derive not from a lack of experience, but from the kind of experience he gained. As Ben Christopher of CalMatters explains, he was a fierce enforcer of anti-trust laws in this arena:

One of Becerra’s first moves as attorney general was to consolidate the state Justice Department’s health care antitrust work. In 2018, the new unit sued Sutter Health, securing a $575 million settlement and an agreement from the Sacramento-based hospital chain to end “all-or-nothing” contracting practices that would force insurers to purchase coverage at all of the chain’s hospitals and clinics, even if they aren’t needed or if cheaper local alternatives exist. Becerra’s office also blocked the consolidation of two other northern California hospital groups and imposed strict conditions on a Southern California deal.

But what’s gotten more attention from Republicans is that early in his career, Becerra expressed support for a single-payer health care system (a.k.a. Medicare For All). So, too, did Becerra’s predecessor as Attorney General, currently the Vice-President of the United States. Neither of them is going to dictate health care policy for the Biden administration.

There are two underlying reasons for conservative hostility to Becerra. The first and most obvious is that he’s a devil-figure to the anti-abortion movement, mostly because as Attorney General he was willing to prosecute anti-abortion activists (including those who conducted the famous “sting” interviews with Planned Parenthood staff without disclosing they were taping and editing the content for publication) who violated the law in their zealotry. But, in truth, any HHS nominee in a Democratic administration will be attacked for supporting judicially established reproductive rights that anti-abortion activists typically regard as genocidal. It is part of the bargain Republican pols have struck with the Christian Right to regard its bitterest enemies as their own; hence the heat towards Becerra for standard liberal views on the subject.

Perhaps an equally important factor in the GOP antipathy toward Becerra is that he was the great courtroom sparring partner of the Trump administration on a broad range of issues. When Trump and his appointees demonized the Golden State as a rogue jurisdiction run by business-hating hippies and threatened regulatory or legislative punishment, Becerra didn’t go into a defensive crouch. He aggressively went to court to fight the administration’s “regulations and rollbacks involving climate change, immigration, consumer rights and more,” as California reporter Byrhonda Lyons observed in January as Trump left office:

California filed 110 lawsuits against the Trump administration. The attorney general’s office won 23 and lost five. Six are on hold, and 76 are pending. So far, that’s an 82%-18% win-loss rate over the Trump policies that state officials contested. 

So when Republican senators denounced Becerra as “radical,” they mostly meant he was radically good at his job. He’ll need to be similarly effective at HHS, given its vast jurisdiction during the final stages of the battle against COVID-19 and Biden’s efforts to reverse the damage to health-care coverage Republicans have caused in Washington and the states.

Becerra’s confirmation leaves just three Cabinet posts unfilled: secretary of Labor (former Boston mayor Marty Walsh is the nominee), director of the Office of Science and Technology (Biden has nominated pioneering geneticist Eric Lander), and director of the Office of Management and Budget. Withdrawn OMB nominee Neera Tanden represents the only casualty Biden has suffered in Cabinet confirmations, and he hasn’t named a replacement yet. Becerra’s Senate vote was the closest so far. But the fact that, in addition to Collins, all those moderate Democrats voted for the “radical” Becerra is a good sign.

Becerra Confirmed as HHS Secretary in Closest Vote Yet