Xavier Becerra was confirmed as HHS secretary Thursday afternoon by a razor-thin margin. The former California attorney general now takes the helm as the country attempts to improve the distribution of coronavirus vaccines and the Biden administration works on building up the Affordable Care Act.
The 50-49 vote in the Senate was almost entirely along party lines. The only Republican to cross the aisle was Sen. Susan Collins of Maine. Sen. Mazie Hirono, D-Hawaii, did not vote.
Becerra has the support of payer and provider groups including the American Hospital Association and American Medical Association.
It followed a committee vote Wednesday to send another top health official's nomination to a full vote. Rachel Levine, who got the bid for assistant secretary of HHS, will be the first openly transgender official to be up for a Senate confirmation.
Becerra is the first Latino to head HHS, as President Joe Biden has made a more diverse Cabinet a priority of his administration.
I’m honored and humbled by today’s vote in the Senate. Thank you. I’m ready to get to work at @HHSgov.— Xavier Becerra (@XavierBecerra) March 18, 2021
Becerra led the charge to defend the ACA against a challenge from a coalition of red states that argued the law was unconstitutional without its individual mandate. That case is still pending before the U.S. Supreme Court.
During his nomination hearings he received pushback from Republicans chiefly for his pro-abortion rights stance. GOP members also questioned his lack of clinical experience, although most recent former HHS secretaries have also not been doctors.
Democrats defended his experience, pointing to the duties running the huge California department of justice and his 12 terms in the House, including his time on the Ways and Means Committee.
Becerra in his two Senate confirmation hearings stood behind his past actions to combat provider consolidation and anti-competitive practices. He said he has "taken on drugmakers and hospitals who unfairly jack up prices on patients."
But he was less eager to stump for his previous support of "Medicare for All," reminding senators that he serves at the pleasure of the president and Biden does not support a single-payer healthcare system.
Becerra will now take a position of which Sen. Ron Wyden, D-Ore., said "There may not be a higher-stakes job in the executive branch outside the president's." His job will include overseeing the continued rollout of the coronavirus vaccines and carrying out Biden's healthcare agenda.
The president campaigned on a public option, which could dramatically increase the percentage of insured Americans. Hospitals, however, would lobby heavily against such a policy, as it would mean more coverage at Medicare reimbursement rates, which are lower than commercial insurance payouts.
Biden also wants to build on the ACA, work that has already begun with the $1.9 trillion relief legislation he signed last week. That bill included increased subsidies for plans bought on the exchanges and changes that will make it easier for holdout states to expand Medicaid eligibility.