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Biden HHS Pick Becerra Assures Republicans on Medicare for All (1)

Feb. 24, 2021, 8:16 PM; Updated: Feb. 24, 2021, 9:32 PM

Xavier Becerra, President Joe Biden’s pick to lead the Department of Health and Human Services, assured senators Wednesday that as HHS secretary he will build on the existing private sector insurance scheme in the U.S. rather than push for Medicare for All.

When he was a member of the House, Becerra championed the government-run health program that would cover all Americans, a shift that would effectively wipe out the private-sector health insurance industry.

“The most important thing is to give everyone in this country coverage, good coverage,” Becerra, now California’s attorney general, said in response to a question from the Senate Finance Committee’s top Republican, Sen. Mike Crapo (R-Idaho). “I’m here at the pleasure of the president of the United States. He’s made it very clear where he wants to build on the Affordable Care Act. That will be my mission.”

Crapo said he appreciated the response. “I strongly support private insurance so patients can choose the coverage option that best meets their needs,” he said in an opening statement, adding he and Becerra had spoken privately about the need to maintain the nation’s current system while building on it.

The health-care industry pushed back on proposals favored by some Democrats during the presidential campaign to replace private insurance with Medicare for All or to supplement it with a public option. Industry groups from health insurers, hospitals, and drugmakers are united in their opposition to single-payer public health insurance.

Stock prices in health insurance companies took noticeable dives during the presidential campaign when it appeared a supporter of Medicare for All had a leg up on other Democratic candidates.

Wednesday’s appearance before senators was Becerra’s second in as many days. He testified before the Senate Health, Education, Labor, and Pensions Committee Tuesday, where Republicans were apprehensive about his qualifications.

The Finance Committee is tasked with formally approving an HHS secretary, an act that sets up a Senate floor confirmation vote. HHS nominees typically also appear before the HELP Committee as a courtesy because the activities of the agency fall within both panels’ jurisdictions.

The questioning of Becerra comes at a crucial point for the nascent Biden administration. The death toll for the Covid-19 pandemic has passed the 500,000 mark, and the HHS’s key agencies are working with acting officials because almost all of their leaders still await Senate confirmation.

Republicans Keep Powder Dry

Crapo didn’t state how he would eventually vote on Becerra’s nomination, but his statement was mild compared to some of the others from Republicans saying Becerra is unqualified.

“The opposition here, in my view, is just flailing around,” Sen. Ron Wyden (D-Ore.), chair of the Finance Committee, said in a call with reporters Feb. 22. “They’ve done their best to try to find something that could stick in terms of their opposition, but there’s really just no there there, and I want to get him in there as quickly as possible to turn the tide of the pandemic.”

Wyden said no Democrats have expressed concerns to him about Becerra’s nomination.

Senate Majority Leader Mitch McConnell (R-Ky.) said Tuesday that he was almost certain to oppose Becerra, but multiple GOP members of the HELP committee, including its top Republican, Sen. Richard Burr (R-N.C.), stopped short of saying they would vote “no” when his nomination reaches the floor. They did express concerns about his views on abortion and Medicare for All and his lack of experience in the medical field.

Staying Solvent

Senate Republicans during both hearings pressed Becerra on how to preserve Medicare’s financing, asking him how the government could expand public insurance programs without compromising coverage for seniors.

Becerra both days said any changes, including Biden’s call to buy into Medicare-like public insurance options, wouldn’t use the Medicare Trust Fund, which includes the payroll tax-support fund that supports Medicare’s hospital services coverage. That fund is expected to become insolvent, meaning the program wouldn’t have enough revenue to pay for all claims, by 2026.

“Our seniors who paid into Medicare should not be harmed by our need to come up with policy recommendations and solutions,” Becerra said.

Health Equity

Becerra said he’s committed to health equity issues that have come to the fore during the pandemic and the national reckoning over structural racism. He pledged to increase diversity in clinical trials and improve the diagnosis of dementia among Black and Latino people.

He also said that federally-funded health clinics are “indispensable” in getting Covid-19 vaccines to underserved communities. Biden’s administration has expanded vaccine distribution to the clinics for low-income people.

“Too many people are missed, they fall through the cracks,” Becerra said. “With community clinics able to help provide the vaccines, that makes it more possible for many of our families who’ve often been left behind to actually get the care and the protection they need.”

Recusals

Becerra also promised that if confirmed, he would recuse himself from all lawsuits he has been involved in as California’s attorney general. He is named in several that involve the HHS under President Donald Trump.

Becerra led the fight to preserve Obamacare in a case currently before the Supreme Court. He’s also part of a high-profile lawsuit against the Trump administration over the Affordable Care Act’s contraceptive mandate.

Becerra served 12 terms in Congress and has spent the past four years as California attorney general. He could face a close confirmation vote, particularly because in his role as the Golden State’s top lawyer he sparred with the Trump administration over key questions on Obamacare and abortion.

The Senate is equally split between Democrats and Republicans, and centrist Republicans like Sens. Susan Collins (R-Maine.) and Lisa Murkowski (R-Alaska) and anti-abortion Democrats such as Sen. Bob Casey (D-Pa.) and Sen. Joe Manchin (D-W.Va.) could mean the difference between being confirmed or rejected. Collins said Tuesday that she won’t make a decision on Becerra until after the hearings conclude.

If confirmed, Becerra would be the first Latino to lead the Department of Health and Human Services.

Becerra, 62, was born in Sacramento. He was the first in his family to graduate from college. He completed his undergraduate and law degrees at Stanford University.

(Updates with additional quotes and detail, starting in the fifth paragraph.)

To contact the reporters on this story: Shira Stein in Washington at sstein@bloomberglaw.com; Alex Ruoff in Washington at aruoff@bgov.com ;John Tozzi in New York at jtozzi2@bloomberg.net

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloombergindustry.com; Alexis Kramer at akramer@bloomberglaw.com

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