HHS Nominee’s Lack of Public Health Experience Is a Concern

(Bloomberg Opinion) -- Even some progressives were perplexed when President Joe Biden nominated California Attorney General Xavier Becerra to be secretary of Health and Human Services.

“I would have liked to see the HHS secretary have public health experience,” Representative Pramila Jayapal, a Washington state Democrat, told Politico. The New York Times reported that it was “a surprise” and summarized his health experience as being “at the forefront of legal efforts on health care” and being “vocal in the Democratic party about fighting for women’s health.”

In other words: As California’s attorney general he opposed the Trump administration’s long-shot effort to get courts to strike down Obamacare, and as a congressman he earned 100 percent from Naral Pro-Choice America.

In his long career as a Democratic congressman and as California’s attorney general, Becerra built a strong record as a progressive, especially on social issues, which delights some Americans and appalls others. During the Biden transition, Becerra had been mentioned as a possible secretary of Homeland Security or attorney general. In 2008, President-elect Barack Obama reportedly considered him for U.S. trade representative. While Republicans might have dreaded seeing him in those positions, he was arguably qualified for them.

Running the largest department of the federal government is another story. Becerra has experience in battling Catholic nuns over their employee health plans. (And in losing to them.) But as someone without much background in health or health policy, he’s an odd pick to fix the Centers for Disease Control.

Of course, it’s not out of the ordinary that Biden would pick a Health and Human Services nominee who has an expansive view of abortion rights and a cramped one of religious liberty. That’s what you’d expect in a Democratic administration, and it was true of Obama’s two HHS secretaries as well.

What’s novel is choosing someone whose principal recommendation for the job is his culture-war zealotry. It’s as though President Donald Trump had chosen Rick Santorum to run HHS — except that Santorum has actually done a lot of work on health policy over the course of his career.

Opposing Becerra makes political sense for Republicans. Social conservatives are a crucial part of the Republican coalition, but a part that has long had doubts about the party’s commitment to defending their interests and values. Challenging a nominee who was selected more or less to be a thumb in their eye is one way to reassure and mobilize them.

Explanations for Trump’s strong support from Republican voters have, over and over, found that many of them wanted someone who would fight. The Becerra nomination presents a chance for Republican senators — whether they were foursquare behind Trump, ambivalent or opposed — to show that they are willing to fight.

It’s also an opportunity to make a broader point about today’s Democratic Party. Biden campaigned on waging a war against Covid-19 as much as on anything else. In office, though, he has selected a general who may be more eager to fight another war altogether. Public-health measures need buy-in across the breadth of our population, including from people who will see Becerra as a bitter foe.

If they decide to make a campaign of opposition, Republicans should find themselves relatively unified. Senator Susan Collins, the Maine Republican, often breaks with her party on votes related to social issues. But she too has expressed concern about Becerra’s lack of health-care chops.

Republicans could at the same time find fissures among the Democrats. Senators Joe Manchin of West Virginia and Bob Casey Jr. of Pennsylvania, both Democrats, sometimes vote with opponents of abortion, although Casey also tries to be a team player for his party. If Republicans can’t get Democratic votes, they can at least make voting politically costly.

Yet Republicans have been slow to engage against Becerra, focusing their opposition instead on Neera Tanden, Biden’s nominee for director of the Office of Management and Budget. Her nomination appears doomed since Manchin announced he will oppose her, citing the “overtly partisan attacks” she made on several senators.  It seems curious that the senators’ hurt feelings matter more than their voters, their positions on moral issues or health care.

There are any number of people who could plausibly serve as HHS Secretary in a Democratic administration. Plenty of former governors and prominent physicians would bring executive experience or knowledge of health care — or even both — to the job while satisfying the interest groups that have informal veto power over any Democratic president’s nomination for it. The Senate’s power of advice and consent would be well used prodding Biden to pick one of them.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Ramesh Ponnuru is a Bloomberg Opinion columnist. He is a senior editor at National Review, visiting fellow at the American Enterprise Institute and contributor to CBS News.

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