HHS Nominee Becerra Talks About Biden Medicare Buy-In Plan Thinking

Members of a Senate panel talked mainly about non-insurance topics Tuesday at a hearing on Xavier Becerra, the man nominated to be President Joseph Biden's Health and Human Services (HHS) secretary. The Senate Health, Education, Labor and Pensions (HELP) Committee was the first of two Senate committees to schedule Becerra nomination hearings. The Senate Finance Committee is preparing to holding a hearing of its own on the Becerra nomination around 2 p.m. today.

Xavier Becerra: California's Attorney General

Becerra was born in Sacramento, California, in 1958. He earned a bachelor's degree and a law degree at Stanford University. He served as a member of the California State Assembly from 1990 through 1992, then spent 24 years representing California in the U.S. House. While Becerra was in the House, he served on the House Ways and Means Committee, and on the committee's health, oversight and Social Security subcommittees. Since January 2017, Becerra has been the attorney general of California. He has led efforts by states that support the Affordable Care Act to defend the ACA against efforts by states that dislike the law to have the entire law thrown out by the court. The U.S. Supreme Court heard oral arguments on that case, Texas v. California, in November and is expected to issue a ruling in June.

The Senate HELP Hearing

The Senate HELP Committee has succeeded at developing legislation, including the text at the heart of the new No Surprises Act, on a bipartisan basis, and the mood at the hearing was cordial. But several Republicans on the committee said they wanted to hear more evidence that Becerra knows enough about health policy to run HHS. Sen. Bill Cassidy, R-La. — a medical doctor who went against the Republican majority to vote for impeaching former President Donald Trump — was one of the Republican senators who expressed doubts. "You're a very highly trained attorney, great impeccable credentials," Cassidy said. "I'm a physician. What would you as the attorney think if i the physician were nominated to be the United States attorney general"

Insurance Discussions

Participants in the confirmation hearing referred to Medicaid only twice during they hearing. They talked about Medicare only briefly and did not talk at all about technical health insurance issues, such as reinsurance or federal risk-adjustment program. They used the word "risk" several times, but never in connection with insurance. Becerra himself said during his opening remarks that he saw the importance of health insurance first-hand when he was a child, when his mother was rushed to the hospital after hemorrhaging at home. His mom recovered and is still alive today, at the age of 87, but, from a financial perspective, "we were blessed," Becerra said. "My dad, the laborer, had insurance through his union labor's Local 185. We didn't have much, but we didn't have to face the threat of unpaid medial bills." Sen. Chris Murphy, D-Conn., talked to Becerra about ways to enforce existing federal behavioral health rules that were supposed to make it as easy for patients to see psychologists and counselors' as it is for patients with ailments such as strep throat to so sectors. Becerra has expressed support in the past for moving the United States to an all-government-run health insurance system, but he talked at the hearing in support of building on the current system. Sen. Mitt Romney, R-Utah, asked Becerra whether the idea of letting younger people buy into Medicaid makes sense now, given that the Medicare hospitalization plan trust fund is close to being insolvent. "Transparency is a piece of this, but some of this is also just anti-competitive practices amongst providers and insurers," Romney said. "What can the federal government do here to try to have a functional marketplace in which prices are going down rather [than up]." Becerra said he thinks price transparency would help. "If consumers knew what they were paying, they would really push to make sure prices go down," Becerra said. But Becerra added that there are limits on how much price transparency can help, because the patients who need the most expensive care are usually the people least able to shop for care. Becerra said the Biden administration would expect to use general government resources to pay for any efforts to expand access to coverage by letting some people "buy into Medicare." Any new program would be separate from the traditional Medicare program and would not tap into the Medicare trust fund, he said.