Members of the Senate voted 50-49 Thursday to confirm Xavier Becerra as the secretary of the U.S. Department of Health and Human Services (HHS).
Becerra will oversee a department that regulates activities that account for more than $4 trillion in annual U.S. spending and about 18% of the U.S. gross domestic product.
Becerra — who represented California from 1993 to 2017 in the U.S. House, and who has been California's attorney general since 2017 — will now oversee the agencies that run Medicare, Medicaid, aging programs outside Medicaid, medical research programs and the U.S. response to the COVID-19 pandemic.
The Vote
The vote was split mostly along party lines, however, Sen. Susan Collins, R-Maine, crossed party lines to vote for Becerra. Sen. Mazie Hirono, D-Hawaii, was absent due to a family emergency.
Some Republicans accused Becerra of lacking the health policy experience to be the HHS secretary.
Sen. Bill Cassidy, R-La., a medical doctor, said during the Senate Health, Education, Labor and Pensions Committee hearing on the Becerra nomination that he believes Becerra has impeccable credentials as an attorney but not as an HHS official.
Not all votes have been split. On Wednesday, for example, all 49 Republicans voted yes on the nomination of Katherine Tai to be the U.S. trade representative.
Republican senators voted 32-17 Tuesday in favor of Isabella Casillas Guzman, Biden's Small Business Administration administrator nominee,
The HHS Hierarchy
The last confirmed HHS secretary was Alex Azar II, who held that position under former President Donald Trump.
Norris Cochran, a career HHS employee, has been filling in as the acting HHS secretary since Azar left the post.
The last confirmed HHS secretary to serve under a Democratic president was Sylvia Mathews Burwell. Burwell is now the president of American University.
Becerra's Background
Becerra was born in Sacramento, California, and grew up there. He has a bachelor's degree in economics and a law degree from Stanford University.
Before Becerra began working as a government official, as a deputy attorney general in the California Department of Justice, he worked for a legal assistance organization in Massachusetts.
Now that he has been confirmed as HHS secretary, he will have to give up an interest in the New York Life Stable Value Guaranteed Interest Account, along with an interest in the T. Rowe Price Stable Value N common trust fund, according to an ethics agreement filed with the U.S. Office of Government Ethics.
Becerra's Views
Becerra was known in California for efforts to create a government-run, single-payer health care system.
President Joe Biden said while he was campaigning that he intends to expand access to health care by building on the current Affordable Care Act framework, rather than by replacing the current framework with a single-payer system.
Becerra said during Senate confirmation hearings in February that his goal will be to achieve Biden's goals, by strengthening the ACA system.
Industry Group Reactions
Insurance industry groups appeared to have had a cordial relationship with Kathleen Sebelius and Sylvia Burwell, the HHS secretaries while former President Barack Obama was in office, and with Azar.
Major groups expressed optimism about Becerra in statement's about his confirmation.
Matt Eyles, president of America's Health Insurance Plans, said AHIP shares the Biden administration's commitment to the idea that every American deserves access to affordable, high-quality care.