Biden Transition News, Health Team, December 7, 2020

WHAT

On Monday, December 7, President-elect Biden announced the first members of his health team. Biographies for each individual are below.

 

Xavier Becerra, Secretary of Health and Human Services

Becerra is currently the Attorney General of California, a role he has held since 2017 (taking over from then- Attorney General Kamala Harris after her successful Senate run). He gained national notoriety for joining the legal case against Republican Attorneys General to overturn the Affordable Care Act when the Trump administration opted not to defend the law. The case was recently heard by the Supreme Court. As Attorney General, his office has also led notable litigation against hospital consolidation/anti-competitive behavior, supporting abortion rights, and challenging a number of high-profile suits against Trump administration policies. Becerra was the Democratic Party’s pick to deliver the Spanish-language response to President Trump’s 2019 State of the Union address.

Becerra’s nomination is considered a surprise. Following the 2020 election, Becerra was floated as a possible replacement for Vice President-elect Harris’ Senate seat and was reportedly considered for Biden’s Attorney General nomination. His name only became part of public speculation for HHS at the end of last week.

Becerra served in the House of Representatives from 1993 through 2017, representing parts of Los Angeles. Becerra rose high in the leadership ranks, to the fourth position behind Reps. Pelosi, Hoyer, and Clyburn, but ultimately departed the House after it became clear that those ahead of him were unlikely to be retiring. He served as Chairman of the Congressional Hispanic Caucus from 1997 to 1999. He was offered the position of USTR by President Obama but turned it down.

Prior to joining the House, Becerra served one term in the California State Assembly and as Deputy Attorney General for California. Becerra began his career as a lawyer for the Legal Assistance Corporation in Massachusetts, primarily working on cases involving individuals with mental disorders. Becerra earned his bachelor’s from Stanford University and his J.D. from Stanford Law School.

 

Dr. Vivek Murthy, Surgeon General

Murthy served as Surgeon General of the United States from 2014 through 2017 during the Obama administration. Murthy’s nomination was contentious, as Republican Senators targeted Murthy’s advocacy for treating gun violence as a public health issue. As Surgeon General, Murthy emphasized preventative measures based in physical activity, nutrition, and emotional well-being. He also issued a report on the ease of use and access of e-cigarettes among youth which drew criticism from e-cigarette proponents. Before being nominated for the role of Surgeon General, Murthy was appointed by President Obama to serve on the Presidential Advisory Council on Prevention, Health Promotion, and Integrative and Public Health in the Department of Health and Human Services.

Murthy has held a number of key advisory roles for the Biden campaign. Murthy co-chaired the “Unity Task Force” commissioned by Biden and Senator Bernie Sanders (I-VT) to develop recommendations for health care policy intended to appeal to all parts of the Democratic party, which became the basis for the party’s platform. Murthy is a member and co-chair of the Biden Transition’s Coronavirus Advisory Board.

In his first year at Harvard University, Murthy co-founded VISIONS Worldwide, a non-profit organization providing HIV/AIDS education in India and the U.S. Murthy also co-founded the Swasthya Community Health Partnership to train rural Indian women as community health workers. He is the founder and president of Doctors for America. Since leaving the position of Surgeon General, Murthy has been active addressing the problem of loneliness in the United States, arguing loneliness is widespread and severe enough to qualify as an epidemic. Murthy earned a bachelor’s from Harvard University, an M.D. from Yale Medical School, and MBA from Yale School of Management. He completed his Internal Medicine Residency at Brigham and Women’s Hospital in Boston.

 

Dr. Rochelle Walensky, Director of the Centers for Disease Control and Prevention

Walensky is the Chief of the Infectious Diseases Division at Massachusetts General Hospital, a Professor of Medicine at Harvard Medical School, and a practicing infectious disease physician at both Mass General and Brigham and Women’s Hospital. Walensky previously served as Chair of the Office of AIDS Research Advisory Council at the National Institutes of Health and as an advisor to the World Health Organization and UNAIDS. She is credited with motivating a policy of routine HIV screenings both in the U.S. and abroad.

Walensky’s research focuses on HIV/AIDS policy and strategies of cost-effective care in the U.S. and in resource-limited settings. Walensky currently serves as a member of the Department of Health and Human Services’ Panel on Antiretroviral Guidelines for Adults and Adolescents, the American Society for Clinical Investigation, and the American Association of Physicians. Walensky earned her bachelor’s from Washington University in St. Louis, her M.D. from Johns Hopkins School of Medicine, and her Master’s in Public Health from the Harvard School of Public Health.

 

Dr. Marcella Nunez-Smith, COVID-19 Equity Task Force Chair

Nunez-Smith is one of three co-chairs of the Biden Transition Coronavirus Advisory Board and is an Associate Professor of Internal Medicine, Public Health, and Management at Yale School of Medicine. She is also the Founding Director of the Equity Research and Innovation Center, Director of the Center for Research Engagement, Deputy Director of the Yale Center for Clinical Investigation, Core Faculty in the National Clinician Scholars Program, Research Faculty in the Global Health Leadership Initiative, Director of the Pozen-Commonwealth Fund Fellowship in Health Equity Leadership, and Co-Director of the Doris Duke Clinical Research Fellowship. Her research primarily focuses on health and healthcare equity for marginalized communities, including a focus on U.S. territories.

Nunez-Smith is chair of the community subcommittee of the ReOpen Connecticut Advisory Group giving expert advice to the state of Connecticut. She was the senior co-author of a paper studying state-level reporting on race and ethnicity of COVID-19 cases and outcomes, which found weak or lacking reporting from many states despite clear discrepancies in risk of death between different demographics. Nunez-Smith earned her bachelor’s from Swarthmore College, her M.D. from Jefferson Medical College, and her master’s in health sciences from Yale.

 

Dr. Anthony Fauci, Chief Medical Advisor on COVID-19 to the President

Fauci has served as director of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984 and is arguably the most prominent public health official responding to the COVID-19 pandemic. Fauci is one of the lead members of the Trump administration’s Coronavirus Task Force and has been at the forefront of the country’s  response to several viral diseases, including HIV/AIDS, SARS, the H1N1 swine flu in 2009, MERS, and Ebola. Fauci is one of the world’s most frequently cited scientists across all scientific journals and is known for his research into human immune system responses and has worked on strategies for therapies and immune reconstitution of patients with AIDS, as well as on a vaccine to prevent HIV infection. Biden is notably elevating Dr. Fauci within his own coronavirus response as he continues his official position as a career civil servant leading NIAID.

 

Jeff Zients, Coordinator of the COVID-19 Response Team and Counselor to the President

Zients is currently on leave from his position as CEO of the investment firm Cranemere. He served as Assistant to the President for Economic Policy and as the Director of the National Economic Council during the Obama administration from 2014 to 2017. Zients was Acting Director of the Office of Management and Budget (OMB) twice, first in 2010, and again in 2012. He was Deputy Director of OMB from 2009 to 2013 and concurrently served as the first Chief Performance Officer of the United States. Zients was tasked with leading the “tech surge” effort to fix the error-filled launch of healthcare.gov.

On the National Economic Council, Zients worked with the Department of Labor to finalize the Fiduciary Rule which required financial advisers to provide advice in their clients’ best interest, which faced criticism from some business groups and on Wall Street. He was also a proponent of the Trans-Pacific Partnership. Zients was the COO, CEO, then Chairman of the Advisory Board Company and was the Chairman of the Corporate Executive Board, earning his fortune through IPOs of these companies. He was the founder and managing partner of Portfolio Logic. He was a board member of Sirius XM Radio, Revolution Health Group, Best Practices, and Timbuk2 Designs until his Senate confirmation. After leaving the White House, Zients joined the board of Facebook but declined to seek re-election to the seat in 2020 due to disagreements over governance and policy decisions. Zients earned his bachelor’s from Duke University.

 

Natalie Quillian, Deputy Coordinator of the COVID-19 Response Team

Quillian was the Deputy Campaign Manager for the Biden Campaign. She served in the Obama administration in a variety of roles, starting at the Pentagon, before moving to the National Security Council (NSC), then the White House. Quillian was a Presidential Management Fellow and then Special Assistant to the Principal Deputy Undersecretary of Defense Policy at the Department of Defense until 2011. She joined the NSC first as Director for Defense Policy, then as Senior Advisor to the Deputy National Security Advisor. She became the Deputy Assistant to the President and Advisor to the White House Chief of Staff, a role she held from 2013 through 2017. In her role in the White House, Quillian was responsible for managing the White House response to gun violence and the prescription opioid and heroin epidemic. As Director of Defense Policy at the NSC, Quillian led the interagency work on U.S. nuclear weapons and ballistic missile defense policies and programs.

Quillian most recently was a partner at Boston Consulting Group, joining as a principal after leaving the Obama administration. She has also served on the J. William Fulbright Foreign Scholarship Board since 2017. Quillian served overseas at U.S. embassies in the Middle East and the U.S. Mission to NATO. She earned her bachelor’s from Middlebury College and her master’s in International Relations from the since-renamed Princeton School of Public and International Affairs.

 

IMPACT

Becerra’s nomination will require Senate confirmation and will be closely scrutinized by Republicans in the Senate, though it remains early to tell if his nomination will be challenged on a party-line basis. A few key points:

  • ACA front and center – Becerra’s nomination allows Democrats to put national focus on Republican efforts to overturn the Affordable Care Act in the courts. Becerra’s role in defending the law against a lawsuit filed by Republican Attorneys General that has found its way to the Supreme Court is his most notable health care credential at this point.
  • Abortion – Republicans are likely to highlight Becerra’s views on abortions as well as some of the legal actions his office has taken in that space. Becerra defended a California law that would require crisis pregnancy centers to tell their patients about the availability of state-offered services, including abortion – a law the Supreme Court ultimately struck down. Senator Tom Cotton (R-AR) has already come out against Becerra on the grounds of his abortion stances.
  • Medicare for All back in focus – Despite the Biden administration’s efforts to stay away from a Medicare for All debate, Becerra’s nomination likely puts that issue back in focus. Becerra repeatedly supported Medicare for All while in Congress and indicated in recent years his position had not wavered. Biden expressly opposed Medicare for All during the primary and has supported other approaches to expanding access to health care, including a public option.
  • Hospital consolidation – Becerra’s office took notable action to address hospital consolidation. Specifically, Becerra led an antitrust case against Sutter Health, the largest hospital system in Northern California, on the basis of anti-competitive behavior. Becerra’s office targeted contracting behaviors in which the system would only agree to contract with insurers when the entire system was included in-network. Last December, Sutter agreed to pay $575 million to settle the claims.
  • Cuba in focus? – During his tenure in the House of Representatives, Becerra traveled to Cuba and met with Fidel Castro. While not a health care issue, the sensitivity of American relations with that country could lead that issue to resurface.

Drs. Walensky and Murthy will also require a Senate confirmation. Walensky brings strong public health credentials to the role and lengthy experience working at one of the nation’s premier health institutions. However, Republicans are likely to scrutinize closely her perspective on the public health response to COVID-19, particularly as disputes over policies like mask mandates and lockdowns become common at all levels of government. Murthy is also likely to be scrutinized, with many Senators already having a track record of opposing his previous nomination.

In the remaining roles, for which Senate confirmation is not required, President-elect Biden brings a combination of public health expertise and previous service in federal government management. Dr. Fauci boasts a wealth of experience, though he carries the baggage of public disputes with key figures in the Trump administration. Dr. Nunez-Smith comes from an academic background, while Zients and Quillian bring federal experience. Republicans may be critical of Zients’ lack of health care expertise, given the role. In that vein, it may be notable that Zients as COVID-19 czar is not unlike the appointment of incoming Chief of Staff Ron Klain as Ebola czar by then-President Obama. The choice of Quillian, with a strong DoD background, signals the incoming administration likely sees a need for continued coordination and logistics support.

We can expect the incoming team to support a more robust and focused federal response to the COVID-19 pandemic, with an emphasis on clear unified government messages. Look for the CDC and the other advisors to highlight and dial up the volume on current and/or revised recommendations for schools, businesses, and local communities on how to respond to increases in COVID-19 cases.

 

RESOURCES

    1. Press Release via Biden Transition Website