(Updates with quotes from New Mexico Health Care Association executive director in 11th-13th paragraphs.)
President-elect Joe Biden’s health team is shaping up as a competition largely between Obama administration alumni who stayed in Washington and those who joined state health agencies.
Biden, who made fighting the coronavirus and expanding health care top campaign priorities, faces a steep climb for central parts of his agenda, including expanding the Affordable Care Act’s insurance subsidies and creating government-run insurance. Democrats’ majority has been narrowed in the House and control of the Senate remains undecided.
The new president will use his executive powers and lean heavily on the Department of Health and Human Services to achieve his goals by regulation and working with state governments, Democrats say. The Biden transition is looking to name state officials and former Obama administration staff to key Health and Human Services Department positions, people with knowledge of the transition team’s discussions said.
“Having somebody who knows about state-level needs, what governors are looking for, is going to be particularly important at HHS,” said Kathleen Sebelius, who led the department during the early years of Barack Obama’s administration.
The Biden transition has been vetting potential candidates for key positions at HHS and the president-elect is expected to announce his choice for HHS secretary in coming weeks, according to two people involved in the transition.
New administrations typically refrain from naming anyone to key positions, including agency heads, before declaring who will head that agency, Sebelius said.
The transition is eyeing two state officials for key health policy jobs: New Mexico Gov. Michelle Lujan Grisham (D) and North Carolina HHS Secretary Mandy Cohen, seven people with knowledge of the team’s plans said. They’re also considering former Surgeon General Vivek Murthy and Chiquita Brooks-LaSure, a former HHS official who helped lead the department’s steps to carry out the ACA.
Murthy, Lujan Grisham, and Brooks-LaSure didn’t respond to requests for comment.
They’ll likely work alongside Obama-era veterans who stayed in Washington during President Donald Trump’s terms, such as Christen Linke Young, Jonathan Blum, and Meena Seshamani. Lujan Grisham is the only official up for consideration as a top appointee who didn’t serve in the Obama administration.
Lujan Grisham also has served as New Mexico’s secretary of health, secretary of aging and long-term services, and as a member of the U.S. House of Representatives. She is a co-chair of the Biden-Harris transition team and has been nationally recognized for her aggressive response to the Covid-19 pandemic.
Lujan Grisham’s administration has taken a collaborative approach to dealing with the Covid-19 pandemic, said Vicente Vargas, executive director of the New Mexico Health Care Association, which represents long-term care facilities.
Lujan Grisham “seems to expect a lot” from her staff and Vargas had the perception that they have been working “24/7” during the pandemic. That would translate well to running the enormous bureaucracy of HHS, Vargas said, adding that she would “take the time and put in the effort to understand and learn that position.”
Vargas also said that Lujan Grisham’s experience being in New Mexico, which has a lot of “traditional rural values” would help her with work with Republican governors.
Former Surgeon General Vivek Murthy already co-chairs Biden’s coronavirus task force and is widely respected by Democrats.
Murthy was tapped to speak at the Democratic National Convention in August, where he criticized the Trump administration’s handling of the Covid-19 pandemic.
“Joe Biden is the man I trust to look out for my family, and the leader I know will heal this nation,” Murthy said at the convention.
Murthy’s nomination to be surgeon general drew opposition from some Republicans and the National Rifle Association because he viewed gun violence as a public health threat. That’s likely to come up again if he’s tapped to lead HHS.
North Carolina’s Cohen is seen by some within the transition team as an ideal choice for leading the Centers for Medicare and Medicaid Services.
Gov. Roy Cooper (D) picked Cohen to help persuade the state’s Republican-controlled legislature to expand Medicaid there, said Adam Searing, a Georgetown University professor and former director of the Health Access Coalition for the North Carolina Justice Center.
She could help prod more states to expand their Medicaid programs.
“These are complicated negotiations between the federal government and the state,” Searing said. “Having someone you can talk with and trust is important.”
Cohen, asked at a news conference about joining the Biden administration, told reporters she hasn’t been contacted by the transition team but would be “honored” to serve.
“I am focused here on making sure the folks in North Carolina stay safe, particularly around the holidays, and I’m going to keep focused on that,” she said.
Another top contender to lead the CMS is Chiquita Brooks-LaSure, who was a staff member for the House Ways and Means Committee and worked to get the ACA passed, then put the law in place as an official at the HHS and CMS’s Center for Consumer Information and Insurance Oversight.
Brooks-LaSure is a co-lead of Biden’s HHS agency review team.
Brooks-LaSure and Cohen are both considered Democratic health-policy all-stars, said Lauren Aronson, who worked with both during her time in the Obama administration. Both understand politics, policy, and bureaucracy, and they “know how to work to get things done,” she said.
Considering candidates like Brooks-LaSure and Cohen shows Biden “is serious about getting things done and really putting people with the capability and expertise to right the ship,” Aronson, a partner at Mehlman Castagnetti Rosen & Thomas, said.