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 Becer­ra offers hope that the Depart­ment of Health and Human Ser­vices won’t active­ly fight against sin­gle-pay­er at the state lev­el, and may even tar­get some of the health­care sector’s more egre­gious busi­ness prac­tices. (Photo by Justin Sullivan/Getty Images)

Becer­ra offers hope that the Depart­ment of Health and Human Ser­vices won’t active­ly fight against sin­gle-pay­er at the state lev­el, and may even tar­get some of the health­care sector’s more egre­gious busi­ness prac­tices. (Photo by Justin Sullivan/Getty Images)

Biden's HHS Pick Will Be In a Position to Finally Take On the Healthcare Industry

Xavier Becerra has been a longtime supporter of Medicare for All and has shown willingness to confront pharmaceutical monopolies. There’s a lot he could do to make U.S. healthcare more progressive.

Natalie Shure

 by In These Times

On Mon­day, Cal­i­for­nia Attor­ney Gen­er­al Xavier Becer­ra was nom­i­nat­ed to serve as Pres­i­dent-elect Joe Biden’s Sec­re­tary of Health and Human Ser­vices (HHS), the fed­er­al agency that over­sees health­care and many immi­gra­tion pro­grams. Unlike oth­er nom­i­nees or poten­tial can­di­dates such as Rahm Emanuel, Bruce Reed and Neera Tanden who have been met with out­rage from the Left, the response to Becerra’s announce­ment has large­ly been pleas­ant surprise. 

Rep. Ro Khan­na (D‑Calif.) tweet­ed, ​“He is a strong choice and has always worked well with pro­gres­sives.” Zephyr Tea­chout, a for­mer cam­paign sur­ro­gate for Bernie Sanders, gushed ​“I am gen­uine­ly excit­ed about the Becer­ra choice.” As a long­time sup­port­er of a sin­gle-pay­er sys­tem whose AG tenure has focused dogged­ly on health­care, Becer­ra may well be poised to use a pow­er­ful fed­er­al post to secure key pro­gres­sive gains. 

Becerra’s high­est-pro­file act as AG has been to defend the Afford­able Care Act against a spu­ri­ous right-wing law­suit, which would seem to fit well into Biden’s pro­fessed goal of defend­ing the ACA. It’s also easy to imag­ine HHS revers­ing sev­er­al of the Trump administration’s moves to weak­en the land­mark health law, which includ­ed trun­cat­ing the open enroll­ment peri­od, defund­ing nav­i­ga­tor pro­grams and adver­tis­ing, and expand­ing the sale of flim­sy short-term plans that skirt basic cov­er­age requirements. 

But it’s also easy to imag­ine ways in which HHS could go beyond straight­for­ward ACA fix­es under Becerra’s lead­er­ship. He sup­port­ed sin­gle-pay­er health­care leg­is­la­tion both as a mem­ber of the Cal­i­for­nia State Assem­bly in the 1990s, as well as in Con­gress, where he co-spon­sored Medicare for All bills in the House. Even after being tapped to replace Sen­a­tor-elect Kamala Har­ris as California’s AG in 2017, Becer­ra reit­er­at­ed his sup­port for pub­lic financ­ing of the health­care sys­tem, argu­ing that sin­gle-pay­er ​“takes away the inef­fi­cien­cies in a sys­tem that has turned health­care for peo­ple into a commodity.” 

While he’s report­ed­ly assured his future boss he won’t be push­ing for Medicare for All in office, his appoint­ment could nonethe­less be a boon for state-lev­el advo­ca­cy: Biden’s team has pre­vi­ous­ly indi­cat­ed open­ness to issu­ing waivers to allow states to real­lo­cate fed­er­al health­care fund­ing into a sin­gle-pay­er pro­gram — a process Becer­ra would be in charge of. As one of the strongest state-lev­el push­es for such an over­haul is tak­ing place now in Cal­i­for­nia, it’s hard to see Becer­ra reject­ing nec­es­sary waiv­er appli­ca­tions from his own state. 

It’s not just that he’s unlike­ly to obstruct state sin­gle-pay­er pro­grams. Becer­ra has also demon­strat­ed a will­ing­ness to use state pow­er to con­front the health­care indus­try — a rel­a­tive­ly low bar that many Democ­rats nonethe­less fail to clear. He filed suit against Sut­ter Health, a poster child for con­sol­i­da­tion whose sta­tus as a mega­corp allowed it to wield undue pric­ing pow­er and bilk patients. He also chal­lenged a Trump admin­is­tra­tion rule that sought to make it hard­er for home care work­ers to union­ize. This past year, he urged insur­ers to review their com­pli­ance with men­tal health par­i­ty laws, to make sure suf­fi­cient num­bers of providers are cov­ered by their plans. 

Cru­cial­ly, Becer­ra has also urged the use of ​“march-in rights,” a nev­er-used pro­vi­sion of the 1980 Bayh-Dole Act, to seize cer­tain phar­ma­ceu­ti­cal patents and break man­u­fac­tur­ers’ monop­oly on pro­duc­tion and pric­ing. Along with Sec­tion 1498 of the fed­er­al code — which grants even greater gov­ern­ment pow­er to break patents—these statutes could be key tools for an admin­is­tra­tion look­ing to advance health­care pre­rog­a­tives with­out the help of Con­gress. Even the mere threat of invok­ing march-in rights or 1498 could have sig­nif­i­cant rip­ple effects that curb pric­ing growth in one of the most prof­itable indus­tries on the plan­et, deliv­er­ing much-need­ed relief for patients strug­gling with stag­ger­ing costs.

Ulti­mate­ly, the Left can only expect so much to come from inside a Biden admin­is­tra­tion. But Becer­ra offers hope that the Depart­ment of Health and Human Ser­vices won’t active­ly fight against sin­gle-pay­er at the state lev­el, and may even tar­get some of the health­care sector’s more egre­gious busi­ness prac­tices. That’s not enough to alle­vi­ate the ram­pant suf­fer­ing at the hands of the pri­vate health­care indus­try, but com­pared to Alex Azar — the for­mer phar­ma exec­u­tive occu­py­ing the job now—it’s cer­tain­ly a start.

© 2021 In These Times

Natalie Shure

Natalie Shure is a writer and researcher in Boston. Her work focuses on history, health, and politics.

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