Senate Narrowly Confirms Single-Payer Proponent to Lead HHS

March 19, 2021

With a 50–49 vote, the tightest margin for any of Biden Cabinet pick to date, the Senate confirmed California Attorney General Xavier Becerra to be Secretary of Health and Human Services.  Meanwhile, House progressives reintroduced legislation to create a government-run single-payer health system.

Becerra will have significant regulatory authority to reshape the ACA and the ability to provide greater flexibility to states to implement their own single-payer systems.  His immediate focus will be implementing new surprise billing and transparency rules which could have a significant impact on employer health plans.

Progressive Democrats reintroduced their Medicare for All plan to achieve universal health coverage, which they claim is more urgent after the COVID-19 pandemic exposed and exacerbated disparities in the U.S. health-care system.  The bill has the support of more than half of House Democrats and has new commitments from party leaders to hold hearings on the measure.

While Becerra has previously supported Medicare for All, during his confirmation hearing he said he would support the policies President Biden ran and won on, which include a public option and shoring up and expanding the ACA. 

Outlook:  Although the bill has little chance of clearing this Congress, Democrats hope to include parts of the plan in the next fast-track reconciliation bill including a lower age limit for Medicare and enabling HHS to negotiate drug prices.