WASHINGTON – Up soon for President-elect Joe Biden: naming his top health care officials as the coronavirus pandemic rages. It's hard to imagine more consequential picks.
Already two Democratic governors seen as candidates for health and human services secretary have faded from the frame. Rhode Island's Gina Raimondo told reporters Thursday that she would not be the nominee and is staying to help her state confront a dangerous surge of COVID-19 cases.
New Mexico Gov. Michelle Lujan Grisham was offered another Cabinet post — interior secretary — and turned it down, a person close to the Biden transition said Wednesday. That person spoke on the condition of anonymity to discuss internal deliberations.
Members of the Congressional Hispanic Caucus made a fresh push during a virtual conference call Thursday for Biden to nominate Lujan Grisham as HHS secretary. One lawmaker, Rep. Ben Ray Lujan of New Mexico — a distant cousin of hers by marriage — told Biden’s team that news leaks about her turning down the interior job were inappropriate, according to a person on the call who spoke on condition of anonymity to discuss it. Biden's chief of staff, Ron Klain, agreed and said it should not have happened, the person said.
Biden is expected to announce his choice for HHS secretary next week. That person has to have “the confidence of the president, the ability to operate collaboratively across the government, credibility within the health care world, and the capacity to work with the states,” said former HHS Secretary Mike Leavitt, who served under Republican President George W. Bush.
In the running for a top health job is former Surgeon General Vivek Murthy, co-chair of Biden's coronavirus task force. Murthy has a soft-spoken demeanor and a reputation for consensus building. He's the author of a recent book addressing the human toll of loneliness, a problem that has become more widely recognized in the time of COVID-19.
Job prospects for the pandemic's most recognizable public figure — Dr. Anthony Fauci — are not in question. Biden told CNN he's making Fauci a chief medical adviser and a member of his COVID-19 advisory team. As the government’s top infectious-disease specialist, Fauci isn’t a political appointee, so he will also continue at his post heading the National Institute of Allergy and Infectious Diseases. Fauci's candor has drawn the ire of President Donald Trump.
Alongside his health secretary, Biden is expected to name a top-level White House adviser to coordinate the government’s extensive coronavirus response. Vaccines developed under the Trump administration will be delivered on Biden's watch, a massive undertaking that's bound to have its share of logistical problems. The leading candidate is widely seen as businessman Jeff Zients, an economic policy adviser in the Obama White House who was widely credited with rescuing HealthCare.gov after its disastrous launch in 2013.
Zients parachuted into HHS after the “Obamacare” website locked up on the first day of business, leaving millions of consumers frustrated and angry and creating deep embarrassment for then-President Barack Obama. After extensive reengineering, Zients and his team got HealthCare.gov running acceptably well, and the program managed to meet its sign-up target for 2014, the first year of coverage.
Keeping the focus on the virus, Biden is also said to be close to nominating a commissioner for the Food and Drug Administration and a director of the Centers for Disease Control and Prevention.
Under consideration for FDA are former deputy commissioner Dr. Joshua Sharfstein, who has also served as Maryland's health secretary, and Dr. Luciana Borio, a member of Biden's coronavirus advisory board who formerly held senior posts with the FDA and the National Security Council and has expertise in responding to disease outbreaks and bioterrorism.
Being considered for CDC director is Dr. Julie Morita, a top executive of the nonprofit Robert Wood Johnson Foundation, which works across a broad range of health care issues. Morita spent nearly 20 years in leadership jobs with the Chicago public health department, rising from medical director to commissioner.
It's unclear if Biden will move right away to name an administrator for the Centers for Medicare and Medicaid Services, the HHS agency responsible for the government's health insurance programs. CMS will play a central role in the new president's efforts to expand health insurance coverage. A number of former Obama administration officials are under consideration.
Health care will be a defining issue of Biden's presidency even after expected vaccines defuse the threat of COVID-19, former HHS Secretary Leavitt predicted. Addressing Medicare’s shaky finances will become an urgent priority before the end of the first term. The Congressional Budget Office projects that Medicare's giant trust fund for inpatient care will unable to cover expected costs in 2024.
“If that is the case, they are going to have to deal with it legislatively in 2021 or 2022,” Leavitt said.
Meanwhile, millions still don't have access to affordable insurance coverage. And racial and ethnic health disparities remain a festering source of preventable suffering. “The human services programs go through HHS," said Leavitt.
Associated Press writers Alexandra Jaffe and Lisa Mascaro in Washington and Michelle R. Smith in Providence, R.I., contributed to this report.