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Image: California Attorney General Xavier Becerra
California Attorney General Xavier Becerra speaks in Sacramento, California on Feb. 20, 2018.Rich Pedroncelli / AP

The surprise pick on Joe Biden's incoming health care team

Managing health policy is obviously a key part of the HHS secretary's job, but as Xavier Becerra is about to demonstrate, it's not the only part.


President-elect Joe Biden's transition office this morning unveiled the incoming administration's health care team, and the list isn't short on impressive members. (It also doesn't include any weird and unqualified television personalities, reinforcing the fact that the team will be superior to the status quo.)

Dr. Vivek Murthy is poised to return as the nation's surgeon general; Dr. Rochelle Walensky will take the reins at the Centers for Disease Control and Prevention; Dr. Marcella Nunez-Smith will chair the COVID-19 Equity Task Force; Dr. Anthony Fauci will serve as the incoming president's chief medical adviser while maintaining his current NIH role; and Jeff Zients and Natalie Quillian will oversee the White House's COVID-19 response.

But those weren't the names that came as a surprise to the political world overnight. NBC News reported this morning on Biden's decision to choose California Attorney General Xavier Becerra to lead the Department of Health and Human Services.

Becerra, 62, served 12 terms in the House of Representatives and was a vigorous defender of the Affordable Care Act who led the defense of the law in the Supreme Court last month. If he is confirmed, he would be the first Latino to lead the massive department as the incoming administration tries to elevate more diverse candidates to front-line positions.

For those unfamiliar with Xavier Becerra's career trajectory, he's been an interesting guy to watch over the years. After a stint as a state legislator, the California Democrat was elected to Congress in 1992 at the age of 34, and he slowly climbed the ranks, reaching the House leadership in 2013 -- a decade after arriving on Capitol Hill -- as chair of the House Democratic Caucus.

After Kamala Harris arrived in the Senate, Becerra surprised many by giving up his congressional seat and heading home to become state attorney general. Now he's poised to head back to D.C. as the new secretary of Health and Human Services.

To be sure, Becerra wasn't an obvious pick for this cabinet post, and in recent weeks, he wasn't rumored to be in contention for the job. Indeed, at first glance, there may appear to be a disconnect between serving as a state attorney general and leading HHS.

But it's worth emphasizing just how much experience Becerra has with health care. In Congress, he was on the House Ways & Means Committee and played a leading role in passing the Affordable Care Act. (Remember the February 2010 White House Health Care Summit? That was Becerra quarreling with Paul Ryan at the table.)

More recently, when Republican state attorneys general and the Trump White House launched a renewed effort to destroy the ACA through the courts, it was Becerra who took the lead to defend the health care law in court.

The L.A. Times added this morning that Becerra "also has carved out an increasingly important role confronting healthcare costs, using his position to challenge pricing practices at Sutter Health, one of California's most powerful medical systems. And he has become a leading champion of reproductive health, going to court repeatedly to challenge Trump administration efforts to scale back women's access to abortion services and contraceptive coverage."

NBC News' report added that as state A.G., Becerra also increased access to COVID-19 treatments and spearheaded legal challenges to opioid manufacturers.

All of which is to say, managing health policy is obviously a key part of the HHS secretary's job, but it's not the only part.