As Health and Human Services secretary, Becerra is an acknowledged Beltway embarrassment leading a decrepit yet overpowered department.
As Health and Human Services secretary, Becerra is an acknowledged Beltway embarrassment leading a decrepit yet overpowered department.
I n December 2019, the Los Angeles Times declared Centers for Medicare and Medicaid Services chief Seema Verma “a threat to public health.” The previously unknown health-policy consultant had become a bit of a media fixation since President Trump tapped her to run the nation’s health-care entitlements. Columnists salivated over the details of a reported feud between Verma and her then-boss, Secretary of Health and Human Services Alex Azar, while wannabe Woodwards reported on her alleged misuse of taxpayer dollars.
It was, without exaggeration, the most attention anyone has ever paid to CMS: possibly the most boring part of the federal government. And it was par for the course during the Trump administration, when the Department of Health and Human Services and its subsidiaries appeared at the center of every news cycle.
Now, no Googling: Do you know who runs CMS today? It’s okay if you don’t. I had to check twice. The fact is no one cares about HHS anymore. This was made brutally clear earlier this month when a damning Politico piece about current HHS secretary Xavier Becerra had the entire Beltway asking: “Wait, who?”
Becerra hasn’t fallen by the wayside because health care is no longer politically salient. Quite the contrary: The recent Inflation Reduction Act was in large part a drug-pricing bill, and everyone nowadays has an opinion about vaccines. Rather, the reason for Becerra’s relative obscurity is that the Biden administration has stopped talking about the HHS. Like Schrödinger’s cat or a Kardashian, HHS only matters when we’re staring at it. If we’re smart, we’ll keep averting our eyes.
In his Very Serious newsletter, Josh Barro notes that the Biden administration appointed Becerra to placate the Congressional Hispanic Caucus and is now sidelining him to keep the spotlight off his managerial and policy incompetence. But perhaps Becerra has been shunned for too long, as he seems to have forgotten Democrat Rule No. 1 and suggested that states do something to help Washington fight monkeypox. Becerra’s apostasy earned him the scorn of progressive activists, and the aforementioned Politico piece. But the interesting thing isn’t that Becerra is waking up to the glories of federalism; it’s that even he probably realizes his job is kind of a joke.
Since the Obama administration, we’ve tended to give undue attention to HHS secretaries. Obama’s health chiefs, Kathleen Sebelius and Sylvia Burwell, were immortalized in two landmark Supreme Court cases bearing their names, which upheld Obamacare’s individual mandate and expanded its subsidies, respectively. The Trump health team garnered even more media attention, albeit more critical in nature. The average New York Times subscriber should be forgiven for having thought, for a few years, that Tom Price was going to nuke Obamacare and Azar was going to sell the country to Pfizer. By the time Biden took office, federal health officials had attained an even higher level of national recognition. People rushed to make a demigod out of Dr. Anthony Fauci, an animal-testing advocate who believes he is the human embodiment of truth. Perhaps Fauci’s fame gave Biden cover to pick Becerra, who may have not even known the difference between Medicare and Medicaid, to lead the national health bureaucracy.
Whatever the reasons for his appointment, the White House quickly hid Becerra and his team under a bushel, and the HHS remained as it was. The FDA is still approving drugs too slowly, Medicare is still careening toward bankruptcy, and the CDC continues contradicting its own Covid guidance. All this is likely going to keep happening, regardless of who’s running HHS — or who’s in the White House, for that matter. Like the rest of the federal government, the Department of Health and Human Services is bloated, inefficient, and not going anywhere any time soon. Xavier Becerra’s disappearing act is a good reminder that, despite years of media attention, the department isn’t the driver of meaningful change. Republicans especially would do well to remember this as 2024 looms, and certain wings of the party fall prey to the seductive charm of the administrative state.
After all, even the best of Health and Human Services secretaries would still be twelfth in the presidential line of succession. Don’t place your hope for the future in someone who’s outranked by the secretary of agriculture.