WHO WANTS TO BE HHS SECRETARY? — Joe Biden's health secretary is set to become one of the most consequential figures of his new administration – assuming he can eventually find one. Rhode Island Gov. Gina Raimondo is a no, abruptly ending her candidacy just hours after those in Biden's orbit began referring to her as the lead candidate. New Mexico Gov. Michelle Lujan Grisham was once thought to be a top contender, yet has since fallen to the back of the pack despite the pleas of her allies in Congress. And former Surgeon General Vivek Murthy will be returning to his old job. (More on that below.) — The Biden transition team had hoped to announce its HHS picks as soon as this weekend, as part of a slate of senior health care appointments. But the last 48 hours appear to have scrambled the race for one of the biggest roles in a Biden administration that will immediately confront a worsening pandemic. "I think we're all confused," one person close to the transition told PULSE after Raimondo publicly dropped out, leaving the administration with no remaining obvious choice for health secretary. Other Democrats are taking comfort in the party's deep bench of health care experts, expressing confidence that the Biden team can still find plenty of highly qualified candidates to run HHS. "It's a staggeringly impactful job," said one former senior Obama HHS official. "I would assume there's no shortage of eager and appropriate nominees." — By this time in the prior two transitions, the HHS secretary was picked. Trump publicly announced Tom Price on Nov. 29, 2016, while Obama had picked Tom Daschle by mid-November 2008. What Biden defenders say: This transition has been complicated by 2020's unusual dynamics, like Covid-related logistics and Trump's election challenges, plus Biden's pledge to make his team diverse — an important goal that's made personnel decisions more complex. — But don't forget: Until the job is filled, nothing's final. Kathleen Sebelius said no to joining Obama's Cabinet in December 2008, only to reverse course and accept the HHS secretary nomination in February 2009 after Daschle's confirmation fell apart. WHAT IS SET: JEFF ZIENTS, MURTHY TO TAKE BIG ROLES — Zients, who helped lead the crash team to fix HealthCare.gov in 2013-2014, will play a similar role steering the Covid-19 response, POLITICO's Alice Miranda Ollstein and Tyler Pager reported. Biden also will tap Murthy to be surgeon general again, after a tenure that got started late — with the National Rifle Association helping hold up his nomination for more than a year — and ended early, when President Donald Trump fired Murthy about 20 months before his term was set to end. That said, PULSE expects Murthy to be the most super-charged surgeon general in modern history, with a direct line to the West Wing, after closely advising Biden through his campaign and becoming one of the president-elect's most trusted confidants on the pandemic. But he isn't the only doctor set to have the ear of the president… TONY FAUCI WILL BE A 'CHIEF MEDICAL ADVISER' — Biden said in a Thursday CNN interview that he spoke with Fauci earlier in the day and asked him to remain in his role at NIH and serve as chief medical adviser, POLITICO's Matthew Choi writes. Biden had pledged on the campaign trail to empower the longtime infectious disease expert, after Trump often discarded Fauci's advice. "I asked him to stay on the exact same role he's had for the past several presidents, and I asked him to be a chief medical adviser for me as well, and be part of the Covid team," the president-elect told CNN's Jake Tapper. WHAT PULSE WANTS TO KNOW: When Biden has a question on Covid strategy, who's going to be the final voice? Zients, Murthy, Fauci and the to-be-determined HHS secretary all could, presumably. ADD ONE MORE DOC TO THE MIX: MARCELLA NUNEZ-SMITH — A co-chair of Biden's Covid-19 advisory board, Nunez-Smith will take a key role in the administration's pandemic response focused on health disparities. The Yale professor is an expert on health care inequality — an area that the incoming administration has made a focus amid a health crisis that's disproportionately affected communities of color. "Folks who are African Americans and Latinos are the first ones hurt when something happens, the last ones to recover," Biden said Thursday on CNN. "They need the help and they need to get it immediately."
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