News : HHS’ Becerra eyes California governorship

Wednesday, April 10, 2024

HHS’ Becerra eyes California governorship

Apr 10, 2024

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By Ben Leonard and Chelsea Cirruzzo

Presented by the Healthcare Distribution Alliance

With Daniel Payne

Driving The Day

Xavier Becerra is pictured.

HHS Secretary Xavier Becerra could be looking to run for governor of California, according to people briefed on his deliberations. | Alex Wong/Getty Images

CALIFORNIA DREAMING — HHS Secretary Xavier Becerra is considering leaving the Biden administration to mount a run for California governor in 2026, people briefed on his deliberations told POLITICO.

Over the past weeks, Becerra and his supporters have had conversations where the secretary and former California attorney general indicated to fellow Democratic officials and operatives that he would leave Washington after the November election and join the crowded field to succeed Gov. Gavin Newsom in two years, POLITICO's Christopher Cadelago, Dustin Gardiner and Adam Cancryn report.

The people were granted anonymity to describe private conversations, which they characterized as more serious in recent weeks.

Becerra’s potential departure follows a sometimes tense relationship with the West Wing, which, on occasion, suspected he was ill-suited to manage the crises that defined a portion of the president’s first term.

President Joe Biden and his advisers weren’t expected to bring him back for a second term, though no official decision has been made. Some in the president’s orbit in recent months have speculated about who might be in the running for HHS secretary after November.

When asked by POLITICO at an event Tuesday in San Francisco if he planned to run, Becerra sidestepped the question.

“It’s a blessing to hear that someone is saying that I’m running for governor because I don’t know who they are,” Becerra said. “I am secretary of HHS and, by law, I have to be secretary of HHS and nothing else. So I’m gonna do my job as best I can,” he added.

When pressed, Becerra said he wasn’t making calls to supporters and then an aide abruptly cut off the questioning.

Still, Becerra has been an enthusiastic supporter of the administration and has traveled the country — including frequent stops in California — to promote the policies that are a cornerstone of Biden’s reelection campaign: Medicare drug price negotiations and record numbers for the Affordable Care Act. Of late, he has been especially vocal on protecting abortion rights.

Becerra presided over the health department during a historically difficult stretch. His early days were spent in the throes of the Covid-19 pandemic when the administration was managing an unprecedented campaign to distribute and administer new vaccines.

Simultaneously, HHS worked to rebuild enthusiasm for Obamacare, which had been denigrated and, at times, undermined during the Trump administration. Thanks, in part, to new subsidies approved by Congress and signed into law by Biden, enrollment has surged to more than a record 21 million.

Last year, Becerra’s department undertook implementation of the Inflation Reduction Act, announcing the first 10 drugs in the Medicare program that would be subject to price negotiations with the government. And Becerra, who has often talked about mental health care as a priority, oversaw the launch of 988, a three-digit number that routes callers in crisis to suicide prevention call centers.

But his early difficulties in managing an influx of children at the southern border in 2021 cost him influence in the White House, and subsequently, he’s rarely played a significant role in driving the policymaking decisions that shaped the administration's health agenda.

WELCOME TO WEDNESDAY PULSE. Rep. Tom Cole (R-Okla.) is poised to become the next Appropriations Committee chair. Reach us and send us your tips, news and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.

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Mental Health

Students stand behind a table.

Members of the Miami Arts Studio mental health club stand behind a table as they raise awareness on World Mental Health Day. | Rebecca Blackwell/AP

WHY AREN’T THE KIDS ALRIGHT? Government leaders are facing tough decisions when it comes to the mental health crisis among young people.

Despite not having robust data on the cause of the crisis, the elevated caseload is overwhelming health systems — and demanding new solutions from policymakers, Daniel reports.

The reason for skyrocketing rates of depression and anxiety in recent years is unclear. In a POLITICO survey, nearly 1,400 health providers who treat kids with mental illnesses offered varying ideas for what’s behind the crisis — and what policymakers should do about it.

Government leaders are forging ahead even though they don’t fully understand what’s causing the crisis, creating a host of new approaches. The measures differ from the solutions that have been core to mental health efforts — namely, building up the health care system’s capacity — but they won’t be enough to stem the tide, experts tell POLITICO.

Doubts about the adequacy of previous approaches have left government leaders nationwide desperate to determine — and stop — the crisis’ causes.

Government leaders’ solutions are coming in a number of forms, almost all aiming to intervene before mental health conditions worsen:

— Schools have added curricula to teach resilience and moved mental health care into school buildings.

— Technology has become a big part of the strategy to improve mental health.

— Online therapy, community-focused online spaces and even artificial intelligence have been employed to scale solutions — even as states and lawmakers go after social media companies.

— Primary care doctors are working to better integrate mental health care into their practices, and hospitals are opening facilities to handle mental health emergencies that would otherwise be routed to their emergency rooms.

But the new approaches aren’t without critics, who say the care sometimes gets ahead of the available evidence. Even some elected officials admit not all the initiatives may work out in the end — but contend the moment’s urgency requires action.

Others see a larger need beyond more comprehensive solutions in health, tech and health systems: transforming society to foster environments that prevent mental illness in the first place.

But how exactly lawmakers can reverse the mental health declines that came with major cultural, political and environmental changes over the past decade is a question that’s even more confounding than trying to fully understand the cause of the crisis in the first place, experts say.

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Abortion

ARIZONA COURT GREENLIGHTS ABORTION BAN — Arizona’s high court upheld an 1864 law barring abortions at any point in a pregnancy, save for if a patient’s life is in danger, POLITICO’s Alice Miranda Ollstein and Megan Messerly report.

Abortions through 15 weeks will continue until at least late May because the former attorney general said the office wouldn't enforce the law until 45 days after a final Arizona Supreme Court ruling. The decision came a day after former President Donald Trump said abortion should be left to the states.

The potential enforcement of the 160-year-old law — passed before Arizona was a state or women had the right to vote — is expected to boost efforts to get a measure on the November ballot protecting the right to abortion in the state constitution. Democratic Attorney General Kris Mayes has said she would not prosecute anyone under the law, though local prosecutors could still do so.

Around the Agencies

FIRST IN PULSE: HEALTH CENTER EXPANSION — HHS today will propose expanding the scope of health centers to allow them to provide services to incarcerated people who are 90 days out from release, Chelsea reports.

The proposal, to be posted on the Federal Register, will ask for public comment on updating Health Resources and Services Administration policy to clarify that health centers can provide services to people who will be released from detention soon. The HRSA proposal would coincide with the opening of applications for a $51 million grant program to be awarded across 51 health centers.

It’s similar to guidance issued last year by CMS.

HRSA Administrator Carole Johnson told Pulse the agency will take public comments through June 14 but grant applications for health centers to implement the policy will be available immediately.

“We know our health centers are seeing [formerly incarcerated] people on the other side of this, who have been disconnected from care, and finally someone gets them to a health center and they’re in poor health,” she said.

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In Congress

HEALTH CENTERS FIGHT BACK — Advocates for community health centers are pushing back on a Government Accountability Office report released Monday that found revenues for the centers have grown significantly in recent years.

The GAO found that revenues grew from more than $26 billion in 2017 to $42.9 billion in 2022, but it didn’t delve into expenses.

The report was requested by Sen. Bill Cassidy (R-La.), ranking member of the Health, Education, Pensions and Labor Committee, and Cathy McMorris Rodgers (R-Wash.), chair of the House Energy and Commerce.

The group Advocates for Community Health said in a statement Tuesday that medical health center margins are “relatively thin” — “less than 5 percent." The group said the centers are “severely under resourced.”

“The report shows a slower rate of increase in funding than the preceding five years, with a more volatile funding mix than that of other primary care providers,” the group said.

Funding for the centers got a boost in a recent government funding package.

Amy Simmons Farber, a spokesperson for the National Association of Community Health Centers, said the reported boost in Medicaid revenue was linked to eased pandemic Medicaid rules that aimed to ensure access to care.

“As these policies wind down, there will be a discernible difference in … operating margins,” she told Pulse.

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