New Mexico Gov. Michelle Lujan Grisham and former Surgeon General Vivek Murthy have emerged as top contenders to be President-elect Joe Biden’s health secretary, with Hispanic advocacy groups making a strong push for Lujan Grisham.
The nomination of Lujan Grisham, 61, would continue a tradition of presidents tapping governors to lead the sprawling Department of Health and Human Services, and make her the first Latina ever nominated for the post. Murthy, a 43-year-old Yale-educated internist who’s grown close to Biden as a top adviser on the coronavirus pandemic, would be the first nominee of Indian descent for the department’s top job.
Either would face potentially tough confirmation hearings as the Biden administration begins coordinating one of the largest immunization programs in history — and confronts the economic fallout of a pandemic that’s left tens of millions of people out of work and uninsured. The next secretary will play a key role in managing the Covid-19 response, and convincing a fatigued and distrustful public to buy into the tough public health measures needed to suppress the virus.
“It’s Covid 24/7 now,” said Don Berwick, a former Obama administration Medicare and Medicaid chief. “That’s got to be dealt with.”
Biden has not yet made a final choice, according to three Democrats familiar with the selection process, and an announcement is unlikely to come until Monday at the earliest. The deliberations could still circle back to others in a field of as many as a half-dozen finalists, like Rhode Island Gov. Gina Raimondo, former Louisiana health secretary Rebekah Gee and North Carolina health secretary Mandy Cohen.
But Lujan Grisham and Murthy are widely viewed as leading candidates, said more than a half-dozen people on or close to the transition, with each boasting a distinct mix of political experience, health policy chops and connections dating back to the Obama years.
A former Democratic congresswoman who currently co-chairs Biden’s transition, Lujan Grisham has gotten a boost in recent weeks from the Congressional Hispanic Caucus, which is lobbying the Biden team to put her atop HHS.
“When we think about someone who’s a manager and a leader who knows these issues, Michelle is top of the list,” said California Democratic Rep. Pete Aguilar, who worked closely with Lujan Grisham during her three terms in the House.
Influential Latino advocacy groups have also weighed in on her behalf, pointing in particular to her state leadership during the pandemic.
“She’s seen directly the impact of Covid-19 on her state and managed the response — and she’s had to do a lot because there hasn’t been a lot of federal guidance,” said UnidosUS President Janet Murguia, a former Clinton White House official. “She knows what it’s like to lead in this space and is a very credible candidate.”
Murthy, meanwhile, enjoys support from within the broad base of Obama administration alumni who have quickly populated the Biden transition. A health adviser to Biden during the campaign, he’s helped lead the incoming administration’s pandemic planning as co-chair of Biden’s Covid-19 advisory board.
If not picked to run HHS, Murthy is likely to be appointed to another prominent health post in the administration, several people close to the transition said — potentially as part of the White House’s Covid-19 response team.
A spokesperson for the Biden transition declined to comment. Lujan Grisham’s office did not respond to a request for comment. Earlier this week, she told reporters she hasn’t talked to the Biden team about roles in the incoming administration.
The emergence of the two as top HHS candidates reflects the outsized influence that the pandemic is playing in Biden’s thinking, as he prepares to take office amid deep public health and economic crises.
The incoming administration is bracing for a frenetic first several months spent trying to curb the pandemic and organize a large-scale vaccination campaign — a massive logistical challenge that will require close coordination across the federal government.
In Lujan Grisham, Democrats argue the Biden team would get a competent and steady leader with extensive management experience running New Mexico’s health agency and then the state as a whole. She has also been one of the most aggressive governors in combating Covid-19, declaring a statewide emergency on the same day New Mexico confirmed its first positive case and closing schools soon after.
More recently, she ordered a two-week lockdown after a 200 percent jump in hospitalizations that put the state at what she called a “breaking point.” It’s the kind of action that could face intense scrutiny from Republicans if she’s nominated — but one allies tout as a sign of decisiveness in a state that requires balancing all manner of political and cultural considerations.
“This pandemic puts a premium on someone who can bring people together and be a good manager,” Aguilar said. “She has a very diverse population; urban areas, very rural areas and Native American tribal lands. The complexity of that isn’t lost on those of us outside the state.”
The Biden team tasked with filling health positions has been similarly drawn to governors and former governors in seeking candidates, said one person close to the president-elect, given state leaders’ experience managing large bureaucracies and their skills as both public messengers and political operators. Past HHS secretaries who were governors include Kathleen Sebelius, Mike Leavitt and Tommy Thompson.
And Lujan Grisham in particular is seen among some Biden officials as a long-term prospect who could advance a broader policy agenda beyond the pandemic response. While running for governor in 2018, Lujan Grisham called for creating a program that would allow people to buy into Medicaid. The effort never got off the ground amid concerns about its cost, but the concept aligns with Biden’s core proposal for a public insurance option at the federal level.
“On paper, she has a lot of credentials in her favor,” said one Democrat tracking the deliberations, adding that Lujan Grisham also has pre-existing relationships on Capitol Hill. “Her reputation is that she’s pretty pragmatic and was able to work across the different facets of the different caucuses in the House.”
Still, her Senate confirmation would not be guaranteed — a key consideration for an administration that could need Republican help to install one of the leaders of its pandemic response. As a House lawmaker, Lujan Grisham profited when her former consulting group received a contract to run New Mexico’s high-risk insurance pool — even after Obamacare largely eliminated the coverage model. The arrangement has since prompted conflict of interest accusations.
And despite her role atop the transition, Lujan Grisham does not have the kind of close relationship with Biden or strong ties to the Obama White House shared by nearly all of Biden’s high-level picks to date — including Murthy.
The former Obama administration surgeon general was chosen to speak at the Democratic National Convention in August, and has become a top health adviser to Biden since then, briefing him regularly on the pandemic and helping lead the Covid-19 advisory board designed to oversee the transition work on the crisis response.
Biden has also dispatched Murthy to brief congressional Democrats on the pandemic in recent weeks, a role that some close to the transition pointed to as a sign of Murthy’s elevated status within the incoming administration.
A longtime public health advocate who first rose to prominence as co-founder of a pro-Obama doctors group during the 2008 presidential campaign, Murthy was appointed the nation’s top doctor in 2014, where he played an outspoken role in efforts to stem the opioid crisis and tackle a broad array of pressing public health issues.
If chosen as HHS secretary, it would signal a major recommitment to public health issues that have often been drowned out by divisive debates over policies like Obamacare — leaving the nation’s public health infrastructure underfunded and susceptible to disasters like Covid-19. Murthy has also written extensively about the health impact of loneliness, a focus that fits with Biden’s focus on tackling the mental health consequences of the pandemic.
Yet Murthy has little managerial experience — a drawback when it comes to running department with a trillion-dollar budget and 80,000 employees.
And he has already struggled through one confirmation process, facing fierce resistance over his support for contraception access and declaration of gun violence as a public health threat. That standoff lasted for more than a year — a delay that the Biden administration can ill afford this time around, as it races to confront the growing Covid-19 crisis.
Still, some officials contended that views on gun violence as a health issue have since changed — and that Biden’s affinity for Murthy could ultimately still win out.
“If you look at the president-elect’s other personnel announcements, it’s clear that he cares a lot about having people he knows and trusts, who have a pre-existing relationship with him,” one person working with the transition told POLITICO. “Obviously, Vivek is one of them.”
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