Report Highlights How Delays of Health Secretary Could Impede Administration’s Ability To Fight COVID-19 Pandemic

Senate Republicans’ obstruction of Biden’s HHS Secretary nominee Xavier Becerra could leave HHS without top leadership — possibly for weeks

New report shows acting secretaries have a harder time implementing their agendas

Delay of HHS Secretary also delays sub-cabinet positions, including CDC Director

With COVID-19 cases and deaths surging, never has it been more critical to have confirmed leaders at nation’s top health agency 

Washington, D.C. – Today, Accountable Senate War Room released a new report outlining the harms of delaying the confirmation of Xavier Becerra, President Biden’s nominee to lead the Department of Health and Human Services (HHS), including causing further delays to the vaccine distribution plan and tackling the COVID-19 pandemic. After crossing the grim 400,000 death marker and amid a surge of COVID-19 cases, the need for a fully functioning HHS department has never been greater. The Senate has been unable to move forward on Becerra’s nomination thus far due to the inaction from Senate Republicans during the lame duck and the unprecedented obstruction from Minority Leader Mitch McConnell, who refused to allow Democrats to take control of committees. While Senate Republicans play politics for the sake of their special interest donors, President Biden and his team are working to dig the country out of the worst economic, health, and national security crises in modern history.

While the Biden administration has hit the ground running in its COVID-19 response, they have their work cut out for them to create a national response plan, including an effective vaccine rollout, after being left with almost nothing from the Trump administration. Studies suggest that acting secretaries, regardless of qualifications, lack the internal influence to quickly implement agenda items, and that turnover in federal appointees contributes to agency inaction. Additionally, a delay in confirming a HHS secretary also may lead to delays in confirming critical sub-Cabinet positions, including a CDC director. After inheriting a once-in-a-generation pandemic and botched vaccination plan from the previous administration, President Biden is at risk of going without an HHS secretary for possibly weeks. The American people have waited long enough for our leaders to take charge of this pandemic. They can’t afford further delays.

Below are some highlights from Accountable Senate War Room’s report:

The Biden administration will take office amid an unprecedented and escalating crisis over COVID-19:

Cases and deaths from COVID-19 have surged, doubling from a previous peak in the spring.
Recent reporting indicates a total lack of a federal vaccination strategy from the Trump administration, earning criticism from Senators such as Mitt Romney (R-UT), who called it “inexcusable.” Biden’s team has subsequently said their strategy will require them to start from scratch.

The Department of Health and Human Services (HHS) plays a critical role in fighting the pandemic, as it’s tasked with distributing hundreds of millions of vaccines across the country. Yet the confirmation of Biden’s HHS nominee Xavier Becerra is being stalled, with concerns grounded more in politics than his administrative competency. HHS deputy assistant secretary, Norris Cochran, has been left as the acting HHS secretary as Becerra awaits confirmation.

Obstruction of Becerra’s confirmation could impede the ability of the Biden administration to effectively manage the pandemic. Even competent acting officials suffer from issues such as weakened authority and administrative turnover compared to confirmed officials:

• A Southern California Law Review study details how acting secretaries have harder times implementing administrative agendas, as they lacked the political capital and authority of confirmed officials. The author concluded that relying on acting officials leads to an increased chance of federal inaction, more confusion among career workers, and decreased accountability.
• Partnership for Public Service CEO Max Stier, who has worked on multiple presidential transitions include Donald Trump’s, stated that acting officials suffer from a “substitute teacher” problem: the lack of tenure results in both the acting official and the official’s team recognizing that actions may not have long-term impact, as they know their time is designed to be temporary. This creates problems for both long-term thinking and agency accountability.
• A former Justice Department counsel and NSC director argued that acting officials inherently have less ability to speak truth to institutional power, as they lack an ability to drive institutional changes or raise issues for congressional attention.

Headline: CNN: “Biden inheriting nonexistent coronavirus vaccine distribution plan and must start ‘from scratch,’ sources say.” [CNN, 1/21/21]

After President Obama’s initial pick for HHS withdrew from consideration, the department was without a confirmed Secretary until Kathleen Sebelius was confirmed in late April 2009, creating delays and possibly impacting swine flu readiness:

• The earliest actions by the Obama administration on vaccinations related to the swine flu epidemic were forced to operate from Obama’s Department of Homeland Security due to the vacancy.
• Numerous senators noted the urgency of the need to get Sebelius into the position at the time – including Republican Senator Susan Collins (R-ME). Facing some criticism over her efforts to remove pandemic funding from the 2009 stimulus bill, Collins pointed the finger back at Congress, arguing the real issue with swine flu readiness was a failure to fill top HHS positions. Collins subsequently called on the Senate to “move promptly” to confirm Sebelius’ nomination.
• The delay meant that the Obama White House lacked an authoritative voice on early health care reform discussions; led to delays in filling sub-Cabinet positions, such as at the CDC; and led the eventual secretary, Kathleen Sebelius, to have a backlog of pressing concerns upon entering office.

Lack Of Confirmed Secretary For HHS Led To Delays In Sub-Cabinet Positions, Including At CMS, CDC, And NIH. “The secretary fiasco. The collapse of Daschle’s nomination was one of Obama’s biggest embarrassments, prompting him to issue an unusually blunt mea culpa: ‘I screwed up.’ It meant the department that was supposed to take an early lead role on health care reform lacked a figure of authority in 8 budget talks. The secretary stumble also led to delays in filling key sub-Cabinet positions at the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and the National Institutes of Health.” [Politico, 4/24/09]

April 28, 2009: Nominee Kathleen Sebelius Was Confirmed As HHS Secretary, With Nomination Taking On Greater Urgency In Wake Of Swine Flu Outbreak. “Kansas Gov. Kathleen Sebelius (D) has been confirmed as secretary of the Health and Human Services Department. The Senate vote was 65-31. Sixty votes were needed for approval. The nomination took on a greater urgency in the wake of the swine flu outbreak. That apparently outweighed Republican objections to her record on abortion.” [NPR, 4/28/09]

Kathleen Sebelius Subsequently Received 8 Republican Votes To Confirm. [Senate – Roll Call PN188, 4/28/09]