Washington: President-elect Joe Biden has selected Xavier Becerra, the Democratic attorney general of California, as his nominee for secretary of Health and Human Services, tapping a former congressman who would be the first Latino to run the department as it battles the surging coronavirus pandemic.

Becerra became Biden’s clear choice only over the past few days, according to people familiar with the transition’s deliberations, and was a surprise. Becerra has carved out a profile on the issues of criminal justice and immigration, and he was long thought to be a candidate for attorney general.

But as attorney general in California, he has been at the forefront of legal efforts on health care, leading 20 states and the District of Columbia in a campaign to protect the Affordable Care Act from being dismantled by his Republican counterparts. He has also been vocal in the Democratic Party about fighting for women’s health.

If confirmed, Becerra will immediately face a daunting task in leading the department at a critical moment during a pandemic that has killed more than 281,000 people in the United States - and one that has taken a particularly devastating toll on people of colour.

“The ACA has been life-changing and now through this pandemic, we can all see the value in having greater access to quality health care at affordable prices,” Becerra said in June, when he filed a brief with the Supreme Court in defence of the health care law. “Now is not the time to rip away our best tool to address very real and very deadly health disparities in our communities.”

A spokesperson for Biden’s transition team declined to comment. The president-elect plans to formally announce Becerra as his choice to lead the Health Department early this week, along with several other top health care advisers, according to people familiar with the rollout.

Dr. Rochelle Walensky, the chief of infectious diseases at Massachusetts General Hospital, will be selected to lead the Centres for Disease Control and Prevention, according to a person familiar with Biden’s deliberations. Walensky, whose selection was reported earlier by Politico, will replace Dr. Robert R. Redfield as the leader of the scientific agency at the forefront of the nation’s pandemic response.

Surgeon General

Dr. Vivek Murthy, who served as surgeon general under President Barack Obama, will reprise that role for Biden. A telegenic confidant of the president-elect, Murthy will become one of Biden’s closest advisers on medical issues and will lead much of the public outreach on the pandemic.

Jeffrey D. Zients, an entrepreneur and management consultant who served as the head of Obama’s National Economic Council and fixed the bungled rollout of the health law’s online insurance marketplace, will become a coronavirus czar in the White House, leading efforts to coordinate the fight against the coronavirus pandemic among the government’s sprawling agencies.

Some medical experts, who have been pushing the Biden team to name people with medical or public health expertise to serve in health leadership positions, were caught off guard - and unhappily so - by the news of Becerra’s selection.

In a letter sent last week to Biden, five leading medical groups - the American Academy of Paediatrics and the American College of Physicians among them - called on the president-elect to appoint “qualified physicians to serve in key positions critical to advancing the health of our nation.”

‘Astounded’

One person familiar with that effort said people involved were “astounded” by the selection of Becerra, and suggested that Biden elevate Murthy to a Cabinet-level position.

But in an interview Sunday night, Dr. Ada D. Stewart, the president of the American Academy of Family Physicians, one of the groups that sent the letter, described Becerra as “a good choice” and “an experienced legislator and executive” - even as she conceded that her group would “prefer, of course, to have a physician in this position.”

“We’ve already seen his commitment to health and equity, and those things can’t be overlooked,” she said.

Becerra’s experience in Washington may also help Biden secure legislative changes to bolster the Affordable Care Act, a central promise that the president-elect made during the 2020 campaign.

Becerra, 62, served 12 terms in Congress, representing Los Angeles, before becoming the attorney general of his home state in 2017. He is the first Latino to hold that office, and while in Congress he was the first Latino to serve as a member of the Ways and Means Committee, where he worked on health care as a senior member of the health subcommittee. He also led the House Democratic Caucus, which gave him a powerful leadership post.

An outspoken advocate of improved health care access, Becerra said in 2017 that he would “absolutely” support “Medicare for All,” a proposal for government-run health care that Biden has explicitly rejected. A source familiar with the selection said Becerra would support the president-elect’s call for strengthening and preserving the ACA and would not be pushing Medicare for All while in office.

Early days

Born in Sacramento, California, Becerra grew up in a working-class family; his mother emigrated from Mexico, and he was the first in his family to graduate from college. He attended Stanford University as an undergraduate and received his law degree there in 1984.

Biden was impressed by Becerra’s personal story, according to a person familiar with his thinking. In particular, the president-elect liked the fact that Becerra served clients with mental health needs shortly after graduating from law school, the person said.

While in Congress, Becerra was a fierce advocate of the Latino community and became deeply involved in efforts to overhaul the nation’s immigration system. He also promoted plans to build a national museum devoted to exploring the culture and history of American Latinos. The House voted this year to create such a museum.

Rep. Filemon Vela, D-Texas, praised Biden’s choice of Becerra, calling it “historic” and saying the California attorney general was the right person to lead the sprawling agency during the worst public health crisis in 100 years.

“Becerra will lead an agency that will play a crucial role in overseeing a massive immunization effort and help manage a bolstered federal response to tackle the worsening COVID-19 crisis,” Vela said. “He will also help shape the Biden administration’s efforts to build on the Affordable Care Act.”

Becerra has been California’s attorney general since 2017, when Harris was elected to the Senate and Gov. Jerry Brown appointed him to fill her seat. His term would expire in 2022.