WASHINGTON — Xavier Becerra, President-elect Joe Biden's pick for health and human services secretary, the Cabinet member tasked with overseeing vaccinating millions of Americans against the coronavirus as quickly as possible, faces an uphill confirmation battle.
It won't be because of how he'll handle the pandemic, but over his support for abortion rights and universal health care, say Republicans who control the Senate and are already warning that he could be denied confirmation, or see the process take longer.
To be sure, nearly any Democrat nominated for the job would back abortion rights. And while Biden has said he doesn't support universal health care, or Medicare for All, Becerra's support is hardly outside the Democratic mainstream.
Still, it's unclear just how fast Senate Republicans will be willing to move on Becerra's confirmation, meaning he may not be able to get to work on Jan. 20 when Biden takes office. In past transitions, the Senate has lined up the top priority nominations to confirm quickly.
Republican Sens. Mike Braun of Indiana, Bill Cassidy of Louisiana, John Cornyn of Texas and Tom Cotton of Arkansas are among the handful of GOP lawmakers who have raised concerns about Becerra.
"I will meet with Xavier Becerra to ask how his political donations from insurance companies and his support for abortions and Medicare for All makes him qualified to serve," Braun said, adding that he had "serious concerns" about Becerra's ability to lead the agency.
Cassidy, one of the few doctors in Congress, said Becerra was a "nice person," but didn't think his background fit the job. "I just don’t know what expertise he has in health care."
Cornyn predicted that Becerra's confirmation process will be "controversial" and lamented that some of Biden's nominees "are pretty radical."
The Susan B. Anthony List, an influential group on the right that advocates against abortion, called for Republican senators to "stand firm and stop this unacceptable nomination from going forward," and Cotton has already pledged to vote against Becerra in part due to his position on abortion.
"Xavier Becerra spent his career attacking pro-life Americans and tried to force crisis pregnancy centers to advertise abortions," Cotton tweeted. "I’ll be voting no, and Becerra should be rejected by the Senate."
Still, Democrats need to win over only a few Republican senators to confirm Becerra, and moderate Republicans have been more cautious in their response to his nomination.
"I was surprised that it wasn’t an individual who had a health care background, but I truly don’t know him," said Sen. Susan Collins, R-Maine, a critical swing vote.
While Democrats remain confident that Becerra's confirmation is not in any real danger, a delay could complicate Biden's Covid-19 response. The early pushback from Republicans also offers a sharp reminder of the divided Senate that Biden will be forced to navigate as he works to put together a new administration.
"I think it's fair to say that the Republicans are looking for one nominee to torpedo. But I don’t think he's going to be it," Jim Manley, a former senior aide to Sen. Harry Reid., D-Nev., said of Becerra.
Sean Savett, a spokesperson for the Biden transition, said in a statement that the transition expected Becerra to get confirmed.
"Xavier Becerra has spent his career fighting to protect underserved communities and expand access to quality, affordable health care," Savett said. "With a proven record successfully managing a large and complex agency, Xavier Becerra is prepared to lead HHS on day one and we are confident the Senate will confirm his historic nomination."
Becerra, 62, served 12 terms in the U.S. House, representing Los Angeles, before becoming California attorney general in 2017. He served on the House Ways and Means committee that helped craft the Affordable Care Act and has long supported moving the country to a government-run Medicare for All health care system. Both Biden and Vice President-elect Kamala Harris stopped short of endorsing Medicare for All during the election.
As attorney general, Becerra vigorously defended the Affordable Care Act, filing multiple lawsuits against President Donald Trump’s administration and leading the defense of the law in the Supreme Court last month.
If confirmed, Becerra would be the first Latino to lead the agency.
"This is going to be about Obamacare and re-litigating those fights and how those have morphed. And Medicare for All is a big part of that," said Doug Heye, a former communications director for the Republican National Committee who served as deputy chief of staff to former GOP House Majority Leader Eric Cantor of Virginia.
"Republicans have struggled to define what they are for on health care," Heye added. "So in a bizarre way, it will give Republicans an opportunity to be on offense on Obamacare."
Many Democrats do not view the GOP attacks against the ACA as particularly effective in tarnishing Becerra. A majority of the public has a favorable view of the law and Republican threats to repeal it without providing an alternative plan have caused trouble for the party in the past.
"Obviously he's going to be questioned on his views on health care, but that's tricky for some Republicans," Manley said. "They don't have an agenda."
"He's going to have to spend a lot of time talking about the contraceptive mandate and abortion. Conservatives, including the Wall Street Journal editorial page and the National Review, are going to come after him when it comes to abortion," Manley added, referring to recent opinion articles arguing that Becerra would be a "radical pro-abortion warrior at HHS."
Becerra has long been a vocal supporter of women's health care and access to abortion. He has defended the ACA's requirement for employers to cover contraception and recently lead a challenge in Mississippi to a law that prohibited doctors from providing abortion services past 15 weeks.
Despite the immediate opposition from some, Senate Republicans will also feel pressured to get HHS up and running quickly amid the pandemic. Any attempt to delay the process could be seen as a threat to derail vaccine distribution.
"I do believe a president is entitled to the team he wants to put together, unless they're completely off the mark," said Republican Sen. Mitt Romney of Utah.