The Senate on Thursday voted to confirm Xavier Becerra as secretary of the Department of Health and Human Services despite nearly unanimous opposition from Republicans, who have tried to brand him as a radical and unqualified.
The near party-line vote was 50-49 with Maine Republican Susan Collins the only Republican to support his confirmation. Democratic Sen. Mazie Hirono of Hawaii was not present.
Becerra, who was the attorney general of California, becomes first Latino to lead the department.
Becerra is a controversial selection to lead HHS, and though Democrats have unanimously supported his confirmation -- citing his experience advocating for health care policy reform -- Republicans almost universally opposed him.
That opposition to Becerra has been mounting since Biden announced his nomination in December. They argue Becerra is not sufficiently experienced in health care to lead an agency with a key stake in coordinating the federal response to the pandemic.
Becerra served 12 terms in Congress before transitioning to his role as California attorney general, but his focus hasn't been on public health, Republicans say.
Sen. Bill Cassidy, R-La., who serves on the Senate Health Committee and is a medical doctor, opposed Becerra on the grounds that he lacks "subject matter" expertise to lead the department.
And Sen. Ted Cruz, R-Texas, took to the Senate floor Wednesday to further emphasize Becerra's lack of experience in health administration.
"The Department of HHS is in the process of distributing and administering hundreds of millions of vaccines," Cruz said. "Mr. Becerra has never so much as distributed french fries at McDonald's."
Republicans also point to Becerra's prosecutorial record, which includes efforts to challenge bans on abortion, as a major red flag. Becerra prosecuted a well-known case challenging the religious exemption made by the Little Sisters of the Poor, who argued they did not need to provide access to contraceptives under the Affordable Care Act.
Minority Leader Mitch McConnell, R-Ky., has railed against Becerra for weeks. In floor remarks Wednesday morning, McConnell again slammed Becerra for partisan leanings and a lack of experience.
"The most significant health-related experience on the nominee's record are his efforts to wield the legal system against religious sisters to make them violate their faith and conscious," McConnell said.
Despite GOP efforts, Becerra is on the path to confirmation. Democrats say the vote couldn't come soon enough.
"There is so much work to be done -- and with this pandemic the clock is already ticking, and the reality is we are already way, way behind," said Washington Sen. Patty Murray, the top Democrat on the Senate Health, Education, Labor and Pensions Committee. "We all want the pandemic to end, which means we all should want the Biden-Harris administration to succeed, and we should be getting qualified nominees like Attorney General Becerra on the job as quickly as possible."
Democrats refute claims that Becerra lacks experience, and cited his experience in health care policy, first as a congressman who oversaw components of Medicare and the Affordable Care Act and then as a defendant of Obamacare as attorney general.
They've also highlighted his work with a Republican attorney general from Louisiana, who he teamed up with last year to try to pressure the Trump administration into reducing the cost of remdesivir, a treatment for coronavirus.
"Xavier Becerra has decades of health care policy experience, worked with Republicans and Democrats to expand access to COVID treatments and take on opioid manufactures while leading the largest state department of justice in the country, and has a strong record of fighting to lower costs for patients," Andrew Bates, Biden's spokesperson, said in a statement.
"That's why Biden chose this tested, qualified leader to be at the forefront of the pandemic response and to help lower drug prices," he added. "We look forward to his hearings and confirmation votes."
Oregon Sen. Ron Wyden, the top Democrat on the Senate Finance committee, threw his weight behind Becerra on Wednesday.
"In my view, AG Becerra proved in his nomination hearing that he is ready to lead HHS, and he knows health policy inside and out," Wyden said. "That shouldn't have been any surprise, because he's got decades of valuable leadership and policy experience that will help him succeed in this job."
The Senate Finance Committee vote on Becerra earlier this month was split down party lines, forcing Senate Majority Leader Chuck Schumer, D-N.Y., to hold a floor vote to advance the nomination out of committee.
That vote, and another key procedural vote cleared by the slimmest of margins, with Sen. Susan Collins, R-Maine, as the sole Republican to cross party lines.