Xavier Becerra of HHS has focused on improving Medicare and access to healthcare.

Health and Human Services Minister Xavier Becerra, the first Hispanic to head a powerful, sprawling bureaucracy, often quotes his mother: “Prevention is better than cure.” The former California Attorney General and 12-term member of the House of Representatives applies this philosophy when it comes to implementing and enforcing policies while ensuring that such efforts weather legal challenges.

During a meeting with Modern Healthcare on Thursday, the second anniversary of Becerra’s cabinet entry and the 13th anniversary of the Affordable Care Act, he said his style is “pushing the boundaries” as much as possible.

Becerra, 65, joined HHS in the midst of the COVID-19 crisis as the department and its agencies prepared to implement President Joe Biden’s agenda and respond to important new health laws. “It’s not just sitting and watching the work progress. It matters and that’s what you want to be able to do,” he said.

What was your time like when you were in charge of the department, and what did you learn?

We had no choice but to jump into the seething, raging waters of COVID in 2021. You absolutely hit the ground running… You had to learn how to run right away because people were dying and we needed to save lives. Looking back over those two years: Nearly 700 million shots in the hands of Americans from the COVID vaccine. … Today, while COVID is still with us, we can work, go to school, play, enjoy our families because we know how to protect ourselves. In the process of not only fighting COVID, we have also found a way to increase the number of Americans with health insurance so that they can see a doctor or go to the hospital without going broke. And today more than 300 million Americans – again historical numbers – have access to healthcare because they are insured. The uninsured rate dropped to 8%. … That’s still 8% of the population without insurance, so we still have a lot of work to do. But you see, in the midst of a pandemic, in the midst of the real challenges of the President and his team, we have been able to do very little when it comes to healthcare. We are expanding our reach when it comes to behavioral health. The President has made it clear that we need to do much more to deal with mental health, and we need to fight the drug scourge. We do a lot of things. I would say: if I had to look back on those two years, we were busy.

How does your experience as a lawyer affect how you approach your work in terms of delivering on President Joe Biden’s agenda and balancing the need to follow rules while promoting access to care?

It helps to have this experience to push the boundaries, because the passage of the Affordable Care Act in 2010 pushed the boundaries. The introduction of a $35 per month limit on insulin is out of reach compared to what it used to be. That’s where I think it’s useful to have not only the best team when it comes to medical knowledge and experience in healthcare, because we have some of the best scientists, doctors. [and] healthcare professionals who work for HHS but also have experience as a legislator and know how to get a bill, a proposed law, across the finish line. And then, as a lawyer who knows how to defend this law in court. …

What will be on the agenda of the department?

We want to keep moving towards mental health parity, so that mental health is treated the same as physical health, so we can ensure that if you have insurance, when you go to treatment for depression, you get the same. type of access and coverage, as if you were treating a broken bone. …

We have to keep working on Medicare because the president wants to keep it for the next generation. We are constantly working on rules to help ensure that every dollar a taxpayer pays through their FICA deductions goes towards their paycheck, to the extent possible, goes towards actually providing care when they are in Medicare, and not just let intermediaries withdraw money. top and make a profit.

We have a lot of work to do to make Medicaid work well in every state. One of our main goals now will be to ensure that with the end of the public health emergency, many people receiving Medicaid services do not lose their insurance coverage, and we help them find good insurance coverage. That is why we continue to work on Affordable Care Act and expand coverage. For example, we maintain a special open enrollment period for people who may end up losing their health coverage, whether through Medicaid or for any other reason due to the end of a public health emergency. This way, they can register as soon as they know about it, instead of waiting until the end of the year for open enrollment.

These are the things we will continue to do. Of course, we must issue regulations to enforce the No Surprises Act, which prevents Americans from receiving unexpected medical bills in the mail. We must continue to implement provisions such as our OTC hearing aids so that people know they can get quality hearing aids at an affordable price instead of having to go to some specialist to get those hearing aids. … We must still continue to work to provide the care and protection that unaccompanied children crossing the border deserve – a child is a child. Recently there have been stories of some companies hiring them at the immature ages of 12 and 13. What can we do as a government to ensure that no child is exploited?

We have a lot to do. We will continue the work that the President has given us and, most importantly, we will continue to thank the people at HHS who continue to do such an excellent job every day.

What made you move back to Washington after working for the California government?

When you grow up without everything, you don’t mind pushing the boundaries to see if you can get a little more. … I [was] Attorney for the largest state in the country. And now I will be the Minister of Health of the whole country, not just one state. The order of magnitude is so big what you’re doing. I thought I had a big budget when I was Attorney General and it was over a billion dollars. My budget at HHS is $1.8 trillion. Those dollars go towards trying to provide health care, so you can make a big difference. I have always been driven by the opportunity to change things for the better. That’s why I left the State Assembly to go to Congress. That’s why I left Congress to become Attorney General, and that’s why I left the Attorney General’s office to become Secretary of Health and Human Services.

What makes me want this? I know we still have so much to do. The beauty is that, being the secretary here, I can see how we do it. Not only have we broken records for the number of people getting health insurance through marketplaces and Obamacare, we have made sure to connect with communities that have often been left behind. …

What does it mean to you to be the first Hispanic Secretary of HHS?

I have the honor of being the first in my family to complete a four-year higher education. First in my family to become a professional with a degree, first in my family to be elected to office, first in my family to meet the President of the United States. … Why should I be the first and only? What you want to do is open the door so others can come in, and that’s what you do. The day I have the opportunity to introduce my parents to the President of the United States, that’s when you realize how important it is to change the world for the better, because a six-year-old man who worked with his hands all his life and a mother who did not come to this country, until she was 18, from Guadalajara, Jalisco, Mexico – would they believe that they would have a chance to meet the president? … Maybe for someone it’s not that big of a deal, but for someone like my parents it’s huge. …

It seems to me that when I become a secretary, attorney general or congressman, there will be a kid like me, whose family member never went to college, and who will say, “Hey, this Xavier Becerra, I could just like that.”

That’s what you want, open those doors. But you won’t do it unless you open the envelope.