The Senate voted, 50-49, on Thursday to confirm Xavier Becerra as the first Latino secretary of the Department of Health and Human Services.

Becerra will take charge of a health department a year into a global pandemic that has reshaped how doctors provide care, highlighted racial and ethnic disparities in the health care system and threatened employer-sponsored health insurance for people who lost their jobs.

He’ll also start the job as the administration is grappling with a surge of migrants at the southern border, many of whom are children placed into HHS’ charge.

Becerra is expected to take on a key role in addressing the COVID-19 pandemic, the administration’s top priority, alongside the White House and HHS officials who took the lead during President Joe Biden’s first two months.

“It’s going to be very important for Xavier to be at that table, and for the entire team to be working closely with one another,” said Sen. Ben Ray Luján, D-N.M., who previously served in the House with Becerra.

Many of the policy issues that Biden and congressional Democrats campaigned on, like lowering prescription drug prices and other health care costs, will also run through HHS, he said.

“He brings people together. He convenes people. He’s a good listener,” Luján said of Becerra. “But he also is able to make tough decisions that make a positive difference in people’s lives.”

Other Democrats who previously worked with Becerra say the pandemic will be the top issue, even as Becerra will likely look to expand health insurance coverage and ensure equitable access to health care.

“Getting to the other side of COVID is going to be critical to reestablishing the economy and getting that labor participation rate back to where it was,” said Ways and Means Chairman Richard E. Neal, D-Mass., who served with Becerra on the committee. “You can’t get to full economic recovery until you defeat the virus and we’re still battling the virus.”

Rep. Mike Thompson, D-Calif., who also worked with Becerra on the panel, said Becerra has been a “tenaciously hard worker for access to quality, affordable health care for everyone.”

Sen. Alex Padilla, D-Calif., who was California’s secretary of state alongside Becerra as the state’s attorney general, said they’d worked together on issues such as voting rights during that time, and that he expected him to advance those types of issues by improving equity in health care.

Republican opposition

Becerra was confirmed by a slim margin, with most Republicans sharply opposed to his views on abortion and arguing he was unqualified for the role, citing his lack of medical experience.

Sen. Mazie K. Hirono, D-Hawaii, did not vote. An aide said Hirono is in Hawaii because of a family emergency.

Republicans were nearly unanimously opposed to Becerra with the exception of Maine Sen. Susan Collins.

Lawmakers and conservative groups also poured money into ad campaigns opposing the nomination based in part on Becerra’s views on abortion and his previous support for “Medicare for All” as a House member.

Still, Becerra committed to working with Republicans on issues such as vaccine distribution, telehealth and reopening schools.

Some of the key Republicans who opposed Becerra’s nomination, such as Finance Committee ranking member Sen. Michael D. Crapo, R-Idaho, said they would work with him if confirmed.

Other Republicans say they will focus on holding Becerra to what he said during his confirmation hearings. For example, in testimony before the Finance Committee, Becerra told Sen. James Lankford, R-Okla., that because of ethics rules he would recuse himself from certain cases that he sued the Trump administration over, including a legal challenge around the Title X program. Becerra also intervened in a high-profile lawsuit to defend the 2010 health care law that the Supreme Court is set to rule on by June.

“We’ll obviously follow through on that one as well to make sure that he’s not trying to interfere in something that he clearly has a personal preference,” Lankford told CQ Roll Call last month.

Lankford added that he would also focus on whether the administration treats faith-based groups equally to nonfaith-based groups when considering how to distribute grant money and ensuring that Becerra enforces a set of federal laws identified by the HHS Office for Civil Rights.

Sen. Lisa Murkowski, R-Alaska, told reporters earlier this week that the “almost visceral” reaction some Republicans had to Becerra’s nomination could complicate his ability to do the job.

“In addition to finding out whether these nominees have the qualifications to do it, you also have to look at: Do they have the ability to, to make things happen, working with the legislative body? And that’s part of the criteria,” she said.