Becerra Runs for California Governor on His Health Care Record as Coverage Gains Erode
Former U.S. Health and Human Services Secretary Xavier Becerra is running for governor of California against Republican Steve Hilton to succeed two-term Gov. Gavin Newsom. Polling suggests Becerra could win comfortably in November 2026. NPR
Becerra campaigned in Los Angeles' Little Tokyo on August 18, making the case that the health coverage gains he helped secure during two decades in Washington are now under threat.
By the time Becerra left HHS, more Americans had health insurance than ever before. He helped pass, defend, and expand the Affordable Care Act — the 2010 law better known as Obamacare — across two administrations. The national uninsured rate reached a record low of 8% in early 2022, according to an HHS report. ASPE data show the rate for all ages declined 1.9 percentage points from 2019 to 2022, with early 2023 data showing further decreases. Census Bureau estimates released August 6, 2026, show that 46.3% of U.S. counties had an uninsured rate below 10% in 2023, up from 45.2% in 2022 and 39.2% in 2021.
California saw one of the steepest drops in uninsured residents in the nation, driven by the state's strong adoption of the ACA. Becerra's role in that record is direct: as California attorney general in December 2018, he led a coalition of 17 states defending the ACA in federal litigation that threatened to strike down the law entirely. NPR The U.S. Senate confirmed him as HHS secretary on March 18, 2021. Newsom called the confirmation historic.
The coverage landscape Becerra aims to oversee as governor is now deteriorating. A May analysis by the University of California, Berkeley Labor Center projected that the number of uninsured Californians under 65 would nearly double from 2.4 million to 4.6 million by 2030. The projected rise is driven by recently enacted state and federal cuts to Medicaid — the government insurance program for low-income Americans — and to ACA marketplaces, where people shop for private plans. Those cuts are expected to roll back coverage gains.
The same Census Bureau release that documented pre-cut gains also captured the turn: between 2023 and 2024, uninsured rates declined in 65 counties and increased in 427 counties nationally.
Miranda Dietz, healthcare program director at the UC Berkeley Labor Center, told California legislators in February that the coverage cuts could cost the state roughly 200,000 jobs, most of them in healthcare. Hospital executives have begun reporting more unpaid medical bills, and experts warn that health plans will raise premiums further as they are left with sicker, more expensive enrollee pools.
Jessica Altman, executive director of Covered California — the nation's largest state-run health insurance marketplace — described the situation bluntly: "It's triage," she said of what the next governor is walking into.
The broader context for Becerra's candidacy is the collision between the coverage expansion he helped engineer at the federal level and the fiscal pressures now contracting it. The Berkeley Labor Center projections, the job-loss estimates, and the premium spiral that Altman and hospital executives describe are not speculative concerns about a hypothetical policy debate. They are the downstream effects of enacted cuts already producing measurable coverage losses in the county-level data.
Becerra's governing pitch rests on a specific argument: that the person who helped build the coverage architecture is best positioned to hold it together when the funding underneath it is being pulled away. Whether voters in a state that has leaned heavily into ACA adoption accept that framing, and whether the fiscal reality of a state confronting multibillion-dollar Medicaid pressures allows for the preservation approach Becerra's record implies, are the questions the remaining weeks of the campaign will test.
The contest gives California voters a choice between a Democrat whose career is bound up with the ACA's implementation and defense, and a Republican running against the backdrop of a coverage system that the sitting president's party helped expand and that subsequent legislative action is now contracting. The polling advantage sits with Becerra. The policy terrain is less settled.
