Biden plans to pick physician Mandy Cohen to lead CDC

Cohen would replace Rochelle Walensky, who is stepping down on June 30 as head of the sprawling agency that for decades was touted as a model for global public health but has come under fire for its slow response to the coronavirus pandemic.

The three people spoke with The Washington Post on the condition of anonymity so as not to get ahead of the White House on a personnel matter. Neither the White House nor Cohen immediately responded to requests for comment.

Cohen, a Yale- and Harvard-trained internal medicine physician and public health expert who is now a health-care executive, worked closely with White House Chief of Staff Jeff Zients and other senior Biden officials during the Obama administration.

The next CDC director faces enormous challenges: reforming a sprawling agency to make it more responsive to the next pandemic and communicating the latest science on public health threats to Americans at a time of extreme political divisions and fading trust in government.

“A tall order for even the most talented of leaders,” said Tom Inglesby, director of the Johns Hopkins Center for Health Security, who co-wrote a report on how to improve the CDC’s operations and pandemic response.

The position of CDC director does not require Senate confirmation, but the agency’s next leader will face close scrutiny from Congress.

House Republicans, who have launched a flurry of probes into the beleaguered agency, on Wednesday announced a hearing next week intended to address what they characterized as the “CDC’s failures in fulfilling its mission.”

The CDC “has broken the American people’s trust through its mismanagement of recent responses, especially during the COVID-19 pandemic,” Reps. Cathy McMorris Rodgers (R-Wash.) and H. Morgan Griffith (R-Va.) said in a statement. Republicans also have targeted the agency’s pandemic guidance, saying the CDC moved too slowly to encourage the return of in-person school.

Walensky last year announced that the CDC would overhaul its operations in an attempt to make the 13,000-person agency more nimble and accountable. She established a center for forecasting and outbreak analytics to provide better, faster information about what was likely to happen next in the coronavirus public health emergency and in future disease outbreaks. She took steps to modernize data and improve the public health workforce. The fate of those efforts has been unclear since Walensky announced her resignation last month, and as CDC director, Cohen could choose a different direction.

Meanwhile, some of the agency’s most pressing needs, such as greater authority to mandate state data reporting to the CDC, require action from Congress.

Unlike Walensky — an infectious-disease doctor who had never held a government leadership role — Cohen would arrive at the CDC with considerable experience at the federal and state levels. She served in the Obama administration as a senior official at the Centers for Medicare and Medicaid Services (CMS), where she helped oversee federal health insurance programs that provided health coverage to more than 140 million people. She later served as North Carolina’s health secretary for nearly five years, where she helped roll out the state’s Medicaid managed care program and forged alliances with Republicans who controlled the state legislature, laying the groundwork for North Carolina to expand Medicaid after a contentious decade-long battle.

Cohen also steered the state’s covid response in 2020 and 2021, arguing that North Carolina adopted tactics — such as a daily focus on transparency — that could be copied by other agencies to build public confidence in health care.

“Trust was not built at the national level, but I know trust was built in North Carolina,” Cohen said in a speech last month, touting how the use of data dashboards and regular news conferences helped boost confidence in the state’s covid response.

Public health experts on Thursday hailed Cohen’s planned selection, crediting her management experience and ability to translate public health information to broader audiences.

Cohen can “take the wonky stuff and make it work on the ground,” said Anne Zink, Alaska’s chief medical officer and president of the Association of State and Territorial Health Officials.

Some of the CDC’s fiercest critics also held their fire. Jay Bhattacharya, a Stanford professor of medicine who has advised Florida Gov. Ron DeSantis (R) on his state’s covid response, called Cohen’s planned selection “maybe a hopeful sign” in a tweet, citing her efforts to reopen schools in North Carolina in 2020.

Cohen also has close ties to several senior Biden officials. As a young physician, she worked with Surgeon General Vivek H. Murthy to co-found Doctors for Obama, a group that initially campaigned for Barack Obama in 2008 and later broadened its focus, under the new name Doctors for America, to champion the Affordable Care Act, Obama’s signature health law. Cohen also forged a relationship in 2013 with Zients, who oversaw efforts to repair Healthcare.gov after the disastrous rollout of the government website for Americans to shop for health insurance.

In a 2017 interview on Politico’s “Pulse Check” podcast, Cohen credited her decision to volunteer for the Healthcare.gov repair effort as a professional turning point.

“Sometimes out of crises are opportunities. And for me, it was an opportunity for a big step forward in my career,” Cohen said. “I feel like I had a 10-year career of learning in a one-year period of time.”

Cohen currently works as an executive at Aledade, a private-sector firm focused on improving primary care health practices. Earlier in her career, she worked at the Department of Veterans Affairs on women’s health, and also worked on HIV issues in South Africa.

Biden officials had previously considered Cohen for senior roles in the administration. North Carolina officials in 2020 had advocated for Cohen to be Biden’s pick to run CMS.