WASHINGTON -- President Joe Biden intends to appoint Dr. Mandy Cohen to lead the US Centers for Disease Control and Prevention, the White House confirmed exclusively to CNN, succeeding Dr. Rochelle Walensky in the critical public health role as the agency grapples with challenges in the aftermath of the pandemic.
"Dr. Cohen is one of the nation's top physicians and health leaders with experience leading large and complex organizations, and a proven track-record protecting Americans' health and safety," Biden said in statement shared first with CNN.
Cohen stepped down from her position as North Carolina's Secretary of Health and Human Services in 2021 after nearly five years on the job. She helped lead North Carolina through the COVID-19 pandemic and was a public face and spokeswoman for health policy out of Gov. Roy Cooper's administration.
And as Cohen takes on what's become an increasingly politicized role at the CDC, Biden heralded her capacity to work across the aisle.
"Dr. Cohen has been recognized by leaders from both parties for her ability to find common ground and put complex policy into action. I look forward to working with Dr. Cohen as she leads our nation's finest scientists and public health experts with integrity and transparency," the president said.
However, Biden received a letter from several Republican lawmakers expressing opposition Cohen's appointment, saying that she was unfit for the position. Those lawmakers cited Cohen's defense and support of mainstream, scientifically-backed health practices during the COVID-19 pandemic as their reasoning for why she was unfit for the position.
Cohen, who will soon step away from a role in the private sector, previously served as secretary of North Carolina's Department of Health and Human Services, where she oversaw the state's response to the Covid-19 pandemic during the Trump and Biden administrations, and also oversaw a major transition for the state's Medicaid program. She previously was chief operating officer and chief of staff at the Centers for Medicare and Medicaid Services (CMS), where she was instrumental in implementing Affordable Care Act health insurance exchanges, working closely with now-White House chief of staff Jeff Zients.
"I would like to extend my sincere congratulations to Dr. Cohen on her selection to lead the CDC," said Congresswoman Deborah Ross. "Dr. Cohen skillfully guided North Carolina through the worst of the COVID-19 pandemic as the Secretary of the North Carolina Department of Health and Human Services. We were lucky to have her expertise and unfailing commitment to public health. I'm confident that she will serve as an effective and successful director of the CDC, and I know she will have a tremendous positive impact on the lives and health of millions of Americans. North Carolina is fortunate to call Dr. Cohen one of our own, and I applaud President Biden for making this choice."
Cohen received her medical degree from the Yale School of Medicine and a master's degree in public health from the Harvard T.H. Chan School of Public Health. She is an internal medicine physician who also has experience working in state and federal government.
Cohen's selection was first reported by The Washington Post.
Walensky announced her departure from her government role last month in the days before the Covid-19 public health emergency lifted. Her last day at the CDC will be June 30.
As she prepares to step into the role, Cohen inherits an agency wracked with challenges and low morale. The CDC is in "a moment of peril" and a "strong, effective, and more accountable" agency is an urgent matter of national security, according to a report from the Center for Strategic and International Studies' (CSIS) Commission on Strengthening America's Health Security that was published earlier this year.
Those who have worked with Cohen describe her as adept at building relationships across the political spectrum and someone who leans in to crises and challenges - pointing to her experience with the healthcare.gov rollout during the Obama administration and working across the aisle in North Carolina during the pandemic.
"She doesn't run from a challenge. She embraces the challenge. She's the kind of person who says the thing in the room that everybody doesn't want to say or is fearing, including, you know, the truth about whether or not they're doing the right thing or doing their job or not," said former Biden adviser Andy Slavitt, who worked with Cohen when he served as CMS administrator and she was his chief of staff.
"She's able to be both a participant in the solution but also kind of sit on top of the problem and have enough perspective. She reaches out to people and asks for advice, and she just goes at it without fear," Slavitt added.
Cohen earned the praise of former Republican Sen. Richard Burr of North Carolina.
"She's got all the tools and the firsthand experienced and knows what has to be done. And she's got the intelligence to know how to do it. ... I've seen Mandy firsthand in North Carolina make tough decisions. And I don't think there was ever a period that I can remember in public health, where there was such a bright spotlight on every health decision that was made in the entire system," Burr told CNN in a phone interview.
In her time leading North Carolina's Department of Health and Human Services through the pandemic, Burr said, "You would expect if people wanted to play politics, they would do it - they would do it aggressively - and you would come out with a sort of mixed resume from it. She came out with 100%. And I think it was because she never made anything political. She called balls and strikes based upon what was best for the health care of North Carolinians," he said.
Yet the CDC has become significantly politicized in recent years, a challenge Cohen will have to navigate, particularly as she advocates for agency funding during what's expected to be a fraught government funding battle this fall.
"It is a political job. It is a job where you have to pay attention to people who fund you and appropriate money, people who are voters and constituents because they have to see that these agencies provide for their life," Slavitt said.
Cohen, he added, was "beloved" in North Carolina on both sides of the aisle for her willingness to listen, calling her "very adept politically," a critical skillset when testifying on Capitol Hill, working with the White House and communicating with states in the CDC role.
As she led the state's response, Democratic North Carolina Gov. Roy Cooper said Cohen "believed that being clear eyed and transparent about challenges was critical to building consensus and finding solutions and she really knows how doctors, regulators, and even lawmakers, think and work."
Cohen has been critical of the CDC's initial response to Covid-19 during the Trump administration.
"It was a crisis. No one's perfect in a crisis. ... And I think getting through a crisis is really all about both preparation and execution. I think on the CDC side, they were under-prepared and their execution was lacking. ... And unfortunately, they had a few early missteps that really hurt their credibility long-term," she said during a conversation with the Center for Health Sector Management at Duke University's Fuqua School of Business, pointing to her own state's efforts to build trust and "have a lot of humility in saying what we did and didn't know."
"I sometimes feel that the CDC wasn't able to both articulate with certainty how to give advice, yet also articulate, 'We are learning, we are watching science happen here in real time guys. Like, this is the best answer I have for you today ... but in two weeks, that may be different.' That was not easily communicated," she said.
Cohen continued, "There are a lot of wonderful scientists and thinkers at CDC. They did not have the operational execution capability that was needed," adding that states had to "fill that void."
While the position is currently a political appointment, Burr led a push for legislation passed recently that will make the role Senate-confirmed effective in 2025 - setting up a test of Cohen's ability to steady the CDC's ship in preparation for a successor.
"She's going to be the bridge in between the period that we don't require it to the time we do. ... My advice to her is you're going to be judged based upon your abilities to set CDC up in a way that the next CDC director will be judged based upon their qualifications," Burr said.
Cooper echoed those sentiments. As she took the helm at the state health department, Cooper said, "She gave employees new hope and vision and a plan of action and built that department back to where it needed to be and beyond. And I think she'll find is a similar situation with the CDC. We know that that agency has been under attack, and I think she will know what to do to instill confidence in her employees there. And she'll also be good at dealing with the outside forces because there are a lot of challenges."
Cohen will begin her new role next month.
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