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Dr. Mark Ghaly, who led California’s response to the COVID-19 pandemic as a top adviser to Gov. Gavin Newsom, is stepping down from his position as secretary of Health and Human Services, the governor’s office announced Friday.

Ghaly has been a consistent face in Newsom’s administration since 2019, when the pediatrician took office in the governor’s cabinet. Many California residents may recognize the bespectacled doctor as he often delivered the latest COVID-19 updates, either from a podium or from his desk with his kids’ colorful drawings in the background. 

When some in the public criticized Newsom’s pandemic rules as overreaching, Ghaly was often responsible for explaining the reasoning and the science behind the state’s decisions. He also gave the governor a COVID vaccine in a live broadcast when the shots became available.

“We went through a lot. I think we achieved a lot,” Ghaly said at a press conference. “Leaving state service by no means means leaving service of the state. I hope that I will continue to have opportunities to show up in lots of places and push an ambitious set of goals that lifts up as many vulnerable communities as possible.”

Newsom at the event said Ghaly is leaving the agency to “focus a little bit more on himself and his kids rather than 40 million Americans.” Newsom called Ghaly “the most transformative leader in the health space” in the U.S. in recent years.

“His steadfast leadership of California’s nation-leading response to the pandemic saved countless lives and set the stage for our state’s strong recovery,” Newsom said in a statement.

Ghaly will stay in his role through the end of the month. Newsom appointed Kim Johnson, who currently heads the California Department of Social Services, as the state’s new Health and Human Services secretary. Johnson will start her new role on Oct. 1. 

Focus on access to health care and cost

As the state’s top health official, Ghaly guided just about every health conversation in the state. He served as the board chair of the state’s health insurance marketplace, Covered California; he led a new board charged by law with bringing down the cost of health care, and he steered the Healthy For All Commission, a group of experts assigned with exploring paths to getting California to a state of health coverage for all residents. 

“That doesn’t happen without a center of gravity that allows things to align for change,” said Dr. Sandra Hernandez, president of the California Health Care Foundation, who has worked with Ghaly on multiple health commissions, including the state’s affordability board and Covered California.

Advocates and community groups have worked for decades on many of the health care changes that took place during Ghaly’s tenure, including the multibillion-dollar overhaul of the state’s public insurance program known as CalAIM, but Hernandez credits Ghaly for his “unique ability to see how all the pieces work together.”

“To move all of the necessary levers of government to make those things come together and have momentum…that’s extraordinary leadership,” Hernandez said.

Newsom also credited Ghaly with overhauling California’s behavioral health system to expand treatment for people in need; creating a blueprint for the state to better serve aging Californians; and launching CalRx, an initiative for the state to manufacture and distribute its own, more affordable medications, starting with insulin and naloxone.

Health advocates commended Ghaly for prioritizing underserved communities as health secretary. 

“The secretary gets it. He gets that our health care system is broken and it is not meeting the needs of our most marginalized communities. He used his role to move the needle in the right direction,” said Mayra Alvarez, president of The Children’s Partnership, a nonprofit that focuses on health equity for kids.

Alvarez, who also serves on the Covered California board with Ghaly, said children’s advocates could be confident that Ghaly’s work as a pediatrician meant kids and families would not be overlooked in state health policy. When Newsom asked voters to approve an overhaul of the state’s behavioral health system in March, Ghaly was “particularly involved in how these resources would serve children and families,” Alvarez said.

He also took the time to listen to community health workers and promotores when designing a new benefit for those on Medi-Cal, the state’s public insurance program for low-income residents. 

“Implementation has not been perfect but he has not wavered in making sure it works,” Alvarez said.

Bringing local health care ideas to Newsom’s cabinet

Ghaly had a long career in local public health prior to joining the Newsom administration. Dr. Clemens Hong, director of community programs at the Los Angeles County Department of Health Services, first met Ghaly as a medical resident when Ghaly was running a clinic in San Francisco’s Bayview Hunters Point community.

Ghaly and the team there developed a program to help recently released incarcerated people get health care and return to  the community. Los Angeles County’s Department of Health Services adopted that idea after Ghaly went to work there as deputy director.. In 2023, under Ghaly’s watch, California became the first state to offer Medi-Cal insurance to inmates 90 days before release, something which federal law had prohibited but advocates say was essential to get people on their feet.

Other programs Ghaly oversaw in Los Angeles, such as expanded insurance for undocumented immigrants, funding for street medicine teams, and recuperative care for hospitalized homeless individuals, have all been folded into the state’s CalAIM program. 

“He has been the visionary to take it from this local level and realize how to scale it,” Hong said. “It has had a huge impact having someone at the state that truly understands the work on the ground.”

Ghaly will long be associated with Newsom’s handling of the COVID-19 pandemic, which frustrated some Californians because of its long business lockdowns and school closures. Those concerns propelled the failed recall campaign against Newsom in 2021. 

Newsom and Ghaly have defended their policies by saying they saved lives in an unprecedented pandemic. Newsom has acknowledged he would have opened up the state earlier if he had today’s understanding of the virus when he made those decisions.

“I think we would’ve done everything differently,” Newsom said on NBC’s Meet the Press a year ago. 

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.