NC DHHS Sec. Mandy Cohen, here at a Thursday press conference on COVID-19, is among those being considered to join the Biden Administration. (Image via NC DPS) Headed to DC?
NC DHHS Sec. Mandy Cohen, here at a Thursday press conference on COVID-19, is among those being considered to join the Biden Administration. (Image via NC DPS)

Mandy Cohen has been the face of NC’s COVID-19 response. But she is on a short list of people that might head to Biden’s federal health agency.

Wait six feet apart. Wash your hands. Wear a mask. This has been Dr. Mandy Cohen’s mantra for the past eight months, and she may take those three Ws to Washington come January.

Cohen, the Secretary of the North Carolina Department of Health and Human Services, is on a short list to join the White House cabinet under President-elect Joe Biden as the head of the US Department of Health and Human Services. The New York Times and Politico have listed Cohen among the top candidates for HHS secretary at the federal level, alongside Obama’s surgeon general Vivek Murthy, New Mexico Gov. Michelle Lujan Grisham and former FDA commissioner David Kessler.

Cohen, when asked at a press conference Thursday, said she’s flattered that her name has been floated around. She hadn’t yet been contacted by anyone from Biden’s camp but said she’d be open to it. 

“It’s a privilege to serve in public service at this important time in our state’s history and our nation’s history,” Cohen said. “I’d be honored to serve here in North Carolina, or at the federal level if that is an opportunity.”

READ MORE: Need Health Insurance? The ACA Marketplace Is Now Open Until Dec. 15.


North Carolina has fared better than most states when it comes to COVID-19’s spread, though the state is seeing some of its worst numbers yet. The state consistently ranked in the bottom half of states on the number of COVID-19 cases and deaths per 100,000 residents, according to data kept by the Centers for Disease Control and Prevention. 

Her boss, Gov. Roy Cooper, credits Cohen with that success. He’s hoping she stays right where she is. 

“I know her name is all over the news,” Cooper said this week when he and Cohen were asked by a reporter about a move for Cohen to the incoming Biden cabinet.  “One of the reasons she would be considered is the fact that North Carolina has done well and has done the things that we need to do to create a positive response. So anybody would be fortunate to have Dr. Cohen, and of course I want her right here.”

Biden ‘would be fortunate to have her’

After undergraduate studies at Cornell University, medical school at Yale University and a public-health degree from Harvard, North Carolina’s top health official has held high-profile government posts. 

Before coming to North Carolina, Cohen served in the Obama administration as chief operating officer and chief of staff at the Centers for Medicare and Medicaid Services. She also served as the Deputy Director of Comprehensive Women’s Health Services at the United States Department of Veterans Affairs. 

Cohen earned accolades and bipartisan respect after arriving in North Carolina in 2017 to lead the NC Department of Health and Human Services under Cooper, a Democrat. 

“Secretary Cohen is highly competent, diligent and dedicated to doing an outstanding job. The administration would be fortunate to have her,” said state Sen. Joyce Krawiec, a Republican who chairs several healthcare-related committees in the NC General Assembly. “We have worked together to find solutions for our citizens, and I would hope she chooses to remain in North Carolina.”

Consensus In: NC Lucky to Have Cohen

The NC Pediatric Society recently recognized Cohen’s department with its James D. Bernstein Excellence in Public Service to Children Award for its guidance during the pandemic. 

“We look forward to her continued leadership whether in North Carolina or on a national level,” said Southern Pines doctor Christoph Diasio, NCPeds’ president.

Gregory Griggs, CEO at the NC Academy of Family Physicians, said Cohen’s scientific, evidence-based leadership has helped to protect North Carolinians during an unprecedented health crisis.

“We have been lucky to have her,” he said. “She is an exceptional leader and has not only guided our state’s response to COVID-19 but is also moving our state’s healthcare system to one based on value versus volume, taking into account all the factors impacting an individual’s health.”

Cohen Long on National Radar

Praise for Cohen has indeed gone far beyond North Carolina. 

In September, Harvard University’s T.H. Chan School of Public Health honored Cohen,  a 2004 alumna, with its prestigious Leadership in Public Health Practice Award, citing her “strong leadership during the COVID-19 pandemic response, including her use of data and ability to communicate calmly and with empathy, compassion, and transparency.”

Last year, the venture-capital fund Rock Health recognized Cohen as “Digital Health’s Biggest Digital Care Champion.” The trade publication Modern Healthcare named her among its Top 25 Women Leaders. A year ago, well before the pandemic struck, Politico was musing on North Carolina as “the most innovative healthcare state in the nation” under Cohen’s leadership.

Medicaid Changes Key Piece of Cohen’ Time in NC

Under Cohen, NC DHHS has been tasked with moving NC’s Medicaid system from its current model, where the state uses a mix of federal and state money to pay for every service needed by the low-income seniors, children and persons with disabilities that qualify for the healthcare safety net program. Medicaid will move to a privatized “value-based” managed care model, a transition the Republican-led General Assembly had legislated in 2015. That switch was delayed to this summer because of the ongoing fight between the governor and legislative leaders over Cooper (and Cohen’s) wish to expand Medicaid coverage to low-income adults, a move that all but a dozen US states have already done to address healthcare access. 

Medicaid expansion is but one of many conflicts Cohen has had to manage, as nearly her entire career has tracked with the history of Obamacare amid the ebb and flow of partisan power.  Pregnant with her second daughter in 2014, Cohen famously faced off with former congressman, now outgoing White House chief of staff, Mark Meadows, over maternity coverage provided by the Affordable Care Act. But having served presidents in both parties and a divided government in North Carolina, Cohen has sutured Republican thrift and Democratic ambition. 

While Cohen and Gov. Roy Cooper continue to spar with GOP legislators’ over Medicaid expansion, Cohen’s NCDHHS is piloting a much anticipated “Healthy Opportunities,” effort that would leverage $650 million in Medicaid dollars toward preventing homelessness, hunger and domestic violence and providing healthcare transportation, all underlying factors that exacerbate healthcare costs when left untreated.  It’s being watched nationally, to see if the project can show different, and better, ways to improve the health of Americans. 

“Everyone is trying to figure out, how do we get more value out of the dollar in spending?” Cohen told Politico in a profile published last year. “It’s not a left or right issue. Everyone wants to figure it out. We want to systematically try to embed food, housing, transportation, jobs into what is happening in the health system.”