SACRAMENTO, California — Mark Ghaly, dubbed “California’s Dr. Fauci” by Gov. Gavin Newsom for his leading role in handling Covid-19, is stepping down as the state’s health and human services secretary, telling POLITICO he wants to spend more time with his family in Los Angeles.
He will be replaced by Kim Johnson, who currently serves as the director of the California Department of Social Services.
Ghaly, a trained pediatrician who first took office in 2019, has led the department through generational shifts in California’s health care landscape and along with Newsom became the face of the state’s pandemic response, which came to define his tenure and riled critics of the administration’s strict lockdown measures.
Under his watch, the state also started rolling out all new Medi-Cal benefits to keep populations with the highest needs out of the hospital and expanded coverage to include undocumented immigrants. He’s overseen a complete revamp of the state’s behavioral health system and how California provides prescription medications.
“Californians want health care to be better and more affordable,” Ghaly said in an interview with POLITICO ahead of the announcement Friday, “and until we get a system that is those two things, I think we're going to see an ongoing piercing of this balloon that is health care, until we see some radical change.”
His departure comes during a period of transition for the Newsom administration in the final two years of the governor’s term, and there’s pressure to start showing progress. Now, Newsom will have to finish work on some of the state’s biggest health problems without Ghaly.
“It’s not just the next two years that matter,” Ghaly said. “I think we've dug a new foundation, we've rebarred, we've done all the reinforcements so that it's stable in times of uncertainty to really see California thrive.”
Throughout the Covid-19 pandemic, Newsom referred to Ghaly as “my doctor,” as he gave the governor both his vaccine and booster doses on TV. More than three years later, Ghaly said he’s proud of how the Newsom administration responded to the pandemic: distributing meals to seniors, the aggressive push to test and vaccinate and the staged reopening of businesses and activities outlined in the state’s “Blueprint for a Safer Economy.”
“Dr. Ghaly’s heroic service to the people of our state and his profound contribution to reshaping California’s health and social services cannot be overstated," Newsom said in a statement announcing Ghaly's departure.
"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."
Through Newsom and Ghaly, California put forward some of the strictest Covid measures in the country, keeping students out of school longer than any other state and requiring vaccinations for health care workers, all unpopular moves among Newsom’s detractors. A 2021 failed recall attempt against Newsom was nominally about a list of complaints including over taxes and immigration, but the vote became a referendum on Newsom’s handling of the pandemic , especially schools.
Some of Newsom’s recall opponents made reopening schools the cornerstone of their campaigns , with former San Diego Mayor Kevin Faulconer saying at the time that it was the governor’s fault “our public schools have not been safely reopened. And yet private schools are open and public schools across the country have safely reopened.”
Ghaly himself said in the POLITICO interview that his biggest regret about the pandemic was that children were kept out of school too long.
“The goal would be to have kids in school more,” Ghaly said. “As we learn of the impact, and frankly, the overall lower impact on death and morbidity in kids, we may have been able to have kids in school differently than we did throughout the pandemic.”
The pandemic would become one of the most significant moments of Ghaly’s term, not just for the scale of the problem but for the impact it had on policy going forward. Ghaly called Covid-19 an “accelerant” at HHS, pushing forward and broadening Medi-Cal reforms as well as more deeply embedding housing as a core mission of public health.
“When we as a nation have advanced policy proposals and investments that allow other safety net systems to adequately support people being housed, then maybe the health system won't have to either pick up the tab or be so focused on that,” he said.
Housing has become a massive part of the Newsom administration’s approach to health, especially behavioral health. The state’s behavioral health system is undergoing a period of immense change, and most of these overhauls are in the very early stages. The Newsom administration pushed through a $6.4 billion bond in March by a close margin — Proposition 1 — meant to build thousands of new treatment slots, inpatient beds and supportive housing. Counties will now be devoting a third of some mental health budgets to housing interventions.
“My successor is going to need to continue to lengthen the implementation of each of those things,” Ghaly said. “Sure, we got a narrow win at the ballot, but in 2026, it's go time. … Are people going to be ready?”
Activists and mental health professionals have expressed some trepidation about the suite of reforms Ghaly and Newsom have pushed through. The renewed focus on severe mental health and substance use issues on the street — which critics argue could come at the expense of prevention — and the push for more compelled treatment have elicited doubts about the state’s direction.
Still, this “tapestry” of behavioral health changes is what Ghaly says he’s most proud of. Newsom even brought up these ideas during Ghaly’s job interview, the secretary said.
But it could still be years before some of these programs show results, meaning they will fall to the next HHS secretary, and even the one after that.
“Decisions happen in Sacramento, they get implemented locally, and that's not always easy, it's hard,” Ghaly said. “So I wish so many of these things on the bullet list were done to further completion that it didn't take as long to get the kind of progress and results.”
Ghaly will stay on at HHS through the end of the month, and Johnson will take over starting Oct. 1.
Looking to the future, Ghaly was clear about what else he thinks needs to be done next. He wants to see California-branded insulin on the shelves soon after the state pledged to produce its own in 2020. He wants to see more transparency and accountability from health insurance plans and predicts a greater role for community health workers in the future.
“I think the affordability of health care is going to keep boiling,” Ghaly said. “I do think it will get to that boiling point if some changes are not made.”
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