Trump nominating Azar as next HHS secretary

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November 13, 2017

President Trump's nominee to lead the Department of Health and Human Services has a deep knowledge of the regulatory process, those who worked with him said, but Democrats are likely to raise flags.

November 13, 2017

President Trump's nominee to lead the Department of Health and Human Services has a deep knowledge of the regulatory process, those who worked with him said, but Democrats are likely to raise flags.

On Monday, Trump tapped Alex Azar to fill the HHS secretary role vacated by Tom Price in late September amid revelations that Price took repeated trips on government and private jets that cost taxpayers over $1 million.

    Happy to announce, I am nominating Alex Azar to be the next HHS Secretary. He will be a star for better healthcare and lower drug prices!

    – Donald J. Trump (@realDonaldTrump) November 13, 2017

The role is high profile, tasked with overseeing various facets of health care, from Medicare and Medicaid, to drug approvals and disease control – and most controversially, the implementation of the health care law Republicans want to tear down.

It's almost certain the nomination process won't be easy, as Democrats will put up a fight against any potential secretary who supports key items of the Republican agenda, such as repealing and replacing ObamaCare. But, the GOP controls 52 seats, and Azar only needs 51 votes to win Senate confirmation.

Azar left the pharmaceutical company Eli Lilly in January after working there for nearly a decade, most recently serving as the president of Lilly USA. He now runs a consulting firm, according to his LinkedIn. Working in HHS in former President George W. Bush's administration, he served as the department's general counsel from 2001 to 2005 and then assumed the role of deputy secretary for the next two years.

He would bring "competence, leadership, a smart, conservative agenda, and also an understanding of how the regulatory process works, which I think is important given that the Trump administration is trying to accomplish a lot of its health policy goals via the administrative process," said Tevi Troy, who served as Bush's deputy head of the White House Domestic Policy Council when Azar was at HHS.

Nominating someone familiar with the regulatory process could be important for Trump, who is examining ways to unwind ObamaCare that wouldn't need approval from Congress, after Republicans' months-long effort to repeal and replace the health law failed.

Azar served as HHS' No. 2 under Secretary Mike Leavitt, who said he asked Azar to oversee the department's regulatory process.

"He understands the process and he knows the levers and how you make it work and where the potential roadblocks are," Leavitt said. "I think he would be of particular value given the fact that … so far a repeal bill has not occurred and they're going to need to make their imprint on existing laws through replacing the ideology underpinning it."

GOP leadership worked on a repeal bill for months, but it was dogged with concerns from centrists that it could hurt their constituents' coverage under the ObamaCare Medicaid expansion and from conservatives who argued it didn't do enough to lower premiums.

Azar was asked for his position on that bill by a Fox Business host over the summer.

"I think, Stuart, you and I generally agree that the status quo is pretty bad and any change to that that's productive is a good thing," Azar said on July 17, adding he'd like to see more changes.

Stuart Varney, the host, responded: "You cut right through to it, I keep saying that something – no matter what it is – something is better than nothing. Where do you stand on that?"

"It's very dangerous to let the perfect be the enemy of the good especially when you have to get 50 people in the U.S. Senate to agree to it," Azar replied.

Two days before Senate Republicans failed to pass a scaled-down version of an ObamaCare repeal bill, Azar predicted on Fox Business that, "At the end of the day this is a hot potato that lands back in Secretary Price's lap for him to use as many authorities as he has to grant flexibility and try and dig us out of the ObamaCare mess as much as he can."

It's likely lawmakers will question his role at the Eli Lilly, as they've have pressed pharmaceutical companies for more transparency behind their prices, especially after some high profile price hikes last year.

Drug prices are one issue where President Trump is more in line with the opposition party, and has many times said the industry is "getting away with murder."

Still, the administration hasn't taken a hard line, and legislation backed by Democrats is not likely to move anywhere in the GOP-controlled Congress. It's hard to see Republicans voting against Azar's nomination simply because he worked at a drug company.

Democrats, though, are another story.

Two ranking members on panels overseeing health care – Sen. Ron Wyden (D-Ore.), with the Finance Committee, and Sen. Patty Murray (D-Wash.), with the Health Committee – sent a letter in October to Trump outlining their priorities for the next HHS secretary. Some of the 51 priorities are key components of Trump's agenda, setting up a confirmation showdown.

Price's nomination was a hard-fought battle.

Finance Committee Democrats boycotted a vote to send Price's nomination to the Senate floor. The panel's chairman – Sen. Orrin Hatch (R-Utah) – had to temporarily suspend committee rules to pass the nomination.

Notably, as HHS general counsel, Azar worked to help then HHS Secretary Tommy Thompson officially declare the first public health service emergency after two airplanes flew into the World Trade Center on Sept. 11.

"He was able to research the law very quickly and said, 'we have the authority to do so' and gave me the authority," Thompson said. "And we went away and declared a health emergency. It was badly needed and it was right on, and nobody's ever questioned" our legal ability to do it.


Courtesy/Source: The Hill