Senate confirms Trump health secretary

The Department of Health and Human Services (HHS) has a new boss, Alex Azar, after nearly four months without a permanent leader.

The Senate confirmed Azar, a former pharmaceutical executive, on Wednesday by a 55-43 vote with six Democrats and Independent Sen. Angus King (Maine) joining all but one Republican to support the nominee.

Sen. Rand Paul (R-Ky.) was the lone Republican to vote against his confirmation, after having previously expressed concern over Azar’s reticence to let drugs be imported from overseas.

Azar replaces Tom Price, who resigned in September after Politico detailed repeated trips he took on private and military jets, costing taxpayers more than $1 million.

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Democrats have attacked Azar over drug prices — saying the cost of several drugs more than doubled during his time at Eli Lilly — and expressed concern that he would continue what they view as the Trump administration’s attempts to sabotage ObamaCare.

Meanwhile, Republicans cast Azar’s nearly 10 year tenure at Eli Lilly, where he served as president of Lilly USA from 2012 to 2017 years, as an asset because he already knows the ins and outs of such a complex industry.

Azar will take the helm of the massive department at a critical juncture for ObamaCare. It’s unlikely congressional Republicans will return to the difficult task of repealing and replacing President Obama’s signature health-care law, leaving the White House to seek changes on its own through administrative action.

Azar knows the regulatory process well. Under former President George W. Bush, he served HHS as general counsel from 2001 to 2005. He then became deputy secretary for two years under Secretary Mike Leavitt, who 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 told The Hill last year. “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.”

Prescription drugs prices are also likely to be discussed under Azar’s tenure. Lawmakers have criticized the high costs of prescription drugs, and President Trump has said drug companies were “getting away with murder.” In nomination hearings, Azar said “drug prices are too high.”

But in those hearings, Democrats expressed concerns over Azar’s record as a pharmaceutical executive, and that was, in part, a reason why some senators voted against his confirmation.

“Here’s my view: Mr. Azar’s nomination is a perfect encapsulation of the president’s broken promises on prescription drugs and health care overall,” Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, said in a press release ahead of a procedural vote on Azar’s confirmation.

The panel’s chairman, Sen. Orrin Hatch (R-Utah) has countered that Azar has the right experience to helm HHS, which oversees everything from Medicare and Medicaid to drug approvals and disease control.

“Mr. Azar spent several years as a senior official at HHS, holding key positions overseeing Medicare Part D and Medicare Advantage. He also led HHS’s responses to the anthrax attacks shortly after 9/11, the SARS and monkeypox crises, Hurricane Katrina, and many others,” Hatch said in a press release ahead of the confirmation vote.

“Clearly, Mr. Azar has seen both the good and bad at HHS and knows how to manage them. I don’t think there is anyone here, even on the other side of the aisle, who would contest that.”

The six Democrats who voted for Azar are Sens. Tom Carper (Del.), Christopher Coons (Del.), Joe Donnelly (Ind.), Heidi Heitkamp (N.D.), Doug Jones (Ala.) and Joe Manchin (W.Va.).