The Senate on Wednesday confirmed Alex Azar as secretary of the Health and Human Services Department, entrusting a former pharmaceutical executive to tamp down drug prices and steer President Trump’s attempts to reshape Obamacare.
A handful of Democrats joined all but one Republican in approving the nominee, 55-43, brushing aside liberal voices who said Mr. Azar’s track record of raising prices at drugmaker Eli Lilly made him the wrong man for the job.
Republicans said Mr. Azar’s resume was an asset, not a liability.
A sharp lawyer who served in the Bush administration, Mr. Azar is said to have an encyclopedic knowledge of how HHS works and a firm grasp on how perverse market incentives are driving drug prices upward.
“His distinguished record – including prior HHS service as deputy secretary and private-sector work – shows he is the right man for the job,” Senate Majority Leader Mitch McConnnell said. “It is vital that this department be headed by a leader with Mr. Azar’s extensive qualifications and excellent reputation.”
Mr. Azar will fill a secretary chair that’s been occupied by acting boss Eric D. Hargan for several months.
President Trump’s first pick for the job — former congressman Tom Price — resigned amid revelations he used expensive charter planes for business travel.
Once installed, Mr. Azar will oversee a sprawling, $1-trillion agency that regulates and approves drugs, combats disease and runs public health programs such as Medicaid and Medicare.
His confirmation process largely centered on two issues, however — soaring drug prices and the fate of Obamacare.
Mr. Azar said his inside knowledge of the pharmaceutical industry will make him an effective reformer. He wants to speed generics to market and make sure companies don’t game patents to shut out competition. Those market-oriented ideas satisfied majority Republicans, but fell short of the type of direct government intervention that liberal senators prefer.
Republicans largely failed to repeal and replace Obamacare as promised, forcing Mr. Trump to find ways to chip away at the 2010 law on his own.
Regulations that chip away at the law will come across Mr. Azar’s desk. They include efforts to let people duck the Affordable Care Act’s exchanges by holding onto short-term plans, or requiring able-bodied people who gained Medicaid coverage under Obamacare to find a job, volunteer or go to school as a condition of their benefits.
“Some of the most consequential decisions the new secretary will make will be in reviewing state waivers under the ACA and Medicaid,” said Larry Levitt, senior vice president at the Kaiser Family Foundation. “These waivers have the potential to reshape insurance markets and the Medicaid program in far-reaching ways.”
Some of Mr. Trump’s moves threaten to sap critical customers from Obamacare’s exchanges, meaning unsubsidized customers could face even higher premiums in the individual market.
“In particular, because these actions have driven up premiums and deductibles higher, they have hurt the 40 percent of households who make too much money to get a premium subsidy,” said Robert Laszewski, a health policy consultant in Virginia. “I doubt very much this new secretary of HHS is going to go up against Trump and reverse that.”
Sen. Chris Murphy, Connecticut Democrat, said Mr. Azar was a better pick than his predecessor, Mr. Price, but he couldn’t bring himself to support the nominee. He said voters who beat back GOP efforts to replace Obamacare don’t want to see it watered down by the Trump administration, either.
“People know the strength of the Affordable Care Act,” he said. “That’s why they pressed Congress not to repeal it.”
Yet six Democrats were willing to defer to Mr. Trump’s pick and voted “yes.”
Sen. Rand Paul of Kentucky was the only Republican to reject the nominee.
During the confirmation process, Mr. Paul had pressed Mr. Azar to give more vocal support for plans that would allow Americans to import prescription drugs from overseas.