Trump picks ex-pharma govt Azar to steer HHS

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The Department of Health and Human Services building is pictured.

A veteran of HHS, Alex Azar constructed a fame as a realistic and principled. | Evan Vucci/AP Photo

Azar’s allies describe him as a pragmatist and a no-drama supervisor.

By ADAM CANCRYN and SARAH KARLIN-SMITH

Updated

2017-11-13T10:46-0500

President Donald Trump on Monday nominated former pharmaceutical govt Alex Azar to be his subsequent Health and Human Services secretary, shifting to stabilize the company on the heart of his administration’s largest home coverage failure.

Azar, a veteran of George W. Bush’s administration, would succeed Tom Price, who resigned after POLITICO reported he spent roughly $1 million on non-public and authorities air journey in simply seven months on the job.

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“He will be a star for better health care and lower drug prices!” Trump tweeted from the Philippines this morning.

If confirmed, the 50-year-old Azar can be thrust onto the entrance traces of a White House agenda that features repealing Obamacare, reining in drug costs and rolling again rules — targets which have remained largely unfulfilled since Trump took workplace.

The Trump administration is wagering Azar has the coverage and political chops to get these priorities again on monitor, and the managerial experience required to restore relationships inside HHS and on Capitol Hill left frayed by congressional Republicans’ dysfunctional repeal effort and the next scrutiny of Price’s journey habits.

Azar spent almost a decade at Indianapolis-based Eli Lilly, the place he rose to grow to be president of the pharmaceutical big’s U.S. operations earlier than leaving earlier this 12 months. Prior to that, he served as HHS common counsel after which deputy secretary throughout six years years with the Bush administration.

It was there the place Azar constructed a fame as a realistic and extremely competent — if demanding — chief steeped in each the processes of policymaking and the federal paperwork.

A low-key operator who’s since remained principally out of the political highlight, he’s considered as a near-diametrical reverse of his firebrand predecessor, individuals near Azar and the White House’s search course of mentioned. That’s an interesting distinction for an administration nonetheless smarting over Price’s scandal-plagued downfall, and anticipating a gentle hand to information its rising set of well being care initiatives.

“It’s a great pick for where the agency is right now,” mentioned Lanhee Chen, who labored with Azar on Mitt Romney’s 2012 presidential marketing campaign. “I don’t think anybody can question his credentials from an experience perspective.”

Even the AIDS Institute, usually essential of the Trump administration on well being points, praised the choice.

“As both a former HHS Deputy Secretary and General Counsel, together with his private-sector experience, Alex Azar has the knowledge, expertise and leadership to oversee our Nation’s health response,” mentioned Carl Schmid, the group’s deputy govt director.

The nomination comes at a essential level for the administration. The White House is barreling towards the top of its first 12 months with no main legislative accomplishments — the consequence of a botched Obamacare repeal effort riddled with missteps and infighting.

Price, an ex-congressman who was picked based mostly partly on his anti-Obamacare zeal and connection to congressional conservatives, did not ship essential votes and ended up largely absent from a course of the White House had anticipated him to steer.

Trump insists Congress will take one other shot at dismantling the legislation early subsequent 12 months. But with midterm elections looming and Republicans on Capitol Hill cautious about one other pitched battle over well being care, reaching that aim would require far stronger management and a clearer coverage imaginative and prescient from the administration.

The White House within the interim has taken a collection of administrative steps to undermine Obamacare that pose an ongoing menace to the soundness of the well being care markets, together with a obscure however sweeping mandate to rewrite federal insurance coverage rules and the elimination of a key stream of federal subsidies for insurers that despatched tremors by the Obamcare markets.

If confirmed, Azar must translate Trump’s hasty orders into workable long-term coverage or threat watching the markets fall into chaos early on in his time period.

Republicans initially nervous that problem would complicate the seek for a professional HHS secretary.

But Azar rapidly emerged because the front-runner, bolstered by his ties to plenty of administration officers together with Vice President Mike Pence, Domestic Policy Council Director Andrew Bremberg and HHS performing Secretary Eric Hargan. He served with the latter two throughout the Bush administration, earlier than ingraining himself in Indiana’s tight well being coverage group over his tenure at Lilly.

“I know [Pence] thinks highly of Alex — a lot of us in Indiana do,” mentioned Bob Grand, a longtime Pence donor who speaks often with the vice chairman.

Just as importantly, Azar’s allies have pitched him as a no-drama supervisor who will not let his private ideology get in the best way of the administration’s priorities. A staunch conservative who clerked for Antonin Scalia earlier than becoming a member of Ken Starr’s Whitewater investigation staff within the 1990s, he is however thought to be a staff participant who’s maintained relationships with Republicans throughout the political spectrum.

Azar was an adviser on Mitt Romney’s 2012 presidential marketing campaign, and throughout the 2016 cycle did a stint on Jeb Bush’s Indiana steering committee. When Bush dropped out, he joined Ted Cruz’s state steering committee. And after Cruz dropped out and Trump emerged because the GOP nominee, Azar donated $2,700 to Trump’s marketing campaign fund simply forward of the election.

“He’s a traditionally intellectual conservative, [House Speaker] Paul Ryan type,” mentioned one one that is aware of Azar from his time in Indiana. “He is by no means a Steve Bannon type of ideologue.”

That marks a pointy distinction with Price, a physician whose hard-right coverage views and sympathy for his fellow physicians guided his decision-making — and who rapidly alienated profession staffers on the well being division.

Still, Azar’s standing as the final word “safe pick” — as a number of Republicans put it — in a area that included ex-Sen. Rick Santorum and former Louisiana Gov. Bobby Jindal is more likely to immediate concern from the far proper and intense scrutiny from the left.

Azar is a largely unfamiliar identify to the grbadroots tea occasion teams who’ve carved out a distinguished place in at present’s GOP, a number of conservative strategists mentioned, and who will likely be skeptical of his institution background.

And whereas Democrats privately take into account Azar’s choice removed from the worst-case situation, they’re positive to grab on his time at Lilly as proof he’ll be overly deferential to the highly effective pharma foyer.

“All these drug corporations are jacking up prices because Washington isn’t doing its job to oversee them, and so I have great concerns,” Sen. Tammy Baldwin, who has championed bipartisan laws on drug pricing, mentioned of Azar’s candidacy. “I’ll look at it when it officially comes to us, but I’m very disquieted.”

Trump has threatened to crack down on pharmaceutical corporations over rising drug costs, however hasn’t adopted by with any concrete motion. And his administration is already stocked with pharmaceutical trade gamers.

Joe Grogan, OMB’s director of well being packages, spent the previous 5 years as head of federal affairs for Gilead Science. The White House’s lead on well being coverage for its Domestic Policy Council, Katy Talento, is a former aide for Sen. Thom Tillis, an enormous booster of the drug trade. In August, Trump appointed Tomas Philipson, co-founder of pharmaceutical advisory agency Precision Health Economics, to his Council on Economic Advisers.

Azar has echoed a lot of the pharma playbook on pricing in current months, deflecting blame for top prices to different elements of the trade and to different nations. He’s opposed authorities negotiations of drug pricing and drug importation, and prompt throughout a Fox News look that the administration ought to strain Europe over its “radical price controls.”

During the tail finish of Azar’s time at Lilly, the corporate was hit with a clbad-action lawsuit alleging collusion to drive up the price of insulin. Lilly has since come beneath investigation by state attorneys common over its insulin pricing.

Allies of Azar waved off considerations that he’d find yourself being a shill for the trade, arguing his time with the drug maker represents only one section of a prolonged resume.

“I would hope people would evaluate him based on the entirety of his career,” Chen mentioned. “It’s politics, so you can imagine how people might use his background against him. But I hope that they don’t.”

Senate Democrats will not be inclined to provide Azar a cross. In late October, the rating members on the Finance and HELP Committees — the panels that can oversee Azar’s affirmation course of — despatched the Trump administration a listing of 51 rules they mentioned they will use to guage the following HHS nominee.

And towards the backdrop of a GOP agenda that is nonetheless dedicated to repealing Obamacare, Azar’s nomination will function a high-profile alternative to launch contemporary badaults on a White House that critics argue has shed its populist guarantees in favor of big-business affect.

“They’ve also said they’re going to drain the swamp and crack down on Wall Street,” Sen. Patrick Leahy mentioned. “You’ve got the rhetoric. Let’s see what the reality is.”

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