Senate Sets Jan. 9 Hearing for Health Secretary Nominee

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By Victoria Pelham and Alex Ruoff

President Donald Trump’s choice to be the next head of the Department of Health and Human Services will go before the Senate Finance Committee Jan. 9, a major step toward his confirmation.

The agency has been without a permanent leader at its helm since former secretary Tom Price resigned in late September.

Alex Azar, former president of Eli Lilly & Co. and former deputy secretary at the HHS, is likely to face the same questions about his ties to the pharmaceutical industry and his ideas for tackling high drug prices he faced the last time he went before a congressional committee. In November, Senate Democrats questioned whether Azar could take on an industry he was a part of for several years.

Senate Finance Committee Chairman Orrin Hatch (R-Utah), however, has been effusive in his praise of Azar and said in a Jan. 2 statement his experience will help him “tackle the challenges facing the American healthcare system head-on.”

Azar served as HHS general counsel and deputy secretary under President George W. Bush.

Next for Azar

Senate Republicans don’t expect any delays on renominating Azar, whose appointment had to be resubmitted at the start of the year. The paperwork is still the same, and Senate Finance lawmakers hope to confirm him as HHS secretary by February, according to a congressional staffer.

The committee will likely approve his nomination by party line, the same as it did for Trump appointee Price.

Brian Rye, a health-care analyst for Bloomberg Intelligence, said the nomination will likely advance and will be reflective of other hearings on Trump picks with “consistent” support from Republicans and opposition from Democrats.

Public Citizen, a left-leaning nonprofit focused on citizens’ rights, and more than 60 other groups, including unions and abortion rights activists, called on senators Jan. 3 to block Azar’s nomination.

Azar’s Vision

In a letter, Public Citizen cautioned against the nominee’s opposition to Obamacare, support of Medicaid block grants, and noncommittal stance on mandatory birth control coverage, as well as his background working for a drug company. His tenure at Eli Lilly saw an insulin price increase from $74 to $269 and lawsuits and state investigations over its insulin sales, the letter said. Advancing Azar would hurt health-care access, the nonprofit said.

“At a time when our country is facing a crisis of access to affordable medicines, we need an untainted and credible advocate for patients and our health-care system,” the letter said. “A former prescription drug company executive with a history of spiking the prices of lifesaving medicines simply is unqualified to address the needs of our national health care system.”

Medicaid Health Plans of America, which backs Azar’s nomination, told Bloomberg Law in a separate statement that, on the contrary, the nominee’s drug industry experience “gives him the expertise about drug pricing needed to set a direction for increased value at lower cost.” Additionally, Azar has shown a “commitment to work with the private sector to address drug prices,” Jeff M. Myers, president and CEO of Medicaid Health Plans of America, said in the statement.

The managed care lobby is “all in” on Azar and believes he will understand and appreciate the group’s upcoming proposal to overhaul the Medicaid Drug Rebate Program, Myers said.

Hatch, in his Jan. 2 statement, said the Finance Committee’s hearing next week would allow lawmakers to hear Azar’s “plans to help mitigate Obamacare’s corrosive effects, while ensuring Medicare and Medicaid are strengthened and maintained.”

Rye noted lawmakers were “taking a breath” on health policy in the coming months, turning their attentions to immigration, infrastructure, transportation, and other priorities: But another internal Republican battle is likely brewing over whether to repeal other Affordable Care Act provisions in 2018, especially given that it’s an election year and in light of the need for more Senate Republican consensus.

Other Health Nominees in Limbo

Seventeen key positions remain unfilled at HHS, according to a database of the Partnership for Public Service and the Washington Post.

A lack of leadership fully on hand “certainly makes it harder for the agency to fulfill its mission in as seamless a manner as they would like while they debate what that mission’s going to be during the year,” Rye said. “It obviously would behoove them to have all their key positions lined up.”

That’s especially true if changes for Medicaid are proposed again, for example, and regulators will need to field questions.

Other held-up HHS nominations could take longer because Democrats are slowing the process, a Republican congressional staffer said.

Democrat source confirmed the nominations must be re-submitted at the beginning of each year unless Senate agrees to keep them. No unanimous consent was passed, so nominations need to be re-submitted.

Nominations for three assistant health policy positions must also be resubmitted, because no unanimous consent was passed, according to a Democratic congressional aide. Unconfirmed nominations have to be renominated by the White House at the beginning of each year unless the Senate agrees to keep them there.

Those nominees are Stephen Parente of Minnesota, Brett Giroir of Texas, and Matthew Bassett of Tennessee to be assistant secretaries of health and human services.

To contact the reporters on this story: Victoria Pelham in Washington at vpelham@bloomberglaw.com and Alex Ruoff in Washington at aruoff@bloomberglaw.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bloomberglaw.com

Copyright © 2018 The Bureau of National Affairs, Inc. All Rights Reserved.

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