On November 29, 2017, the Senate Health, Education, Labor and Pensions (HELP) Committee held a courtesy hearing to consider the nomination of Alex Azar as Secretary of the U.S. Department of Health and Human Services (HHS). Mr. Azar has been nominated to replace Tom Price, who resigned as Secretary in late September of this year. The hearing lasted for about three hours and included opening statements from Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray as well as the nominee, Mr. Azar. These statements were followed by two rounds of questioning.
In his opening testimony, Mr. Azar highlighted four areas he would prioritize if confirmed as HHS secretary: high drug prices, making health care more affordable, shifting to paying for health outcomes, and following through on President Trump’s call for action combating the opioid crisis.
Similar to the confirmation hearings for Price, this hearing took a decidedly partisan tone. Democrats often asked critical questions, particularly about Mr. Azar’s tenure working at drug manufacture Eli Lilly, while Republicans asked more supportive questions. Senators highlighted a number of issues in their questions, particularly the cost of prescription drugs.
Drug pricing was a hot topic throughout the hearing, particularly for Democratic committee members. Multiple senators, including Ranking Member Murray, Rand Paul (R-KY), Elizabeth Warren (D-MA), and Tammy Baldwin (D-WI) expressed skepticism at Mr. Azar’s role in fighting drug prices due to his tenure at Eli Lilly, which is facing scrutiny for its pricing of insulin. When asked about efforts he might take, Azar discussed combating any gaming of the patent system, applying lessons from private sector negotiations in Medicare Part D, and increased competition for both branded and generic drugs. Other questions addressed importation, price negotiation, and company investment in research and development activities.
Multiple Senators, including Murray, Chris Murphy (D-CT), Lisa Murkowski (R-AK), Bob Casey (D-PA), and Al Franken (D-MN), also pushed Mr. Azar on recent actions taken by the Trump administration related to the Patient Protection and Affordable Care Act (ACA). These included cutting the budget for advertising, navigators, and shortening the open enrollment period. While not taking any specific position on these decisions, Azar stated that as secretary, he would rely on data and information to make such decisions, saying he would evaluate what is and is not working in HHS programs.
Other questions from Senators focused on specific health policy topics of interest to the individual members. For example, Sen. Maggie Hassan (D-NH) asked about women’s health and combating the opioid crisis. Both Sens. Murray and Murkowski were also curious about Azar’s position on women’s health issues. Azar spoke of striking a balance between giving women access to the care they need and the moral and conscience leanings of employers.
Finally, Sens. Murray and Bill Cassidy (R-LA) asked about health IT and electronic health records. Azar expressed an interest in working with the committee and others to find ways to successfully utilize this type of technology while not putting an undue burden on providers. Sen. Sheldon Whitehouse (D-RI) discussed Accountable Care Organizations (ACOs) and their role in driving down costs and improving quality. Azar spoke positively about these types of efforts and the role Medicare can play.
Mr. Azar’s nomination will next be considered in a hearing with the Senate Finance Committee who will then vote on his nomination. The date of this hearing has not yet been set. Should his nomination pass the Finance Committee, the entire Senate will then consider Mr. Azar’s nomination.