President Donald Trump’s top choice to replace Tom Price as the secretary of the Department of Health and Human Services is a departure from the norm.
Unlike previous HHS secretaries who had backgrounds in government, Alex Azar, 50, comes from an industry that the federal agency regulates: pharmaceuticals. As the former head of Eli Lilly and Company, Azar, if confirmed, would be tasked with reducing rising prices of prescription medications including those that the pharmaceutical company manufactures.
Senate Democrats have vowed to oppose Azar’s nomination during hearings (the Senate Health Committee has scheduled a hearing for Wednesday, Nov. 29). But healthcare industry trade groups seemed pleased with Trump’s choice for the top HHS post.
RELATED: Despite Azar’s ties to pharma, healthcare industry insiders seem pleased with Trump’s HHS pick
Here are 10 things to know about the HHS nominee:
1. His ties to pharma run deep
Azar worked for Eli Lilly for the greater part of the last decade. He held several positions at the company, including as president, senior vice president of corporate affairs and communication and vice president of managed healthcare services for Puerto Rico.
After 5 years leading the company, Azar stepped down in January to start a consulting firm, Seraphim Strategies, LLC, in Indianapolis. The firm provides strategic consulting and counsel to the biopharmaceutical and health insurance industries.
2. He doesn’t have a great track record on reducing drug prices
Trump declared on Twitter that Azar will be “a star for better healthcare and lower drug prices!” But Politico reported that while he headed up Eli Lilly’s U.S. operation, the drug manufacturer tripled the price of a best-selling insulin drug. The publication stated that Azar has defended the pharmaceutical industry’s pricing practices and has been opposed to suggestions that Medicare be allowed to negotiate drug prices, something Trump advocated for during his campaign.
3. He has contributed a lot of his money to the pharmaceutical industry political spending
Although Trump has criticized the amount of money drug companies give to politicians, Rollcall reported that since 2000, Azar has spent approximately $105,000 in political contributions. He gave to Eli Lilly’s political action committee and Republican candidates, including the Trump campaign, President George W. Bush and Senate Majority Leader Mitch McConnell.
4. He opposes Trump’s policy proposal to import medications from Canada
One of the best parts of the American healthcare system, he told Fox Business during an interview in June, is its closed distribution system and the tight control of products in the U.S.
Azar said that American-produced drugs don’t sit in a Canadian retail pharmacy. The drugs, he said during the interview, may come from China or India and are transshipped through Canada into the U.S. There is no guarantee of their safety, according to Azar. “The U.S. distribution system is a crown jewel. Let us not mess that up,” he said.
5. Prior to his work within the pharmaceutical industry, he worked as a lawyer
Azar studied government and economics at Dartmouth College, where he earned his Bachelor of Arts degree. He then obtained his law degree from Yale Law School in 1991. His LinkedIn profile indicates he was a law clerk for U.S. Supreme Court Justice Antonin Scalia for one year in the early 1990s.
Azar described Ken Starr as his mentor. He worked with Starr after he became the independent counsel for the Clinton Whitewater investigation.
6. He knows the inner workings of HHS because he’s already worked for the agency
Azar served as the general counsel for HHS from 2001 to 2005, and during his tenure The Washington Post reported that he assisted with the George W. Bush administration’s response to 9/11, as well as the anthrax attacks and health issues, including a stem cell policy and Medicare prescription drug benefits. He then became the deputy secretary under then-HHS Secretary Mike Leavitt, a position he held for two years.
The Post said he advocated for price transparency associated with medical services and supported efforts to convert medical records from paper to electronic form during that stint. He was confirmed for both HHS positions by a unanimous voice vote.
7. He admits he came to the healthcare industry by accident
In his Yale alumni profile, Azar wrote that he was involved in the Bush-Cheney campaign in 2000 and that after Bush won, HHS Secretary Tommy Thompson asked if he would be interested in serving as General Counsel.
“I'll confess that I wrestled with the question, since I had not focused on health law in my legal career,” he said. ”Within 30 days of being at HHS, however—with a team of unbelievably talented and dedicated lawyers, the superb career leadership at the department and the dynamic team around Secretary Thompson—I realized I had found my life's calling: to help people around the world live longer, healthier and happier lives.”
8. He could use his legal expertise to undermine the Affordable Care Act
As HHS secretary, Azar would be in charge of ACA enrollment and implementation. But Azar described former President Barack Obama's signature legislation during an interview with Fox in May as a "fundamentally broken" system.
“Much of the focus will likely be changing the ideology under which the existing law will be administered,” Leavitt told the New York Times. “I’m confident that he would like to see the way the law works change.”
9. He has ties to Vice President Mike Pence
Eli Lilly is based in Indiana, the home state of Pence.
"I know [Pence] thinks highly of Alex—a lot of us in Indiana do," Bob Grand, a longtime Pence donor, told Politico. A second Politico article noted that Azar has been a longtime Pence supporter.
10. He's married with two children and enjoys hunting
Azar grew up in Salisbury, Maryland, where his father is a practicing ophthalmologist. The Wall Street Journal reported that Azar and his son hunt duck, geese and pheasant. The newspaper said he is also a member of the Nome and Kotzebue Polar Bear Clubs in Alaska.