Skip to main content
Subscribe
  • Login
  • My Account
  • Logout
  • Register For Free
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HLTH 2024
    • Sponsored Content: Vital Signs Blog
  • Opinion
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • 40 Under 40
    • Best Places to Work in Healthcare
    • Healthcare Marketing Impact Awards
    • Innovators Awards
    • Diversity Leaders
    • Leading Women
    • Best in Business Awards
    • The 2030 Playbook Conference
    • Innovations in Patient Experience
    • Leading Women Conference & Awards Luncheon
    • Leadership Summit
    • Workforce Summit
    • Best Places to Work Awards Gala
    • Diversity Leaders Gala
    • - Looking Ahead to 2025
    • - Financial Growth
    • - Hospital of the Future
    • - Value Based Care
    • - Looking Ahead to 2026
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Skilled Nursing Facilities
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
    • Sponsored Content
MENU
Breadcrumb
  1. Home
  2. Government
November 12, 2017 11:00 PM

Can Trump's pick to lead HHS navigate the churning political waters of healthcare?

Harris Meyer
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Alex Azar

    (Story updated at 3:30 p.m. ET)

    Former pharmaceutical executive Alex Azar will face daunting management and policy challenges if he's confirmed as President Donald Trump's nominee to lead HHS.

    Trump on Monday announced Azar as his choice to succeed Dr. Tom Price, who resigned in September following reports of his extensive use of government and charter air travel. Azar "will be a star for better healthcare and lower drug prices!" Trump tweeted.

    Azar would inherit a huge, sprawling agency currently torn by political and policy divisions in the wake of Price's leadership. He will have to make key decisions to avoid further disruption in the individual health insurance market, while navigating around fierce partisan schisms. In addition, he will have to decide how much leeway to give states to make big changes in their Medicaid expansion programs.

    And he'll face pressure to address rising prescription drug costs.

    Azar formerly headed pharmaceutical giant Eli Lilly & Co.'s U.S. division. Before that, he served as HHS general counsel and deputy secretary during the George W. Bush administration. During that stint, he received praise for his management competence. He did not have a healthcare background prior to his HHS work.

    "I worked with Alex every day for the whole time I was at the CMS, and he's a very nice human being and a smart lawyer," said Tom Scully, who served as CMS administrator in the Bush administration.

    "He's a great listener, he's smart enough to know what he doesn't know," added Scully, now a general partner with private equity firm Welsh, Carson, Anderson & Stowe. "He won't come in with strong policy views. He will talk to people in the department and on the Hill and see what they think."

    Andy Slavitt, CMS administrator under the Obama administration, offered cautious praise for Azar as the choice to head the $1.15 trillion, 80,000-employee agency that oversees the CMS, the Food and Drug Administration, the National Institutes of Health, and the Centers for Disease Control and Prevention.

    "I have reason to hope he would make a good HHS secretary," Slavitt said in a written statement. "He ... has real-world experience enough to be pragmatic, and will hopefully avoid repeating the mistakes of his predecessor in over-politicizing Americans' access to healthcare."

    "It's good to have somebody who has the perspective of the industry that plays the most important part of drug development," said Dr. David Spigel, chief scientific officer and director of the lung cancer research program at HCA's Sarah Cannon Research Institute.

    Still, Azar has been a sharp critic of the Affordable Care Act, saying in May that the ACA is "fundamentally broken" and "circling the drain." In June, he envisioned the Trump administration shifting the ACA in a more conservative direction even without repeal and replacement of the law.

    He previously has opposed ideas for reducing prescription drug prices such as purchasing drugs from other countries where prices are lower.

    Azar went to work for Lilly in 2007 as senior vice president of corporate affairs and communications, and later became chief of Lilly's U.S. operations, a position he held until this past January. He also served on the board of BIO, which represents biotechnology companies.

    In his confirmation hearings, Senate Democrats are expected to probe Azar's close ties to the drug industry and whether he has the independence to take strong steps to curb drug prices, an issue on which Trump has urged action. They also are likely to question him on his approach to implementing the ACA.

    "This confirmation process will be a referendum on the Trump administration's repeated efforts to sabotage our healthcare system and raise premiums on millions of Americans," Senate Democratic leader Chuck Schumer of New York said in a written statement on Azar's nomination. "It's time to turn over a new leaf at HHS."

    Azar would take charge of an agency that is still roiled by investigations into Price's air travel, with senior political appointees reportedly divided into different political factions.

    In addition, many career staff are concerned about Trump administration moves to roll back ACA coverage and impose tougher conditions on Medicaid eligibility for low-income adults, said Tim Gronniger, a CMS deputy chief of staff in the Obama administration who's now senior vice president of strategy at Caravan Health.

    Azar will have to decide whether to continue the Obama administration's aggressive push for much broader use of value-based payment programs in Medicare. Price had slowed HHS implementation of value-based payment, especially mandatory programs.

    Observers predict Azar will be less openly ideological than Price, a former orthopedic surgeon who vocally advocated less regulation of healthcare businesses and medical practices. "I would expect him to be less out there opining on a regular basis," Scully said. "He's a lawyer, he's not going to be out there winging it. It's not his style. He's a nice, honest, pleasant guy."

    Gronniger agreed. "I think it's great he comes in without really strong public policy positions," he said. "That was a huge weakness for Price."

    One management issue Azar would quickly face is how to deal with Price's ambitious Reimagine HHS initiative to streamline the department's operations. That plan accompanied the White House budget proposal to slash the HHS' budget for 2018 by 18%, a move congressional Republicans do not support.

    Azar is considered a skilled manager, but he'll have his hands full administering the huge agency and coordinating efforts with CMS Administrator Seema Verma.

    "As much or more than what he thinks about policy, the manager part is more important than anything else," Gronniger said. "It's a hard place to run, and he'll have to work through a lot of tensions."

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Legal-government-0225
    HHS lawsuit by Democratic AGs aims to stop restructuring, layoffs
    GettyImages-654573744.jpg
    Federal watchdog to retract medical debt collection opinion
    Most Popular
    1
    'Legendary' Hemsley takes over at UnitedHealth amid rough seas
    2
    Big retail tried to disrupt healthcare—who is making a dent?
    3
    These are the regulations the AHA wants RFK Jr. to scrap
    4
    Downside risk, upside payment highlight new CMS innovation agenda
    5
    Medicaid cuts bill clears key House committee
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2025. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HLTH 2024
      • Sponsored Content: Vital Signs Blog
    • Opinion
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • 40 Under 40
        • Best Places to Work in Healthcare
        • Healthcare Marketing Impact Awards
        • Innovators Awards
        • Diversity Leaders
        • Leading Women
        • Best in Business Awards
      • Conferences
        • The 2030 Playbook Conference
        • Innovations in Patient Experience
        • Leading Women Conference & Awards Luncheon
        • Leadership Summit
        • Workforce Summit
      • Galas
        • Best Places to Work Awards Gala
        • Diversity Leaders Gala
      • Virtual Briefings
        • - Looking Ahead to 2025
        • - Financial Growth
        • - Hospital of the Future
        • - Value Based Care
        • - Looking Ahead to 2026
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Skilled Nursing Facilities
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing
      • Sponsored Content