ACA, reproductive laws eyed as Azar sworn in as health secretary

Jan. 29 (UPI) -- Alex Azar, criticized by women's reproductive rights groups for his position that life begins at conception, was sworn in to lead the Department of Health and Human Services on Monday.

Azar, an attorney and former executive at pharmaceutical firm Eli Lilly & Co., was confirmed last week by the Senate in a 53-47 vote. Azar, 50, replaces Tom Price, who resigned in September after it was revealed that he spent $1 million in government funds to use private chartered plane flights.

President Donald Trump, present for Azar's swearing in, praised the new HHS chief for his doing an "incredible job" at Eli Lilly & Co., and said he expects him to take the department to a "brand-new level."

"As our new secretary, Alex will continue to implement the administrative and regulatory changes needed to ensure that our citizens get the affordable, high-quality care they deserve," Trump said. "He will help lead our efforts to confront the national emergency of addiction and death due to opioids. And I think we're going to be very tough on the drug companies in that regard and very tough on doctors in that regard, because what's going on is pretty incredible."

Trump said HHS must work "to get the prices of prescription drugs way down and unravel the tangled web of special interests that are driving prices up for medicine and for really hurting patients."

Azar's new post is one in which he has some experience. Between 2001 and 2007, he served as HHS general counsel and its deputy secretary under former President George W. Bush's administration.

Prior to joining the government, Azar clerked for a federal judge and Supreme Court Justice Antonin Scalia. In the mid-1990s, he was an associate at Kenneth Starr's firm, and helped the Texas attorney in the Whitewater investigation related to former President Bill Clinton and first lady Hillary Clinton. He's a graduate of Dartmouth and Yale University.

Once in office, Azar will oversee the department's $1 trillion budget and supervise expected Republican efforts to reduce the Medicaid program for low-income and disabled people. He's also a critic of the Affordable Care Act, former President Barack Obama's signature healthcare reform law.

Speaking in February 2017, Azar said there were methods other than the ACA in which the government can play a role in expanding insurance coverage to individuals. He previously said the expansion of Medicaid has been unsuccessful and preferred that government funding through "private sector vehicles" would be more efficient. He has chosen Peter Urbanowicz, a former hospital executive who worked at HHS during Azar's tenure there, to be his chief of staff.

Urbanowicz was partly responsible for drafting legislation in 2003 that led to the creation of the Part D drug benefit. In audio interviews last year from Alvarez & Marshal, where he specialized in turnarounds of large healthcare organizations, Urbanowicz said personnel is the best indicator of government policy.

"The personnel that the president puts into place in the executive branch is the most important sign of what the president thinks," he said. "We have to look closely at the people that President-elect Trump is putting into these health policy positions."

Azar is expected to make numerous changes in HHS staff following the short, controversial tenure of Price, Politico reported.

During confirmation hearings in November, Azar stated his support for a Trump administration effort to allow employers to deny insurance to cover contraception for employees on grounds of conscience.

"I do believe we have to balance of course a woman's choice of insurance that she would want with the conscience of employers and others," Azar said.

The department, in a strategic draft plan, acknowledges that its mission is to serve all Americans, beginning at conception. Azar's comments indicate that he is in agreement. In a written statement to Sen. Patty Murray, D-Wash., during confirmation hearings, he said the mission of HHS is "to enhance the health and well-being of all Americans, and this includes the unborn."

The Trump administration has rescinded guidance from Obama's government on reproductive health issues that made defunding Planned Parenthood difficult. The Office of Refugee Settlement, an HHS department, last year attempted to deny abortion care to an undocumented woman -- and Trump became the first sitting president to address the annual pro-life March for Life, earlier this month.

Azar's confirmation was praised by Marjorie Dannenfelser, president of the anti-abortion Susan B. Anthony List.

"He takes the reins at a time when major pro-life policy initiatives are being rolled out at this crucial department," Dannenfelser said in a statement. "Azar's commitment to HHS' mission 'to enhance the health and well-being of all Americans,' including unborn children and their mothers, is so encouraging."

Although Azar has not been particularly outspoken on reproductive rights, abortion rights groups have been critical of his nomination.

"The Affordable Care Act has helped millions of patients have access to affordable and high-quality reproductive health care," said Dr. Anne Davis of Physicians for Reproductive Health. "Mr. Azar, however, has been a harsh critic of the ACA and once called it a 'fundamentally broken system.' As physicians, we seek to preserve gains brought by the ACA for Americans, and we are concerned Mr. Azar does not have those same interests in mind."

Azar has said he will consider a readjustment of government payments in Medicare Part B, which covers the cost of medication for the elderly.

Democrats are also concerned that as a former pharmaceutical executive, Azar, will not address rising drug prices -- and like Price, he will make further attempts to dismantle the ACA.

"Mr. Azar is latest in a string of ideologically driven healthcare appointees from President Trump," Murray said. "I am alarmed that he might not stand up to the pharmaceutical industry. And I am alarmed that he might not stand up to President Trump's agenda driven by sabotage and ideology."