Very shortly the Senate is going to take two votes on Trump nominees. The first is to confirm Jerome Powell as the next Fed Chair. Once that vote wraps up, the Senate will vote on whether to begin debate on the nomination of Alex Azar to be secretary of Health and Human Services -- one of the key roles in the federal government when it comes to caring for the sick and vulnerable.
Let me start by saying that Mr. Azar doesn’t come with the staggering ethical challenges of the first Trump HHS nominee, Tom Price. And by the strict definition, Mr. Azar is qualified for this position. But here’s my view: Mr. Azar’s nomination is a perfect encapsulation of the president’s broken promises on prescription drugs and health care overall. And at the outset of my remarks, I want to dive right into the issue of rising drug prices.
It’s one thing for a presidential candidate to have claimed he’d be too busy working to have time to golf and then spend almost one out of three days in office golfing.
It’s another thing altogether to promise cheaper prescription drugs to sick Americans who empty their pockets to pay for their medications, only to abandon them completely once you're in office.
It was barely a year ago that Donald Trump stood before the country and said price-hiking prescription drug companies were “getting away with murder.” Now he’s nominated Alex Azar, a drug company executive with a documented history of raising drug prices to lead the Department of Health and Human Services.
From 2012 until last year, Mr. Azar was the head of Eli Lilly’s American subsidiary, Lily USA. He chaired its U.S. pricing, reimbursement and access steering committee, which gave him a major role over drug price increases for every product Lilly marketed in this country.
On Mr. Azar’s watch, the price of Forteo, a Lilly drug used to treat osteoporosis, more than doubled. The price of Effient, a Lilly drug used to treat heart disease, more than doubled. The price of Strattera, a Lilly drug used to treat ADHD, more than doubled. The price of Humalog, a Lilly drug used to treat diabetes, more than doubled. And those are only a few of the drugs that were under his purview.
Mr. Azar told the Finance Committee staff that he never, not one time, signed off on a decrease in the price of a drug. And when asked about that statement in his confirmation hearing, Mr. Azar was quick to say that that’s just the way the system works. But he gave no concrete examples of how he’d buck the system at HHS. With his lack of concrete ideas on this issue, he’ll fit right in with the Trump administration.
In its first year, the Trump administration has made zero progress when it comes to drug prices. No new initiatives. No executive orders with any teeth. No new legislative proposals from HHS or the White House.
Perhaps, in my view, that’s because the administration has kept itself plenty busy finding ways of taking health care away from people who need it -- people who can least afford to find their bills climbing upward because of a decision made by bureaucrats in Washington.
This nomination is about more than just the administration’s failure on prescription drug prices. It’s a referendum on an entire health care agenda.
It’s a year in, and the Trump administration’s track record on health care is clear. New data that came out a few days ago showed that the number of Americans with health insurance dropped by more than three million. That means three million Americans are a sudden illness or injury away from the nightmare of personal bankruptcy -- having to sell a home or a car or empty their retirement accounts to escape from under a mountain of medical bills.
And that’s owed, in large part, to the Trump administration’s sabotage of the Affordable Care Act. They cut the open enrollment period in half, meaning anybody who clicked onto the internet hoping to sign up this month has found out they’re too late. They slashed advertising budgets that help reach the younger and healthier consumers that make the private health insurance markets affordable. They made it harder for people having difficulty signing up for coverage to get in-person assistance.
That sabotage agenda amounts to an attack on the private health insurance market in America. And it’s being perpetrated by the party, and the president, who profess to want to run this country like a business.
If that wasn’t harmful enough, the administration is allowing fraudsters to once again sell junk coverage plans that aren’t worth the paper they’re printed on. A major part of the Affordable Care Act was laying down basic consumer protections in the private market. It was all about saying that Americans would no longer get stuck with junk insurance that turned out to be worthless when they actually suffered an injury or came down with an illness. The Trump administration has decided to take a sledgehammer to those basic consumer protections.
So instead of working on a bipartisan basis to make the private health insurance markets more affordable and competitive, the Trump team is sabotaging those markets, hiking the number of Americans without coverage and sticking a whole lot of people with junk insurance that’s virtually guaranteed to fail them when they’re most in need.
And the biggest threat that strategy poses, on a basic level, is that it wipes out the ironclad guarantee of protection for Americans with pre-existing conditions.
A guarantee of access to health care isn’t worth much if you can’t afford it, and the Trump administration is doing a bang-up job of making health care unaffordable for those with pre-existing conditions.
The Trump administration has also undermined years of progress with respect to women’s health. They attacked a rule that says women have to have guaranteed, no-cost access to contraception, one of the most popular health care rules in recent memory. Fortunately, the administration’s action on that issue has been held up in the courts. But that’s only one key part of the anti-women’s health agenda playing out right now.
Just last week the Trump administration overturned longstanding protections dealing with states and family planning providers in what amounts to another attack on Planned Parenthood. The administration is also broadening the exceptions that give employers and universities say over what kind of health care women can access.
Here’s how Mr. Azar described his perspective on that issue when he went before the Health Committee. He said, quote, “...We have to balance, of course, a woman's choice of insurance that she would want, with the conscience of employers and others...”
No, we do not. A woman’s choice of health care is her choice -- nobody else’s. The care she has access to and receives is not up to her employer, it’s not up to a university, it’s up to her and her doctor. And now the administration is even going after protections for LGBTQ Americans.
Bottom line, the Trump administration is doing a lot more to protect the perpetrators of discrimination than its women and LGBTQ victims.
Health care is a right in America, but discrimination is not. The way Mr. Azar describes the position he’s nominated to fill, it sounds like he understands that. He said in his confirmation hearing, quote, “if I get this job, my job is to enhance and protect the health and wellbeing of ALL Americans.” But Mr. Azar has not committed to reversing these anti-woman, anti-LGBTQ, discriminatory policies as secretary.
When I heard Mr. Azar say it’d be his job to “enhance and protect the health and well-being of ALL Americans,” I couldn’t help but think back to the first nomination hearing the Finance Committee had for a Trump HHS nominee.
Back then, a year ago, Tom Price told the committee it would be his job at HHS simply to administer the law as passed by the Congress -- that he wouldn’t act as a legislator. Once he got on the job, he broke his word, and that’s been the norm for the Department over the last year. The Congress has every reason to believe that will continue, regardless of the talking points Mr. Azar and administration officials use.
Finally, I want to address Medicaid. Just in the last few weeks, the administration has begun giving states a green light to slap punitive, dangerous work requirements and other limitations on Americans covered by state Medicaid programs. Here’s my bottom line -- Medicaid is a health care program. And the vast majority of people who count on Medicaid either already have a job or are unable to work due to old age or infirmity.
This action by the Centers for Medicare and Medicaid Services goes after people who are just trying to get by. It’s a decision by bureaucrats in Washington that goes after Americans who are walking an economic tightrope, already balancing the costs of food, rent, gas, electricity, people who are taking care of their kids or elderly parents, or struggling with a chronic condition.
This looks, in my view, like another ideologically-motivated attack on a Medicaid program that is at the heart of health care in America -- that helps cover Americans of all generations, from newborn infants to two out of three seniors in nursing homes. The Trump administration is giving states permission to attack it.
In a short while, the Senate will have a cloture vote on Alex Azar’s nomination to run the Health and Human Services Department. But the debate we’re going to have will be about a lot more than that. It’s a question of whether the Trump administration should be allowed to continue a retrograde, discriminatory agenda that’s harmful to women and LGBTQ Americans. It’s a question of whether the attacks on Medicaid should continue. It’s a question of whether this administration will be held accountable for all its broken promises -- lower drug prices, insurance for everybody, no cuts to Medicare or Medicaid.
I have no confidence Mr. Azar will change course at HHS. I will not support his nomination, and I urge a no vote today.
