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Senate confirms Trump health secretary

The Department of Health and Human Services (HHS) has a new boss, Alex Azar, after nearly four months without a permanent leader.

The Senate confirmed Azar, a former pharmaceutical executive, on Wednesday by a 55-43 vote with six Democrats and Independent Sen. Angus KingAngus Stanley KingLawmakers are failing in duty to respond to the American people Congress fails miserably: For Asian-Americans, immigration proposals are personal attacks GOP senators float fallback plan to protect Dreamers MORE (Maine) joining all but one Republican to support the nominee.

Sen. Rand PaulRandal (Rand) Howard PaulDem wins Kentucky state House seat in district Trump won by 49 points GOP's tax reform bait-and-switch will widen inequality Pentagon budget euphoria could be short-lived MORE (R-Ky.) was the lone Republican to vote against his confirmation, after having previously expressed concern over Azar's reticence to let drugs be imported from overseas.

Azar replaces Tom PriceThomas (Tom) Edmunds PriceGreen group calls on Pruitt to pay back first-class flight costs Top Dems seeks answers from HHS on ethics lapses GOP lawmaker calls for Shulkin to resign MORE, who resigned in September after Politico detailed repeated trips he took on private and military jets, costing taxpayers more than $1 million.

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Democrats have attacked Azar over drug prices — saying the cost of several drugs more than doubled during his time at Eli Lilly — and expressed concern that he would continue what they view as the Trump administration’s attempts to sabotage ObamaCare.

Meanwhile, Republicans cast Azar’s nearly 10 year tenure at Eli Lilly, where he served as president of Lilly USA from 2012 to 2017 years, as an asset because he already knows the ins and outs of such a complex industry.

Azar will take the helm of the massive department at a critical juncture for ObamaCare. It’s unlikely congressional Republicans will return to the difficult task of repealing and replacing President Obama’s signature health-care law, leaving the White House to seek changes on its own through administrative action.

Azar knows the regulatory process well. Under former President George W. Bush, he served HHS as general counsel from 2001 to 2005. He then became deputy secretary for two years under Secretary Mike Leavitt, who asked Azar to oversee the department’s regulatory process.

“He understands the process and he knows the levers and how you make it work and where the potential roadblocks are,” Leavitt told The Hill last year. “I think he would be of particular value given the fact that ... so far a repeal bill has not occurred and they’re going to need to make their imprint on existing laws through replacing the ideology underpinning it.”

Prescription drugs prices are also likely to be discussed under Azar's tenure. Lawmakers have criticized the high costs of prescription drugs, and President TrumpDonald John TrumpAccuser says Trump should be afraid of the truth Woman behind pro-Trump Facebook page denies being influenced by Russians Shulkin says he has White House approval to root out 'subversion' at VA MORE has said drug companies were “getting away with murder.” In nomination hearings, Azar said “drug prices are too high.”

But in those hearings, Democrats expressed concerns over Azar’s record as a pharmaceutical executive, and that was, in part, a reason why some senators voted against his confirmation.

“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,” Sen. Ron WydenRonald (Ron) Lee WydenOvernight Health Care: Trump eases rules on insurance outside ObamaCare | HHS office on religious rights gets 300 complaints in a month | GOP chair eyes opioid bill vote by Memorial Day Trump eases rules on insurance sold outside of ObamaCare Grassley, Dems step up battle over judicial nominees MORE (D-Ore.), the top Democrat on the Senate Finance Committee, said in a press release ahead of a procedural vote on Azar’s confirmation.

The panel’s chairman, Sen. Orrin HatchOrrin Grant HatchOvernight Finance: NAFTA defenders dig in | Tech pushes Treasury to fight EU on taxes | AT&T faces setback in merger trial | Dems make new case against Trump tax law | Trump fuels fight over gas tax What sort of senator will Mitt Romney be? Not a backbencher, even day one Lawmaker interest in NAFTA intensifies amid Trump moves MORE (R-Utah) has countered that Azar has the right experience to helm HHS, which oversees everything from Medicare and Medicaid to drug approvals and disease control.

“Mr. Azar spent several years as a senior official at HHS, holding key positions overseeing Medicare Part D and Medicare Advantage. He also led HHS’s responses to the anthrax attacks shortly after 9/11, the SARS and monkeypox crises, Hurricane Katrina, and many others,” Hatch said in a press release ahead of the confirmation vote.

“Clearly, Mr. Azar has seen both the good and bad at HHS and knows how to manage them. I don’t think there is anyone here, even on the other side of the aisle, who would contest that.”

The six Democrats who voted for Azar are Sens. Tom CarperThomas (Tom) Richard CarperTrump states would bear brunt of gas tax increase: conservative groups Trump talk riles advocates on both sides of gas tax Senate bill would let EPA implement global greenhouse gas deal MORE (Del.), Christopher CoonsChristopher (Chris) Andrew CoonsAfter Florida school shooting, vows for change but no clear path forward Democrats put Dreamers and their party in danger by playing hardball Sunday shows preview: Russian charges, Florida shooting dominate coverage MORE (Del.), Joe DonnellyJoseph (Joe) Simon DonnellyDemocrats now attack internet rules they once embraced Dem group launches M ad buy to boost vulnerable senators Senate rejects Trump immigration plan MORE (Ind.), Heidi HeitkampMary (Heidi) Kathryn HeitkampSenate rejects Trump immigration plan Cramer to announce North Dakota Senate run on Friday Senate Democrats not sold on bipartisan immigration deal MORE (N.D.), Doug Jones (Ala.) and Joe ManchinJoseph (Joe) ManchinPavlich: The claim Trump let the mentally ill get guns is a lie Toomey to introduce bill broadening background checks for firearms Scott Walker backs West Virginia attorney general in GOP Senate primary MORE (W.Va.).