OPIOID SERIES:

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 KingPompeo lacks votes for positive vote on panel Democrats mull audacious play to block Pompeo Overnight Defense: Trump steps up fight with California over guard deployment | Heitkamp is first Dem to back Pompeo for State | Dems question legality of Syria strikes MORE (Maine) joining all but one Republican to support the nominee.

Sen. Rand PaulRandal (Rand) Howard PaulPompeo lacks votes for positive vote on panel CIA declassifies memo on nominee's handling of interrogation tapes Overnight Defense: House to begin work on defense policy bill | Panel to vote Monday on Pompeo | Trump to deliver Naval Academy commencement speech | Trump appeals decision blocking suspected combatant's transfer 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 PriceDem lawmaker rips Trump's taxpayer spending on Tax Day Trump admits mistakes with Cabinet picks HHS secretary briefly hospitalized for 'minor infection' 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 TrumpFlynn to campaign for Montana GOP Senate candidate Trump considering pardon for boxing legend after call from Sylvester Stallone Decline in EPA enforcement won't keep climate bill from coming 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 WydenCIA declassifies memo on nominee's handling of interrogation tapes Dem senators demand Trump explain ties to Koch brothers Schumer to introduce bill to decriminalize marijuana 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 HatchSenate Finance leaders call on Commerce to improve the tariff-exclusion process GOP senators raise concerns about babies on Senate floor House passes series of bills to improve IRS 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 CarperGOP chairman probes Pruitt’s four email addresses Watchdog requests probe into relationship between top EPA aide and man investigating him Overnight Finance: Wells Fargo could pay B fine | Dems seek info on loans to Kushner | House to vote on IRS reform bills | Fed vice chair heading before Congress MORE (Del.), Christopher CoonsChristopher (Chris) Andrew CoonsPompeo lacks votes for positive vote on panel Overnight Defense: House to begin work on defense policy bill | Panel to vote Monday on Pompeo | Trump to deliver Naval Academy commencement speech | Trump appeals decision blocking suspected combatant's transfer Heitkamp becomes first Dem to back Pompeo for secretary of State MORE (Del.), Joe DonnellyJoseph (Joe) Simon DonnellyPompeo lacks votes for positive vote on panel Democrats mull audacious play to block Pompeo Heitkamp becomes first Dem to back Pompeo for secretary of State MORE (Ind.), Heidi HeitkampMary (Heidi) Kathryn HeitkampPompeo lacks votes for positive vote on panel Overnight Defense: House to begin work on defense policy bill | Panel to vote Monday on Pompeo | Trump to deliver Naval Academy commencement speech | Trump appeals decision blocking suspected combatant's transfer The Hill's Morning Report: Inside the Comey memos MORE (N.D.), Doug Jones (Ala.) and Joe ManchinJoseph (Joe) ManchinPompeo lacks votes for positive vote on panel Democrats mull audacious play to block Pompeo Heitkamp becomes first Dem to back Pompeo for secretary of State MORE (W.Va.).