Human services. The Health Committee holds a courtesy hearing on the nomination of the secretary, the finance committee receives paperwork, it will vote on the nomination. Senator murray and i will have an Opening Statement and former secretary and former governor of utah Michael Leavitt who we welcome today, good to see you and have you back and senator young who is a member of this committee will introduce alex azar after his testimony then senators will each have five minutes of questions. We have a lot going on in the senate today but we have a good turnout so i anticipate a good, vigorous questioning period. Alex azar, if confirmed will be did the of health and Human Services, you will be running 1. 11 trillion organization, that almost equals the total of 12 Appropriations BillsCongress Passes each year to Fund Everything from National Parks to National Defense to national laboratories. You will be overseeing medicare and medicaid, the nations government run Insurance Programs for the poor and elderly, Mental Health and Substance Abuse where you will have to address the Opioid Crisis among many other issues, the National Institutes of health where with francis collinss excellent leadership the United States is leading efforts to lead a cure for alzheimers, new nonaddictive painkiller to prevent opioid use and treatments for cancer, the fda, where we have gotten a start speeding up approval of generic drugs working to spur innovation and access to Regenerative Medicine and you will be faced with skyrocketing premiums in the individual Health Insurance market that are currently a nightmare for 9 million americans who dont receive a government subsidy to pay for their Health Insurance. We also have an opportunity to implement what the majority leader of the senate called the most important piece of legislation last year, the 21stcentury cures act which senator murray and i and members of this committee agreed upon and gave broad new powers to the fda, National Institutes of health, included the first major organization, worked on that, Mental Health programs in a decade as well as significant new funding for the Opioid Crisis which virtually all of us support. I believe you are an excellent nominee for this job. You have been confirmed by the United States senate twice, you have offered to meet with every member of this committee and have met or spoken with 15 Committee Members, you served in the Judicial Branch for Supreme Court justice antonin scalia. The executive branch, having been hhs general counsel for four years and deputy secretary for two years, you know the private sector, you spent decades in a leadership position at one of the Major Pharmaceutical Companies so you know how drugs get the manufacturer to patients. With all of these prospectives you should need no onthejob training to lead this department and should be able to take advantage of this exciting time in Biomedical Research to speed safe drugs through the system to patients more rapidly. I see your brought experience as one of your principal assets, experience in healthcare to me is an obvious asset for someone called upon to lead the nations most important healthcare agency. One reason doctor gottlieb, the fbi director has done so well so rapidly as he knows the agency. Having been deputy commissioner, he knows the private sector having worked in it. Doctor collinss knowledge of an eye agent leading the human genome project made him an effective leader at the National Institutes of health. Im glad to know people like you and doctor collins have the experience on the issues you will be dealing with 3 day. Healthcare costs and drug pricing are issues this committee has studied to better understand existing challenges and find solutions which we plan to hold a third hearing on how the supplychain effects what patients pay for Prescription Drugs on the server 12, and hear from the national academies. I would welcome your input as we examine the price patients pay when picking up their prescriptions. Healthcare is much broader than Health Insurance was only 6 of insured americans purchase their insurance in the individual market but that is where we have had our debate and discussion. 9 billion in individual market dont qualify for a subsidy and are hammered by skyrocketing prices. Tennessee premiums increased 176 in four years, an additional 58 for this coming year. Both congress and the administration need to act to provide relief for these americans which members of this Committee Work on an agreement cosponsored by 11 other republicans and 11 other democrats which the congressional offices will prevent a 25 price increase in premiums by 2020 by paying costsharing subsidies, decreasing federal dollars on aca premiums and the deficit. The agreement would give states the authority to use the innovation waiver already in the law to find other ways to lower premiums. Alaska created a Reinsurance Program and lowered premiums by 20 with new federal spending. Yesterday the president said he supported the Alexander Murray agreement becoming law by the end of the year. Our agreement has so much in it that appeals to so Many Democrats and independents hard to imagine our not passing something prevented 25 increase in premiums by 2020 and offers states flexibility to further lower rates. The democratic leader called it a good compromise, the senate has the support of all 48 democrats and the senate, chairman of the Democratic National committee tom perez tweeted last month Alexander Murray has widespread bipartisan support. As a secretary there are many other steps you can take to lower premiums and stabilize the markets such as approving innovation waivers which would increase access to lowercost plans and incentivize younger and healthier individuals to purchase insurance. The Opioid Crisis that is ravaging this country is a priority for the president and every member of this committee. Having hearings on the state perspective on the Opioid Crisis tomorrow. You will be coordinating a departmentwide effort to combat the opioid drug abuse, Drug Overdose deaths in tennessee went up by 12 from 201516, in particular overdose drugs related to fentanyl, synthetic opioid have dramatically increased 74 from 169 in 2015 to 294 in 2016. Congress has passed legislation to streamline programs, provide funding to states and communities on the front line of this crisis including protecting our infants act comprehensive addiction and recovery act, the 21stcentury cures act. We have included 816 million in fiscal year 2018 appropriations bill to address this growing and tragic crisis. As you implement these laws we want to hear from you what is or is not working, we stand ready to work with you if you have additional tools for authorities that need it, some are saying we need an opioid czar. I hope you will join me advising the president this is a bad idea. You need to be the czar, the federal government does not need a new czar. Once confirmed you need to be the one to take charge of leading the federal government response and letting us know how to help. I mentioned we have an exciting opportunity to implement the 21stcentury cures act as we continue oversight hearing on cures i hope your work with us to take advantage of all this law offers including president obamas Precision Medicine initiative, Vice President s cancer moonshot, the brain initiative, cures also gave you in the fda new authority to hire the scientists it needs to make sure these exciting new advances are safe and effective for americans which we all thought that was a big priority. I hope you use these authorities to make sure we take full advantage of this exciting time in science. The committee will perform oversight on drug quality and security act. A law we passed to help ensure the safety of compounded drugs. Also hope we will continue to look at how to lower healthcare costs including the cost patients pay for Prescription Drugs and how to keep people healthy. Looking at next year the committee will have to reauthorize the pandemic and all hazards preparedness act which provides the authority to ensure our nation is prepared for and able to respond to Public Health emergencies such as hurricanes, Infectious Diseases like zika and bioterror attacks. Another important bill to fund the fda, the one focused on animal drugs, the animal drug engineering animal drug user fee act. There is a lot to do. I look forward to working with you on this and hearing more about your priorities today. Thank you, chairman alexander and thank you to our colleagues for being here today. Alex azar, thank you and your family for being here and your willingness to serve. In november 2016, people started emailing me and calling, coming up to me in the Grocery Store editorials with tears in their eyes wondering what the future of health especially for their healthcare and it hasnt stopped and because these worries and challenges are what this congress and the department were discussing today is supposed to be focused on i am going to start my remarks with a few examples of the stories i have been told over the last year. My constituents julie from Mercer Island in four time cancer survivor, she said she would not be able to afford her medical expenses or stay alive without Affordable Care act protections. Kim shared her story about her addiction to opioids and her ability to overcome it with the right comprehensive treatment. Christina said before going to planned parenthood she struggled to get Birth Control regularly given her unpredictable schedule and the fast food industry, those are just a couple examples, there are many others and so many pressing Health Problems this administration could be solving. Instead of solving problems that developed health and Human Services under donald trump so far has been determined to create problems. That permit has not attempted to help people get high quality affordable coverage. They made it harder by stopping payments for outofpocket cost reduction, letting insurers cover fewer benefits, cutting this years open Enrollment Period and cutting funding for Consumer Outreach and a lot more. Rather than allowing women to make their own Health Care Choices the department has tried at every turn to impose rightwing ideology on women and even prevent them from getting care from a provider that they trust. Donald trump went to states like New Hampshire and ohio and said he would confront the Opioid Epidemic head on and called it a tremendous problem. People believed he would make sure hardhit communities get the resources that they need at this administration and its Health Department did the opposite and propose getting medicaid which offers critical Wraparound Services and Substance AbuseDisorder Treatment to people who otherwise could not afford it. Experts say that would cripple response efforts and all it took was a meeting with few pharmaceutical executives for donald trump to go dark on the skyrocketing cost of Prescription Drugs despite a president s promises about bringing prices down. In fact it is hard to find the healthcare problem the leadership at hhs is not only failed to address so far but actively made worse. That obama has proposed using Public Health funds to close nearterm budget caps rather than to prevent costly illness and disease down the road. And utterly failed to see the urgency of the Public Health crisis still unfolding today in puerto rico and the Us Virgin Islands in the wake of hurricane maria. The administration is even rolling back protections that prevent discrimination against people who have been historically denied equal access to health care. It shouldnt have to be said that the absolute last thing our nations healthy permit should be spending time on is encouraging more discrimination in our Healthcare System. That is wrong. Alex azar, you and i have some stark disagreements but your nomination still could be an opportunity for hhs to reset, to put aside the extreme politics that are actively endangering people nationwide and start focusing on that the permits mission instead of Donald Trumps ideological agenda. People across the country would be far better off if you took this opportunity but i have to say with concern my review of your record leaves me with serious doubts that you will. As a pharmaceutical effective you need to raise drug prices year after year, eli lilly currently under investigation for working under your tenure with other Drug Companies to needlessly raise the price of insulin and you have said many times you oppose government efforts to lower drug prices. You made it clear on questions of Womens Health you side with ideology over science and rightwing politicians over women. Although conservative experts and governors and even some members of congress have rejected Donald Trumps attempts to sabotage the Healthcare System and jammed trumpcare through, you said this legislation would undermine protections for people with preexisting conditions, gutted medicaid, cost tens of millions of people their healthcare, defunded planned parenthood and more, you said it didnt go far enough. This leaves me very concerned about whether you would faithfully implement the bipartisan agreement chairman Alexander Just talked about, we reached earlier this year should it become law. And finally in light of Donald Trumps profoundly underwhelming followthrough on his Campaign Promises about tackling the Opioid Epidemic it is deeply disappointing that yet another nominee for the role of secretary of health hasnt supported committing the new resources we need for this effort. I worry about your professional history and statements that point to a continuation of some of the extreme damaging and approaches we have seen so far from this administration so let me return to the stories i mentioned at the beginning of my remarks to make my final point. Right now, dewey is traveling around the country raising awareness about open enrollment to help more people sign up and get access. Kim is now pursuing a masters in social work and helping people in Central Washington to get the necessary treatment and services they can overcome their addiction. Christina has become a vocal advocate for helping women in washington and nationwide to give care that works for their needs, jillian, kim and christina are doing more than their part to keep our communities healthy so my question is why isnt the nations healthy permit doing the same . People should have a secretary of health who will work for and with patients and families, not against them and who is committed to making policy based on science, not ideology. Alex azar, i am looking forward to your thoughts on the many serious concerns i have raised and how you would be an appropriate choice for this position but im concerned that donald trump has sent us an extreme ideologically driven nominee to pick up where secretary prices left off and that women and children and seniors and families deserve a lot better. Im interested in your responses today. I hope i am pleasantly surprised and i do want to say if you are confirmed i want to make it very clear i have not and will not let this administrations approach so far lower my expectations for any of the departments this committee oversees and i will continue doing everything i can to hold hhs to the highest possible standards of accent service for people in my state and across the country. Thank you for being here and i will turn it back over. We now welcome the nominee, Mister Alex Azar and we welcome your family