The committee will come to order. Welcome everybody to this mornings hearing. Today the committee will consider and examine the nomination of vista alex cesar to serve as a sect of health and Human Services, one of the most aboard jobs in any government anywhere in the world. Id like to welcome mr. Azar to the finance committee this morning. Thank you for being here and for your willingness to serve in this important capacity. Mr. Azar certainly has his work cut out for him. Health and Human Services is a massive, Sprawling Department that oversees trillions of dollars in spending and liabilities and encompasses all areas of our Nations Health care system. As a result, if confirmed, mr. Azars work will impact the lives of every single american. Thats a big job. It requires knowledge, experience, and, most important, strong leadership. Fortunately, our nominee brings all of this to the table, having nearly two decades of experience in the health care sector, including about six years working at the highest levels of hhs. During his time at hhs, mr. Azar played key roles in implementing new policies, including Medicare Part d and the Medicare Advantage program. He was also a leader in hhss responses to the anthrax attacks shortly after 9 11, the sars and monkeypox crisis, and hurricane katrina, among others. If confirmed, mr. Azar will be congresss primary contact on all matters relating to our Nations Health care system. He will be responsible for the ongoing effort to bring down costs, provide greater access to care, and give patients more choices when it comes to coverage. Whether were talking about work to modernize federal Health Programs like medicare and medicaid in order to preserve them for future generations, innovating the chip program, or reforming the private market, mr. As are will be the administrations primary policy driver. He has made clear his intention to address the growing Opioid Epidemic that continues to ravage communities across the country, including in my home state of utah. This crisis is robbing families of loved ones, employers of productive and able workers, and communitie of the safety and security they once enjoyed. This is an important issue to me and other members of the committee and i look forward to working with mr. Azar to figure out how hhs and cms can make improvements to save lives. As many know, i coauthored the ensuring Patient Access and effective Drug Enforcement act, which has recently come under scrutiny in relation to the Opioid Epidemic. This law requires hhs to submit a report to Congress Regarding obstacles to legitimate Patient Access to controlled substances and issues with diversion of controlled substances. The required report is long overdue, and so, today, id like to impress upon mr. Azar the importance of getting this report to congress so that we can have an opportunity to review and make any necessary changes to the law that may help turn the tide of this epidemic. I hope to get his commitment to produce and releasing this report as soon as possible, once hes confirmed. He has expressed his commitment to succeeding in these important endeavors. And, i believe his record shows that he is more than capable of leading hhs through these next few consequential years. Of course, there are some on the committee who have already made up their mind about mr. Azar and are committed to opposing his nomination. This is essentially par for the course for the highprofile nominees that have come before us under this administraon. And, as in previous cases, none of the attacks leveled at mr. Azar are focus on his record, his experience, or his qualifications. Instead, were hearing talk about supposedly Revolving Doors and nonexistent conflicts of interest. While i believe mr. Azar is more than capable of responding to his critics on his own, id like to take just a moment to address some of the more prominent attacks weve heard thus far. Opponents of this nomination have claimed mr. Azars work in the pharmaceutical industry, hes been a Senior Executive for the past 10 years, disqualifies him to serve in this position. I would hope that my colleagues would want to avoid creating standards or setting new precedents where work in the private sector is somehow a knock against a nominee. That certainly wasnt a standard they applied to nominees from the previous administration, and it shouldnt apply to this one. Mr. Azar has committed to fully adhering to all necessary ethics requirements, including the Trump Administrations requirement prohibiting nominees from participating in matters involving their former employers and clients for two years after the end of their government service. In addition, he has committed to divesting any Financial Holdings that could present a conflict of interest or even the appearance such a conflict. So, were not talking about anything unethical. Were not talking about a mineetteming to unduly profit off his governmt positi. Experience in the private sector and dealing with the policies and regulations that come from Government Agencies is, in my view, a mark in favor of a nominees qualifications. Mr. Azars work in the pharmaceutical industry will give him important insights regarding the impact of policies designed and implemented by hhs. And when you add that knowledge and background to the years he spent as a senior official at hhs, you have an exemplary resume for an hhs secretary. Once again, i believe mr. Azar is more than capable of responding to what have so far been empty criticisms. By any objective standard, mr. Azar is well qualified to serve as secretary of hhs. My hope is that we can have a productive hearing today and report his nomination in short order. Thank you, once again, mr. Azar, for being willing to go through this and to appear here today. I want to thank you again for returning to the call to serve the American People. I i personally look forward to testimony. Before turning to senator wyden, i would like to reemphasize my support for the Childrens HealthInsurance Program and my commitment to making sure it gets reauthorized. Its one of the most important programs that ive worked on and got through. Ofou w senator kenned and others. We have a bipsaagreement that was reported out of committee, and i believe that it improves chip for the longterm. Congress has passed patches and fixes, but the time for shortterm solutions is over. Chip needs to be extended by january 19, and im going to do all i can to make sure we get it done. Children, their families, and states are counting on us. And with that now i will turn to my good companion, senator wyde wyden. Thank you very much, mr. Cha. And i very much appreciate you are competing for hearing, and colleagues, this is a first time weve been together since chairman hatch has announced his retirement. And i would just like to take a moment, we talked on the phone to say publicly what i mentioned to you. First, youve always been the gentleman every member of this body feels that. We know about your passion. We know about your dedication. We know about the fact that youve always had an ear for your colleagues. Often when you and i talked you say what are my democratic friends up to . Who should i be listening to . You were always there with an ear, and i would just like to note something, i dont think everybody knows, that chairman hatch was a boxer and basketball players know a little bit about endurance. But, colleagues, just picture 40 years in the rain, 40 years a boxer. That is real endurance so im sure we will have the colleagues talk at greater length, but since this is this is a first e actually been together publicly, mr. Chairman, i just wanted to note that. I also appreciate the fact that you mentioned chip. As you know we have teamed up on this now for quite some time. Id like to think the fact that we came out of the gate early, moved the house. They didnt follow all our approach to be partisan, particularly as a cane to revenue, but i think we all understand that weve got to get this done ande got to get it done quickly. And the American People said to me during the break, what happened at the end of the year is the kids got a patch. And if you are powerful, uranium multinational corporation, you got permanent relations. Were better than that. Mr. Chairman, i just want to say im looking forward to working closely with you. Weve got virtual you nam and in a in this committee unanimity in this committee with respect to chip and getting this across the finish line and ensuring families across this country dont go to bed at night in near panic about the prospect of an emergency illness the next day is critical. So i look forward to working with you on that. Now to todays business. The same donald trump who said the most exactly a year ago that price hiking Drug Companies were getting away with murder as nominated a Drug Company Executive with a documented history of raising Prescription Drug prices. Mr. Alex azar is here with the committee, nominated to serve as the next secretary of health and Human Services. Its my view that the issues he will work on, if confirmed, are going to be defining issues, defining domtic issues in 2018. Thats because he American People heard a lot of promises two years ago about how great their healthcare would be under a President Trump and now the era of skyrocketing drug prices was over. Americans are going to want to know come this november if all those big promises, if all those big pledges they heard in the fall of 2016 actually happened. To say the administration hasnt yet delivered would be a wild understatement. Now, mr. As are was the president of eli lilly, u. S. Based subsidiary lilly usa from 20122017. He chaired its u. S. Pricing Steering Committee which gave him a major role over drug price increases for every product lilly marketed in the United States. Now, chairman hatch noted, and i appreciate him doing this because he and i talk about this, focusing in on the record, the public record. So our staff has done a a fair amount of homework on it, and i want to spend some time looking at the track record. The price of lilies bone growth drug used to treat osteoporosis more than doubled on mr. Azars watch. The price of a a drug used to treat Heart Disease more than doubled. The price of a drug used to treat adhd more than doued. The price of a drug used to treat diabetes more than doubled. These are just some of the drugs that were under mr. Azars purview as head of lilly. Significantly, mr. As are told the Committee Staff that while he chaired the companies, Pricing Committees he never, not even once signed off on a decree in the price of a drug. This morning the committee, in my view, is likely to hear from mr. Azar and colleagues that its the system that is a fall, the system that ought to be blamed. My view is theres a fair amount of validity in that. The system is broken. Mr. Azar was part of that system. Given ample opportunity to provide specific examples of how he fixed it. Mr. Azar has come up empty. If mr. As or is confirmed it will be the first time at the president and health kicking rope their promises. A virtual parade of trump healthcare officials came before this committee and of the h. E. Committee and promised up along with respect to the Affordable Care act. Right out of the gate we remember tom price telling us it would be his job to administer the law, administer the law at hhs, not be a legislator. The track record doesnt look so great there because in effect on day one it sure seems that the sabotage policy kicked in. Along with allies in congress, the trump team wasted no time undermining private Health Insurance markets, emphasize, private Health Insurance markets. They kept the open Enrollment Period in half, advertising budgets were slashed ppb can hard for people having difficulty signing up for coverage to get in person assistance. They attacked a rule that says women have to have guaranteed nocost access to contraception. Fortunately, thats in the thats been held up in the courts. And whats been particularly troubling to me, because it goes back to my days when ive director of the gray panthers, theeasier to sell junk insurance that sales people when they a healy emergency. All in all the Trump Administration has made millions of Peoples Health care worse, and it doesnt seem to be a serious plan to undo the damage. Mr. Azar have to explain whether he will continue that policy. We talked about in the Office Yesterday and he should because it stands in stark contrast to what mr. Azar did and he was a member of the Bush Administration to help launch Medicare Part d. He was part of a bus roadshow and public events, local media appearances. So when you came to promoting the medicare Prescription Drug benefit, which i was one of the democrats who voted for it, he toured like using the grateful dead. Now he is set to join the administration thats tweeted less about open enrollment and about thanksgiving safety. Finally, its been a lot of talk about welfare reform coming up. Mr. Azar told he believes medicaid counts as welfare. But anybody asks seems to have a different answer for what exactly welfare reform means. The Common Thread to the republican talk year is pretty obvious, substantial draconian cuts to programs that are lifelines, medicare, medicaid, Social Security, antihunger programs, support for strugglg families. With respect to medicaid, for millions this program is at the heart of healthcare in america and it spans generations from newborns to two out of three older people in nursing homes. Today, medicaid is built on a guarantee. The trump team says it wants to end that. Those are public statements, end it. They are set in motion plans that make it harder to a lot of people to get the care they need. In some cases its older people, sometimes its folks with disabilities who need longterm care. In other cases its adults of limited means, people who struggle to climb the economic ladder. Thats kind of my background so im interested in hearing what mr. Azar as in mind with respect to seniors. To me, risking the medicaid guarantee, so essential for longterm care for the eligible seniors, i want everybody to know thats a nonstarter here. Furthermore, my view is you cant get it in life if you dont have your health, so endangering the health of lowincome americans in my view is the absolute wrong way to go. So there going to be other issues that fall under the welfare of umbrella. Mr. Azar has no experience in those areas. I am one who feels that people with business backgrounds, those viewpoints can be welcomed, but its got to be combined with the set of values that are in line with what i believe are the real priorities for the American People. So thats my sense of where we are and id like to wrap up this way, mr. Chairman. The leaders on both sides of this committee previously had regular beatings and calls with sitting hhs secretaries. I see mr. Leavitt who went out of his way when he was secretary to have those kinds of meetings, and Sylvia Burwell and whole host of democratic secretaries did the same thing. I would like to note as we wrap up that in my meeting with mr. Azar yesterday, he noted that he wasnt going to go along with the last hhs secretary who broke that bipartisan tradition, to the detriment of the senate. And in my view good policy. And mr. Azar without any prompting said he was interested in having those kinds of meetings that he would revive. So mr. Azar, thank you for being here. Thank you for meeting yesterday, and we look forward, your statement and questions. Thank you, mr. Chairman. Here to introduce mr. Azar are to distinguish over sectors of health and Human Services. Well first or from former secretary thompson picky tru great to see again. Its been quite a while since ive seen you. We had a lot to do with each other way back when. But you serve as the head of hhs from 20012005. Prior to that time he served four terms as the governor of wisconsin, the longest tenure of anybody in that states history. As governor he was pioneer in aa number of initiatives including welfare reform, which gained national prominence. As a secretary of hhs he oversaw the initial application of Medicare Part d and lead the department through the aftermath of september 11, 2001. Next we are going to hear from a very personal friend of mine, both our friends. We will hear an introduction from a good friend from secretary Michael Leavitt who headed hhs 20052009. Before that mike served as sere administrator of Environmental Protection agency for two years, as governor of utah for almost a decade. As governor he presided over some very prosperous times for our state and had a number of National Leadership positions. As secretary of hhs he sounded the alarm about medicares longterm fiscal