Speeches & Floor Statements

Opening Statement: Alexander to Azar: Your Broad Experience is an Obvious Asset in Leading HHS

Posted on November 29, 2017

Mr. Azar, if confirmed to lead the Department of Health and Human Services, you will be running a $1.11 trillion organization, which almost equals the total of the 12 Appropriations bills that Congress passes each year to fund everything from national parks to national defense to national laboratories.

You will be overseeing

Medicare and Medicaid – our nation’s government-run insurance programs for the poor and elderly;

Mental health and substance abuse programs – where you will have to address the opioid crisis, among many other issues;

The National Institutes of Health – where, with Francis Collins’ great leadership, the United States is leading efforts develop a cure for Alzheimer’s, a new non-addictive painkiller to prevent opioid abuse, and new treatments for cancer;

The Food and Drug Administration – where Scott Gottlieb has gotten off to an excellent start speeding up the approval of generic drugs and working to spur innovation and access to regenerative medicines;

And you will be faced with skyrocketing premiums in the individual health insurance market that are currently a nightmare for the nine million Americans who do not receive a government subsidy to help them pay for their health insurance.

You will also have an opportunity to implement what Leader McConnell called, “the most important piece of legislation” last year, the 21st Century Cures Act, which gave new, broad powers to FDA and NIH, and included the first major reorganization of mental health programs in a decade, as well as significant new funding for the opioid crisis.

I believe you are an excellent nominee to do this job.

You have been confirmed by the 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 as a law clerk for Justice Antonin Scalia.

You know the executive branch, having been HHS General Counsel for four years and Deputy Secretary for two years.

And you know the private sector. You spent a decade in a leadership position at one of the country’s major pharmaceutical companies, so you know the system of how drugs get from the manufacturer to patients.

With all of these perspectives, you should need no on the job training to lead this Department and take advantage of this exciting time in biomedical research to speed safe drugs through the system to patients more rapidly.

I see your broad experience as one of your principal assets.

Experience in health care is an obvious asset for someone called upon to lead the nation’s most important health care agency.

One reason Dr. Gottlieb, the current FDA Commissioner, has done so well so rapidly is he knew the agency, having been Deputy Commissioner, and he knew the private sector as well.

Similarly, Dr. Collins’ knowledge of NIH and his experience leading the Human Genome Project has made him an especially effective leader at NIH.

I am glad to know that people like you, Dr. Gottlieb and Dr. Collins have experience in the issues you will face.

Health care costs and drug pricing are issues this committee has studied to better understand existing challenges and find solutions. We plan to hold a third hearing on how the supply chain affects what patients pay for prescription drugs on December 12 to hear from the National Academies. Given your experience, I would welcome your input as we continue to examine the price patients pay when picking up their prescriptions.

Health care is much broader than just health insurance, and only about six percent of insured Americans purchase their health insurance in the individual market.

As I mentioned nine million in the individual market do not qualify for a subsidy and are really getting hammered by skyrocketing prices.

In Tennessee, premiums have increased 176 percent in four years, and an additional 58 percent this year.

Both Congress and the Administration need to act to provide relief for these Americans.

Senator Murray and I worked together on an agreement, co-sponsored by 11 other Republicans and 11 other Democrats, which the Congressional Budget Office says will prevent a 25 percent price increase in premiums by 2020 by paying cost sharing subsidies, decrease the federal dollars spent on ACA premiums subsides, and as a result, lower the deficit.

The agreement would also give states the authority to use the innovation waiver already in the law to find other ways to lower premiums.

For example, Alaska created a reinsurance program and lowered premiums by 20 percent with no new federal spending.

Yesterday, President Trump said he supported the Alexander-Murray agreement becoming law by the end of the year.

Our agreement has so much in it that it appeals to so many Democrats and Independents that it is hard to imagine not passing something that prevents a 25 percent increase in premiums by 2020 and offers states flexibility to further lower rates.

Senator Schumer called it a “good compromise,” and said it has the support of “all 48 Democrats” in the Senate. And the Chairman of the Democratic National Committee, Tom Perez tweeted last month that, “Alexander-Murray…has widespread bipartisan support.”

As HHS Secretary, there are other steps you can take to lower premiums and stabilize the market, such as approving states’ innovation waivers, which could increase access to lower cost 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 for every member of this committee. We are having a hearing on the state perspective of the opioid crisis tomorrow.

You will be coordinating a department wide effort to help combat the opioid abuse crisis. Drug overdose deaths in Tennessee went up by 12 percent from 2015 to 2016. In particular, overdose deaths related to fentanyl, a synthetic opioid, have dramatically increased 74 percent from 169 in 2015 to 294 in 2016.

Congress has passed legislation to streamline programs and provide funding to states and communities on the frontlines of this crisis, including the Protecting Our Infants Act, the Comprehensive Addition and Recovery Act, and the 21st Century Cures Act I mentioned earlier.

We have also included $816 million in the fiscal year 2018 Appropriations bill to help address this growing and tragic crisis.

As you implement these laws, we want to hear from you what is or is not working. I stand ready to work with you if additional tools or authorities are needed.

Some are now saying we need an opioid czar, and I hope you will join me in advising the president that this is a terrible idea. 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.

As I mentioned at the beginning, you have an exciting opportunity to implement the 21st Century Cures Act. As this committee holds oversight hearings on Cures, I hope you will work with us to take advantage of all this law offers, including the Precision Medicine Initiative, the Cancer Moon Shot, and the BRAIN Initiative.

Cures also gave you and the FDA new authority to hire the scientists it needs to make sure these exciting new advances are safe and effective for Americans. I hope you will use these authorities to make sure we take full advantage of this exciting time in science.

The committee will also perform oversight on the Drug Quality and Security Act, which is the law we passed to help ensure the safety of compounded drugs.

I also hope we will continue to look at how to lower health care costs, including the cost patients pay for their prescription drugs and how to keep people healthy.

Looking at next year, this 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 virus, and bioterror attacks.

And, another important bill to fund the FDA, this one focused on animal drugs: The Animal Drug and Generic Animal Drug User Fee Acts. 

I look forward to working with you on this and hearing more about your priorities today.