[Congressional Record Volume 164, Number 16 (Tuesday, January 23, 2018)]
[Senate]
[Pages S458-S460]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                        Nomination of Alex Azar

  Mr. WYDEN. Mr. President, very shortly, the Senate is going to take 
two votes on the President's nominees. The first is to confirm Jerome 
Powell as the next Fed Chair. Once that vote wraps up, the Senate will 
vote on whether to begin debate on the nomination of Alex Azar to be 
Secretary of Health and Human Services.
  This is one of the key roles in our entire Federal Government in 
caring for America's sick and vulnerable. Let me begin by saying that 
Mr. Azar does not come with the staggering ethical challenges of his 
predecessor, the first Trump HHS nominee, Tom Price.
  Here is my concern: Mr. Azar's nomination is a clear symbol of the 
President's broken promises on prescription drugs and pledge to secure 
better and more affordable healthcare for all Americans. At the outset 
of my remarks, I am going to start with the issue of skyrocketing 
prescription drug prices that now clobber millions of Americans at 
pharmacy windows across America. It is one thing for a Presidential 
candidate to have claimed he would just be too busy working to have 
time to golf and then spend almost 1 out of 3 days in office golfing. 
It is another thing altogether to promise cheaper prescription drugs to 
sick and vulnerable Americans who empty their pockets to pay for their 
medications only to abandon them completely once you are in office.
  Now, it was barely a year ago that Donald Trump stood before our 
country and said prescription-hiking drug companies were getting ``away 
with murder.'' Those were his words, not mine, not somebody in the news 
media. The President said the drug companies were ``getting away with 
murder.''
  Now he has nominated Alex Azar, a drug company executive with a 
documented history of raising drug prices, to lead the Department of 
Health and Human Services. From 2012 until last year, Mr. Azar--who is 
the head of Eli Lilly's American subsidiary; that is, Lilly USA--
chaired the U.S. pricing reimbursement and access steering committee, 
which gave him a major role over drug price increases for every product 
Lilly marketed across the country.
  On Mr. Azar's watch, the price of Forteo, a Lilly drug used to treat 
osteoporosis, more than doubled. The price of Effient, a Lilly drug 
used to treat heart disease, more than doubled. The price of Strattera, 
a Lilly drug used to treat ADHD, more than doubled. The price of 
Humalog, a Lilly drug used to treat diabetes, more than doubled, and 
these are only a few of the drugs that were under Mr. Azar's purview.
  Mr. Azar told the Senate Finance Committee that he had never--not 
even one time--signed off on a decrease in the price of a medicine, and 
when asked about that statement in his confirmation hearing, Mr. Azar 
was quick to say: That is just the way the system works, but he didn't 
give us any concrete examples of how he would buck that system if he 
became the head of the Department of Health and Human Services. It 
seems to me, given the fact that he was asked questions about what 
concrete ideas he had for reforming the system and carrying out the 
President's promises to hold down prescription drug prices, he came up 
empty. I guess that says he would fit right in with the Trump 
administration on prescription drug practices.
  In its first year, the Trump administration has made exactly no 
progress when it comes to tackling these skyrocketing pharmaceutical 
prices. They don't have any Executive orders that have any teeth in 
them. There don't seem to be any new initiatives at all. No new 
legislation has come from the Department or the White House. Perhaps, 
in my view, that is because the administration seems to be busy on 
other fronts, like taking healthcare away from those who need it, 
people who can least afford to have their bills climbing upward because 
of a decision made by a bureaucracy here in the Nation's Capital.

  This nomination, as you are going to hear Senators discuss tomorrow, 
is about more than just the administration's failure on prescription 
drugs. It is, in effect, a proxy on an entire healthcare agenda. This 
is really a referendum on a healthcare policy from this administration 
that I think is an abject failure.
  It is a year in now, and the administration's track record on 
healthcare is pretty clear. New data came out a few days ago showing 
that the number of Americans with health insurance dropped by more than 
3 million people. That means 3 million Americans are a sudden illness 
or injury away from the nightmare of personal bankruptcy, having to 
sell their home or their car or empty a retirement account to escape 
from under that mountain of medical bills.
  A very substantial part of that problem stems from the 
administration's sabotage on the Affordable Care Act. The 
administration cut the open enrollment period in half. That meant 
anybody who clicked on the internet, hoping to sign up this month, has 
found out that they are just too late. They slashed advertising budgets 
that helped reach the younger and healthier customers that make the 
private health insurance market affordable. And they made it harder for 
those having difficulty signing up for coverage to get a little bit of 
help in person.
  This sabotage agenda, in my view, is an attack on the kind of health 
insurance this administration says it is for. They say they are for a 
private health insurance market, but the fact is, what they have been 
doing is undermining

[[Page S459]]

the private health insurance market as part of their effort to 
undermine the Affordable Care Act. So this policy, perpetrated by a 
party and the President who professed to want to run this country like 
a business, certainly doesn't reflect the kinds of sound business 
practices we see from business leaders in my home State of Oregon.
  If that wasn't harmful enough, the administration also is allowing 
fraudsters to, once again, sell junk coverage insurance policies that 
aren't worth the paper they are printed on.
  A major part of the Affordable Care Act was laying down basic 
consumer protections for the private market. It was all about saying 
that Americans would no longer get stuck with junk insurance that 
turned out to be worthless when they actually suffered an injury or 
came down with an illness. I can't tell you what a step backward it is 
to see the sale of these junk insurance policies.
  Years ago, when I was director of the Gray Panthers, it was common to 
see older people buy 15 or 20 private health insurance policies to 
supplement their Medicare, and they weren't worth the paper they were 
written on. They were junk. Finally, we got that changed. We passed a 
law with teeth to change it.
  But now the Trump administration has, with respect to the private 
market and the Affordable Care Act, decided to turn back the clock and 
bring back junk insurance in the private insurance marketplace. So 
instead of working on a bipartisan basis to make the private health 
insurance market more affordable and competitive, the Trump 
administration has sabotaged those markets, hiking the number of 
Americans without coverage and sticking a whole lot of Americans with 
junk coverage that, in my view, is virtually guaranteed to fail them 
when they are most in need. The biggest threat their strategy poses on 
a basic level is that it wipes out the ironclad guarantee of protection 
for Americans with preexisting conditions. Guarantee of access to 
healthcare isn't worth much if you can't afford it, and the Trump 
administration is doing a bangup job of making healthcare unaffordable 
for those with preexisting conditions.
  The Trump administration has also undermined years of progress with 
respect to women's health. They attack the rule that says women have to 
be guaranteed no-cost access to contraception--one of the most popular 
healthcare rules in recent memory. Fortunately, the administration's 
action on that issue has been held up in the courts, but that is only 
one part of the anti-women's health agenda that plays out now.
  Just last week, the Trump administration overturned longstanding 
protections dealing with States and family planning providers. This, in 
my view, is an attack both on a woman's right to see the provider of 
their choosing and Planned Parenthood. The administration is also 
broadening the exceptions that give employers and universities say over 
what kinds of healthcare women can access.
  Here is how Mr. Azar described his perspective on that issue when he 
went before the HELP Committee. He said: ``We have to balance, of 
course, a woman's choice of insurance that she would want with the 
conscience of the employers and others.''
  We don't have to that. A woman's choice of healthcare is her choice--
her choice and nobody else's. The care she has access to and receives 
is not up to her employer and not up to her university. It is up to 
that woman and her physician. And now the administration is even going 
after protections for LGBTQ Americans.
  The bottom line is, the administration is doing a lot more to protect 
the perpetrators of discrimination than the victims. Healthcare is a 
right in America, but discrimination is not.
  The way Mr. Azar describes the position he is nominated to fill, it 
sounds as if he understands it. He said in his confirmation hearing: If 
I get this job, my job is to ``enhance and protect the health and 
wellbeing of all Americans.'' But he is not committed to reversing 
these kinds of anti-discriminatory practices I just described.
  When I heard Mr. Azar say it would be his job to ``enhance and 
protect the health and wellbeing of all Americans,'' I couldn't help 
but think back to the first nomination hearing the Finance Committee 
had for a Trump HHS nominee. Back then, Tom Price told the committee it 
would be his job at the Department just to administer the laws passed 
by Congress. He would be out of the legislative business. Once he got 
the job, he broke his word, and that has been the norm for the 
Department over the year. Congress has every reason to believe that is 
going to continue, regardless of the talking points Mr. Azar and 
administration officials use.
  Finally, I want to discuss Medicaid. Just in the last few weeks, the 
administration has begun giving States a green light to slap new and 
punitive requirements and other limits on Americans covered by State 
Medicaid Programs. My bottom line is, Medicaid is a healthcare program. 
The vast majority of those who count on Medicaid either already have a 
job or are unable to work due to old age and infirmity. We shouldn't be 
trying to make life harder for those folks. The action by the Centers 
for Medicare and Medicaid Services goes after people who are just 
trying to get by. It is a decision by bureaucrats in Washington, going 
after Americans who walk an economic tightrope, who might just be 
trying to take care of kids or elderly parents or struggling with a 
chronic condition. This looks, on Medicaid, like yet another 
ideologically motivated attack on a program that covers vulnerable 
Americans--all generations, from newborn infants to two out of three 
seniors. The Trump administration is giving States permission to attack 
it.
  Mr. President, I ask unanimous consent for 2 additional minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WYDEN. Mr. President, in a short while, the Senate will have a 
cloture vote on Mr. Azar's nomination to run the Department of Health 
and Human Services. The debate will be about a lot more than that. It 
is a question of whether the Trump administration should be allowed to 
take this country backward on health and to discriminate against 
Americans. It is a question of whether the attacks on Medicaid should 
continue and whether this administration will be held accountable for 
its broken promises on lower drug prices, insurance for all, no cuts to 
Medicare or Medicaid.
  I regret to say to the Senate today that I have no confidence that 
Mr. Azar will change course at the Department of Health and Human 
Services. I do not support his nomination, and I urge a ``no'' vote 
today.
  I yield the floor.
  The PRESIDING OFFICER. Under the previous order, all postcloture time 
has expired.
  The question is, Will the Senate advise and consent to the Powell 
nomination?
  Mr. WYDEN. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Tennessee (Mr. Corker), the Senator from Arizona (Mr. 
McCain), and the Senator from South Carolina (Mr. Scott).
  The PRESIDING OFFICER (Mr. Rubio). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 84, nays 13, as follows:

                       [Rollcall Vote No. 19 Ex.]

                                YEAS--84

     Alexander
     Baldwin
     Barrasso
     Bennet
     Blunt
     Boozman
     Brown
     Burr
     Cantwell
     Capito
     Cardin
     Carper
     Casey
     Cassidy
     Cochran
     Collins
     Coons
     Cornyn
     Cortez Masto
     Cotton
     Crapo
     Daines
     Donnelly
     Duckworth
     Durbin
     Enzi
     Ernst
     Fischer
     Flake
     Gardner
     Graham
     Grassley
     Hassan
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johnson
     Jones
     Kaine
     Kennedy
     King
     Klobuchar
     Lankford
     Leahy
     Manchin
     McCaskill
     McConnell
     Menendez
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Perdue
     Peters
     Portman
     Reed
     Risch
     Roberts
     Rounds
     Sasse
     Schatz
     Schumer
     Shaheen
     Shelby
     Smith
     Stabenow
     Sullivan
     Tester
     Thune
     Tillis
     Toomey
     Udall
     Van Hollen
     Warner
     Whitehouse
     Wicker
     Wyden
     Young

[[Page S460]]


  


                                NAYS--13

     Blumenthal
     Booker
     Cruz
     Feinstein
     Gillibrand
     Harris
     Lee
     Markey
     Merkley
     Paul
     Rubio
     Sanders
     Warren

                             NOT VOTING--3

     Corker
     McCain
     Scott
  The nomination was confirmed.
  The PRESIDING OFFICER. The Senator from California.