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Alex Azar LAW ’91 was nominated to lead the U.S. Department of Health and Human Services on Monday morning.

The announcement came in a morning tweet from President Donald Trump. HHS has a budget of more than $1 trillion and oversees the National Institutes of Health, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services and the Affordable Care Act, commonly known as “Obamacare.” Trump’s first HHS secretary, Tom Price, resigned in September after it became public that he spent government funds on charter flights.

Azar, a Yale Law School graduate who in recent weeks had emerged as the only likely candidate for the position, was a prominent HHS official in the George W. Bush administration, serving as the general counsel and deputy secretary of the department. Until recently, Azar was the president of Lilly USA, LLC, the largest affiliate of global biopharmaceutical leader Eli Lilly and Company. Earlier this year, Azar founded Seraphim Strategies, LLC. According to Azar’s LinkedIn profile, the company “provides strategic consulting and counsel on the biopharmaceutical and health insurance industries.”

“[Azar] will be a star for better healthcare and lower drug prices!” Trump wrote on Twitter.

In his alumni profile on the Law School website, Azar wrote that he entered health care “largely by accident.”

In 2000, Azar was active in the Bush-Cheney campaign while still working at the law firm Wiley, Rein & Fielding. After the campaign was over, then-HHS Secretary Tommy Thompson offered him the position of general counsel in the department.

“I’ll confess that I wrestled with the question, since I had not focused on health law in my legal career,” Azar wrote. “Within 30 days of being at HHS, however … I realized I had found my life’s calling: to help people around the world live longer, healthier and happier lives.”

Azar is an outspoken critic of Obamacare. During an interview in May on the Fox Business Network, he said Obamacare “has made it impossible to predict risk” and is “circling the drain.” In other interviews, Azar has argued that Medicaid expansion under the health care law was unsuccessful.

Azar’s confirmation hearing will be held by the Senate Finance Committee, chaired by Sen. Orrin Hatch, R-Utah.

If his nomination is confirmed, Azar will join a Cabinet already full of Yalies. Ben Carson ’73 serves as the secretary of housing and urban development, Steven Mnuchin ’85 as the secretary of the treasury and Wilbur Ross ’59 as the secretary of commerce.

Since Trump’s tweet this morning, Hatch and other Republicans have commended Azar’s nomination.

“For too long, hardworking, middle-class families have been forced to bear the brunt of Obamacare’s failures in the form of higher premiums and fewer choices,” Hatch said in a statement on the Senate Finance Committee website. “The leader of HHS will be at the tip of the spear, working to not only right the wrongs of this deeply flawed law but also ensure the long-term sustainability of both Medicare and Medicaid. Mr. Azar has the experience, knowledge and fortitude to take on these daunting challenges.”

Azar’s past involvement with Big Pharma, however, made many Democrats displeased with his nomination.

Sen. Ron Wyden of Oregon, the senior Democrat on the Senate Finance Committee, said he would question Azar vigorously during the committee hearings.

“I will closely scrutinize Mr. Azar’s record and ask for his commitment to faithfully implement the Affordable Care Act and take decisive, meaningful action to curtail the runaway train of prescription drug costs,” Wyden said in a statement. “Health care is too personal to be driven by politics, but that is what the leadership of HHS has offered so far.”

The Yale College Democrats also weighed in on the nomination, saying that even though Trump tweeted that Azar can “lower drug prices,” it is important to remember that Azar will come into the position as a pharmaceutical executive.

“This potential conflict of interest raises questions about his ability to lower prices for individuals,” said Keera Annamaneni ’20, the organization’s communications director.

The Yale College Republicans did not respond to a request for comment Monday night.

HHS was founded in 1953.

Anastasiia Posnova | anastasiia.posnova@yale.edu