Department of health and Human Services. While we hold a courtesy hearing on the nomination of the secretary, it finance committee receives his paperwork and will vote hon the nomination. Senator murray and i will each have an Opening Statement and then former secretary and governor of utah whom we welcome today. Mike, good to see you and have you back. And senator young, whos a member of this committee, will introduce him after mr. Azars testimony, senators will each have five minutes of questions. We already have a good turnout so i anticipate a good vigorous questioning period. Confirmed to leave the department of health and Human Services, youll be leading a 1. 11 trillion budget. That almost equals the totals of the Appropriations Bills that Congress Passes each year to Fund Everything from National Defense to national laboratories. Medicare and medicaid. Our nations government run Insurance Programs for it poor and elderly. Mental hilth health and Substance Abuse. The National Institutes of health, where, with francish collins excellent leadership, the leading efforts to discover a cure for alzheimers, a new treatments for cancer. The food and drugged a menstruation where scott leeb has gotten off to an excellent start, speeding up the approval of generic drugs and access to regenerative medicines. And kwoul rr be faced with sky rocketing premiums in the individual Health Insurance mark lt that are currently a nightmare for the americans that dont receive a government subsidy to help pay for their Health Insurance and you have an opportunity to lead what they call it most important piece of legislation last year. The 21st century cures act which members of this committee agreed upon and gave broad new powers of the fda and included the first Major Organization senator casty and murphy especially worked on that oof Mental Health programs in a decades a well as significant more funding for the Opioid Crisis. I believe youre an excellent nominee for this yaub. Youv ror been confirmed by the United States senate twice. Youve offered to meet with every member of this committee and have met and spoken with 15 members. Youve served in the judicial clerk as law clerk for Supreme Court justice scalia. You know the executive branch having been h had hs general counsel and deputy secretary for two years and you know the private sector. A decade at one of the countrys major pharmaceutical companies. So you know the system of how drugs get to the manufacturer to patients. With all of these perspectives, you should need no on the job training and 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 broad experience as one of your principal assets. Experience in health care is an obvious asset for someone called upon to lead the most Important Health care agency. One reason the fda commissioners done so well so rapidly is he knows the agency. Having been Deputy Commissioner and he knows the private sector well, having worked in it. Similarly dr. Collins knowledge of nih and experience in the genome projelkt has made him an effective leader at the National Institutes of health. So im glad to know that you will have the experience you need. Health care costs and drug pricing are issues this committee has studied to find solutions. We plan to hold a third hearing on how the supply chain effects what patients pay on december 12 to hear from the national academies. I would welcome your input as we continue to kbamen the price patients pay when picking up their preskripgdss. Its much broader than Health Insurance and only about 6 of the insured americans purchase their insurance in the individual market. But that is where we have had had much of their debate and discussion. 9 million individual market dont qualify for a subsidy and theyre getting hammered by sky rocketing prices. Premiums have increased in four years and additional 58 for this coming year. Both congress and the administration need act to provide relief for these americans. Senator murray and i members of this committee worked on an agreement co sponsored by 11 other republicans and democrats which they say will prevent a 25 price increase by 2020 by pairing cost sharing subsidies, decreasing the federal dollars spent and as a result lower the deficit and give states the up thort to use the innovation waver to find other ways to lower premiums. Alaska created a Reinsurance Program and lowered premiums by 20 with no new federal spending. Yesterday the president said he supported the Alexander Murray agreement becoming law by the end of the year. It has so much tin that appeals to so Many Democrats and independents, riltser hard to imagine our not passing something by 2020 and offers states flexibility to further lower rates. The democratic leader called it a good compromise and said it has the support of all 48 democrats. In the chairman and tom perez tweeted last month, Alexander Murray has widespread bipartisan support. As secretary there are many other steps you can take to stabilize the markets, such as approving states inovashz wavers and incentivize younger and healthier individuals to purchase insurance. The Opioid Crisis is a priority for the president and every member of this committee. Were having a hearing on the state perspective on the Opioid Crisis tomorrow. Youll be coordinating a Department Wide effort to help combat the opioid drug abuse. Deaths in tennessee went up by 12 from 2015 to 2016. In addition, deaths related to fentanyl have dramatically increases from 169 in 2015 to 294 in 2016. Congress has passed legislation to streamline programs, provide funding on the frontlines of this crisis including the protecting our infant sack, the comp are ehencive adiction and are ecovery act and the 21st century cures act. Weve included althman 16 million in the fiscal appropriations bill to help address this greeing and tragic crisis. As you implement these laws, we want to hear what is or is not working. We stand ready to work with you if additional tools are needed. I hope you will join me in advising the president this is a bad idea. The federal government does not need a new czar. Once confirmed, you need be to the one to take charge leading the federal government response and letting us know how to help. Zeen exciting opportunity to implement the 21st century cures act. As we continue oversight hearings i hope youll work with us to take advantage all this law offers, inhadcluding proems Precision Medicine initiative, the Vice President s cancer moon shot and the brain initiative. Cures also gave you and the federal authority to hire the scientists they need to make sure these exciting advances are safe and effective for americans. We all thought that was a big priority. I hope we take full advantage of this exciting time in science. And the law we passed to help insurance the safety of compounded drugs. Also hope well continue to look at how to Lower Health Care costs including the costs patients pay for preskrapgds trugs and how to keep people had healthy. Thal arer have to authorize the pandemic which provides the authority to insure our nation is prepared for and able to respond to Public Health emergencies such as hurricanes, Infectious Diseases like zika and bio terror attacks and another important bill, the one focussed on animal drugs. The generic animal drug user fee act. I look forward to working with you on this and hearing more about your priorities today. Senator murray sfwlp thank you very much, chairman alexander and to all of our colleagues for being here today. Thank you. And your family for being here and your willing noosz serve. In november of 2016 people started emailing me and calling, coming up to me in the Grocery Store and everywhere else with tears in their eyes wondering what the future held, especially for their health care and it hasnt stopped and because these worries and challenges are what this congress and the department were discussing today is suppose ood be focussed on. Im going to start with a few examples of the stories ive been told over the last year. My constituent from Mercer Island is a fourtime cancer survivor. She would not be able to afford her medical expenses or even stay alive without Affordable Care act protections. Kim from ellensburg shared her story about her addiction to opioids and her ability to overcome it with the right comprehensive treatment. Christina from marysville said before going to planned parenthood, she struggled to get Birth Control regularly. Those are just a couple examples. There are many others and so many pressing Health Problems this administration could be solving but it appears instead of solving problems, the department of health and Human Services so far has been determined to create problems. The department has not attempted to help people get high quality affordable coverage. They made it harder by stopping payments for out of pocket cost reductions, letting insurers cover fewer benefits. By cutting this years open Enrollment Period and slashing funding for consumper out reach 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 prevent them from getting care from provider that they trust. President trump went to states like New Hampshire and ohio and said he would confront the Opioid Epidemic head on. People believe he would make sure hard hit communities get the resources that they need but this administration and its Health Department did the opposite, proposed gutting medicaid which provides critical wrap around services and Substance UseDisorder Treatment to people who otherwise kds not afford it. They say that would crippal response efforts and all it took was a meeting with a few pharmaceutical executives for President Trump to go dark on the sky rocketing costs of drugs despite the promises about bringing prices done. In fact, its hard to find a Health Care Problem the leadership at hhs has not only failed to address so far but actively made worse. The department has proposed using Public Health funds rather than prevent costly illness and disease down the road and utterly failed to see the urgency of the Public Health crisis that is still unfolding today in the u. S. And puerto rico virgin islands. The administration is even rolling back protections that prevent discrimination against people who have historically been denied equal access to health care. But the absolute last thing our nations Health Department should be spending time on is encouraging more discrimination in our Health Care System. You and i do have stark disagreements but your nomnation could be an opportunity to reset, to put aside the extreme politics actively endangering people nation wide and start focusing on the mission instead of President Trumps ideological agenda. People across the country would be far better off if you took this opportunity. But i have to say, with concern, that my review of your record leaves me with serious doubts that you will. As a pharmaceutical executive you raised drug prices year after year. Eli lilly is currently under investigation for working under your tenure with other Drug Companies to needlessly raise the price of insulen and you oppose efforts to lower drug prices. Youve also made the clear on questions of women was health. You side with ideology or science and rightwing politicians over women. Although conservative experts, governors and even members of congress have rejected President Trumps attempts to sabotage the Health Care System and jam trump care through you said this would have spiked premiums, undermined protections for people with preexisting conditions, gutted medicaid, cost 10s of millions their health care, 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 that chairman alexander agreed with andside the become law. And despite the follow through on tacktling 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. So, mr. Azar, i worry about your professional history and statements that point to a continuation of some of the extreme damaging and political driven approaches weve seen so far from this administration. So let me just return briefly to the stories i mentioned at the beginning of my remarks to make my final point. Right now julie is travelling around the country raising awareness about open enrollment to help more people get access. Kim is pursuing a masters in social work and helping people in Central Washington get the necessary treatment and services so they can overcome their addiction. Christina has become a vocal advocate for helping women in washington and nation wide to get care that works for their needs. Julian, kim and christina are doing more than their part to keep our communities healthy and well, so my question is why isnt our nations Health Department doing the same . They should have a secretary of health who will work for and with patients and families, not against them. And committed to policies based on science and not ideology. Im looking forward to your thoughts on the many serious concerns ive raised and how you would be an appropriate choice for this position. Im concerned President Trump has yet sent us in an extreme ideological driven nominee to take off where secretary price left off and women, seniors and families deserve a lot better. So im interested in your responses today. I hope i am pleasantly surprised and i want to say if you are confirmed, i want it make it very clear i have not and will not let this administrations so far lower my expectations for any of the department this committee over sees and i will continue doing everything i can to hold hhs to the highest possible standards of ethics and service for people in my state and across the country. With that, thank you very much for being here and i will turn it back over. Well, now welcome the nominee, alex azar and your family and friends in attendance. Theres a pretty good group of them and you may want to nrbt deuce them when you begin. Mr. Azar will first be introduced by governor mike levt. He served as president george w. Bushs secretary of the department of health and Human Services from 2005 to 2009. He worked closely with mr. Azar then while he served as his deputy secretary. Then the nominee will be introduced by his home state senator, senator todd young. Governor levt, please put the deuce mr. Azar and welcome. Thank you, chairman alex abder and senator murray and members of the committee. They have very ably dejibed the complexity and the importance of this role. And therefore its my privilege to introduce and to unequivocally recommend alex azar. He is up to the task. He is supremely well qualified to carry out this important work. As mentioned during my service as secretary of hhs, mr. Azar was deputy secretary. In essence he was the chief operating officer of this very large and complex department. Prior to his service he served as the general counsel under secretary thompson who i believe later will also introduce and robustly recommend him to the finance kmilty as they consider his nomination. That plus his experience in the private sector thats been mentioned leads me to conclude that there may not have been a nominee to this office of secretary better prepared to hit the ground running than alex azar. It was mentioned that. Had h. S. Is a long and complex place. While deputy secretary, alex azar was essentially the manager of the day to day operations of 90,000 employees and 1. 1 trillion budget. Just a brief example that i think would illustrate his capability. President bush had had a management agenda that laid out a criteria of several dozen different objectives and then had a dashboard of green, yellow, red. Alex set an objective to have every criteria green and he was the first deputy secretary in the if had tire federal government to achieve that. He was also deligated oversight of much of the regulatory p