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President Trump, who has repeatedly assailed pharmaceutical companies for the high cost of prescription medications in the United States, nominated on Monday a former executive of one of the nation’s largest drug companies to be secretary of health and human services, which has responsibility for regulating the pharmaceutical industry. Mr. Trump announced his choice of Alex M. Azar II, a former president of the American division of Eli Lilly and a health official in the George W. Bush administration, on Twitter while traveling in Asia. (Shear, 11/13)

If confirmed, Alex Azar would oversee a $1 trillion department responsible for major health insurance programs, including "Obamacare," as well as medical research, food and drug safety, and public health. The nomination of Azar is unusual because Health and Human Services secretaries have come from the ranks of elected officials such as governors, leaders in academia and medicine, or top executive branch managers — not industries regulated by the department. (Alonso-Zaldivar, 11/13)

Azar also favors moving authority to the states over Medicaid, the program that provides health care to the poor, elderly and disabled. That means turning over the program to the states to make them "better stewards of the money," he said in an interview at a February conference on YouTube. "It turns these sovereign states and governors from supplicants to the HHS secretary into people running their own health insurance system for the poor." He said at the time that HHS could use its regulatory powers to allow states to customize the rules around Medicaid. (Kodjak, 11/13)

The choice of a detail-oriented lawyer familiar with the workings of the federal government drew praise from Republicans, who said that Mr. Azar would bring significant institutional knowledge to the job. Some consumer groups criticized Mr. Azar’s pharmaceuticals background, saying he might neglect to focus on lowering drug costs. Democrats also said they would press broad objections to the administration’s desire to overturn the ACA during his confirmation process. (Armour and Radnofsky, 11/13)

In announcing his decision on Monday, Trump tweeted that Azar “will be a star for better healthcare and lower drug prices!” He has a close rapport with the department’s top political appointees as well as Vice President Pence. Azar has been highly critical of the Affordable Care Act, saying in interviews in recent months that the law was “certainly circling the drain” and that many of its problems “were entirely predictable as a matter of economic and individual behavior.” (Eilperin and Goldstein, 11/13)

Azar’s pharmaceutical industry background prompted immediate questions about potential conflicts of interest and criticism from Democrats, who expressed concern about how he will handle Obamacare and whether he will be tough on drug makers. (Rosenberg, 11/13)

The drug executive President Donald Trump has picked to lead the Department Health and Human Services isn’t likely to shy away from the topic of sky-high medication prices -- but it may be insurers and drug plans that feel the heat as much as his former industry. (Edney, Hopkins and Rausch, 11/14)

[A]mong many of those those well-versed in healthcare policy, Azar's pick was seen as heartening. Andy Slavitt, who oversaw Medicare, Medicaid and insurance markets during the Obama administration, said that while he differed with any Trump pick over "political values…realistically, it could have been a helluva lot worse." "He's somebody who has been a career civil servant; he has a lot of respect for the people in the department and that's a good start," Slavitt said. (Decker, 11/13)

The nomination of Alex Azar to be the next HHS secretary suggests the department will continue to shun Obamacare and reduce the federal government's role in various parts of the health sector. The former Eli Lilly executive and top health official in the George W. Bush administration has said Obamacare is hopelessly broken and spoken in glowing terms about the U.S. drug industry, noting in May that "any country on earth would like to have the biopharmaceutical industry that we have here in the U.S.” (Pradhan, 11/13)

President Donald Trump has nominated Alex Azar as the next secretary of the Department of Health and Human Services. If Azar is confirmed by the Senate, it’ll be a return trip for him. He was deputy secretary of HHS under the George W. Bush administration. Then he took a break, to work as a top executive at the drug maker Eli Lilly. This swinging back and forth between the public and private sector is not unusual. It’s known as the revolving door — you work in government for a while, then go to work for the industry you used to regulate. Then, sometimes you go back to government. There have been concerns about it ever since the days of Alexander Hamilton. The revolving door really started swinging in the 1800s. “The first federal regulatory body was the Interstate Commerce Commission," said Matthew Mitchell, an economist at the Mercatus Center at George Mason University. "They had former railway men that were working there.” (Marshall-Genzer, 11/13)

Vice President Mike Pence is exerting growing influence over the American health care system, overseeing the appointments of more than a half-dozen allies and former aides to positions driving the White House's health agenda. On Monday President Donald Trump nominated Alex Azar, a former Indianapolis-based drug executive and longtime Pence supporter as HHS secretary. If confirmed, Azar would join an Indiana brain trust that already includes CMS Administrator Seema Verma and Surgeon General Jerome Adams. Two of Verma’s top deputies — Medicaid director Brian Neale and deputy chief of staff Brady Brookes — are former Pence hands as well, as is HHS’ top spokesman, Matt Lloyd. (Cancryn, 11/13)