ROBERT SIEGEL, HOST:
President Trump has announced his choice to become the new secretary of Health and Human Services. Alex Azar is a former drug company executive who also served as deputy HHS secretary in the George W. Bush administration. If he is confirmed, he'll be charged with administering the Affordable Care Act, a law that President Trump has tried repeatedly to repeal and which the nominee himself has publicly opposed.
Joining us now is NPR health policy correspondent Alison Kodjak to tell us more about Trump's choice. Hello, Alison.
ALISON KODJAK, BYLINE: Hi, Robert.
SIEGEL: The president today announced his choice on Twitter. Alex Azar would succeed Tom Price as HHS secretary. Price, of course, resigned in September in the midst of a controversy over his choosing to travel on private chartered airplanes at the expense of taxpayers. What can you tell us about Alex Azar?
KODJAK: Well, unlike Secretary Price, he is not a doctor. He is a lawyer. And most recently he was president of Eli Lilly, the pharmaceutical giant, their U.S. operations. He left that job in January. He served as No. 2 at HHS under - in the George W. Bush administration. And today I talked with former HHS secretary Mike Leavitt, who was Azar's boss at that time.
He says Azar - he described him as sort of a meticulous bureaucrat. He knows how the government works and particularly how the regulatory system works, which may not sound very interesting, but Leavitt says that's probably exactly why the president chose him. Since the repeal of the Affordable Care Act has failed, the administration's likely going to try to change how the law works from the inside, changing the regulations that govern how the law is implemented.
SIEGEL: Wouldn't that take a great deal of time? Regulations take months or even years to revise. Do you have any sense of what he'll actually try to do?
KODJAK: There's not a whole lot out there in terms of specifics. Obviously, we're undergoing open enrollment right now, so that's already ongoing. But last spring, Azar was on Fox News, and in that interview, he sort of declared the Affordable Care Act pretty close to dead. Here's how he put it.
(SOUNDBITE OF ARCHIVED RECORDING)
ALEX AZAR: Well, it's certainly circling the drain.
KODJAK: And then he went on to say that there isn't much the government can do to save it.
(SOUNDBITE OF ARCHIVED RECORDING)
AZAR: There's actually fairly few levers that the government can do at this point to try to stabilize this fundamentally broken system.
KODJAK: Now, since then, the Affordable Care Act markets have opened. People are enrolling. But when he said - made these statements, Congress was still working on Obamacare repeal bills. I suspect that since then he's come up with some ideas. And one that he's mentioned a few times is creating a reinsurance program that's very popular with Republicans. They protect insurance companies from unexpected losses, and they also theoretically can help lower premiums.
SIEGEL: Of course, the Department of Health and Human Services is huge. It's more than just the ACA. It oversees a trillion dollars of government spending - Medicare, Medicaid, the Food and Drug Administration. Where else could Alex Azar leave his mark?
KODJAK: Well, he has spoken publicly about Medicaid, the program for the poor and disabled and the elderly. President Obama expanded it, and Republicans for the last year have been trying to rein it in because they worry about this huge and growing entitlement program. Azar at a conference earlier this year in an interview said he'd like to see Medicaid turned into a block grant program. And that was in most of the Republican bills. The concern is that if the money is capped as a block grant, it won't allow for the increases in health care costs that are going to be part of this growing need for Medicaid. So the fear is that services may have to be cut.
SIEGEL: And just for a moment, a word about pharmaceuticals. He's a drug company - a former drug company executive.
KODJAK: Well, President Trump has been promising to lower drug prices, and in his tweet today announcing Azar he said that again. So what Leavitt says is that Azar knows how the drug system works. And he might be able to do that.
SIEGEL: NPR's Alison Kodjak on Alex Azar, President Trump's nominee for Health and Human Services secretary to succeed Tom Price. Alison, thanks.
KODJAK: Thanks, Robert.
(SOUNDBITE OF TYCHO'S "HORIZON")
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.