When President Trump needed to find his first Health and Human Services secretary, at a time when his top priority was pushing Congress to repeal the Affordable Care Act, he went with a member of Congress. Now, with the repeal effort in a ditch, he's chosen someone who knows how to navigate the bureaucracy to make big changes administratively.
Alex Azar, Trump's pick to succeed former HHS secretary Tom Price, worked at HHS in the George W. Bush administration, first as its general counsel, then as deputy secretary. Both of those positions are deeply involved in the regulatory process.
- People who have worked with him say he's a smart lawyer (he clerked for the late Antonin Scalia) — a good skill to have when you're running the traps on controversial rules and regulations.
"He seems like the right guy," said Tevi Troy, a conservative scholar who worked with Azar while Azar was at HHS and Troy at the White House. Troy later succeeded Azar as HHS deputy secretary.
- HHS is vast, and Azar is already familiar with all of its responsibilities.
- His tenure as deputy secretary gave him considerable experience not only navigating HHS' internal bureaucracy, but also trying to coordinate with the White House, Troy said — an especially valuable skill in the Trump administration (and one of Price's weaknesses).
- "We worked side-by-side on the implementation of Medicare Part D, pandemic preparedness, and Hurricane Katrina recovery," former HHS secretary Mike Leavitt said. "He is an expert on health policy and HHS operations, as well as a skilled manager. Because he knows the department so well, there may never be a HHS secretary better able to hit the ground running than Alex Azar."
The bottom line: Although Trump keeps insisting he wants Congress to try again on ACA repeal, picking Azar suggests a much stronger focus on administrative action.
One useful thing: "He seems to know everybody," Troy said.