The selection of Alex Azar to head the Department of Health and Human Services (HHS) represents yet another instance of the Trump Administration elevating an anti-choice man to a position of power over women’s health and bodies. The Senate Finance Committee meeting this week should reject his nomination, said the International Women’s Health Coalition (IWHC).
While Azar may be less of an ideological crusader than his predecessor, former Congressman Tom Price, his record is nevertheless clear: Azar has consistently supported efforts to restrict women’s rights.
As head of the HHS, Azar would oversee US global health policy and commitments, and play a significant role at the World Health Assembly (WHA), the governing body of the World Health Organization (WHO). The WHO sets global standards and guidance for sexual and reproductive health care, including crises such as Zika, which could be subject to political meddling from the US government if ideological positions hold sway. His appointment comes at a critical time, as HHS is currently considering a draft strategic plan that proposes policy-making based on religious ideology, rather than facts and evidence.
A pharmaceutical executive with a history of raising drug prices, Azar also served under anti-choice Supreme Court Justice Antonio Scalia, and as Deputy Secretary of Health and Human Services under President George W. Bush.
In the latter role, Azar praised the Born Alive Infants Protection Act, legislation passed in 2002 to extend legal protection to infants born alive after a failed attempt at induced abortion, and spoke about the importance of “protecting the health and well-being of the unborn, the sick, and the dying.” He also praised religious refusal laws that permit doctors to refuse to provide or refer for abortion services, restricting the care available to women who need health care. Azar also has donated significant money in recent years to anti-choice candidates.
Azar raised additional red flags when, at a Senate hearing in late 2017, he argued that employers should have a say in women’s reproductive choices, stating “We have to balance a woman’s choice of insurance with the conscience of their employers.” Azar went on to describe protecting employers’ ability to object to health care on the basis of personal views as being a part of “American values,” suggesting that he would, if confirmed, prioritize so-called “conscience” provisions at the expense of women’s health and rights.
Like the rest of President Trump’s HHS appointments, Azar has heavily criticized the Affordable Care Act (ACA), which he will be tasked with implementing if confirmed as Secretary but which he has suggested he would work to dismantle from inside the agency. He recently said the program was “circling the drain” and cited the “tremendous amount of authority” given to the HHS Secretary as a potential tool to undermine the law if congress failed to repeal the ACA. Like other Trump nominees, he has been a vocal opponent of the very programs he is being tasked to lead.
Azar would be the latest in a string of confidants of Vice President Mike Pence to be installed at HHS. Other Pence allies at the agency already include Seema Verma, the Centers for Medicare & Medicaid Services Administrator; Surgeon General Jerome Adams; spokesman Matt Lloyd; Medicaid director Brian Neale; and Brady Brookes, the deputy chief of staff in the Office of the Administrator of the Centers for Medicare and Medicaid Services. The concentration of Pence allies at HHS suggests that the vice president—a longtime proponent of restricting women’s access to health care as well as a vocal opponent of the Affordable Care Act—wields a great deal of influence over this Administration’s health care decision-making.
The national elevation of this so-called “Indiana braintrust” is even more concerning because Indiana has some of the lowest health indicators of any state in the United States. A 2016 United Health Foundation survey ranked Indiana as only the 39th healthiest state in the nation; experts have attributed its poor performance on the low public health spending—including on preventative and education programs—championed by then-Governor Pence and his allies. The nationalization of Indiana’s healthcare policies is bad news for Americans, and the exportation of these ideas around the world would have devastating consequences for global health.
As the US government agency charged with protecting public health, the leadership of HHS has major implications for the lives of women and girls in the United States and around the world. IWHC has serious concerns about Azar’s history of supporting candidates and policies that seek to restrict women’s access to health care services. We urge the Senate to reject his nomination.