Trump health nominee faces another grilling on U.S. drug costs

High drug prices are sure to come up again. So is Obamacare.

President Donald Trump’s pick to lead the U.S. Health and Human Services Department is likely to face questions on those subjects and others when he faces senators at his second hearing on Capitol Hill on Tuesday.

Until about a year ago, nominee Alex Azar was an executive at Indianapolis-based drugmaker Eli Lilly and Co., a role that’s fueled lawmakers’ concerns that he might not be willing to take a tough stance against the pharmaceutical industry on drug prices.

Azar told senators at a November hearing that he wants to end “gaming” by drugmakers that allows them to extend monopolies and keep prices high, an idea backed by both Republicans and Democrats.

His commitment to a crackdown may receive extra scrutiny during the Senate Finance Committee hearing after Politico reported that Lilly gained extra time on its exclusive sales rights to the erection drug Cialis by studying its effects on a rare muscular disorder in children.

Senate Republicans are also divided over continuing their largely failed effort to repeal the Affordable Care Act. As part of the recent tax overhaul, they were able to overturn the requirement that everyone have health-care coverage, although most of Obamacare remains intact. Both parties are likely to want to know where Azar stands on that debate.

Congress also must reauthorize funding for the Children’s Health Insurance Program after it expired at the end of September, or else the program’s funding will run out. In a short-term spending bill passed last month, lawmakers provided $2.85 billion that’s supposed to fund the program for a few more months. The short-term patch has left states wondering if longer-term funds are coming for the program, which covers 9 million low-income children.

Obamacare changes

Senate Majority Leader Mitch McConnell, a Republican from Kentucky, said at a year-end news conference that while he’d like to see “more substantial changes” to Obamacare, he wants to work on bills that have a chance to pass. The GOP failed several times last year to gain enough votes from its own members to repeal and replace the Affordable Care Act.

Republican Senators Bill Cassidy of Louisiana and Lindsey Graham of South Carolina have said they’ll continue trying to build support for their proposal to redirect billions in Obamacare funding to states to use as they see fit. The senators also want to change Medicaid’s funding to a fixed, per-enrollee amount, instead of a set percentage of states’ costs.

Some Republicans have advocated changing parts of the law to bring down premiums, but Democrats, who are necessary to pass any such bill, are now considering whether they’ll make additional demands as part of any such bill.

Azar would be Trump’s second HHS secretary after his predecessor, Tom Price, resigned in September amid a scandal over his use of private jets at taxpayer expense. Democrats have accused the administration of attempting to sabotage Obamacare after it stripped funding for advertising open enrollment and cut off money for workers who helped consumers choose coverage. Trump also stopped making payments to insurers meant to help defray health-care costs for low-income Americans.

Despite that, enrollment in Obamacare plans for this year went better than experts who feared significantly fewer sign-ups anticipated.