WASHINGTON — The Senate confirmed Alex M. Azar II on Wednesday to be secretary of health and human services, clearing the way for President Trump’s second health secretary to begin controlling more than a trillion dollars a year in spending on medical insurance coverage for about one-third of all Americans.
The vote was 55 to 43.
Mr. Azar, an ophthalmologist’s son and former drug company executive who served in the administration of George W. Bush, faces two huge challenges.
He is supposed to find a way to rein in prices charged by drug companies, which Mr. Trump said last year were “getting away with murder” — a view shared by many consumers.
In addition, Mr. Azar must decide how to administer the Affordable Care Act, a task for which he will be personally and legally responsible, at a time when Mr. Trump and many Republicans in Congress want to undermine and eventually kill the law.
Senator Debbie Stabenow, Democrat of Michigan, was frustrated. “Mr. Azar says he agrees that prices are too high, but he does not seem ready or willing to do much about it,” she said.
From 2012 to early 2017, Mr. Azar was the president of Lilly USA, a unit of Eli Lilly and Company, the global drug maker based in Indiana. Senator Ron Wyden of Oregon, the senior Democrat on the Finance Committee, said Mr. Azar told the panel that “he had never — not even one time — signed off on a decrease in the price of a medicine.”
“On Mr. Azar’s watch,” Mr. Wyden said, “the price of Forteo, a Lilly drug used to treat osteoporosis, more than doubled,” as did the prices for Humalog, used to treat diabetes, and Strattera, for attention deficit hyperactivity disorder.
Six Democratic senators and one independent joined 48 Republicans in voting for Mr. Azar. Opposing him were 41 Democrats, one Republican and one independent.
The Democrats who voted for Mr. Azar were Senators Thomas R. Carper and Chris Coons, both of Delaware, Joe Donnelly of Indiana, Heidi Heitkamp of North Dakota, Doug Jones of Alabama and Joe Manchin III of West Virginia. Senator Rand Paul of Kentucky was the only Republican to vote no. The independent senators split, with Angus King of Maine supporting Mr. Azar and Bernie Sanders of Vermont opposing him.
Mr. Hatch said Mr. Azar’s experience as a drug company executive, far from creating a conflict of interest, was an asset. And he said he hoped Mr. Azar would undo many of the policies put in place because of “poor decisions made throughout the eight years of the Obama administration.”
Mr. Azar will replace Tom Price, who resigned as health secretary in September, in the face of multiple federal inquiries into his use of private and government planes for travel.
Republicans tried unsuccessfully last year to roll back the expansion of Medicaid authorized by the Affordable Care Act. But the Trump administration is determined to make major changes in the program.
Mr. Azar told Congress that states should be allowed to impose work requirements on able-bodied Medicaid beneficiaries. “One of the best ways to improve the long-term health of low-income Americans is to empower them with skills and employment, for those who are able to work,” Mr. Azar said.
JAN. 25, 2018