Azar's Senate confirmation could be hard, with the chamber's 48 Democrats unlikely to approve a candidate who supports dismantling the Affordable Care Act. Trump and Congressional Republicans have called to repeal the health law, and the administration has taken steps to destabilize it, such as cutting funding for some programs and refusing to pay subsidies to health insurers.
He previously served in the department under George W. Bush and most recently served as the head of the American division of Eli Lilly, a major pharmaceutical company.
Azar, who ran Indianapolis-based Lilly's USA operations until earlier this year, has been an advocate for more state flexibility under Obamacare. "I don't know what's going to be in the substance of it, but there will be a piece of legislation that says that". He's seen as an expert on government health care regulation.
Azar's nomination, which must be confirmed by the Senate, comes a month and a half after Secretary Tom Price resigned amid a scandal over his use of private jets to conduct government business. He left Lilly in January 2017 and now consults and counsels with pharmaceutical and health insurance companies. Early enrollment in Obamacare plans earlier this month was also up considerably compared to past year.