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Alex Azar

Secretary of Health and Human Services (HHS)

Nominated by Trump: 11-13-2017

Who is Alex Azar?

Alex Azar has long been an outspoken opponent of the Affordable Care Act (ACA) and its birth control mandate, as well as many other health care programs he was tasked with leading. Before joining the Trump-Pence administration, Alex Azar worked for big pharma and, before that, he served as deputy secretary of the Department of Health and Human Services (HHS) under President George W. Bush. Azar was confirmed to his position as HHS secretary in January 2018. As HHS secretary, Azar drove policy changes that reduced access to health care.

“The mission of the HHS is to enhance the health and well-being of all Americans, and this includes the unborn.”

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What Alex Azar Controlled

U.S. Department of Health and Human Services (HHS)

HHS is charged with protecting the health of all Americans. The Trump-Pence administration has slowly reshaped HHS to roll back reproductive rights and limit access to health care.

Related Issues

Title X

Planned Parenthood

Sex Education

Refusal Policies

Birth Control Coverage


The Title X Gag Rule

The Health Agenda

Abortion Coverage

Background on Alex Azar

Restricting Medicaid

Alex Azar’s first act as secretary was to approve a Medicaid work restriction that could take away basic health care coverage for hundreds of thousands of people, mostly women.

Medicaid Block Grants

Under Azar, HHS moved to let states cap Medicaid spending. Under this “block grant” system, the federal government would give states a fixed amount of funding for Medicaid, instead of picking up the slack when states go over budget on Medicaid costs (such as when there’s a natural disaster). The likely results of block grants: states limiting Medicaid by enrolling fewer people, or offering fewer services, or paying health care providers less (which, in turn, would stop some providers from taking Medicaid patients).

Funding Anti-Abortion Efforts

Alex Azar donated thousands of dollars to politicians and organizations that work to eliminate access to abortion.

Open Secrets
Ignoring the Benefits of the ACA Birth Control Mandate

Nearly 63 million women now have access to birth control without copayments thanks to the ACA’s birth control mandate, which guarantees no-copay birth control coverage in the country’s insurance plans. Nationwide, the ACA’s birth control benefit saved women an estimated $1.4 billion on birth control pills the first year (2013) that the law was in effect.

Making Abortion Coverage Less Accessible

Under Alex Azar’s watch, HHS’s Center for Medicare and Medicaid Services (CMS) proposed a rule to impose an onerous system to bill consumers for abortion coverage in ACA insurance plans. The CMS billing rule would make it much more difficult for people to get abortion coverage through the ACA because plans are expected to drop abortion coverage entirely rather than jump through unnecessary bureaucratic hoops.

Tracking Trump: Abortion Coverage
Greenlighting Texas’s Backdoor “Defund”

On the 47th anniversary of Roe v. Wade, HHS decided to let Texas receive federal Medicaid funding for a state program that bars patients in the program from accessing preventive care at Planned Parenthood and other health centers that also provide abortion. This move upends longstanding federal law.  In the past, the federal government refused to fund state Medicaid programs that aim to take away the right of Medicaid users to choose whatever qualified reproductive health care provider they want.  

Planned Parenthood Blog
Attacking Health Care Access for Marginalized Communities

In January 2020, agencies including HHS and USAID proposed rules that could make it easier for faith-based groups to receive taxpayer funding while promoting their religion and not sharing secular alternatives with patients. This proposal could make it more likely that taxpayer dollars end up supporting culturally incompetent providers that deny services to marginalized communities — including LGBTQ people, women, and religious minorities. In turn, this policy could impact peoples' access to HIV and STI prevention programs, reproductive health services, youth homelessness services, and foster care and adoption services both domestically and abroad.

Interfering in Abortion Access

Alex Azar defended efforts to block young undocumented women’s access to safe, legal abortion.

Planned Parenthood Action Newsroom
Letting Bosses Control Birth Control Access

Alex Azar believes employers should be able to control a woman’s birth control options. To actually let bosses deny birth control coverage in their employee insurance plans, Alex Azar tried to weaken the ACA's birth control coverage mandate.

Ignoring Over-the-Counter Birth Control Prices

Without no-copay coverage, an IUD could cost more than $1,300 out-of-pocket, and birth control pills could cost up to $600 per year. Taking away birth control coverage will make it harder for millions of people to get the care they need. Forty percent of Black women ages 18-44 say they couldn’t afford more than $10 a month for birth control if they had to pay out of pocket.

Planned Parenthood: Birth control methods & costs
Furthering What Tom Price Started

Alex Azar was the Trump-Pence administration’s second secretary of Health and Human Services (the pharma exec was confirmed on January 24, 2018). Azar got the job after Tom Price resigned amid scandal. Price’s legacy includes sabotaging ACA enrollment and making other changes to roll back the ACA. Alex Azar built on Tom Price’s legacy by reducing people's access to health care from his perch atop HHS.

Supreme Court Thwarts Administration’s Narrow Definition of Sex Discrimination

One of the ways that the administration has targeted LGBTQ rights was suggesting defining gender as being binary, unchangeable, and determined by one’s genitals at birth — regardless of how people identify. In October 2017, the Department of Justice determined that Title VII of the Civil Rights Act of 1964 — which prohibits sex discrimination — would no longer protect transgender people from employment discrimination. Azar did not object. On June 16, 2020, the U.S. Supreme Court ruled against the DOJ’s interpretation. The ruling protects employees from being fired or otherwise discriminated against for their gender identity, as well as for their sexual orientation.

NBC News

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