So, you’re looking back and wondering who actually held the keys to the Department of Health and Human Services before Xavier Becerra took over. The name you’re looking for is Alex Azar.
He was the 24th person to lead the agency. Honestly, he didn't just walk into a quiet office. He stepped into a whirlwind. To understand his tenure, you've gotta look at the sheer scale of what he was managing. We’re talking about a $1.4 trillion budget. That is more money than the GDP of most countries.
Azar served under President Donald Trump from January 2018 until the very end of that administration in January 2021. But the transition wasn't just a straight line from one guy to the next.
Who Was the Previous HHS Secretary Before Becerra?
Technically, if we’re being super precise, there was a brief "acting" period. Between Azar leaving on Inauguration Day and Becerra getting confirmed by the Senate, a career official named Norris Cochran filled the gap for a few months in early 2021.
But for the history books, Alex Azar is the "previous" permanent secretary.
Before he became the face of the department, Azar had a pretty deep background in both law and big pharma. He wasn't a doctor. He was a Yale-trained lawyer who had clerked for Supreme Court Justice Antonin Scalia.
That legal background shaped everything he did. He knew the bureaucracy because he’d already been the Deputy Secretary under George W. Bush. After that, he spent about a decade at Eli Lilly, eventually becoming the president of Lilly USA.
👉 See also: Who needs to evacuate for Hurricane Milton: The hard truth about surge and zones
This corporate history was a massive talking point during his confirmation. Some people saw it as "fox guarding the henhouse" stuff. Others thought he was exactly what the department needed to understand how to actually lower drug prices.
The Operation Warp Speed Legacy
It’s impossible to talk about Azar without mentioning Operation Warp Speed.
Basically, this was the moonshot project to get a COVID-19 vaccine developed and distributed in record time. Usually, vaccines take a decade. They did it in less than a year. Azar was one of the chief architects of this partnership between the government and the private sector.
Kinda wild when you think about it. He was the guy sitting at the table when the first vials were being shipped out.
But it wasn't all wins and handshakes. His time was also defined by some pretty public friction. You might remember the headlines about him clashing with Seema Verma, who ran the Centers for Medicare & Medicaid Services (CMS). It was the kind of internal West Wing drama that leaked into the papers constantly.
Policies That Actually Changed Things
Most people focus on the pandemic because, well, it was a global crisis. But Azar pushed for things that still affect how you pay for healthcare today.
- Price Transparency: He pushed rules requiring hospitals to post their "real" prices online. Before this, finding out what a procedure cost was like trying to guess the weight of a cake without a scale.
- The Opioid Crisis: He oversaw a massive surge in funding and resources to combat addiction, which he often called the "crisis of our time" before the virus showed up.
- Kidney Care: He actually worked on a major overhaul of how the U.S. treats kidney disease, trying to move people away from centers and toward home dialysis.
It's easy to forget that HHS is more than just "health." It’s also "human services." That means Azar was also in charge during the highly controversial "zero tolerance" border policy. The department's Office of Refugee Resettlement was responsible for the care of children separated from their parents.
This part of his tenure was arguably the most criticized. He faced intense questioning from Congress over the logistics and the ethics of how those children were tracked—or not tracked—within the system.
Why His Tenure Matters for 2026
You might be asking why we’re even looking back at a guy from 2018.
👉 See also: Trump’s Stance on Abortion: What Most People Get Wrong
The reason is simple: the precedents he set. Whether it's the use of "Emergency Use Authorizations" (EUAs) for medicine or the way the federal government negotiates with drug companies, the "Azar era" created the playbook that many current officials are still following—or trying to rewrite.
He was a Republican who actually spoke about the need for "value-based care." That’s a fancy way of saying doctors should be paid for keeping you healthy, not just for how many tests they run.
Life After the Cabinet
What does a former HHS secretary do when they leave?
In Azar's case, he didn't just disappear. He’s spent a lot of time in academia and consulting. He’s been an adjunct professor at the University of Miami and has stayed active in the healthcare policy debate.
He didn't leave without a final word, either. In his resignation letter, he specifically mentioned the January 6th Capitol riots, stating that the actions of that day "threaten to tarnish" the administration’s legacy. It was a rare moment of a cabinet member publicly breaking rank right at the exit.
Actionable Insight for You:
💡 You might also like: I 295 Accident Today: What You Need to Know About the Current Gridlock
If you’re tracking how healthcare laws change, don't just look at the current person in charge. Look at the administrative rules passed during Azar's time. Many of those transparency and "interoperability" rules (the ones that make it easier for you to get your medical records on your phone) are still being implemented or challenged in court. Understanding the "previous" guy helps you see where the current guy is going.
To stay on top of this, you should check the official HHS Archive if you want to see the specific memos he signed that still affect your insurance coverage today.