WASHINGTON — The Trump administration just lost its most effective health policy salesman.
Scott Gottlieb, the charismatic FDA commissioner who announced this week he will step down in about a month, was better than any other administration official at selling key Trump administration policies — particularly those related to lowering prescription drug prices — on Capitol Hill, lawmakers and aides in both parties told STAT.
Gottlieb isn’t on television to talk about the administration’s high-profile goal of bringing down drug prices nearly as often as health secretary Alex Azar. Nor is his agency drafting many of the regulatory changes that have become the centerpiece of the administration’s agenda on the issue. But behind the scenes, he has been constantly fielding lawmakers’ and their staff’s questions, establishing such a strong rapport that he began serving as something of a backchannel for others in the administration hoping to connect with Capitol Hill.
Gottlieb was “more than accessible” and would reliably answer calls from members of Congress in both parties, said Rep. Anna Eshoo, the California Democrat who chairs the House Energy and Commerce Committee’s health panel.
Congressional staff, in particular, were stunned by Gottlieb’s accessibility. “Republican or Democrat, if you had a question related to the FDA you knew you could go straight to the commissioner,” a senior congressional aide told STAT, who added that staff would personally text message with Gottlieb “a couple of times a week.”
In nearly a dozen conversations with STAT, lawmakers, congressional aides, and lobbyists all acknowledged that no one, including Azar, had the same level of extensive relationships on Capitol Hill. And while many hesitated to opine on what Gottlieb’s departure may mean for the administration’s legislative agenda moving forward, several suggested it could at least tarnish the administration’s standing on Capitol Hill.
“I’ve never seen an administration official, Republican or Democrat, that has worked with the Hill so well on a bipartisan basis,” the senior congressional aide told STAT, referring to Gottlieb.
Not only would Gottlieb personally call members and staff to follow up on his own priorities, he would also check in about members’ personal concerns. “It wasn’t just window dressing,” a recently departed FDA staffer said. “He was actively working on their issues to keep them happy.”
Gottlieb also had a penchant for explaining drug pricing policy wholly outside of the FDA’s purview. He’s been a top spokesman, in particular, for the administration’s plan to eliminate drug rebates. He first broke the news of the administration’s plan to eliminate rebates to a conference of FDA lawyers back in May, and hasn’t stopped talking about it since.
The outgoing FDA commissioner even launched into an impromptu lecture on rebates in the commercial biosimilar market at an event Wednesday, just hours after announcing his resignation. That issue doesn’t even fall within HHS’s jurisdiction, let alone FDA’s.
‘Called it the way he saw it’
Sporting snug suits, flashy socks, and a jet-black, slicked-back head of hair, Gottlieb was authoritative on policy and deferential to lawmakers at the same time — quickly establishing himself as a congressional go-to on an array of issues, even ones only partially within FDA’s purview: the opioid crisis, prescription drug prices, vaccines, and tobacco or e-cigarette use.
It helped, too, that Gottlieb does not carry much of the baggage that his bosses do. Democrats saw the conservative former congressman Tom Price as overly ideological even before the revelations that he had used millions of taxpayer dollars on private jet travel.
Azar, his successor, has also seen some relationships on Capitol Hill suffer as a result of recent administration controversies, including an agency rule currently facing multiple legal challenges that would restrict access to health care at medical facilities that provide abortions. Azar has also overseen the detention and care of thousands of migrant children near the country’s southern border, and has publicly feuded over his handling of the migrant crisis with Rep. Frank Pallone (D-N.J.), who chairs the House Energy and Commerce Committee and has oversight purview over much of the health department.
Gottlieb’s steady presence just below the surface left lawmakers to associate policymaking with him as much as any other administration health official, aides said. Even after recently lambasting Azar, Pallone called Gottlieb “a good steward of FDA” and a “powerful partner.”
The reputation, said aides from both parties, was well-earned. Gottlieb would proactively reach out to lawmakers to ask their priorities, stunning staff with his accessibility.
The recently departed senior FDA official lamented to STAT that Gottlieb’s departure will further decrease the administration’s standing with Democrats.
“Over [the] long term it will eliminate the one area members could point to as a success,” the official told STAT in a text message.
Still, Gottlieb had his detractors — many of whom were befuddled by the FDA’s approval in 2018 of the mega-potent opioid drug Dsuvia. More recently, Gottlieb’s tough stance on menthol cigarettes and youth e-cigarette use earned the scorn of Sen. Richard Burr (R-N.C.), a powerful tobacco-state lawmaker who took to the Senate floor to all but invoke the president’s wrath.
But whether they agreed or disagreed with his policies — and they most often agreed — Gottlieb was accessible to lawmakers ranging from committee chairs to backbenchers.
“He did his job,” Rep. Peter Welch (Vt.), a Democrat active on drug-pricing issues, told STAT when asked why Gottlieb garnered respect from both Republicans and Democrats.
“He tried to get a smoother process to get drugs to market,” Welch said. “He called it the way he saw it. He wasn’t chasing headlines. He was doing his job. He was doing the work. That’s kind of odd around here.”
Even Gottlieb’s biggest detractors were singing a softer tune on the day he announced his resignation.
“Scott,” Burr said Tuesday in a statement, “has been one of the best commissioners I’ve seen in the 25 years I’ve been in Washington.”