Just days after being sworn in as the deputy secretary of the U.S. Department of Health and Human Services, Eric Hargan has been catapulted to the agency's top spot, at least in an acting capacity.
Hargan replaced Don Wright, who had temporarily filled the HHS secretary's job after Tom Price resigned Sept. 29 under a cloud of scandal over his taxpayer-paid flights on chartered and government jets, which may have cost Americans up to $1 million over his seven months in the position.
Wright has returned to his role as deputy assistant secretary for health and director of the Office of Disease Prevention and Health Promotion at HHS.
The White House disclosed President Donald Trump's decision to move Hargan to the acting secretary's role in a late-night Oct. 10 statement, tucking the big reveal about the new designation at the bottom of an announcement involving personnel nominations.
But Hargan's road to the deputy job — where he was expected to run the day-to-day bureaucracy of HHS — came much slower.
Before Trump tapped him for the No. 2 spot at HHS, Hargan was a shareholder at the Chicago law firm Greenberg Traurig, where his practice focused on health and U.S. Food and Drug Administration business. He also was previously a partner at McDermott Will & Emery.
Hargan is not new to government. During the George W. Bush administration, Hargan served in three positions at HHS: deputy general counsel, principal associate deputy secretary and acting deputy secretary.
Before that, he was a partner at the law firm Winston & Strawn.
The Senate Finance Committee convened a hearing on Hargan's nomination June 7, where several Democrats, including Sen. Ron Wyden of Oregon, the panel's ranking member, criticized the lack of insight and responses to questions the nominee gave about how he would handle implementing and enforcing the Affordable Care Act, given the administration's effort to dismantle it.
"Obviously, that's a subject of a lot of dispute here on Capitol Hill," Hargan said.
Some eyebrows were raised when Hargan said he was "not particularly a policy person in this area to opine about the influence exactly what the gears between the Affordable Care Act and all of the changes in the healthcare landscape that have taken place."
Wyden also asserted that Hargan had used his position during the Bush administration to block efforts by the FDA to increase food safety inspections — an accusation the then-nominee ignored and did not address at the hearing.
At the June 14 Finance Committee's session where a vote was held on Hargan's nomination, Wyden said he had not seen any evidence that the nominee would support efforts to inject more competition into U.S. insurance markets, help bring down drug prices or update the Medicare program to "reflect the care seniors need today and in the future, particularly those with chronic conditions like cancer and diabetes."
"It's impossible for us to evaluate a nomination for the number two spot at HHS without viewing it through that lens," Wyden said just before voting against Hargan.
But Sen. Orrin Hatch, R-Utah, chairman of the Finance Committee, argued that Hargan would "bring experience, common sense and a meaningful work ethic to Health and Human Services."
"No doubt his prior service at HHS will bring thoughtfulness and institutional stability at a crucial time," Hatch said.
It took three more months before Senate Majority Leader Mitch McConnell, R-Ky., brought Hargan's nomination to the chamber's floor for a full vote on Oct. 4.
McConnell argued that Hargan's experience would be an asset in helping HHS respond to the hurricanes that struck the U.S. in recent weeks, particularly in hard-hit Texas, Florida, Puerto Rico and the U.S. Virgin Islands.
Just before the vote, Wyden predicted that Trump would fast-track Hargan to the top job at HHS once confirmed.
Sen. Catherine Cortez Masto, D-Nev., questioned Hargan's qualifications, saying she "could not in good conscience vote to confirm someone about whom I have so many concerns."
In the end, Hargan won the confirmation in a 57-38 vote, with seven Democrats and Independent Angus King of Maine joining 49 Republicans in backing his nomination for the HHS deputy position.
Hargan was sworn in the next day, and five days later was put into the secretary's chair in an acting capacity.
Trump has not yet indicated whom he wants to take the HHS secretary job permanently — whether Hargan or someone else.
FDA Commissioner Scott Gottlieb has been viewed as a popular choice, although he has signaled he is happy in his current role.