MONTGOMERY, Ala. — The Alabama State Employees’ Insurance Board of Directors unanimously voted Wednesday to elect Stephanie Azar the new SEIB chief executive officer.
Azar has been the Alabama Medicaid Agency commissioner since 2012.
“It’s very humbling to me to be honest with you,” Azar said just ahead of the vote, speaking during an SEIB meeting in Montgomery. “I’m just going to give it my all, do the best I can to uphold SEIB’s mission and vision, so I can guarantee you, you’ll get the best of me with that.”
Alabama Medicaid Agency Commissioner Stephanie Azar has been recommended by the State Employees Insurance Board to become the new CEO of the SEIB.#ALPolitics pic.twitter.com/PDc7K6cDxt
— Alexander Willis (@ReporterWillis) June 18, 2025
Outgoing CEO William Ashmore announced his retirement in March after leading the agency for nearly 40 years.
Azar will not take over as CEO until Gov. Kay Ivey selects a new Medicaid commissioner and there is a transition period.
“Stephanie Azar has been an instrumental part of my administration, and I could not be prouder to see her selected as the new CEO of the State Employee Insurance Board,” Ivey told Alabama Daily News. “She has over 26 years of experience with the Alabama Medicaid Agency and is truly an expert. I am confident she will continue serving our state well.”
Azar is the longest consecutively serving commissioner in Alabama Medicaid’s history, Ivey’s office said, which also confirmed that a transition plan for the Medicaid Agency and that cabinet position is already in place. More will be shared in the coming weeks when Ivey finalizes her decision.
In its search, the SEIB had waded through 49 candidates, ultimately whittling its selection down to two. After SEIB Chair Faye Nelson revealed Azar would be put forward for a vote to lead the SEIB, board member Bob Childree expressed his strong support for the decision, while also voicing his concern for SEIB’s financials going forward.
“I am very concerned about the financial viability of the SEIB,” Childree said. “I think it needs to be very strong.”
The SEIB, which provides health insurance and benefits to around 90,000 active and retired state employees and their dependents, was faced last year with a potential budget shortfall due to federal policy changes, including a reduction of the federal government’s cost share of prescription drugs, and a cut to Medicare payouts.
State lawmakers also came up short in allocating SEIB its requested 5% budget increase for the 2026 fiscal year, ultimately approving an increase of just under half of 5%.
Azar said she was confident to confront any funding challenges as SEIB CEO, telling ADN that through leading AMA, she was all too familiar with navigating a tight budget.
“There are always challenges with health care’s rising costs; I’m accustomed to those issues, so I’m looking forward to tackling that with the board,” she said.
Ashmore described Azar as a “very good candidate.” He also told ADN that lawmakers would, sooner or later, be forced to take action to counter rising health care costs.
“We’ve gone 16 years where our average increase in claims and cost have been less than 1% a year, which is incredible, but you cannot, in health care, continue at that level,” Ashmore told ADN.
“In order to continue to provide those benefits to our beneficiaries, we’ve got to have the funds. So we’ve been trying to prepare the legislature, the decision makers that these things are on the horizon, and we need to address them now, not wait until it’s a problem.”
Childree, while still concerned over the SEIB’s finances, said he was glad to see Azar leading the helm as the state agency navigates increasing health care costs.
“It’s a matter of funding, and you realize that the cost of medical care is going to skyrocket, and so the level of funding that’s necessary to do that is always a concern,” he told ADN. “There are many options for how to deal with that, but that’s a job for Stephanie to look at and see where we go from here.”
Medicaid is the state’s largest General Fund budget expense — nearly $1.2 billion in 2026 — and probably it’s most complex. Azar’s ability to explain the agency’s many funding streams and expenditures has been valued by lawmakers, including Rep. Rex Reynolds, the House General Fund committee chairman.
“When I was incoming budget chairman in 2023, I can’t tell you how much I appreciated the amount of time that she sat and worked with me so that I had a total understanding of the Medicaid process,” Reynolds told Alabama Daily News on Wednesday. “Because she’s so intelligent, sometimes I’d say, ‘Okay, now break that down to layman’s terms?’ And she’s always been good to do that.
“But SEIB is an integral part of state government and supports our state employees and retirees. So I’ll be honored to work with her in that position, too, and just wish her all the best.”
Sen. Clyde Chambliss, R-Prattville, vice-chair of the Senate General Fund committee, agreed.
“Ms. Azar has been great to work with in her role as commissioner of Medicaid,” Chambliss said. “While I will miss having her as a resource at Medicaid, I very much look forward to continuing to work with her at the State Employees Insurance Board. She will serve the board well.”
Alabama Daily News’ Mary Sell contributed to this report.