As Hezbollah Rises in Lebanon’s Government, Fears About U.S. Response Follow

BEIRUT, Lebanon — Lebanon’s newly formed government, which gives the Islamist movement Hezbollah key ministries, has raised concerns that the country could run afoul of sanctions by the United States that prohibit material support for the Iran-backed group.

On Friday, the United States warned Hezbollah against propping up its agenda with its new position, which includes key posts in Lebanon’s government, including in the Ministry of Health.

American officials are concerned Hezbollah will use the ministry to provide state-subsidized health care and patronage jobs to its supporters and possibly even its fighters, helping it endure punishing American sanctions that have made it difficult for the group to offer its usual social services to its Shiite Muslim base.

“We call on the new government to ensure the resources and services of these ministries do not provide support to Hezbollah,” said a State Department spokesman, Robert Palladino.

As the new cabinet coalesced on Thursday after nearly nine months of political deadlock, the assistant United States Treasury secretary for terrorist financing, Marshall Billingslea, warned Hezbollah that if it tried to “exploit these ministries to funnel money or undertake other activities in support of their terrorist agenda, then we will have significant concerns.”

Hezbollah had been expected to gain strength in government after the group and its allies expanded their share of seats in Lebanon’s parliamentary elections last May, significantly weakening the Western-backed prime minister, Saad Hariri, and his bloc. Now that it has won control of the Health Ministry, which has the fourth-largest budget in the government, its ability to embed itself in Lebanese state institutions has made it both a bigger target and a more elusive prey for the United States, which has designated it a terrorist group.

Lebanon’s political system awards posts and patronage spoils to politicians of different religious affiliations in order to maintain a balance among the country’s 18 officially recognized religious sects. There is a long history of ministers of all stripes using the Health Ministry to provide free or subsidized health care to supporters. Analysts believe Hezbollah may try to do the same, whether for its Shiite base or, more troublingly for the United States, for Hezbollah fighters wounded in the Syrian civil war next door.

“This is yet another example of Hezbollah openly holding Lebanon’s security and prosperity hostage,” said Rachel Mikeska, a spokeswoman for the American Embassy in Lebanon. She added that the United States was “prepared to take whatever actions are necessary to protect the interests of the Lebanese people.”

She declined to say what those actions might be. But analysts said the possibilities ranged from the relatively restrained — such as reducing funding to the Health Ministry and squeezing other international donors, like the World Health Organization, to do the same — to the dire. The United States could theoretically impose sanctions on Lebanese hospitals, preventing the export of American medications to Lebanon, or cut off American military aid to the Lebanese Army.

It is unclear what Hezbollah might do at the Health Ministry that the Trump administration would consider a violation of the sanctions lawPresident Trump signed in October. Analysts said Hezbollah may have chosen Dr. Jamil Jabak, a 63-year-old internist with close ties to Hezbollah, as health minister to try to avoid direct sanctions on the ministry. Dr. Jabak is not a member of Hezbollah, but is said to have once served as a personal physician to the group’s leader.

“Would Washington consider free health care to Hezbollah members provided by the Health Ministry as an example of ‘significant financial support?’” wrote Michael Young, a political observer and journalist with the Carnegie Middle East Center in Beirut, in an opinion columnlast year. “It’s difficult to say that it would never do so.”

The United States’ various interests in Lebanon often end up in conflict, including when it comes to Hezbollah: It wants to counter Iran and its proxies, but also maintain Lebanon’s stability as the war in Syria continues to burn; it also wants to battle terrorism and push back on Russian influence in the Middle East.

Though Washington has designated Hezbollah as a terrorist organization for its actions around the world and its close relationship to Iran, the group has also baked itself into legitimate parts of the Lebanese state, making it difficult for the United States to target it without also affecting the rest of the country.

“The debate in the U.S. about Lebanon is always about which to prioritize and how to balance these competing priorities,” said Firas Maksad, the director of the Arabia Foundation, a Washington-based think tank that leans toward pro-Saudi Arabia and anti-Iran policies.

Opposing these hawkish views are those, including much of the traditional foreign policy establishment, who prefer a more measured response.

Given Lebanon’s floundering economy and political instability, Mr. Maksad said, “they don’t want the whole place to come down.” (The prospect of economic collapse greatly increased pressure on the country’s political factions to strike a power-sharing agreement.)

They also argue that reducing military aid would leave room for Russia, which has expanded its influence across the Middle East, to make inroads in Lebanon.

In general, sanctions and financial tools have come to be the primary stick used by the United States against Iran and its regional partners. On a trip to Beirut last week, Mr. Billingslea urged Lebanese officials to exclude Hezbollah from involvement in the country’s banking and financial sectors, and called for reforms that would allow the Lebanese authorities to block and freeze accounts associated with the group.

But as Hezbollah continues to expand its influence in Lebanese institutions, sanctions may prove to be an overly blunt tool, hitting legitimate government services and civilians in addition to the party.

In the past, when Hezbollah played a smaller role in government, “you could easily separate between Hezbollah and state institutions,” said Hanin Ghaddar, a Lebanese-American analyst at the Washington Institute for Near East Policy and a frequent critic of Hezbollah.

Now, with Hezbollah commanding a broad swath of government, she asked, “How do you keep the stability of Lebanese institutions while going after Hezbollah with everything you have?”

“Nobody can have sole control over Lebanon, neither Hezbollah nor anybody else,” he said. “Lebanon is a diverse country.”

In a televised interview on Saturday, Hassan Nasrallah, the organization’s secretary general, said the group did not intend to meddle with Lebanon’s balance of power.

But Mr. Maksad noted that Hezbollah had managed to forge pacts with Christian and Sunni politicians as well as Shiite ones, then held up the formation of the new government until the prime minister, a Sunni, agreed to allow Hezbollah’s Sunni allies into the cabinet — an unmistakable mark of its strength.

Of the new faces in the 30-seat cabinet, it was Dr. Jabak, the physician leading a ministry closely watched by the West, who attracted the most immediate attention.