The working relationship between HHS Secretary Alex Azar and CMS Administrator Seema Verma has grown so dysfunctional that both President Trump and Vice President Pence have intervened to try to salvage the situation, three senior administration officials told Axios' Jonathan Swan and me.
Why it matters: It's an extraordinary intervention at the highest levels of government. And it highlights, as Politico extensively reported in this story, the White House's urgent desire for the heads of Health and Human Services and the Centers for Medicare and Medicaid Services to repair their working relationship.
Behind the scenes: Azar had a clearing of the air meeting with Verma on Wednesday, at Pence's request, according to two administration officials.
- The president had made clear, according to a third administration official, that he "is fond of both of them and he expects them to work together on what could easily be a signature issue in 2020 for him."
- "He just wants them to figure it out between themselves and get the work done," per a fourth source familiar with the president's view of the situation.
The tensions between the two officials have already disrupted the rollout of health care initiatives that Trump's team considers important for his reelection.
- This includes the delay of the administration's Affordable Care Act replacement proposal, Politico reported.
At their meeting on Wednesday, Verma raised her concerns directly with Azar about his leadership style. The two officials agreed to try to work better together and that her concerns would be addressed and mitigated going forward, a source familiar with the meeting added.
- "These concerns are predominantly about media rollouts and in some cases staffing issues that are not reflective of a leadership or management style," another source familiar with the meeting pushed back. "They are individual instances that are petty and not reflective of a larger leadership or management style."
- HHS, CMS and the White House did not provide a comment.