Good morning. If you missed our deep dive over the weekend into health care and 2020, check it out.
D.C. readers: Join Axios' Mike Allen Wednesday at 8am for conversations about the future of comprehensive health care.
Today's word count is a monstrous 1,055, or a 4-minute read.
CMS Administrator Seema Verma. Photo: Steven Ferdman/Getty Images
On a scale of one to 10, tensions between Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma are at a 15 — and the stories about the fallout keep coming.
Why it matters: These are huge agencies that control all federal health spending. Azar and Verma are in charge of executing President Trump's health agenda heading into an election in which health care is front and center, and at a time when he could use some wins.
Driving the news: Axios' Jonathan Swan and I scooped on Friday that things got so bad at the end of the summer that HHS brought in a third-party lawyer to investigate Verma's claims of sex discrimination.
Then on Saturday, Politico's Dan Diamond reported that Verma asked taxpayers to reimburse her $47,000 for lost property — mostly jewelry — in August 2018 after her bags were stolen on a work trip.
Both Trump and Vice President Mike Pence have become involved in the situation, urging the officials to find a way to work together, as Jonathan and I reported last week, and Azar met with Pence on Friday.
What's next: Both Azar and Verma have powerful allies and committed detractors at the highest level of the administration, meaning it's unclear which — if either — of them will become a casualty of this increasingly untenable situation.
The chances of Congress being able to pass a bill protecting patients from surprise medical bills were looking pretty bleak, but a deal announced by some of the key players yesterday may have turned that around.
Details: The agreement — announced by Sen. Lamar Alexander, Rep. Frank Pallone and Rep. Greg Walden — would set benchmark rates for the providers who send such bills, and it would use an arbitration process to settle certain high-value payment disputes.
Yes, but: Notably absent from the announcement was Sen. Patty Murray, Alexander's Democratic counterpart.
What they're saying: The American Hospital Association still isn't pleased.
Go deeper: Hospitals' dog in the surprise billing fight
House Speaker Nancy Pelosi. Photo: Michael Brochstein/Echoes Wire/Barcroft Media via Getty Images
The House is set to vote this week on its drug-pricing bill, but the outlook for an ultimate deal continues to not look great, Axios' Sam Baker writes.
Driving the news: House leaders may bring the bill to the floor without an amendment from Rep. Pramila Jayapal, a progressive stalwart.
Where it stands: The White House has already criticized Pelosi's bill, and pushback from the left obviously wouldn't help its chances.
Spending on prescription drugs wasn't actually quite as low as the recent National Health Expenditures report made it seem, Axios' Bob Herman notes.
Driving the news: Retail prescription spending stayed relatively low last year, at $335 billion, because more people used cheaper generic drugs, and because price increases were held in check, actuaries wrote in the government's report.
Yes, but: This part of the NHE report does not factor in inpatient pharmacies, chemotherapy, infusions and other drugs that people have to receive in a hospital or clinic — drugs that equal a quarter of the entire pharmaceutical market.
People who are in the middle of a health crisis often are at an especially high risk for surprise medical bills, according to previously unreleased data from the Kaiser Family Foundation.
The big picture: The new data underscore the importance of a legislative solution to help patients who are powerless to protect themselves, KFF president Drew Altman writes in his latest column.
Details: People having surgery or receiving mental health and substance abuse treatment at an in-network hospital are the most likely to experience a surprise bill from an out-of-network provider.
Drew's thought bubble: It's hard to imagine many patients who are so prepared and insurance-savvy that they could protect themselves from an out-of-network bill in the middle of a heart attack.
A new report from ProPublica, the Texas Tribune and Vox sheds some light on the terrible state of maternity care in Texas, Axios' Marisa Fernandez writes.
Details: The state "prioritize[s] babies over mothers, thwarts women at every turn, frustrates doctors and midwives, and incentivizes substandard care," the report states, citing gross medical errors, racial disparities and structural deficiencies.
If all of that wasn't enough: