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President Trump is flanked by HHS Secretary Alex Azar and CMS Administrator Seema Verma at an event in July. Photo: Alex Wong/Getty Images

The working relationship between the Trump administration's top health officials, 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, according to three senior administration officials.

Why it matters: It's an extraordinary intervention at the highest levels of government. And it highlights, as Politico extensively reported, 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. This wasn't the first time the White House had to intervene to fix this broken relationship at the top of HHS.

  • On Nov. 15, at the White House event on price transparency, Trump challenged Azar about his troubled working relationship with Verma, per two senior 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, which Verma spent six months developing only to have Azar kill it before it reached the president, Politico reported.
  • This Laura Ingraham tweet, in which the Fox host attacked Verma the day the Politico story came out, caught the attention of senior administration officials. Administration officials regard Ingraham — who has lavished praise on Azar — as a staunch ally of the HHS secretary.

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.

Go deeper... Azar: Trump says America should get "the best deal" on drug prices

Go deeper

Senate confirms retired Gen. Lloyd Austin as defense secretary

Photo: Greg Nash-Pool/Getty Images

The Senate voted 93-2 on Friday to confirm retired Gen. Lloyd Austin as secretary of defense. Sens. Mike Lee (R-Utah) and Josh Hawley (R-Mo.) were the sole "no" votes.

Why it matters: Austin is the first Black American to lead the Pentagon and President Biden's second Cabinet nominee to be confirmed.

House will transmit article of impeachment to Senate on Monday, Schumer says

Photo: Drew Angerer/Getty Images

Senate Majority Leader Chuck Schumer (D-N.Y.) announced that the House will deliver the article of impeachment against former President Trump for "incitement of insurrection" on Monday.

Why it matters: The Senate is required to begin the impeachment trial at 1pm the day after the article is transmitted.

Dan Primack, author of Pro Rata
2 hours ago - Politics & Policy

Private equity bets on delayed tax reform in Biden administration

Illustration: Brendan Lynch/Axios

In normal times, private equity would be nervous about Democratic Party control of both the White House and Congress. But in pandemic-consumed 2021, the industry seems sanguine.

Driving the news: Industry executives and lobbyists paid very close attention to Treasury Secretary nominee Janet Yellen's confirmation hearings this week, and came away convinced that tax reform isn't on the near-term agenda.