Dec 6, 2019

Scoop: Trump and Pence intervene in clash between top health officials

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

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Scoop: Top Trump officials' feud prompts sex discrimination probe

HHS Secretary Alex Azar speaks at a July event with Medicare chief Seema Verma (right). (Photo: Cheriss May/NurPhoto via Getty Images)

The Department of Health and Human Services took the extraordinary step of bringing in outside counsel earlier this year to investigate allegations of sex discrimination, Axios has learned — a sign of how badly the working relationship had deteriorated between Secretary Alex Azar and Medicare chief Seema Verma.

Why it matters: While the outside lawyer investigating the claims ultimately described them as unsubstantiated, the revelation of the investigation is more evidence that bad blood between the nation's top two health officials has sidetracked one of the biggest arms of the federal government.

Go deeperArrowDec 7, 2019

White House summons Azar, Verma to meeting that Trump may join

HHS Sec. Alex Azar, President Trump and CMS Administrator Seema Verma. Photo: Alex Wong/Getty Images

Chief of Staff Mick Mulvaney has arranged a conflict resolution session at the White House between the nation's two top health officials, according to three administration officials. President Trump himself is likely to join, one of the officials said.

Why it matters: Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma are engaged in a bitter feud that has exploded into the public eye over the last few weeks.

Go deeperArrowDec 10, 2019

Trump officials leave peace meeting with their jobs

HHS Sec. Alex Azar, President Trump and CMS Administrator Seema Verma. Photo: Alex Wong/Getty Images

Health and Human Services Sec. Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma both still have their jobs after Wednesday night's White House meeting, per three sources familiar with the matter.

Details: The peace meeting between the two feuding officials was held in Vice President Mike Pence's office. Pence, acting chief of staff Mick Mulvaney, Azar, Verma and Pence's chief of staff Marc Short attended, two sources familiar told Axios' Jonathan Swan.

Go deeperArrowDec 12, 2019