Trump Pulled Into Feud Between Top Health Officials

President Donald Trump has personally tried to settle the long-running feud between his two top health appointees, telling his health secretary to fix the relationship with his Medicare chief, said three individuals with knowledge of the situation.

Trump and Seema Verma, who runs the Centers for Medicare and Medicaid Services, privately met in mid-November amid escalating tensions between her and Health and Human Services Secretary Alex Azar, according to two sources familiar with the meeting. Around the same time, Trump instructed Azar to smooth things over. Those conversations came shortly before POLITICO first reported on the souring relationship between Azar and Verma, whose agency sits within HHS.

Days after the POLITICO report, Verma also met one-on-one with Vice President Mike Pence, one of her strongest backers in the White House. The meeting was unusually publicized, appearing on Pence’s official schedule.

Axios first reported Trump’s involvement. The White House didn’t respond to request for comment. HHS and CMS declined to comment.

Trump’s and Pence’s efforts to end the feud come amid broader leadership battles at the health department, which some administration officials worry has threatened Trump’s agenda on Obamacare, drug prices and other policies central to his reelection effort.

Azar and Verma — his subordinate who oversees Medicare, Medicaid and Obamacare — have battled for months over policy and personnel. They met Wednesday to try to clear the air, a day after Verma’s meeting with Pence, according to four officials with knowledge.

Neither Azar nor Verma’s job is believed to be at immediate risk. But Trump has overruled Azar on multiple policy decisions and shown flashes of irritation with him, even reportedly joking during a White House meeting on vaping last month that he should fire Azar.

The rift between Azar and Verma intensified this summer after Verma, in an Oval Office meeting with Trump and other senior officials, criticized a major drug pricing proposal that Azar had been pushing for months, said three officials with knowledge. Azar’s proposal was subsequently shelved. Disclosures about Verma’s extensive use of highly paid outside contractors to raise her personal profile have exacerbated the tensions between her and Azar’s camps.

Verma last week convinced Senate Finance Chairman Chuck Grassley (R-Iowa) to hold off on an investigation of the contractors, two people with knowledge told POLITICO. The arrangements are already being investigated by House Democrats and the health department. A third investigation from a senior Republican could put further pressure on Verma and fuel the combustible situation with Azar.

Grassley privately raised questions about whether the contracts were appropriate after a series of POLITICO stories, including one last month about how several Trump allies benefited from them. Grassley decided against airing those concerns, such as by sending a public letter, after speaking with Verma, said two individuals with knowledge of their conversation.

The rift between Azar and Verma intensified this summer after Verma, in an Oval Office meeting with Trump and other senior officials, criticized a major drug pricing proposal that Azar had been pushing for months, said three officials with knowledge. Azar’s proposal was subsequently shelved. Disclosures about Verma’s extensive use of highly paid outside contractors to raise her personal profile have exacerbated the tensions between her and Azar’s camps.

Verma last week convinced Senate Finance Chairman Chuck Grassley (R-Iowa) to hold off on an investigation of the contractors, two people with knowledge told POLITICO. The arrangements are already being investigated by House Democrats and the health department. A third investigation from a senior Republican could put further pressure on Verma and fuel the combustible situation with Azar.

Grassley privately raised questions about whether the contracts were appropriate after a series of POLITICO stories, including one last month about how several Trump allies benefited from them. Grassley decided against airing those concerns, such as by sending a public letter, after speaking with Verma, said two individuals with knowledge of their conversation.

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