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‘A f—ing soap opera’: The health care drama riveting the White House

While Washington focuses on impeachment, West Wing aides are buzzing about the vicious battle between two top Trump health aides.

Alex Azar, Donald Trump, Seema Verma

President Donald Trump (center) speaks as Secretary of Health and Human Services Alex Azar (left) and Administrator of Centers for Medicare & Medicaid Services Seema Verma listen in July. | Alex Wong/Getty Images

They’re not obsessing about the impeachment imbroglio consuming the rest of the Washington. At the West Wing’s Navy mess, in hallway asides and at staff meetings, many White House aides just want to chatter about an increasingly vicious public spat between two of President Donald Trump’s top health officials.

Among top Trump aides, it’s now an open question as to whether Secretary of Health and Human Services Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma can survive the scale of bickering that has appalled and horrified people internally, a White House official said.

White House aides have been discussing the practical aspects of potentially replacing one or both officials if that decision were to come, as well as concerns associated with another Senate confirmation, according to the White House aide.

Acting White House chief of staff Mick Mulvaney has called both Azar and Verma to the White House for a meeting on Thursday in an attempt to mediate the duo’s months-long personality and policy clashes. Already, Trump told Azar and Verma to knock it off and get along — to no avail, said two senior administration officials.

The White House press office declined to comment. A HHS spokesperson said “Secretary Azar’s and Administrator Verma’s top priority is to advance the president’s health care agenda through lowering drug costs, advancing competition in the marketplace, and ensuring Americans have access to high quality, affordable healthcare.”

A CMS spokesperson echoed the same sentiment: “The Administrator’s number one priority is continuing to deliver on the president’s bold health care agenda to ensure Americans have access to high quality, affordable healthcare.”

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It’s unclear where Trump stands this week after POLITICO reported over the weekend that Verma tried to have taxpayers reimburse her for $47,000 worth of property stolen during a work trip. Verma also has come under fire for spending millions of dollars on contracts for Republican communications consultants, whose jobs entailed boosting her public profile.

A person familiar with the president’s thinking said he would like “both the Secretary and the Administrator to stop the friendly fire and work together.”

In interviews, nine current and former senior administration officials and Republicans close to the White House detailed how the rift between the two turned toxic on numerous fronts.

Azar and Verma’s fighting has persisted for months, leaving officials from the Office of Management and Budget and the White House’s two policy councils as frustrated bystanders, and the tension between the two has only escalated in recent weeks.

The deteriorating drama has formed battle lines among White House aides — with camps split between Verma and Azar, contributing to the stalemate. Azar has the backing of two of the administration’s most powerful lawyers, while Verma has known Vice President Mike Pence for years and had a direct line to the president during talk of unveiling an Obamacare replacement.

But the constant bickering now threatens to blow back on both of them, as allies allege one is smearing the other. The risk is that one looks so consumed by this conflict that he or she appears unable to carry out the duties of the job.

The two have clashed over matters small and large, including policy issues such as the president’s desire to lower drug prices — seen as a key talking point for his reelection campaign.

“What a fucking soap opera,” said one person familiar with the dynamics. “This does not help either of them.”

Throughout the Trump presidency, health care has been one of the administration’s chief tripwires. The White House and Republican lawmakers failed to repeal Obamacare after years of conservative outrage over the sweeping health care law. The first Secretary of Health and Human Services Tom Price resigned after facing multiple investigations into his use of private aircraft for taxpayer-funded work trips. Policy-wise, other high-profile health care efforts have either been stalled in the courts or over disagreements including Verma’s push to institute the first-ever Medicaid work requirements and her efforts to develop an Obamacare replacement plan.

Meanwhile, Azar has come under fire for cutting Verma out of the department’s decision-making and attempting to block her access to the president and a high-profile event related to a Medicare executive order. The health secretary blocked Verma from traveling with Trump on Air Force One in October for the unveiling of a Medicare executive order in Florida, according to a half-dozen officials with knowledge of the multi-day episode. Verma was only allowed aboard the plane after the White House intervened. An HHS spokesperson denied that Azar or anyone at the agency blocked Verma from boarding the flight.

Within the White House, both Azar and Verma have their defenders as well as serious detractors.

As an attorney, Azar remains close to White House counsel Pat Cipollone and Attorney General Bill Barr, powerful allies in the Trump orbit. Azar has a reputation throughout the administration as a fierce bureaucratic infighter, who does not hesitate to create a paper trail to inoculate himself against potential criticism.

 Alex Azar
Secretary of Health and Human Services Alex Azar. | Zach Gibson/Getty Images

He’s also known for his fierce temper, dubbed by several senior administration officials as “the purple rage” because of his face color when he becomes angry.

Verma is close with Vice President Mike Pence, with whom she worked in Indiana when he served as governor. White House aides have spotted her dining in the Navy mess with Jared Kushner, with whom she worked on health care-related information technology initiatives. She also has a direct line to the president, speaking to him with some frequency when the White House was contemplating unveiling a potential Obamacare replacement plan.

On Verma, the criticism is that she is a micromanager who only trusts people inside her very inner circle and refuses to share information more broadly inside HHS, said a former senior administration official. Although the president knows and likes her, he once accidentally called her “Reema” in an Oval Office meeting.

“The president likes them both,” said a Republican close to the White House. “There is a reason Alex has earned his stripes on drug pricing, but Seema has also been very effective. That is why this is annoying. Very senior people involved in policy are just wondering why they can’t just figure this out.”

When asked if their ongoing fights were restraining the administration’s health care policy, a former senior administration official called that “a no-brainer.”

“Your two highest health care officials feuding will be damaging to policy wins,” the official added.

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