White House Summons Feuding Health Officials for Counseling Session
White House chief of staff Mick Mulvaney wants to see if the Medicare
chief Seema Verma and the health secretary, Alex M. Azar II, can still
work together.
The acting White House chief of staff has
summoned President Trump’s top two health policy officials to the White
House on Thursday to assess whether the president’s health secretary
and his Medicare chief can continue to work together, a senior
administration official confirmed on Tuesday.
White
House aides said President Trump is still standing by his embattled
administrator of the Centers for Medicare and Medicaid Services, Seema
Verma, amid reports that she had requested that taxpayers reimburse her
$47,000 for property stolen on a trip, including jewelry priced at more
than $40,000.
But her feud with Alex
M. Azar II, the health and human services secretary, has reached the
president’s desk and the attention of the acting White House chief, Mick
Mulvaney. For now, Mr. Trump is not expected to attend Thursday’s
session, the official said, but he could stop by.
Ms. Verma’s reimbursement request, reported in Politico over the weekend,
was the latest revelation in a string of reports that have portrayed
the upper echelons of the Department of Health and Human Services as
divided on policy and personality, and roiled by expenditures that have
come under scrutiny.
A particular sore point has been the decision
by Ms. Verma, who heads a trillion-dollar agency within the Health and
Human Services Department, to spend millions of taxpayer dollars on
contracts with communications consultants, in part to raise her public
profile. The contracts are now under review by the department’s
inspector general.
But the
long-simmering rivalry between Ms. Verma and Mr. Azar is also causing
problems. The feud burst into the open after reports in Politico and Axios.
Then
came news that Ms. Verma sought reimbursement of $43,065 for more than
20 pieces of jewelry, including an Ivanka Trump-branded pendant, about
$2,000 for clothes and $2,000 for other stolen goods, including $325 for
moisturizer and $349 for noise-canceling headphones.
“It’s perfectly appropriate that the
administrator filed a personal property loss claim for goods stolen
while on work travel, and this is not an unusual practice for federal
employees,” the Health and Human Services Department said in an emailed
statement, which concluded that the law makes clear that jewelry would
not be eligible for reimbursement. Ms. Verma was ultimately reimbursed
$2,852.40.
The fighting between Ms. Verma and Mr. Azar has forced Mr. Trump to intervene, a development first reported by Axios last week.
The president and Vice President Mike Pence have told Mr. Azar and Ms.
Verma to find a way to work together, a senior administration official
said.
Ethical disputes that have burst forward in the past have cost some
administration officials their jobs. Mr. Trump’s first health secretary,
Tom Price, resigned amid accusations
that he inappropriately used expensive private charter flights at
taxpayer expense. His first Environmental Protection Agency chief, Scott Pruitt, and interior secretary, Ryan Zinke, were also forced to resign amid accusations that they had abused the taxpayers’ trust.
Beyond allegations of unwarranted
expenditures, the Health and Human Services Department is also
contending with reports of serious policy conflict, including one dispute that may be delaying a promised plan to replace the Affordable Care Act.
Should either Mr. Azar or Ms. Verma depart any time soon, it would
create a significant headache for the administration during the
impeachment hearings and as Mr. Trump prepares for the election, in
which health care is expected to play a major role.
The
loss of either official could weaken the administration’s efforts to
tackle the high cost of prescription drugs and force hospitals to make
public the secret prices they negotiate with insurers, both of which Mr.
Trump is hoping to claim as significant accomplishments.
Both
the Department of Health and Human Services and the Centers for
Medicare and Medicaid Services tried to minimize the disclosure about
Ms. Verma’s stolen jewelry on Monday.
“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 health care,” the Health and Human Services
Department statement said.
Ms. Verma
said she was advised by counsel at the Health and Human Services
Department to include a full inventory of the items in her luggage. She
initially approached her own insurance company but was told to contact
her workplace about the lost property, according to her office.
But
some of Ms. Verma’s critics argued that it was another example of poor
judgment, saying putting in the claim for tens of thousands worth of
personal jewelry was at best tone deaf.
Her
office also defended her use of outside contractors, saying in a
statement that Ms. Verma “wanted to ensure that the agency was
communicating with the American people about C.M.S. programs and not
just relying on inside-the-Beltway health press.”
The
statement, issued by a spokesman for Ms. Verma, also pointed out that
she commutes to Washington every week from her home in Indiana, “which
is why she was traveling with her personal collection of jewelry.”
Representative Joseph P. Kennedy III, Democrat of Massachusetts, who questioned Ms. Verma at a hearing in October on the contracts with communications consultants, called for her resignation on Monday.
“I
feel terrible for her that her items were stolen,” Mr. Kennedy said in a
phone interview, “but the idea that taxpayers should be on the hook for
that is, I don’t think, accurate or appropriate at all.”
Ms.
Verma, whose agency oversees not only Medicare and Medicaid but also
the federal insurance marketplace created under the Affordable Care Act,
was a health policy consultant for Mr. Pence in his previous job as
governor of Indiana. He remains a powerful ally for Ms. Verma, who has
pushed hard for a number of Mr. Trump’s health care priorities, such as
imposing work requirements on many adult Medicaid recipients and
replacing the Affordable Care Act.
Many
view her willingness to repeatedly attack the Affordable Care Act and,
more recently, Democratic proposals for “Medicare for all,” as winning
her points with the White House.
Mr. Azar, a cabinet secretary with a larger portfolio than Ms. Verma’s, is a former senior executive at the drug company Eli Lilly,
which is headquartered in Indiana. His top priority as health secretary
has been lowering the cost of prescription drugs, for which Mr. Trump
wants to be able to claim credit on the campaign trail next year. He has
worked in the agency’s top echelons before, during President George W.
Bush’s tenure, and is considered more politically moderate than Ms.
Verma.
Earlier this year, Mr. Azar lost a battle over one of his main policy
goals: eliminating the drug rebates that companies pay pharmacy benefit
managers, such as CVS Caremark or Express Scripts, which he saw as a
reason for rising drug prices. Mr. Trump killed the proposal in July
after fiscal conservatives in the White House raised concerns about the
potential costs.
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