Clashes among top HHS officials undermine Trump agenda

[brooklynite]

Politico

President Donald Trump’s health secretary, Alex Azar, and his Medicare chief, Seema Verma, are increasingly at odds, and their feuding has delayed the president’s long-promised replacement proposal for Obamacare and disrupted other health care initiatives central to Trump's reelection campaign, according to administration officials.

Verma spent about six months developing a Trump administration alternative to the Affordable Care Act, only to have Azar nix the proposal before it could be presented to Trump this summer, sending the administration back to the drawing board, senior officials told POLITICO. Azar believed Verma’s plan would actually strengthen Obamacare, not kill it.

Behind the policy differences over Obamacare, drug pricing and other initiatives, however, is a personal rivalry that has become increasingly bitter. This fall, Azar blocked Verma from traveling with Trump on Air Force One from Washington to Florida in early October for the unveiling of a high-profile Medicare executive order — an initiative largely drawn up by Verma's agency — said six officials with knowledge of the episode, which played out over days. Only after Verma complained to White House staff was she allowed on Trump’s plane, according to seven people familiar with the situation. HHS disputed the account, saying that the White House had identified space limitations on the plane.

Azar is a Cabinet secretary who oversees the 80,000-person Health and Human Services department, while Verma runs the Centers for Medicare and Medicaid Services, which administers Medicare, Medicaid and Obamacare and accounts for the lion's share of the overall HHS budget. That often affords the CMS administrator outsize autonomy and public visibility.

[erronis]

1. I've seen this friction between HHS, CMS, NHS, NCI, CMMI, and other fiefdoms before

There's way too much parochialism and empire-building in this sprawling agency (HHS).

The world has changed since it was originally created yet new divisions keep getting bolted on, frequently based on executive or legislative pressures.

I guess this is true throughout this government and many others. Every now and then a well-thought-out redesign is needed. But that only happens during a crisis such as a World War or significant Depression/Recession.

[Bernardo de La Paz]

2. It's all his fault. tRump had two years with both chambers to pass anything. But nothing. . . . nt