For much of the country, I imagine Centers for Medicare and Medicaid Services Administrator Seema Verma is a relatively obscure figure in the Trump administration. She occasionally enters the fray – pushing Medicaid work requirements, blasting “Obamacare,” and making underwhelming political arguments – but for the most part, Verma is only known to public officials, industry stakeholders, health care wonks, and journalists who follow health care issues closely.

It’s against this backdrop that Politico has a new report on eight former members of Donald Trump’s operation – from his campaign, presidential transition team, or White House – who were paid quite a bit to reportedly work as outside public-relations consultants on Verma’s behalf.

They were among at least 40 consultants who worked on a one-year, $2.25 million contract directed by Centers for Medicare and Medicaid Services Administrator Seema Verma. The contractors were hired to burnish Verma’s personal brand and provide “strategic communications” support. They charged up to $380 per hour for work traditionally handled by dozens of career civil servants in CMS’s communications department. The arrangement allowed the Trump allies to cycle through the federal government’s opaque contracting system, charging hefty fees with little public oversight or accountability.

If this sounds at all familiar, it’s because the story has been percolating for much of the year. In March, for example, Politico first reported on Verma’s agency using federal funds to hire communications consultants who were tasked with writing her speeches and improving her “brand” – despite the objections of career staff at the Centers for Medicare and Medicaid Services.

The Department of Health and Human Services halted the contracts less than a week after they came to public light.

But the more details emerge, the more significant the controversy appears. Broadly speaking, there are three angles to consider with the story.

First, why would the CMS chief need so many well-paid contractors to burnish Verma’s brand and provide “strategic communications” support?

Second, why did so many of the fairly lucrative contracts go to veterans of Team Trump, including a firm led in part by Ken Nahigian, a top official from the Trump transition team in early 2017?

And third, if Seema Verma is concerned about her public image, wouldn’t it be easier to be more popular if she stopped pushing Trump’s regressive health care agenda?

For its part, as Politico’s report added, CMS described its use of contractors as “appropriate and in line with long-standing practices, contending in a statement that it did not have the in-house staff needed to carry out an ambitious messaging campaign promoting Verma’s policy priorities for the agency.”

Verma also told lawmakers at a recent hearing, “All the contracts we have at CMS are based on promoting the work of CMS.”

Former CMS officials and government ethics experts didn’t quite see it that way, and the matter is likely to generate ongoing interest from House Democrats, who’ve begun examining what Rep. Frank Pallone (D-N.J.) described as Verma’s “questionable use of contracted political operatives for her own benefit on the taxpayers’ dime.”