Although Mick Mulvaney is technically only an “acting” chief of staff, he’s still quickly reshaping the West Wing in his own image.

Since taking on the job’s duties in late December, Mulvaney has tapped roughly half a dozen former aides to accompany him to the White House, with several more potentially on the way. And while it’s not surprising for any new chief of staff to install people he knows and trusts in top jobs, administration officials say, Mulvaney’s latest moves illustrate the extent to which he is settling into his new job despite its temporary-seeming title.

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“By keeping the ‘acting’ title, he gives himself an out in case things go south,” said a Republican close to the White House. “He can say he was only the acting chief, if his relationship with the president sours in six months. Then, he won’t be fired.”

Essentially, Mulvaney has become an “acting” chief of staff in name only.

Mulvaney recently hired Rob Blair, an associate director of national security programs at the Office of Management and Budget, as the White House’s new counselor to the chief, according to one administration official and the Republican close to the White House. Blair will join four other budget agency veterans who moved into the West Wing in late December, including the new deputy-chief-of-staff Emma Doyle.

And next week, John Czwartacki, chief communications officer at the Consumer Financial Protection Bureau, will join the White House as the senior adviser to chief-of-staff for strategy. Czwartacki helped Mulvaney navigate his confirmation process to become OMB director during the Trump transition and then worked for him in top jobs at the budget agency and bureau. In the process, he became one of Mulvaney’s most trusted aides alongside Doyle.

In the coming days, Mulvaney is also slated to interview Joe Grogan, a top health care official at the budget agency, to potentially become the next head of the Domestic Policy Council, according to three sources familiar with the discussions. The current director of the council, Andrew Bremberg, is leaving the White House shortly to potentially work for the State Department while he awaits a confirmation hearing to become the next ambassador to the United Nations Mission in Geneva.

The White House press office did not respond to an immediate request for comment.

Taken together, the hires signal that Mulvaney aims to put his policy stamp on the White House in whatever time he has. Mulvaney has long been known as a budget deficit hawk with strong thoughts on health care, government spending, and the federal budget. He earned a reputation while in Congress for refusing to raise the nation’s debt limit even though it meant shutting down the government.

As a former House member, Mulvaney also intends to play a larger role in outreach to congressional members, said one former administration official, a departure from his predecessor, John Kelly. Compared to Kelly, a longtime military general, Mulvaney already personally knows lawmakers and feels comfortable connecting with them directly, the former official said.

The hiring moves could make it harder for the White House to once again swap in a new chief of staff. In Trump’s two years in office, he went through two chiefs of staff before landing on this third. Reince Priebus, who first held the role, lasted only six months. His replacement, Kelly, made it to 18 months, but spent much of that time fighting off speculation about his job security and trying to manage the White House’s infighting, with constant reports that he and the president weren’t getting along.

With roughly half a dozen Mulvaney acolytes in place, ousting the acting chief of staff would raise even more questions about staff churn in an administration already known for high turnover.

The Domestic Policy Council position, in particular, is one Mulvaney cares deeply about. The council offers input on everything from immigration to health care, drug prices and welfare reform. But so far, it has played a much lesser role in internal policy debates than the powerhouse National Economic Council, chaired by Larry Kudlow.

That could change under Grogan, whose vision for the DPC includes reestablishing it as a key driver of conservative policy within the administration, after two years where it has been viewed as largely ineffective at accomplishing anything agenda-wise.

Grogan and Mulvaney worked closely together at OMB, with Grogan becoming another trusted advisers. The two share a similar ideology as conservatives and skeptics of the Republican establishment — something that can’t be said of the vast majority of the Republican health policy wonks throughout D.C.

Mulvaney first started mapping out potential scenarios for Grogan to join him in the West Wing in December.

A former top lobbyist for pharmaceutical giant Gilead Sciences prior to joining OMB and previously a senior policy adviser at the FDA under President George W. Bush, Grogan would likely take on an even more prominent role in the administration’s efforts to lower drug prices. Trump has expressed frustration lately at the inability to make meaningful headway on what he views as a key campaign promise.

“The job is broader than health policy, but it’s an extremely important component of it,” said one source familiar with the council hiring discussions. If Grogan takes over, “they’re going to be a stronger partner in advocating and pushing through meaningful reforms on prescription drug pricing.”

Although Grogan is seen as the frontrunner for the director position, Lance Leggitt, the current deputy director of the DPC and former chief of staff at the Health and Human Services Department, will also be interviewed. Brooke Rollins, an assistant to the president who worked closely with Jared Kushner on his prison reform legislation, is also in the running for the job.

The Trump administration is quietly devising a plan bypassing Congress to give block grants to states for Medicaid, achieving a longstanding conservative dream of reining in spending on the health care safety net for the poor.

Three administration sources say the Trump administration is drawing up guidelines on what could be a major overhaul of Medicaid in some states. Instead of the traditional open-ended entitlement, states would get spending limits, along with more flexibility to run the low-income health program that serves nearly 75 million Americans, from poor children, to disabled people, to impoverished seniors in nursing homes.

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Capping spending could mean fewer low-income people getting covered, or state-designated cutbacks in health benefits — although proponents of block grants argue that states would be able to spend the money smarter with fewer federal strings attached.

Aware of the political sensitivity, the administration has been deliberating and refining the plan for weeks, hoping to advance an idea that Republicans since the Reagan era have unsuccessfully championed in Congress against stiff opposition from Democrats and patient advocates. During the Obamacare repeal debate in 2017, Republican proposals to cap and shrink federal Medicaid spending helped galvanize public opposition, with projections showing millions would be forced off coverage.

In addition to potential legal obstacles presented by moving forward without Congress, the administration effort could face strong opposition from newly empowered House Democrats who’ve vowed to investigate the administration’s health care moves.

The administration’s plan remains a work in progress, and sources said the scope is still unclear. It’s not yet known whether CMS would encourage states to seek strict block grants or softer spending caps, or if new limits could apply to all Medicaid populations — including nursing home patients — or just a smaller subset like working-age adults.

A spokesperson for CMS did not comment on the administration’s plans but indicated support for the concept of block grants.

“We believe strongly in the important role that states play in fostering innovation in program design and financing,” the spokesperson said. “We also believe that only when states are held accountable to a defined budget — can the federal government finally end our practice of micromanaging every administrative process.”

Republicans have sought to rein in Medicaid spending, especially as enrollment swelled under Obamacare’s expansion of the program to millions of low-income adults in recent years. CMS Administrator Seema Verma has warned increased spending on the Medicaid expansion population could force cutbacks on sicker, lower-income patients who rely on the program.

The administration wants to let states use waivers to reshape their Medicaid programs, but the effort could face legal challenges in the courts. Waivers approved by the Trump administration to allow the first-ever Medicaid work requirements for some enrollees, for example, are already being challenged in two states.

Also complicating the administration’s push: the newfound popularity of Medicaid, which has grown to cover about one in five Americans. Voters in three GOP-led states in November approved ballot measures to expand Medicaid, which has been adopted by about two-thirds of states. Newly elected Democratic governors in Kansas and Wisconsin are pushing their Republican-led legislatures to expand Medicaid this year.

Verma has been trying to insert block grant language into federal guidance for months but has encountered heave scrutiny from agency lawyers, two CMS staffers said. She mentioned interest in using her agency’s authority to pursue block grants during a meeting with state Medicaid directors in the fall but did not provide details, said two individuals who attended.

There is some precedent for the federal government capping its spending on the entitlement program. Former President George W. Bush’s health department approved Medicaid spending caps in Rhode Island and Vermont that would have made the states responsible for all costs over defined limits. However, those spending caps were set so high there was never really any risk of the states blowing through them.

In recent years, governors have complained about the rising costs of Medicaid, which is eating up a bigger share of their budgets. States jointly finance the program with the federal government, which on average covers 60 percent of the cost – though the federal government typically shoulders more of the burden in poorer states. The federal government covers a much higher share of the cost for Medicaid enrollees covered by the Obamacare expansion.

An official from a conservative state, speaking on background to discuss an effort not yet public, said states would consider a block grant as long as the federal government’s guidance isn’t overly prescriptive.

CMS is hoping to make an announcement early this year, but it could be further delayed by legal review, which has already been slowed by the prolonged government shutdown.

Some conservative experts said the administration’s plans ultimately may be limited by Medicaid statute, which requires the federal government to match state costs. However, they say the federal government can still try to stem costs by approving program caps.

“There’s no direct provision of authority to waive the way that the federal government pays the states,” said Joe Antos of the American Enterprise Institute, a right-leaning think tank. “However, that doesn’t mean that you can’t try to have some of the effects that people that like block grants would like to see, in terms of encouraging states to be more prudent with the ways they spend the money.”