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Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

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Illustration: Sarah Grillo/Axios

Premiums for Affordable Care Act coverage are going down in some places, and barely rising in others.

The big picture: Health insurers raised ACA rates dramatically over the past few years, largely due to political chaos. But their plans have still proven to be extremely profitable. Now many companies are lowering premiums as they expect to send money back to their customers.

Driving the news: Blue Cross Blue Shield of North Carolina is reducing the average premium for ACA plans by 5.5% in 2020.

  • Nationally, average ACA premiums are basically flat for next year and are going down in a handful of states, according to an analysis by ACA tracker Charles Gaba.

Between the lines: Insurers jacked up ACA premiums after the Trump administration cut off cost-sharing subsidies and nullified the individual mandate, and as Republicans threatened to eradicate the entire law, among other things. Now, they're correcting for that overpricing.

  • BCBS of North Carolina CEO Patrick Conway said in an interview premiums are falling because the plan cut some providers from its already narrow network and changed the way it pays some hospitals. But he also said the company has "more expertise in the market than when we started."
  • BCBS of North Carolina's ACA plans have been extremely lucrative — in fact, too lucrative. The ACA requires insurers to spend at least 80% of their premiums on medical care, or rebate the difference back to their customers.
  • In the first quarter of this year, BCBS of North Carolina spent just 67 cents of every premium dollar on care for most of its ACA plans, according to financial documents.
  • Many other insurers are in the same boat.

The bottom line: ACA plans for many middle-class people remain prohibitively expensive — often around $600 a month for individuals who get no subsidies. But for those who get financial help, "this is a stable, functional, mature market," said David Anderson, a health policy researcher at Duke University.

Go deeper

J&J and Merck to partner for COVID vaccine production to boost supply

Empty vials that contained a dose of the Johnson & Johnson vaccine against the COVID-19. Photo: Phill Magakoe/AFP via Getty Images

President Biden will announce Tuesday that pharmaceutical giant Merck will help Johnson & Johnson manufacture its newly authorized coronavirus vaccine to boost supply, a senior administration official tells Axios.

The big picture: The development has the potential to vastly increase supply, possibly doubling what the J&J could make on its own, the official said. The company has run into challenges while trying to expand its vaccine production to a global scale.

Casinos throw cash at sports betting media

Illustration: Sarah Grillo/Axios

Casinos are investing millions on sports betting content to lure bettors to their online and in-person sportsbooks.

Why it matters: It’s a mini gold rush for some sports media companies that were struggling in the pandemic.

Ben Geman, author of Generate
29 mins ago - Energy & Environment

Global carbon emissions rebound to pre-COVID levels

Newly released data show that global CO2 emissions had returned to pre-pandemic levels by the end of last year and surpassed them in some major economies.

Why it matters: The International Energy Agency warned that clean energy efforts are falling short.

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