Nov 1, 2018

5. The ACA is actually pretty stable for Trump's second open enrollment

Illustration: Sarah Grillo/Axios

Today is the beginning of the second Affordable Care Act enrollment season under President Trump. And things are … surprisingly normal.

The big picture: The ACA has been in a state of upheaval since Trump’s inauguration. Some of the changes Republicans made during that upheaval will likely weaken the law. At this moment, though, the watchword for insurers is stability. Things may not be ideal, but at least they’re largely settled.

What they’re saying: “From a consumer perspective, the experience should be pretty good,” said Kelley Turek, a policy specialist at America’s Health Insurance Plans, the industry’s leading trade organization.

  • Technical testing with HealthCare.gov has gone well, Turek said, and back-end systems that coordinate between enrollees and insurers seem to be in good shape.

This will be the first enrollment period in which Trump’s ACA agenda is fully in place.

  • People will be able to buy skimpy, inexpensive “short-term” plans as an alternative to comprehensive, potentially subsidized ACA coverage. They won't be sold through the ACA's exchanges, but will compete through brokers and other websites.
  • The individual mandate won’t be in effect.
  • Federal outreach funding, and grants to “navigators” who helped people compare their options, have been slashed.

What we’re watching: Insurers generally feel that they’ve already calibrated for those policy changes, mainly through sky-high premium increases a year ago. This upcoming enrollment period will determine whether they got that balance right.

  • Before the ACA’s exchanges had opened, losing the individual mandate seemed like a disaster. Its actual disappearance was greeted more with a shrug. Real-world experience raised questions about whether it had enough “teeth,” Turek said.
  • Short-term plans could siphon healthy consumers away from ACA coverage, making it more expensive for those who remain. But they could also be a reasonable option for people who can’t afford ACA coverage, Turek said, as long as they know what they’re buying.

The bottom line: The ACA may not be working as Democrats had initially hoped, but it’s not dead, and for now it seems to have settled into a scaled-back status quo that’s sustainable.

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Trump forces fateful choices on Twitter and Facebook

Illustration: Sarah Grillo/Axios

President Trump's war with Twitter is confronting social media platforms with a hard dilemma: whether to take fuller responsibility for what people say on their services, or to step back and assume a more quasi-governmental role.

The big picture: Facebook is trying to be more like a government committing to impartiality and protecting free speech and building mechanisms for arbitration. Twitter, pushed by Trump's inflammatory messages, is opting to more aggressively enforce conduct rules on its private property, like a mall owner enforcing rules inside the gates.

Updated 16 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 1 p.m. ET: 5,851,494 — Total deaths: 362,238 — Total recoveries — 2,445,181Map.
  2. U.S.: Total confirmed cases as of 1 p.m. ET: 1,729,185 — Total deaths: 101,706 — Total recoveries: 399,991 — Total tested: 15,646,041Map.
  3. 2020: North Carolina asks RNC if convention will honor Trump's wish for no masks or social distancing.
  4. Public health: Hydroxychloroquine prescription fills exploded in March —How the U.S. might distribute a vaccine.
  5. Transportation: National mobility keeps rising as more states reopen economies.
  6. 🎧 Podcast: Saying goodbye to U.S. megacities.

Obama on George Floyd's death: "This shouldn't be 'normal'"

Photo: Getty Images/Getty Images for EIF & XQ

Former President Obama said in a statement Friday that the death of George Floyd, an unarmed black man who was killed by a white Minneapolis police officer, "shouldn't be 'normal' in 2020 America."

What he's saying: "[W]e have to remember that for millions of Americans being treated differently on account of race is tragically, painfully, maddeningly 'normal' — whether it’s while dealing with the health care system, or interacting with the criminal justice system, or jogging down the street, or watching birds in a park."