Photo: Brendan Smialowski/AFP/Getty Images

The Trump administration is using a regulatory workaround to achieve some of the same goals of Republicans' failed efforts to repeal and replace the Affordable Care Act.

Driving the news: HHS released new guidance yesterday about how it will approach the ACA's existing waiver process. It said it would, in some circumstances, approve waivers that go far beyond what's currently allowed.

  • States could change the way the ACA's subsidies are administered. They're currently based on income and the cost of insurance. States could change that to take consumers' age into account — a model that was also used in repeal-and-replace legislation.
  • States obtaining a waiver could also let people use their ACA subsidies to buy insurance that doesn't meet the ACA's coverage requirements — for example, newly expanded "short-term" plans that are able to turn away people with pre-existing conditions.

The big picture: This is one of the administration's most significant anti-ACA moves to date — if it works.

  • States that ask for everything they're now allowed to, and get it, could set up an insurance market that looks a lot different from what the ACA envisioned.
  • But they have to be approved first. Actuaries at the Centers for Medicare & Medicaid Services, who are independent from the agency's political leadership, will have to certify that a waiver wouldn't weaken the state's overall insurance market too badly.

What's next: The new standards and/or any approved waivers could face legal challenges — both on the merits and because these new rules were articulated in a guidance document rather than a formal regulation with opportunities for public comment, Brookings fellow Christen Linke Young writes.

Go deeper: Trump administration loosens rules for ACA waivers

Go deeper

Updated 27 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Annelise Capossela/Axios

  1. Global: Total confirmed cases as of 1:30 a.m. ET: 20,089,624 — Total deaths: 736,191 Total recoveries — 12,280,520Map.
  2. U.S.: Total confirmed cases as of 1:30 a.m. ET: 5,094,394 — Total deaths: 163,463 — Total recoveries: 1,670,755 — Total tests: 62,513,174Map.
  3. Politics: Trump claims he would have not called for Obama to resign over 160,000 virus deathsHouse will not hold votes until Sept. 14 unless stimulus deal is reached.
  4. Business: Richer Americans are more comfortable eating out.
  5. Public health: 5 states set single-day coronavirus case records last week — A dual coronavirus and flu threat is set to deliver a winter from hell.
  6. Sports: The cost of kids losing gym class — College football is on the brink.
  7. World: Europe's CDC recommends new restrictions amid "true resurgence in cases."
Updated 2 hours ago - Politics & Policy

Trump whisked out of press briefing after shooting outside White House

President Trump was escorted out of a coronavirus press briefing by a Secret Service agent on Monday evening after law enforcement reportedly shot an armed suspect outside of the White House.

What's new: The 51-year-old suspect approached a uniformed Secret Service officer on the corner of 17th Street and Pennsylvania Avenue NW, near the White House, and said he had a weapon, the agency alleged in a statement late Monday. He "ran aggressively towards the officer, and in a drawing motion, withdrew the object from his clothing."

Updated 2 hours ago - World

Protests in Belarus turn deadly following sham election

Belarus law enforcement officers guard a street during a protest on Monday night. Police in Minsk have fired rubber bullets for a second night against protesters. Photo: Natalia Fedosenko/TASS via Getty Image

Protesters and security forces have been clashing across Belarus overnight in a second night of protests that has left at least one person dead, hundreds injured and thousands arrested.

Why it matters: Sunday’s rigged presidential elections have yielded political uncertainty unlike any seen in Aleksander Lukashenko’s 26-year tenure. After claiming an implausible 80% of the vote, Lukashenko is using every tool in the authoritarian arsenal to maintain his grip on power.