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The Senate's health-care overhaul would quickly pull $215 billion in federal funding out of the health care system, and those cuts could later grow as high as $4 trillion, according to a new analysis from the consulting firm Avalere Health.

Why it matters: Avalere is a respected and independent voice, and because the Congressional Budget Office won't have time to completely evaluate the bill's effects before a vote, this will likely be one of the best estimates we have available.

Expand chart

Data: Avalere Health Consulting; Cartogram: Lazaro Gamio / Axios

What Avalere found: The bill, sponsored by Sens. Lindsey Graham and Bill Cassidy, would redistribute federal health care dollars while also shrinking the overall pot. Avalere's analysis looks at how the cuts would grow over time:

  • 2020-2026: Total federal spending would shrink by $215 billion; 34 states and Washington, D.C. would lose money, compared with the status quo, while seven states would get more.
  • By 2027, the total national cut would climb to $489 billion.
  • 2027-2036: Federal spending would shrink by more than $4 trillion, and every state would be getting less than they're on track to get under current law.

Key caveat: The Graham-Cassidy bill would roll federal funding for the Affordable Care Act's premium subsidies and Medicaid expansion into a single pool, then convert it into block grants to the states. Those grants are set to expire in 2026. Avalere analyzed the bill as written — with that money disappearing completely — but the bill's supporters say Congress would obviously step in to authorize a new round of grants.

Go deeper

Updated 1 min ago - World

Vehicle bombing near Afghan school in Kabul kills at least 30

People gather at the scene of the bombing. Photo: Haroon Sabawoon/Anadolu Agency via Getty Images

A vehicle bombing outside of a high school in the Afghan capital of Kabul on Saturday killed at least 30 people and injured more than 50, including multiple female high school students, according to Reuters.

Why it matters: It is at least the second bombing to strike students in Afghanistan in a little over a week. Violence in Afghanistan has escalated since President Biden announced that the U.S. would begin withdrawing troops in May and would complete a full withdrawal by Sept. 11, 2021.

Updated 1 hour ago - Energy & Environment

Ransomware attack forces shutdown of major U.S. fuel pipeline

A police officer stands guard inside the gate to the Colonial Pipeline Co. Pelham junction and tank farm in Pelham, Alabama, in 2016. Photo: Luke Sharrett/Bloomberg via Getty Images

A major U.S. fuel pipeline running from Texas to New York has been taken offline by its operator because of a ransomware attack, Colonial Pipeline said Saturday.

Why it matters: It's a significant breach of critical infrastructure and comes on the heels of multiple other major cyberattacks on both U.S. companies and the federal government.

Erica Pandey, author of @Work
2 hours ago - Economy & Business

The wealthy exodus from superstar cities

Pandemic-induced remote work is chipping away at a recent trend of Americans staying put — but only for the well-off.

Why it matters: Telework has been lauded as a geographic equalizer, allowing talented people from all over the country to go for jobs in superstar coastal metros. But the benefits have largely been limited to wealthier workers — so far.

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