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

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Sen. Susan Collins has named a price for voting to repeal the individual mandate. Photo: Robert F. Bukaty/AP

Sen. Susan Collins has suggested she'd vote for a tax bill repealing the Affordable Care Act's individual mandate only if Congress also passes separate legislation to establishing a new reinsurance fund.

Why this matters: Collins may be the key to passing the Senate's tax reform bill. But it's hard to see the Republican-controlled Congress passing a reinsurance bill — and though experts say such a measure would help offset the effects of repealing the mandate, many say it wouldn't go far enough.

What Collins has said about repealing the individual mandate: "I hope that will be dropped or, that bills have been introduced by Senators Alexander and Murray and Bill Nelson and myself will be adopted to mitigate the impact of those provisions … But there is a way to mitigate the impact that it would have on insurance premiums."

  • Collins' bill with Nelson would set aside $4.5 billion over two years to help states establish reinsurance programs. Reinsurance directly compensates insurance carriers for their most expensive customers.

The bottom line: There's no question reinsurance programs can help lower insurance premiums — if they're big enough.

  • Reinsurance is "not trivial. You can do some significant work with that," said Rodney Whitlock, a former GOP Finance aide. "Again, this all depends which pew of the church you're in with the individual mandate in the first place."
  • "A reinsurance fund could offset the premium increase resulting from repeal of the individual mandate, holding middle-class consumers harmless and keeping the market stable," says Larry Levitt of the Kaiser Family Foundation. It could also keep insurers in the marketplace.

Yes, but: Collins' bill might not be enough to make up for the loss of the individual mandate.

  • Tim Jost, a Washington and Lee law health law professor emeritus: "Federal reinsurance is necessary at this point to re-stabilize the individual market. But $2.25 billion a year, allocated only to states that get … waivers to establish invisible high risk pools or reinsurance programs, would only be a drop in the bucket."
  • If repealing the individual mandate really did cause premiums to rise by 10%, as the Congressional Budget Office expects, a reinsurance program would need $3-5 billion a year to fully offset that increase, Levitt said.
  • Brookings expert Matt Fiedler said that even if a reinsurance fund were large enough to offset premium increases, "keeping premiums from rising would not meaningfully address the reductions in insurance coverage from mandate repeal. And reducing insurance coverage is how the individual mandate does its real damage."

Go deeper

Updated 15 mins ago - Health

California surpasses 50,000 COVID-19 deaths

A man prepares a funeral arrangement in in Los Angeles, California, Feb. 12. Photo: Mario Tama/Getty Images

California's death toll from COVID-19 surpassed 50,000 on Wednesday, per Johns Hopkins data.

The big picture: It's the first state to record more than 50,000 deaths from the coronavirus.

2 hours ago - Technology

Facebook bans Myanmar military

A protester holds a placard with a three-finger salute in front of a military tank parked aside the street in front of the Central Bank building during a demonstration in Yangon, Myanmar. Photo by Aung Kyaw Htet/SOPA Images/LightRocket via Getty Images

Facebook said on Wednesday it would ban the rest of the Myanmar military from its platform.

The big picture: It comes some three weeks after the military overthrew the civilian government in a coup and detained leader Aung San Suu Kyi, causing massive protests to erupt throughout the country. Military leaders have been using internet blackouts to try to maintain power in light of the coup.

It's harder to fill the Cabinet

Data: Chamberlain, 2020, "United States of America Cabinet Appointments Dataset" Chart: Will Chase/Axios

It's harder now for presidents to win Senate confirmation for their Cabinet picks, an Axios data analysis of votes for and against nominees found.

Why it matters: It's not just Neera Tanden. The trend is a product of growing polarization, rougher political discourse and slimming Senate majorities, experts say. It means some of the nation's most vital federal agencies go without a leader and the legislative authority that comes with one.

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