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Photo: Mark Wilson/Getty Images

President Trump rejected a push to let states adopt a scaled-down version of the Affordable Care Act’s Medicaid expansion, The New York Times reports.

Why it matters: Senior health officials pushed the partial expansion as a middle ground for red states, but it was ultimately seen as too pro-ACA, the Times reports. Without that option, though, some conservative states are poised to adopt the full Medicaid expansion this fall.

The ACA’s Medicaid expansion covers everyone with an income up to 138% of the poverty line, in states that adopt it.

  • But some Republican-led states want to adopt a partial expansion, covering people only up to the poverty line. They would need the administration‘s OK to modify the terms that way.

The intrigue: Alex Azar and Seema Verma, the administration‘s two most senior health care officials, both supported partial expansion. But were shot down by the White House, per the NYT, which opposed doing anything that might look like an ACA expansion ahead of the midterms.

Yes, but: At least some of the governors who wanted to undertake a partial expansion could instead see their states fully expand during the midterms.

  • Idaho, Nebraska and Utah will all have ballot initiatives in November to expand the program. It passed last year via ballot initiative in Maine.

What to watch: The Trump administration is already working to roll back the ACA’s Medicaid expansion by allowing states to add work requirements to the program.

If it revisits partial expansions after the midterms, Republican governors would likely be able to quickly roll back the program even further.

Go deeper

Michigan board certifies Biden's win

Poll workers count absentee ballots in Detroit, Michigan on Nov. 4. Photo: Salwan Georges/The Washington Post via Getty Images

The Michigan Board of State Canvassers certified the state's election results on Monday, making President-elect Joe Biden's win there official and granting him the state's 16 electoral votes.

Why it matters: Republican Party leaders had unsuccessfully appealed to delay the official certification, amid the Trump campaign's failed legal challenges in key swing states.

Biden to nominate Janet Yellen as Treasury secretary

Photo: Photo by Alex Wong/Getty Images

President-elect Joe Biden is preparing to nominate former Fed Chair Janet Yellen as his Treasury Secretary, four people familiar with the matter tell Axios.

Why it matters: Yellen, 74, will bring instant economic celebrity to Biden’s team and, if confirmed, she will not only be the first female Treasury Secretary but also the first person to have held all three economic power positions in the federal government: the chair of Council of Economic Advisers, the chair of Federal Reserve and the Treasury Secretary.

3 hours ago - Podcasts

Bob Nelsen on AstraZeneca and his plan to revolutionize biotech

AstraZeneca and the University of Oxford on Monday reported promising efficacy data for their COVID-19 vaccine, which has less stringent storage requirements than the Pfizer and Moderna vaccines and may be distributed earlier in developing countries.

Axios Re:Cap digs into the state of vaccine and therapeutics manufacturing with Bob Nelsen, a successful biotech investor who on Monday launched Resilience, a giant new pharma production platform that he believes will prepare America for its next major health challenges.

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