Photo: George Frey/Getty Images

Wall Street panicked a little after the Trump administration rolled out its drug rebate proposal, but the stock prices of companies most at risk recovered because there’s still so much uncertainty about how the policy would change their businesses.

The big picture: The proposal would bar pharmacy benefit managers and insurers from accepting rebates from drug companies in Medicare and Medicaid under anti-kickback law. Instead, the two sides could work out fixed-fee arrangements, with rebates flowing directly from manufacturers to patients at the pharmacy counter.

Yes, but: The rule...

  • Would not immediately affect the commercial market, although HHS Secretary Alex Azar wants Congress to pass the proposal into law so it would apply everywhere.
  • Would not touch the other profitable tactics that PBMs have mastered, like spread pricing and generic drug algorithms.
  • Would take a swipe at a flawed rebate system, but push middlemen to raise premiums — which federal actuaries said could raise Medicare spending as much as $196 billion over the next decade.
  • Would almost certainly initiate a lawsuit on antitrust grounds.
  • Would "not have a meaningful impact on our growth or earnings trajectory," David Cordani, CEO of Cigna and its newly acquired Express Scripts, said on an earnings call Friday.

One thing that is pretty certain: Pharma wins. There’s no mandate to lower list prices, and drug companies would get to see competitors' rebates.

Go deeper: The Trump administration's major shakeup in the way we pay for drugs

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Coronavirus cases rise in 25 states

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Data: The COVID Tracking Project, state health departments; Map: Andrew Witherspoon, Sara Wise/Axios

New coronavirus infections rose over the past week in half the country.

Why it matters: The U.S. remains largely unable or unwilling to control the spread of the virus.

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 3 a.m. ET: 33,976,447 — Total deaths: 1,014,266 — Total recoveries: 23,644,023Map.
  2. U.S.: Total confirmed cases as of 3 a.m. ET: 7,233,945 — Total deaths: 206,959 — Total recoveries: 2,840,688 — Total tests: 103,939,667Map.
  3. Education: School-aged children now make up 10% of all U.S COVID-19 cases.
  4. Health: Moderna says its coronavirus vaccine won't be ready until 2021
  5. Travel: CDC: 3,689 COVID-19 or coronavirus-like cases found on cruise ships in U.S. waters — Airlines begin mass layoffs while clinging to hope for federal aid
  6. Business: Real-time data show economy's rebound slowing but still going.
  7. Sports: Steelers-Titans NFL game delayed after coronavirus outbreak.
Updated 3 hours ago - Politics & Policy

Trump signs stopgap bill to prevent government shutdown

Senate Majority Leader Mitch McConnel and President Trump arrives at the U.S. Capitol in March. Photo: Samuel Corum/Getty Images

President Trump signed a bill to extend current levels of government funding after funding expired briefly, White House spokesperson Judd Deere confirmed early Thursday.

Why it matters: The move averts a government shutdown before the Nov. 3 election. The Senate on Wednesday passed the legislation to fund the federal government through Dec. 11, by a vote of 84-10.