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

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AP file photo

The issue:

President Trump and Republicans are building their case for their health care bill on the claim that the Affordable Care Act is in crisis, with insurers hiking premiums and fleeing the markets.

The facts:
  • The law is facing troubles. Aetna announced yesterday that it's pulling out of Delaware and Nebraska, and has already said it won't sell ACA plans in Virginia. The last major insurer in Iowa has threatened to pull out. And CareFirst Blue Cross Blue Shield asked for a huge rate increase in Maryland.
  • On the other hand, Blue Cross and Blue Shield of Tennessee announced this week that it will sell ACA plans in the eastern part of the state that was in danger of having no insurers.
  • As we've previously noted, two independent analyses concluded the marketplaces aren't imploding — insurers' financial stability improved in 2016 after a rough first two years.
  • Insurers pin some of the blame on the health status of ACA enrollees. Connecticut's insurers cited "greater demand for medical services" when they asked for double-digit rate increases. And CareFirst's CEO told the Washington Post that "the pool of beneficiaries is becoming sicker."
  • But insurers are also citing the lack of guarantees from the Trump administration that it will keep paying them for the law's cost-sharing reduction subsidies, or that it will enforce the individual mandate that's supposed to attract healthy customers. CareFirst said the individual mandate uncertainty played "a significant role" in its rate increase.
  • In its letter to regulators, Blue Cross and Blue Shield of Tennessee said it would charge higher rates because of those uncertainties and would reserve the right not to sell coverage if any post-bid changes "destabilize the market."
Why it matters:

There are some problems because of the design of the law — but when insurers are specifically saying they're raising prices because of the Trump administration's actions, the administration is going to share the blame if there is a meltdown.

Go deeper

Updated 6 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Eniola Odetunde/Axios

  1. Health: Most vulnerable Americans aren't getting enough vaccine information — Fauci says Trump administration's lack of facts on COVID "very likely" cost lives.
  2. Politics: Biden unveils "wartime" COVID strategyBiden's COVID-19 bubble.
  3. Vaccine: Florida requiring proof of residency to get vaccine — CDC extends interval between vaccine doses for exceptional cases.
  4. World: Hong Kong to put tens of thousands on lockdown as cases surge.
  5. Sports: 2021 Tokyo Olympics hang in the balance.
  6. 🎧 Podcast: Carbon Health's CEO on unsticking the vaccine bottleneck.

Trump impeachment trial to start week of Feb. 8, Schumer says

Senate Majority Leader Chuck Schumer. Photo: The Washington Post via Getty

The Senate will begin former President Trump's impeachment trial the week of Feb. 8, Majority Leader Chuck Schumer announced Friday on the Senate floor.

The state of play: Schumer announced the schedule after reaching an agreement with Republicans. The House will transmit the article of impeachment against the former president late Monday.

7 hours ago - Health

CDC extends interval between COVID vaccine doses for exceptional cases

Photo: Joseph Prezioso/AFP via Getty

Patients can space out the two doses of the coronavirus vaccine by up to six weeks if it’s "not feasible" to follow the shorter recommended window, according to updated guidance from the Centers for Disease and Control and Prevention.

Driving the news: With the prospect of vaccine shortages and a low likelihood that supply will expand before April, the latest changes could provide a path to vaccinate more Americans — a top priority for President Biden.

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