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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

Trump sues National Archives, Jan. 6 committee to block records request

Photo: Chip Somodevilla/Getty Images

President Trump filed a lawsuit Monday seeking to block the National Archives from releasing White House records to the House select committee investigating the Jan. 6 Capitol insurrection, citing executive privilege.

Why it matters: It's the latest escalation in Trump's campaign to disrupt the committee's sweeping probe into the circumstances surrounding Jan. 6, including his actions and communications leading up to the Capitol attack.

Obama says Powell exemplified what America "can and should be"

Then-President Obama speaks alongside former Secretary of State Colin Powell during a meeting in the Oval Office in 2010. Photo: Saul Loeb/AFP via Getty Images

Former President Obama called Colin Powell an "exemplary soldier and an exemplary patriot" in a statement honoring the former general following his death from COVID-19 complications on Monday.

Why it matters: Powell, the first Black U.S. secretary of state, was known as a Republican but played a critical role in helping Obama get elected in 2008.

Justice Department asks Supreme Court to block Texas abortion ban

Abortion rights activists rally at the Texas State Capitol on Sept. 11 in Austin, Texas. Photo: Jordan Vonderhaar/Getty Images

The Justice Department on Monday asked the Supreme Court to temporarily block Texas' near-total ban on abortions while federal courts consider its constitutionality.

The big picture: The court last month allowed the ban to take effect, rejecting an emergency application by abortion-rights groups. The law bars the procedure after cardiac activity is detected, as early as six weeks into pregnancy.

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