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From our Expert Voices conversation on plans for health care reform after Trump's executive order:

Here's what the bipartisan Alexander-Murray bill would do to prevent large marketplace premium hikes on the eve of the 2018 mid-term election:

  • Ensure payments that reduce cost sharing for low-income enrollees for the next two years (cut by Trump's executive order)
  • Provide needed outreach support to help Americans sign up for coverage for the next two years (previously cut by the Trump administration)
  • Facilitate state waivers like Alaska's to provide reinsurance that lowers premiums

Yet, should this deal pass, it could be undone — and then some — by regulations pursuant to the order. Individual-market premiums could spike next fall if unregulated short-term plans could be sold alongside Marketplace plans. They would siphon off young and healthy enrollees.

Increasing premiums further, employers could drive their high-cost employees to the individual marketplace through loosely regulated health reimbursement arrangements. And employer risk-pooling could be frayed by unbounded association health plans that would separate low- from high-risk small employers.

Necessary as it is, the Senate bill cannot improve marketplace stability if the administration remains determined to undercut it.

The bottom line: Congress should block executive actions that raise premiums, especially for people with pre-existing conditions — in this bill or any other legislation.

Other voices in the conversation:

  • James Capretta, resident fellow at the American Enterprise Institute and former associate director for health programs at the OMB: Alexander-Murray deal a flawed first attempt at bipartisanship
  • John McDonough, professor at the Harvard T.H. Chan School of Public Health and former Senate adviser on health reform: Obamacare is dead. Long live the Affordable Care Act.
  • Tevi Troy, CEO of the American Health Policy Institute and former deputy secretary of HHS: Expanding HRAs would bolster individual market
  • Christopher Condeluci, principal at CC Law and Policy and former tax and benefits counsel to the Senate Finance Committee: Clearing the air on AHPs

Go deeper

Updated 6 hours ago - Politics & Policy

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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.