Axios

Michael Neidorff, CEO of health insurance company Centene, told investors Tuesday during a first-quarter earnings call that he doesn't think the Affordable Care Act's cost-sharing subsidies will get eliminated and that he expects to stay in the exchanges next year.

"We see nothing at this point to prevent us from proceeding from our 2018 marketplace participation." — Centene CEO Michael Neidorff

Why this matters: Anthem is one of the most important ACA health insurers right now, but Centene holds a lot of power as well. Centene had 1.2 million ACA exchange members as of March 31 (or about 10% of the individual market). However, as Duke University researcher David Anderson has pointed out, Centene uses a strategy that captures the healthiest, price-sensitive shoppers.

Just 37% of Americans want to repeal and replace the Affordable Care Act, while 61% say it should be kept and improved, per a new ABC News/Washington Post poll.

Don't blow it up: There's an ongoing lawsuit by House Republicans, which would defund the cost-sharing reductions of ACA, bringing the law's entire framework down. That's probably what Trump is referring to when he says ACA is in "serious trouble," but that'd be a terribly unpopular choice for the GOP as only 13% of Americans want to see the law fail.

The American public largely disagrees with the process President Trump and congressional Republicans are taking to repeal and replace the Affordable Care Act, according to a new Washington Post-ABC News poll.

The new flashpoint: The GOP's new proposal would let states decide whether to keep all of the law's insurance protections for people with pre-existing conditions, as well as determine whether to provide them with minimum coverage benefits.

• Let states decide on pre-existing conditions: 26%
• Require for all states: 70%
• Let states decide on minimum benefits: 33%
• Require for all states: 62%

Why it matters: The poll suggests that Republicans risk drifting farther away from public opinion in their latest health care compromise. It doesn't say states should decide whether to cover pre-existing conditions at all, but it would let them opt out of federal rules that ban insurers from charging more to sick people.

Fresenius Kabi, a U.S. subsidiary of German health care giant Fresenius SE & Co., is acquiring generic pharmaceutical company Akorn for $4.3 billion. However, Fresenius included a stipulation in the merger agreement that would allow it to back out of the deal if Akorn's generics business materially deteriorates.

Largest shareholder backs it: John Kapoor, an Akorn board member and former Insys Therapeutics CEO who owns 25% of the company, has "committed to supporting the transaction," which bodes well for the deal closing early next year. Kapoor would bank more than $1 billion alone if the deal closes.

Venture-backed startup Zoom said earlier in April it is exiting the entire health insurance market, and now it's officially entering voluntary receivership with the state of Oregon, spokesman Len Bergstein confirmed to Axios. The Oregon-based company began several years ago as a chain of neighborhood clinics, and it expanded into health insurance in 2015 with the hopes of becoming the next iteration of the successful Kaiser Permanente organization.

The issue:

President Trump and many Republicans in Congress say the Affordable Care Act is "imploding" due to some health insurer exits and higher premiums in the individual market.

The facts:

S&P Global Ratings analysts looked at financial data at Blue Cross and Blue Shield companies, which serve as the anchors for most ACA marketplaces. S&P reported the Blues' gross profit margins for the individual market went up in 2016. The Kaiser Family Foundation also found that insurance companies improved the financial stability of their ACA plans in 2016, although a lot of uncertainty remains in the marketplaces.

Why it matters:

The ACA marketplaces had problems in the first two years, such as the technological meltdown of HealthCare.gov in the first year. And middle-class people who make too much to qualify for subsidies are feeling the pain of higher premiums and high deductibles in many areas. But the recent reports show the individual insurance market is not imploding. Enrollment has been stable, and insurers are not losing as much money after setting premium prices too low in the beginning.