Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

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

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

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Denver news in your inbox

Catch up on the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Des Moines news in your inbox

Catch up on the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Minneapolis-St. Paul news in your inbox

Catch up on the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tampa Bay news in your inbox

Catch up on the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Charlotte news in your inbox

Catch up on the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Federico Gambarini / dpa via AP

Environmentalists and scientists aren't the only ones who are upset about President Trump's decision to pull the United States out of the Paris climate accord. Leaders at many of the country's largest hospital systems are grumbling behind the scenes that the withdrawal is a mistake after pleading with the Trump administration this month to stay.

Between the lines: Hospitals are on the front lines of climate change, as studies have shown climate change increases the incidence of infectious diseases, respiratory illnesses and other health problems.

What we're hearing: The CEOs of three large faith-based health systems — Kevin Lofton at Catholic Health Initiatives, Lloyd Dean at Dignity Health and Dr. Richard Gilfillan at Trinity Health — sent a letter to Trump in May urging him not to abandon the Paris deal because it is "simply essential to the health of the U.S. and global populations."

But many hospital leaders are concerned that the partial repeal and replace of the Affordable Care Act is sucking the air out of any other relevant health care issue. Hospital officials thought the Paris pact was a no-brainer, but it's been difficult for them to prioritize it over the Republican health care bill, which would drastically slash Medicaid funding and increase the ranks of the uninsured.

"The idea that we're going to pull back on our commitment to reduce our reliance on fossil fuels, and we're going to cut everybody else's health insurance on top of that — it's a double blow," said Gary Cohen, president of advocacy group Health Care Without Harm.

Reality check: Like corporate America, hospitals won't stop pursuing efforts that mitigate climate change because of the Paris agreement. Virginia Mason Health System in Seattle told Axios that it was "disappointed" by Trump's decision. However, "Recognizing that climate change is a significant threat to human health, Virginia Mason will continue to pursue a path of providing quality health care in such a way that it protects individual, community and global health."

Which hospitals to watch: Cohen helped create the Health Care Climate Council, a group of 19 health systems that have aggressively moved toward renewable energy and in some instances stopped investing in fossil fuel companies. Their next battle will be supporting clean-energy proposals that are under attack at the state level, Cohen said.

Go deeper

Dion Rabouin, author of Markets
1 hour ago - Economy & Business

First glimpse of the Biden market

Photo: Jonathan Ernst-Pool/Getty Images

Investors made clear what companies they think will be winners and which will be losers in President Joe Biden's economy on Wednesday, selling out of gun makers, pot purveyors, private prison operators and payday lenders, and buying up gambling, gaming, beer stocks and Big Tech.

What happened: Private prison operator CoreCivic and private prison REIT Geo fell by 7.8% and 4.1%, respectively, while marijuana ETF MJ dropped 2% and payday lenders World Acceptance and EZCorp each fell by more than 1%.

Mike Allen, author of AM
2 hours ago - Politics & Policy

Biden-Harris, Day 1: What mattered most

President Joe Biden and first lady Dr. Jill Biden arrive at the North Portico of the White House. Photo: Alex Brandon-Pool/Getty Images

The Axios experts help you sort significance from symbolism. Here are the six Day 1 actions by President Biden that matter most.

Driving the news: Today, on his first full day, Biden translates his promise of a stronger federal response to the pandemic into action — starting with 10 executive orders and other directives, Caitlin Owens writes.

3 hours ago - Politics & Policy

Read: Pete Buttigieg's opening statement ahead of confirmation hearing

Pete Buttigieg, President Biden's nominee to be secretary of transportation, in December. Photo: Kevin Lamarque/AFP via Getty Images

Pete Buttigieg, President Biden's nominee to lead the Transportation Department, will tell senators he plans to prioritize the health and safety of public transportation systems during the pandemic — and look to infrastructure projects to rebuild the economy — according to a copy of his prepared remarks obtained by Axios.

Driving the news: Buttigieg will testify at 10 a.m. ET before the Senate Committee on Commerce, Science and Transportation. He is expected to face a relatively smooth confirmation process, though GOP lawmakers may press him on "green" elements of Biden's transportation proposals.