Aug 23, 2017

Iowa submits waiver with big ACA alterations

Charlie Neibergall / AP

Iowa officials have filed a far-reaching waiver that would massively reform pieces of the Affordable Care Act in the state, the Wall Street Journal reports. This could pave the way for other states to file and implement ambitious changes to the health care law without having to wait for Congress to act.

What the waiver does:

  • Creates a market with only one insurance plan.
  • Makes premium subsidies flat payments tied to age and income.
  • Eliminates subsidies that help low-income people with out-of-pocket costs.
  • Requires consumers to prove they've maintained continuous coverage.
  • Establishes a reinsurance program to help insurers with expensive enrollees.

Context: The ACA is not working well in Iowa (partially due to the state's own implementation decisions). Earlier this year, there was set to be no insurance option for 2018 in most of the state until Medica stepped in. That averted disaster, but means there is no competition in most counties. If the waiver is approved, Wellmark Blue Cross and Blue Shield will participate in the marketplace.

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Mark Meadows considers new White House press secretary

Photos: Alyssa Farah, Defense Department; Stephanie Grisham, Alex Wong/Getty Images; Kayleigh McEnany, Scott W. Grau/Icon Sportswire via Getty Images

White House chief of staff Mark Meadows has privately discussed bringing on Pentagon spokeswoman Alyssa Farah or Trump campaign spokeswoman Kayleigh McEnany as a new White House press secretary, two sources familiar with the talks tell Axios.

Why it matters: Meadows' start on Tuesday as Trump's new chief — and televised coronavirus briefings that feature President Trump himself — present a chance to overhaul a press shop that's kept a low profile since President Trump ended the tradition of daily press secretary briefings.

CNN: Fauci advises all states issue stay-at-home orders

Dr. Anthony Fauci listens to President Trump speak during a briefing on April 1. Photo: Win McNamee/Getty Images

Director of the National Institute of Allergy and Infectious Diseases Anthony Fauci recommended on Thursday that all states across the U.S. implement stay-at-home orders, at a CNN town hall.

Why it matters: The recommendation stands in contrast to President Trump's calls for "flexibility." Nearly 4o states have issued stay-at-home orders to promote social distancing as a way to combat the novel coronavirus — but the orders vary in strictness and duration.