Linley Sanders / AP

Iowa's insurance regulators have some ideas for how to rescue their state's Affordable Care Act exchange — namely, by restructuring the ACA's tax credits into something a lot more similar to the House's health care bill. But it's not clear whether the federal government has the technical capacity to implement these changes, even if wanted to, or how quickly it could do so.

The IRS systems would need to make eligibility determinations using different criteria than they're using now, and pay out a different type of subsidy, as well. All for just one state, and in short order.

"Could you change the subsidy structure six months before open enrollment? My instinct would be no," said Sean Mullin, a senior director at former HHS Secretary Mike Leavitt's consulting firm.

Why it might get a hearing: Iowa's proposal is at least plausible, Mullin said — slimming down to one plan design would probably help, and these are the kinds of policy changes you'd think the Trump administration would be open to. But, he noted, other states are still waiting for answers on far more straightforward waiver requests.

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Updated 48 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Eniola Odetunde/Axios

  1. Global: Total confirmed cases as of 6:30 p.m. ET: 34,124,948 — Total deaths: 1,016,723 — Total recoveries: 23,703,113Map.
  2. U.S.: Total confirmed cases as of 6:30 p.m. ET: 7,273,244 — Total deaths: 207,605 — Total recoveries: 2,840,747 — Total tests: 103,946,170Map.
  3. Politics: House prepares to pass revised COVID relief bill as White House talks hit roadblock — Biden to expand voter outreach with in-person canvassing amid pandemic.
  4. Health: Health officials urge flu shots, warning of "twindemic" with COVID-19 — Coronavirus infections rise in 25 states.
  5. Business: Remdesivir is good business for Gilead — Amazon says over 19,800 employees contracted coronavirus — Doomsday has arrived for tens of thousands of workers.

Doomsday has arrived for tens of thousands of workers

Illustration: Sarah Grillo/Axios

Federal coronavirus aid for airlines expires on Thursday with no renewal in sight, meaning massive layoffs for the industry aren't far behind.

The big picture: Airline workers aren't alone on the unemployment line. Oil companies, tire manufacturers, book publishers and insurers are among those that have announced tens of thousands of layoffs. Federal aid through the CARES Act earlier this year delayed most layoffs — until now.

4 hours ago - Science

How the brain handles the unknown

Illustration: Sarah Grillo/Axios

Uncertainty can be hard for humans. It drives anxiety, an emotion neuroscientists are trying to understand and psychologists are trying to better treat.

Why it matters: Under the threat of a virus, job insecurity, election uncertainty, and a general pandemic life-in-limbo that is upending school, holidays and more, people are especially anxious.