We could get a decision from Trump today on whether the administration will keep paying insurers for their cost-sharing reduction subsidies to low-income people. A few things to keep in mind if he stops the payments:

Expand chart

Data: Centers for Medicare & Medicaid Services; Map: Lazaro Gamio / Axios

  • Insurers have to keep providing the subsidies anyway — they just won't be reimbursed. That's why they'd respond by raising premiums for next year by as much as another 20%.
  • In Iowa, Medica — the last ACA insurer standing — says it would raise its premiums another 12% to 20% for next year if the payments end, per the Des Moines Register.
  • About 5.9 million people get the subsidies — about 57% of everyone who's enrolled in ACA private insurance coverage, according to the Centers for Medicare and Medicaid Services.
  • They're heavily concentrated in red states, and especially in the south, as you can see from this map by our visuals editor, Lazaro Gamio. (We ran this map back in April, and now that the payments are under threat again, we thought it was time for an encore.)
  • The move would end up costing the federal government more money, rather than saving money, because the ACA tax credits would adjust to cover the higher premiums. The Kaiser Family Foundation predicts a net increase of $2.3 billion in federal costs next year.
  • But anyone who doesn't qualify for the tax credits would have to eat the extra costs.
  • The White House will point out, correctly, that Congress didn't fund the payments and that it could end the uncertainty at any time by doing so.
  • Now that the repeal bill — which would have funded the payments for two years — has collapsed, most Republicans won't want to provide the funding on its own. But some are reluctantly acknowledging they may have no choice. "I think we're going to have to do that," Senate Finance Committee chairman Orrin Hatch told Reuters.

Go deeper

Updated 59 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Annelise Capossela/Axios

  1. Global: Total confirmed cases as of 8 p.m. ET: 20,188,678 — Total deaths: 738,668 — Total recoveries: 12,452,126Map.
  2. U.S.: Total confirmed cases as of 8 p.m. ET: 5,138,850 — Total deaths: 164,480 — Total recoveries: 1,714,960 — Total tests: 63,252,257Map.
  3. States: Georgia reports 137 coronavirus deaths, setting new daily record Florida reports another daily record for deaths.
  4. Health care: Trump administration buys 100 million doses of Moderna's coronavirus vaccine.
  5. Business: Moderna reveals it may not hold patent rights for vaccine.
  6. Sports: Big Ten scraps fall football season.

Voters cast ballots in Minnesota, Georgia, Connecticut, Wisconsin and Vermont

Photo: Spencer Platt/Getty Images

Primary elections are being held on Tuesday in Minnesota, Georgia, Connecticut, Vermont and Wisconsin.

The big picture: Georgia and Wisconsin both struggled to hold primaries during the coronavirus pandemic, but are doing so again — testing their voting systems ahead of the general election. Rep. Ilhan Omar (D-Minn.) is facing a strong challenger as she fights for her political career. In Georgia, a Republican primary runoff pits a QAnon supporter against a hardline conservative.

3 hours ago - Health

Trump administration buys 100 million doses of Moderna's vaccine

A volunteer in Moderna's vaccine clinical trial receives a shot. Photo: Paul Hennessy/NurPhoto via Getty Images

The U.S. government has agreed to buy 100 million doses of Moderna's experimental coronavirus vaccine for $1.5 billion, or $15 per dose.

Why it matters: The Trump administration, through Operation Warp Speed, has now bought initial batches of vaccines from Moderna, GlaxoSmithKline and Sanofi, Pfizer, Novavax, Johnson & Johnson and AstraZeneca before knowing whether they are safe and effective. The federal government also appears to own some of the patent rights associated with Moderna's vaccine.