Good morning ... Hey, check it out, there's a new (but horrific) way to read Vitals in the morning!
The Trump administration is relaxing a new set of Affordable Care Act regulations — a little more state flexibility over here, a faster waiver process over there, all adding up to a relatively cohesive next step in the administration’s effort to scale back the health care law.
The big picture: All these changes were announced yesterday in a 523-page regulation outlining the standards ACA plans will have to meet next year. It’s a big, dense rule that comes out every year, and this edition advanced the administration’s broader goals of incrementally chipping away at the ACA’s mandates.
The details: Here’s what federal regulators are doing this time:
What they’re not saying: Yesterday’s rules did not ban the practice known as “silver loading,” in which insurers structured their premium hikes somewhat awkwardly to make up for the loss of separate cost-sharing payments. But that’s still a possibility.
Photo: Scott Olson/Getty Images
There are about a million health care mergers in the works right now, some of them with the power to consolidate very large parts of the industry. But my colleague Bob Herman explains that Walmart's potential takeover of Humana could be among the most consequential.
The merged company would control a ton of health care resources, including:
Seniors and low-income shoppers already are Walmart's core demographics. With Humana, Walmart could easily snag a piece of their health care spending and boost food and retail sales in the process.
Go deeper: Bob has more on Axios.com.
I read the Congressional Budget Office’s “Budget and Economic Outlook: 2018 to 2028” so that you don’t have to. Here’s what you need to know from CBO’s latest projections.
Trump's yo-yo effect is real. The federal government will probably spend about $757 billion over the next 10 years on the ACA's premium subsidies, CBO said. That estimate is lower than the last time CBO ran these numbers, in part because of policy changes from the White House and Congress.
It’s the prices. As federal health care spending climbs, it’s mainly driven by the rising costs of underlying health care services — not by increased demand, CBO said.
Hey everyone, we found a California Democrat who doesn’t want to ride the single payer train! It’s Henry Waxman, the former congressman who helped write and pass the Affordable Care Act.
What’s new: In a Washington Post op-ed, Waxman warns Democrats not to make it a “litmus test” for Democratic candidates to support single payer. It won’t solve all of the health care system’s problems, he writes, and it could require tax hikes at “politically suicidal levels.”
Between the lines: Of course Waxman wants to preserve the ACA — he’s one of its actual “architects.” But he has supported single payer in the past, so it’s not like he’s always been a wonky incrementalist. Given Democrats’ frustrations with the constant ACA battles, though, it’s going to take more than an ex-congressman’s op-ed to convince them to lower their sights again.
What we're watching this week: Both the Senate health committee and House Energy and Commerce Committee hold opioid hearings on Wednesday.
Spot anything good in yesterday's regulations? I'm all ears: email@example.com.