Good morning … Several of us here at Axios have friends and family — as well as readers — throughout Florida, and our thoughts and prayers are with everyone who's been affected by Hurricane Irma. We hope you and your loved ones are safe and can begin rebuilding soon.
The Senate HELP Committee this week is scheduled to resume its hearings on stabilizing the Affordable Care Act, and it's already clear Chairman Lamar Alexander wants that effort to focus on the process by which states can obtain what are known as "innovation waivers."
How it works: States can already seek a waiver from many of the ACA's mandates, including the one that requires insurance plans to cover certain "essential" benefits. But, to get a waiver, they have to prove that their new plan would cover just as many people, with plans that are just as generous, without increasing federal spending.
What could change: During the repeal-and-replace effort, Republicans wanted to remove some of those "guardrails" — allowing states to chip away more substantively at some of the law's benefit mandates and coverage guarantees.
Will it work? The problem with expanded waivers, last time, was that the ACA is so interconnected, rolling back one part of the law can quickly implicate another, more politically sensitive part. Could Alexander run into the same issue just with process changes? And will process changes alone make any difference in premiums, which is the whole point here?
Congress still needs to figure out what it's going to do about the Children's Health Insurance Program, since the program's federal funding expires at the end of the month.
The biggest challenge may not be policy, but legislative strategy. It's unclear whether the Senate wants to handle CHIP as a standalone bill this month, bundle it with some other must-pass reauthorizations, or wait until later in the year (likely December) to add to a big end-of-the-year package.
Don't look now, but Medicare spending is in the midst of a slowdown.
Axios' Bob Herman wrote about a study last week that said unnecessary emergency room visits are not that common (especially the runny nose or sore throat types), and penalizing patients after the fact minimizes how they felt in the moment.
Feedback: We heard from a lot of readers about that study, and their comments are a reminder that — get ready for this understatement — ER usage is a hot topic among researchers and in the industry.
Keep the conversation going: Email email@example.com. (All other comments and health care business tips/scoops are welcome, too.)
What we're watching this week:
Tuesday: HELP Committee hearing on state flexibility. Finance Committee hearing on "issues impacting cost and coverage." Census Bureau releases new data on the number of uninsured Americans.
Wednesday: Sen. Bernie Sanders introduces his single-payer bill.
Thursday: HELP hearings conclude with testimony from stakeholder groups.
Got tips? Or other feedback? Are you, like me, still reeling from the news that Max Baucus supports single-payer and just need to talk to someone who understands what you're going through? I'm here for you: firstname.lastname@example.org.