Good morning ... If you missed Axios’ deep dive over the weekend on global threats, I highly recommend you check it out. Maybe our bananas health care system is the least of our worries.
Many Republicans assume their party will take another stab at repealing and replacing the Affordable Care Act if the midterm elections go their way, Axios' Caitlin Owens reports this morning.
"Repeal is like fight club," one GOP operative told Caitlin. "First rule is not to talk about it."
They may not get the chance. Democrats have a pretty good shot at winning the House, or at least picking up enough seats that another repeal bill couldn't pass the lower chamber. And Democrats' prospects are bright largely because the last repeal-and-replace effort was so unpopular.
Policy is also an obstacle. Republicans couldn't come up with a policy last year that could get 50 votes, and that would remain a challenge even with a slightly bigger Senate majority.
American drug companies are rushing into the Chinese market, which is growing rapidly after the government beefed up its version of the FDA as well as its public insurance programs.
Until last year, China required drugmakers to replicate all their clinical trials in China. But now, the country is done with that requirement, is increasing the size of its FDA ten-fold, and is reducing its backlog of drug approvals — lowering it by 80% since 2014.
Why it matters: The Chinese pharmaceutical market could be worth $170 billion in just three years, according to Bloomberg. And because its health care system has been so closed off for so long, these changes will likely make the Chinese population much healthier.
Not too long ago, people were afraid the Trump administration would ban “silver-loading” — the practice through which insurers made up for the loss of an important ACA payment. Instead, the administration offered advice Friday about how to make the practice work better.
Refresher: When President Trump cut off the ACA’s cost-sharing payments, insurers responded by raising premiums. Many of them loaded those increases onto “silver” plans (the ones that offer the cost-sharing benefit). That bumped up federal premium subsidies, effectively making up for the lost cost-sharing dollars.
Details: The Centers for Medicare & Medicaid Services told insurers Friday to make sure this process isn’t creating higher costs for people who pay their premiums themselves, without the help of a subsidy.
The big picture: Obviously, this is all incredibly technical. But broadly, it's important that the administration is helping insurers with this workaround. And it's consistent with the administration's stated goal of reducing the burden on unsubsidized enrollees.
Correction: An item in Friday's Vitals said that the American Medical Association opposed the ACA. That is incorrect. The AMA endorsed the ACA. I apologize for the error.
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