Good morning ... Today's the day — We can't wait to read the Senate health care bill. In the meantime, if you're visiting the Capitol, and you see hordes of reporters coming at you as we interview some senator, find somewhere to hide. Apologies in advance.
And we have one more newsletter joining the Axios family! It's Media Trends, by our colleague Sara Fischer, and it's about the changes in different kinds of media that affect our lives — from cord-cutting to consolidation to fake news. It starts next week. Sign up here.
It's not just the rest of us who are in suspense. When Senate GOP leaders post the draft bill online this morning, it will be the first look at the details for a lot of rank and file Senate Republicans, too — aside from the leaks, of course.
Reality check: It's not a total mystery — Caitlin Owens has as good a read as anyone, and we're getting new details this morning from sources who have been briefed. And the bottom line is, it's not going to be radically different than what the House passed. It still gets rid of as many Affordable Care Act insurance rules as it can, rewrites the subsidies, and puts a tight squeeze on Medicaid spending.
The highlights of what we're likely to see:
Looking ahead: Democrats (and Republicans) will have a "virtually unlimited opportunity to amend it during the budget process on the floor" next week, per Senate HELP Committee chairman Lamar Alexander. So at least you can look forward to that.
We're getting a better idea of what's in the bill, but a huge number of policy details still have the potential to significantly alter the way it would affect real-world insurance markets — which means there are also a lot of political landmines for GOP leaders to avoid.
Here are a few big things we'll be looking for once the actual bill drops:
There was no nightmare scenario yesterday — no ACA marketplace meltdown. Health insurers across the country submitted preliminary rate filings yesterday to sell ACA plans on HealthCare.gov, and many companies stayed in their existing markets, as Bob Herman reported.
There were some notable defections — like Anthem's exit from Indiana (its home state) and Wisconsin. Those two states lost two smaller ACA carriers as well.
The bottom line: David Anderson, a health policy researcher at Duke University who used to work at a health insurance company, put the process to Bob this way: "[Yesterday] the plans and states swiped right for each other. August is dinner with the parents. And September is down on a knee."
Bob waded through a 1,000-page proposed rule tied to the Medicare and CHIP Reauthorization Act — which is the next iteration of Medicare paying doctors for quality care — so you don't have to. You can read the entire tome here, if you want to.
In the meantime, a couple highlights:
OK, FDA fans, mark your calendars for July 18. That's when the agency is holding a public hearing to get suggestions on how to promote more competition from generic drugs — one of FDA commissioner Scott Gottlieb's main solutions to rising drug prices. In a blog post yesterday, Gottlieb said the goal is to find out if the agency's rules "are being used in ways that may create obstacles to generic access, instead of ensuring the vigorous competition Congress intended."
Between the lines: His post suggests he's especially interested in finding ways to keep the makers of brand-name drugs from blocking generic drug companies from getting samples of their products — an issue Collins raised with him at a Senate subcommittee hearing earlier this week. The key quote: "We are actively looking at ways our rules are being used and, in some cases, misused."
What we're watching today: Come on.
What we're watching this week: Congressional Budget Office score, maybe tomorrow but more likely Monday. President Trump signs the VA Accountability Act into law Friday. Also, the Biotechnology Innovation Organization's annual convention in San Diego ends today, and Mylan's annual shareholder meeting is today too, because why not?
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