Good morning ... Vitals is coming to you a little late this morning because of an embargo on the big news of the day. Hope you don't mind.
HHS Secretary Alex Azar and President Trump. Photo: Chip Somodevilla/Getty Images
The Trump administration this morning will finalize new rules for "short-term" insurance plans — one of its most significant steps yet to chip away at the Affordable Care Act's insurance markets.
The big picture: Short-term plans are cheap, and offer few benefits. They appeal mainly to healthy people, and that's why the Obama administration limited the plans — to keep healthy people in the ACA's exchanges. The Trump administration is moving hard in the other direction.
How it works: The new regulations will allow a "short-term" plan to last up to a year, and consumers will be able to renew them for a maximum of two more years, senior Health and Human Services officials said.
“We don't expect there to be significant migration away from the exchanges," Jim Parker, an HHS senior adviser, told reporters.
Yes, but: Even if only 200,000 people leave the exchanges for these plans, this regulation isn't happening in a vacuum. It comes on top of the nullification of the individual mandate, the cuts to enrollment outreach, and the separate (less controversial) rules expanding association health plans.
The bottom line: Taken together, all of these steps clearly steer healthy people away from the ACA and toward other options, all but giving up on the balanced risk pool the Obama administration had hoped to create.
Illustration: Sarah Grillo/Axios
My colleague Bob Herman takes a look this morning at a new effort to quantify and visualize the intricate, secretive process through which drug prices are determined.
The new research firm, called 46brooklyn, was founded by two former pharmacists, who decided to independently mine federal data after noticing pharmacy margins tied to Ohio's Medicaid program were dropping.
PBMs that serve Medicaid plans reap particularly large windfalls from generics, not just brand name drugs with high sticker prices, according to 46brooklyn.
Go deeper: Bob has more here.
New York Gov. Andrew Cuomo is taking an unusual tack on ACA premiums: He told the state's insurance department earlier this week not to approve any rate increases tied to the nullification of the individual mandate.
By the numbers: Insurers in New York's individual market have proposed an average 24% rate hike, attributing about half of that to the loss of the mandate, according to the NY Daily News.
Why it matters: The loss of the individual mandate is an actual cost. Pretty much every actuary or insurance expert will tell you it's a legitimate reason for insurers to raise their premiums, at least to some degree.
Meanwhile, Blue Cross of North Carolina says it will reduce its premiums next year, by an average of 4%. The reduction would have been twice as big, the insurer said, if Congress hadn't zeroed out the individual mandate.
This is the fifth election cycle since the ACA became law. And as Republicans try to build on their razor-thin Senate majority, some dreams will never die.
The other side: “Democrats are laying the groundwork to make a push for ‘Medicare for All’ legislation if they win back the House in November,” The Hill reports.
Reality check: Neither of these initiatives is likely to happen before 2021 at the absolute earliest. And with the parties already so far apart and looking ahead to 2020, not much else is likely to happen until then, either.
I always welcome your tips: email@example.com.