Good morning … So, we're really doing this, huh?
Senate Republicans' latest tax proposal includes a provision to repeal the Affordable Care Act's individual mandate. It's a risky maneuver, but one that GOP leaders waded into with at least an outward projection of confidence, saying they believed they had 50 votes for the overall tax package.
The big picture: Remember "skinny repeal"? The repeal bill that all but three Senate Republicans voted for on the express condition that it not become law? Because, as Sen. Lindsey Graham put it, "the skinny bill as policy is a disaster"? The policy is basically the same this time around.
Why now? The savings. Repealing the mandate would save the government roughly $340 billion over a decade, and Republicans need that money to help offset the lost revenues from $1.5 trillion in tax cuts.
What's next: The House isn't expected to add in mandate repeal before passing its tax bill, so this would have to be worked out in a conference between the House and Senate bills, if they both make it that far.
GOP leaders said that, in addition to voting to repeal the individual mandate, they had agreed to hold a vote on the ACA stabilization bill from Sens. Lamar Alexander and Patty Murray. Democrats don't really see that as much of a deal, and on the substance, they have a point.
Be smart: These two policies would not cancel each other out.
Buzz: Some liberal-leaning policy wonks have already started to question how much they actually care about Alexander-Murray. The end of cost-sharing subsidy payments has, somewhat bizarrely, made coverage more affordable for a lot of people.
Axios' Bob Herman has been tracking the health care industry's financials over the third quarter, in which the 99 largest publicly traded health care companies cumulatively collected $33 billion of profit and $577 billion of revenue worldwide.
Winners: Pharmaceutical companies collected more than 60% of those profits, but only 22% of the revenue.
The federal government owes insurance companies more than $12 billion in payments from the ACA's risk corridor program, and didn't even take in enough money last year to finish paying off its debts from 2014.
Washington & Lee law professor Tim Jost breaks down the math over at Health Affairs, finding that insurers paid just $27 million into the program last year, and were owed more than $4 billion, on top of the roughly $8 billion in debts already outstanding.
How it works: Under the risk corridor program, insurers with better-than-expected results in the ACA's exchanges would pay into a fund, and insurers with worse-than-expected results could draw money from that fund to help cover their losses.
Jim Chanos and his hedge fund "are short [selling] the dialysis companies," the famed short seller who predicted the collapse of Enron said at a Reuters event Tuesday. He predicts private insurers won't continue paying higher rates for dialysis than what Medicare or Medicaid pays.
Why it matters: Short selling is a fickle business, but Chanos' view is a pretty big shot fired at the major dialysis companies — namely, DaVita, Fresenius and American Renal Associates. And it's not like dialysis chains aren't vulnerable. Some of their profits come from patients who controversially get their premiums subsidized by charities.
The health policy world lost a brilliant mind and generous soul yesterday with the death of Uwe Reinhardt, who was not only one of the smartest thinkers on health care, but had a unique knack for making that work seem fun.
Health economist Austin Frakt has a very nice remembrance that I highly recommend, especially if you knew Reinhardt or his work.
What we're watching today: HELP Committee hearing with the surgeon general, on building healthy communities (10am, livestream here). Senate Appropriations subcommittee hearing on the VA's efforts to combat opioid overuse.
What we're watching this week: The tax bill's progress through the Senate Finance Committee.
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