Good morning … Barring any huge surprises, Congress is likely to repeal the individual mandate this week. I know you know that. It's just kinda crazy that, after so many failed attempts, it's actually happening.
As we wrote on Friday, the next year for the Affordable Care Act is already looking pretty grim, given the impending death of the individual mandate and the return of short-term plans that don't cover much and therefore don't cost much. How bad it is, though, will vary from state to state, even county to county — and from one insurance company to the next.
Be smart: When we talk about the factors that can increase premiums and drive insurance companies out of certain markets, it's important to remember that all of those factors have to be measured relative to insurers' expectations — not just in absolute terms.
The bottom line: In actuarial science, as in life, reality will vindicate the biggest pessimists.
There's been a ton of responses to The Washington Post's report Friday night that officials at the Centers for Disease Control and Prevention have been given a list of seven words and phrases they're not supposed to use in the agency's annual budget request.
What's happening now: CDC director Brenda Fitzgerald sort of pushed back yesterday. She said "there are no banned words at CDC," but did not explicitly deny what the Post reported — that the Trump administration had told CDC officials it did not want those seven words used.
Threat level: Because this is all related to the budget and its supporting documents, I was curious how often CDC has been using these terms in the first place.
Agencies submit long, detailed "budget justifications" to Congress each year, alongside their funding requests. I went back through the 2017 and 2018 budget justifications — President Obama's last budget and President Trump's first, respectively, to search for all seven terms. (One note: Obama's last budget was twice as long as Trump's first, so it used many more words overall.)
Here's the latest on the settlement House Republicans, the Trump administration and Democratic state attorneys general have reached in the ongoing lawsuit over the ACA's cost-sharing reductions.
The details: The proposed settlement would essentially brush aside a federal court ruling that said the president could not continue to pay insurance companies for those cost-sharing reductions, in the absence of an appropriation from Congress.
Meanwhile, elsewhere in the lucrative subspecialty of ACA litigation, a federal court on Friday temporarily blocked the Trump administration from implementing its new rules on the ACA's contraception mandate.
The bottom line: The ACA will never be out of court.
Clarification: In last Thursday's Vitals, I wrote about a survey that found a stark increase in the number of ads being run by health insurance companies. Although that spike has coincided with the end of federal outreach for HealthCare.gov, the survey tracked all health care advertising — not just marketing for policies sold through the individual market.
What else we're watching this week:
What's good? I always want to hear your questions, tips, feedback and complaints. I'm at email@example.com.