J. Scott Applewhite / AP

Sen. Rand Paul sent a letter on Tuesday to Majority Leader Mitch McConnell, laying out his "policy priorities" for the senate's new health care bill:

  • Allow small business plans or association health plans to self-insure.
  • Reconsider the "insurance company bailout," which he says will come to $136 billion.
  • Reconsider the premium tax credits policy proposed by BCRA.
  • Remove the "Republican version of the individual mandate" and allow insurance companies to impose a waiting period.

Why it matters: Senate Republican leaders don't really think Paul was ever "gettable," but the letter is a good example of the lengthy lists of demands we're likely to see from other Republican holdouts — because they know they have leverage.

One more thing: Paul got face-time with Trump at the White House yesterday, tweeting that the President is "open to making [the] bill better."

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Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Politics: Ex-FDA chief: Pence campaigning after COVID exposure puts others at risk — Mark Meadows: "We are not going to control the pandemic"— COVID-19 looms over White House Halloween celebrations.
  2. Health: 13 states set single-day coronavirus case records last week — Fauci says maybe we should mandate masks if people don't wear themU.S. reports over 80,000 new cases for second consecutive day.
  3. World: Italy tightens restrictions Spain declares new state of emergency.

Amy Coney Barrett's immediate impact

Illustration: Eniola Odetunde/Axios

In her first week on the job, Amy Coney Barrett may be deciding which votes to count in the presidential election. By her third week, she’ll be deciding the fate of the Affordable Care Act.

Where it stands: The Senate votes on Barrett’s nomination tomorrow. If she’s confirmed, Chief Justice John Roberts is expected to swear her in at the Supreme Court within hours, an administration official tells Axios.

Texas Democrats beg Biden to spend now

Photo: Ron Jenkins/Getty Images

The Biden campaign is rebuffing persistent pleas from Texas Democrats to spend at least $10 million in the Lone Star state, several people familiar with the talks tell Axios.

Why it matters: If Texas — which has 38 electoral votes and is steadily getting more blue, but hasn't backed a Democrat for president since 1976 — flipped to the Biden column, it would be game over. But the RealClearPolitics polling average stubbornly hovers at +2.6 for Trump — and Team Biden appears more focused on closer targets.