Emergency care center paramedic Michael Gilbert cleans equipment in an exam room at Grady Memorial Hospital, in Atlanta. Photo: David Goldman / AP

Getting rid of the ACA's individual mandate would cause premiums to spike across the country, but would have an outsized impact in a handful of largely rural, largely conservative states, including in Alaska, Iowa, Missouri, Nebraska, Nevada and Wyoming, according to a Los Angeles Times analysis of data from the Kaiser Family Foundation.

Reality check: The effects here are no different from the effects of "skinny repeal" — the last-ditch repeal-and-replace effort that GOP senators insisted they would only vote for if they had assurances it would never become law.

Skinny repeal would have repealed the individual mandate; so would the Senate's tax overhaul. The policy is essentially the same and the effects are essentially the same. The only thing that's changed is lawmakers' willingness to let it happen.

  • Those states the Times identifies would take an especially big hit because they're heavily rural and already suffer from limited competition and high premiums. In other words, they're already the markets that insurers are least attracted to, and they would only become less attractive if their healthiest residents start to leave the risk pool.
  • "Markets where there is already little choice and high premiums are especially vulnerable … Rural areas could be especially hard hit," Kaiser's Larry Levitt told the paper.

Go deeper

Dan Primack, author of Pro Rata
4 mins ago - Economy & Business

White House pushes to uphold TikTok ban

Illustration: Aïda Amer/Axios

The U.S. Department of Justice on Friday filed legal opposition to TikTok's request to delay a ban on downloading the app, with a judge expected to rule before the ban is set to go into effect Sunday.

Why it matters: The White House could have simply postponed the ban on its own for another week or two, as it did last Friday. This move suggests it's seeking to use the ban as leverage in ongoing negotiations.

17 mins ago - Podcasts

Substack and the future of media

Traditional media models, and even some of the digital ones, are either under pressure or outright broken. Some journalists have responded by going out on their own, leveraging a new group of startups that help them self-publish and monetize their work.

Axios Re:Cap digs in with Chris Best, CEO of Substack, which has more than 250,000 paying subscribers on its writer network.

Updated 26 mins ago - Politics & Policy

In photos: Ruth Bader Ginsburg lies in state at Capitol

A bipartisan group of female lawmakers line the steps of the Capitol as Ginsburg's casket is carried to a hearse. Photo: Jose Luis Magana/AFP via Getty Images

The late Supreme Court Justice Ruth Bader Ginsburg laid in state at the Capitol on Friday, the first woman and the first Jewish person to receive such an honor.

Driving the news: After a ceremony in National Statuary Hall, Ginsburg's casket was carried down the building's steps — flanked by a group of bipartisan female lawmakers for a final farewell.

Get Axios AM in your inbox

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Subscription failed
Thank you for subscribing!