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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Skinny repeal would have repealed the individual mandate; so would the Senate's tax overhaul.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

Updated 6 hours ago - World

Mexican President López Obrador tests positive for coronavirus

Mexico's President Andrés Manuel López Obrador during a press conference at National Palace in Mexico City, Mexico, on Wednesday. Photo: Ismael Rosas/Eyepix Group/Barcroft Media via Getty Images

Mexican President Andrés Manuel López Obrador announced Sunday evening that he's tested positive for COVID-19.

Driving the news: López Obrador tweeted that he has mild symptoms and is receiving medical treatment. "As always, I am optimistic," he added. "We will all move forward."

6 hours ago - Politics & Policy

Sarah Huckabee Sanders to run for governor of Arkansas

Sarah Huckabee Sanders at FOX News' studios in New York City in 2019. Photo: Steven Ferdman/Getty Images

Former White House press secretary Sarah Huckabee Sanders will announce Monday that she's running for governor of Arkansas.

The big picture: Sanders was touted as a contender after it was announced she was leaving the Trump administration in June 2019. Then-President Trump tweeted he hoped she would run for governor, adding "she would be fantastic." Sanders is "seen as leader in the polls" in the Republican state, notes the Washington Post's Josh Dawsey, who first reported the news.

Coronavirus has inflamed global inequality

Illustration: Aïda Amer/Axios

History will likely remember the pandemic as the "first time since records began that inequality rose in virtually every country on earth at the same time." That's the verdict from Oxfam's inequality report covering the year 2020 — a terrible year that hit the poorest, hardest across the planet.

Why it matters: The world's poorest were already in a race against time, facing down an existential risk in the form of global climate change. The coronavirus pandemic could set global poverty reduction back as much as a full decade, according to the World Bank.