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Pablo Martinez Monsivais / AP

Senate Republicans have spent three days throwing around all kinds of health policy ideas, but they're all united around Thursday's topic du jour: lowing premiums.

"There's no reason that premiums on the individual market should double and triple in a state like mine. There was no reason for that other than Obamacare," Sen. Ron Johnson of Wisconsin told reporters. "We need to diagnose that then figure out what policies we can agree on to bring those premiums down."

There are two emerging ideas as to how to do that: Tinker with the Affordable Care Act's consumer protections — which is both better understood by members but more controversial — or automatically enrolling people in a basic health plan.

Reforming or repealing the Affordable Care Act regulations: This is the main way the House health care bill tackles premiums. It allows states to opt out of the ACA's essential health benefits and, in limited circumstances, its ban on charging sick people higher premiums.

But senators have varying opinions on whether or not they should do this. It's also questionable whether they'll be allowed to under Senate rules.

  • Johnson: In order to bring down premiums, the regulations "absolutely" must be addressed. When asked whether he would guarantee pre-existing conditions will be covered, with sick and healthy people paying the same premium, he said, "I'm guaranteeing nothing other than my effort to try and bring those premiums down."
  • Health, Education, Labor and Pensions Committee Chairman Lamar Alexander: "We would like to move more decisions out of Washington, back to the states, about regulating insurance."
  • Sen. Bob Corker: "I have to believe that when you mandate ten essential health benefits in a rigid way that it affects the cost of premiums." But, Corker said, pre-existing conditions protections are "something that has to stay ... It does drive up costs for others, but to me, I'm perfectly comfortable and appreciative of the fact that we've gotten to a place where people [who] have pre-existing conditions can be covered."On charging sick people higher premiums: "I would hope that we would be in a place where regardless, if it's just based on the luck of the draw that you have these pre-existing conditions, then I would hope people would pay the same premiums as others in that case."

Another alternative: Auto-enrolling people in a very basic, bare-bones health plan. This would essentially be catastrophic coverage that is paid for by a person's federal tax credit, but people would have to opt out instead of choose to buy it. This, in theory, would get a lot more healthy people in the marketplace and help balance out costs.

  • Sen. Bill Cassidy: "Your best way to lower premiums is to expand the risk pool ... Auto-enrollment would allow expansion of the risk pools."
  • A senior GOP aide said auto-enrollment is "absolutely" the key to lowering premiums. The aide said Sen John Cornyn, the majority whip, spoke about the idea at Thursday's working group meeting and it was "well received."
  • Another senior GOP aide told me that auto-enrollment "is one of many ideas being examined for their utility and impact ... There's no leading options yet; lots for members to explore and implications to assess before any decisions will be made."

Go deeper

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Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, cautioned on Sunday that the COVID-19 Omicron variant will "inevitably" be found in the United States.

Driving the news: Fauci, Biden's chief medical adviser, told ABC's George Stephanopoulos on "This Week" that U.S. officials will meet with colleagues from South Africa later on Sunday to try to determine the severity of the cases, as countries scramble to learn more about the variant.

Updated 4 hours ago - Politics & Policy

Dems fear supply-chain blame

Illustration: Aïda Amer/Axios

As supply-chain kinks drive up prices and disrupt holiday shopping, Democrats are scrambling to show action and deflect blame.

Why it matters: With their party controlling both the White House and Capitol, vulnerable Democrats worry supply-chain snafus will hurt them in next year's midterms.

4 hours ago - World

Scoop: Germany urges Congress not to sanction Putin’s pipeline

Photo: Mikhail Svetlov/Getty Images

The German government has urged members of Congress not to sanction the Nord Stream 2 pipeline, arguing that doing so will "weaken" U.S. credibility and "ultimately damage transatlantic unity," according to documents obtained by Axios.

Why it matters: At a time when roughly 100,000 Russian troops are massing at its border, Ukraine views Nord Stream 2 as an existential threat to its security. The pipeline would circumvent Ukrainian transit infrastructure and deliver Russian gas directly to Germany, eliminating one of the last deterrents Ukraine has against an invasion.