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Four Senate Republicans — Ted Cruz, Mike Lee, Rand Paul, and Ron Johnson — just released a statement saying they're "not ready to vote for" the Senate health care bill. That's enough to kill the bill if they actually vote against it. "It does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their healthcare costs," they wrote.

The bottom line: If a rebellion happens, it's largely because conservatives want to get rid of more of the Affordable Care Act's insurance regulations. And that's a big part of the Republican dilemma. Conservative Republicans say those rules make individual health insurance more expensive, and they're right — but the most expensive regulations are the ones that protect people with pre-existing conditions, which is exactly what Senate Republicans don't want to get rid of.

Deeper dive: The draft Senate bill would let states escape some of the ACA's "Title I" insurance regulations, like minimum benefit requirements — but not the pre-existing condition protections, like requiring insurers to cover sick people and preventing them from charging those consumers higher rates. According to an analysis circulated by Sen. Bill Cassidy, prepared by the consulting firm Oliver Wyman, that's what added the most to individual insurance costs.

Here's what Cruz said earlier this week: "There is no doubt there has got to be significant reform to reduce the burdens from the Title I insurance mandates. Why? Because they're one of the principal drivers of premiums skyrocketing."

For context: Sen. Rand Paul said today that it's more than just the regulations — it's also the fact that the Senate bill keeps the ACA subsidies in a scaled-back form: "It doesn't fix the death spiral in Obamacare, it simply subsidizes it with taxpayer money to insurance companies."

What the House bill does: It allows states to waive the pricing rules for sick people under certain conditions. The Senate bill doesn't go that far.

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17 mins ago - Health

Axios-Ipsos poll: Fear of voting

Data: Axios/Ipsos poll; Note: ±3.0% margin of error for the total sample; Chart: Andrew Witherspoon/Axios

Democrats are twice as likely as Republicans to worry about in-person voting — with nearly two in three seeing it as a large or moderate risk to their health — according to this week's installment of the Axios-Ipsos Coronavirus Index.

Why it matters: This could pose a significant disadvantage for Joe Biden and other Democratic candidates in November if the pattern holds — especially in states where high infection rates persist, or where there are significant hurdles to mail-in, absentee or early voting.

Trump: Coronavirus is "under control"

President Trump said in an interview with “Axios on HBO” that he thinks the coronavirus is as well-controlled in the U.S. as it can be, despite dramatic surges in new infections over the course of the summer and more than 150,000 American deaths.

  • “They are dying, that's true. And you have — it is what it is. But that doesn't mean we aren't doing everything we can. It's under control as much as you can control it. This is a horrible plague,” he told Axios' Jonathan Swan.
Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 5 a.m. ET: 18,295,434 — Total deaths: 694,233 — Total recoveries — 10,926,704Map.
  2. U.S.: Total confirmed cases as of 5 a.m. ET: 4,717,716 — Total deaths: 155,471 — Total recoveries: 1,513,446 — Total tests: 57,543,852Map.
  3. Education — Fauci: Schools can reopen with safeguards, but those in virus hot spots should remain closed
  4. Politics: White House will require staff to undergo randomized testing — Pelosi says Birx "enabled" Trump on misinformation.
  5. Sports: 13 members of St. Louis Cardinals test positive, prompting MLB to cancel Tigers series — Former FDA chief says MLB outbreaks should be warning sign.
  6. 1 🎥 thing: "Tenet" may be the first major film to get a global pandemic release.