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AP file photo

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.

Go deeper

Ben Geman, author of Generate
25 mins ago - Energy & Environment

What we’re watching during the final countdown to COP26

Illustration: Eniola Odetunde/Axios

This is shaping up as a critical week for climate policy in the U.S. and worldwide.

Driving the news: Democrats are in the final stages of trying to craft the big social spending and climate package they're trying to move on a thread-the-needle party-line vote.

"Atmospheric river" swings Northern California from drought to flood

Satellite view of the bomb cyclone swirling off the coast of the Pacific Northwest and the atmospheric river affecting California on Oct. 24. Photo: CIRA/RAMMB

A series of powerful "atmospheric river" storms are delivering historic amounts of rainfall across parts of drought-stricken California and the Pacific Northwest.

Why it matters: The atmospheric river, packing large amounts of moisture, was causing Northern California to whiplash from drought to flood, as it slowly moved south overnight. It's triggered widespread power outages, flooding and mudslides.

Facebook's pivotal week

Illustration: Aïda Amer/Axios

They're battening down the hatches at Facebook headquarters this week as the company faces a trifecta of tumult: a continuing wave of negative press coverage fueled by document leaks, a critical earnings report Monday and a reported name change looming.

The big picture: All this is unfolding as Mark Zuckerberg tries to transform Facebook from a social network into the prime mover behind a new "metaverse" of VR- and AR-driven remote work and play.