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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

Biden will reverse Trump's attempt to lift COVID related travel restrictions

Photo: Tasos Katopodis via Getty

The incoming Biden administration will reverse President Trump's last-minute order to lift COVID-19 related travel restrictions, Jen Psaki, the incoming White House press secretary, tweeted.

Why it matters: President Trump ordered entry bans lifted for travelers from the U.K., Ireland, Brazil and much of Europe to go into effect Jan. 26, but the Biden administration will "strengthen public health measures around international travel in order to further mitigate the spread of COVID-19," Jen Psaki said. Biden will be inaugurated on Wednesday, Jan. 20 and Trump will no longer be president by the time the order is set to go into effect.

Dominion sends cease and desist letter to My Pillow CEO Mike Lindell

Photo: Stephen Maturen/Getty Images

Dominion Voting Systems on Monday sent a cease and desist letter to My Pillow CEO Mike Lindell over his spread of misinformation related to the 2020 election.

Why it matters: Trump and several of his allies have pushed false conspiracy theories about the company, leading Dominion to take legal action. It's suing pro-Trump lawyer Sidney Powell for defamation and $1.3 billion in damages, and a Dominion employee has sued Trump himself, OANN and Newsmax.

Off the Rails

Episode 5: The secret CIA plan

Photo illustration: Aïda Amer, Sarah Grillo/Axios. Photo: Zach Gibson/Getty Images

Beginning on election night 2020 and continuing through his final days in office, Donald Trump unraveled and dragged America with him, to the point that his followers sacked the U.S. Capitol with two weeks left in his term. This Axios series takes you inside the collapse of a president.

Episode 5: Trump vs. Gina — The president becomes increasingly rash and devises a plan to tamper with the nation's intelligence command.

In his final weeks in office, after losing the election to Joe Biden, President Donald Trump embarked on a vengeful exit strategy that included a hasty and ill-thought-out plan to jam up CIA Director Gina Haspel by firing her top deputy and replacing him with a protege of Republican Congressman Devin Nunes.