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HELP's top Democrat and Republican, Patty Murray and Lamar Alexander, at a hearing. Photo: Alex Brandon/AP

Republicans and Democrats on the Senate HELP Committee disagree about the how far they should go in overhauling the Affordable Care Act's "state innovation waivers" — a dispute that could spell trouble for the committee's bipartisan talks about how to shore up the ACA.

The committee's public hearings have focused mainly on non-controversial changes to the waiver process. But private negotiations, HELP Chairman Lamar Alexander has talked more explicitly about making more substantial changes, a senior GOP aide said. Alexander wants to make it easier for states to waive some of the ACA's consumer protections and benefit mandates — which Democrats would staunchly oppose.

The ACA allows states to waive some of its requirements, as long as they can prove that they could still cover just as many people, with plans that are just as generous, without increasing federal spending. In effect, those "guardrails" keep states from tinkering with many of the law's consumer protections.

While the committee's public hearings have focused largely on more minor changes to the waiver process, Alexander has been pushing in negotiations for more substantial changes to the guardrails. Alexander has said Democrats will need to make concessions in order for Republicans to fund the ACA's cost-sharing subsidies, but hasn't been explicit about what they would be.

"Dems need to strike a deal with Alexander which means meaningful change to guardrails," the senior GOP aide told me.

In contrast: "Democrats have been clear from the start that rolling back protections around affordability and coverage isn't something we're willing to do—so the fact that some Republicans are more concerned with notching a political win on Obamacare than lowering health care costs for families is certainly a challenge," a Democratic aide said.

Background: Many Republicans are highly averse to any stabilization effort that could come across as an ACA "bailout," and many of them are sick of dealing with health care in general. See Finance Committee Chairman Orrin Hatch's op-ed on the subject from last week.

Go deeper

Updated 8 mins ago - World

Biden reviews U.S. arms deals with Saudi Arabia and UAE

Trump struck several large arms deals with Mohammed bin Salman (L) and Saudi Arabia. Photo: Kevin Dietsch-Pool/Getty Images

The Biden administration has put on hold two big arms deals with Saudi Arabia and the United Arab Emirates which were approved in the final weeks of the Trump administration, a State Department official told Axios.

Why it matters: The sales of F-35 jets and attack drones to the UAE and a large supply of munitions to Saudi Arabia will be paused pending a review. That signals a major policy shift from the Trump era, and may herald sharp tensions with both Gulf countries.

Trump supporter found with pipe bombs accused of plot to attack Democrats

Five improvised explosive devices that the FBI says "were fully operational and could cause great bodily harm or injury if handled improperly." Photo: FBI/Justice Department

The FBI believes California Gov. Gavin Newsom (D) and the Bay Area headquarters of Twitter and Facebook were targets of a man facing federal explosives charges, according to a criminal complaint.

Driving the news: Prosecutors charged Ian Benjamin Rogers after finding weapons including five pipe bombs, 49 guns and thousands of rounds of ammunition following a Jan. 15 search of his Napa County home and auto repair business. His alleged goal was to ensure former President Trump remained in office.

4 hours ago - Health

Fauci: COVID vaccine rollout needs to prioritize people of color

Anthony Fauci. Photo: Alex Wong via Getty Images

Infectious disease expert Anthony Fauci highlighted the need to address racial disparities in the COVID-19 vaccination process, per an interview with The New England Journal of Medicine on Wednesday.

What he’s saying: "I think that's the one thing we really got to be careful of. We don't want in the beginning ... most of the people who are getting it are otherwise, well, middle-class white people."