Mar 26, 2018

Don't count on states to shore up the ACA

Protestors hold signs against Affordable Care Act repeal outside the Capitol last year. Photo: Bill Clark / CQ Roll Call

Now that Washington has decided not to help shore up the Affordable Care Act’s insurance markets, a lot of attention will inevitably turn to the states. But don’t expect to see anything approaching a comprehensive fix at the state level.

The latest: States are mainly looking at two big policy solutions to try to stabilize their individual insurance markets — passing their own version of an individual mandate, or creating their own reinsurance programs to help compensate insurers for their most expensive patients, so that they don’t recoup those costs through higher premiums.

Not all of them are going to be able to come in on their white horse and save the day, although I think several of them will try.
— Sabrina Corlette, a health policy expert at Georgetown University.

Yes, but: It’s mostly the usual blue-state suspects — California, Maryland, Washington — considering these steps.

  • Individual mandates aren’t much more popular at the state level than the ACA’s was.
  • Experts agree reinsurance would work, but they’re reasonably complex programs that needs a lot of logistical support to actually stand up and start operating.
  • And states’ legislative calendars are already making it hard to envision many of them tackling that undertaking before insurers have to set their premiums for next year.
  • “If states want to move on that, they should have been working on it weeks ago,” Corlette said. “That is not something that you can just flip a switch and make it happen.”

Go deeper

Biden says he's starting VP search this month

Joe Biden. Photo: Scott Olson / Staff

Joe Biden said he's spoken to Sen. Bernie Sanders and former President Barack Obama about selecting a running mate — and that he wants to build "a bench of younger, really qualified people" who can lead the nation over the course of the next four presidential cycles.

Driving the news: Biden spoke about the state of the 2020 race during a virtual fundraiser on Friday night that was opened to pooled coverage.

Trump ousting intelligence community inspector general

Michael Atkinson, inspector general of the intelligence community. Photo: Bill Clark / Getty Images

President Trump notified key lawmakers on Friday that he’s firing Michael Atkinson, the intelligence community's inspector general, who first alerted Congress last September of an "urgent" complaint from an official involving Trump's correspondence with the Ukrainian president.

Why it matters: The move, to take effect in 30 days, comes amid a broader initiative to purge the administration of officials seen as disloyal to the president.

Coronavirus dashboard

Illustration: Axios Visuals

  1. Global: Total confirmed cases as of 10 p.m. ET: 1,097,909 — Total deaths: 59,131 — Total recoveries: 226,106Map.
  2. U.S.: Total confirmed cases as of 10 p.m. ET: 277,828 — Total deaths: 7,406 — Total recoveries: 9,772Map.
  3. Public health latest: The CDC is recommending Americans wear face coverings in public to help stop the spread of the coronavirus. The federal government will cover the costs of COVID-19 treatment for the uninsured, Health and Human Services Secretary Alex Azar said.
  4. 2020 latest: "I think a lot of people cheat with mail-in voting," President Trump said of the 2020 election, as more states hold primary elections by mail. Montana Gov. Steve Bullock said Friday that every county in the state opted to expand mail-in voting for the state's June 2 primary.
  5. Business updates: America's small business bailout is off to a bad start. The DOT is urging airlines to refund passengers due to canceled or rescheduled flights, but won't take action against airlines that provide vouchers or credits.
  6. Oil latest: The amount of gas American drivers are consuming dropped to levels not seen in more than 25 years, government data shows. Trump is calling on the Energy Department to find more places to store oil.
  7. Tech updates: Twitter will allow ads containing references to the coronavirus under certain use cases.
  8. U.S.S. Theodore Roosevelt: Senators call for independent investigation into firing of Navy captain.
  9. What should I do? Answers about the virus from Axios expertsWhat to know about social distancingQ&A: Minimizing your coronavirus risk.
  10. Other resources: CDC on how to avoid the virus, what to do if you get it.

Subscribe to Mike Allen's Axios AM to follow our coronavirus coverage each morning from your inbox.