Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to Axios Closer for insights into the day’s business news and trends and why they matter

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Stay on top of the latest market trends

Subscribe to Axios Markets for the latest market trends and economic insights. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with Axios Sports. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Pablo Martinez Monsivais / AP

Over the past several weeks, senior GOP aides have repeatedly said that if the Senate bill touches pre-existing conditions in any way, it will lose around a third of the caucus. Today, a provision that could cause sick people to pay much higher premiums than they currently do has not caused any Republicans to say they'll vote against the GOP health bill.

  • When Senate GOP leaders first presented their plan to the caucus in a PowerPoint presentation, it explicitly said that pre-existing conditions wouldn't be touched, aides say.
  • As recently as two weeks ago, aides said members were surprised and angry to learn that Sen. Ted Cruz's Consumer Freedom Option would allow plans that didn't include the Affordable Care Act's pre-existing conditions protections. (They could only be sold by insurers that also offered plans with the protections.)
  • Sen. Bob Corker: "I think people understand that's got to be protected, and people understand what happened when the House dealt with it and opened it up, and it's just not something that senators are wishing to do."
  • Sen. Shelley Moore Capito over recess: "I think that reopens an issue that I can't support, that it would make it too difficult for people with pre-existing conditions to get coverage."
  • Sen. Chuck Grassley last week: "There's a real feeling that that's subterfuge to get around pre-existing conditions."

Now, that resistance is "melting away," as one Senate Republican aide put it today. "No one wants to be bad guy."

Indeed, almost seven hours after the revised bill — including the Cruz provision — had been released, no Republican senator had threatened to vote against the bill unless the provision is removed. In fact, Republicans had surprisingly little to say about it.

What the Consumer Freedom Option does:

  • It allows insurers that offer ACA-compliant plans to also sell plans that do not comply with ACA regulations, including the law's essential health benefits and its pre-existing conditions protections.
  • Advocates of the bill say that while this could sort sick and healthy people into two different marketplaces, causing premiums to skyrocket for sick people, they'll be insulated from these costs by premium subsidies and the bill's stabilization fund.
  • Members "don't realize we are basically creating single payer for sick people," the GOP aide told me, saying that Republicans' support is growing because people with pre-existing conditions can still get exchange plans.
  • The problem: "If there were hearings, everyone would have a lot more information about Cruz. Right now, Cruz is the only seller of the amendment and he's the only one with information about the amendment," said one well-connected GOP lobbyist, who said Cruz's sales pitch seems to be convincing members to support his idea.

What insurers and experts are saying:

  • America's Health Insurance Plans: "Patients with pre-existing conditions … would potentially lose access to comprehensive coverage and/or have plans that were far more expensive."
  • Scott Serota, president and CEO of the Blue Cross Blue Shield Association: "The 'Consumer Freedom Option' is unworkable as it would undermine pre-existing condition protections, increase premiums and destabilize the market."
  • Kaiser Family Foundation: 1.5 million people with pre-existing conditions could have higher premiums under the Cruz amendment.

Yes, but: The conservative groups love it, as it addresses the ACA regulations that weren't fully addressed in the previous version of the bill. They believe those regulations are driving up the cost of insurance. Stripping the provision could lose these groups' support.

And Michael Cannon of the libertarian Cato Institute says the provision "would make access to healthcare more secure for patients who develop expensive conditions" — because it would free insurers to introduce a wider variety of health plans and make them less likely to leave the markets.

Go deeper

Home confinees face imminent return to prison

Illustration: Aïda Amer/Axios

Thousands of prisoners who've been in home confinement for as long as a year because of the pandemic face returning to prison when it's over — unless President Biden rescinds a last-minute Trump Justice Department memo.

Why it matters: Most prisoners were told they would not have to come back as they were released early with ankle bracelets. Now, their lives are on hold while they wait to see whether or when they may be forced back behind bars. Advocates say about 4,500 people are affected.

The "essential" committee that still doesn't exist

House Speaker Nancy Pelosi. Photo: Stefani Reynolds/Getty Images

Nearly five months after House Speaker Nancy Pelosi (D-Calif.) announced the creation of the bipartisan Select Committee on Economic Disparity and Fairness in Growth, it's not been formed much less met.

Why it matters: Select committees are designed to address urgent matters, but the 117th Congress is now nearly one-quarter complete without this panel assembling. When she announced this committee, Pelosi described it as an "essential force" to "combat the crisis of income and wealth disparity in America."

Biden's ethics end-around for labor

President Biden surveys a water treatment plant during a visit to New Orleans today. Photo: Brendan Smialowski/AFP via Getty Images

The Biden administration is excusing top officials from ethics rules that would otherwise restrict their work with large labor unions that previously employed them, federal records show.

Why it matters: Labor's sizable personnel presence in the administration is driving policy, and the president's appointment of top union officials to senior posts gives those unions powerful voices in the federal bureaucracy — even at the cost of strictly adhering to his own stringent ethics standards.

You’ve caught up. Now what?

Sign up for Mike Allen’s daily Axios AM and PM newsletters to get smarter, faster on the news that matters.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!