Evan Vucci / AP

They had the vote and the White House victory rally. Now they have to go out and make the case for their replacement for the Affordable Care Act — and not just to the faithful who wanted repeal all along. The bill was loaded up with politically dangerous changes all along, and judging from all the damaging headlines about what might count as a pre-existing condition, now it has even more.

Here's what could make them the most vulnerable, at town halls and in next year's mid-term elections.

  • Pre-existing condition waivers. They're spending so much time explaining the waivers that states could get under Rep. Tom MacArthur's amendment, and the specific circumstances in which they might apply, that all of their work to limit the damage isn't doing them much good. It didn't help when Wisconsin Gov. Scott Walker immediately suggested he might apply for one.
  • Essential health benefit waivers. They're going to spend a lot of time explaining which benefits might be cut and arguing about which ones aren't important. (Maternity coverage seems to be a big one.)
  • Medicaid cuts. As Health and Human Services secretary Tom Price found this weekend, when the bill cuts $880 billion over 10 years, it's hard to convince people that no one will be hurt by that — especially when the Congressional Budget Office says 14 million people will lose coverage.
  • Age rating. AARP is already firing away at the "age tax" — the provision that would let insurers charge older customers as much as five times more than young adults, compared to the 3:1 ratio under the ACA.
  • Replacing the tax credits. The bill replaces the ACA's tax credits, which adjust for income and geography, with flat credits based on age. But by reinventing the ACA tax credit, they're finding all kinds of problems that have to be fixed — like CBO's warning that they'd leave the low-income elderly vulnerable to massive premium increases. (Sen. Susan Collins said on ABC's This Week that the GOP tax credits should adjust for — wait for it — income and geography.)
  • Net investment tax repeal. The bill gets rid of the ACA's taxes, but by repealing the 3.8 percent tax on high-income people's net investment income, they're getting hammered with charges that the bill is a tax cut for the rich.
  • Congressional exemption. The House scrambled to pass a separate bill to get rid of the exemption that shields members of Congress and their staffs from the effects of the state waivers. But judging from the way that exemption has taken off in social media, the damage is already done.

Go deeper

Dion Rabouin, author of Markets
1 hour ago - Economy & Business

Coronavirus surge is sinking consumer confidence

Data: Hamilton Place Strategies, CivicScience; Chart: Axios Visuals

The rise in coronavirus cases in certain parts of the U.S. is stunting confidence across the country, a crop of new reports show.

Driving the news: After stalling during the previous two-week period, overall economic sentiment declined for the first time in two months, according to the Economic Sentiment Index, a biweekly survey from data firm CivicScience and Hamilton Place Strategies (HPS).

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Politics: Obama: Trump is "jealous of COVID's media coverage."
  2. Health: Mask mandates help control the rise in coronavirus hospitalizations. Hospitals face a crush.
  3. Business: Coronavirus testing is a windfall. Winter threat spurs new surge of startup activity.
  4. Media: Pandemic causes TV providers to lose the most subscribers ever.
  5. World: Putin mandates face masks.

The GOP's monstrous math problem

Illustration: Sarah Grillo/Axios

Republicans, win or lose next week, face a big — and growing — math problem.

The state of play: They're relying almost exclusively on a shrinking demographic (white men), living in shrinking areas (small, rural towns), creating a reliance on people with shrinking incomes (white workers without college degrees) to survive.