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AP Photo/Andrew Harnik

Senate Republicans aren't sure what they're going to vote on this week — yet their options are vastly different. They all would make massive changes, but to different parts of the health care system, and with different winners and losers.

The "repeal-only" bill — which would gut most of the Affordable Care Act without replacing it — would likely cause the individual market to collapse in most of the country within 10 years and would end the ACA's Medicaid expansion, but would leave traditional Medicaid basically untouched. The "repeal and replace" bill, on the other hand, would be far gentler to the individual market but would make much deeper cuts to Medicaid.

Why this matters: While none of the options on hand are likely to pass, it's important to remember that the Senate GOP isn't having substantial debate about these big ideas. They're just trying to find something that will get 50 votes.

Here's a rundown of the biggest differences between the two leading two bills under consideration. The first, the Better Care Reconciliation Act, is the leading replacement plan — although what's in it is certainly subject to change, including a controversial addition from Sen. Ted Cruz. The second is an updated version of a 2015 repeal bill passed by Congress and vetoed by President Obama, which would gut major pieces of the ACA beginning in two years.

ACA regulations

  • The BCRA (with the Cruz amendment) addresses these in two major ways. First, it would let states waive some of the law's regulations, like essential health benefits. Second, the Cruz amendment would allow insurers offering ACA-compliant plans to also offer noncompliant plans. This would likely create two separate markets: One mostly for healthy people, and one mostly for sick people.
  • The repeal-only bill doesn't touch these, although there's an argument that if there are no functional exchanges in the majority of the country, people with pre-existing conditions don't have much access to affordable health care.

Individual market subsidies

  • The BCRA largely keeps the ACA subsidy structure intact, but makes the subsidies less generous, especially for older people. It also substantially increases patients' cost-sharing .
  • The repeal bill eliminates all federal financial assistance in two years. This will hit low-income people exceptionally hard.

Medicaid expansion

  • The BCRA phases out the Medicaid expansion over three years
  • The repeal bill completely repeals the expansion in two years.

Traditional Medicaid

  • The BCRA creates a new way of funding the traditional Medicaid program. It would institutes a per-person funding cap, and calculates that cap using a formula that most experts say would not keep up with rising medical costs.
  • The repeal bill generally doesn't touch traditional Medicaid.

Go deeper

Biden: There won't be "American forces moving into Ukraine"

President Joe Biden told reporters Tuesday that he does not foresee U.S. troops moving into Ukraine.

Why it matters: Biden's comments come as tensions between Russia and Ukraine persist, and a Russian invasion of Ukraine appears increasingly likely.

Updated 4 hours ago - Politics & Policy

Omicron dashboard

Illustration: Shoshana Gordon/Axios

  1. Health: Axios-Ipsos poll: Omicron's big numbersAnother wave of death — FDA limits use of Regeneron and Lilly antibody treatments — Fauci: "Confident" Omicron cases will peak in February.
  2. Vaccines: Pfizer begins clinical trial for Omicron-specific vaccine — The shifting definition of fully vaccinated.
  3. Politics: Biden admin withdraws temporary vaccine-or-test mandate for large employers — New York Supreme Court strikes down Gov. Hochul's mask mandate for public areas — Sarah Palin tests positive, delaying defamation trial — Virginia school boards sue Gov. Youngkin for lifting mask mandate.
  4. World: U.K. to lift travel testing requirement for fully vaccinated — Beijing Olympic Committee lowers testing threshold ahead of Games.
  5. Variant tracker

The Robinhood M&A rumor mill churns

Illustration: Sarah Grillo/Axios

Robinhood's valuation is now just over $11 billion, a fraction of where it traded in August and below that of its last private round of funding. Cue the M&A mongers.

Why it matters: It's not just Robinhood—falling values of growth-oriented tech stocks have raised speculation that formerly high-flying fintechs could be snapped up by more well-capitalized buyers.