J. Scott Applewhite / AP

The Senate health care bill, which Majority Leader Mitch McConnell has said will be released on Thursday, will contain optional state waivers of some Affordable Care Act insurance regulations, according to two senior GOP aides. But those waivers may not end up in the final bill — because they could get stripped out for violating Senate budget rules.

Here's why: The Congressional Budget Office has to give its cost estimates for the bill before Republicans can argue their case to the Senate parliamentarian that the waivers should be allowed. (The bill has to comply with Senate budget rules, and she decides whether it does.) And there's a good chance that she'll rule that the waivers, including essential health benefits, have to come out. One of the aides described the parliamentarian as "skeptical."

The Senate has long said that altering the ACA's regulations would not comply with the rules of the process the GOP is using, but the House included the state waivers in their final bill.

So that means Republicans may only be able to make the ACA's current state waivers more flexible. It's unclear how many members know this, but conservatives — who were pushing to waive even more of the ACA regulations than the House did, or even require states to opt into the regulations rather than out — will surely be disappointed.

Which ACA regulations would be covered in the state waivers:

  • Essential health benefits, or the list of 10 services insurers must cover.
  • The medical loss ratio, or the regulation of how much premium income insurers must spend on patient claims.
  • The age rating band, or the requirement that premiums for older people be no more than three times the amount of premiums charged to younger people.
  • The actuarial value, or the requirement that plans cover a certain percentage of a person's total health care costs.

Go deeper

Trump tightens screws on ByteDance to sell Tiktok

Illustration: Aïda Amer/Axios

President Trump added more pressure Friday night on China-based TikTok parent ByteDance to exit the U.S., ordering it to divest all assets related to the U.S. operation of TikTok within 90 days.

Between the lines: The order means ByteDance must be wholly disentangled from TikTok in the U.S. by November. Trump had previously ordered TikTok banned if ByteDance hadn't struck a deal within 45 days. The new order likely means ByteDance has just another 45 days after that to fully close the deal, one White House source told Axios.

Updated 4 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Global: Total confirmed cases as of 9:30 p.m. ET: 21,056,850 — Total deaths: 762,293— Total recoveries: 13,100,902Map.
  2. U.S.: Total confirmed cases as of 9:30 p.m ET: 5,306,215 — Total deaths: 168,334 — Total recoveries: 1,796,309 — Total tests: 65,676,624Map.
  3. Health: CDC: Survivors of COVID-19 have up to three months of immunity Fauci believes normalcy will return by "the end of 2021" with vaccine — The pandemic's toll on mental health — FDA releases first-ever list of medical supplies in shortage.
  4. States: California passes 600,000 confirmed coronavirus cases.
  5. Cities: Coronavirus pandemic dims NYC's annual 9/11 Tribute in Light.
  6. Business: How small businesses got stiffed — Unemployment starts moving in the right direction.
  7. Politics: Biden signals fall strategy with new ads.

Harris: "Women are going to be a priority" in Biden administration

Sen. Kamala Harris at an event in Wilmington, Del. Photo: Drew Angerer/Getty Images

In her first sit-down interview since being named Joe Biden's running mate, Sen. Kamala Harris talked about what she'll do to fight for women if elected VP, and how the Democrats are thinking about voter turnout strategies ahead of November.

What they're saying: "In a Biden-Harris administration women are going to be a priority, understanding that women have many priorities and all of them must be acknowledged," Harris told The 19th*'s Errin Haines-Whack.