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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

2 hours ago - Technology

3D printing's next act: big metal objects

Chief Scientist Andy Bayramian makes modifications to the laser system on Seurat's 3D metal printer. Photo courtesy of Seurat Technologies.

A new metal 3D printing technology could revolutionize the way large industrial products like planes and cars are made, reducing the cost and carbon footprint of mass manufacturing.

Why it matters: 3D printing — also called additive manufacturing — has been used since the 1980s to make small plastic parts and prototypes. Metal printing is newer, and the challenge has been figuring out how to make things like large car parts faster and cheaper than traditional methods.

Rising rates may hammer the stock market

Illustration: Sarah Grillo / Axios

Stocks are much more vulnerable to interest rate swings than they used to be.

Why it matters: A sharp rise in rates in early 2022 is the key reason the stock market is off to an ugly start. And with the Federal Reserve making noise about trying to keep inflation in check, rates could go higher.

Ina Fried, author of Login
2 hours ago - Technology

Microsoft's Activision Blizzard deal complicates Big Tech regulation

Illustration: Megan Robinson/Axios

Microsoft's surprise $68 billion deal to buy Activision Blizzard is adding a fresh twist to the heated debate over which tech companies have monopolies that need to be reined in.

The big picture: The deal could force a question the company has happily ducked for a decade: whether its size and power make it just as deserving of regulatory scrutiny as its Big Tech rivals.