Jun 20, 2017

This week's Senate health bill likely to change next week

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

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 4 p.m. ET: 1,187,798 — Total deaths: 63,902 — Total recoveries: 244,246Map.
  2. U.S.: Total confirmed cases as of 4 p.m. ET: 301,902 — Total deaths: 8,175 — Total recoveries: 14,505Map.
  3. Public health latest: How the coronavirus is upending childbirth. CDC launches hospitalization and coronavirus fatality trackers and recommends face coverings in public. Federal government will cover costs of COVID-19 treatment for uninsured.
  4. 1 community thing: Coronavirus hits poor, minority communities harder.
  5. Business updates: Restaurants step up for health care workers. Employees are pressuring companies to provide protections during coronavirus. America's small business bailout off to bad start.
  6. Oil latest: Monday meeting among oil-producing countries to discuss supply curbs is reportedly being delayed amid tensions between Saudi Arabia and Russia.
  7. Education update: Many college-age students won't get coronavirus relief checks.
  8. 1 🏀 thing: The WNBA postpones start of training camps and season.
  9. What should I do? Pets, moving and personal health. Answers about the virus from Axios expertsWhat to know about social distancingQ&A: Minimizing your coronavirus risk.
  10. Other resources: CDC on how to avoid the virus, what to do if you get it.

Subscribe to Mike Allen's Axios AM to follow our coronavirus coverage each morning from your inbox.

U.S. coronavirus updates: Death toll surpasses 8,000

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios

Recorded deaths from the coronavirus surpassed 8,000 in the U.S. on Saturday afternoon, per Johns Hopkins data. The death toll in the U.S. has risen over 1,000 every day for the past four days, since April 1.

The big picture: As expected, COVID-19 death tolls are rising in the U.S. The CDC is recommending Americans wear face coverings in public to help stop the spread, marking a significant change in messaging from the Trump administration.

Go deeperArrowUpdated 2 hours ago - Health

World coronavirus updates: Spain tracks more cases than Italy

Data: The Center for Systems Science and Engineering at Johns Hopkins, the CDC and China's Health Ministry. Note: China numbers are for the mainland only and U.S. numbers include repatriated citizens and confirmed plus presumptive cases from the CDC

Spain overtook Italy in its number of coronavirus cases on Saturday. The global death toll has surpassed 62,000, per Johns Hopkins data.

The latest: About half the planet's population is on lockdown amid the coronavirus crisis. Fatalities are exponentially increasing across Europe, with roughly half of deaths worldwide located in Italy and Spain.

Go deeperArrowUpdated 2 hours ago - Health