Nov 1, 2018

The ACA is actually pretty stable for Trump's second open enrollment

Illustration: Sarah Grillo/Axios

Today is the beginning of the second Affordable Care Act enrollment season under President Trump. And things are … surprisingly normal.

The big picture: The ACA has been in a state of upheaval since Trump’s inauguration. Some of the changes Republicans made during that upheaval will likely weaken the law. At this moment, though, the watchword for insurers is stability. Things may not be ideal, but at least they’re largely settled.

What they’re saying: “From a consumer perspective, the experience should be pretty good,” said Kelley Turek, a policy specialist at America’s Health Insurance Plans, the industry’s leading trade organization.

  • Technical testing with HealthCare.gov has gone well, Turek said, and back-end systems that coordinate between enrollees and insurers seem to be in good shape.

This will be the first enrollment period in which Trump’s ACA agenda is fully in place.

  • People will be able to buy skimpy, inexpensive “short-term” plans as an alternative to comprehensive, potentially subsidized ACA coverage. They won't be sold through the ACA's exchanges, but will compete through brokers and other websites.
  • The individual mandate won’t be in effect.
  • Federal outreach funding, and grants to “navigators” who helped people compare their options, have been slashed.

What we’re watching: Insurers generally feel that they’ve already calibrated for those policy changes, mainly through sky-high premium increases a year ago. This upcoming enrollment period will determine whether they got that balance right.

  • Before the ACA’s exchanges had opened, losing the individual mandate seemed like a disaster. Its actual disappearance was greeted more with a shrug. Real-world experience raised questions about whether it had enough “teeth,” Turek said.
  • Short-term plans could siphon healthy consumers away from ACA coverage, making it more expensive for those who remain. But they could also be a reasonable option for people who can’t afford ACA coverage, Turek said, as long as they know what they’re buying.

The bottom line: The ACA may not be working as Democrats had initially hoped, but it’s not dead, and for now it seems to have settled into a scaled-back status quo that’s sustainable.

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Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 6 p.m. ET: 1,192,028 — Total deaths: 64,316 — Total recoveries: 245,949Map.
  2. U.S.: Total confirmed cases as of 6 p.m. ET: 301,902 — Total deaths: 8,291 — Total recoveries: 14,520Map.
  3. Public health latest: CDC launches national trackers and recommends face coverings in public. Federal government will cover costs of COVID-19 treatment for uninsured. The virus is hitting poor, minority communities harder and upending childbirth.
  4. 2020 latest: "We have no contingency plan," Trump said on the 2020 Republican National Convention. "We're having the convention at the end of August."
  5. Business updates: Restaurants step up for health care workers. Employees are pressuring companies to provide protections during coronavirus.
  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.

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U.S. coronavirus updates: Death toll surpasses 8,200, case count tops 300,000

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

Recorded deaths from the coronavirus surpassed 8,100 in the U.S. on Saturday, 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: Trump said Saturday that America's "toughest week" is ahead. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the country should expect to see deaths continue to increase in the next week.

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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.

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