Illustration: Aïda Amer/Axios

President Trump's 2021 budget proposes massive reductions in Medicare and Medicaid spending, which would be felt most acutely by hospitals and Medicaid beneficiaries.

Why it matters: Budget proposals are more about messaging than policies that have any chance of becoming law, but it's still a good indication of the direction the administration would like to head in if Trump wins re-election.

Yes, but: The budget isn't entirely theoretical; the administration is moving full steam ahead on some of its Medicaid proposals — like work requirements and block grants — and is still hoping to notch a victory on prescription drug prices before the election.

Details: The budget would reduce Medicare and Medicaid spending by hundreds of billions of dollars each over the next decade.

  • The budget doesn't include new policy ideas to replace the Affordable Care Act or protect pre-existing conditions, but does include $844 billion in spending reductions from the "President's Health Reform Vision," which accounts for a large portion of its Medicaid savings.

Between the lines: These huge Medicare savings come at the expense of hospitals, including through site-neutral payment policies and reduced uncompensated care payments.

  • Although the Medicaid reforms are largely unspecified, if the Trump administration's past actions indicate future behavior, they'd likely include cuts to the ACA's expansion population and capping federal payments to states.
  • "The level of spending reductions called for would inevitably mean fewer people covered and more uninsured," the Kaiser Family Foundation's Larry Levitt said.

My thought bubble: It's extremely hard to see Congress legislating these kind of cuts to hospitals, no matter who's in charge. But if Republicans are in control after the election, it's pretty easy to see them at least trying to pass these large-scale Medicaid reforms again.

Go deeper: Trump vs. Medicaid

Go deeper

Trump commutes Roger Stone's sentence

Roger Stone arriving at his sentencing hearing on Feb. 20. Photo: Drew Angerer/Getty Images

President Trump on Friday evening commuted the sentence of his longtime associate Roger Stone, according to two senior administration officials. Stone in February was sentenced to 40 months in prison for crimes including obstruction, witness tampering and making false statements to Congress.

Why it matters: The controversial move brings an abrupt end to the possibility of Stone spending time behind bars. He had been scheduled to report to prison on July 14.

Updated 4 hours ago - Health

Which states have set single-day coronavirus records this week

Data: COVID Tracking Project and state health department data compiled by Axios; Map: Danielle Alberti and Naema Ahmed/Axios

13 states this week surpassed records set just last week for their highest number of coronavirus infections in a single day, according to the COVID Tracking Project and state health department data. 16 states in total reported new highs.

The big picture: The United States' alarming rise in coronavirus cases isn't just due to increased testing — particularly where the number of cases has grown fastest over the last month, Axios' Andrew Witherspoon and Caitlin Owens report.

Updated 5 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 6:30 p.m. ET: 12,389,660 — Total deaths: 557,279 — Total recoveries — 6,830,596Map.
  2. U.S.: Total confirmed cases as of 6:30 p.m. ET: 3,169,611 — Total deaths: 133,885 — Total recoveries: 983,185 — Total tested: 38,856,341Map.
  3. Public health: The reality of the coronavirus bites.
  4. Trade: Trump says he's no longer considering phase-two trade deal with China because the pandemic damaged the two countries' relationship.
  5. 🎧 Podcast: Rural America has its own coronavirus problem.