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Source: FactSet; Chart: Axios Visuals

President Trump's decision to withdraw the rule that would've overhauled behind-the-scenes drug rebates led to huge stock gains yesterday for health insurance companies and pharmacy benefit managers, which have suffered since the rule was first proposed in January.

The big picture: The health care industry's largest middlemen dodged a giant bullet since rebates are an important part of their businesses. But they are not out of danger, as states and Congress are working to change how they influence the price of drugs.

Driving the news: Cigna, which recently bought Express Scripts for $67 billion, surged the most of any health insurer with a 9% boost in its stock price Thursday.

  • Anthem, Humana, CVS and UnitedHealth Group all picked up a lot of ground as well.

Between the lines: The rebate rule raised fears that drugmakers would engage in "tacit collusion," as Northwestern University health economist Craig Garthwaite recently wrote.

  • That plus the imminent threat health insurers and PBMs would raise drug premiums allowed the industry to escape any changes to a system that many believe is flawed.

Yes, but: PBMs have already faced new state regulations and still could run up against seismic changes at the federal level.

  • A new Senate bill would eliminate the practice of "spread pricing" and would require every rebate dollar to flow back to employers.

Go deeper

Updated 13 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Politics: Biden ahead in Wisconsin, Michigan as cases surge in the Midwest.
  2. Health: Surge "is real" and not just caused by more tests, Trump's testing czar saysMask mandates help control rise in hospitalizations Some coronavirus survivors have "autoantibodies."
  3. Business: Surge is sinking consumer confidence Testing is a windfall.
  4. Media: Pandemic causes TV providers to lose the most subscribers ever.
  5. World: Germany to close bars and restaurants for a month Putin mandates face masks.

Parties trade election influence accusations at Big Tech hearing

Photo: Michael Reynolds/Pool/AFP via Getty Images

A Senate hearing Wednesday with Big Tech CEOs became the backdrop for Democrats and Republicans to swap accusations of inappropriate electioneering.

Why it matters: Once staid tech policy debates are quickly becoming a major focal point of American culture and political wars, as both parties fret about the impact of massive social networks being the new public square.

2 hours ago - World

Germany goes back into lockdown

Photo: Fabrizio Bensch/Pool/AFP via Getty Images

German Chancellor Angela Merkel will enact one of Europe's strictest coronavirus lockdowns since spring, closing bars and restaurants nationwide for most of November, Reuters reports.

Why it matters: Germany is the latest European country to reimpose some form of lockdown measures amid a surge in cases across the continent.