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Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

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Illustration: Aïda Amer/Axios

President Trump vowed to overhaul the health care system, notably saying in one of his first post-election speeches that pharmaceutical companies were "getting away with murder" over their pricing tactics.

Yes, but: Four years later, not a lot has changed. If anything, the health care industry has become more financially and politically powerful.

"Most of the bigger ideas have either been stopped in the courts or just never got implemented," said Cynthia Cox, a vice president at the Kaiser Family Foundation who follows the health care industry.

  • The administration killed its own regulation that would have changed behind-the-scenes negotiations between drug companies and pharmacy benefit managers.
  • One of the most consequential drug proposals — tying Medicare drug prices to lower prices negotiated abroad — is not remotely close to going into effect.
  • Forcing drug companies to disclose prices in TV ads was a small gambit, and the courts ultimately struck down the idea.

The other side: The policies the administration has seen through, so far, have been relatively modest.

Between the lines: Health care has consistently raked in large sums of profit every year of Trump's presidency. That has been especially true during the pandemic.

  • The 2017 tax cuts and this year's tax cuts that were attached to the coronavirus legislation significantly benefited large health care companies that had massive cash reserves overseas or wanted easy tax refunds.

Meanwhile, surprise medical bills are still a thing, consolidation hasn't stopped, lobbying has skyrocketed and federal coronavirus bailouts have favored affluent hospital systems over rural and safety-net hospitals.

  • Spending also continues to soar for people who get health insurance through their jobs because hospitals, drug companies and other providers still have no limits on how much they charge for their services and products, and because health insurers and employers always pass along the costs to everyone else.

Go deeper

Jan 30, 2021 - World

Germany to impose travel restrictions to curb spread of coronavirus variants

Border police officers check passports and COVID-19 tests at Frankfurt Airport. Photo: Thomas Lohnes via Getty Images

Germany announced Friday that it was imposing new travel restrictions in an effort to curb the spread of more contagious coronavirus variants.

Details: All non-German residents traveling from countries deemed "areas of variant concern," including the United Kingdom, South Africa, Portugal, Ireland, Brazil, Lesotho and Eswatini, will be banned from entering the country, even if they test negative for the coronavirus.

Updated 8 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Vaccines: U.S. to mandate vaccines for anyone who crosses borders starting in January — Shots lagged data by months — The next big bottleneck in the global vaccination effort.
  2. Health: The Thanksgiving bouncers — Axios-Ipsos poll: Thanksgiving roulette — Experts criticize CDC's language on vaccine boosters — America's Thanksgiving gamble.
  3. Politics: Biden administration asks appeals court to reinstate vaccine mandate — Michigan recommends face masks for all residents amid surge.
  4. Education: A COVID strategy backfires at schools — Schools across the U.S. offer vaccine drivesBenefits of in-person school outweigh risks, study finds.
  5. World: EU drug regulator recommends Pfizer COVID vaccine for kids — Italy announces new COVID restrictions for unvaccinated people — European health agency urges expanding booster shot access.
  6. Variant tracker: Where different strains are spreading.
Jan 29, 2021 - Health

WHO says most pregnant women can now receive coronavirus vaccine

A doctor administering Moderna's coronavirus vaccine at a university hospital in Essen, Germany, on Jan. 18. Photo: Lukas Schulze/Getty Images

The World Health Organization has altered its guidance for pregnant women who wish to receive the coronavirus vaccine, saying now that those at high risk of exposure to the COVID-19 or who have comorbidities that increase their risk of severe disease, may be vaccinated.

Why it matters: The WHO drew backlash for its previous guidance that did not recommend pregnant women be inoculated with vaccines made by Pfizer-BioNTech or Moderna, even though data indicated that pregnancy increased the risk of developing severe illness from the virus.