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Greg Ruben / Axios

So after all of that talk about big changes to the House Obamacare replacement bill, Republican leaders skipped some of the biggest ones they could have made. They did give some concessions to conservatives and moderates in the manager's amendment they released last night, but they also did a lot of punting. That means we will still have lots of drama between now and Thursday night.

The biggest actual changes the House GOP is making:

  • States can now choose Medicaid per capita caps or block grants.
  • There will be an optional Medicaid work requirement (with extra federal funds for states that do it).
  • There will be a more generous Medicaid inflation adjustment for the costs of elderly and disabled.
  • Obamacare taxes get repealed a year earlier.

The punty change:

  • A reserve fund to beef up the tax credit, especially for the low-income elderly, but no actual change to the tax credit. That's up to the Senate.

What they left out:

  • It doesn't end the Medicaid expansion earlier, as conservatives wanted. Rep. Joe Barton could still bring that to the Rules Committee on Wednesday.
  • It doesn't try to repeal Obamacare's insurance regulations. GOP leaders say that can't be done in a budget "reconciliation" bill, but conservatives want them to try.

It may not be good enough for the Freedom Caucus. Chairman Mark Meadows told Jonathan Swan that "our leadership is going to put forth a bill that does not address any of the concerns in a meaningful way and will dare us to vote against it." He says the group won't take a formal position against it, so that frees up some group members to vote for it.

But not Rep. Justin Amash, who tweeted: "They haven't changed the bill's general framework. They don't have the votes to pass it. They have seriously miscalculated." Get ready for suspense!

For the radar: The Club for Growth is launching a $500,000 TV and digital ad buy to urge House Republicans to vote against the bill. (Mainly ones who are already opposed or leaning against it.)

Go deeper

Everyone wants to be an influencer

Illustration: Aïda Amer/Axios

The number of people looking to become online influencers has exploded during the pandemic.

Why it matters: Almost anyone can find themselves in a position to become an influencer, and brands are throwing billions of dollars at online content creators.

At least 3 dead after Amtrak train derails in Montana

Photo: Jacob Cordeiro/Twitter

An Amtrak train derailed near Joplin, Montana, resulting in at least three deaths and multiple injuries to passengers and crew on Saturday, per authorities and a company statement.

The big picture: 141 passengers and 16 crew members were estimated to be on the Empire Builder train, traveling from Chicago to Seattle and Portland, when eight of the 10 cars derailed about 4p.m., Amtrak said early Sunday.

Updated 10 hours ago - Politics & Policy

Federal judge blocks vaccine mandate for NYC teachers

Students are dismissed from the first day of school at PS 133 in Brooklyn on Sept. 13. Photo: Michael Nagle/Xinhua via Getty Images

A federal appeals court is set to hear a challenge Wednesday to a vaccine mandate planned for New York City school employees.

Why it matters The vaccine mandate was set to begin on Monday, prompting concerns over staffing shortages in schools across the nation's largest school system. But a judge on Friday temporarily blocked the measure, per AP.

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