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Good morning ... This is looking to be a slower week on the health care front, so we're going to keep the newsletters shorter and not waste your time. Just be aware that top Senate Republicans will be writing the first draft of a health care bill while Congress is on recess. The Budget Committee will take the first crack at it, with the GOP leadership and the Finance and HELP Committees all pitching in.

And it's not too late to sign up for our newest thing! This afternoon, we're launching Axios PM, Mike Allen's afternoon update with the most important stories of the day. It'll be a super-speedy rundown of everything you missed, so if you've been crashing on something and you've tuned out, this is your way to catch up. Sign up here.

The risk of ignoring CBO's warnings

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Republicans are heading into their next phase of health care — drafting the Senate bill — with a lot of skepticism about the Congressional Budget Office. Health and Human Services secretary Tom Price declared that CBO "was wrong when they analyzed Obamacare's effect on cost and coverage, and they are wrong again." Senate Majority Whip John Cornyn tweeted in response to a House Democrat who quoted CBO's warnings about the House bill: "Fake news."

Senate Republicans can't ignore CBO completely — they have to pay attention to the cost estimates to make sure they comply with budget rules. But they can decide how much to worry about CBO's most dire predictions about the House bill, like escalating premiums for people with pre-existing conditions and unraveling state markets.

Reality check: There's a lot of analysis out there, including from conservative experts, about how badly CBO missed the mark with its estimates of the original Affordable Care Act. So let's take a quick look at what they got right and what they got wrong.

  • Prediction: 32 million uninsured would gain coverage.
  • Reality: 20 million uninsured gained coverage.
  • Prediction: 23 million people would be enrolled in the ACA exchanges in 2017.
  • Reality: 12.2 million people are signed up for 2017.
  • Prediction: 17 million people would gain coverage through Medicaid and CHIP in 2016.
  • Reality: CBO nailed this one: 17 million gained coverage through Medicaid and CHIP in 2016.

The difference: Yes, CBO was off — but the big lesson is that the ACA "only" covered 20 million uninsured people. There were no warnings that the law would have catastrophic effects. This time, there are. So Republicans have to decide whether it's worth the risk to ignore those warnings.

Yes, but: You could argue that CBO should have issued a stronger warning about premiums with the original ACA. Its 2009 analysis only estimated that individual insurance premiums would be 10 to 13 percent higher in 2016 than they were under the old system. Instead, HHS found last week that average individual insurance premiums doubled between 2013 and 2017.

The other implication of the CBO report: election-year pain

That's what the Kaiser Family Foundation's Drew Altman lays out in today's column. He walks through all of the pain points in the CBO report — rising premiums in the short term, higher rates for older people, tax credits that don't help older and low-income people, and the state budget fights that are sure to follow from the cutbacks in federal Medicaid funds.

The bottom line: If CBO is right, there will be damaging effects that kick in before the 2018 mid-term elections, and another round that will become issues in the 2020 election. The impact, Altman writes, will be "the political equivalent of tearing off a bandage slowly." Read his column here.

Here's how chronic conditions drive up health spending

Source: RAND Corporation; Chart: Chris Canipe / Axios

We've heard a lot about how a small number of people with serious health problems drive a disproportionate amount of health care spending, but a new report by the RAND Corporation, prepared for the Partnership to Fight Chronic Disease, shows that reality in vivid detail. The big finding: 12 percent of people with five or more chronic conditions account for 41 percent of total health care spending.

Why it matters: The big dilemma in health care right now is how to cover the costs of the sickest people — and if Congress doesn't keep the ACA system, which covers all people in the same insurance pools regardless of health, then it has to come up with a better system. This chart shows how the spending is distributed for all patients.

Of note: Six out of 10 U.S. adults have at least one chronic condition.

High drug prices are un-closing the Medicare "doughnut hole"

The Wall Street Journal's Joseph Walker had a must-read story this weekend about how rising drug prices are affecting seniors who get their prescription drug coverage through Medicare Part D. The part that caught my eye probably won't get as much attention as the rest of the story: The rise in drug prices are undermining the Affordable Care Act's attempts to close the Part D "doughnut hole."

What's happening: The "doughnut hole" was the gap in coverage where, after a certain amount of drug spending, seniors would have to pay the full cost of brand-name drugs until their catastrophic coverage kicks in. The ACA is slowly closing that hole, so this year they'll only have to pay 40 percent of those costs after they've had $3,700 in drug expenses. But because drug prices are increasing so much, the Journal reports, the benefits of the ACA changes are disappearing.

Why it's happening: It's partly due to rising prices for existing medicines, and partly because new drugs are being introduced that cost more than $50,000 a year.

While you were weekending ...

  • President Trump tweeted that he wants to "add more dollars" to health care, even though all of the GOP proposals cut health care spending, as does his own budget. (So far, GOP aides say his tweet isn't changing the Senate's plans.)
  • Maryland Gov. Larry Hogan allowed a bill cracking down on "unconscionable" generic drug price increases to become law without his signature.
  • Jonathan Swan reports that the Senate will take up a bill to reform the Department of Veterans Affairs, including making it easier to fire an employee for misconduct, next week after the recess.
  • My colleague Becca Rotenberg reports that the "Goldwater rule," which discourages psychiatrists from giving professional opinions about someone they've never treated as a patient, is getting a new debate in the Trump presidency.

What we're watching today: Sen. Chuck Grassley holds Guthrie County town meeting, 2:15 p.m. Central.

What we're watching this week: Senate Republican leaders and staff write the first draft of the health care bill over the recess.

What we're watching next week: The Senate comes back and passes health care, right? Also, the investment bank Jefferies holds its global health care conference in New York City, June 6-9.

Thanks for reading, and always have the courage to tell us what else we should be covering: david@axios.com.

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Mulvaney: Trump "doesn't know who to believe" on Moore allegations

Screenshot of Mick Mulvaney on "Meet the Press" with Andrea Mitchell.

Mick Mulvaney, the director of the Office of Management and Budget, and Marc Short, White House director of legislative affairs, both attempted on Sunday to explain President Trump's silence on the accusations of child sexual abuse and other sexual misconduct against GOP Senate nominee Roy Moore:

  • Mulvaney said on NBC's "Meet the Press" that Trump "doesn't know who to believe," and "thinks that the voters of Alabama should decide."
  • Short said on ABC's "This Week" that "the president has expressed his concern" about the allegations against Moore: "As you noted, the president has not gone down to Alabama to campaign for Roy Moore since the primary concluded. We have serious concerns about the allegations that have been made, but we also believe that all of this info is out there for the people of Alabama."
Why it matters: The RNC has pulled its support from Moore and most high-ranking Republicans have repudiated him. Trump hasn't, but he has weighed in on the allegations against Democratic Sen. Al Franken.
Featured

Zimbabwe dictator Mugabe to resign after 37 years in power

Zimbabweans sing and pray at a Christian peace and prayer rally Sunday in Harare. Photo: Ben Curtis / AP

Robert Mugabe, the 93-year-old dictator who led Zimbabwe for 37 years, will resign tonight, Reuters reports. He has already been removed as the leader of his party and early today was negotiating his resignation with military leaders, per the NY Times.

Mugabe was facing impeachment if he did not resign. Emmerson Mnangagwa, who was Zimbabwe's vice president until Mugabe precipitated the coup by placing his wife next in line for the presidency, appears poised to take control. He is known as a ruthless strongman.

Sunday Times of London lead story, "Fear is gone as the people turn on 'thief' Mugabe ... Zimbabweans unite against the tyrant who enslaved them," by Chief Foreign Correspondent Christina Lamb:

  • "It felt like a revolution. They came from all over the country and all walks of life. Young and old, opposition activists and party apparatchiks, white farmers and black war veterans, housewives and their maids."
  • "The slow-motion coup that began when the army arrested President Robert Mugabe on Wednesday was not yet over, but everyone knew that his own party was preparing to remove him."
  • Why it matters: "In 20 years of reporting on Zimbabwe I have never seen anything like it. This country has infuriated me like no other. The people are incredibly friendly but I have watched them vote for a ruling party that made their lives a nightmare — for fear of being beaten or their daughters being raped."
Featured

Broadcom and Qualcomm move forward on other deals

Raimond Spekking via Wikimedia Commons

Broadcom hasn't yet gotten a "yes" on its takeover approach for Qualcomm, but both chipmakers are moving forward on other deals that could smooth their path to a mega-merger:

  • Broadcom on Friday closed its $5.5 billion purchase of networking switch maker Brocade, which was first announced last November.
  • Qualcomm is set to win "imminent" Japanese antitrust approval for its $38 billion takeover of Dutch chipmaker NXP Semiconductors, according to Reuters, with European approval expected by year-end.

Key move: Broadcom's recent decision to redomicile from Singapore to the U.S. seems to have gotten it over the final regulatory hurdles to buying California-based Brocade, as it had received antitrust approval in July but refiled in October with a U.S. body that oversees foreign investments. It also should aid in buying Qualcomm — although first it needs to make a higher offer.

Featured

System failure on the NYC subway

A northbound #1 on Oct. 31. Photo: Richard Drew / AP

A front-page story from the NY Times' Brian Rosenthal, Emma Fitzsimmons and Michael LaForgia breaks down "How Politics and Bad Decisions Starved New York's Subways," starting with "a perennial lack of investment in tracks, trains and signals."

  • Wait, what? "[T]he actual movement of trains [relies] on a 1930s-era signal system with fraying, cloth-covered cables." (See the archaic equipment.)
  • "Daily ridership has nearly doubled in the past two decades to 5.7 million, but New York is the only major city in the world with fewer miles of track than it had during World War II."
  • "New York's subway now has the worst on-time performance of any major rapid transit system in the world ... Just 65 percent of weekday trains reach their destinations on time, the lowest rate since the transit crisis of the 1970s."
  • "Reporters for The Times reviewed thousands of pages of state and federal documents, including records that had not previously been made public; built databases to compare New York with other cities; and interviewed more than 300 people."
  • Let 'em out!

N.Y. Times Quote of the Day ... Roger Toussaint, former head of the MTA's main union, on what he sees as a focus on flashy subway projects instead of maintenance: "They haven't been spending money on the spine. They've been spending money on the limbs."

P.S. "Conductors on [New York] subway trains have been told to stop addressing passengers as 'ladies and gentlemen' when making announcements about delays, detours or other things, and instead use the gender-neutral terms 'passengers,' 'riders,' and 'everyone.'" (AP)

Featured

Weinstein dominos, updated

Top: Harvey Weinstein, former Amazon Studios head Roy Price, director James Toback, New Orleans chef John Besh. Middle: fashion photographer Terry Richardson, New Republic contributing editor Leon Wieseltier, Mark Halperin, former Defy Media executive Andy Signore. Bottom: filmmaker Brett Ratner, Kevin Spacey, Jeremy Piven, Dustin Hoffman. (AP)

Some stories move so fast and far, we lose sight of the scale. So here's a freeze-frame on a defining story of our time: Men accused of sexual misconduct post-Weinstein, compiled by AP (click for details on each):

Entertainment:

  • Celebrity chef John Besh
  • Comedian Louis C.K.
  • Cinefamily executives Hadrian Belove and Shadie Elnashai
  • Actor Richard Dreyfuss: One woman alleges sexual harassment. He denies the allegation.
  • Director-producer Gary Goddard
  • Casting employee Andy Henry
  • Actor Dustin Hoffman: Accused by woman of sexual harassing when she was 17. He has apologized.
  • Actor Robert Knepper
  • Showrunner Andrew Kreisberg
  • Actor Jeremy Piven: Accused by three women of sexual misconduct. He denies all allegations.
  • Filmmaker Brett Ratner
  • Comedy festival organizer Gilbert Rozon
  • Producer Chris Savino
  • Actor Steven Seagal: Accused by two women of rape. He denies the allegations.
  • Actor Tom Sizemore: Accused of groping an 11-year-old actress in 2003. Utah prosecutors declined to file charges, citing witness and evidence problems. He denies the allegation.
  • Actor Kevin Spacey
  • Actor Jeffrey Tambor
  • Actor George Takei
  • Writer-director James Toback
  • "Mad Men" creator Matthew Weiner
  • Actor Ed Westwick

Media, publishing and business:

  • Billboard magazine executive Stephen Blackwell
  • Penguin Random House art director Giuseppe Castellano
  • New Republic publisher Hamilton Fish
  • Mark Halperin
  • Artforum publisher Knight Landesman
  • NPR news chief Michael Oreskes
  • Amazon executive Roy Price
  • Webster Public Relations CEO Kirt Webster
  • Rolling Stone publisher Jann Wenner: Accused by one man of sexual harassment. He says he did not intend to make the accuser uncomfortable.
  • New Republic editor Leon Wieseltier
  • NBC News booking exec Matt Zimmerman
Politics:
  • Sen. Al Franken (D-Minn.)
  • Senate candidate Roy Moore (R.-Ala.)
  • Florida Democratic Party Chairman Stephen Bittel: Accused of sexually inappropriate comments and behavior toward a number of women, Bittel resigned Friday.
  • Florida Democratic state Sen. Jeff Clemens resigned after a report that he had an extramarital affair with a lobbyist.
  • Florida Republican state Sen. Jack Latvala is being investigated by the Senate over allegations of harassment and groping. Latvala has denied the allegations.
  • Kentucky House Speaker Jeff Hoover
  • British Defense Secretary Michael Fallon
Sports:
  • International Olympic Committee member Alex Gilady
  • Former South African soccer association president Danny Jordaan
  • Former FIFA president Sepp Blatter
P.S. L.A. Times front page today: "[Brett] Ratner, [Russell] Simmons face new allegations of misconduct: Powerful Hollywood friends shared party lifestyle."
Featured

Senate tax plan's winners and losers

CNBC screen on the floor of the New York Stock Exchange. Photo: Richard Drew / AP

Winners, per AP's Marcy Gordon, beginning with a big win for wealthy individuals and their heirs:
  • Corporations win all around, with a tax rate slashed from 35% to 20% in both bills — though they'd have to wait a year for it under the Senate measure.
  • U.S. oil companies with foreign operations would pay reduced taxes under the Senate bill on their income from sales of oil and natural gas abroad.
  • Beer, wine and liquor producers would reap tax reductions under the Senate measure.
  • Companies that provide management services like maintenance for aircraft.

Losers:

  • An estimated 13 million Americans could lose health insurance coverage under the Senate bill, which would repeal the "Obamacare" requirement that everyone in the U.S. have health insurance.
  • People living in high-tax states would be hit by repeal of federal deductions for state and local taxes under the Senate bill, and partial repeal under the House measure. That's the result of a compromise allowing the deduction of up to $10,000 in property taxes.
  • Many families making less than $30,000 a year would face tax increases starting in 2021 under the Senate bill, according to Congress' nonpartisan Joint Committee on Taxation. By 2027, families earning less than $75,000 would see their tax bills rise, while those making more would enjoy reductions.
Featured

FBI report on "black identity extremists" raises civil rights fears

AP's Jon Elswick

"An FBI report on the rise of black 'extremists' is stirring fears of a return to practices used during the civil rights movement, when the bureau spied on activist groups," AP reports:

  • "The 12-page report, issued in August, says 'black identity extremists' are increasingly targeting law enforcement after police killings of black men ... It warned that such violence was likely to continue."
  • "Black leaders and activists were outraged after Foreign Policy revealed the existence of the report last month."
  • Why it matters: "The Congressional Black Caucus, in a letter to FBI Director Christopher Wray, said the report 'conflates black political activists with dangerous domestic terrorist organizations' and would further erode the frayed relationship between police and minority communities."
  • "A similar bulletin on white supremacists ... came out about the same time."
  • "The FBI noted it issued a similar bulletin warning of retaliatory violence by 'black separatist extremists' in March 2016, when the country had a black president, Barack Obama, and black attorney general, Loretta Lynch."
Featured

Life under Kim Jong-un

In Pyongyang, a North Korean uses his smartphone in front of portraits of the late leaders Kim Il Sung (left) and Kim Jong Il. (2015 photo by AP's Wong Maye-E)

In six months of interviews in South Korea and Thailand, Anna Fifield, the Washington Post's Tokyo bureau chief, talked with more than 25 North Koreans from different walks of life who lived in Kim Jong-un's North Korea and managed to escape. What she found:

  • "They paint a picture of a once-communist state that has all but broken down, its state-directed economy at a standstill."
  • "Today, North Koreans are making their own way, earning money in an entrepreneurial and often illegal fashion."
  • The "Aha!" moment: "Market activity is exploding, and with that comes a flow of information, whether as chitchat from traders who cross into China or as soap operas loaded on USB sticks. And this leads many North Koreans to dream in a way they hadn't before."
Featured

Every industry identifying its creeps

Participants at the #MeToo March in the Hollywood section of Los Angeles. Photo: Damian Dovarganes / AP

There has been an outpouring of sexual misconduct allegations in recent weeks, spanning from politics to the music industry and the restaurant business. Every industry is scrambling to identify the men behaving badly and do something about it.

Why it matters: It's a clear picture of just how widespread this problem is. From the TED talk empire, to Harvey Weinstein in Hollywood, and the U.K. defense secretary, there is no one industry or field that isn't affected by sexual harassment.

Politics

Tech

Restaurants

Advertising

Hollywood

Hotels

  • The Huffington Post reported a study that revealed a majority of Chicago-area hospitality industry employees had been sexually harassed by a guest, had a guest touch or try to touch them, and more.

Science

  • Sexual harassment in the field of scientific research is prevalent, per Vox, when studies occur in remote workplaces (like Antarctica).

Music

  • Kirt Webster, major country music publicist, left his company after sexual assault allegations.

Media

  • Mark Halperin lost his book and HBO show deal, as well as contributing position with MSNBC, after five women accused him of harassment during his time at ABC.
  • NPR news chief Michael Oreskes resigned after two women accused him of sexual misconduct and harassment.
  • New Republic literary editor Leon Wieseltier lost financial backing on his coming magazine after being accused of sexual harassment.

Fashion

Sports