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Seth Wenig / AP

Hemophilia groups filed a civil rights complaint Tuesday against health insurer Wellmark for preventing patients with the disorder from accessing coverage under the Affordable Care Act to avoid paying the expensive medical bills, per Washington Examiner.

The complaint, filed by the National Hemophilia Foundation, the Hemophilia Federation of America and Hemophilia of Iowa, claims that Wellmark discriminated against patients with hemophilia — which keeps blood from clotting, and can require expensive infusions of protein — first by limiting coverage to only certain counties in Iowa, and later by stating it was pulling out of the Iowa marketplace altogether in 2018.

Why it matters: The groups argue that Wellmark's actions could open the door for other insurance agencies to dodge paying for pre-existing illnesses.

Wellmark's defense: The agency has pointed to one patient with hemophilia, whose care reportedly costs $1 million a month, to highlight the problems facing the Iowa individual health insurance market. Wellmark has also stated that it would consider re-entering Iowa's ACA exchange if the state approves the agency's proposal for a federally-funded reinsurance program, which would help manage the steep medical costs.

Big picture: The case shows the underlying struggle health insurers face to fulfill the ACA's goal of covering sick people instead of separating them out into high-risk pools. Looking ahead, insurers will likely pressure Congress for changes to help them absorb the costs of expensive patients more easily.

Go deeper: Axios' David Nather covered Iowa's $12 million patient in a June version of his Vitals newsletter.

Go deeper

Updated 7 hours ago - World

Mexican President López Obrador tests positive for coronavirus

Mexico's President Andrés Manuel López Obrador during a press conference at National Palace in Mexico City, Mexico, on Wednesday. Photo: Ismael Rosas/Eyepix Group/Barcroft Media via Getty Images

Mexican President Andrés Manuel López Obrador announced Sunday evening that he's tested positive for COVID-19.

Driving the news: López Obrador tweeted that he has mild symptoms and is receiving medical treatment. "As always, I am optimistic," he added. "We will all move forward."

7 hours ago - Politics & Policy

Sarah Huckabee Sanders to run for governor of Arkansas

Sarah Huckabee Sanders at FOX News' studios in New York City in 2019. Photo: Steven Ferdman/Getty Images

Former White House press secretary Sarah Huckabee Sanders will announce Monday that she's running for governor of Arkansas.

The big picture: Sanders was touted as a contender after it was announced she was leaving the Trump administration in June 2019. Then-President Trump tweeted he hoped she would run for governor, adding "she would be fantastic." Sanders is "seen as leader in the polls" in the Republican state, notes the Washington Post's Josh Dawsey, who first reported the news.

Coronavirus has inflamed global inequality

Illustration: Aïda Amer/Axios

History will likely remember the pandemic as the "first time since records began that inequality rose in virtually every country on earth at the same time." That's the verdict from Oxfam's inequality report covering the year 2020 — a terrible year that hit the poorest, hardest across the planet.

Why it matters: The world's poorest were already in a race against time, facing down an existential risk in the form of global climate change. The coronavirus pandemic could set global poverty reduction back as much as a full decade, according to the World Bank.

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