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Rebecca Zisser / Axios

It looks like the House Republican health care bill may be coming back to life after all. And if the leadership is this close to having 216 votes, they may well get the rest when the roll call starts. But don't get the impression this means the Affordable Care Act repeal effort is alive and well. This is Republicans just scraping by, getting a deeply unpopular bill off of their plates as quickly as they possibly can.

The debate in two quotes:

  • "The president has worked to make sure that in every single scenario, anybody — everybody — he has kept true to his word that pre-existing conditions are covered." — White House press secretary Sean Spicer
  • "Hey GOP, don't ever lecture us again on fiscal responsibility. You're about to reorder 1/6 of the US economy w no idea what it costs." — Tweet from Democratic Sen. Chris Murphy

Here's what to keep in mind for today's vote:

  • The bill is now a patchwork of classic Republican health care ideas mixed in with just enough concessions to conservatives and moderates to attract the bare minimum votes that they need.
  • The final change, the one that won the votes of Rep. Fred Upton and a few others, was an $8 billion fund created by an amendment that no one outside of a handful of Republicans even saw before last night.
  • The House will vote on this version of the Affordable Care Act replacement without a Congressional Budget Office estimate, and therefore no idea what it costs, how many people it might help, or how many it might hurt.
  • What Republicans will gain from this vote: They'll be able to say they didn't give up on their campaign promises to get rid of Barack Obama's health care law.
  • They'll also be able to put some of their ideas into practice, like lowering insurance prices through competition and flexibility.
  • In an op-ed for CNBC last night, Health and Human Services secretary Tom Price noted that it will also give states waivers from some of the ACA's insurance rules, "based on the insight — gleaned from experience, not partisan ideology — that the people closest to a problem are best equipped to fix it."
  • But any Republican who votes for this bill is also taking a lot of risks. They're voting for waivers from the ACA's ban on charging higher premiums to sick people, as well as waivers from the minimum benefits it requires insurers to cover.
  • They're also voting for $880 billion in Medicaid cuts over 10 years.
  • And — based on the original CBO estimate — they're voting for a bill that could cover 24 million fewer people.

Go deeper

1 hour ago - World

Scoop: Iran preparing to enrich weapons-grade uranium, Israel warns U.S.

Iranian President Ebrahim Raisi holds a press conference. Photo: Presidency of Iran handout via Getty

Israel has shared intelligence over the past two weeks with the U.S. and several European allies suggesting that Iran is taking technical steps to prepare to enrich uranium to 90% purity — the level needed to produce a nuclear weapon, two U.S. sources briefed on the issue tell me.

Why it matters: Enriching to 90% would bring Iran closer than ever to the nuclear threshold. The Israeli warnings come as nuclear talks resume in Vienna, with Iran returning to the negotiating table on Monday after a five-month hiatus.

Biden: Fight against Omicron won't include "shutdowns or lockdowns"

Photo: Mandel Ngan/AFP via Getty Images

President Biden on Monday said that the new coronavirus variant, Omicron, is "a cause for concern, not a cause for panic."

Driving the news: Biden said later this week the administration will be releasing a strategy on how "we're going to fight COVID this winter. Not with shutdowns or lockdowns, but with more widespread vaccinations, boosters, testing and more."

Updated 2 hours ago - Politics & Policy

Omicron dashboard

Illustration: Aïda Amer/Axios

  1. Health: WHO says Omicron poses "very high" risk — Fauci says Omicron variant will "inevitably" be found in U.S. — U.S. restricts air travel from 8 countries over Omicron concerns.
  2. Politics: Biden says fight against Omicron won't include "shutdowns or lockdowns."
  3. States: New York declares state of emergency amid concerns over Omicron.
  4. World: Omicron adds urgency to vaccinating worldWHO warns against travel bans on southern African countries — First North American Omicron cases identified in Canada.
  5. Variant tracker: Where different strains are spreading.