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Illustration: Rebecca Zisser / Axios

Throughout this summer's effort to repeal and replace the Affordable Care Act, Republican senators outlined a treasury of specific provisions they needed to see tweaked, added or eliminated in order to win their support. The latest effort, from Sens. Lindsey Graham and Bill Cassidy bill addresses almost none of them.

A quick rundown of some one-time must-haves that have gone missing:

  • A soft landing: Republicans went back and forth last time about how to gradually phase out the ACA's Medicaid expansion; which formula to use in setting new caps on the program's spending; and how to make new premium subsidies more generous. Graham-Cassidy comes with a steep cliff after which all funding for both the subsidies and Medicaid expansion would disappear.
  • Opioid funding: A former must-have for moderate Republicans, it's not in the new bill at all.
  • Taxes: Conservatives like Sens. Tom Cotton, Pat Toomey and David Perdue have complained about the ACA's taxes for years. Graham-Cassidy would leave many of the ACA taxes in place (a big reason why Sen. Rand Paul opposes it).
  • Pre-existing conditions: Any number of Republican senators said they wanted to retain the ACA's protections for people with pre-existing conditions. Graham-Cassidy would let states waive parts of those regulations.
  • Coverage estimates: The Congressional Budget Office said yesterday it will be able to determine whether the bill would meet the Senate's budget rules, but could not deliver estimates next week about its effects on premiums, the federal deficit, or the number of uninsured Americans.
  • A clear path through the House: The House has way more Republicans from blue states than the Senate does. Some representatives from New York have already raised concerns, and we're sure to hear more from California, New Jersey, Michigan and other states do the same.

Go deeper

Updated 1 hour ago - Science

Huge wildfire reaches edge of Sequoia National Park

A plume of smoke and flames rise into the air as the fire burns towards Moro Rock during the KNP Complex fire in the Sequoia National Park near Three Rivers, California, on Saturday. Photo: Patrick T. Fallon/AFP via Getty Images

Firefighters in Sequoia National Park were working into the night after two wildfires merged to reach the Giant Forest Saturday.

Why it matters: This forest contains over 2,000 giant sequoias, including the General Sherman Tree — the world's largest tree by volume. Park officials wrapped the redwoods in foil last week as the Paradise and Colony Fires, now known as the KNP Complex Fire, neared. Protection efforts appeared to be working overnight.

2 hours ago - World

Hong Kong holds first "patriots only" elections

Hong Kong Chief Executive Carrie Lam during a news conference last Monday. Photo: Lui Siu Wai/Xinhua via Getty Images

Hong Kong's elections to choose the city's Election Committee members opened to a select group of voters on Sunday, under a new "patriots only" system imposed by China's government.

Why it matters: All candidates running to be members of the electoral college have been "vetted" by Beijing, per Reuters. They will go on to choose the Asian financial hub's next leader, approved by China's government, and some of its legislature.

4 hours ago - World

Israeli forces capture final 2 escaped Palestinian prisoners

An Israeli security forces member on Saturday stands guard at the Gilboa prison in northern Israel, from where the six inmates escaped. Photo: Ahmad Gharabli/AFP via Getty Images

Israeli forces captured the two remaining Palestinian prisoners who tunneled their way out of an Israeli maximum-security prison with four others in a "Shawshank Redemption"-style escape, authorities announced Sunday.

Why it matters: The escape sparked a massive manhunt and turned the prisoners into heroes in the West Bank and Gaza, with Hamas and Islamic Jihad in Gaza threatening an escalation if they were harmed, per Axios' Barak Ravid.