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The Senate health care bill is expected to allow states to relax the Affordable Care Act rules only on benefits, not on pricing as the House bill does. But that change could impact people far beyond those states, according to a new analysis by the liberal Center for American Progress — because it could lead to a return of annual and lifetime benefit limits, and not just in the states with the waivers.

The bottom line: As many as 27 million Americans could face annual limits on their coverage, and 20 million could be hit with lifetime limits, according to the analysis.

Expand chart
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Data: CAP analysis, 2015 American Community Survey, Centers for Medicare & Medicaid Services, 2017 Willis Towers Watson Survey; Table: Andrew Witherspoon / Axios

Why it could happen: The Affordable Care Act bans lifetime and annual limits, but only for the 10 categories of "essential health benefits" defined in the law. If a state decides that, say, prescription drugs or maternity care aren't essential benefits anymore, insurers can bring back annual and lifetime limits for them.

Why it could spread beyond those states: Large employers that operate in several states can choose which state they want to use as the basis for their benefits. So if an employer operates in 15 states, and one of them has a waiver from ACA benefit rules, it can set all of its benefits based on that state.

How the study was done: CAP based its estimates on a Willis Towers Watson survey of large employers, in which 20 percent said they'd bring back annual limits and 15 percent said they'd bring back lifetime limits if the ACA rules were repealed. It also used survey data suggesting how many people get their health insurance from large employers.

Go deeper

Biden administration reinstates fast-track deportation flights

Guatemalan immigrant Yamari Yaneli, 1, waits with her family for U.S. Border Patrol agents to transport them to a processing center. Photo: John Moore/Getty Images

The Biden administration on Friday resumed fast-track deportation flights to Central America, the Department of Homeland Security announced.

The big picture: Officials said Monday that they were planning to resume "expedited removal flights" following an increase in the number of migrants crossing into the Rio Grande Valley of South Texas, the Washington Post reports.

More corporations are requiring workers to get vaccinated

Graphic: Axios Visuals

Life for the unvaccinated could get more difficult as bosses increasingly move to make COVID-19 vaccines mandatory.

The big picture: The federal Government in May said that it is legal for companies to require employees to get vaccinated for coronavirus.

White House: Over 500,000 new shots recorded Friday, highest since July 1

Photo: Anna Moneymaker/Getty Images

The United States recorded more than half a million new COVID-19 vaccine shots on Friday, the highest number since July 1, White House deputy press secretary Karine Jean-Pierre said.

Why it matters: The Delta variant is continuing to spread across the United States and it now comprises over 80% of the coronavirus cases in the country, Jean-Pierre said. A report from the Centers for Disease Control and Prevention noted that "vaccination is the most important strategy to prevent severe illness and death."

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