Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Denver news in your inbox

Catch up on the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Des Moines news in your inbox

Catch up on the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Minneapolis-St. Paul news in your inbox

Catch up on the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tampa Bay news in your inbox

Catch up on the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Charlotte news in your inbox

Catch up on the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Greg Ruben / Axios

Republicans on the Hill are taking a close look at an idea they believe could actually expand health coverage: just enroll everyone in a health plan unless they opt out.

Hill staffers and conservative health wonks have been tossing the idea around for awhile as a way to replace Obamacare's individual mandate while continuing to cover everyone with pre-existing conditions — something that becomes too expensive without healthy people to cover the costs. Many now point to auto-enrollment as one of the best ways to cover more people without bleeding federal dollars.

The goal: By automatically enrolling people into a basic insurance plan, some Republicans hope to create a new system where coverage is the default for everyone. The idea is a feature of some of the leading Obamacare replacement plans, including a bill by Sen. Bill Cassidy and Rep. Pete Sessions and a white paper by the American Enterprise Institute.

Trump's HHS nominee: Tom Price included auto-enrollment in employer coverage in his Obamacare replacement plan, another sign the idea could gain traction.

There's no consensus that this is the way forward, but "there's a lot of work being done to look into it," said a senior GOP aide.

How it would work: People who don't get health insurance from another source, like an employer, would be enrolled in a bare-bones plan.

It would have the same value as the financial help uninsured people would get — meaning the federal government would cover the cost of the premium, so enrollees would get coverage for free. But they could buy better coverage if they want it.

The catch: This could be a workable policy idea, but it's a political and logistical nightmare. While some Republicans are on board with the idea already, it's going to take some clever messaging to convince small-government conservatives an automatic enrollment policy is less intrusive than an insurance mandate.

The key, supporters say, is to cover the costs. As long as that's done, "it's not viewed as a harmful mandate, because there's no consequence" to someone who doesn't enroll, said the GOP aide.

Here are some outstanding questions and concerns, raised by both liberal and conservative health wonks:

  • Figuring out who to automatically enroll is an insane task. Basically, it would require coming up with a list of everyone in the country and then comparing that to the list of everyone who has private insurance, Medicare or Medicaid.
  • Private insurers have to agree to participate. Figuring out how it actually works — and how insurers can turn a profit — would be complicated. "You'd have to find a way to make sure, if there's more than one insurer, that the actual expenses of covering these upper-end costs for people pretty much balances out with a reasonable profit margin," said Joe Antos, a conservative health economist and a member of the Axios board of experts.
  • Liberals still think the mandate is the better option. "I think more people would opt out of enrollment than would take a fine with the individual mandate," said Jonathan Gruber, an MIT economics professor who consulted on Obamacare. But "it's better than nothing."
  • The default health plan would be very skimpy coverage. Deductibles would probably be at least $10,000, and many services wouldn't be covered — meaning people would have to pay for a lot of medical costs themselves. "I don't think that's going to fly with the American public," since high deductibles are already one of the biggest complaints about Obamacare, Gruber said.
  • It probably would help keep the individual market balanced. That's not nothing — it's better than a market meltdown. But don't expect the customers to be happy with what they're getting. "The best case scenario is a stabilized market for shitty insurance," Gruber said.
  • This isn't a money-saving idea for the government. At least not if it's going to work, Antos said. "It's a way of stabilizing the individual market. But if it's also going to be used as a way to save billions of dollars, then it's not going to save the individual market."

Our thought bubble: This seems to solve the GOP's biggest problems, but if there's a reason it doesn't go anywhere, it's because not enough members know about it or understand it.

Go deeper

Justice Department drops insider trading inquiry against Sen. Richard Burr

Sen. Richard Burr (R-N.C.) walking through the Senate Subway in the U.S. Capitol in December 2020. Photo: Stefani Reynolds/Getty Images

The Department of Justice told Sen. Richard Burr (R-N.C.) on Tuesday that it will not move forward with insider trading charges against him.

Why it matters: The decision, first reported by the New York Times, effectively ends the DOJ's investigation into the senator's stock sell-off that occurred after multiple lawmakers were briefed about the coronavirus' potential economic toll. Burr subsequently stepped down as chair of the Senate Intelligence Committee.

Netflix tops 200 million global subscribers

Illustration: Rebecca Zisser/Axios

Netflix said that it added another 8.5 million global subscribers last quarter, bringing its total number of paid subscribers globally to more than 200 million.

The big picture: Positive fourth-quarter results show Netflix's resiliency, despite increased competition and pandemic-related production headwinds.

Janet Yellen plays down debt, tax hike concerns in confirmation hearing

Treasury Secretary nominee Janet Yellen at an event in December. Photo: Alex Wong via Getty Images

Janet Yellen, Biden's pick to lead the Treasury Department, pushed back against two key concerns from Republican senators at her confirmation hearing on Tuesday: the country's debt and the incoming administration's plans to eventually raise taxes.

Driving the news: Yellen — who's expected to win confirmation — said spending big now will prevent the U.S. from having to dig out of a deeper hole later. She also said the Biden administration's priority right now is coronavirus relief, not raising taxes.