 Welcome to Monday’s Overnight Health Care, where it’s just one day until Election Day! Health care is front and center in the final stretch. The pandemic is getting worse and cases are rising to historic levels across the country, but President Trump said he might fire Anthony Fauci. Meanwhile, Georgia got permission to end healthcare.gov in the state. Let’s start with Trump. Trump suggests he may fire Fauci after election President Trump suggested at a campaign rally late Sunday that he may attempt to fire Anthony Fauci after Election Day, escalating his criticism of the nation’s top infectious diseases expert. Trump’s remarks came after his supporters in Opa-Locka, Fla., broke out into loud chants of “fire Fauci.” “Don’t tell anybody, but let me wait until a little bit after the election,” Trump responded to the crowd. “I appreciate the advice. I appreciate the advice. No, he's been wrong though a lot. He's a nice man though. He's been wrong on a lot,” Trump continued. More than 230,000 people in the U.S. have died from COVID-19 to date, and cases are rising to historic levels in numerous states. Despite this, Trump has expressed frustration that the virus continues to dominate the news coverage. Backstory: It's not clear just how serious Trump is about trying to remove Fauci, but it's far from the first time he has criticized the country's top infectious disease doctor. Tensions between Trump and Fauci, who was a regular fixture at White House coronavirus briefings earlier this year, have been building for months due to the president’s handling of the coronavirus pandemic and disregard for public health guidelines. Fauci’s willingness to contradict Trump publicly has made him a target of the president’s allies and supporters Read more here. Related: Obama rips Trump over suggestion that he may fire Fauci And a big picture look from our colleague Reid Wilson’s On the Trail column: A campaign defined by a pandemic After eight months of downplaying the threat of a pandemic that has killed nearly a quarter-million of his constituents, President Trump faces voters Tuesday in an election that has become all about a virus that is running unchecked throughout the nation. The number of confirmed COVID-19 cases is racing toward a third apex, one that has already surpassed the first two spikes in April and July. Nearly 100,000 people are testing positive each day in the U.S., and hospital capacity is being strained in states across the Upper Midwest and the Mountain West. Case counts are rising in 45 states and the District of Columbia. The Covid Exit Strategy, a group of independent analysts, rates the spread of the virus as uncontrolled in all but one swing state; the lone exception, Georgia, is “trending poorly.” “It’s hard to imagine a worse confluence. Cases are surging in most of the United States,” said Tom Frieden, director of the Centers for Disease Control and Prevention (CDC) during the Obama administration who now runs Resolve to Save Lives, a global health nonprofit. “One of the most startling things is just how deeply incompetent the U.S. federal response has been.” Read more here. Trump officials approve Georgia plan to remove healthcare.gov as enrollment option In a campaign focused on health care in the final days, the Trump administration had one more action. It announced on Sunday evening that it approved Georgia’s proposal to eliminate the federal healthcare.gov website as a path to enroll in health insurance, instead directing people to private brokers and insurers. The Trump administration and Georgia Gov. Brian Kemp (R) argue the move will increase innovation from the private sector, but Democrats denounced the move as creating confusion for consumers that will result in some people losing coverage. The move would make Georgia the first state to have no government-run website to enroll in ObamaCare coverage, starting in 2023. The federal Centers for Medicare and Medicaid Services (CMS) said in a statement Sunday that this approach will “drive improvements in the consumer shopping and enrollment experience as the market innovates to meet consumer preferences.” However, enrolling through insurers and brokers is already an option, so Democrats said the move would simply take away the option of healthcare.gov for Georgians looking to enroll in ObamaCare coverage, without adding anything new. Read more here. Biden and Trump closing arguments diverge sharply on COVID-19 A little more than 24 hours before polls close, President Trump and Democratic nominee Joe Biden are digging in on their vastly different coronavirus messages. For weeks, the dissonance between the two candidates has been unmistakable on an issue that has defined the campaign and remains one of the top issues for many voters. Even as COVID-19 cases rise to record levels across the nation, Trump is pressing ahead with large-scale campaign rallies, showing no signs of backing off his plans to hold 14 major campaign gatherings in the three days leading up to the election. Along the way, he is calling on states to lift public health restrictions in order to boost the economic recovery and raising unrealistic expectations about the development of an effective vaccine and therapeutics. Biden, meanwhile, is laser focused on using the final days of the campaign to hammer Trump over his administration’s response to a virus that has killed more than 230,000 people in the U.S. The majority of Americans disapprove of the way Trump has handled the public health crisis. Polls show that voters trust Biden to handle the coronavirus more than they do Trump, who is lagging behind the former vice president in national and most swing state polling. Despite that, Trump has not adjusted his rhetoric, repeatedly minimizing the threat posed by the coronavirus, questioning the efficacy of masks and disagreeing publicly with the advice of top experts. Read more here. A preview of next year if Democrats sweep tomorrow: Pelosi says Democrats would fast-track ObamaCare, COVID-19 aid next year Speaker Nancy Pelosi (D-Calif.) said Monday that, given control of both chambers of Congress next year, Democrats intend to fast-track legislation to strengthen ObamaCare and provide coronavirus relief. To do so, they would lean on a special budget procedure, known as reconciliation, that empowers the majority party in the Senate to move legislation with just a simple majority — a move that would erase the minority party's filibuster powers. Democrats have vowed throughout this year's campaign to strengthen the Affordable Care Act (ACA) and deliver more federal help to tackle the dual crises of health and economy caused by the coronavirus pandemic. Pelosi said they can do both via reconciliation. "It is a budget bill, it is consistent with the rules of the House and the Senate that you can pass a bill under reconciliation," she said during a health care forum with Protect Our Care, a liberal advocacy group. "And we most certainly will be passing a reconciliation bill, not only for the Affordable Care Act, but for what we may want to do further on the pandemic, and some other issues that relate to the well-being of the American people." Read more here. What We're Reading: Trump’s dismissal of Covid risk paved way to White House outbreak (Bloomberg) ‘His lies are killing my neighbors’: swing-state health workers try to defeat Trump (Kaiser Health News) Will Fauci have a job? Will the public regain trust in the FDA? 8 of the scientific institutions and traditions on the line on Tuesday (Stat News) State by State: Virus rate fell to 2% from 34% in one area. But did anything change? (New York Times) Surge in coronavirus cases straining Nebraska hospitals (AP) Colorado nursing homes still face shortage of masks, gloves to fight COVID-19 (Denver Post) Op-eds in The Hill: Serious public health issues face next president | 
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