"The Trump administration's recent move to abandon its legal defense of protections for people with pre-existing conditions has launched the latest battle in the health-care war. The decision, which is already a 2018 midterm topic, signifies that the fight over the direction of the health system will undoubtedly continue into the 2020 presidential election." — Jeanne Lambrew, The Century Foundation

Health insurers are finding success in Obamacare this year and are planning to expand their offerings in many states, defying expert's predictions. Insurance startup Oscar Health filed to sell Obamacare plans in Florida, Arizona, and Michigan for the first time, and will enter new markets in Ohio, Tennessee and Texas. Smaller insurers are also making moves, such as Bright Health in Tennessee and Presbyterian Healthcare in New Mexico. It will be the first time Bright Health is selling plans in Tennessee, while Presbyterian is returning to the state exchange after leaving in 2016. Experts have been hailing these developments, saying that insurers have finally figured out how to become profitable in the Obamacare marketplace. (Nathaniel Weixel, The Hill)

Since the early 2000s, employers have mostly embraced high-deductible health plans. The thinking has been that requiring workers to shoulder more of the cost of care will also encourage them to cut back on unnecessary spending. But it didn't work out that way. In the wake of the 2008 financial crisis, many families were hard-pressed to meet their soaring health insurance deductibles. At the same time, studies show that many put off routine care or skipped medication to save money. That can mean illnesses that might have been caught early can go undiagnosed, becoming potentially life-threatening and enormously costly for the medical system. (John Tozzi and Zachary Tracer, Bloomberg News)

The first Sunday after his inauguration, New Jersey Gov. Phil Murphy signed an executive order directing state agencies to report everything they could do to ramp up the visibility of the Affordable Care Act and persuade more people to buy health coverage under the law. Four months later, the Democratic governor signed into law a requirement that makes New Jersey the first state in a dozen years to compel most residents to carry insurance. As bureaucrats in Trenton scramble to set the mandate in motion, New Jersey’s decisions are at the forefront of a nascent movement with states stepping out on their own to counteract Washington’s efforts to erode the ACA. Taken together, the moves mean the nation is starting to revert to the insurance landscape of a decade ago—a hodgepodge that created the political pressures that culminated in the sweeping 2010 law. At the time, Americans’ ability to find and afford decent health plans, especially if they could not get one through a job, depended on where they lived and whether they were healthy or sick. (Amy Goldstein, Washington Post)

Amazon said on Thursday it would buy small online pharmacy PillPack, a move that will put the world's biggest online retailer in direct competition with drugstore chains, drug distributors, and pharmacy benefit managers. The deal's potential to disrupt major players across the drug supply chain nationwide prompted a sell-off in shares of possible rivals, while sending Amazon shares up 2.5 percent. PillPack supplies pre-sorted prescription drugs and other services to people who take multiple medications, a growing market as the U.S. population ages and requires treatment for multiple complex, chronic conditions. (Ankur Banerjee and Bill Berkrot, Reuters)

A wave of breakthrough drugs is transforming the medical world, offering hope for people with deadly diseases despite their dizzying price tags. But what if it turns out that some of these expensive new drugs don't work that well? That's the quandary over Orkambi, a drug that was approved in 2015 for cystic fibrosis and was only the second ever to address the underlying cause of the genetic disease. Orkambi, which is sold by Vertex Pharmaceuticals, costs $272,000 a year, but has been shown to only modestly help patients. Now, in a case that is being closely watched around the country, New York state health officials have said Orkambi is not worth its price, and are demanding that Vertex give a steeper discount to the state's Medicaid program. The case is the first test of a new law aimed at reining in skyrocketing drug costs in New York's Medicaid program. (Katie Thomas, New York Times)

Members of the Senate Finance Committee on Tuesday called on the Trump administration to use stronger tactics to curb high drug prices than its tempered strategy unveiled last month. In its first hearing on the White House's drug pricing blueprint, lawmakers on both sides of the aisle pushed for price controls and broad-strokes negotiation. The central focus of the White House's proposal is moving Medicare Part B drug purchasing to the Medicare Part D model, in which prices are negotiated by pharmacy benefit managers. (Susannah Luthi, Modern Healthcare)

A Yale study found that one in four patients admitted to cutting back on insulin use because of cost. The consequences can be deadly. A surprisingly large number of people with diabetes are using less insulin than prescribed because of the rising cost of the drug, putting themselves in danger of serious complications. The study found that at one clinic in New Haven, Conn., one in four patients admitted to cutting back on insulin use because of cost. Not getting enough insulin can have severe consequences for someone with diabetes who does not produce enough of the hormone, which regulates levels of glucose in the blood. (Randi Hutter Epstein, M.D. and Rachel Strodel, New York Times)

For decades Republicans succeeded where Democrats have failed, in making court nominations a motivating force at election time — turning out religious conservatives with the promise that Republican candidates would support Supreme Court justices opposed to Roe vs. Wade, the decision that guaranteed a nationwide right to abortion. Now, with Trump poised to tip the Supreme Court's balance decidedly rightward, Democrats' hope lies in shaking their own voters' complacency about that 45-year-old ruling. (Jackie Calmes, Los Angeles Times)

American political dynamics around health care and other issues could be changed by a U.S. Supreme Court decision Wednesday that significantly weakens public-sector labor unions. In a ruling with major ramifications for health care organizations, a bitterly split high court ruled that public-sector unions cannot collect mandatory service fees from members for representing them in contract negotiations.Unions are one of the strongest political forces advocating for protecting Medicare, Medicaid and other social programs. Overall, nearly 1.5 million workers in health care occupations are represented by unions, according to the U.S. Bureau of Labor Statistics. (Harris Meyer, Modern Healthcare)

The White House is proposing to reduce by nearly 40 percent the uniformed public health professionals who deploy during disasters and disease outbreaks, monitor drug safety, and provide health care in some of the nation's most remote and disadvantaged areas. The proposal is part of a plan announced last week by the Office of Management and Budget to overhaul the federal government. It would cut the size of the U.S. Public Health Service Commissioned Corps from its current 6,500 officers to "no more than 4,000 officers." Administration officials, who have said the officers are "more expensive" than equivalent civilians, want "a leaner and more efficient organization" better prepared to respond to public health emergencies. They have not offered projections on how much might be saved.  (Lena H. Sun, Washington Post)