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Sen. Ben Sasse (R-Neb.) is ramping up his vow to block all of President Obama’s health-related nominees until he gets answers about the failure of ObamaCare co-op plans. Twelve of the 23 co-ops — nonprofit health insurers set up under ObamaCare and meant to compete with established companies — have failed because of financial problems. Sasse has demanded answers from the Department of Health and Human Services (HHS) about why the co-ops are failing but said he had heard nothing. He now plans to use Robert Califf’s nomination as Food and Drug Administration commissioner as leverage. (Sullivan, 11/18)

A federal investigation into Washington-style insider trading got the green light to continue this week when a judge ruled that congressional staff must provide information to investigators about possible leaks of sensitive information to investors. ... The investigation has focused attention on a relatively new and highly lucrative form of Washington consulting in which “political intelligence” firms leverage their connections on Capitol Hill and inside executive agencies to provide investors with special insights to inform their trading decisions. That Washington-to-Wall Street communication is at the heart of the SEC investigation into the health-insurance stock surge. The episode began after a Washington-based firm, Height Securities, published an alert to clients on April 1, 2013, predicting an imminent change in a rule governing health insurance companies participating in a Medicare program. (Hamburger, 11/18)

Republicans and Democrats showed rare unity in a hearing over competition among pharmacy benefit managers, combining their attacks against companies for contributing to soaring drug prices and trampling independent pharmacies. The House Judiciary Regulatory Reform, Commercial and Antitrust Law Subcommittee, which has maintained a focus on a rapidly consolidating health care industry, turned its attention on Tuesday to these specialized companies that typically negotiate discounts and rebates with drug manufacturers for their clients. (Chamseddine, 11/18)

In recent days, the largest managers of private prescription drug benefits in the U.S. have cut off at least eight pharmacies that work closely with drugmakers, intensifying scrutiny of a system that helps inflate drug prices, officials at the benefit managers told Reuters. The terminations come from payers who together manage drug benefits for more than 100 million Americans, and they follow disclosures by Valeant Pharmaceuticals International Inc. in late October that one pharmacy accounted for about 7 percent of its sales. (Humer and Beasley, 11/18)