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Anthem Inc. is pushing for a speedy decision on the government’s bid to block the health insurer’s planned $48 billion merger with rival Cigna Corp. The government doesn’t want that, and on Wednesday its lawyers told a federal judge the case is too complex to rush a ruling. Justice Department lawyers told U.S. District Judge John D. Bates in Washington that the antitrust case they filed last week is far more complicated than a coal company lawsuit that Anthem attorneys cited on Monday as an example of what could be done. (Harris, 7/28)

The pullback by Blue Cross and Blue Shield of Minnesota from the state's individual market has prompted competing health insurers to consider if they need higher premiums for 2017. As a result, an expected release of preliminary rate requests that was planned for Monday isn't going to happen, state officials said Thursday. It's now likely the premium proposals will be posted by Sept. 1. (Snowbeck, 7/28)

Blue Cross Blue Shield of Texas wants to cover gender reassignment surgery in plans sold on HealthCare.gov. And the state’s largest insurer noted the change in the same filing that calls for increasing next year’s premiums by almost 60 percent on individual plans. ... Studies show that extending coverage to transgender people has a tiny impact on health costs. While surgery is expensive, up to $89,000, few people get it. And those “in transition” often receive hormone treatments or other less expensive therapies. (Schnurman, 7/28)

Noah [Smart] has a feeding pump, a suction machine, and needs oxygen, his father says. These needs are highly complex, and while some members of Noah’s makeshift support system have medical skills — Brian’s mother is a retired registered nurse, the au pair has a nursing license from the Philippines — everyone agrees this care system is not sustainable. “Ideally, we would want a nurse 24 hours a day,” Brian says, although he also says they’d take even 8-hour support. But trying to access that level of care has been a months-long odyssey. (Katz, 7/28)