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As the clock ticks toward Jan. 20, 2017, the Obama administration is racing to burnish its health care legacy, introducing major new initiatives that will take full effect just weeks before the president leaves office. The ranks of the uninsured have dropped dramatically since the passage of the Affordable Care Act six years ago. But administration officials are now hustling to use other parts of the law to reshape how health care itself is delivered across the United States. They’re trying to tackle the biggest health care issue of the day — drug prices — and setting ambitious goals for revamping how primary care is provided. They have also undertaken significant new efforts when it comes to paying for surgeries and preventing disease. (Scott, 5/10)

No one in Washington is going to be shocked if insurers request double-digit increases in premiums on exchanges. That’s partially because ahead of Wednesday’s filing deadline, Democrats are making a lot of efforts to control the narrative. Their talking point plan will take them through the November election, which coincidentally occurs right after final insurance rates will be posted for 2017. Even if there are large increases at that point, Democrats plan to argue they are still the party to go with on health care issues. They are up against heavy messaging from the right opposing the health care law. (Owens, 5/10)

Investors got an update last week on the progress of two giant health insurer mergers that, if regulators approve, will shrink the number of major insurers in the U.S. from five to three. On Friday Cigna (CI), the nation's fourth-largest health insurance company, which agreed to be acquired by Anthem (ANTM), the No. 2 health insurer, announced that the deal, scheduled to close by the end of 2016, may be delayed into 2017. (5/11)

California’s health insurance exchange estimates that its Obamacare premiums may rise 8 percent on average next year, which would end two consecutive years of more modest 4 percent increases. The projected rate increase in California, included in the exchange’s proposed annual budget, comes amid growing nationwide concern about insurers seeking double-digit premium hikes in the health law’s insurance marketplaces. Any increases in California, a closely watched state in the health law rollout, are sure to draw intense scrutiny during a presidential election. Republicans are quick to seize on rate hikes as further proof that President Obama’s signature law isn’t doing enough to hold down health care costs for the average consumer. (Terhune, 5/11)