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It has been a hard couple of weeks for Obamacare. The law’s online marketplaces — where people were supposed to be able to easily shop for health insurance — have been suffering from high-profile defections and double-digit premium increases. Critics of Obamacare have pointed to the recent problems as proof the market is not working, while even the law’s staunchest defenders are arguing that the marketplaces need some fixes. Here are four key challenges to the program and a survey of some possible solutions. (Reed Abelson and Margot Sanger-Katz, 8/29)

Problems in the Affordable Care Act marketplaces are the big story in health care, spurred by Aetna’s pullback in participation. With headlines questioning whether these problems mean the ACA is “failing,” let’s take a step back for perspective. The marketplaces have a special role in health insurance, and they face real challenges, but they are a modest part of the overall insurance system. They are also only one part of the ACA – if an important part – and they are not having trouble in all states. (Drew Altman, 8/29)

The last few weeks have featured a great deal of news for Obamacare, most of it bad. Insurers are pulling out of the exchanges and premiums are rising. Coverage has been expanded, but it increasingly looks as if that coverage will mostly consist of companies taking their Medicaid managed care plans and repackaging them for private customers. Call it “Medicaid with premiums.” Or worse, that the exchanges will enter into a cycle of premiums rising and healthier customers dropping their insurance, until some markets have no insurance available at all. (Megan McArdle, 8/29)

Why did the Mylan execs raise the price of an old treatment sixfold? Because they could get away with it. Why could they get away with it? Because the United States Congress let them. The U.S. is the only advanced country that doesn’t routinely negotiate drug prices with the makers. (The Department of Veterans Affairs and Medicaid are exceptions.) Mylan surely didn’t want this scandal leading to serious efforts in Washington to start regulating what drug companies may charge the American people. Better to stage this semi-retreat and change the subject. (Froma Harrop, 8/29)

It’s almost as if Mylan, maker of the EpiPen, had drawn up a list of ways to game a dysfunctional health care system — and decided to check off every last one. ... News of a $300 generic version could help get Congress off the company’s back. But for Mylan and its CEO, Heather Bresch, the generic is also a shrewd business move. The price is still high enough to generate lots of money. Indeed, it’s more than the brand-name EpiPen cost as recently as a few years ago. (Dante Ramos, 8/29)

Generic drug manufacturer Mylan’s extreme price hike for the EpiPen soared to the top of the headlines last week. This product, consisting of an auto-injector devised by the U.S. military, combined with a $1 dose of epinephrine used to save the life of people suffering from a serious allergy attack, costs no more than $20 to manufacture. ... But the government already has the power to prevent such behavior. They don’t need to pressure Mylan to “fix” the problem itself; they don’t even need to pass a new law. Multiple federal agencies could solve this simply by exhibiting the political will to use their authority to take on the drug companies.  (David Dayen, 8/30)

Consumers have likely seen the headlines that Tennessee health insurers are asking for big premium increases in 2017. On the marketplace, BlueCross BlueShield has asked the state Department of Insurance for a 62 percent increase. Cigna and Humana originally asked for less than half of that, but then requested to refile with higher rates—46 percent and 44.3 percent, respectively. It isn’t just the marketplace, either—employer premiums are going up 5 percent, according to the National Business Group on Health, a rate that’s outpacing wage growth. (Alex Tolbert, 8/28)

Insurance companies in Illinois and Missouri for years have been pocketing hundreds of millions of dollars from life insurance policies when beneficiaries don’t step forward to file claims. For once, Republicans and Democrats are lining up on the same side to fight corporate greed. Illinois State Treasurer Michael Frerichs has been on a statewide campaign to halt this practice and alert citizens that they’re leaving too much money on the table. Last week, Gov. Bruce Rauner signed a law, House Bill 4633, requiring insurers to locate beneficiaries and hand over unclaimed cash. A similar law went into effect in Missouri this month, having passed both houses by overwhelming majorities. (8/29)

The Centers for Medicare and Medicaid Services (CMS) has recently exercised its Section 1115A waiver authority to allow Medicare Advantage plans in seven states to offer benefit flexibility in the form of Medicare Advantage Value Based Insurance Design (MA-VBID). The model will launch on January 1, 2017 and run for five years. (Megan Katherine McGrath and Kenneth Thorpe, 8/29)

Like all of us, Hillary Clinton and Donald Trump are going to die. Will it be in the next four years? Probably -- ideally -- not. But for voters, that’s a reasonable question, especially given that Clinton is 68 and Trump, 70. Unfortunately, the candidates have refused to divulge the kind of information that would enable anyone to arrive at an informed opinion about their health. (8/29)

About half of opioid overdose deaths involve prescription drugs. With that stark fact in mind, the surgeon general, Dr. Vivek Murthy, sent an unusually direct plea last week to 2.3 million doctors and other health care workers to help fight the opioid epidemic by treating pain “safely and effectively.” A website for his “Turn the Tide” campaign highlights alternative, nonaddictive treatments for pain. Not only doctors but also policy makers, insurance companies and other players in the health care system should pay attention. (8/30)

I brush my teeth twice a day, but not for as long as my dentist would like. I’d like to say I floss regularly, but that would be stretching the truth. I don’t scrape my tongue, I don’t rinse with mouthwash and I don’t use an interdental brush or Waterpik. However, I have one filling in my mouth, and I got that only when I had braces as an adult 15 years ago. My wife, on the other hand, cares for her teeth fastidiously. She does all the things you’re supposed to do, and then some. But she has more fillings than I can count. I remember once, years ago, when one of her teeth broke while she was eating scrambled eggs. Clearly, the stuff we’re doing might not make as much of a difference as we think. (Aaron E. Carroll, 8/29)

For a pregnant woman and her developing baby, Zika can be devastating. If a mother-to-be is infected with Zika — either from a mosquito or through unprotected sex with an infected partner — the virus can cause severe damage to the developing fetal brain resulting in microcephaly and other serious, irreversible birth defects. (Dr. Tom Frieden and Heidi Murkoff, 8/29)

It would be presumptuous to draw a straight, unbroken line between Texas lawmakers' draconian, unconstitutional war on family planning clinics and a frightening surge in the number of Texas women dying of pregnancy-related causes. A 2011 law forced through by the state's Republican-led Legislature placed such demanding restrictions on clinics performing abortions that dozens of them have shut down. In some cases, women in poor and rural areas have been left with no access to reproductive care at all. The law was overturned by a sharply worded U.S. Supreme Court ruling in June, but the damage has been done. (Jacquielynn Floyd, 8/29)

Ten years ago this month, my world as I knew it ended. My husband of 19 years, the father of my two sons, was diagnosed with terminal cancer. Over the course of seven months, Bill went from beating me silly on the tennis court to needing my help to go to the bathroom and bathe. It was the best seven months of my life. (Grant, 8/30)