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It’s easily forgotten that Congress and the Obama administration did the health insurance industry an enormous favor in enacting the Affordable Care Act in 2010. Several favors, in fact. They placed commercial insurers at the center of Obamacare, giving them most of the responsibility for covering enrollees—and therefore access to an army of new customers. They left in place private insurers’ access to the immense Medicaid pool via Medicaid managed care. They killed the public option, which would have provided a nonprofit counterweight to private insurers, hopefully goading the latter into maintaining competitive pricing and customer service. (Michael Hiltzik, 8/9)

Humana recently announced that next year it is withdrawing from 88% of the counties where it sold Affordable Care Act (ACA) exchange plans this year. United Healthcare forecasts higher earnings in 2017, stemming in part from its decision to shut down most of its exchange business. Aetna has cancelled plans to expand its ACA market footprint and is instead reevaluating its current participation. At least four states, Alaska, Alabama, Oklahoma and Wyoming will likely have only one exchange insurer this coming year. Sixteen of the 23 co-ops initiated with ACA funding have collapsed. And researchers supportive of the ACA estimate that insurers are requesting average gross premium increases of 23% next year. These data points suggest the ACA’s individual market changes are faring poorly thus far. (Doug Badger, Brian Blase, Seth Chandler and Ed Haislmaier, 8/9)

“I’m thinking of decamping to Maine for the rest of my pregnancy,” a pregnant patient told me last week. Her comment came days after the news of at least 17 confirmed cases of Zika in Florida. My patient worried that it was only a matter of time before the disease made its way to Virginia. Experts say Zika will probably remain farther south, but I could not argue with my patient’s logic. The pregnant women I care for do everything in their power to keep their unborn children healthy. They give up alcohol, quit smoking and see their doctor regularly. They even forgo deli meats and soft cheeses to decrease the minute risk of contracting a rare bacteria. (Emily Binkley Huffstetler, 8/9)

Data sharing is one of the “next big things” in cancer research. This essential extension of laboratory and clinical research will rely on cancer patients voluntarily sharing their private health information. Unfortunately, we aren’t making it easy or attractive for them to do this. Researchers seek patients’ DNA samples, detailed medical histories, and honest assessments of daily lifestyle habits to advance the study of disease. These data are already being collected when individuals are diagnosed with cancer and treated for it, but largely aren’t being shared with researchers. The National Institutes of Health has announced plans to dole out $55 million in grants over five years to enlist 1 million volunteers to allow access to their clinical data from electronic health records, use mobile health devices and apps to track activity in real time, and submit their genetic and biological information through blood and urine tests. (Maurie Markman, 8/9)

Kentucky is known nationally for reducing the percentage of people without health insurance — from 20.4 percent uninsured in December 2013 to 7.5 percent in December 2015. What is needed to sustain these gains? Making insurance — and health care — harder to access is not the answer. Making health care delivery more cost-effective is a better path. (Susan Zepeda, 8/9)

In Missouri and across the country, opioid addiction is a fast-growing problem that disproportionately affects rural communities. New data from the Centers for Disease Control and Prevention show opioids were involved in 28,648 deaths in 2014. As a predominately rural state, Missouri has been hit hard by this epidemic. (Tom Vilsack and Claire McCaskill, 8/9)

The law allows exemptions to school vaccine requirements for medical reasons such as life-threatening allergies to vaccine components or immune deficiencies. No one would disagree that waivers should be allowed for these children. But these make up a tiny portion of the unvaccinated school children. The much larger share are the "exemptions of conscience" for parents who don't want their children vaccinated because they simply don't like vaccines. Let's be clear: There is nothing conscientious about rejecting vaccines for non-medical reasons. (Anna C. Dragsbaek, 8/9)

Last year, I became a mom. During my pregnancy, I read all the books and all the articles, and my husband and I mentally crafted a framework to use to raise our baby. I would breast-feed. We would use cloth diapers. We would eschew television and electronic devices for her first two years. And we would vaccinate on time, following the Centers for Disease Control and Prevention’s recommended immunization schedule. (Jenn Kauffman, 8/9)

A case in which a doctor performed an abortion on a woman who was known to be high on drugs raises an important question about medical ethics. But any disciplinary action that might be taken could be muddied by abortion politics. In the spring of 2015, an abortion was performed at Women’s Med Center in Dayton on a patient who was so high on drugs that, after the abortion, she had to be hospitalized and treated for a suspected overdose. (8/10)

Cannabis. Hash. Weed. Locoweed. Pot. Grass. Mary Jane. Bud. Reefer. Hemp. Dope. Acapulco Gold. As you know, these are all synonyms for marijuana (there are many more), and they are especially helpful if one is writing a column about the stuff and doesn't want to type "marijuana" 37 times. So with that out of the way: Ohio is less than a month away from joining the 25 other states that have legalized at least some uses of marijuana. (Ted Diadiun, 8/10)