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Big health plans stung by losses in the first few years of the U.S. health law’s implementation are seeking hefty premium increases for individual plans sold through insurance exchanges in more than a dozen states. The insurers’ proposed rates for individual coverage in states that have made their 2017 requests public largely bear out health plans’ grim predictions about their challenges under the health-care overhaul. According to the insurers’ filings with regulators, large plans in states including New York, Pennsylvania and Georgia are seeking to raise rates by 20% or more. (Radnofsky, 5/25)

Average premium requests for 2017 for the most popular type of ACA marketplace plans are 16 percent higher in the first nine states to make them public, according to an Avalere Health analysis released May 24. The 16 percent average increase is for all silver-tier plans, which cover an average of about 70 percent of medical claims. (Hansard, 5/24)

The Pennsylvania Insurance Department on Wednesday released preliminary rate requests for 20 small-group health plans and 18 individual plans that will be offered under the Affordable Care Act for next year. The requests for increases now under review by the insurance department averaged 7.9 percent for small group plans and 23.6 percent for individual plans, but the final rates that will be posted in October could be lower. (Brukbaker, 5/25)

Insurers are seeking double-digit rate increases for 2017 health plans that will be sold to individual Floridians under the Affordable Care Act, a reflection of increasing medical costs and the end of a safety net for insurers. (Gentry, 5/25)

Iowans buying Obamacare-subsidized health insurance could be in for a big price increase next year. The main insurance carrier selling such plans to Iowans wants to raise rates to most of its customers by at least 18 percent. Coventry Health Care has notified the Iowa Insurance Division of its proposed 2016 rate increases, which would affect about 47,000 Iowans. (Leys, 5/26)

Harken Health Insurance Company, an independent subsidiary of UnitedHealth Group, the nation’s largest health insurer, said it will sell coverage for 2017 on the ACA exchange in Miami-Dade and Broward counties using a managed care model that includes a network of primary care clinics and personal counselors to guide members through the healthcare experience. (Chang, 5/25)

The IRS raised concerns in early 2014 about the legality of certain ObamaCare payments that Republicans are now challenging in a lawsuit, according to a deposition from a former agency official. David Fisher, who was the IRS’s chief risk officer, told the House Ways and Means Committee that agency officials questioned whether the Affordable Care Act provided the authority to make certain payments to insurers without an appropriation from Congress. (Sullivan, 5/25)

The Supreme Court may be keeping a lower profile while it is short-handed, but high-stakes cases remain in Washington—at a powerful appeals court that could determine the fate of several important Obama administration initiatives. The U.S. Court of Appeals for the District of Columbia Circuit is preparing for cases examining signature Obama administration climate change regulations on power plants, as well as economic-crisis era rules for the nation’s largest financial firms. The court also soon could be reviewing a challenge to the implementation of President Barack Obama’s signature health-care law, a showdown between the administration and House Republicans. (Kendall, 5/25)

A Republican-led U.S. House committee has found former Gov. John Kitzhaber and a federal agency mishandled the creation of Oregon's health insurance enrollment website, with the Democratic governor's political advisers making decisions based on his re-election campaign. In a staff report released Wednesday, the Republicans on the committee said they are asking the Justice Department and state attorney general to conduct criminal investigations into the actions involving Cover Oregon. (5/25)

Ex-Oregon Gov. John Kitzhaber and his staff mismanaged the creation of the state’s doomed health insurance website, including by making decisions based on his re-election campaign, according to a congressional report released Wednesday which seeks a criminal probe. ... Democrats on the committee released their own report, which laid the blame at the feet of Oracle Corporation, the state’s contractor, saying it misled officials and failed to deliver a functioning website. (5/25)

[N]ext year, the Medicaid expansion agreement between states and the federal government will begin to change. “Starting in January of 2017, West Virginia will have to pay a 5 percent match for Medicaid Expansion. In the governor’s budget that’s 14 million extra dollars for next year,” said Renate Pore, director of health policy for West Virginians for Affordable Healthcare. In 2018, the state will have to match 6 percent, then 7 the following year, until by 2020 the match will cap at 10 percent and approximately 50 million additional dollars out of the state budget to pay for Medicaid. ... advocates like Pore they are worried about how the state will continue funding Medicaid. (Lofton, 5/23)

With officials from the state Department of Health and Human Services wrapping up work on an overhaul of the state’s Medicaid program this week, lawmakers, physicians and patient advocates gathered at the General Assembly Wednesday to push for Medicaid expansion to be included in the state’s reform plan. Dozens gathered for a press conference in the state legislative building that featured patients who could qualify for the state’s Medicaid program but don’t. (Nigam, 5/26)

A tie-up of Aetna Inc and Humana Inc would be anti-competitive in Missouri for several types of insurance, including individual Medicare Advantage plans where the combined company would have more than a 50 percent market share, the Missouri Department of Insurance said. The department said in an order, dated May 24 and posted on its website, that if the proposed acquisition of Humana by Aetna were to go forward, the companies would need to stop selling individual insurance, small group and certain Medicare Advantage plans in its state. (Humer, 5/25)

Aetna’s proposed $37 billion takeover of Humana suffered a major setback when Missouri regulators rejected the deal on Wednesday. While one state's decision won't kill Humana's merger with Aetna, “the question is whether this is the tip of the iceberg," said Martin Gaynor, an antitrust expert at Carnegie Mellon University. (Demko, 5/25)

Missouri insurance officials have issued a preliminary order against the merger of Aetna and Humana, the first state to find serious antitrust problems with the massive transaction. However, Aetna and Humana have 30 days to “submit a plan to remedy the anti-competitive impact of the acquisition.” That likely means the state may push the health insurers to divest Medicare Advantage plans in areas where competition would have been smothered. (Herman, 5/25)

Deciding that a merger between Aetna and Humana would hurt consumers, Missouri’s top insurance regulator has issued a preliminary order that bars the companies from offering certain plans if they complete the $37 billion deal announced last summer. (Liss, 5/25)

Missouri is the first state to signal disapproval of the pending merger, which would combine two of the largest health insurers in the country. An state analysis determined the combined company would control too much of the market for the four types of health plans. It gave the insurers 30 days to propose changes. (Bouscaren, 5/25)

The Connecticut Insurance Department has signed off on Aetna’s proposed merger with Humana, but other hurdles remain for that deal and another merger proposed by Cigna and Anthem. (Radelat, 5/25)

Walgreens was considering a partnership with Theranos Inc. when founder Elizabeth Holmes arrived at Johns Hopkins University in the spring of 2011. She brought with her a machine she said could test tiny samples of blood for dozens of conditions and thick binders of data to show its accuracy. A Hopkins scientist told her that his researchers needed to put the device in their Baltimore laboratory to verify the technology on Walgreens’ behalf, and Ms. Holmes agreed to provide one, say people familiar with the meeting. (Weaver and Carreyrou, 5/25)

The lawyers have come knocking at Theranos’s door. A lawsuit filed Wednesday on behalf of an Arizona man alleges that the embattled Silicon Valley company deceptively marketed tests it said would deliver accurate medical results from a finger prick of blood. (Robbins, 5/25)

Startup Theranos is now facing heat from consumers. On Wednesday, a lawsuit was filed in Northern California, accusing Theranos of falsely marketing its proprietary finger-prick blood test.n (O'Brien, 5/25)

Republican Gov. Nikki Haley signed legislation Wednesday that immediately outlaws most abortions in South Carolina at 20 weeks beyond fertilization. The only exceptions are if the mother’s life is in jeopardy or a doctor determines the fetus can’t survive outside the womb. Doctors face up to $10,000 in fines and 3 years in prison for each violation; prison time is mandatory on a third conviction. (Adcox, 5/25)

South Carolina Gov. Nikki Haley on Wednesday signed a bill to ban nearly all abortions after 20 weeks of pregnancy. The legislation, which offers exceptions only to women whose lives are threatened or if their fetus would not survive outside the womb, is considered the cornerstone of the anti-abortion movement's policy agenda in 2016. (Ferris, 5/25)

Republican South Carolina Governor Nikki Haley on Wednesday signed into law a bill banning most abortions after 19 weeks of pregnancy unless the mother's life is at risk, a spokesperson told Reuters on Wednesday. (McCleod, 5/25)

A 2012 Georgia law banning abortions after 20 weeks quietly took effect nearly six months ago with no fanfare or resistance — until lawyers for three obstetricians who had challenged the measure realized what had happened. Now those lawyers, who say they never got notice that their challenge was dismissed and therefore didn’t appeal in time, want the law suspended again while they continue their fight. (Brumback, 5/25)

Some public schools are starting summer vacation several days early. Others are contemplating a four-day week to cut costs. And more than 200 teachers in Oklahoma City were handed pink slips in March. But instead of addressing a burgeoning budget crisis that threatens public education and other critical state services, Oklahoma lawmakers have been busy debating proposals to criminalize abortion, police students’ access to public bathrooms and impeach President Obama. (Ross, 5/25)

Coercing a woman to have an abortion would be a crime under a bill that is headed to Gov. Rick Snyder for his signature. The state Senate, on a 26-11 mostly party-line vote, gave final approval to the bill Tuesday, making it a misdemeanor punishable by a fine of $5,000, unless the person charged is the father of the unborn child, in which case the fine would grow to $10,000. (Gray, 5/25)

Planned Parenthood of Kansas and Mid-Missouri announced plans Wednesday to merge with the abortion provider's central Oklahoma affiliate in July and open a new Oklahoma City clinic, even as political leaders in the three states seek to cut off Medicaid funding. Laura McQuade, the Kansas and Mid-Missouri affiliate's president and CEO, said the merger is designed to create a regional health care "powerhouse" and isn't a response to attempts by legislators and governors in the three states to prevent public funds from going to Planned Parenthood. (5/25)

Cecile Richards, the president of the Planned Parenthood Federation of America, visited New Orleans Wednesday (May 25) to celebrate the ribbon cutting of the new $4.5 million, 8,000-square-foot clinic on South Claiborne Avenue. The clinic, which is expected to open and accept patients in June, has been the focus of several bills in the 2016 session of the Louisiana Legislature aimed at preventing it from providing abortions and, ultimately, shutting it down. One such bill, which is on the desk of Gov. John Bel Edwards, would prevent public funding for abortion clinics. Edwards said he intends to sign it. (Webster, 5/25)

A Florida congressman said the Veterans Administration cut off the benefits of more than 4,200 people nationwide after they were wrongly declared dead. Representative David Jolly, a Republican, said they were ‘‘very much alive’’ and their benefits were resumed after the VA looked into their cases, which happened between 2011 and 2015. Jolly raised the issue with the VA in November on behalf of a group of veterans in the Tampa Bay area. He said Wednesday that the agency has changed its protocols for confirming deaths. (Lush, 5/26)

When Veterans Affairs Secretary Robert McDonald compared the exceptionally-long wait times veterans still endure to get health care to lines at Disneyland, a national firestorm erupted. House Speaker Paul Ryan said his words reflected a “culture of indifference” and McDonald apologized, but two years after the first VA scandal, wait times are still a major problem. (5/25)

On its surface, the movie “Vaxxed: From Cover-Up to Catastrophe” appears to be a slickly produced scientific documentary with lots of charts and data about one of the most important issues of our time. The central premise of the film is that the country’s mandatory measles, mumps and rubella (MMR) vaccine — when given to children under age 2 — may be leading to an epidemic of autism diagnoses. It contains heartbreaking footage of happy, laughing toddlers who, their parents say, became profoundly disabled almost overnight after receiving the shot. It explains the findings of a study that confirms the link and unearths recordings from a former Centers for Disease Control and Prevention scientist who purportedly claimed the government quashed findings of the connection. But what the movie doesn’t get into is as compelling as what it does present. (Cha, 5/25)

Could it be that Alzheimer’s disease stems from the toxic remnants of the brain’s attempt to fight off infection? Provocative new research by a team of investigators at Harvard leads to this startling hypothesis, which could explain the origins of plaque, the mysterious hard little balls that pockmark the brains of people with Alzheimer’s. It is still early days, but Alzheimer’s experts not associated with the work are captivated by the idea that infections, including ones that are too mild to elicit symptoms, may produce a fierce reaction that leaves debris in the brain, causing Alzheimer’s. (Kolata, 5/25)

As the international epidemic of Zika virus disease has unfolded and led to devastating birth defects for at least 1,300 children in eight countries, an agonizing question has persisted: What is the chance that an infected pregnant woman will have a baby with these defects? Researchers don't yet have a complete answer, but they are slowly homing in on one. The largest study to ever look at the question says the risk of one especially severe type of birth defect is "substantial" — in the range of 1 percent to 14 percent. It also reinforces the understanding that women infected in the early stages of pregnancy face the greatest risk. (5/25)

The nation's top infectious disease doctor doesn't scare easy. But Tom Frieden — the head of the Centers for Disease Control — is deeply worried about the rise of Zika virus, which is spreading across the Americas and causing birth defects in babies. And he's shocked that Congress, which has refused to fund the White House's emergency Zika request, doesn't share his concern. (Diamond, 5/25)

U.S. officials are starting a massive effort to protect American athletes from Zika, even as they are learning more about the mysterious disease in real time. Some members of the U.S. Summer Olympics delegation are already being monitored for the virus as they begin to go to Brazil, the epicenter of the rapidly evolving outbreak. The Centers for Disease Control and Prevention is also assessing the threat that athletes and other travelers to the Games may increase the global spread of the mosquito-borne virus when they return to their home countries. (Sun, 5/25)

The state of Alaska has suspended Medicaid payments to hospitals and clinics amid a continuing budget impasse in the Legislature, but the state’s director of health care services said the two events are unrelated. On Wednesday, in a letter emailed to health care providers, health care services director Margaret Brodie said “it is necessary for us to temporarily pend some Medicaid claims while Medicaid funds are reallocated among accounts.” (Brooks, 5/26)

DHSS Deputy Director for Health Care Service Lori Campbell said her department will decide weekly which claims to suspend and which to pay. Medicaid claims are usually paid or denied in a weekly cycle, which Campbell said “starts at noon on Monday and is typically not finalized until late Wednesday, early Thursday.” During each weekly cycle, a financial team in DHSS will now choose which claims will be processed based on how dependent on Medicaid the provider is. ... the lack of funds that led to the suspended Medicaid claims came from the lack of a normally-available state funding source. As DHSS approaches the limits of its budget at the end of the fiscal year, it is usually able to request additional money from the legislature. This year, no money is available to fill the need. (Boettger, 5/25)

Attorneys for two Chicago-area hospital systems argued in federal court Wednesday that a recent decision in a similar antitrust case in Pennsylvania supports the systems' case for being allowed to merge. Attorneys for the Federal Trade Commission, meanwhile, posited that the judge in the Chicago case shouldn't follow the lead of the judge in the recent Pennsylvania matter. (Schencker, 5/25)

Stratus Healthcare, an alliance of hospital systems, said Wednesday that it’s entering partnership talks with a large physician organization in Central Georgia. The talks between Stratus and Central Georgia Health Network could lead to forming a “clinically integrated network’’ to treat patients in South and Middle Georgia. (Miller, 5/25)

The consolidation of the hospital industry progressed Wednesday as state regulators gave tentative approval to the $105 million purchase of Manchester Memorial and Rockville General hospitals by Prospect Medical Holdings, a for-profit company based in Los Angeles. (Pazniokas, 5/25)

A medical marijuana legalization bill has been sent to Ohio Gov. John Kasich in an effort by state lawmakers to offset support for a proposed fall ballot measure. The measure cleared the Ohio Senate by just three votes, and the House followed by OK'ing Senate changes 67-28. The proposal, which Kasich has not committed to signing, would bar patients from smoking marijuana or growing it at home, but it would allow its use in vapor form for certain chronic health conditions. (Carr Smyth, 5/25)

After passing a reluctant Senate by just three votes, Ohio is poised to become the latest state to legalize medical marijuana, so long as Gov. John Kasich signs it into law. After more than a day of uncertainty about whether the bill had enough support in the Senate, the chamber voted 18-15 Wednesday afternoon, passing the bill despite opposition votes from the top two members of Senate Republican leadership — Senate President Keith Faber, R-Celina, and Sen. Larry Obhof, R-Medina. The House concurred 67-28 late Wednesday night. (Johnson and Siegel, 5/25)

During the last few years, state legislatures and voters in the United States have been much more receptive to making the use of marijuana legal for medical purposes than for recreational use. (Palmer, 5/26)

Governor Rick Scott highlighted a mental-health reform bill at a ceremonial signing in Miami on Tuesday. (5/25)

A bill to end sales taxes on tampons and sanitary napkins received final approval from New York lawmakers on Wednesday and is headed to the governor, who voiced strong support of the legislation. Several other states have already enacted such exemptions as a movement builds against a tax that critics say unjustly targets women. (5/25)

Massachusetts has replaced Vermont as the healthiest state for seniors, while Louisiana ranks as the unhealthiest for the second-straight year, according to a new report released Wednesday by the United Health Foundation, a nonprofit arm of insurer UnitedHealth Group. Mississippi, which usually scores poorly in national health assessments, ranked 48th, trailed only by Oklahoma and last-place Louisiana. (Pugh, 5/24)

When it comes to supporting people with developmental disabilities through art-making, the activities are much more than just a pastime. For some in St. Louis, being creative helps them buy food, or get a job.Those are goals – and outcomes – of a St. Louis-area organization called Artists First. But budget cuts are jeopardizing the nonprofit, forcing some hard decisions. (Fowler, 5/26)

The Wisconsin Department of Health Services reported another case of Elizabethkingia infection, bringing the total number of confirmed cases in Wisconsin to 61. (Stephenson, 5/25)

In what could be first-of-its-kind case in Florida, an appeals court Wednesday rejected arguments that both parents need to sign off before a child can undergo surgery. (Ochoa, 5/25)

Meharry Medical College, University of Miami and Vanderbilt University Medical Center will receive $11.6 million from the National Institute on Minority Health and Health Disparities over five years to launch a new center, called Vanderbilt-Miami-Meharry Center of Excellence in Precision Medicine and Population Health, to look at the role of genetics in the health of larger groups, particularly African-Americans and Latinos. (Fletcher, 5/25)

If Mariela Diaz could travel back in time, she would go back to Monday morning, Aug. 12, 2013, and block her teenage daughter from going to a cosmetic surgery clinic for a breast augmentation procedure. Five minutes after the surgery at Coral Gables Cosmetic Center, 1800 SW 27th Ave, Linda Perez, 18 at the time, started developing problems when her heart rate and blood pressure dropped significantly, causing her to become unconscious, barely breathing. (Medina, 5/25)

CVS pharmacists who have been working without a contract for nearly three weeks will head back to the bargaining table with the company Thursday as their union highlights concerns including alleged understaffing and 12-hour shifts. (Elejalde-Ruiz, 5/25)

A senior living center in Livonia became a scene of turmoil Wednesday as state health officials abruptly suspended the home’s license to operate two of its buildings and essentially evicted several senior citizens with just hours’ notice. (Bethencourt, 5/25)

Misdemeanor cases filed by city attorneys are driving a surge in competency cases that is overwhelming Los Angeles County's mental health court, according to a preliminary report released Wednesday. The report suggests that the increase might be linked to the county’s rising homeless population, to criminal justice reform measures that may have resulted in fewer people participating in mandated treatment programs, and to the scarcity of psychiatric hospital beds. (Sewell, 5/25)

Offices, a corporate training center and auditorium, corporate lodging, store space and parking garages comprise Centene Corp.’s expansion project in Clayton. “Extraordinary landscaping” and “architecturally distinct buildings” will be included in the project, according to a document Clayco Corp. has filed with the city of Clayton. ... Centene, the nation’s largest Medicaid managed care company, has long planned to expand near its headquarters in downtown Clayton. (Bryant, 5/26)

An appeals court has affirmed the 45-year prison sentence for a Detroit-area cancer doctor who put hundreds of patients through needless treatments. Farid Fata's appeal focused on how a judge calculated the sentencing guidelines and whether it was proper to allow many victims to speak in court. In a 3-0 decision Wednesday, the appeals court says the arguments lack merit. (5/25)

Do you want to know what the future of health care could look like? You should pay attention to a little-known yet hugely important event taking place in St. Louis on Thursday. But don’t expect a rosy vision — what you’ll actually see is terrifying. The event in question will be hosted by the Institute for Clinical and Economic Research, a national nonprofit funded with millions of dollars from the health insurance industry and like-minded interests. The group — known as ICER — is unveiling its new method of determining the cost of medical treatment for patients. It’s called a “value framework,” and it could potentially harm the health and well-being of the millions of Americans with cancer and other life-threatening diseases. (Jonathan Wilcox, 5/26)

The Zika virus exploded out of Brazilian slums at 21st-century speeds, and raced north into Central America and the Caribbean in a matter of months. A full-blown outbreak in the United States looks imminent. This statistically small virus is part of a global insurgency that adapts rapidly to developments of human progress. It exploits cultural dynamics: rapid over-urbanization, a changing climate and increased levels of travel and economic activity among countries. (Grey Frandsen, 5/26)

Chronic dysfunction on Capitol Hill is often cause for amusement, but not when lives and public health are at stake. That's what's happening now, with the menace of the spread of the Zika virus to the United States becoming ever more concrete. The House and Senate haven't been utterly idle on the Zika front. Their actions have been merely inadequate and cynical. Both chambers have proposed funding plans to combat Zika -- the Senate at $1.1 billion, the House at $622 million. But neither matches the $1.9 billion President Obama requested in February, and the House proposal would raid other disease programs to cover the bill. (Michael Hiltzik, 5/25)

Boys with lethal Duchenne muscular dystrophy have waited years for the Food and Drug Administration to approve a safe and innovative treatment, and they’ll have to hold out longer. On Wednesday the FDA delayed a decision on eteplirsen by Sarepta Therapeutics, but the agency can still choose the correct scientific and legal outcome. Sarepta said FDA had notified the company that a decision would not be issued on Thursday as scheduled. The agency offered no clues beyond promising to finish “internal discussions” and the broader review “in as timely a manner as possible.” An FDA advisory panel voted against approval in April, though agency bosses can accept or disregard the input. (5/25)

Everyone loves a happy ending, and in this season of political meltdown and partisan deadlock, the impulse is more acute than usual. So the question lingers from the Supreme Court’s non-resolution last week of the latest controversy brought about by the Obama administration’s effort to make birth control available to women in the work force: Was it a sign of a new appetite for compromise or of institutional dysfunction? Along with the many headline writers who stressed “compromise,” I’d like to believe the former. But I fear the latter. (Linda Greenhouse, 5/26)

Presumptive Republican presidential nominee Donald Trump has said before that he doesn’t get much sleep. And at a campaign event Wednesday in Anaheim, California, less than two weeks before the California presidential primary, Trump bragged again: “I don’t sleep much. I don’t sleep much.” ... That last claim is actually terrifying. (Sarah DiGiulio, 5/25)

The Theranos saga hit another low last week when the company informed regulators that it was voiding two years of tests from its Edison blood testing devices and sending of tens-of-thousands of revised tests results to doctors. This means that thousands of patients received incorrect results and were likely given the wrong treatments. Surely the doctors and the patient victims were not responsible for this misplaced trust. (Vivek Wadhwa and Jeffrey Sonnenfeld, 5/24)

[Veterans Affairs Secretary Robert] McDonald has been VA chief two years, and apparently has been co-opted utterly by the bureaucracy. His resignation should be the first one the next president accepts. (Editorial Board, 5/25)

Bob McDonald inherited a stink bomb when he was appointed Veterans Affairs secretary in July 2014. The agency was bloated with a backlog of nearly 350,000 unprocessed disability claims filed by veterans who put their life on the line for their country. Wait times ranged from months to years. Worst of all, it had come to light that VA employees were covering up average wait times to make the VA appear more efficient than it was. (Gary Peterson, 5/25)

Not only can it take months for the Brownback administration to process and approve Medicaid applications, but even applying for Medicaid can be an ordeal. No wonder there has been a drop in the number of Medicaid beneficiaries in Kansas. The state’s expensive new online application system and reorganized processing clearinghouse were supposed to make enrolling in Medicaid faster and easier. The opposite happened. (Phillip Brownlee, 5/26)

[T]he U.S. Supreme Court ruled that states could “opt out” of the Medicaid expansion, and Republican leaders in North Carolina – ideologically opposed to the ACA and more specifically to all things associated with President Obama – did just that. So now perhaps 500,000 North Carolinians who could qualify for the federal/state health insurance program for the poor and disabled don’t have the coverage thanks to that “Medicaid gap.” It was an astonishingly partisan and cruel step from the General Assembly. (5/25)