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Health insurance rates will rise next year by an average of just 4 percent in California, one of the few states that actively negotiate prices, state officials said Monday. In other states, insurers, including Blue Cross and Blue Shield, have requested rate increases of 10 percent to 40 percent or more. New customers under the Affordable Care Act turned out to be sicker than expected, many insurers have said. Some insurers reported financial losses on their exchange business, saying they paid out more in claims than they collected in premiums. (Pear, 7/27)

The modest price increases for 2016 may be welcome news for many of the 1.3 million Californians who buy individual policies through the state marketplace, known as Covered California. California's rates are a key barometer of how the Affordable Care Act is working nationwide, and the results indicate that industry giants Anthem and Kaiser Permanente are eager to compete for customers in the nation's biggest Obamacare market. (Terhune, 7/27)

This increase is slightly less than last year’s increase of 4.2 percent. ... Consumers who live in different parts of the state will see varying rates. ... On the flip side, some consumers could see their premiums go down, if they choose to shop around. (Aliferis and Dembosky, 7/27)

The average increase in Southern California is 1.8 percent, for a total of $296 a month, compared to 7 percent, or a total of $384 a month, in Northern California. Southern Californians can get better rates because the region has more provider competition. The exchange also added two new participants for the first time — UnitedHealthcare, the nation's largest health insurer, and a New York startup called Oscar. Lee said California's 2016 rates are proof that the Affordable Care Act is working in the state. He credited California's aggressive approach on haggling with insurers. (Lin, 7/27)

Northern Californians will pay $88 more in average monthly healthcare premiums than Southern California consumers, under new 2016 rates announced Monday by Covered California, the state’s official healthcare marketplace under the Affordable Care Act. (Buck, 7/27)

Covered California, the state's health insurance exchange, on Monday boasted a second straight year of modest rate hikes next year for the majority of its customers, but one region of the state won't have it so easy: the Bay Area. While average premiums will rise only 4 percent statewide, rates will climb as high as 12.8 percent in Santa Cruz County, 7 percent in Santa Clara County and more than 6 percent in Alameda and San Mateo counties, exchange officials revealed. (Seipel, 7/27)

Up to 10 million Americans will soon have a new option for lowering their cholesterol – at a price of $14,600 a year. The Food and Drug Administration surprised much of the medical community Friday by broadly approving a new cholesterol drug for a vast potential patient population. The agency approved Praluent for people with an inherited condition that causes very high levels of LDL, or bad cholesterol, as well as for the millions of Americans who have had heart attacks, strokes or other types of heart disease and whose LDL is higher than it should be. (Szabo, 7/27)

The newly approved cholesterol-lowering drug, Praluent, is powerful almost beyond belief. It can drive levels of LDL cholesterol, the dangerous kind, into the 20s or even the teens, numbers almost never before seen in adults. In general, it lowers cholesterol by 50 percent to 70 percent, compared with 25 percent to 55 percent with statins. The $14,600 yearly price of the drug, which is injected under the skin once every two weeks, is a stunner. Yet for some patients, that might actually be a bargain. (Kolata, 7/27)

The new drugs are expensive. And unlike a much cheaper class of pills called statins—which are proven to reduce cardiovascular risk—the jury is still out on whether the new drugs reduce serious events like heart attacks. For these reasons, many insurers plan to require rigorous evaluations before authorizing prescriptions, to make sure patients can’t get their cholesterol down with statins. An estimated 10% to 25% of people who have tried statins report having muscle pain, which limits the dose they can tolerate or precludes them from taking a statin at all. Doctors who specialize in the condition, known as statin intolerance, say by changing statins or trying other strategies, many patients initially considered intolerant can end up taking a statin after all—which is the aim of payers who plan to aggressively challenge claims of statin intolerance. (Winslow, 7/27)

High-cost specialty drugs, including a new class of cholesterol medications expected to come to market later this year, are key drivers of the need to raise health insurance premiums by nearly 10 percent, ConnectiCare’s chief actuary told state regulators during a public hearing Monday. (Levin Becker, 7/27)

The world’s largest manufacturer of generic drugs, Teva, has bagged some big game. Monday morning, the company announced that it has agreed to buy Allergan’s generic business for a little more than $40 billion. If approved, the deal places Teva amongst the largest drug companies on the planet. (Gorenstein, 7/27)

Israel's Teva Pharmaceutical Industries will pay $40.5 billion in cash and stock for Allergan's generic drugs business, solidifying Teva's position as the world's No. 1 maker of generics while freeing Allergan to focus on branded drugs, paying down debt and potential "transformational" acquisitions. The deal, the largest in Israel's corporate history, allows Teva stronger economies of scale, crucial in the low-margin generic drugs business. Teva , which dropped its hostile pursuit of Mylan, will likely have to sell off some drugs to allay antitrust concerns. (Cohen and Scheer, 7/27)

Analysts say they expect more tie-ups are coming in the generic drug industry in the wake of Teva’s mammoth deal for the generic drug business of Allergan. The Dutch drugmaker Mylan, which had resisted Teva’s advances for three months, is pressing ahead with its offer for Irish drug and ingredients maker Perrigo. Teva withdrew its offer for Mylan on Monday as it announced its alternative deal. (7/27)

The U.S. House of Representatives Judiciary Committee is planning two hearings for September to discuss concerns about reduced competition in the healthcare industry, lawmakers from both parties said. In July, insurer Aetna said it would buy rival Humana for $33 billion, while Anthem said it would buy Cigna for $54.2 billion. The dual deals would effectively lower the number of major U.S. health insurers from five to three. (Bartz, 7/27)

Republican lawmakers on a powerful House committee are planning a comprehensive overhaul clearing up how Medicare pays hospitals for short-term patient stays, but hospitals opposing the effort say a recent proposal from the Obama administration offers a much better solution. (Mershon, 7/27)

Kansas 4th District Congressman Mike Pompeo has agreed to co-sponsor a joint resolution that would allow states to form a health care compact and, potentially, circumvent parts of the Affordable Care Act. “Mike has agreed to be a part of the health care compact because he views it as one of the last remaining opportunities to protect Kansans from the disaster that is the Affordable Care Act,” Heather Denker, a spokesperson for Pompeo’s office, said in an email. Pompeo, she said, believes the Affordable Care Act, also known as Obamacare, will “drive up costs for the poorest people in Kansas and diminish access, especially in the rural areas of Kansas.” (Ranney, 7/27)

Senate Majority Leader Mitch McConnell got his hands on something he believed to be damning: An email from Sen. Mike Lee’s aide to conservative activists plotting to use an Obamacare vote as a political weapon. So McConnell quickly summoned the GOP to a closed-door session in the Senate’s Mansfield Room Monday night. ... The sitdown appeared to be an effort by McConnell to impose order in his caucus after days of infighting, initiated by [Sen. Ted] Cruz, who accused McConnell of “lying” in a hard-charging series of floor speeches and public statements. Cruz, along with Lee, have sought to use arcane Senate procedures to force through simple majority votes on a range of conservative causes — to take a hard line on Iran, defund Planned Parenthood and repeal Obamacare. (Raju, 7/27)

Conservative Sen. Mike Lee backed down on Monday from a controversial plan to demand a simple-majority vote to repeal Obamacare, following a meeting in which he apologized to Senate Majority Leader Mitch McConnell for the actions of a Lee staffer. Lee abandoned his plan after first offering to give up in exchange for a later repeal vote as part of budget reconciliation and failing to find support from leadership. (Snell and Kane, 7/27)

So when Cruz came to the floor looking for at least 11 senators to agree to hold a roll-call vote, only three raised their hands. McConnell, sitting at his desk, turned around and peered at Cruz, who looked stunned at what had just happened. The Senate dispensed with his effort by a voice vote and quickly moved on, doing the same to Sen. Mike Lee (R-Utah), a Cruz ally who sought to use arcane procedures to force a vote on defunding Planned Parenthood. It all went down in an instant, but the message was clear: If Cruz doesn’t want to play nice with his Republican colleagues, they will respond in kind. (Raju and Everett, 7/27)

As Congress races toward its long summer recess, Sen. Rand Paul (R-Ky.) is confident that he’ll get a vote to bar any taxpayer funds going to Planned Parenthood. “There’s a nationwide movement that we’ve been leading,” Paul said in an interview, after participating in a town hall with military veterans. “We will probably send a million emails out on this subject. I think by motivating the grassroots, there’s a very good chance we’ll get a vote on this.” (Weigel. 7/27)

Planned Parenthood has been swept up in a storm of controversy in recent weeks, after an antiabortion group started to release undercover videos of officials at the organization discussing how it provides organs from aborted fetuses for research. Now, even the group’s Web site is on the defense. Hackers who say they oppose Planned Parenthood claim to have posted a database associated with the organization’s Web site as well as the names and e-mail addresses of employees online. (Ohlheiser and Peterson, 7/27)

Planned Parenthood confirmed Monday that anti-abortion hackers have attempted to infiltrate the organization, potentially exposing sensitive data on their employees. Dawn Laguens, Planned Parenthood executive vice president, called the incident a “gross invasion of privacy” that could put staff at risk. (Bennett, 7/27)

Planned Parenthood called on the FBI and the U.S. Department of Justice on Monday for help managing cybersecurity, following a report that the reproductive healthcare group's website had been hacked by anti-abortion activists. The organization has come under scrutiny since the release of two secretly recorded videos earlier this month that critics said showed it was involved in the illegal sale of aborted fetal tissue for medical research. (Cassella, 7/27)

Legislators on the Senate Health and Human Services Committee are being offered the chance to view a video obtained by the Texas Attorney General's Office as part of its inquiry into Planned Parenthood's practices regarding fetal tissue donation. A spokesman for Republican Committee Chairman Charles Schwertner confirmed that lawmakers on the committee and their staffers are "currently reviewing the video and gathering all the relevant facts" ahead of a Wednesday hearing on Planned Parenthood's "business practices" when it comes to fetal tissue. (Ura, 7/27)

The anti-abortion group behind two undercover videos of Planned Parenthood executives discussing fetal tissue donation visited one of the organization’s clinics in Houston, Planned Parenthood officials said Sunday. Two people “fraudulently representing themselves” as research executives and providing fake California driver's licenses toured the Planned Parenthood facility in April “under the guise of discussing tissue research with our clinic research staff,” said Planned Parenthood Gulf Coast spokeswoman Rochelle Tafolla. (Ura, 7/27)

Videos released by an anti-abortion group during the last two weeks have drawn attention to a little-known practice: the buying, selling and research use of fetal tissue acquired from abortion clinics. The group behind the tapes accuses Planned Parenthood of selling fetal tissue for profit — which is illegal and which Planned Parenthood denies doing. House Republicans plan to investigate. This may be just one more battle in the nation’s long war over abortion, but the dispute has raised questions about who the buyers and sellers are, what fetal tissue is used for and what the law allows. (Grady and St. Fleur, 7/27)

Betty Valdez has chronic lung disease, known as COPD, high blood pressure, kidney disease, arthritis and diabetes. Remembering when to take her 20-plus medications is difficult. Getting up from a chair is a significant obstacle, making any regular exercise unlikely. With a primary care provider and help at home, maintaining her current health would be a challenge. Without them, the 65-year-old Valdez spent a lot of time in the emergency room. (Pelcyger, 7/27)

Nurse practitioners and physician assistants are a fast-growing part of the medical marketplace, getting paid more often for procedures people generally associate with doctors, such as electrocardiograms, pelvic exams and even helping with heart bypasses, a USA TODAY analysis of federal data finds. Medicare billing records show 15% more nurse practitioners and 11% more physician assistants received payments in 2013 than in 2012 for all types of care. During that same year, the number of general practice physicians paid by the insurance program for the elderly and disabled dropped by 5%. (Ungar and Hoyer, 7/27)

Despite medical evidence showing the benefits of breastfeeding and how to prevent cot deaths, some doctors are not passing on the information to new mothers in the United States, researchers said on Monday. In a survey of more than 1,000 new mothers funded by the National Institutes of Health, they found that about 20 percent of women did not receive guidance on breastfeeding or on placing infants to sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS). (7/27)

U.S. adults should be screened for depression, according to a proposal from a government-backed panel of medical experts. With this proposal, the U.S. Preventive Services Task Force broadens its 2009 recommendation that adults be screened in doctors' offices if staff-assisted depression care is available. (Seaman, 7/27)

Each time mental illness is cited as a possible factor in a high-profile mass killing in the United States, there’s a collective sigh among mental health professionals here. Even as they see an opportunity for serious discussions of problems and remedies, they also worry about setbacks to their efforts to destigmatize mental illness. “Most people who suffer from mental illness are not violent, and most violent acts are committed by people who are not mentally ill,” said Dr. Renee Binder, president of the American Psychiatric Association. If, hypothetically, everyone with mental illness were locked up, “you might think you were safe, but you are not,” Binder said. (7/27)

The Food and Drug Administration announced today it is investigating the risk of brain deposits for patients who are given repeated MRIs using imaging drugs that contain a heavy metal. The FDA did not announce any label changes for the nine medicines that contain the metal, gadolinium, saying there was a “need for additional information.” However, “to reduce the potential for gadolinium accumulation,” the safety announcement asked health care professionals to “consider limiting” their use and to reexamine “the necessity of repetitive” MRIs involving these drugs. (Gerth, 7/27)

Drug companies may be endangering the lives of patients by not promptly reporting cases of drug-related illness or death to federal regulators, a new report suggests. About 10 percent of cases where a drug does serious harm to a person are not reported to the U.S. Food and Drug Administration within the required 15-day period, the new analysis reveals. (Thompson, 7/27)

UMass Memorial Health Care will spend $700 million over the next decade to upgrade its patient records and information technology systems, its chief executive, Dr. Eric W. Dickson, said Monday. Central Massachusetts’ largest health network has agreed to buy clinical and billing software programs from Epic Systems Corp. of Verona, Wis., the country’s biggest vendor of electronic health record systems, Dickson told the Globe. (Dayal McCluskey, 7/27)

Insurers participating in Florida's new Medicaid managed care program say they've lost $542 million through 2014 and want the state to raise their rates. But after losing major federal funding for hospitals, Gov. Rick Scott doesn't want to use any more state money for the Medicaid program. Scott and the insurers are locked in intense negotiations that could undermine the fledgling program that gives federal funds to private health insurance companies to oversee medical care for poor and disabled people instead of reimbursing doctors and hospitals for each service. (7/27)

Two New Jersey hospital chains are suing the state over a New Jersey law that could result in a major change in paramedic service in Camden. Virtua, which operates paramedic services in Camden and Burlington counties, said a law signed this month by Gov. Chris Christie violates the state constitution as "special legislation" aimed at benefiting just one community. The law gives hospitals with Level 1 trauma centers the right to run ambulance and paramedic services in their host communities. (7/27)

Virtua Health Inc. sued the State of New Jersey on Monday to block a law, signed earlier this month by Gov. Christie, that transfers control of emergency medical services in Camden to Cooper University Hospital. Virtua, which currently provides the advanced life support, or paramedic, portion of those services, contends that the law gives Cooper an "exclusive privilege" without any rational medical basis, thereby violating the state constitution. (Avril and Boren, 7/27)

About 3,000 Georgians have been told that some of their health information was inadvertently disclosed. The data breach affected clients in the Community Care Services Program, which helps people at risk of nursing home placement to remain in their communities. (Miller, 7/27)

Nearly four months after a California healthcare software company won a patent infringement verdict against UnitedHealth Group, it filed a new lawsuit alleging the insurance giant obtained its patents fraudulently and violated federal antitrust laws. San Mateo, California-based Cave Consulting Group and it's attorney Richard Brophy of Armstrong Teasdale launched the new complaint on Friday in the U.S. District Court for the Northern District of California against UnitedHealth's OptumInsight subsidiary, which also makes healthcare-related software. (Chung, 7/27)

A judge on Monday dismissed a lawsuit against the state on behalf of three terminally ill Californians seeking doctor-prescribed fatal medication. San Diego Superior Court Judge Gregory Pollack said his court is not unsympathetic to their plight but lawmakers — not a judge — would need to change the law barring such prescriptions. Pollack said in his written ruling that the current law that makes it a felony to assist a suicide in any way is constitutional and so he does not have the power to suspend its enforcement. (Watson, 7/27)

Legislative researchers say North Carolina can save up to $64 million annually by switching health costs to federally-funded Medicare Advantage plans, but they caution that additional action is needed to close the state's unfunded liability. A report released Monday by the Program Evaluation Division of the General Assembly says the state would need to provide around $2.2 billion more each year to be on track to fully fund an estimated $25.5 billion shortfall in covering long-term benefits to retired state employees. (7/27)

State audit says Robeson County's school system used $3 million meant for special needs students for other purposes — and other districts may have made a similar mistake. The audit issued Monday says for three fiscal years starting in 2011, the school system did not use about $1 million per year in Medicaid reimbursements to provide services for special-needs students as required. (7/27)

A Colorado transgender woman's insurance company has denied her coverage for gender reassignment surgery she says is medically necessary and should be ensured by state law and policy. Ashlyn Trider, 33, said Aetna Life Insurance Company's refusal to pay for gender reassignment surgery prescribed by her doctor violates Colorado law. The Transgender Legal Defense Fund & Education Fund has demanded Aetna reverse its decision. (Draper, 7/27)

The Lou Colen Children's Health and Wellness Center is part of a network of free clinics that have historically served uninsured patients in Los Angeles County. Though this branch — which opened in Del Rey last month — still treats many low-income families, its patient-friendly design and services reflect a shift in the way clinics across the nation are delivering healthcare. (Karlamangla, 7/27)

Ken knows there were many signs of how bad things got when he was drinking. Like the people who told him they were worried – the woman at the bank he’d done business with back when he was a successful mortgage broker, the officer manager at his doctor’s office, the friend who kicked him out of his home, saying he didn’t want to watch Ken kill himself. (Levin Becker, 7/28)

But the budget impasse is hitting a growing number of people, as social service agencies don't get promised payments, programs are reduced or eliminated and some agencies close their doors. The agencies estimate tens of thousands — most of them low-income working parents, seniors, people with disabilities and immigrants — have become the collateral damage in an ideological battle between the newly elected governor and Democrats that could go on for months. (Burnett, 7/27)

Real estate investment trust Medical Properties Trust Inc said on Monday it would buy privately held Capella Holdings Inc, owner of hospital operator Capella Healthcare Inc, for $900 million in cash. Based in Franklin, Tennessee, Capella Healthcare owns and/or operates acute care and specialty hospital facilities in six states and is one of the 10 largest for-profit acute care hospital operators in the United States based on revenue, Medical Properties Trust said. (7/27)

Early reports that 2016 health insurance premiums would increase in double digits brought out the usual cadre of critics to claim — once again — that Obamacare is not financially sustainable. These proposed premiums were neither finalized nor did they reflect the full picture of rates in most states. We now have the full picture in California, where we are proving that health insurance exchanges can keep prices in check. Residents who enroll through Covered California, our statewide exchange, will see only modest 4% increases in 2016. Those selecting the lowest-priced plans actually will save 4.5%. (Peter V. Lee and James C.Robinson, 7/27)

By this time next year, a crucial federal safety-net program could be out of cash, or almost out of cash. We refer to Social Security Disability Insurance (SSDI), which paid benefits to 9 million disabled workers (and 2 million of their dependents) in 2014, at a total annual cost of $141 billion. There’s no mystery why this has happened: Growth in beneficiaries has outstripped the accumulation of payroll taxes in the Social Security trust fund dedicated to disability benefits. There’s also no doubt about what will happen if Congress fails to act: a sudden 19 percent benefit cut, possibly right in the middle of the 2016 election campaign. (7/27)

It makes you wonder: Has there ever been a high-profile merger that's resulted in lower prices or higher quality for consumers? In the wake of several big deals in recent days, I put that question to dozens of business professors, economists and lawyers specializing in mergers and antitrust issues. These are people who study and track this sort of thing for a living. Not one was able to cite a single big-ticket merger that irrefutably benefited consumers in a long-term, demonstrable way. Not one. ... On Monday, Israel's Teva Pharmaceutical Industries, a leading maker of generic drugs, said it's buying Allergan's generic drug unit. Meanwhile, health insurer Anthem is buying rival Cigna, creating the country's biggest health-insurance company. (David Lazarus, 7/28)

The sustainability of the U.S. fiscal outlook depends on the path of health costs, particularly Medicare, the health insurance program for the elderly and disabled. If health costs continue to rise more rapidly than gross domestic product, then Medicare will be increasingly unaffordable. The recent slowdown in Medicare spending has been touted as evidence that the health cost curve has finally “bent” and that the Medicare financing problem can be managed with modest changes in policy. (Louise Sheiner, 7/27)

What do these recent news stories in the Observer have in common? An insurance agent connives to sell Affordable Care Act policies to homeless people by encouraging them to report inflated incomes. His clients/victims discover they can’t afford their deductibles nor can they any longer receive medications or other services earmarked for the uninsured. Health care advocates across the state call on Governor McCrory to develop a plan for Medicaid expansion, noting that hundreds of thousands of North Carolinians would benefit significantly, at little cost to the state. A benefit concert is held to pay mounting medical bills for an artist severely injured when struck by a car. (Jessica Schorr Saxe, 7/27)

In 1967, Richard S. Harris wrote a four-part series for The New Yorker, describing how Medicare came to be enacted. The leading opponent of that legislation was the American Medical Association. The AMA's central argument against this valuable piece of legislation was its contention that government-supported health care would pave the way to the horror of socialized medicine. The principal spokesman for the AMA’s fear-mongering claptrap was a Hollywood B-movie actor and TV pitchman named Ronald Reagen. According to one of the lawmakers who spoke to Harris, the way it turned out was that, "the docs just cried socialism once too often and after a while, people stopped believing them." (Daniel Hoffman, 7/27)

Good intentions are no excuse for perpetual legal chaos. The Americans with Disabilities Act promised a bright new era of equality and freedom. Instead, it has spawned endless lawsuits and absurd federal decrees while harming some of the people it sought to relieve. The 1990 ADA defined disability as “a physical or mental impairment that substantially limits one or more of the major life activities” — a far broader definition that what previously prevailed in the statute book. In 2008, Congress vastly expanded that definition to include people with diabetes, depression, heart disease, or cancer, as well as people who have significant troubles standing, lifting, bending, reading, concentrating, thinking and communicating. (James Bovard, 7/27)

The American taxpayer is paying $80 billion per year for federal information technology. But if you ask anyone who’s applied for veterans healthcare, or searched for a job on USAjobs.gov, or tried to explore small business resources on BusinessUSA.gov, you’ll wonder where that $80 billion went. They’re encountering websites that are confusing, complicated, and not mobile-friendly. Modernizing government isn’t sexy, but is incredibly important — especially given the pressure of budgets and the rapid evolution of consumer-facing technology. As a country, we risk falling behind. (Nick Sinai and Matt Lira, 7/27)

Many Americans are skeptical about foreign aid because they believe a large share of U.S. assistance is lost to corruption. When it comes to global health, as the chart above shows, 83% of Americans say corruption and misuse of funds is a barrier to improving health in developing nations, and 43% say it is the most important barrier. Corruption is a problem. World Bank President Jim Kim has called it “public enemy number one.” So it was of no small consequence when UNAIDS announced this month that the global goal adopted in 2011 of getting 15 million people on HIV antiretroviral treatment by the end of 2015 had been met nine months early. (Drew Altman, 7/27)

In the past year I’ve talked to dozens of these patients in states where medical marijuana is legal, as well as in Colorado, Washington and Oregon, which allow recreational use. Many people with serious illnesses turn to medical marijuana because they’re not getting the careful, comprehensive treatment they need for symptoms like pain or nausea or anxiety. That was certainly true for Robin, whose physicians didn’t seem to have the time or the skills to help her. As a palliative care physician, every day I see firsthand the suffering my patients have experienced, and the lengths to which they’ve gone to manage their symptoms and control their lives. (David Caserett, 7/28)