Progressive supporters of health reform wanted a public plan option to compete with private insurers offering insurance in the state and federal health exchanges. To draw support from progressives, proponents of the Patient Protection and Affordable Care Act (ACA) created a type of nonprofit health insurance cooperative that would compete with established health insurers. Consumer Operated and Oriented Plans, or health insurance COOPs, as they are commonly known, were a political compromise for those who supported allowing non-seniors to buy their way into Medicare or a similar public program.

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Pence has always been a vocal opponent of the Affordable Care Act, even after the federal law passed in 2010 and was upheld by the Supreme Court.

But when faced with the choice of whether to expand Medicaid to cover Indiana residents who earn incomes that are 138 percent or below the federal poverty level — a key part of the ACA — Pence made a compromise. He debuted a conservative-friendly version of the expansion, one that requires Medicaid recipients to pay a monthly contribution, based on income, into a health savings account.

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The Obama administration went to court Thursday to block two major health insurance mergers, siding with consumer advocates and medical groups worried that the consolidation of large national health plans could lead to higher premiums.

The long-anticipated move by the Justice Department and attorneys general in California and 10 other states,  will at least temporarily prevent Anthem Inc.’s $48-billion purchase of Cigna Corp., a combination that would create the nation’s largest health insurer.

And it will stop Aetna Inc.’s $34-billion bid to acquire Humana Inc., a merger that would have combined the nation’s third- and fifth-biggest health plans.

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The Journal of the American Medical Assn. recently published a very unusual article: a scientific study authored by a sitting president of the United States. That’s never happened before.

In a sense, it’s cool that President Obama cares enough about science to want to publish a paper in one of the world’s leading medical journals. But JAMA has set a bad precedent. The article, on healthcare reform in the United States, is problematic not only in its content but in the threat it poses to the integrity of scientific publishing.

It would be difficult, if not impossible, to find another paper in any scientific journal in which a politician was allowed to subjectively analyze his own policy and declare it a success. This is a textbook definition of conflict of interest.

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Politicians tend to be most enraged by the problems they cause, and the liberal fury against insurance mergers is a classic of the genre. ObamaCare was designed to create government-directed oligopolies, but now its authors claim to be alarmed by less competition.

Last week federal and 11 state antitrust regulators filed a double lawsuit to block the pending $54 billion insurance tie-up between Anthem and Cigna and the $37 billion acquisition of Humana by Aetna.

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The man selected by presumptive Democratic presidential nominee Hillary Clinton as her vice presidential running mate is a strong ally of Clinton’s in her push for improving the Affordable Care Act and expanding Medicaid to more states.

Virginia Sen. Tim Kaine, whom Clinton named Friday as her running mate, has sponsored several bills to fix gaps and glitches in the ACA and to encourage more states to extend Medicaid to low-income adults. None have won Republican support and passed. He also has strongly backed Virginia Gov. Terry McAuliffe’s unsuccessful efforts up to now to expand Medicaid in his own state.

As governor in 2009, Kaine signed a letter with 21 other governors to congressional leaders urging them to enact federal healthcare reform legislation.

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Hillary Clinton led a health care reform effort in the 1990s, promoted medical research as a senator, and has been bashing price-hiking drug companies on the campaign trail and in TV ads.

So there’s every reason to expect her to make health care a major theme when she accepts the Democratic presidential nomination in Philadelphia on Thursday night. What she says about the future of medical research, public health, and the uninsured will give a valuable preview of what her priorities would be — and how far she’s willing to go to co-opt the ideas of her defeated rival, Bernie Sanders.

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Today’s headline in The Los Angeles Times: “California Obamacare rates to rise 13% in 2017, more than three times the increase of the last two years.” The increase will be 17.2% for Anthem and 19.9% for Blue Shield–the largest Obamacare insurers.

Obamacare supporters have long pointed to Covered California as the example of just how good Obamacare could be if the entire program were run as well as it is in California.

Covered California’s average rate increase for 2017 will be 13.2%.

But half of the California market is controlled by two carriers who will be asking for much bigger increases. Blue Shield of California said its average rate increase for 2017 will be 19.9%, the biggest statewide increase. Anthem Blue Cross said it will increase its rates by an average of 17.2% for 2017.

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California’s Obamacare premiums will jump 13.2 percent on average next year, a sharp increase that is likely to reverberate nationwide in an election year.

The Covered California exchange had won plaudits by negotiating 4 percent average rate increases in its first two years. But that feat couldn’t be repeated for 2017, as overall medical costs continue to climb and two federal programs that help insurers with expensive claims are set to expire this year.

The increase announced Tuesday comes as major insurers around the country seek even bigger rate hikes for open enrollment this fall, and the presidential candidates clash over the future of President Barack Obama’s landmark health law.

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Humana will exit eight of the 19 individual health insurance markets where it has sold Obamacare plans this year, the insurer announced Thursday.

The company is still struggling to make a profit on the exchanges, according to its second quarter earnings guidance released Thursday. The company expects to offer individual plans in 156 counties across 11 states compared to the 1,351 counties in 19 states it has offered plans in the year, according to a release.

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