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With millions of people getting health insurance coverage since 2010, health insurers can buy one another faster than they can sign up new customers.

State-run health insurance markets that offer coverage under President Barack Obama’s health law are struggling with high costs and disappointing enrollment. These challenges could lead more of them to turn over operations to the federal government or join forces with other states.

The Affordable Care Act created a new kind of “cooperative” health insurance arrangement heralded by supporters of health reform. The co-ops were founded on the idealistic belief that community members could band together to create health insurance companies that would be member-driven, service-oriented, and would not have to answer to shareholders or turn a profit.

The Louisiana Department of Insurance announced today that the Louisiana Health Cooperative, Inc. (Co-Op), a health insurer formed under the provisions of the Affordable Care Act (ACA) as a non-profit health insurance company, will be winding down its operations at the end of 2015. The Co-Op will not offer coverage in 2016 but will continue to honor all in-force policies for the approximately 17,000 individuals that currently receive health insurance coverage from the Co-Op. Most of the Co-Op members enrolled in coverage through the health insurance exchange operated by the federal government under the ACA.

The settlement announced this week between the state and Noridian Healthcare Services over Maryland’s bungled online health exchange is not quite a done deal.

The $45 million deal must still be approved by Centers for Medicare and Medicaid Services, the U.S. attorney’s office for Maryland and the North Dakota insurance regulators, who oversee Noridian Healthcare’s parent company.

Anthem Inc. has agreed to acquire rival Cigna Corp. for $54 billion, creating the health insurance industry’s biggest company by enrollment.

The agreement announced Friday caps weeks of frenzied deal making in the healthcare sector.

Glenview Capital Management LLC made a bold decision when President Barack Obama’s health-care overhaul was rolling out: Bet on it.

A group of Colorado nuns said Thursday they will go to the U.S. Supreme Court to appeal a ruling that allows their employees to receive birth control from a third party under the Affordable Care Act, fueling a combustible argument over contraception and religion ahead of next year’s presidential election.

Momentum is building for a House vote on the rarest of bills: bipartisan legislation to reform President Barack Obama’s signature legislation, the Affordable Care Act. The Protecting Affordable Coverage for Employees, or PACE Act would tweak the employer mandate to shield larger businesses from stricter requirements.

A year and a half after the Affordable Care Act brought widespread reforms to the U.S. healthcare system, Chicago’s Cook County Health & Hospitals System has made its first profit in 180 years.

Seven hundred miles south, the fortunes of Atlanta’s primary public hospital, Grady Health System, haven’t improved, and it remains as dependent as ever on philanthropy and county funding to stay afloat.