“Basically, anybody who knows anything about healthcare is opposed to these proposals,” said Sandy Praeger, a former president of the National Association of Insurance Commissioners.

One of the largest insurers in the U.S. behind the Big Five of UnitedHealthcare, Aetna, Anthem, Cigna and Humana, WellCare would add more Medicaid and Medicare Advantage (MA) members with the purchase of Meridian Health Plans.

The legislation, sponsored by California Assemblyman Ash Kalra, a Democrat from San Jose, would have created a state commission to set rates for many medical services currently covered by private insurers in the group and nongroup markets.

Michael Frank has worked for health insurance companies for decades, doing the actuarial science which determines how much people should pay in monthly premiums. He knows insurers are supposed to be his “advocate” to restrain costs and get him a fair rate—so he was shocked when Aetna agreed to pay $70,000 to NYU Langone Medical Center in New York City for his partial hip replacement.

CMS had requested comments on allowing direct provider contracting (DPC) with Medicare beneficiaries in the form of the alternative payment model. Among major healthcare groups, the response was decidedly mixed, ranging from cautious optimism to telling CMS to focus on other payment reforms.

Calling 2017’s failed efforts to repeal the Affordable Care Act “one of the greatest disappointments to conservative and libertarian activists in history,” conservative groups pushed for another attempt at getting rid of the law with a series of principles they want to see enacted in place of the ACA.

The deal will still need to be approved by federal and state regulators, but after delays in contract talks and an unsolicited bid from Brown University, the agreement advances Partners HealthCare’s aim of expanding beyond Massachusetts and matching the increased scale of other Boston-based health systems.

The Congressional Budget Office has scaled back its projections of coverage losses from the Affordable Care Act’s individual mandate being repealed, estimating 8.5 million people will be uninsured in 2027 due to the penalty being eliminated by Republicans’ tax legislation beginning next year.