Efforts from Republicans in Washington, D.C., failed to repeal the Affordable Care Act (ACA), but that hasn’t stopped some states from taking matters into their own hands. Iowa Gov. Kim Reynolds is expected to sign legislation that would allow insurers to sell certain plans that don’t meet ACA regulations.

Jefferson Health and Einstein Healthcare Network, both based in Philadelphia, have announced they’ve signed a letter of intent to merge, the latest in a string of acquisitions by Jefferson.

Discussions to create the largest hospital system in the country by combining Ascension and Providence St. Joseph Health have ended, with the two companies deciding to focus on restructuring existing operations, according to the Wall Street Journal.

Mergers and acquisitions that have consolidated healthcare markets in California have raised prices for procedures and insurance premiums, especially in the northern part of the state, according to a report from the University of California, Berkeley’s Petris Center on Health Care Markets and Consumer Welfare.

An election year usually means little movement in Congress on major policies. That’s especially true for hot-button issues in healthcare, according to Tom Nickels, the American Hospital Association’s executive vice president of government relations, meaning major reforms may have to wait until after the midterm election—or perhaps after the next presidential race.

In the midst of threats to the Affordable Care Act and pushes for more dramatic shifts to single-payer healthcare, some Democrats in Congress and state legislatures have begun proposing a different option: allowing people to buy into Medicaid. But not all those proposals would achieve their goals in the same way, argue Duke University researcher David Anderson, MSPPM, and Harvard University PhD student and former CMS spokesperson Emma Sandoe.

The last few months in mergers and acquisition (M&A) activity in healthcare have been dominated by massive deals proposed across sectors—like drugstore chain CVS Health wanting to buy health insurer Aetna for $69 billion. What those companies should watch for, writes Morning Consult’s Jon Reid, is the result of the case challenging a merger with similar dynamics: the combination of AT&T and Time Warner.

For-profit hospital giant HCA has entered into discussions to acquire Mission Health, a nonprofit six-hospital system based out of Asheville, North Carolina, in a deal Mission admitted may result in some jobs being eliminated.