The Trump administration said Thursday that states could bypass major requirements of the Affordable Care Act by using federal funds for a wide range of health insurance programs that do not comply with the law. The new policy outlined by the administration on Thursday upends a premise of the Affordable Care Act: that federal subsidies can be used only for insurance that meets federal standards and is purchased through public marketplaces, also known as insurance exchanges. (Robert Pear and Abby Goodnough, New York Times)

Enrollment is down sharply on the federal health insurance marketplace this fall, and the consumer assistance groups that help with sign-ups think they know why. They don’t have the staff to help as many customers as before because the Trump administration slashed funding. The federal government is spending $10 million this year on navigators who help individuals enroll in coverage. The government spent $36 million in 2017 and $63 million in 2016. Nationwide, navigator groups are scrambling to make up for the loss of federal funding to ensure they can help people make sense of their health insurance options. (Phil Galewitz, Kaiser Health News)

Sen. Patty Murray (D-Wash.) on Wednesday called for reviving bipartisan efforts to reach a deal to fix Obamacare after an agreement she was part of collapsed last year. Still, Sen. Lamar Alexander (R-Tenn.) and Murray have not sat down to reopen negotiations, and it is unclear what each side would be pushing for in these early stages. One change is that Democrats will control the House next year, which could add new pressures. (Peter Sullivan, The Hill)

The number of children in the United States without health insurance increased last year for the first time in more than a decade, according to a new report that highlights potentially worrisome backsliding in pediatric care. The erosion in health insurance came despite a robust economy, which in the past has helped fuel expansions in coverage. (Noam N. Levey, Los Angeles Times)

A top Trump administration health care official on Tuesday said she is “looking closely” at why thousands of people have lost Medicaid coverage in Arkansas due to the state’s new work requirements, but indicated the administration would not slow down in implementing the new rules. (Peter Sullivan, The Hill)

Federal regulators have approved New Hampshire’s proposal to require some Medicaid recipients to work. New Hampshire Public Radio reports that the Granite State joins a handful of states that have proposed such requirements. The new rules will require some Medicaid recipients to log at least 100 hours a month in qualifying activities including holding a job, going to school, or participating in community service. (Associated Press)

Iowa saved $126 million this year from privatizing its Medicaid system, barely half what former Gov. Terry Branstad projected when he forced the change in 2016, according to an audit released Monday. The report also found officials and lawmakers have failed to file quarterly financial reports as required by state law. (David Pitt, Associated Press)

CVS Health Corp. completed its nearly $70 billion acquisition of Aetna Inc., forging a new industry giant and starting the clock ticking on ambitious goals of curbing health care costs and improving consumers’ experience. The combined company faces significant challenges in bringing together its diverse set of health assets, including CVS’s sprawling network of pharmacies, a pharmacy-benefit manager, and Aetna’s employer insurance, Medicare, and Medicaid managed care businesses. (Anna Wilde Mathews and Aisha Al-Muslim, Wall Street Journal)

Amazon.com is starting to sell software that mines patient medical records for information doctors and hospitals could use to improve treatment and cut costs. The move is the latest by a big technology company into health care, an industry where it sees opportunities for growth. (Melanie Evans and Laura Stevens, Wall Street Journal)

Life expectancy in the United States declined again last year amid the twin scourges of opioid addiction and an unrelenting rise in suicides. Three reports by the Centers for Disease Control and Prevention released Thursday paint an increasingly grim picture of mortality in the United States, with life expectancy dropping, overall death rates increasing, and mortality from drug addiction and suicide rising fast among young adults. It was the third year in a row that life expectancy had either fallen or stayed flat — the first three-year stretch since the flu pandemic a century ago. (Brianna Ehley, Politico)