Axios

The health care system's complex payment system gives doctors and hospitals lots of incentives to bill for more expensive services than they actually provide, a practice known as upcoding. Numerous settlements between health care companies and the Department of Justice indicate it's a widespread problem.

Why it matters: Upcoding affects everyone — it saps money from the taxpayer-funded Medicare and Medicaid programs and could lead to higher premiums for people with commercial insurance. But there's no evidence the health care system is fighting upcoding effectively, or that the problem will go away.

As if things weren't rough enough already... On Monday, the progressive group Save My Care will air a new seven-figure TV campaign across four key states, showing footage of Republican Senators promising they won't back a health care repeal bill that would hurt their constituents.

Republican leaders say these members must vote to repeal the ACA because it's been the party's central promise for the past 7 years; these ads show four Republican Senators making their own countervailing promises to protect health care. The subtext: They'll be breaking a promise no matter how they vote.

• The kicker line: "Keep your promise. Vote no on health care repeal."
• The ads will target Republican senators who oppose the current bill: Lisa Murkowski in Alaska, Dean Heller in Nevada, Susan Collins in Maine, and Shelley Moore Capito in West Virginia.
• Here are the ads: Heller, Collins, Capito, Murkowski.