Axios

One year after leaving British pharmaceutical giant GlaxoSmithKline, Andrew Witty is becoming CEO of Optum, the conglomerate owned by UnitedHealth Group. One of Optum's largest businesses is its pharmacy benefit manager, which negotiates down drug prices from companies like GlaxoSmithKline.

Why it matters: Witty, a critic of high drug prices who also is a paid UnitedHealth board member, is moving to the other side of the pharmaceutical bargaining table. It's also worth noting that under Witty's watch, GlaxoSmithKline had to pay China a $489 million fine over bribery and corruption charges.

Health insurer Premera, the only option in Alaska’s individual market, says new corporate tax cuts will allow it to keep selling Affordable Care Act coverage there. Premera sells Blue Cross Blue Shield plans in the state, and it says it will spend $50 million to help stabilize that market.

Why it matters: Health care companies have largely used their windfalls from the GOP tax law on share buybacks or to pay down debt. Premera is one of the few to even claim that its tax benefits will flow through to consumers.

Here’s one bright spot for the 10 Senate Democrats up for re-election this year in states that President Trump won: Their constituents aren’t too fired up against the Affordable Care Act. Our Axios/Survey Monkey poll shows that most voters in all 10 states want Congress to either modify the law or leave it alone, rather than try to repeal it.

Why it matters: Repeal is still a strong motivator for the GOP base, but that’s about the extent of its political potency. And most of these 10 Democrats have already tried to stake out a middle ground on health care, opposing the ACA repeal while also not joining their party’s shift toward embracing a single-payer system.

After months of circular finger-pointing over high drug prices, lawmakers, administration officials and parts of the health care industry seem to have settled on an initial target: pharmacy benefit managers, the middlemen that health insurers and employers hire to negotiate with drug companies.

Yes, but: There are savings to be wrung out of the highly concentrated PBM industry. That's why insurers are so eager to operate their own PBMs. But analysts say squeezing PBMs won't solve some of the fundamental problems that drive high drug spending.

By making their Affordable Care Act marketplaces and Medicaid programs more conservative, the leaders of several red states may actually strengthen the ACA and Medicaid by creating a stronger Republican constituency for both programs.

The bottom line: As they make a series of changes — through waivers and other means — to swing the programs to the right, those state leaders are building a broader political base for the programs in red states. That could make ACA repeal and Medicaid cuts an even tougher sell in the future than it is now.