Although many readers were unplugged for the holidays, healthcare and pharma news kept moving. Here are a few stories from the late-December stretch that may have flown under the radar—but are worth a closer look now.

1. Lapsed ACA tax credits put health insurance affordability in jeopardy

What happened: Enhanced ACA marketplace tax credits that lowered health insurance premiums for some 22 million Americans expired on December 31. The tax credit extension remains a key point of contention in Congress and was a major factor in the recent 43-day government shutdown.

Why it matters: Congress reconvenes this week, and it’s still possible that an agreement could be reached to extend the subsidies. But a Democratic proposal to extend the tax credits for three years has already been rejected, making a clean extension unlikely to pass. With ACA open enrollment ending January 15 in most states, millions may face higher premiums, be forced into plans with less generous coverage, or drop coverage altogether.

2. Pharma price hikes hit 350 drugs despite pressure from Trump admin

What happened: Pharma companies will raise prices on about 350 branded drugs this year, according to a Reuters report citing data from 3 Axis Advisors. The median of this year’s price hikes is about 4% and applies to a range of drugs and treatments, including vaccines, cancer drugs, and more.

Why it matters: Despite buzz around pharma price cuts amid pressure from the Trump administration, many drugs will still get more expensive. The 350 drugs on the list this year tops last year’s 250. It’s a reminder that TrumpRx-driven price cuts don’t apply across a drugmaker’s portfolio, and companies will still raise prices to offset inflation, R&D, and other expenses.

3. California ends Medicaid coverage for weight loss drugs

What happened: Effective January 1, Medicaid members in California can no longer get weight loss drugs covered by their health plan, per the LA Times. California's Medi-Cal program (its state Medicaid program) will still cover the drugs when used to treat type 2 diabetes.

Why it matters: Novo Nordisk and Eli Lilly recently cut prices on their blockbuster GLP-1 drugs, making the discounts available to state Medicaid plans. But states can choose whether to cover weight loss drugs under Medicaid, and fewer than one-third did as of October, according to KFF. Medicaid plans already pay lower drug prices than other insurers, so Novo and Lilly’s cuts are unlikely to ease states’ concerns about covering weight loss medications for a much larger patient pool.

4. Sanofi doubles down on vaccines with Dynavax acquisition

What happened: Sanofi agreed to buy vaccine maker Dynavax Technologies for $2.2 billion. Dynavax makes a hepatitis B shot for adults and has a shingles vaccine candidate in its pipeline.

Why it matters: It’s a challenging moment for US vaccine makers as hesitancy grows and the CDC rolls back recommendations for some shots. But Sanofi, which manufactures a range of vaccines itself and acquired another vaccine developer earlier this year for $1.6 billion, does not appear to be deterred. It suggests that even amid rising vaccine skepticism, demand will remain strong for products that prevent life-threatening diseases.

5. UnitedHealth audit returns positives, but trust issues persist

What happened: UnitedHealth Group reported mostly positive results from an independent audit of its Medicare Advantage business, OptumRx pharmacy benefit manager, and UnitedHealthcare care services management.

Why it matters: UnitedHealth remains under DOJ investigation over allegations that it pressured doctors to document certain conditions to boost Medicare Advantage payments. UnitedHealth may think that the auditors’ findings could help the company regain some public goodwill, but concerns about the company’s use of prior authorization to deny care and its role in raising prices through vertical integration are too loud to be drowned out by consultant reports.

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