Repeal was replaced for much of 2018, but then December came along.
U.S. District Judge Reed O'Connor put the industry back into a frenzy when he ruled in mid-December to invalidate the Affordable Care Act. Although the Trump administration has pledged to enforce the law while the case makes its way through the appeals process, the ruling has created long-term uncertainty.
Throughout 2018, Congress moved on from failed attempts to repeal the ACA and drama unfolded on a number of other fronts.
With the CMS' guidance, a dozen states advanced plans to impose new enrollment mandates on Medicaid beneficiaries, including work and job training requirements. The Trump administration added a new twist to insurance markets with rules allowing for non-compliant ACA plans.
Deaths mounted from opioids and gun violence, causing public health officials to amp up calls for policy solutions.
Across the industry, the consolidation trend showed no signs of abating. Providers stared down declining admissions by imagining a world dominated by ambulatory care.
Consumer-facing companies continued their push into healthcare aiming to do what the industry hasn't on data exchange. But hackers upped their game too, making breaches an all-too-frequent occurrence.