Coupons, which are used to get steep discounts, typically come in the form of cards that consumers get in drug ads or from doctors. Coupons help drug companies sell more products, but studies show coupons also raise health care costs because they encourage people to buy more expensive drugs, even when cheaper generics are available. Insurance companies, therefore, don’t think much of coupons.

Health insurer Cigna is buying the nation’s biggest pharmacy benefit manager, Express Scripts, the latest in a string of proposed tie-ups as health care’s bill payers attempt to get a grip on rising costs.

The practice of charging a copay that is higher than the full cost of a drug is called a “clawback” because the middlemen that handle drug claims for insurance companies essentially “claw back” the extra dollars from the pharmacy.

The House rejected legislation Tuesday easing how experimental drugs are provided to people with terminal illnesses, as Democrats calling the bill risky and misleading overcame support from President Donald Trump and emotional arguments by Republican lawmakers and ailing constituents.

In April, the government will start sending out new Medicare cards, launching a massive, yearlong effort to alter how 59 million people enrolled in the federal health insurance program are identified.

Antonio Villaraigosa thinks he has a solid weapon to hammer Lt. Gov. Gavin Newsom with as they run for governor. And he probably does.