Nevada residents who receive medical insurance through the Silver State Health Insurance Exchange face an average increase of 38 percent under rates proposed for 2018.

The Silver State Health Insurance Exchange announced at its public board meeting earlier this week that residents in 14 Nevada counties will not have access to Qualified Health Plans (QHPs). These are insurance plans certified by the Health Insurance Marketplace under the Affordable Care Act and qualify for subsidies to lower costs.

The effort reflects the tight timeline McConnell faces in his attempt to hold a vote in July — and the pressure he is under to change the bill to garner enough support to pass it. With both conservatives and centrists pushing different policy solutions, Senate leaders were struggling to craft a rewrite of the Affordable Care Act on Wednesday that would attract votes without torpedoing the CBO’s official score of how the legislation affects coverage levels and federal spending.

Senate Republicans have asked the Congressional Budget Office to score a revised version of their embattled health-care bill that includes Senator Ted Cruz’s proposed changes, as well as a version that does not, according to Axios.

If Senate Republicans can’t get the 50 votes required to get an Obamacare repeal and replacement over the finish line, they may have to work with Democrats to repair the existing marketplace, Majority Leader Mitch McConnell, R-Ky., said Thursday.

To some, the California Nurses Association’s political tactics in pushing for a single-payer health system seemed a bit, well, extreme.