Heading into this holiday weekend, health-care stocks continue to lead the S&P 500 in 2013. But behind the share-price gains is an industry undergoing dramatic changes. While fellow fool Sean Williams recaps the week's biotech and pharmaceutical news, here's a look at the top stories from the other parts of the health-care industry.

Two stories this week displayed the uncertainty that surrounds some forthcoming Obamacare changes. In addition, a Consumer Reports investigation showed which drugstores have the lowest margins on generic drugs.

The Volunteer State and Medicaid
Arkansas' tentative permission to use federal Medicaid expansion money to purchase private insurance led many other states to pursue that route. But the matter's a bit more complicated, and Sarah Kliff reports at WonkBlog that Tennessee has run into opposition from the Department of Health and Human Services.


The problem wasn't the state's desire to use the money for private insurance, but that Gov. Bill Haslam also proposed that the newly eligible Medicaid members should have similar co-pays to others in the health-insurance exchanges. And that could mean the government might spend far more than it would on a traditional Medicaid plan. The HHS remains open to negotiations, but Gov. Haslam seems firm in his proposal.

Tennessee's Medicaid program includes Magellan as its pharmacy benefits manager and counts UnitedHealth and WellPoint as its major insurance backers. So investors for those companies should keep an eye on this story.

Medicare cuts
Turning to the Medicare side of the Affordable Care Act, health plans rose this week on the suggestion that Medicare Advantage rates might see lower cuts than previously announced. Those rates were based on the assumption that Congress will go through with a 25% physician pay cut for next year, which would require the higher insurance rates for balance. But Congress hasn't implemented the pay cut in more than a decade, so the rate cuts haven't been necessary. We'll find out for sure with the final rate announcement on Monday. Humana is overly dependent on Medicare, and shares were up nearly 3% on Wednesday following the news.

Finding cheap drugs
Consumer Reports was out with a study showing which drugstores have the best prices on generic medications. Costco had the lowest prices, while CVS Caremark had the highest. The publication theorizes that the price difference comes from how much the pharmacy segment means to the overall business. After all, a big-box store like Costco can afford narrower margins on its generics because there's more general store than pharmacy, while CVS is more dependent on its pharmacy to drive the bottom line.

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The article 3 Health-Care Stories You Should Know originally appeared on Fool.com.

Brandy Betz has no position in any stocks mentioned. The Motley Fool recommends Costco Wholesale, UnitedHealth Group, and WellPoint and owns shares of Costco Wholesale and WellPoint. Try any of our Foolish newsletter services free for 30 days. We Fools don't all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.

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