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With its current waiver, California successfully expanded Medi-Cal, its Medicaid program, and launched the dual eligibles demonstration project. That federal-state agreement -- known as a Section 1115 waiver -- is due to expire in October 2015, but that doesn't mean the state is done with it. State health officials have formulated a new plan, a multifaceted proposal for payment and delivery system reforms under a new federal waiver they hope will be ready to start when the current one ends. (Gorn, 10/23)

Ever since the Planned Parenthood health center here opened, the six cushioned recliners in the recovery room had been in steady demand every Friday. That's when a physician would rotate through to perform abortions for four hours. When everyone in the crowded waiting room knew why the woman next to her was there, when they all had to walk past a cluster of antiabortion protesters. (Romney, 10/23)

A pair of ballot initiatives in California and South Dakota is putting health insurers on edge about November. One would give a state regulator power to shoot down health insurance premium increases. The other would require insurers to include any willing provider in their networks. Proposition 45 in California would require health insurance rate changes in the individual and small group markets to be approved by the state’s insurance commissioner before taking effect, going further than the Affordable Care Act. In South Dakota, Initiated Measure 17 would require insurers to include all providers who are willing, qualified and meet conditions for participation, something the insurance industry and business groups say will make costs skyrocket. (Pradhan, 10/23)

The plan is to create a “social impact bond,” a contract in which Wall Street and other investors agree to support programs with goals such as taxpayer savings and improved health outcomes. If the programs can demonstrate with solid evidence that they have met those goals, the investors recoup their principal and get a return, typically from the government. The asthma project is among the first to focus on improving health outcomes. But a rising number of 'pay for success' projects are planned or underway around the nation, including in Ohio, Connecticut, South Carolina and Massachusetts. One seeks to expand early childhood education in Utah, for instance, and another to reduce homelessness in Colorado. (Gorman, 10/23)

The state-run Wyoming Retirement Center in Basin would be privatized or closed, and the Wyoming State Hospital in Evanston and the Wyoming Life Resource Center in Lander would have their roles better defined, under recommendations made by a task force. The Wyoming Task Force on Department of Health Facilities released its final recommendations on Wednesday for the future of the state's five state-run safety net medical facilities. The panel's report now goes to the state Legislature. The state operates five health care facilities: Wyoming Life Resource Center in Lander, Wyoming State Hospital in Evanston, Wyoming Retirement Center in Basin, Wyoming Pioneer Home in Thermopolis, and the Veterans' Home of Wyoming in Buffalo. (10/23)

Federal officials fined UCLA Health System $470,000 for allowing an anesthesiologist who was banned from Medicare and other federal programs to treat patients and bill the government for their care. Dr. John Edward Miller, an anesthesiologist at Ronald Reagan UCLA Medical Center, was excluded from federal programs from April 2009 to November 2013 while working there, according to the U.S. Department of Health and Human Services. The information was obtained by The Times under a Freedom of Information Act request. (Terhune, 10/23)

Piamela Seyum, 29, of Seattle, is No. 450 of those who wait patiently through the early hours of Thursday at Seattle Center’s Northwest Rooms. When free medical care is advertised for everything from a root canal to on-site prescription eyeglasses to mammograms, lines form. She’s taking advantage of a four-day eventadvertised as the state’s largest free health-services event. Some 4,000 people are expected through Sunday. If you want to see one of those working poor that get written up in news articles, here she is. Seyum works as an office manager at a small health-care office. She has Obamacare, but it mostly doesn’t cover adult dental procedures. (Lactis, 10/24)

A Texas woman who lost her wife to cancer in 2012 is taking her fight for spousal benefits to federal court, suing the Social Security Administration for denying federal benefits to same-sex couples in states with gay marriage bans. Austin resident Kathy Murphy filed suit Wednesday against Acting Social Security Administration Commissioner Carolyn Colvin, seeking to receive federal survivor benefits and death payments available to widows of opposite-sex couples. Lambda Legal, a national gay rights organization, filed the suit on behalf of Murphy and co-plaintiff National Committee to Preserve Social Security and Medicare. The U.S. Supreme Court’s decision to strike down portions of the federal Defense of Marriage Act last year meant the Colvin’s agency began disbursing federal benefits to some same-sex couples. However, the agency is still required “to follow state law in Social Security cases,” meaning many same-sex couples in states with gay marriage bans have been denied federal benefits. (McGaughy, 10/23)

Usually, the Kansas Health Care Association and Kansas Advocates for Better Care don’t see eye to eye on much. KHCA, which represents the state’s for-profit nursing homes, is quick to argue against passing laws that might increase their costs or add to their regulatory burden. KABC typically says the state doesn’t do enough to improve conditions in poor-performing nursing homes and advocates for tighter regulation. But on Wednesday, the directors of both organizations said far too many nursing homes have come to rely on using antipsychotic drugs to control residents’ dementia-driven behaviors. (Ranney, 10/23)