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Iowa health officials on Wednesday lowered the state’s projected savings for switching its $4.2 billion Medicaid program to private care, saying its initial estimate was released a year ago. Iowa Department of Human Services Director Chuck Palmer told lawmakers on the Fiscal Committee that the department now estimates it will save about $47 million in the first six months of 2016 with the move to privatization on Jan. 1. That’s a slight decrease from the $51 million that’s been publically used for months. It’s also what the Legislature used to approve its current state budget. (Rodriguez, 12/16)

Virginia Gov. Terry McAuliffe on Thursday morning plans to unveil a two-year budget proposal that represents his priorities for the second half of his term. In recent weeks he has rolled out some plans, including funding for teachers and economic development incentives, but he left the big question unanswered: Will he try to expand Medicaid for the third consecutive year? (Portnoy, 12/17)

Rising health care costs have outpaced the incomes of Massachusetts families over the past decade, despite efforts by the state to control medical expenses, according to a report released Wednesday. The cost of health insurance grew at twice the rate of incomes, jumping 55 percent from 2005 to 2014, compared to 23 percent for income, according to the report from the Health Policy Commission, a state watchdog agency that monitors health spending. Health insurance costs averaged $19,300 per family last year, consuming about one-fifth of the average family income of $88,000. (Dayal McCluskey, 12/16)

A Coral Gables-based health insurance company and dozens of its employees are the latest casualties of a Republican-led legislative gambit in 2014 to undermine the Affordable Care Act — a maneuver for which presidential hopeful and U.S. Sen. Marco Rubio of Florida has taken credit on the campaign trail. Preferred Medical Plan filed notice on Wednesday that the private insurance company intends to lay off 162 employees in February, according to the Florida Department of Economic Opportunity. (Chang, 12/16)

The number of Mainers enrolling in health care exchanges under the Affordable Care Act continues to grow even with a decision by one insurance cooperative to stop enrolling new clients. Lewiston-based Maine Community Health Options has the lion’s share of the business on the marketplace created by the health care overhaul, but Harvard Pilgrim and Anthem have good options that’ll remain after Community Health Options stops accepting new enrollments this month, said Janice Daku, who oversees the state’s health care navigators. (Sharp, 12/16)

There have been 342 drug deaths in New Hampshire so far this year, and state officials are expecting the total to surpass 400 by the end of 2015. There were 326 drug deaths in 2014, and nearly 200 the year before. The latest data from the Office of the Chief Medical Examiner shows that more than half of the drug deaths reported through mid-December have involved fentanyl, either on its own or combined with other drugs. It can sometimes take several months for officials to fully review the toxicology results and other aspects of each death, according to the examiner's office. (McDermott, 12/16)

When the Affordable Care Act went into effect, many health-care economists hoped it would reduce the number of emergency room visits made by uninsured people. The idea was that if more people had health insurance, they would be more likely to have access to a primary care doctor and avoid the emergency room. New data released by the St. Louis Regional Health Commission shows that theory might be playing out. In 2014, St. Louis-area emergency rooms saw a 5 percent decrease in visits by people without health insurance. That only represents about 7,000 fewer visits, but it comes after three years of steady increases of the same size or larger. (Bouscaren, 11/16)

A new strain of marijuana plant could slash costs for medical cannabis users in Minnesota. Otsego-based Minnesota Medical Solutions, one of two medical cannabis operators in the state, announced the creation of a new strain with a higher cannabidiol (CBD) content than any cannabis plant known. The new strain, named the Katelyn Faith strain, was cultivated through months of germination research, MinnMed CEO Kyle Kingsley said Wednesday at the company's Otsego greenhouse and laboratory. (Jeffries, 12/16)