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Texas' Republican leadership has fought tooth and nail against federal health care reform, adamantly opposed to taking either money or direction from the Obama administration when it comes to providing health care for the poor. But putting politics aside, public health care costs in Texas are rising about $1.3 billion over the next two years, according to one legislative budget estimate. Medicaid enrollment is growing, whether or not the state decides to accept more federal funds to expand the program's coverage to poor adults. And fiscal conservatives are raising the possibility, for first time in recent memory, that state appropriators will this year allocate more money for health care than education. (Walters, 1/27)

State officials say Missouri's Medicaid program will save an estimated $4.2 million in fiscal year 2016 by using a newer, cheaper drug to treat hepatitis C. The state joined a group of 25 other states to receive rebates on Viekira from drug maker AbbVie. The state in most cases will provide that drug instead of Gilead Science's Sovaldi in an agreement announced Monday. (1/27)

In the midst of negotiations over a new contract, UnitedHealthcare has notified its brokers that Carolinas HealthCare System “wants to be paid up to 150 percent more than other hospitals in the Charlotte area for providing the same services.” The multiyear contract between Charlotte-based Carolinas HealthCare and the insurance company will expire Feb. 28 if a deal isn’t reached. That would leave 12 Charlotte-area hospitals and many doctors offices in Carolinas HealthCare “out-of-network” for the nearly 80,000 Charlotte-area members covered by UnitedHealthcare. (Garloch, 1/27)

UnitedHealthcare began notifying patients this week by mail that its contract with Carolinas HealthCare System is scheduled to expire Feb. 28. Unless a deal is reached, Carolinas HealthCare facilities — including its hospitals and physicians practices — will no longer be considered in-network for individuals covered by UnitedHealthcare. That could mean higher out-of-pocket costs for nearly 80,000 patients with insurance coverage through UnitedHealthcare's commercial plans or Medicare starting March 1. (Thomas, 1/27)

Ten years after California voters passed Proposition 63’s tax on millionaires to fund programs for the mentally ill, the state cannot document whether billions of dollars in funding have improved residents’ lives, according to a new report by the Little Hoover Commission. (Siders, 1/27)

Legislators expressed skepticism Tuesday about a bill that would require hospitals to provide discharge instructions to patients’ designated caregivers. Kansas AARP has made House Bill 2058 one of its priorities for the session, running ads for it on public television. But the group has not come to an agreement with the state hospital association on the bill, and members of the House Children and Seniors Committee questioned whether it’s necessary. (Marso, 1/27)

At the annual meeting of North Carolina’s state health directors last week in Raleigh, small knots of people gathered in the halls and the backs of conference rooms, all discussing the same question: How will public health survive the coming changes in health care financing? One of the biggest concerns voiced by health directors both off and on the record centered around the future of North Carolina’s Medicaid program. Currently, legislators are discussing changing both how the program gets administered and how services get paid for. And for many local health departments, Medicaid payments – small as they are – are key to keeping budgets solvent. (Hoban, 1/27)

There's a new push to legalize medical marijuana in Florida, and a Republican lawmaker is leading the charge. Though a constitutional amendment to legalize medical marijuana failed in November, Republican lawmaker state Sen. Jeff Brandes has filed a bill to make medical marijuana legal for Florida residents. (Watts, 1/27)

The first Legislature in the country to pass an aid-in-dying law may revisit the issue, as a key backer says changes to automatically take effect in mid-2016 would remove too many patient protections. (1/27)