Â鶹ŮÓÅ

More than 100 demonstrators rallied at the State House on Thursday — some disrupting the governor's inauguration — to let him know that they were upset with his decision not to ask lawmakers this year for a plan to pay for a new universal health care system. Twenty-nine protesters were arrested on charges of unlawful trespass after they were asked to leave but didn't. (Gram, 1/8)

California's budget, which bounced back after years of deficits, is now being squeezed by rising healthcare costs for the poor and for retired state workers. The mountain of medical bills threatens to undermine Gov. Jerry Brown's efforts to strengthen state finances — his central promise of the past four years. Enrollment in the state's healthcare program for the poor, known as Medi-Cal, has exploded by 50% since President Obama's signature law took effect. Although the federal government picks up most of the tab, state costs have also been growing, and faster than expected. (Megerian, 1/8)

A state senator wants the Texas auditor to review how a private firm was selected to operate a state psychiatric hospital in Terrell. The request from state Sen. Robert Nichols, R-Jacksonville, is the second recent call for an audit of the way the Texas Health and Human Services Commission strikes a deal with a private contractor. (Langford and Satija, 1/8)

A leading state senator says she will propose tougher safeguards against unethical behavior by those involved in awarding contracts to the private vendors who increasingly deliver medical care and social services to vulnerable Texans. Sen. Jane Nelson, R-Flower Mound, is calling for stronger conflict-of-interest laws. They would prevent the state from issuing health and human services contracts to companies that have ties to agency employees. (Garrett, 1/8)

A contractor hired to replace New Jersey's antiquated computer network used for welfare programs has agreed to reimburse the state $7.5 million as part of a termination agreement. The state hired Hewlett-Packard in 2009 to build a new computer system that would assist eligibility and enrollment functions for Medicaid and other benefit programs such as the Supplemental Nutrition Assistance Program, commonly known as food stamps. (1/8)

Reimbursement rates dropped Jan. 1 for Medi-Cal primary care providers in two ways. A provision of the Affordable Care Act temporarily set primary care reimbursement rates at Medicare levels, significantly higher than Medicaid payments. The increase lasted two years and expired on Jan. 1. A state reduction in Medi-Cal reimbursement for primary care providers hit on the same day. (Gorn, 1/8)

A $10 million payment to Connecticut Children’s Medical Center – approved Thursday without going through the legislature, and despite a state budget deficit – sparked questions about legal precedent and fairness. The $10 million approved by the Finance Advisory Committee comes on top of $15.8 million the state already planned to pay the hospital this year, a 64 percent increase. (Phaneuf and Levin Becker, 1/8)

[Republican] Gov. Doug Ducey is sticking with four directors who have overseen state agencies during Jan Brewer's administration. The retention of the directors comes as Ducey continues to fill out the roster of his top staff, adding a vocal critic of the state's Medicaid expansion as his policy advisor for healthcare and human services. (Pitzl, 1/8)

Amid a change in top leadership at Los Angeles County, the Board of Supervisors is considering a major overhaul of the way the county provides health services to its 10 million residents. Supervisor Michael D. Antonovich wants to merge the county's public health department — which is responsible for preventing and responding to disease outbreaks, running substance abuse programs and inspecting restaurants, nursing homes and other facilities —- and a separate mental health agency with the Department of Health Services, which runs county hospitals and clinics. (Sewell, 1/8)

Statewide, dozens of rural hospitals are struggling to survive in the face of declining populations, fewer paying patients and decreasing payments from the government and private insurers. Eight have closed since 2001. Nearly two-thirds of the remaining 61 hospitals have experienced significant losses in the past five years, state data shows. Dodge County Hospital is a rare success story — one of only seven rural hospitals to consistently make a profit in recent years. But that success may be short-lived. (Williams, 1/8)

Health care costs are increasingly squeezing American workers, especially those in Georgia and the South, a new [Commonwealth Fund] report released Thursday finds. Nationally, workers’ out-of-pocket costs for premium contributions and deductibles in 2013 accounted for a higher percentage of median family income in all states compared to 2003. (Miller, 1/8)

Eleven Kansas hospitals are among more than 700 nationwide that have been penalized for having high rates of infections or patient injuries, leading to a 1 percent reduction in Medicare reimbursements since the current fiscal year began in October. Medicare evaluated 51 Kansas hospitals, 40 of which were not penalized after scoring below 7 on a 10-point scale for hospital-acquired conditions. (1/8)

Doctors at the U.S. Department of Veterans Affairs medical center in Tomah, Wis., hand out so many narcotic painkillers that some veterans have taken to calling the place "Candy Land." They call the hospital's chief of staff, psychiatrist Dr. David Houlihan, "the Candy Man." The number of opiate prescriptions at the Tomah VA more than quintupled from 2004, the year before Houlihan became chief of staff of the hospital, to 2012, according to data obtained by the Center for Investigative Reporting. (Glantz, 1/9)