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The evidence keeps mounting: Six years after being signed into law, ObamaCare is a costly and unsustainable disaster. Look at what has happened in the past month alone. A federal court ruled that the Obama administration violated the law by spending money on ObamaCare subsidies without an appropriation from Congress. In Florida, 15 health insurers are seeking an average increase in premiums of 17.7% for 2017. The continued raiding of Medicare Advantage—ObamaCare was projected in 2012 to cut $156 billion from the program over a decade—hurts many seniors in my home state and nationwide. (Marco Rubio, 5/24)

Last week, the Missouri Department of Insurance held a hearing on the proposed merger of Aetna and Humana. The hearing was not widely noticed, but it could not be more timely or important — the proposed merger threatens to raise premiums of more than 300,000 older Missourians who depend on Medicare Advantage. History demonstrates a simple and compelling truth: When insurers merge, premiums go up. Faced with this daunting truth, the merging companies presented the best economists money can buy to muddy the issue and bring confusion to simplicity. But as John Adams once said, “Facts are stubborn things,” and the simple facts are that the Aetna-Humana merger will eliminate competition and increase consumer costs. (David Balto, 5/24)

On April 27, the Centers for Medicare & Medicaid Services (CMS) released the highly anticipated 962-page proposed rule1 for implementing the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA will overhaul Medicare’s physician payment system starting in 2019, placing most physicians in the Merit-Based Incentive Payment System (MIPS), a pay-for-performance system that adjusts payments based on measures derived from prior care. Physicians can be exempt from MIPS and receive bonus payments by demonstrating sufficient participation in advanced alternative payment models (APMs), which are intended to support greater flexibility in care delivery alongside greater accountability for efficiency and care improvement. (Jeffrey D. Clough and Mark McClellan, 5/23)

Paybacks are hell, Gov. Terry McAuliffe told Virginia Republicans last week. He didn’t put it in such undiplomatic terms, but the message is clear nonetheless. Republicans have frustrated the chief aim of McAuliffe’s only term: expanding Medicaid. Their recalcitrance has made him visibly angry at times, and the dispute over the issue has soured relations that were not exactly warm and fuzzy to begin with. (5/24)

The Missouri Legislature’s opioid obstinance must be confounding, even to conservative leaders at the national level. Under the guise of preventing government intrusion into citizens’ lives, conservatives in the Legislature refused this session to advance an important bill designed to help fight the nation’s increasingly deadly opioid-addiction epidemic. At the same time in Washington, conservatives — including Missouri Republicans —rallied behind a House of Representatives bill aimed precisely at the same addiction epidemic. Somehow, GOP leaders on Capitol Hill have wrapped their minds around the idea that an overwhelming public danger takes priority over contrived threats of government overreach. (5/24)

Florida’s recently enacted mental health legislation is sound and well-meaning. Good intentions, though, don’t reinvent a system of care. The challenge we face is that funding from Tallahassee is not likely to move the needle very far from Florida’s ranking of No. 50 in the United States for mental health spending. (Susan Racher, 5/24)

Oklahoma Gov. Mary Fallin was absolutely right to veto a bill on Friday that would have made it a felony for a doctor to perform an abortion, except to save the life of the woman. Not only did the measure set a bad policy, it was obviously unconstitutional and could not have survived a court challenge. Nonetheless, there are rumblings among legislators about trying to override Fallin’s veto. That would be a waste of time. They should stand down immediately. (5/24)

The decrease in the rate of dementia was attributed largely to two things that we have some control over -- education and heart disease. The decline was registered only in high-school graduates, but they made up most of the Framingham participants. The rate of cardiovascular disease -- including stroke, atrial fibrillation, and heart failure -- was also falling during the study period years. In that sense, the results give further support to evidence that education, which may build up a "cognitive reserve," protects against dementia -- and that cardiovascular disease, which restricts blood flow to the brain, may promote it. (Beverly Merz, 5/25)

It started with a bout of mononucleosis. Two college roommates and I got it at the same time. They felt better after a month. I didn’t. Decades later, I’m still living with bone-penetrating exhaustion and brain fog as thick as pea soup. I spent much of my 30s and 40s tethered to my bed, too weak to function. I’ve had to abandon both my career in international relations and my social life. (Rivka Solomon, 5/24)

The Ebola outbreak that started in 2013 confirmed what had long been evident: That the structure and approach of the World Health Organization were deeply flawed. The global community was sluggish in reacting to the crisis, with inadequate coordination and confused decision making. Vaccines and treatments that showed promise only came on stream toward the end of the epidemic, and even those owed much to luck. (Jeremy Farrar, 5/24)