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Along with “stakeholders” (campaign donors), “investments” (government spending) and “obstruction” (Congress), one of our favorite political euphemisms is “improper payments.” That’s how Washington airbrushes away the taxpayer money that flows each year to someone who is not eligible, or to the right beneficiary in the wrong amount, or that disappears to fraud or federal accounting ineptitude. Now thanks to ObamaCare, improper payments are soaring. (9/6)

With Congress returning from its long summer recess this week, Senate Majority Leader Mitch McConnell could help improve the low standing of the entire institution by allowing a vote on the mental health reform bill that passed the House this summer by a 422-2 margin. Even though this is an election year and other major issues—including the budget—are on the table, helping people with severe mental health problems is an issue that unites both political parties, the American public, mental health advocacy groups and the nation's criminal justice and healthcare systems. (Merrill Goozner, 9/3)

Everyone agrees the Affordable Care Act exchanges need more people to sign up for coverage to make those marketplaces more stable. A larger number of enrollees -- especially a higher percentage of younger and healthier people -- would help convince nervous insurers to continuing selling plans in the exchanges and would moderate premium increases. But as I was reminded on a reporting trip here last week, many Americans haven't enrolled because they find the health insurance and healthcare system complex and confusing – before, during, and after they sign up for coverage. (Harris Meyer, 9/6)

[T]he focus on what’s going wrong with Obamacare makes it easy to lose sight of what’s going right. The law has ended the insurance industry’s most pernicious practices, fostered improvements in the way doctors and hospitals deliver care and brought the number of Americans without coverage to a historic low. Some state markets appear to be working just fine, and at least a few insurers are making money. The law’s achievements don’t make the problems any less real. But they do put those problems into perspective ― and suggest that fixing them is worthwhile. (Jonathan Cohn, 9/3)

Welcome back to work, Congress! We see the Senate picked up right where it left off before its seven-week summer recess — blocking a bill to provide $1.1 billion for Zika prevention efforts because it would bar funding for Planned Parenthood and its affiliates. While you were out campaigning, fundraising or barbequing, however, the number of Zika cases in the U.S. more than doubled to 2,700, and people infected with the virus have turned up in every state. A total of 17 babies have been born with Zika-related birth defects (two in California), and about 1,600 pregnant women are known to have been exposed. (9/7)

Some four million children are born each year in the U.S., about half in areas where the mosquito species capable of carrying the Zika virus is found. If we assume that 3% of pregnant women in the U.S. will become infected over the next three years and at least 1% of children born to those mothers will be microcephalic, we can anticipate up to 20,000 microcephalic children. Humanitarian considerations aside, the estimated cost of caring for one such child over the course of his lifespan is $10 million. (W. Ian Lipkin, 9/6)

[A] single health center like ours, even an entire city like Houston known for its world-class medicine, can’t manage Zika alone. Nor can the state of Texas, which has admirably stepped up to allow Medicaid to pay for insect repellant for low-income pregnant moms. Governor Greg Abbott has allocated state and federal funds to help prevention efforts. All of the public health players are doing their part. Except the United States Congress. (Katy Caldwell, 9/6)

Securing funding to combat the Zika virus was supposed to be one issue on Capitol Hill that would be free of the political games that are typical in election years. That's because we have all seen the heartbreaking photos of Zika babies and heard the toll the virus has had on families in affected countries, including right here in the United States. The call for Washington to fund the effort to stop the spread of Zika was swift and bipartisan. (Sen. Thom Tillis, R-N.C., 9/7)

Electronic health records slow doctors down and distract them from meaningful face time caring for patients. That is the sad but unsurprising finding of a time and motion study published in Tuesday’s Annals of Internal Medicine. A team of researchers determined that physicians are spending almost half of their time in the office on electronic health records (EHRs) and desk work and just 27 percent on face time with patients — which is what the vast majority of doctors went into medicine to do. Once they get home, they average another one to two hours completing EHRs. (Jonathan Bush, 9/6)

This week, the Georgia Chamber of Commerce released a new plan to impose more of Obamacare on their state. The Chamber acknowledged that their “guiding principle” in crafting the Medicaid expansion plan was simply to “take advantage of all federal dollars available.” As such, they’re lobbying for policymakers to expand Medicaid to a new welfare class of more than 700,000 able-bodied adults. (Nic Horton, Jonathan Ingram and Josh Archambault, 9/6)

2,615. That's the number of people who died in Northeast Texas in 2014 who wouldn't have died if mortality rates in the region were simply the same as in Texas overall. That's 16 percent of all deaths in the region that year. We don't always think of this region on its own terms, as a distinct part of Texas. If Northeast Texas were its own state, however, it would be the size of West Virginia and would rank 45th in the nation in overall mortality, sandwiched in between its geographic neighbors Arkansas (44th) and Louisiana (46th). Texas, by comparison, ranks 31st even if you include the Northeast region in the numbers. (David Lakey, Kirk Calhoun and Eileen Nehme, 9/6)

Virginia’s Certificate of Public Need (COPN) law requires government permission before a health-care facility can expand, offer a new service, or purchase certain pieces of equipment. These laws were enacted with the belief that restricting entry would lower health-care costs and increase availability of these services to the poor. But research has shown that COPN laws actually have the opposite market effect, reducing the availability of services and hospital beds. Not only is the COPN law not a solution to escalating hospital bills, but this lengthy and expensive application process also may hinder our state’s ability to attract private business investment to ensure a 21st century health-care system that meets the future needs of everyone. (John Watkins, 9/6)

Employers are increasingly contracting with firms that use big data to predict and promote employee health. By aggregating claims data, browser searches, and demographic information, these firms can foresee whether employees are at risk for health issues—and their associated costs—and target preventive resources accordingly. However, a recent report indicates that this analytic capability is being extended to predict not only diabetes or the need for back surgery but also whether an employee is or is considering becoming pregnant. This trend raises troubling questions about the appropriate limits of wellness program analytics. (Stephanie R. Morain, Leah R. Fowler and Jessica L. Roberts, 9/6)