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Because of the Affordable Care Act (ACA), 20 million more Americans have health insurance and more than 8 million kids receive health coverage each year as a result of the Children’s Health Insurance Program. ... What’s more, expanded consumer protections and access to free preventive services — like vaccinations and cancer screenings — mean all Americans now have stronger, better health coverage. Despite this progress, we still have real challenges ahead. Americans face rising out-of-pocket costs and a health care system that is too fragmented. We need to make health coverage affordable so people can access the care they need. We need to do more to break down barriers and achieve health equity across our communities. We need to expand Medicaid in every state so that everyone has access to care, regardless of their income and where they reside. And we need to devote more resources to the necessary scientific research into the diseases of our time. (Hillary Clinton, 9/28)

On the campaign trail and in the halls of policy wonks, the health care term of the moment is “the public option.” The idea is to create a government-run health care plan that would be an alternative to the private insurance plans offered under the Affordable Care Act, or provide a fallback in markets where insurers have been pulling out. In an article in The New England Journal of Medicine published on Wednesday, Hillary Clinton reiterated her support for such a measure. (Reed Abelson and Margot Sanger-Katz, 9/29)

While Clinton has yet to release any specifics, her 2008 healthcare platform, the American Health Choices Plan, gives us a glimpse. The AHCP stipulated a public option “which could be modeled on the traditional Medicare program, but would cover the same benefits as guaranteed in private plan options … [to] compete on a level playing field with traditional private insurance plans … [and] provide a more affordable option. That assumes insurers are price gouging by not offering affordable options. But the problem isn’t that there’s too much profit being made on the exchanges, it’s that there’s too little. (Paul Howard and Stephen Parente, 9/28)

Health care shows up on the political agenda in 2 very different ways, as a social issue and a budget issue. These 2 views prompt very different sets of questions and also shape how the 2 major political parties focus their respective efforts in the health care arena. (David Cutler, 9/28)

Polls show that most Americans disparage Congress for its inability to agree on even simple issues. Now Obamacare gives a new meaning to "reaching across the aisle" because it has caused Democrats to adopt a traditional Republican principle while the GOP advances a position more often associated with Democrats. (Daniel Hoffman, 9/28)

Banning “pay-for-delay” deals that postpone the production of less-expensive generic drugs is a key action point in Hillary Clinton’s comprehensive plan to lower prescription drug costs. Eliminating these deals, she says, could save Americans billions of dollars on medications. But an even more productive strategy would be to stop drug makers from producing so-called authorized generics. (Farasat Bokhari, 9/28)

Devon Herrick of the National Center for Policy Analysis recommends EpiPens be made available over-the counter (OTC). Herrick explains that about one billion dollars’ worth of EpiPens are thrown out unused in the United States, because they need to be immediately at hand but expire after about a year.  Pharmacies have evolved into very consumer-friendly retail environments – almost more like supermarkets or department stores than old-chemists’ shops. If patients knew they could walk in and pick up EpiPens from the pharmacy, they would not need to stockpile as many injectors as they do when they have to go to a physician for a prescription. (John Graham, 9/28)

Why is this controversy erupting now? Certainly the size and timing of the price hikes played a role. But less discussed is a change in how insurance covers access to prescription medications. In less than a decade, average health care deductibles have risen from approximately $300 to more than $1,000, with some families now facing annual deductibles of almost $5,000. In that same time period, the percentage of individuals enrolled in high-deductible insurance plans has gone from less than 5 percent to potentially approaching 40 percent in the coming year. This means that a family whose fixed copay a few years ago was $25 or $50 per prescription for their twin pack of EpiPens could get the recommended multiple sets for school, home, and to carry around for about $75 to $150. Today, many are now required to pay list price — upwards of $600 — for each set, or almost $2,000 to satisfy their deductibles. (James R. Baker Jr., 9/28)

Real, or inflation-adjusted, compensation has risen 61 percent since 1970; wages, on the other hand, have increased less than 3 percent in real terms in that period. This is a tale that has gotten short shrift in this political season. Much of the narrative of the 2016 election is about middle-class anger over the lack of economic progress in an era of increasing financial inequality. Residual frustration with the financial crisis and bank bailouts isn't making voters feel any better either. (Barry Ritholtz, 9/28)

The United States is in the midst of a bold experiment. Medicare is moving rapidly away from traditional fee-for-service payment. Various alternative payment models (APMs) intended to improve quality and reduce costs are being implemented or tested. The stakes are high. If an evaluation finds that a new model meets the statutory requirements for expansion, the US Secretary of Health and Human Services is authorized to expand the models across the country. Whether these new programs work and how effectively they are evaluated should matter to physicians, patients, and taxpayers. (Elliott S. Fisher, 9/27)

Healthcare wasn't entirely absent from last night's debate. When asked about the economy, both Republican candidate Donald Trump and Democratic candidate Hillary Clinton called for more infrastructure spending. But in his reply, Trump said: “We have a country that needs new roads, new tunnels, new bridges, new airports, new schools, new hospitals,” he said. (Merrill Goozner, 9/27)

This year marks the 20th anniversary of the Health Insurance Portability and Accountability Act, better known as HIPAA. Since it took effect, doctors’ offices, hospitals and other health-care providers have been very careful about releasing information. Sometimes frustratingly so. I’ve had providers refuse to send my information to me by email, because that form of communication is considered less secure than the now-ancient practice of faxing. (Joe Davidson, 9/28)

A few years ago at a large teaching hospital in Texas, a medical resident asked a nurse how to order an autopsy for a patient they were currently treating. It was a reasonable request. Autopsies help further the understanding of disease. There was just one problem: their patient, who was very much alive, was lying nearby. He’d overhead the request, and that’s how he found out he was soon going to die. (Wolfgang Gilliar, 9/29)

In an unprecedented move, Surgeon General Vivek Murthy sent a letter to every doctor in America last month. It did not congratulate us on a job well done; instead, it said we need an urgent change in how we manage pain and opioids. The gesture, launching the TurnTheTideRx campaign, was praiseworthy but unfortunately misses point. (Robert Bonakdar, 9/26)

You don’t have to flip through many TV channels or pick up many magazines before seeing news related to the opioid epidemic in our country. The focus of these stories is often on heroin, but that’s only part of the picture. Prescription drug abuse and misuse is the other part. (Deb Moessner, 9/28)

Ideally, adult film performers would use condoms when they engage in on-screen intercourse. It’s the most reliable way to keep them safe from contracting or spreading sexually transmitted diseases, including HIV. But the adult film industry has doggedly refused to adopt this simple protective measure, even though state labor code requires workers be protected from blood-borne pathogens. ... however ... we part philosophical company with Proposition 60, a heavy-handed measure on the Nov. 8 ballot backed by the AIDS Healthcare Foundation and its president, Michael Weinstein. The proposition would, in effect, make every Californian a potential condom cop by both mandating condom use and creating a private right of action so that any resident who spots a violation in a pornographic film shot in the state could sue and collect cash from the producers and purveyors if they prevail in court. (9/28)

The critical mental health needs of those in treatment at New Hampshire Hospital and the hopes of those who love them should be a priority for our state, regardless of party or political persuasion. Real progress has been made at the hospital in the aftermath of a federal lawsuit, but more needs to happen and I am optimistic it will. (John T. Broderick, Jr., 9/29)

When it comes to dealing with abuses of the most developmentally disabled adults in Colorado, a population that is unable to speak for itself, it’s critical that state officials who work with them be as transparent as possible. For the better half of a year in 2014 and 2015, residents at the Pueblo Regional Center suffered abuse and neglect. ... Now a federal report has been released detailing and documenting the horrors. In addition to rehashing past abuses that the Department of Human Services (DHS) made public in April 2015, the report called for additional safeguards that we hope the state makes serious a commitment to following. (9/28)