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For a program that critics have relentlessly denounced as a failure, Obamacare is doing pretty well, particularly at expanding Americans’ health coverage. A new Gallup report shows there’s now just one state (Texas) left where more than 20% of the people are uninsured .... But for critics there’s never good news, only fresh evidence that Obamacare is a ready-to-implode disaster. Their latest "proof" comes from reports that next year’s premiums for people who buy their insurance on individual health exchanges could spike by 20% to 50% or more in states such as Illinois, Oregon, North Carolina, Oklahoma, Minnesota and Tennessee. ... That does sound bad, and with open enrollment for 2016 beginning on Nov. 1, it would be alarming if that were the whole story. But it’s not. (8/11)

American families, promised they would save $2,500 a year on health insurance premiums, are bracing themselves to see just how much their costs will increase again next year. Health insurers across the country are seeking premium increases of 20% to 40% or more. Some carriers requested only modest increases, largely because they priced premiums in line with expected medical expenses in the first year. But many others found enrollees are sicker and more costly than anticipated. (Grace-Marie Turner, 8/11)

Congress is under pressure to repeal an impending tax on the so-called Cadillac health plans offered by many employers. Scores of legislators from each party have endorsed separate bills to repeal it, and candidates for office, pressed by lobbyists from labor unions, business groups and insurers, may join the call for repeal. The tax should probably be adjusted by Congress to eliminate inequities, but outright repeal would be a mistake that would undermine the viability of the Affordable Care Act. (8/12)

While Republicans have kept virtually none of their promises about how they would run Congress, one promise they have kept is their vow to use essential appropriations bills to manufacture even more crises. Mitch McConnell of Kentucky, the Republican Senate leader, laid out this strategy last year, saying that President Obama “needs to be challenged, and the best way to do that is through the funding process.”... The far right wants riders aimed at repealing the Affordable Care Act and defunding Planned Parenthood, among other things. Republicans have already tried repealing or undermining the health care law 60 times since 2011 and failed every time. The Supreme Court has upheld it twice. It’s time to move on. The same goes for efforts to defund Planned Parenthood, which would limit women’s access to contraceptives, breast cancer screenings, wellness visits and other critical services. (Senate Minority Leader Harry Reid, D-Nev., 8/11)

Ever since the federal government mandated that health insurance cover birth control under the Affordable Care Act without cost-sharing--that is, no co-pay charges or deductibles--Catholic and other religious employers have been trying to undercut the requirement. Fortunately, they've been batting zero at the appeals court level, most recently before the 2nd Circuit U.S. Court of Appeals in New York, which last week knocked down an assertion by two Roman Catholic high schools and two Catholic healthcare systems that their religious rights are violated by even the requirement that they put their objections to contraception on the record so the government, their insurers, and their employees can make other arrangements. (Michael Hiltzik, 8/11)

Today, Congress has Title X—still the only federal grant program dedicated entirely to family planning and related preventive health care—in its sights for severe funding cuts or even elimination. The U.S. House of Representatives has proposed ending the program for the fifth year in a row, and the U.S. Senate is recommending a sizable reduction to Title X’s budget. In addition, while legislation aimed at defunding Planned Parenthood and its affiliates, whose health centers serve one-third of Title X clients nationally, failed to pass in the Senate in August, many in Congress remain committed to defunding the organization. These ideologically driven proposals come despite a wealth of evidence demonstrating the tremendous benefits of investing in Title X. (Kinsey Hasstedt, 8/10)

[Donald] Trump’s ugly bombast is a distraction from a far more serious problem for the GOP. Three years after Romney lost the women’s vote by a double-digit margin, in part because of his support for defunding Planned Parenthood, the presidential debates last week made clear Republicans have only become more disrespectful toward women’s bodies, more deranged in their hatred of Planned Parenthood and more dismissive of female voters. (Katrina vanden Heuvel, 8/11)

There are only five candidates with a plausible path to the Republican nomination: two sitting senators (Marco Rubio and Ted Cruz), two sitting governors (Scott Walker and John Kasich), and a former governor (Jeb Bush). ... Ted Cruz is running as the tea party’s Mr. Conservative—aggressively antigovernment except for national defense .... John Kasich is this generation’s compassionate conservative, who cites his faith as justification for expanding Medicaid and extending “unconditional love” to gays and lesbians. Scott Walker is the fighting conservative who fires supporters’ hopes that he will stick it to the liberals in Washington, as he did to public-sector unions in Wisconsin. (William A. Galston, 8/11)

It will be a delicate balancing act, no doubt, but Medicare is beginning a valuable – indeed, inevitable – program to provide end-of-life counseling as part of a five-year experiment in 40 states. The demonstration program is meant to help patients with terminal illnesses plan for the end of their lives. Under current Medicare rules, patients must choose between medical treatments and palliative care. The demonstration project, which is to begin next year, will give patients access to both. The hope – here is where it gets delicate – is that by offering both services, more patients will receive hospice services that can improve the quality of their remaining days while also lowering what are some of the most costly aspects of medical care. (8/11)

Since the Affordable Care Act (ACA) was enacted in 2010, 16.4 million Americans have entered the healthcare system. This record number of insured individuals applies tremendous pressure on an already stretched system, but it also creates opportunities for innovation. ... Many health centers are responding to the pressure of serving more patients (including those with costly, chronic conditions) by engaging, training, and redeploying medical assistants (MAs) and other frontline health workers. With the right training, MAs can perform advanced tasks such as panel management, health coaching, scribing, and other clinical duties. This allows doctors and nurses to work at the top of their licensure by delegating clinical tasks to MAs and other frontline workers. (Barbara Dyer and Tom Strong, 8/10)

The Centers for Disease Control and Prevention (CDC) has documented that social factors, like income, education, and family, have a big impact on health. Some experts estimate that these factors account for as much as 40 percent of our health. Hospitals experience this reality every day when they care for patients struggling with socioeconomic challenges. Patients of limited means or who speak English as a second language often need different kinds of resources to achieve the best possible health results. Even with specialized services, these patients may end up less healthy than those who have better standards of living. (Paula Bussard, 8/12)

The health care system cannot eliminate racial/ethnic disparities in health. Health care professionals need to collaborate with other sectors of society to increase awareness about the health implications of social policies in domains far removed from traditional medical and public health interventions. Much of the contemporary disease burden is linked to behaviors that are potentially modifiable with access to timely information and the necessary resources and opportunities to facilitate the challenge of behavioral change. Many individuals live, learn, work, and play in disadvantaged contexts where it is nearly impossible to pursue healthy choices. (David R. Williams and Ronald Wyatt, 8/11)