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A push now under way in Congress to defer or repeal the so-called Cadillac tax is the biggest legislative threat the Affordable Care Act has faced in the past five years. And, weirdly, the lawmakers to blame are Democrats. (Peter R. Orzag, 12/11)

At the moment, the proponents of the ACA believe the new law is working, and initiatives are being readied to build upon what was enacted in 2010 by further bolstering the federal government’s power to control costs through additional regulation. We are among those who opposed the ACA because of its heavy emphasis on federal control. But we also believe that unless a credible and practical alternative reform plan is presented to the public, and supported by policymakers, the long-term trend toward ever-increasing governmental control will continue unabated in the years ahead. The plan we present is not confined to replacing the ACA. We propose major reforms to the tax treatment of employer-sponsored health care, Medicaid, Medicare, Health Savings Accounts, and other areas of existing policy. (Joseph Antos, James Capretta, Lanhee Chen, Scott Gottlieb, Yuval Levin, Thomas Miller, Ramesh Ponnuru, Avik Roy, Gail R. Wilensky, and David Wilson, 12/9)

Sen. Marco Rubio's presidential campaign has been crowing lately about the blow he supposedly scored against the Affordable Care Act. "Only one candidate has actually done significant damage to Obamacare," boasts his campaign website. The candidate himself claims to have "saved the American taxpayer $2.5 billion." The New York Times -- excuse me, "even" the New York Times -- credits Rubio with slipping "a little-noticed" provision into a spending bill last year to achieve this aim. These claims are a little overheated, wholly misleading and spectacularly cynical. Let's set the record straight. (Michael Hiltzik, 12/10)

Medicaid is a critical lifeline for Kentucky’s, and our nation’s, most vulnerable patients -- whether children, pregnant mothers, the elderly, the blind, or the disabled. As policymakers, we want to see a strong safety net program that protects those most in need by ensuring they have access to high quality care. There are signs that the safety net is under strain. Too often, vulnerable patients can face problems accessing timely, quality care. The program would also greatly benefit from improved transparency, enhanced accountability and more robust program integrity. But time is critical. Over the longer term, health economists and nonpartisan experts have warned the current paths of Medicaid and other entitlements are unsustainable. (Rep. Brett Guthrie, R-Ky., 12/10)

Insure Tennessee is a health-care solution designed for Tennesseans by Tennesseans. Gov. Bill Haslam created Insure Tennessee, unlike traditional Medicaid expansion, to specifically meet Tennessee's needs. The plan emphasizes personal responsibility and brings much-needed health care to hardworking Tennesseans from Memphis to Mountain City. It is important to correct the record on the points previously raised about Insure Tennessee and its impact on the state. (Craig Becker, 12/10)

Expanding Medicaid, so far at the federal government’s expense, has reduced uncompensated care expenses for hospitals. It has done nothing to hold down costs, and in fact has increased emergency room visits. Expansion supporters like Woodburn will have a chance to make their case in January that putting New Hampshire taxpayers on the hook for a small portion of the program’s cost is a worthwhile investment. They will be hard-pressed to show it’s made any progress in fighting drug addiction. (12/10)

An unfortunate refrain among Democratic presidential hopefuls is that rapacious pharmaceutical and biotech companies are driving up the cost of essential medications, bankrupting the health-care system, and depriving sick Americans of treatment. Hillary Clinton has honed her message to a nice sound bite: Drug companies that charge excessively high prices “are making a fortune off of people’s misfortune.” ... The way we pay for innovative drugs can certainly be improved. But the anger directed at the pharmaceutical and biotech industries overall is misdirected. (Michael Mandel, 12/10)

Most would not be shocked to learn healthcare costs -- and prices -- are going up, not down. But in late November, the Department of Health and Human Resources convened a forum on the rising cost of prescription drugs. The nine-hour event featured discussions on a wide range of issues, from patient access to drug innovation. What was missing, however, was any serious discussion about the chief drivers of healthcare costs – and what effective solutions might look like. (Joel White, 12/10)

His mental health notwithstanding, [Robert L. Dear Jr., the man accused of killing three people at a Planned Parenthood clinic in November] is – to no one’s surprise – a stunning hypocrite. He accused Planned Parenthood of killing even as he freely admitted to gunning people down at the clinic. The only atrocities that took place there that day were the murders of Jennifer Markovsky, Ke’Arre Stewart and Garrett Swasey, and the wounding of nine others. Nor can Mr. Dear’s logic simply be dismissed as the ravings of a mentally ill man — not when others with political influence share his views. (Anna North, 12/10)

A major flaw of this system is that local donation areas vary widely in the size and demographics of their population, the number of transplant centers within the area, and the ratio of patients in need versus organs available. For example, southern California has much lower donor potential due in large part to its lower overall death rate (5.6 per thousand residents verse 8.2 nationwide). Local donation area boundaries were established over 20 years ago without consideration of medical factors and without a goal to equalize access to organs, essentially making them historical accidents. (Milan Kinkhabwala and Sandy Florman, 12/10)