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The two principal expenditures of the Affordable Care Act so far include $850 billion for insurance subsidies and a similar outlay for a massive Medicaid expansion. The truth is that Medicaid—a program costing $500 billion a year that rises to $890 billion in 2024—funnels low-income families into substandard coverage. Instead of providing a pathway to excellent health care for poor Americans, ObamaCare’s Medicaid expansion doubles down on their second-class health-care status. (Scott W. Atlas, 3/15)

In this latest case known as Whole Woman’s Health v. Hellerstedt, Justice Anthony Kennedy is the likely swing vote. If the court ends up with a 4-4 ruling due to conservative Justice Antonin Scalia’s death, the Texas law would stand and possibly set a dangerous precedent. (3/14)

Gov. Matt Bevin has a deep-seated need to end Kynect. Everyone gets that by now. In the spirit of acceptance, may we suggest: Rather than the Rube Goldberg-style shell game outlined recently by Health and Family Services Secretary Vickie Yates Brown Glisson, just rename it. (3/15)

[Ohio Gov. John] Kasich, for all of his conservative positions on issues like abortion and taxes, committed the ultimate act of Republican heresy: He had his state participate in the Affordable Care Act’s expansion of Medicaid. Of course, Kasich wasn’t the only Republican to do so -- Arizona’s Jan Brewer and Michigan’s Rick Snyder, among others, did the same thing. (Jonathan Cohn, 3/15)

Nebraska legislators are currently considering another plan to bring Obamacare’s Medicaid expansion to the Cornhusker state. The proposal would create a new welfare program, dubbed the “Transitional Health Insurance Program,” for more than 130,000 able-bodied adults, costing taxpayers nearly $15 billion over the next ten years. (Josh Archambault, 3/15)

Missouri lawmakers are just as likely to fail as Indiana and Arizona legislators did in efforts to block Medicaid funding for Planned Parenthood. Knowing that has not stopped them from persisting in a battle that is going to cost taxpayers dearly when the issue winds up in court. That is what happened in Arizona and Indiana, which lost court fights over this same issue. Court battles are in progress in other states, too. A federal judge in Louisiana temporarily blocked efforts there, and lawsuits are pending to prevent cutoffs in Alabama, Arkansas, Utah and New Hampshire. Defunding efforts are underway in Florida, Texas and Ohio. (3/15)

The hypocrisy of this one almost leaves me speechless. Recently, I wrote about an Iowa state senator’s failed effort to have abortion classified as a hate crime. It was one in a slew of abortion restrictions that Sen. Jake Chapman of Dallas County has sought, with a few of his Senate Republican colleagues, to get passed into law. (Rekha Basu, 3/15)

Anyone who's ever experienced an ambulance ride — myself included — probably has a horror story to tell about the crazy fee, even when only basic medical care was provided ... Like anyone in such a situation, I wasn't thinking about money. I was just grateful, albeit barely coherent, to be receiving prompt and efficient treatment. Happily my ticker was fine; it was just a weird virus. Then the bill came for nearly $1,000 and I remember thinking, "For what?" (David Lazarus, 3/15)

Providing health care at home is on the minds of many doctors and health system CEOs who are coming to realize that the traditional model of hospital- and clinic-centric care may not be financially viable ... Just as online retailers have threatened the dominance of Walmart, new entrants into the health care market threaten the dominance of clinic- and hospital-based doctors. (Ravi Parikh, 3/15)

A little over a year ago, on January 1, 2015, Medicare implemented a chronic care management (CCM) billing code. This code, which pays an average of $42, can be billed once a month when a practitioner provides at least 20 minutes of CCM services to a patient with 2 or more chronic conditions. The CCM services include the monitoring of a beneficiary’s care plan, the provision of access 24 hours a day, 7 days a week, to clinical staff who can retrieve information from the beneficiary’s electronic health record even when the office is closed; management of a beneficiary’s care transitions; and coordination with other clinicians, hospitals, and others who provide clinical services. (Andrew B. Bindman and Donald F. Cox, 3/14)

Healthcare has made great gains in patient safety in recent years. According to a federal Department of Health and Human Services report issued in December, the rate of hospital-acquired conditions dropped 17 percent from 2010 to 2014. (Tim Jahn and Steve Hanson, 3/15)

"Mr. Johnson, we need to talk. As you know, your cancer has spread in spite of the surgery. The drugs that we tried did not reduce the tumor size. And neither has the radiation therapy. I do not know exactly how much time you have left, but it may be only six months. It's hard to predict; you are a very hardy man. You have essentially two options left. I can refer you to the palliative care team; those folks are really good to help you with pain and suffering; but of course there are no guarantees. (Dr. Jos V.M. Welie, 3/16)

Look no further than Flint to understand why this matters. State and federal investigations are now underway to determine whether any criminal acts were involved in the concealing and distorting of data and decisions that resulted in dangerously polluted water flowing into 60,000 homes, a problem that will take millions of public dollars to fix and years of study to determine how badly people, especially children, have been hurt. Look no further back than the closing hours of the legislative session in 2015, when the Republican majority engineered without public hearings or notice the wholesale substitution of an election reform bill with a far more complex one that muzzled local officials from explaining ballot proposals and further concealed campaign money from public view. (Ron Dzwonkowski, 3/14)

So here's some good news out of Valeant. Remember a couple of weeks ago, when Valeant was doing one-on-one calls with selected research analysts, and those analysts were then telling clients what they had learned? That struck people, including me, as a bit odd. A lot was going on at Valeant! Chief Executive Officer Michael Pearson was just back from medical leave, it had just withdrawn its guidance, it had discovered accounting problems that would delay the filing of its financial statements, and now the CEO was going around chatting up analysts privately? Sure, Valeant said that "in engaging in such dialogue, Valeant’s officers are cognizant of obligations under Regulation FD, and it is the company’s policy not to selectively disclose material non-public information," but it was a little difficult to believe that Valeant hadn't told those analysts anything useful. (Matt Levine, 3/15)