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This week, we learned that Obamacare enrollments are nearly 40% below the original projections—further proof that the American people want nothing to do with this flawed system. Under the Obama administration, we are becoming a nation of rules—not laws—dictated by a president and a White House who are more concerned with pursuing a partisan political agenda than they are with serving the American people. (Carly Fiorina, 1/27)

In her confrontation with Bernie Sanders, Hillary Clinton always promises to “build on the successes” of ObamaCare, so allow us to recommend a follow-up question: What would those be, precisely? The entitlement is becoming less stable and less entrenched, not more, as it gets older. The latest jolt is the $475 million loss UnitedHealth Group booked on the insurance exchanges in 2015, which the largest U.S. mega-insurer by membership expects to rise this year to another $500 million. Only three months ago the company projected losses of $400 million to $425 million. Every other line of UnitedHealth’s business is thriving, but the ObamaCare money-pit sunk its year-over-year profit margin to 3.7% from 4.3%. (1/26)

Flint isn’t alone. There are a lot more Flints out there—overwhelmingly low-income communities of color where pollution, toxic chemicals, and staggering neglect adds to families’ burdens. We need to face some hard truths about race and justice in America. After 250 years of slavery, 90 years of Jim Crow, and decades of “separate but equal,” our country’s struggle with racism is far from over. That’s true in our criminal justice system. In our education system. In employment, housing, and transit. And tragically, it’s true in the very air our children breathe and in the water they drink. (Hillary Clinton, 1/27)

When Bernie Sanders released his universal health care plan last week, promising that most people would receive more generous insurance coverage while paying less for medical care, most policy experts said it sounded too good to be true. Now, a veteran health economist has produced a more serious assessment of Sanders' proposal and concluded that the critics were right. (Jonathan Cohn, 1/27)

The idea that social factors influence health is both obvious and evidence-based. It is intuitive that patients with diabetes who are homeless will have a harder time managing their disease, and the evidence bears this out. As the United States marches towards spending 20% of our economic output on health care, and as the government takes on an increasing share of that spending, policy makers are realizing that we need a new approach to tackling health care expenses. Our current approach, in which the public finances most health care expenses but looks skeptically at covering nonmedical spending, appears unsustainable. Homeless persons struggling to manage their diabetes can expect taxpayers to pay thousands of dollars for their hospitalizations but not necessarily the housing and food that would help them manage the disease and avoid hospitalization. (Ashish K. Jha, 1/27)

Running government on the cheap has a high price, and state lawmakers should finally start paying attention to the devastation it causes. Years of Florida budget cuts to essential government agencies, including the Departments of Health, Children and Families, and Corrections, have started to bear the bitter fruit of skyrocketing new HIV infections, a dysfunctional mental health system and violent, understaffed prisons and mental hospitals that have far too many unexplained patient and inmate deaths. Siphoning resources from government via haphazard tax cuts rips the social fabric of the state, which harms everyone. Because it is about people, the erosion of the social infrastructure is even more insidious than the potholed roads and crumbling bridges of the physical infrastructure. The Legislature should put a stop to it. (1/25)

Bevin’s plan would free up a lot of money, but, as he said, it’s just a start on closing the gaps: The Kentucky Retirement Systems is underfunded by $11 billion and selling assets to meet monthly obligations. The teachers retirement system is underfunded by $24.4 billion. It took years to dig these holes and will take years to climb out. While we can’t argue with the areas Bevin wants to shield from cuts — most prominently basic funding for public schools and Medicaid — sheltering so much of government required deep cuts in the remaining areas. (1/27)

Enacting a bipartisan bill to provide Medicaid coverage to all low-income people in Maine is a challenge not unlike that faced – and overcome – by other states. Times have changed since Maine’s last unsuccessful effort to expand Medicaid. Six states where the expansion controversy was as intense as the debate in Maine are administering “private option” Medicaid programs. Those programs buy private insurance, require premiums and cost sharing and, in one state, disenroll those who fail to meet their premium payments after a grace period. (Trish Riley, 1/27)

We journalists like to think we are special. We are cloaked in the First Amendment. We are a pillar of liberty. If Thomas Jefferson had been forced to choose between a government without newspapers or newspapers without a government, he’d have sided with us. But we are not above the law. (Frankel, 1/27)

North Carolina Gov. Pat McCrory has commendably concentrated on mental health care and substance abuse with a task force focused on issues that have confused and challenged lawmakers for many years. The task force has ideas that seem sound – but it will have to persuade the General Assembly to act. Consider: There is a priority for finding affordable housing for the mentally ill. Some are in prisons; some are in hospitals; some are homeless; some are living with their families in situations that strain everyone involved. The issue also is important because the U.S. Department of Justice had threatened to sue the state because there is a shortage of such housing. (1/27)