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No one who lived through the 1990s would have suspected that one day people would look back on the period as a golden age of bipartisan cooperation. But in some important ways, it was. Amid the policy fights that followed the Republican victories of 1994, President Bill Clinton and the new majorities in Congress reached one particularly good deal: doubling the budget for the National Institutes of Health. (Newt Gingrich, 4/22)

Lawmakers passed a health-care payment reform this month, ending one of the major, recurring legislative crises that has led to a lot of embarrassing last-minute activity over the years. They did so in large part with their usual bipartisan commitment to widening the deficit, but they did include some useful changes, too. They also relented on ill-considered defense spending caps. Assuming the trafficking compromise holds over the coming days, the Senate finally will vote on, and presumably for, Ms. Lynch, with at least some Republican support. ... Legislators have a long way to go. But in an age in which unbridgeable disagreement has been the norm, green shoots of compromise should be welcomed and nurtured. (4/21)

Although Washington and the physician community were expressing euphoria over the end of the SGR, ... unresolved issues are concerning. But moving away from a billing system that reimburses for microunits of service and that indiscriminately increases or decreases unit reimbursement across all physicians irrespective of their own behavior is worth some downside risk. Physician groups and others are rightly raising concerns about the process that will be used to determine which alternative delivery systems warrant bonus payments, as well as the metrics that will determine bonuses and penalties for those remaining in a fee-for-service payment system. What is useful to remember is that the payment under the SGR and until MIPS debuts in 2019 implicitly assumes that there are no variations in quality, efficiency, or value in the clinical care provided by physicians—or at least none worth paying for. These assumptions are surely wrong. (Gail Wilensky, 4/21)

Congress did its job, passing legislation last week -- specifically, a bipartisan Medicare reform bill. And it is pleased with itself. Jon Stewart is not. "The people we picked to be legislators legislated something," the "Daily Show" host said Monday. "So are we supposed to throw them a party for that?" (Hunter Schwarz, 4/21)

Dozens of states, including California, already have similar laws on the books that are stronger and more comprehensive than the proposed federal law. But the federal law would preempt all state laws. ... Take the case of the recent data breach experienced by health insurer Anthem. The personal information of nearly 80 million policyholders was endangered after hackers accessed a company database. Under California's notification law, Anthem had no choice but to disclose the breach. The state law requires that notification be made whenever the personal information of any resident is "acquired, or reasonably believed to have been acquired, by an unauthorized person." (David Lazarus, 4/21)

In the “history lesson” that House Republican leaders gave to their members on Tuesday, they handed out a resource guide that they could refer to in the coming weeks to bolster their position to oppose Medicaid expansion. Included in the packet was an article written by Jason Fodeman, an assistant professor of medicine at the University of Arizona. Why Fodeman? Well, if Nexis-Lexis is any guide, and it is, then Fodeman is one of the earliest opponents of Obamacare. A former health policy fellow at the right-wing Heritage Foundation, Fodeman has made a career out of slamming Obamacare. (Michael Van Sickler, 4/21)

The expansion of Medicaid to cover the thousands of Alaskans in the “doughnut hole” of low income between existing Medicaid coverage and subsidies under the federal Affordable Care Act has long been popular in Alaska despite its association with a president with low approval in the Last Frontier. It was one of Gov. Bill Walker’s most successful issues in his campaign against former Gov. Sean Parnell. A recent poll found support of both the governor and Medicaid expansion surpass 60 percent among Alaska residents. Yet the Legislature is so opposed to passing Medicaid expansion — and accepting the great sum of federal help with medical costs that come along with it — that Gov. Walker is already openly talking about calling legislators back into a special session to deal with the issue. It’s unusual for elected representatives to be so far out of step with the will of the people. (4/19)

Gov. Paul LePage and his administration have claimed repeatedly over the past few years that Maine can’t afford to expand Medicaid to about 70,000 low-income parents and adults without children. But policymakers in Maine can now inform their decisions with the experience so far of states where Medicaid coverage expanded on Jan. 1, 2014. Drawing on that experience, a new analysis of Medicaid expansion’s potential impact on Maine’s state budget complicates the narrative that extending health coverage would be prohibitively expensive. The analysis, released Wednesday by the Maine Health Access Foundation, projects a $26.7 million budget benefit in 2016 if Maine expands Medicaid. (4/21)

The passage of Medicaid expansion in Montana this weekend was an unlikely defeat for the Koch brothers, who came in as heavy favorites and spent a fortune trying to kill the measure. Sadly for the Kochs, poor people in Montana will now get medical care. Montana is the only state where the Kochs got beaten down like this. What is to be learned from this episode? ... The right-wingers the Koch brothers rub elbows with are the kind that go to Lincoln Center. The ones in Montana are a different breed, something the Kochs may not have fully understood. (Eric Stern, 4/21)

Likely Republican presidential candidate Jeb Bush wants to require everyone to fill out an advance directive governing their end-of-life care before they can receive Medicare benefits. His proposal is both ironic and politically audacious. It's notable coming from the former Florida governor who in the mid-2000s battled to keep Terri Schiavo, a brain-damaged young woman, alive on a feeding tube despite multiple courts' determination that it wasn't her wish to be kept alive in that state through artificial support. ... Bush's comments also represent a remarkable reversal from previous GOP rhetoric calling a proposed policy to encourage physicians to help patients fill out advance directives “death panels” and rationing. (Harris Meyer, 4/21)

[Washington's] mental health funding has been in the news. Writing that “jails are not hospitals,” U.S. District Court Judge Marsha Pechman recently ordered the state to stop warehousing those criminal defendants awaiting competency determinations. Both parties in the Legislature have budget proposals that would address the issue. This is both compassionate and legally necessary under Judge Pechman’s orders. Regrettably there is not such bipartisan unanimity when it comes to serving law-abiding seniors with dementia, many of whom are served in assisted living facilities. Medicaid care in assisted living facilities has gone years without funding increases, and has actually seen funding cuts. Rates can be as low as $46.51 a day for 24/7 care, meals and housing, a decrease of 55 cents from 2011. (Robin Dale, 4/22)

Behavioral disorders of childhood are increasingly recognized as making a substantial contribution to poor physical and behavioral health, not only of children but across the lifespan. Advances in prevention and implementation science offer opportunities to avoid costly and devastating outcomes. Behavioral health for young children represents an opportunity for real advances in population health and health care cost containment. (Thomas F. Boat, 4/21)