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Senior Republicans in Congress are seeking major changes to the Children’s Health Insurance Program when the program’s money runs out in September. Their proposal, labeled a “discussion draft” for legislation yet to be written, could deprive more than a million children of insurance or force their families to pay higher out-of-pocket costs for their coverage. It also would shift costs to states, which would be left holding the bag to pay for the children’s insurance or for the care of the children as uninsured patients. (2/27)

[Wisconsin Gov.Scott] Walker and the other governors jostling for the nomination, like Chris Christie of New Jersey and Bobby Jindal of Louisiana, are finding that for all their powers and spotlighted opportunities, governors can run for the White House, but they can’t hide from their state records. ... One Republican governor mentioned as a candidate, Mike Pence of Indiana, could offer the virtue of a budget surplus. But this healthy fiscal status was bolstered by his acceptance of Medicaid expansion funds under health care reform — a no-go zone for Republican zealots like Mr. Walker and former Gov. Rick Perry of Texas as they campaign for the White House by denouncing Obamacare. (2/28)

In the current fight over expanding health-care coverage to low-income people, Republican state leaders often deploy some version of this argument: States shouldn’t accept billions in federal money to expand their Medicaid programs because the debt-burdened federal government won’t keep its financial commitments. Responsible leaders shouldn’t structure their budgets on the fiction that the federal government will maintain the same level of support in the future, lest states be left with the expansion bill years down the road. But in policy areas outside the Affordable Care Act’s Medicaid expansion, GOP state leaders don’t demonstrate the same amount of concern that a tottering federal Treasury is likely to renege on its obligations to the states. (Stephen Stromberg, 2/27)

In health care, government has created a staggeringly inefficient system that often answers to the needs of centralized management rather than consumers. There’s no motivation to provide better care at lower costs. The solution is not for government to define every service or set every price but to infuse health care with market principles, creating competition and giving consumers more choices, not fewer. ... What conservatives should be aiming for is not a slightly less costly liberal welfare state or simply slowing government’s one-way ratchet toward progressivism. They should be more ambitious and more creative: transforming government programs to make them more modern, efficient, responsive and accountable — to have them support and encourage individual initiative, not replace it. (Peter Wehner, 2/28)

Jonathan Gruber -- yes, that Jonathan Gruber -- is in trouble again. This time he's being pummeled by liberal state governments for whom he's done work. Massachusetts Governor Charlie Baker demanded Gruber's resignation from the board of the state's Health Connector insurance website. And more troubling, the Vermont state auditor has raised questions over bills Gruber submitted to the state government for consulting work. ... It's another bad week for a guy who's had a lot of bad weeks recently. Is it merited? For all that Gruber and I vehemently disagree about health-care policy, and for all that I think his comments about stupid voters displayed a galloping case of unseemly arrogance toward the people he professed to be serving, I'm not entirely sure it is. (Megan McArdle, 2/27)

Lyndon B. Johnson was often derided for being egocentric, but when it came time to sign his landmark bill creating Medicare, 50 years ago this July, he graciously insisted on sharing the credit with the 81-year-old Harry Truman. At almost the last moment, Johnson decided to change the location from Washington to Truman’s presidential library in Independence, Mo. During the ceremony, Johnson noted that in 1945, the newly installed President Truman had called for national health insurance, planting “the seeds of compassion and duty which have today flowered into care for the sick, and serenity for the fearful.” Johnson then presented his host with the nation’s first Medicare card. Deeply moved, Truman later wrote in a letter to Johnson that the ceremony was “the highlight of my post-White House days.” (MIchael Beschloss, 2/28)

The epidemic of deaths and addiction attributable to opioid painkillers continues unabated even as an authoritative new review of scientific studies has found no solid evidence that opioids are effective in relieving long-term chronic pain. (3/2)

In December, the Department of Justice indicted 14 people who worked at the New England Compounding Center. The company manufactured drugs in insanitary conditions that produced a fungal meningitis outbreak that killed 64 people and made 751 gravely ill in 2012. One of the owners and a senior pharmacist face charges of racketeering and second-degree murder. ... The indictments are good news. If convictions are obtained, they will serve as some deterrent to further misconduct within an industry that continues to be virtually unregulated.(Rena Steinzor, 2/28)

The F.D.A. has allowed 23andMe to market genetic tests for mutations directly to the public. The agency said that, for the most part, so-called carrier tests would no longer need advance approval before being marketed this way. But 23andMe is also offering access to its data for research, opening up questions about privacy and anonymity. Should commercial companies share genetic information for research purposes? Is it an invasion of privacy or is the potential for scientific breakthrough more important? (3/2)

While underfunded public-employee pensions capture the headlines, health-insurance benefits for retired state and local workers are also a huge problem. But a recent ruling by the Supreme Court may help state and local governments scale back these benefits. Unlike public pension plans, retiree health benefits aren’t funded in advance; they are typically paid out of current tax revenues, so they compete with other budget priorities like schools and police. This competition will only grow more intense, as unfunded retiree health benefits are close to $1 trillion, according to a recent study in the Journal of Health Economics. (Robert C. Pozen and Ronald J. Gilson, 3/1)

Good news: Recurring, predictable out-of-pocket health care expenses remain somewhat stable over the course of retirement. The bad news: Non-recurring unpredictable expenses — such as surgery, hospitalizations, and nursing home care — increase with age, tend to be more expensive, and, in the absence of a plan to manage those costs, can wreak havoc on a household's finances, according to research just published by the Employee Benefit Research Institute (EBRI), a nonpartisan research institute based in Washington, D.C. (Robert Powell, 2/28)