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It has always been irrational for states to decline to expand their Medicaid programs under the Affordable Care Act. The 21 states that have refused to take advantage of this element of Obamacare have denied access to coverage for 4 million people, left billions in federal health-care dollars on the table and thrown the financial fate of their hospitals into doubt. But Florida Gov. Rick Scott (R) is taking irrational to new lengths. (5/14)

For nearly two months in the fall of 2013, [healthcare.gov] simply did not work; people desperate for coverage, in many cases because their old policies had just been canceled, had no practical way to buy insurance. ... But then the administration managed to pull off a technological rescue job almost as spectacular as the failure itself. More important, the Affordable Care Act began to deliver on its promise of helping millions of otherwise uninsured Americans get affordable, reliable insurance for the first time—while quite possibly contributing to a historic, unprecedented slowdown in health-care costs. But media and political attention to Obamacare’s successes have never rivaled the discussions of its failures, real or imagined. (Jonathan Cohn, 5/14)

The lesson of the unpopular Affordable Care Act, then, is that liberals should stop worrying so much about whether their programs have high public-approval ratings, or how to make government as a whole popular. All a popular program accomplishes for those inclined to hate government is to spawn a “keep your government hands off my Medicare” attitude. That is: People who hate government either based on ideology or short-term "thermostat" reactions to liberal presidents won't be deterred even if they like what government is doing. (Jonathan Bernstein, 5/14)

[Luis] Lang, by opting out of Obamacare, decided not to participate in a system that protects others. And now he was the one who needed help. Turns out, he’s getting it. Helms’ story went viral, and readers already have stepped up with more than $17,000 in contributions as of Thursday. Many of the good-hearted are self-described liberals who support Obamacare and hope that Lang learns a lesson. ... Lang was compelling not simply because he had rolled the dice on insurance and lost – there are sadly many examples of that – but because he blamed Obamacare and not himself. So his lack of repentance resulted in the help he’s now getting. (Peter St. Onge, 5/14)

For the second time in two years, the House voted Wednesday to pass legislation that would ban almost all abortions 20 weeks or more after fertilization. The bill, called the Pain-Capable Unborn Child Protection Act, claims that “an unborn child is capable of experiencing pain at least by 20 weeks after fertilization,” though medical evidence does not support this. Of course, the bill is not really about scientific findings of any sort. It is simply another attempt by conservative Republicans to undercut women’s constitutionally protected reproductive rights. (5/14)

But for now the extremes on both sides, and the politicians elected with their support, control the debate. Pro-choice politicians condemn the pro-life side, which justifies killing doctors who perform abortions. Pro-lifers pointed to the mindless extremism of the pro-choice side when a Planned Parenthood lobbyist in Florida testified that when abortions fail, the decision to kill or save the newborn should be left to the “patient and the health-care provider.” Most people would be shocked to learn that a baby born alive isn't given life-saving treatment in every case. (Margaret Carlson, 5/14)

Medicare costs are rising a bit faster than they have during the past few years. But by reinforcing some the changes that are already occurring, we can nip this increase in the bud -- and two developments show the way. (Peter R. Orszag, 5/14)

Passage of the Affordable Care Act, combined with other longstanding trends, has left many hospitals on precarious financial footing. Some will almost certainly close, including in Oklahoma. The good news is this doesn’t necessarily mean worse overall health outcomes for people in surrounding communities, according to researchers at the Harvard School of Public Health. (5/14)

Women deserve clarity from the health-care community on the effectiveness of mammograms and the frequency they should have them. That is why it is distressing to those of us who diagnose and treat breast cancer to have to combat – again – clouded recommendations from the government. On April 20, the United States Preventive Services Task Force (USPSTF) released a draft “update” to its 2009 recommendations on breast cancer screening. No new developments have occurred since its previous flawed report that caused confusion and controversy. (Drs. Matthew Gromet and Nicole Abinanti, 5/14)

Last year, I went with a small group of ophthalmologists to a South Bronx middle school to conduct vision exams. One neatly dressed boy had trouble seeing the big E at the top of the chart. He hesitated and made mistakes on the second line, and then put his head down, embarrassed. “I don’t think you can see the chart,” I said. He told me he couldn’t remember ever having an eye exam. I thought he might be an anomaly. I was wrong. (Pamela F. Gallin, 5/15)

At a press conference in Boston last November, the Tufts Center for the Study of Drug Development announced it had calculated that it costs pharmaceutical companies $2.6 billion to develop a new drug — up from the $802 million the Center estimated in 2003. ... The methods used to generate the $2.6 billion figure will require careful scrutiny once they are available for detailed review. The analysis was based on data that 10 unnamed drug makers provided on 106 unnamed investigational compounds that they had “self-originated.” The raw numbers on which the analysis is based are not available for transparent review — and are likely never to be divulged. ... But as risky as drug development is, the pharmaceutical and biotech industries remain among the most profitable sectors of the U.S. economy and actually spend only a small fraction of their revenues on truly innovative research. (Dr. Jerry Avorn, 5/14)