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For the first six years of the Obama era, many Republicans made an apocalyptic case against the president’s health care law. It was unconstitutional, immoral, borderline tyrannical. It wouldn’t just fail: It would fail disastrously, in a death spiral that would take down most of American health care as we know it. Then the apocalypse failed to arrive. ... Republicans, never particularly eager to grapple with the actual details of health care policy, began talking about the issue less and less. ... Yet the interesting thing is that as Republicans have fallen silent, the law’s struggles have actually increased. (Ross Douthat, 12/19)

Even as state after state has elected to expand Medicaid, thereby extending health insurance to millions of poor people who would otherwise remain without coverage, Virginia Republicans have stood pat. They have blocked expanding Medicaid under Obamacare, which would unlock tens of millions of federal dollars that would buttress Virginia’s hospitals and its economy, on the argument that the state might not be able to afford it. (12/19)

Far too often, in our view, the immediate reaction to a proposal for government to do something different is this: No way, won't work, can't be done. We have been reminded of the usual, predictable resistance to government change this year during criticism, sometimes shared in apocalyptic tones ("a catastrophe of monumental proportions," said one health care executive), over the proposal made by Iowa Gov. Terry Branstad last winter to privatize management of the state's Medicaid program beginning next year. We support privatization because we, in principle, support what Branstad seeks to do: Reduce the rate of growth in state Medicaid spending. (12/20)

Should the First Amendment protect what doctors can say to their patients in the privacy of the examining room? Weighing state prohibitions on gay conversion therapy, liberals have tended to think the state should be able to regulate medical treatment without worrying about free speech. Now the shoe’s on the other foot: Florida’s ban on physicians asking patients about gun ownership puts liberals in the position of wanting to protect the doctor-patient relationship. The U.S. Court of Appeals for the 11th Circuit upheld the Florida “docs vs. Glocks” law this week on the ground that the state’s interest in protecting gun ownership outweighs physicians’ free-speech interests -- a result sure to trouble liberals. (Noah Feldman, 12/18)

How many laws making it harder to get an abortion will pass before the Supreme Court sees them for what they are — part of a tireless, coordinated nationwide assault on the right of women to control what happens with their own bodies without the interference of politicians? One answer is, no fewer than 288. That’s how many abortion restrictions states have enacted since the beginning of 2011, when aggressively anti-choice lawmakers swept into statehouses around the country. (12/19)

The cost of drug prescriptions has become an issue in the presidential-primary season, most notably with Hillary Clinton and Bernie Sanders competing to see who can do the most to protect the wallets of potential voters. Mrs. Clinton this fall proposed capping out-of-pocket drug expenses at $250 a month, while Mr. Sanders vowed to make the federal government drop its unwillingness to negotiate prices with pharmaceutical companies. But the candidates’ proposals should start by addressing the misuse of the Orphan Drug Act, a well-intentioned law passed 33 years ago but now used in ways unanticipated by Congress. (Marty Makary, 12/20)

Computer documentation in health care is notoriously inefficient and unwieldy, but an even more serious problem is that it has morphed into more than an account of our work; it has replaced the work itself. [Nurses] charting, rather than our care, is increasingly what we are evaluated on. (Theresa Brown, 12/19)

[W]hile high-profile people like Caitlyn Jenner and Laverne Cox have brought newfound visibility to transgender issues, many transgender men and women cannot lead open and visible lives for fear of discrimination and violence. ... Health care also remains highly stigmatized and largely unavailable for many transgender people. Data from the National Transgender Discrimination Survey found that 28 percent of the more than 6,000 transgender respondents postponed medical care due to discrimination, and another 48 percent did so because they could not afford it. Both private and public insurance plans continue to have blanket bans on coverage for health care related to gender transition. Even where there has been progress on coverage generally, insurance coverage for care that transgender women need is still elusive. (Gilles Bissonnette and Stephanie Ramirez, 12/20)