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Section 1332 of the ACA, known as “State Innovation Waivers,” allows states, starting in 2017, to apply to the federal government for 5-year renewable waivers from key provisions of the legislation. For instance, states could request changes to or exemptions from the individual and employers mandate, the market exchanges, the exchange subsidies, the Essential Health Benefits requirements, and other provisions. Moreover, states can combine waivers from ACA provisions with waivers from Medicaid provisions (so-called 1115 waivers), Medicare, the state Children’s Health Insurance Program, and waivers available through “any other Federal law relating to the provision of health care items or services.” The opportunity for states to transform the ACA within their borders is breathtaking. It’s little wonder that a former top aide to the late Senator Edward Kennedy describes Section 1332 as “state innovation on steroids.” (Stuart Butler, 4/28)

Remember, Republicans have very good reasons for trying to offer a fix: With some of them openly worrying that the political fallout from millions losing insurance will land squarely on them, they are eying a temporary patch to the subsidies to punt that fallout until after 2016. And putting forth such a contingency plan could also be a way to maximize leverage over Democrats to get them to accept changes to the law Republicans want in exchange for keeping the subsidies going — and keeping insurance markets from imploding — such as junking the tyrannical individual mandate. (Greg Sargent, 4/28)

The Florida Senate will be in session this morning, debating public policy and passing legislation. The Florida House will be dark because its Republican leaders abruptly adjourned three days early in an arrogant power play over Medicaid expansion that they should not win. It is irresponsible, and it is an insult to Floridians who deserve better. (4/29)

Medicaid accounts for more than 30 cents of every state dollar spent. Especially in light of our soaring structural deficit ... we must act now to reinvent Medicaid in Rhode Island. We need to preserve the health benefits of a more widely-covered population. We need to rethink our state system to provide the highest quality of care for patients when, where and how they need it, while also protecting taxpayer dollars. ... But before we can address many of the underlying structural challenges and make meaningful, sustainable reforms, we need to lay a fiscally-sound foundation for reform. Governor Raimondo’s budget lays that foundation and includes $90 million of specific cost savings in Medicaid that maximize efficiency of the state’s managed-care contracts, improve program oversight to combat fraud and waste, transition long-term and hospital services to models that provide incentives for high quality and coordination, and focus programs on those who use them most. (Elizabeth Roberts, 4/29)

A serious ethics complaint was filed last week against U.S. Senator Tammy Baldwin that calls into question not only her ethics, but also her basic competence as the manager of an office that serves the people of Wisconsin. If these allegations are true, Baldwin should resign. In her complaint, Marquette Baylor — a Senate staffer with over a decade of experience working for Senators Herb Kohl and Baldwin — paints the picture of an office with no standard operating procedures, a reluctance to address serious problems with the health care provided to Wisconsin's veterans, and a plan to cover up mistakes with hush money . ... Baylor's complaint makes a strong case that the actions of Baldwin and her staff have endangered the health and welfare of Wisconsin's veterans. (Kevin Nicholson, 4/27)

For decades, Californians have resisted making assisted suicide legal for the terminally ill. Now another try, the End of Life Option Act, is making its way through the Legislature. It has passed one committee, been endorsed by U.S. Sen. Dianne Feinstein, and was buoyed by the attention paid to Brittany Maynard, who last year left her California home for Oregon to carry out her own legal assisted suicide. Dr. Ken Murray is a retired clinical assistant professor of family medicine at USC, whose touchstone essay on death, "How Doctors Die," has ricocheted around the Internet since it was published in 2011 on the Zocalo Public Square website. I asked him to assess the law's ethics and options. (Patt Morrison, 4/28)

In late July 2013, 16-year-old Pablo Garcia, who was in the hospital for a routine colonoscopy to check on his congenital gastrointestinal condition, began complaining of numbness and tingling all over his body. Soon he was having seizures. What caused this strange condition? His medication, it turned out: He'd been given 39 times too much antibiotic. ... There were a lot of human errors that led to that horrific outcome, but here are the two that stand out: alert blindness, and excessive trust in the automated system. (Megan McArdle, 4/28)

In response to what they see as outdated sex education, recent graduates of the University of Tennessee are building a sex ed app that teenagers and young adults can use to ask questions anonymously — and get answers from volunteer experts and Planned Parenthood educators. But can an app provide the necessary guidance? Should technology play a role in teaching kids about health and sexuality. (4/28)

Providing free sunscreen dispensers to Boston’s parks and playgrounds — as City Councilor Matt O’Malley proposed at a council hearing on Wednesday — might seem like a lot of effort for the city to expend on solving a pretty mundane problem. But with the rates of skin cancer on the rise in the United States, providing free lotion could actually be a boon to the Hub’s residents, especially if it’s done at no cost to the taxpayer. O’Malley’s plan would call for free sunscreen dispensers to be set up in all of Boston’s parks as a way to nudge people to take better care of their skin during the summer. (4/29)