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Is Barack Obama a transformational president? ... Not surprisingly, as the president readies his final State of the Union Address, the issue is contested. ... What makes a president transformational? The first African-American president is inherently historic. Obama’s cheerleaders tick off his big accomplishments, as well: healthcare reform; the 2009 fiscal stimulus that helped save the economy; more than 14 million jobs created in a record stretch of 70 months of growth; progressive tax reforms; progress on climate change; the nuclear deal with Iran; the move to normalize relations with Cuba, and more. Skeptics note that his era may be called the “Long Depression” rather than the “Great Recession.” (Robert L. Borosage, 1/12)

Our article on Americans’ struggles with medical debt generated thousands of reader comments. More than 1,200 readers wrote us to answer our question: “How have medical bills changed your life?” The article explored a large new survey of Americans who struggle with their medical bills. It found that while people with no health insurance are particularly vulnerable to financial distress, about 20 percent of Americans with health insurance were still experiencing difficulties paying for health care. Readers responded with their own experiences of medical debt. (Margot Sanger-Katz, 1/11

Poor adults in states that have expanded Medicaid as part of health reform have greater access to health care services and fewer problems paying their medical bills, and hospitals there are admitting fewer uninsured patients, two new studies published in Health Affairs show. These findings provide more evidence that Medicaid expansion is improving the health of beneficiaries, as well as the budgets of many expansion states. It's a powerful lesson for the 20 states that haven't yet expanded. (Jesse Cross-Call, 1/11)

Wyoming Gov. Matt Mead announced last month that he would spend the next few months advocating for Obamacare’s Medicaid expansion in next year’s budget. But so far, Wyoming legislators have taken a thoughtful approach, carefully reviewing all of the evidence and ultimately rejecting Obamacare expansion. And they haven’t just rejected it once. In 2014 alone, state lawmakers rejected Obamacare expansion a whopping six times. They rejected it again in 2015, even after the Governor put his support behind it. Instead of embracing Obamacare, the legislature specifically acted to prohibit Mead from pursuing any expansion without legislative approval. (Josh Archambault and Jonathan Ingram, 1/11)

Republicans in Congress finally achieved their long cherished goal of sending President Obama a bill to repeal his signature health care law. It was a brief victory that lasted only until he vetoed it two days later. But it could be the high-water mark of the repeal drive that has been a pillar of conservative campaigns since 2010 — even if Republicans win the White House. The politics of the Affordable Care Act are changing, as even the newly elected Tea Party governor of Kentucky has acknowledged. Polling on the ACA, or Obamacare, reveals as much public division and ambivalence as ever toward the complicated health law. But it is beginning to reach a critical mass of users and people who know them — and that is the key to survival. (Jill Lawrence, 1/11)

An important but overlooked debate is unfolding in several states: When governments restrict market forces in health care, who benefits? Legislative majorities in 36 states believe that consumers benefit, because restrictions help control health-care costs. But new research confirms what should be common sense: Preventing qualified health-care providers from freely plying their trade results in less access to care. (Thomas Stratmann and Matthew Baker, 1/11)

Iowa’s largest health insurer searched for any way to justify not reimbursing an Iowa City pharmacist for drugs he dispensed to hemophilia patients. Wellmark Blue Cross and Blue Shield ultimately breached its contract with Michael Stein by not honoring 114 claims for drugs dispensed to 24 patients, according to a decision issued last month by the Iowa Court of Appeals. If the ruling stands, the insurer may owe an estimated $9 million. (1/11)

When does Big Pharma profiting become profiteering? This issue was the subject last month of a Senate Finance Committee investigation of pricing practices of Gilead Sciences Inc., a leading provider of hepatitis C medications. After examining 20,000 pages of internal company documents, looking at Medicaid data and interviewing health care experts, the authors concluded that the Foster City drugmaker “pursued a calculated scheme for pricing and marketing its hepatitis C drug based on one goal: maximizing revenue regardless of the human consequences.” Community activists protested this kind of Big Pharma greed in front of the San Francisco hotel where the 34th annual J.P. Morgan Healthcare Conference opened Monday. ( Diana Sylvestre, 1/11)

It’s sad that an epidemic of drug abuse and death is forcing a congressman from the hills of rural Kentucky to learn the science of opiate addiction. But we can all be grateful that U.S. Rep. Hal Rogers is rising to the challenge, and in the process, providing informed leadership to other Kentuckians in state and local government. (1/11)