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History will almost surely rank health care reform as one of President Obama’s greatest accomplishments. About 20 million Americans have insurance that might otherwise have been unaffordable, and the law has cost much less than anticipated. But one senior administration official thinks the Affordable Care Act has fallen short. His name: Barack Obama. ... He recommends that the government offer its own health insurance, a so-called public option, on the exchanges in some parts of the country. That could help make health care more affordable in rural areas and smaller cities where only two or three insurers sell coverage. Republicans and some moderate Democrats fear that this could be the first step to a single-payer health care system. But there might be more support for a policy that is intended strictly for people in places with few choices. (7/16)

News reports across the country are mentioning outsize proposed premium increases from some plans in some marketplaces. Many news reports have been careful to say that these outsize increases are not typical, nor the whole story. But there is a wider misperception about Obamacare premium increases: Many Americans insured through their employers wrongly believe that these large premium increases apply to them though only a much smaller group is affected. (Drew Altman, 7/15)

Last week, two well-respected groups of government economists predicted the end is nigh for the era of restrained growth in healthcare spending. Ignore them. They've been wrong before. They will be proven wrong again. Every summer, the actuaries at the CMS and the money minders at the Congressional Budget Office—economists all—offer their outlooks for future healthcare spending. Every year since the onset of the Great Recession and through the economy's slow-but-steady recovery, they've projected the current era of slow growth is coming to an end. (Merrill Goozner, 7/16)

America's hospitals and health systems must be prepared for anything, but as the range of threats to health in our communities becomes broader and the threats hit more quickly and frequently—whether it's the devastation of natural disasters or emerging threats such as the Zika virus—provider organizations will need to play bigger roles in heading off problems before they spiral into crises. To support resilient communities that can meet and overcome threats to our health security, the Centers for Disease Control and Prevention established the National Health Security Preparedness Index as a streamlined tool to better understand the nation's capabilities. (Paul Kuehnert, 7/16)

Making a profit in the hospital business is tough. At least, that’s the explanation for the surge in hospital mergers we’ve been seeing recently. According to the federal government, however, one California-based hospital chain has figured out how to squeeze the absolute maximum income from Medicare and other government programs and send the money directly to its bottom line. The chain is Prime Healthcare, and the feds say its technique involves systematic fraud. (Michael Hiltzik, 7/15)

In a state of just 4.3 million citizens, we should all find it alarming that in the last decade, the number of those enrolled in Kentucky’s Medicaid program has more than doubled from 600,000 to just under 1.4 million. We have some huge challenges. ... As I followed the criticisms and judgments since the administration announced Kentucky HEALTH, I think this is one of those situations when a sensitive issue is touched, like health care for the disadvantaged, and everyone immediately retreats to a defensive position, often hearing only what they are expecting to hear. What fails to be reported and seems to get missed are many of the actuarial facts. For instance, Kentucky’s managed care organizations are paid more and their average profits are greater than any other state in the nation. (State Rep. Addia Kathryn Wuchner, 7/17)

Kynect and expanded Medicaid have been among of the most extraordinary accomplishments Kentucky has made in the last 30 years. We are talking about 440,000 people in Kentucky who now have a primary care provider, who can get an eye exam, who can see specialists, who can get a dental exam, an x-ray and their teeth cleaned once a year. It has been a tremendous step forward. For some reason Gov. Matt Bevin wants to reverse this progress. (K.A. Owens, 7/17)

Gov. Terry Branstad insisted his plan to privatize administration of Medicaid would save the state money. It made no sense that handing billions of public dollars to for-profit companies would miraculously reduce spending in the health insurance program for 560,000 Iowans. His administration provided no meaningful details about how savings would be achieved. The public was just supposed to have faith and hope for the best. Now perhaps it is becoming clear how the Medicaid belt will be tightened: by not paying health care providers for services. (7/16)

Veterans make up 8.5 percent of America’s adult population but account for 18 percent of its suicides. In 2014, according to new data from the Veterans Affairs Department, 7,403 veterans killed themselves. That is about 20 deaths a day. This is a national emergency, and attacking it is the primary mission of the V.A.’s Veterans Crisis Line, a call center based in Canandaigua, N.Y. ... Since 2007, the crisis line has been an all-purpose safety net for many thousands of veterans in free fall. But the net is badly frayed, according to watchdog reports and news accounts from the first six months of the year. (7/16)

Senate Democrats have taken their latest political hostages, and this time they’re pregnant women at risk for Zika virus infections. After demanding immediate emergency funding for months, they walked out on their own bill on Thursday to use the issue as a campaign bludgeon against Republicans. ... Democrats now claim the measure would have “banned” Planned Parenthood from the health-care providers list and restricted funding for birth control. In fact, Planned Parenthood simply isn’t on the specific list of public health clinics and community health centers that will receive additional and immediate social-services block-grant funding in Zika-hit locales like Puerto Rico. (7/15)

Federal officials have known about the seriousness of the Zika virus for more than a year, yet important funding has been tied up in the worst kind of Washington impasse. In late June, a bill that would have earmarked $1.1 billion for Zika funding was sunk by a series of non-related riders. Democrats did not support the Republican-written bill, which came attached with provisions that cut funding from Planned Parenthood, as well as lift a ban on displaying the Confederate flag at military cemeteries. What the Stars and Bars has to do with birth defects is beyond the scope of this column. Attaching riders to bills is not new politics, but in the case of an encroaching epidemic, doing so seems peculiar, at best. (Susan Campbell, 7/16)

The South Texas Blood & Tissue Center recently began testing for the Zika virus when donors give blood. These tests are optional — about 18 percent of donors so far have said no thanks — but it’s just common sense to do it. (7/17)

There are over 136 million emergency room visits each year in the United States. It is estimated that more than 50 percent of all ER visits could have been avoided had the patient visited their primary care physician first. Indeed, a leading reason for long emergency room wait times is the fact that many patients commonly utilize the ER for their routine health care. In addition, as many individuals still remain uninsured, some of these patients recognize that it is illegal for an emergency room to turn anyone away seeking health care; thus making it a convenient alternative to visiting a doctor to address their non-emergent ailments. Unfortunately, these unnecessary visits lengthen the waiting time for those truly requiring the services of the facility while increasing the excessive costs associated with these institutions. (Michael Schwartz, 7/17)

As the nation begins responding to the epidemic of overdoses and deaths caused by opioids, some people with chronic pain who have relied on these powerful painkillers for years are finding them harder to get. A survey conducted by the Boston Globe and Inspire, a health care social network of 200 online support groups with 800,000 members, found that nearly two-thirds of respondents reported that getting prescribed opioid medication had become more difficult in the past year. STAT asked three Inspire members with Ehlers-Danlos syndrome — a painful condition that affects the connective tissues that support the skin, bones, blood vessels, and other organs and tissues — to talk about their experiences with opioids. (Patrick Skerrett, 7/15)

In an immaculate mid-century spread nestled in the canyons of Beverly Hills, a Hollywood actress plucks her sleepy infant daughter from the co-sleeper bassinet attached to her bed and settles in for a cozy breastfeeding session. Soon, the child’s live-in nurse swoops in to bathe the baby. Across town on L.A.’s East Side, a Guatemalan immigrant clutching her 2-month-old son in a blanket makes her way through the parking lot at a generic brick building. Inside, she waits to receive her monthly voucher from the federal Special Supplemental Nutrition Program for Women, Infants and Children, commonly known as WIC. Later, she will redeem it for infant formula and groceries. (Jennifer Grayson, 7/17)

Thanks to a spate of scientific advances, this decade could be the beginning of the end of the HIV/AIDS epidemic. But it won’t be if the focus stays only on scaling up treatment. It is undeniably good that more people will be treated for HIV, live longer and better lives, and fewer will die of AIDS. But as long as we regard essential components of HIV prevention as secondary, millions of people will continue to be infected with HIV. That means the epidemic will rage on, and the costs of treatment will continue to escalate. (Peter Piot and Mitchell Warren, 7/18)