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By upholding the legality of insurance subsidies on the federal exchange, the Supreme Court secured President Obama’s legacy of expanding access to health care. Now Mr. Obama must secure the other fundamental legacy of the Affordable Care Act: controlling health-care costs. The growth of health-care spending has slowed in recent years, and per-person Medicare and Medicaid costs have declined. ... Still, most analysts expect that the growth in health-care costs will rise without further action. And the latest data from the Census Bureau indicate this acceleration may be starting. The country is at an inflection point: Will we let our foot off the brakes, or will we permanently bend the cost curve? (Ezekiel Emanuel and Topher Spiro, 7/7)

The Supreme Court’s ruling in King v. Burwell defused a political and policy crisis over the Affordable Care Act, but how long any cooling-off period lasts, or whether one exists at all, could affect efforts to address remaining implementation challenges. ... A cooling-off period could provide an opening for some red states to consider expanding their Medicaid programs and to negotiate the terms of waivers with the Department of Health and Human Services that conservatives in these states may want to make expansion more politically acceptable to them. Less controversy around the ACA would also enable efforts to enroll the remaining uninsured to proceed unimpeded by the negative coverage, confusion and misperceptions that often flow from political warfare about the health-care law. (Drew Altman, 7/8)

To obtain better value for health-care dollars, it's important to evaluate in detail which ones are well-spent and which are not. The $150-billion-a-year market for implantable medical devices in the U.S. -- which includes everything from artificial hips to pacemakers -- is a good illustration of this challenge and how to meet it. Examining how well devices are working requires knowing where each one goes. Without tracking, it's difficult to find out which patients do better with one kind of device, and which ones are better off with another kind. (Peter R. Orszag, 7/7)

It was shocking last year when hospitals operated by the Department of Veterans Affairs were caught falsifying data to hide the long delays endured by patients needing medical care. What’s even more shocking is that despite strenuous efforts to improve the system, more veterans are facing long waits than before. ... The problem may well get worse. The department, which operates a huge system of hospitals and clinics, expects a shortfall of about $2.5 billion in programs to treat veterans outside the department’s own facilities for the rest of this fiscal year, ending Sept. 30. (7/7)

The Supreme Court's recent blessing of Obamacare has precipitated a rush among the nation's biggest health insurers to consolidate into two or three behemoths. The result will be good for their shareholders and executives but bad for the rest of us -- who will pay through the nose for the health insurance we need. We have another choice. (Robert B. Reich, 7/7)

This summer, our state lawmakers will choose whether to derail Utah’s fiscal stability for years to come. They have to decide if Utah will expand Medicaid under the Affordable Care Act. Why is this decision so critical? If legislators expand Medicaid, they could imperil the budget and risk funding for critical state services taxpayers rely upon, including transportation and education. (Evelyn Everton, 7/8)

Health care professionals have long known that the most effective way to prevent abortions isn’t to make the last steps into a clinic harder to take. A better way: Give women more tools to prevent pregnancies. For teens, that especially includes education, and states across the country – including North Carolina – have seen significant drops in teen pregnancy in recent years thanks to more robust education programs. But no state has had close to the success of Colorado. (Peter St. Onge, 7/7)

Like other judges, I had been working with our local agencies to do what I could, legally, to keep as many people as possible out of the state hospital. This saves the state resources and avoids the trauma that a person with mental illness may experience when forced to receive treatment outside of his or her community. But it isn’t always possible, or safe, to do this. Some people’s symptoms are so severe that they must receive care and treatment in a hospital. As judges, we must have a place to send people who we determine are a danger to themselves or others. (Kathleen Lynch, 7/7)

Cost sharing has certainly increased, from copayments for physician office visits and prescription drugs to deductibles; the fraction of workers in a plan with at least a $1000 deductible for coverage of a single person increased from 10% in 2006 to 41% in 2014. Higher cost sharing feels like a decrease both in the generosity of coverage and in compensation. It seems particularly unfair to lower-wage workers who face the same deductibles and copayments as their higher-paid counterparts and who may be discouraged from seeking needed care. But increases in cost sharing are not necessarily regressive nor necessarily associated with lower compensation. (Katherine Baicker and Amitabh Chandra, 7/7)