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Sen. Marco Rubio likes to brag that he is the mastermind behind the Republicans' one successful attack on the Affordable Care Act -- that he stopped a "bailout" of private insurance companies and, in the process, saved taxpayers $2.5 billion. The boast has some truth. What the GOP presidential candidate doesn't mention is that, because of his efforts, some people are likely to face higher premiums for their health coverage and insurance markets on the whole are less stable. (Jonathan Cohn, 12/9)

Despite the success of the Affordable Care Act's supporters in fending off a raft of challenges to the law in Congress and the courts, at least one ACA provision seems headed for the scrap heap. That's the "Cadillac tax," a stiff tax that will hit especially generous employer health plans starting in 2018. (Michael Hiltzik, 12/9)

Republican presidential candidate Ben Carson unveiled his agenda to reform the American health care system Wednesday. (Young, 12/9)

If any state should be looking at Medicaid expansion, it is cash-strapped, economically stagnant Kansas, where one rural hospital recently closed and others are struggling. But key lawmakers have cited irrational opposition to “Obamacare” to avoid a meaningful discussion. Brownback disingenuously tries to entwine Medicaid expansion with other priorities. Thirty states have decided that Medicaid expansion makes sense for them. Surely Kansas lawmakers can find a model that would work here. (12/9)

Add South Dakota's Dennis Daugaard to the list of Republican governors who have changed their minds about Obamacare's Medicaid expansion. The second-term governor pitched a plan to expand the joint federal-state health insurance program to as many as 55,000 low-income South Dakotans without using state money during a speech to the overwhelmingly Republican legislature Tuesday. Daugaard rejected the expansion three years ago, objecting to allowing "able-bodied" people to get covered. (Jeffrey Young, 12/9)

Of all the missed opportunities, policy meltdowns and eroded capabilities that have marked state government’s last five years, none stands out quite like the failure to provide health care to 100,000 of our fellow citizens, at no cost to state taxpayers. Yet you’d never know this from reading newspapers or listening to the news. Maine’s inability to adopt any form of the Medicaid expansion included in the Affordable Care Act is, first of all, a human tragedy. Large numbers of Mainers are growing up with preventable illnesses and untreated, chronic conditions that will require huge amounts of remedial spending down the road — and their quality of life will never recover. And, although it’s somehow considered impolite to mention it, as Sen. Angus King once did, significant numbers will die because they couldn’t afford the care they need. (Douglas Rooks, 12/10)

This week, the U.S. Senate begins a series of hearings to investigate enormous spikes in the cost of prescription drugs. Over the past year, more and more pharmaceutical CEOs have been asked to respond to price gouging allegations, particularly for older, affordable medicines that work. Coming weeks before the Iowa caucuses, this hearing is timely. Voters cite rising drug costs as a central pocketbook issue. (Vijay Das, 12/9)

Just like that, Pfizer has decided it's no longer American. It plans to link up with Ireland's Allergan and move its corporate headquarters from New York to Ireland. That way it will pay less in taxes. ... Such corporate desertions from the United States (technically called "tax inversions") will cost the rest of us taxpayers some $19.5 billion, estimates Congress's Joint Committee on Taxation. Which is fueling demands from Republicans to lower the corporate tax rate. ... an easier fix would be to take away the benefits of corporate citizenship from any company that deserts America. One big benefit is the U.S. patent system that grants companies like Pfizer longer patent protection and easier ways to extend it than most other advanced economies. (Robert B. Reich, 12/9)

Well, since I’m a white male, they’re not so focused on my life – but what about the life of my daughter? In Cruz’s ideal world, Republicans would get to tell her whether and when she can use birth control, and what kind. They’d get to forbid her from getting an abortion. And if she was struggling for money, they’d get to prevent her from obtaining affordable cancer screening, family planning advice and prenatal care. (Andrew Rosenthal, 12/9)

Since May, about 9,000 children with unique medical needs have been purged from the Children’s Medical Services roster. State leaders call it the result of a reorganization. They can call it whatever they want. In reality, it’s Florida’s longstanding attempt to save money by rationing care, and it’s taking it out on the most vulnerable. It’s nothing new, but it remains a disgrace. (12/9)

I am telling you all this as a lead-in to a fascinating bill that was recently proposed in the Missouri House of Representatives. It would treat Missourians seeking to buy firearms the same way it treats Missourians seeking to end a pregnancy. “For instance, there would be a 72-hour waiting period,” said the sponsor, Representative Stacey Newman. Missouri has piled so many unnecessary requirements on abortion providers that it’s down to one clinic in St. Louis. Newman didn’t attempt to limit the state to one gun store — her bill just requires that residents buy their guns at a licensed dealer located at least 120 miles from their homes. After cooling their heels in a local motel for three days, the prospective buyers would have to listen to a lecture about the medical risks associated with firearms and view pictures of people with fatal gun wounds. (Gail Collins, 12/10)

Gov. Rick Scott continues to make excuses for his lack of action on stopping the flow of state taxpayer money to [Planned Parenthood] in Florida. And both he and Politifact has fallen back to the excuse that because no court has yet formally "found" Planned Parenthood "guilty" of the sale of human tissue, there's no reason to act. Is this leadership? Is this what pro-life Floridians expected of the governor they twice went to the polls to support? (John Stemberger, 12/9)

A colleague recently announced that he'd been diagnosed with a life-threatening cancer. Don't worry, he wrote. He promised to fight. He promised to recover. As a survivor of multiple cancers and rare diseases, I've had to write my fair share of group emails alerting friends and family to medical news. So I understand the impulse to sound upbeat. Diagnosis emails and social-media posts are now a genre with set tropes and expected turns of phrase. (Adam Baer, 12/9)

On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015. The new law lifted the debt limit and prevented a government shutdown. It also made several important changes to Medicare and the Patient Protection and Affordable Care Act. Of particular importance is Section 603, which excludes certain hospital outpatient department services from the facility fee under the Hospital Outpatient Prospective Payment System. With specified exceptions, services are excluded from this system if they are furnished by a provider’s off-campus outpatient department. This provision is an effort to end payment differences based on the site of service and was inserted at the request of the Administration. (Julius Hobson, 12/9)

Efforts to reduce low-value care can decrease spending while helping patients avoid potentially harmful treatments. ... The current approach focuses on 2 strategies to reduce low-value care. First, professional societies are exhorting physicians to consider costs and value when deciding among alternative treatments. ... These initiatives appeal to a sense of professionalism by promoting the idea that physicians are stewards of societal resources. Second, payers are promoting health care system innovation and implementing payment reforms to reduce the incentives to provide ineffective treatments. Unfortunately, discussions about how to reduce low-value care often gloss over a crucial third strategy: a sustained effort to generate evidence that will distinguish between high- and low-value care. (David H. Howard and Cary P. Gross, 12/8)

In the past, the care of adult patients in children’s hospitals was an uncommon occurrence. However, the face of pediatrics is changing rapidly as advances in care of once-terminal childhood illnesses allow patients to survive well into adulthood. Given the specialized care frequently required to treat these congenital and childhood diseases, adult survivors are often treated by pediatric specialists housed in children’s hospitals. This paradigm shift means that some children’s hospitals must be well equipped to care for these adults, which may stress the capabilities of both pediatric health care professionals and institutions. (Benjamin Kinnear and Jennifer K. O’Toole, 12/8)