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Today, a federal district court in Washington ruled in favor of the House of Representatives — and against the Obama administration — in House v. Burwell, concluding that funds to pay cost-sharing subsidies to health insurers under Section 1402 of the Affordable Care Act had never been appropriated by Congress. In her opinion, Judge Rosemary Collyer concluded that, insofar as such subsidies have been paid, it was unlawful for the executive branch to do so. This is a significant ruling, and one that is certain to be appealed to the U.S. Court of Appeals for the D.C. Circuit. (Jonathan H. Adler, 5/12)

Six years after losing the battle in Congress over the Affordable Care Act, Republicans haven't stopped fighting to reverse the results. They've had little or no luck on Capitol Hill, even though they now control both the House and the Senate. On Thursday, however, they won a skirmish in court when a federal judge canceled funding for the subsidies that help millions of poor people pay the out-of-pocket costs of doctor visits, outpatient care and hospitalizations. The GOP win, if upheld, is a loss for many of their constituents. (5/13)

The most important political event today was not the Donald Trump/House Speaker Paul Ryan (R-Wis.) pantomime, but rather, a critical court ruling against the administration on Obamacare. ... Ryan appeared to be ecstatic. In a written statement, he declared: “This is an historic win for the Constitution and the American people. The court ruled that the administration overreached by spending taxpayer money without approval from the people’s representatives. Here, the executive branch is being held accountable to We the People, and that’s why this decision is very good news.” Since Ryan had just stressed in his post-Trump presser the importance of restraint on the executive branch as a key component of conservatism, the timing could not have been better. (Jennifer Rubin, 5/12)

From the start of his race for the Republican presidential primary run last year, Donald Trump repeatedly has promised that unlike other Republican candidates, he would not touch Medicare, Medicaid or Social Security. It's been one of his core appeals to older working- and middle-class voters. “I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid,” he tweeted last May. As recently as this week, he told Fox Business that “I'm leaving (Medicare) the way it is.” (Harris Meyer, 5/12)

If your parents are in their 80s, you probably have a conditioned response to middle-of-the-night phone calls: “What happened?” The first time, it may be your father who’s in trouble, and your mother is calling from the hospital. When he returns home, she becomes the de facto caregiver, despite being equally elderly and hardly up for the responsibility. The next phone call may be about your mother — perhaps she’s had a fall, and your sibling is calling from the hospital. Now, care becomes more complicated: the siblings negotiate, one of your sisters volunteers to take primary responsibility, even move in, and her life changes. She cuts back to part-time work and takes over managing your parents’ medications, appointments, and checkbook. Each successive call brings more responsibilities and decisions — a home health aide, a life alert bracelet, equipping their home with grab bars and nonslip floors, working out coverage during your sister’s trips and vacations. Resources become strained, emotional health is challenged, and sometimes physical health suffers. (Eve Wittenberg and Lisa A. Prosser, 5/12)

As doctors, patients and former U.S. senators, we’ve seen firsthand how medical innovation benefits patients. Those on our operating tables and in our practices—and we ourselves when we’ve needed medical care—have benefited from breakthroughs in science and newly approved treatments that translate into better health and longer lives. (Bill Frist and Tom Coburn, 5/11)

Cancer and heart disease are the leading causes of death in the United States. People diagnosed with these illnesses turn to the medical community for help. But doing that presents yet another risk to their lives. Medical errors in hospitals and health facilities are now the third leading cause of death in this country, according to a new study. Mistakes made in the places we rely on for care claim 251,000 lives annually. That’s more than respiratory disease, accidents and strokes. It’s more than Alzheimer’s, diabetes and pneumonia combined. (5/12)

With the push of a button, a rural nurse, doctor, or other health provider can activate a telehealth system and be instantly connected to a board-certified emergency medicine physician, experienced critical care nurse, neurologist, cardiologist, trauma surgeon, or other specialists. Access to such specialists improves the quality of emergency health care in rural areas, facilitates interprofessional collegiality, and reduces the professional isolation experienced by some rural clinicians. (Clint MacKinney, 5/12)

A new survey puts the spotlight on the nation's most unpopular governors. A quick look at those governors' records shows many disliked decisions that impacted healthcare. Four of the 10 least popular governors highlighted in the Morning Consult analysis have not expanded Medicaid to more low-income people. Maine Gov. Paul LePage, a Republican who made the “bottom” 10, actually called Medicaid expansion “sinful” a couple years ago. Several other governors, including Republican Matt Bevin of Kentucky, have openly expressed their antipathy for the Affordable Care Act. (Bob Herman, 5/12)

One of the many unpleasant surprises accompanying the troubled debut of Benefind, the state’s new $100 million integrated benefits system, was the lockout of kynectors. This cadre of 500 highly-trained people, working in non-profit organizations and a contractor-run call center, have been key to helping 500,000 Kentuckians navigate new health insurance options under the Affordable Care Act and gain access to routine medical care. The U.S. Department of Agriculture can restore kynectors’ ability to help low-income Kentuckians by approving an exception to some privacy provisions in its Food and Nutrition Service programs. Such an exemption would jeopardize no one’s privacy because kynectors’ already know the financial information of the people who seek their help in applying for benefits through Kynect’s and now Benefind’s online self-service portals. (5/13)

Narrowing the gap between the generous insurance reimbursements awarded to Massachusetts’ biggest medical centers and smaller payments made to community hospitals has long been the subject of debate. With every passing year, alarms about the underfunding of struggling hospitals grow louder. The state legislature’s failure to do its job and address this issue has produced two unpalatable options, which both have the potential to do further harm. (5/13)

On June 9 California will join four other states — Oregon, Washington, Vermont and Montana — in allowing physician-assisted suicide. Meanwhile, my state, Arizona, and a dozen or so others are considering their own “right to die” laws. As a hospice physician, about twice a year I am asked by a patient to prescribe a lethal dose of a medication. Oncologists throughout the country report that up to half of their patients at least ask about it. But even if it were legal in Arizona, and I knew a patient met all the criteria established by law, I would still not hasten his or her death. That would be my right as a doctor, and it will be the right of doctors in California as well. (Ann Marie Chiasson, 5/12)