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Some Republicans want their party to stop bashing poor people as lazy and undeserving of public assistance. Sam Brownback, the conservative governor of Kansas, doesn’t appear to be one of them. Brownback and his allies are in the middle of a major fight over Medicaid, the government-run health insurance program for the poor and disabled. ... And while conservatives who oppose the expansion sometimes rely exclusively on arguments about Medicaid’s efficacy -- or perceived lack thereof -- Brownback has been putting his rhetorical emphasis elsewhere. On Tuesday, the governor's deputy communications director, Melika Willoughby, distributed a letter laying out in detail the heart of Brownback’s argument -- namely, that expanding Medicaid would be “morally reprehensible” because it would help “able-bodied adults … who choose not to work" and would send money to “big city hospitals.” (Jonathan Cohn, 10/7)

Kansas Gov. Sam Brownback’s office sent out one of its trademark propaganda pieces on Tuesday, this one on the subject of Medicaid expansion. In its effort to score political points, it maligns low-income Kansans and pits citizens with disabilities against the working poor. As with other recent messages, the email signed by the governor’s deputy communications director, Melika Willoughby, is rife with inaccurate information. (10/6)

In Kansas Gov. Sam Brownback’s world, expanding Medicaid eligibility to more low-income Kansans would create “new government entitlements” for “able-bodied adults” and benefit a small number of “big city hospitals.” I’ll say this for Melika Willoughby, the deputy communications director who penned that incendiary language in an email on behalf of the Brownback administration: She’s got the code words down pat. ... By spewing this sort of vitriol, the governor’s office is choosing to argue a complex issue with the lowest forms of talking points. (Barbara Shelly, 10/8)

While [former HHS Secretary Kathleen] Sebelius resigned in the shadow of a disastrous roll-out of healthcare.gov, her more damaging legacy is the temptation for state leaders to embrace a bigger welfare state and accept an injection of federal dollars funded by Medicare cuts and deficit spending. Medicaid expansion, like Obamacare, fails to deliver on its promises of quality health care that improves the health of enrollees. Even more troubling, ballooning Medicaid expansion costs threaten every other service and will trap millions in a cycle of dependency and poverty. (Tarren Bragdon, 10/7)

I listened with interest to Tuesday’s Health Reform Task Force, where members of the Gang of Six presented their “Utah Access” plan for Medicaid expansion. This new proposal, built on the premise that health care providers should pay the majority of the state’s expansion costs, did not go over well. Providers are upset, and they have a right to be. Most providers will see no economic benefit from Medicaid expansion. They should not have to pay more than any other Utahn to cover its costs. (Dan Liljenquist, 10/8)

Perhaps Gov. Terry Branstad thought he could quietly privatize Iowa’s Medicaid program. Instruct a state agency to hand over administration to managed care companies, issue a few press releases about “modernization,” quickly secure federal approval and hope no one raises a fuss. Except when 4.2 billion public dollars and health care for 560,000 Iowans are on the line, people eventually pay attention to the details. It doesn’t take long to realize privatization makes no sense. (10/8)

We all know how this plays out in Congress: a moment of silence on the House floor and a fraternal feeling of melancholy when the flag over the Capitol is lowered to half-staff. But that moment of silence will not heal the hearts of those who lost a loved one, and it will not stop the next tragedy. Here and now we need action; we need real change. That’s why I’ve authored the Helping Families in Mental Health Crisis Act. The bill focuses resources and reform where they are most needed: to foster evidence-based care, fix the shortage of psychiatric hospital beds, empower patients and caregivers under HIPAA privacy laws, and help patients get treatment well before their illness spirals into crisis. (Rep. Tim Murphy, R-Penn.)

Diagnostic accuracy is fiendishly difficult to measure precisely, but it is estimated that doctors get it wrong in one out of 10 to one out of 20 cases. Up until now, the focus of the patient safety movement has been on errors of medical treatment — incorrect medications or dosages, postoperative complications, hospital-acquired infections. But diagnostic errors — incorrect or delayed diagnoses — may be more common and potentially more deadly. The Institute of Medicine has taken up the subject, and its new report offers the chilling observation that nearly everyone will experience at least one diagnostic error in their lifetimes. (Ofri, 10/8)

Cecile Richards, the president of Planned Parenthood, says she was "stunned by the total lack of civility and use of raw power" by Republican members of Congress during last week's House Oversight and Government Reform hearing on her organization's federal funding, Richards fired back at Congress and Republicans in general in a Guardian article published Thursday, warning that the Supreme Court's 1973 decision in Roe v. Wade is "on the ballot" for next year's presidential election. (Nick Gass, 10/8)