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Virginia’s hospitals reversed their position this week on a controversial bed tax, potentially giving Gov. Terry McAuliffe (D) a path to the top priority of his administration: Medicaid expansion. Members of the Virginia Hospital and Healthcare Association have traditionally resisted efforts to pay additional fees, but a tax on beds — also known as a provider assessment — would draw down a federal match. (Portnoy, 12/3)

A long-resisted tax on hospitals may be back as a proposed way to reap more federal Medicaid money for health systems and, perhaps, expand health care coverage for uninsured Virginians. Gov. Terry McAuliffe and the state hospital association opened the door Thursday to creating a “provider contribution” that hospitals and health systems would pay to collect additional federal Medicaid money to help pay for uncompensated care and graduate medical education. (Martz, 12/3)

Gov. Gary Herbert will not propose another Medicaid plan and instead will wait to see what, if anything, legislators come up with, his office said Thursday. Lawmakers earlier this year rejected two plans backed by the Republican governor. They intend to tackle the issue again in 2016 after debating it for more than three years and failing to agree. (Price, 12/4)

House Speaker Greg Hughes, R-Draper, outlined more details about the newest Medicaid expansion plan being sought by GOP legislators, explaining that it will focus on the "most vulnerable" Utahns and that lawmakers will look to hospitals — and possibly other Utahns — to fund it. Hughes spoke on a panel Thursday at a health care conference .... In response to an audience member who asked if legislators would consider a statewide tax voted on by ballot measure, Hughes said the idea "has not been delved into deeply, but that's a concept that's certainly worth talking about." (Chen, 12/3)

Gov. Mike Pence says the Obama administration has chosen a biased source to evaluate the state’s alternative Medicaid program. In a letter sent Thursday to Health and Human Services Secretary Sylvia Burwell, Pence asks that the federal review be dropped as the state has contracted with an independent evaluator. ... Indiana is one of a handful of states that received permission to not follow some federal rules when expanding Medicaid coverage under the Affordable Care Act. Indiana’s permission runs through Jan. 31, 2018. (Groppe, 12/3)

Republican Gov.-elect Matt Bevin has chosen a Louisville attorney to lead his efforts to dismantle and replace the health care system put in place by his Democratic predecessor. Vickie Yates Brown Glisson will be the next secretary of the Health and Family Services Cabinet, Bevin announced Thursday. The agency operates the state's Medicaid program, which outgoing Democratic Gov. Steve Beshear greatly expanded under the federal Affordable Care Act. (Beam, 12/3)

The Hawaii Health Connector spent $130 million in federal grant money, but will be closing its doors after failing to achieve financial sustainability. The last day for the state-based health insurance exchange will be Friday, and its customers are re-enrolling on the federal website healthcare.gov. So far, just 4,500 people in Hawaii have signed up on the federal website. Issues with healthcare.gov led to enrollment delays but those problems have improved, said Jeff Kissel, outgoing executive director of the Connector. (Bussewitz, 12/4)

December is the month in which many people enrolled in “Obamacare” must reassess and renew their plans. As they do so, it’s a good time to evaluate the politics and economics behind those health-care costs. Hospitals and health care keep cities employed. Take away hospital and medical care jobs, and you are removing one of the engines of economic hope for urban areas. But the need to add jobs is directly at odds with the Affordable Care Act’s commitment to—well, to affordable health care. (Guian McKee, 12/3)