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Millions of Anthem health insurance customers woke Thursday morning to an e-mail from the company telling them hackers had gained access to the company's computers and that their names, birthdays, Social Security numbers, addresses and employment data including income might have been stolen. "Anthem will individually notify current and former members whose information has been accessed. We will provide credit monitoring and identity protection free of charge so that those who have been affected can have peace of mind," Anthem President and CEO Joseph Swedish said in the e-mail. (Weise, 2/5)

The attack on the nation’s second-largest health insurer could be one of the largest data breaches in the healthcare industry, experts said. Anthem said hackers infiltrated a database containing records on as many as 80 million people. Hackers appear to have accessed customers' names, dates of birth, Social Security numbers, member ID numbers, addresses, phone numbers, email addresses and employment information, Anthem said. Some of the customer data may also include details on their income. At this point, it appears that the data stolen do not include medical information or credit card numbers, according to the company. (Terhune, 2/5)

Anthem Inc. stored the Social Security numbers of 80 million customers without encrypting them, the result of what a person familiar with the matter described as a difficult balancing act between protecting the information and making it useful. Scrambling the data, which included addresses and phone numbers, could have made it less valuable to hackers or harder to access in bulk. It also would have made it harder for Anthem employees to track health care trends or share data with states and health providers, that person said. (Yadron and Beck, 2/5)

The cyberattack on Anthem, one of the nation’s largest health insurers, points to the vulnerability of health care companies, which security specialists say are behind other industries in protecting sensitive personal information. Experts said the information was vulnerable because Anthem did not take steps, like protecting the data in its computers though encryption, in the same way it protected medical information that was sent or shared outside of the database. (Abelson and Goldstein, 2/5)

The federal government is investigating whether the personal information of Medicare beneficiaries was stolen by hackers who breached health insurer Anthem's computer networks. The Health and Human Services inspector general's office said Thursday it is assessing whether personal data about Medicare and Medicaid beneficiaries has been compromised. (Alonso-Zaldivar, 2/5)

All this comes at a time when Anthem is spearheading an ambitious effort to build a controversial database of medical records on 9 million Californians for use by hospitals and doctors. In light of the data breach, patient advocates called on consumers to boycott the Anthem-led California Integrated Data Exchange, or Cal Index, as it prepares to launch this year. California's insurance commissioner said he and other regulators will examine whether the Indianapolis-based company is doing enough to prevent future breaches. (Terhune, 2/5)

Anthem, which revealed Wednesday that the records of 80 million of its customers had potentially been breached, was fined $1.7 million for a 2010 computer breach that resulted in the disclosure of personal information of approximately 612,000 people. The fine was levied by the U.S. Department of Health and Human Services under HIPAA, the 1996 Health Insurance Portability and Accountability Act, which governs the confidentiality and security of medical information. (Weise, 2/5)

David Cordani, chief executive officer of Cigna Corp., talks about the health insurer's fourth-quarter profit, the potential impact of a forthcoming U.S. Supreme Court ruling about the Affordable Care Act on the company and steps Cigna takes to prevent the hacking of customer information. (Steel and Ruhle, 2/5)

Health care is a treasure trove for criminals looking to steal reams of personal information, as the hacking of a database maintained by the second-largest U.S. health insurer proves. The latest breach at health insurer Anthem Inc. follows a year in which more than 10 million people were affected by health care data breaches — including hacking or accidents that exposed personal information, such as lost laptops — according to a government database that tracks incidents affecting at least 500 people. (Murphy and Bailey, 2/6)

A hack at Anthem, the second-largest health insurer in the country, exposed personal information about millions of employees and customers. But the attack is just the latest evidence that cybercriminals are increasingly targeting the medical sector where they can collect health information that can be sold for a premium on the black market. (Peterson, 2/5)

The massive computer breach against Anthem, the nation’s second-largest health insurer, exposes a growing cyberthreat facing health-care companies that experts say are often unprepared for large attacks. Hackers gained access to the private data of 80 million former and current members and employees of Anthem in one of the largest medical-related cyber-intrusions in history. (Harwell and Nakashima, 2/5)

Given the steady beat of security breaches, consumers may assume that a cybercriminal already has at least some of their personal information. But in the latest intrusion, at the health insurer Anthem, hackers got their hands on an especially valuable collection of sensitive information on millions of people. Anthem, which offers several Blue Cross and Blue Shield plans across the country, said the database that was breached included names, Social Security numbers, birthdays, addresses, email and employment information for as many as 80 million people, including some of its own employees. (Siegel Bernard, 2/5)

As many as 80 million people may have had their personal information stolen in a massive hack at health insurance giant Anthem Inc. The data breach could be the largest cyber theft in the history of the healthcare industry. Here is what you need to know. (Khouri, 2/5)

The White House is gearing up for what’s likely to be the most headache-inducing tax season yet as the struggling Internal Revenue Service begins enforcing the more than 40 new Affordable Care Act tax provisions. Many are crucial to the success of the health care law. (Ehley, 2/6)

The man who could cripple Obamacare isn’t shy about telling the world that he thinks the president is an “idiot,” posting altered images of the First Lady in Middle Eastern clothing and expressing his hatred for the “Democraps” who enacted the health care law. David M.King, 64, is the lead plaintiff on the Supreme Court case that challenges the government’s right to grant tax subsidies to millions of Americans in certain states to make health insurance more affordable. When the case is argued on March 4, King — friendly, with graying hair and a mustache — will become the public face of King v. Burwell, the most significant threat to the Affordable Care Act since the 2012 Supreme Court case that put the law’s individual mandate on the line. (Haberkorn, 2/6)

Immigrants and others trying to prove their citizenship and identities to enroll in health insurance still face some of the problems they had during the last open enrollment, according to those helping them sign up. Most people in the 37 states using the federal exchange can complete a relatively short application, but immigrants have to use the still-complex, longer form and deal with a multi-stage process of proving their status and identities. (O'Donnell, 2/5)

As House Republicans once again voted to repeal the Affordable Care Act this week, there was further evidence the controversial bill is contributing to the good health of some of the nation’s major health insurers. (Radelat, 2/6)

Arkansas' first-in-the-nation program using federal funds to buy private health insurance for the poor will survive another year after the Legislature reauthorized the program Thursday, despite an influx of new Republican lawmakers elected on a vow to kill the hybrid Medicaid expansion. The Arkansas House voted 82-16 to reauthorize funding through June 2016 for the "private option" plan, which was crafted two years ago as an alternative to expanding Medicaid under the federal health law. (DeMillo, 2/5)

Members of the governor-appointed group that developed options for expanding Medicaid to cover Idaho's poorest adults told lawmakers Thursday that opposition to the expansion has blocked money that taxpayers are due under federal health care reform. The panel's alternative funding plan provides greater accountability, saves money and gives the state more control over how funds are spent, they said. (Dentzer, 2/6)

Although Medicaid comprises close to $4 billion of North Carolina’s $21 billion budget, Gov. Pat McCrory mentioned the program that covers more than 1.7 million low-income children, their parents, seniors and people with disabilities only once during his 80-minute State of the State speech on Wednesday evening at the General Assembly. And while debate over the idea of expanding the Medicaid program as allowed for under the Affordable Care Act is increasingly being embraced by other Republican governors around the country, McCrory sidestepped the topic, only talking about expansion in veiled terms. (Hoban, 2/5)

A plan by three Republican lawmakers for replacing President Barack Obama’s health care overhaul would leave Americans with less coverage and higher costs than the landmark law they want to repeal, Democrats said Thursday. “It effectively raises taxes on the middle class, removes bedrock protections for consumers and chips away at key coverage benefits that Americans rely on,” Sen. Ron Wyden of Oregon, top Democrat on the Senate Finance Committee, said a day after the GOP authors released their outline. (2/5)

As the Senate’s chief defender of the Affordable Care Act, Sen. Chris Murphy took a sledgehammer to a GOP alternative Thursday. (Radelat, 2/5)

Congressional Republicans are unveiling what they say is a new plan to repeal and replace Obamacare, but the ‘blueprint,’ as they call it, looks an awful lot like what’s been floated before. (Kalman, 2/5)

A war of the right-wing wonks is starting to rage as Republicans debate how best to repeal and replace Obamacare — and potential GOP presidential contender Bobby Jindal is smack in the middle. (Wheaton, 2/5)

Polling in the low single-digits and still trying to build a national donor base, Republican Louisiana Gov. Bobby Jindal is aiming to draw attention to himself and his soon-to-be 2016 presidential candidacy. So there was Mr. Jindal Thursday, calling out Washington’s Republican leaders for being insufficiently committed to repealing the Affordable Care Act. (Epstein, 2/5)

Republicans are seeking to ensure that no federal dollars go to health insurance companies under Obamacare's risk corridors, a program the GOP attacks as an industry "bailout." Sens. Bill Cassidy (R-La.) and Marco Rubio (R-Fla.) introduced legislation Wednesday to make risk corridors budget-neutral. A similar bill from Cassidy was included in the federal spending package passed in December, though the requirement would only apply for one year. (Viebeck, 2/5)

As vaccine skeptics fight laws that would force more parents to inoculate their kids, they are finding unexpected allies in conservative Republicans. Though the stereotype of a vaccine skeptic is a coastal, back-to-the-land type, it’s generally been Democratic-controlled states that have tightened vaccination laws. This week, Democrats in two of those states — California, where a measles outbreak was traced to Disneyland, and Washington state — proposed eliminating laws that allow parents to opt out of vaccination for personal reasons. (Riccardi, 2/6)

One of our colleagues noticed that virtually every Washington Post article concerning the measles outbreak is followed by comments that link the outbreak to illegal immigration. As it turned out, a number of prominent politicians have suggested that there might be a link — or that a link cannot be ruled out. (LePage did not mention measles, but suggested there could be in “uptick” in other diseases.) Our friends at PundiFact noted that Rush Limbaugh flat-out declared the outbreak was linked to “our immigration policy,” earning the commentator a “Pants on Fire.” But the politicians’ statements were much more nuanced and careful. What kind of evidence do they have? (Kessler, 2/6)

Five California state senators want to eliminate waivers that allow parents to opt their children out of vaccinations for personal or religious beliefs, arguing such a step could have prevented the state’s recent measles outbreak. The lawmakers announced their bill late Wednesday, which would require all children to be vaccinated before attending public school, unless they have a medical condition that prevents it. Schools would also be required to make their vaccination rates public. (Ferris, 2/5)

Several state legislatures are debating vaccine-related measures as dozens of people have fallen ill from a measles outbreak that started at Disneyland in December and spread beyond the theme park. Here is a look at some of the legislation around the country. (2/6)

Five infants in the Chicago area have been diagnosed with measles, a situation that highlights the dangers posed by the current measles outbreak, public health officials said Thursday. This is the second time this week that a measles case infecting an infant has potentially exposed other very young children to the virus. ... These situations point to the dangers posed by the current measles outbreak, which has largely centered on California and has sparked renewed focus on the people who do not vaccinate their children. (Officials say that so far, it does not appear that the Illinois cases are linked to the outbreak that began at Disneyland.) (Berman, 2/5)

From food safety to tobacco regulation and politically charged drug approvals, Margaret Hamburg reset the course of the embattled Food and Drug Administration. After nearly six years as FDA commissioner, Hamburg announced her resignation Thursday in an email to staff. She said the agency’s chief scientist, Stephen Ostroff, will serve as acting head of FDA. (2/5)

FDA Commissioner Dr. Margaret A. Hamburg — who has been at the center of controversial decisions such as relaxing age restrictions on the Plan B contraceptive — has decided to step down after six years in the job. In a letter to FDA staff, Hamburg called the tenure "the most rewarding of my career." She cited, among other things, the agency's record in improving food safety, advancing the safety and effectiveness of medical products, reducing the time for pre-market reviews of medical devices as highlights of her six years at the FDA's helm. (Neuman, 2/5)

Has the other shoe dropped? Following mounting speculation, FDA commissioner Margaret Hamburg has told staffers that she will step down at the end of March, after a nearly six-year run heading the agency. The news comes just 10 days after the FDA hired Robert Califf, a widely regarded Duke University cardiologist, as deputy commissioner for medical products and tobacco. That move quickly set off speculation that Califf would, in fact, soon succeed Hamburg, since he starts his new job later this month. (Silverman, 2/5)

FDA Commissioner Margaret Hamburg, who has overseen food and drug safety for nearly six years, will leave at the end of March, she announced in an email to agency staff Thursday morning. Her departure message focused on the agency’s accomplishments in food safety, the approval of drugs and devices and ushering in an era of personalized medicine. She also lauded the new “breakthrough pathway,” which allows the Food and Drug Administration to speed up review of drugs or biologics to help individuals with serious illnesses. (Pradhan, 2/5)

Food and Drug Administration Commissioner Margaret Hamburg will resign her post in late March after six years at the agency, leaving it without a leader as congressional Republicans press efforts to speed approvals of novel medical treatments. In a letter to colleagues sent Thursday morning, Hamburg wrote that she was leaving the agency with "mixed feelings." The White House is expected to announce her departure Friday. (Gustin, 2/5)

House Republicans announced Thursday that their state budget plan will include $124 million for mental-health care and health services for the poor — slightly more than the money proposed last fall by Gov. Terry McAuliffe (D). The move reflects a bid by the GOP to build on mental-health reforms begun after a tragedy involving a senator’s son and to shake off the “party of no” label Democrats have lobbed at them for rejecting McAuliffe’s big push to expand Medicaid under the Affordable Care Act. (Vozzella, 2/5)

Rhode Island faces a very human, budget-cutting dilemma as it tries to close a projected deficit that has been estimated at anywhere from $166.6 million to $200 million. The dilemma? One-fourth of Rhode Island’s residents receive Medicaid. The last time anyone counted, Rhode Island’s cost per Medicaid enrollee was 31 percent higher than the national average, at $9,541 per person. The state’s total Medicaid tab was $1.78 billion during the 12 months that ended on June 30, 2013. Since then, it has ballooned by close to $1 billion more. (Gregg, 2/5)

The state will send out letters to 107,000 Medicaid recipients today telling them that their health-care benefits will be terminated on Feb. 28 for failure to verify their income. ... An additional 140,000 recipients will receive termination notices next week, with 100,000 scheduled for March. The Ohio Job and Family Services Association and advocates for the poor have urged state officials to delay terminating benefits because fewer than half of those sent renewal notifications in December have responded, and many never received them. (Candisky, 2/6)

The incoming CEO at Partners HealthCare says the network will continue to expand, but not necessarily in Massachusetts. (Bebinger, 2/5)

Health care costs are projected to increase by about 7 percent this year, making it likely that employers will try to control expenses by changing benefits, increasing deductibles, and otherwise shifting more costs to their workers, the state’s health insurance companies said Thursday. (Fernandes, 2/5)

Major Massachusetts health plans covering 2.6 million residents announced Thursday they will cover treatment with the drug methadone by July 1, in an effort to address the epidemic of addiction to opiate drugs. (Johnson, 2/6)

For the second time in three months, federal officials have notified Osawatomie State Hospital that it’s on the brink of losing its Medicare payments because it is out of compliance with health and safety standards. The latest warning, issued Jan. 30, stemmed from a Jan. 23 inspection that resulted in the hospital being cited for deficiencies in medication management and infection control, and for not doing enough to prevent suicidal patients from hanging themselves. (Ranney, 2/5)

Arkansas Medicaid officials have reached a legal settlement to resolve claims the state denied patients a cystic fibrosis therapy made by Vertex Pharmaceuticals Inc. due to its cost. In a lawsuit filed in federal court last year, three patients alleged the state had for two years violated their civil rights by denying them the drug, Kalydeco, which has an annual wholesale price of $311,000. (Walker, 2/5)

In the twenty-three states that have decided against expanding Medicaid ...uninsured adults who would have been eligible for Medicaid and have incomes at or above the federal poverty guidelines are generally eligible for Marketplace (insurance exchange) premium tax credits .... This study compared estimated out-of-pocket spending for care and premiums ... under two simulation scenarios: obtaining coverage through a silver plan with subsidized cost sharing and enrolling in expanded Medicaid. Compared with Marketplace coverage, Medicaid would more than halve average annual out-of-pocket spending ($938 versus $1,948), while dramatically reducing the percentage of adults in families with out-of-pocket expenses exceeding 10 percent or 20 percent of income. (Hill, 1/28)

In-person assistance from navigators and other professionals has significantly facilitated individual and family enrollment into the health insurance marketplaces developed under the Affordable Care Act (ACA). However, though enrollment in state and federally facilitated marketplaces was at 6.7 million by late 2014 and has exceeded 9.5 million thus far for 2015, millions eligible for financial assistance through the marketplaces remain uninsured. As federal and state funding for navigators and other publicly funded assisters decreases in the coming years, private insurance brokers and agents ... could play an increasingly important role in expanding coverage to the hard-to-reach uninsured and in ensuring that those already enrolled maintain coverage in the future. (Corlette, Blumberg and Wengle, 2/2)

Efforts to transform primary care through the medical home model may have limited effectiveness if they do not incorporate families’ preferences for different primary care services. ... Parents [contacted through an Internet survey] were most likely to choose primary care offices that guaranteed same-day sick visits, followed by those with higher professional continuity. Parents were also significantly more likely to choose practices with 24-hour telephone advice plus nonurgent email advice, evening hours 4 or more times a week, and at least some hours on weekends. ... As primary care practices for children implement aspects of the medical home model, those that emphasize same-day sick care and professional continuity are more likely to meet parents’ preferences for enhanced access. (Zickafoose et al., 2/2)

[W]e analyzed the economic returns for four cohorts of new prescription drugs ... (in 1991–94, 1995–99, 2000–04, and 2005–09) and compared fluctuations in revenues with changing average research and development (R&D) and other costs to determine patterns in rewards for pharmaceutical innovation. We found that the average present values of lifetime net economic returns were positive and reached a peak with the 1995–99 and 2000–04 new drug cohorts. However, returns have fallen sharply since then .... If this level of diminished returns persists, we believe that the rewards for innovation will not be sufficient for pharmaceutical manufacturers to maintain the historical rates of investments needed to sustain biomedical innovation. (Berndt et al., 2/2)

New preliminary data from the Medicaid Budget and Expenditure System (MBES) released by the Centers for Medicare and Medicaid Services (CMS) details for the first time the number of adults enrolled in Medicaid under the new Affordable Care Act (ACA) Medicaid expansion category. The data show that as of March 2014, among 48 states reporting data, 4.8 million adults out of the total 54.1 million individuals enrolled in Medicaid were in the ACA Medicaid expansion category .... This issue brief provides an overview of the new data. (Snyder et al., 2/2)

In January 2015, the Centers for Medicare and Medicaid Services (CMS) approved Indiana’s amendment of its § 1115 demonstration, the Healthy Indiana Plan (HIP). The amended waiver implements the Affordable Care Act’s (ACA) Medicaid expansion …. Indiana’s demonstration is more complex than others approved to date. The program has multiple parts, including four different Medicaid benefit packages …. Indiana’s waiver is different than other Medicaid expansion waivers approved to date in that it allows the state to prevent certain newly eligible beneficiaries (non-medically frail adults above the federal poverty level) from re-enrolling in coverage for six months after they are disenrolled for non-payment of premiums. (2/3)

The President’s FY2016 budget proposal would reduce net Medicare spending by $423 billion between 2016 and 2025, and is estimated to extend the solvency of the Medicare Hospital Insurance Trust Fund by approximately five years. This brief summarizes the Medicare provisions: More than one-third (34%) of the proposed Medicare savings are due to reductions in Medicare payments to providers, most of which affect providers of post-acute care. Nearly one-third (30%) of the proposed savings are related to Medicare prescription drug spending. The largest single-source of Medicare savings (23% of Medicare savings) is a provision that would require drug manufacturers to provide Medicaid rebates on prescriptions for Part D Low Income Subsidy enrollees. (Jacobson et al., 2/3)

Third quarter 2014 health insurance enrollment data show ... increasing Medicaid enrollment and declining enrollment in employer plans. However, while individual-market enrollment increased substantially in both the first and second quarters, it declined by 357,000 during the third quarter. The net result was 160,000 fewer Americans with health insurance. For the first nine months of 2014, individual-market enrollment grew by 5.83 million, but 4.93 million individuals lost employer coverage—offsetting 85 percent of the individual-market gain. Thus, the net increase in private health insurance for 2014 is so far 893,000 individuals. During the same period, Medicaid enrollment grew by almost 7.49 million. (Haislmaier and Gonshorowski, 1/29)

Doctors say that when patients are seriously ill, the main obstacles to discussing what the goals of care should be are family disagreement and patient denial. “It’s a difficult time,” said lead author Dr. John J. You of McMaster University in Hamilton, Ontario in a phone interview. “But that means we need to be there with extra support and profoundly good skills.” (Doyle, 2/2)

The cost of managing diabetes has more than doubled in the past 20 years, a new analysis says. The average diabetes patient now spends $2,790 more per year than they did in 1987 - and more than half the additional spending is for medications. “People need to be mindful about the substantial increase in the cost of diabetes, which has been partially fueled by the rising prices of newer drugs,” said Xiaohui Zhou, a health economist at the Centers for Disease Control and Prevention (CDC) who led the study. (Kennedy, 2/2)

In the U.S., less than a third of older heart “event” patients being discharged from the hospital get the recommended high-intensity statins, according to a new study that looked at prescriptions filled. National guidelines from the American College of Cardiology and American Heart Association say the majority of patients should be on a high-dose statin following a serious heart disease-related event like heart attack or bypass surgery. (Doyle, 1/29)

Resident salaries are low, but it's not the match's fault, according to a study published in the American Economic Review. Rather, high demand for a limited number of desirable residency positions depresses salaries, wrote author Nikhil Agarwal, PhD, an economist at the Massachusetts Institute of Technology. The medical residency match is one of only a few labor markets in the U.S. that is organized around a centralized clearinghouse, Agarwal told MedPage Today. (Yurkiewicz, 1/30)

Paranoia and fear have spread throughout this human-resource-rich but politically dysfunctional nation, allowing a disease once nearly eradicated to return and ravage large swaths of the U.S. population. Measles, a highly communicable and potentially deadly illness, has been mostly preventable since a vaccine was developed more than 50 years ago. And for decades this North American superpower — like other Western nation-states — had near-universal immunization rates. (Catherine Rampell, 2/5)

The alarming number of measles cases — a record 644 last year, and 102 last month, the most since the disease was declared eliminated in the United States in 2000 — has focused scrutiny on parents who refuse vaccinations for their children. There are some who want state and local governments to sue, or even criminally charge, such parents. A bill in California would end all nonmedical exemptions to immunization requirements. For epidemiologists like me, eliminating exemptions may seem satisfying, but it is not the wisest policy for protecting kids. Instead, we should borrow a concept from behavioral economics, and use administrative rules and procedures to “nudge” parents to immunize their kids, rather than trying to castigate or penalize these parents. (Saad B. Omer, 2/6)

When I walked through the door of Carl and Jodi Krawitt's well-appointed hillside home the other day, I could tell their 6-year-old son Rhett was not super happy to see me. I'd interrupted him as he was getting ready for a swimming lesson. It was easy to read his expression: Please mom and dad. Not another reporter? I don't blame him. Quite unexpectedly, Rhett has become the angelic public face of the pro-vaccination movement in California. (Robin Abcarian, 2/5)

“I have heard of many tragic cases,” said Dr. Paul, “of walking, talking normal children who wound up with profound mental disorders after vaccines.” Following the ensuing firestorm, the Republican senator from Kentucky insisted, “I did not say vaccines caused disorders, just that they were temporally related.” In effect: I did not sleep with that causation. Paul blamed his troubles on the “liberal media” — which, after a little digging, reported that, in 2009, he had called mandatory vaccinations a step toward “martial law.” When Chris Christie commits a gaffe on vaccination and reverses himself, it indicates a man out of his depth. With Paul, it reveals the unexplored depths of a highly ideological and conspiratorial worldview. (Michael Gerson, 2/5)

The test for any Obamacare replacement remains its ability to provide comparable insurance to at least as many Americans, at the same (or lower) cost. And [the Burr/Hatch/Upton] proposal probably fails on the first two characteristics. Nevertheless, it embraces important principles of the Affordable Care Act: that the federal government ought to fund health coverage for those who can't afford it, and that the insurance market should be required to offer coverage to everyone. (2/5)

Republican congressional leaders were wise to propose an alternative to the Affordable Care Act this week, as the Supreme Court may strike down a key provision of the law after hearing King v. Burwell next month. The case involves subsidies to individuals who purchase health insurance on federal exchanges. The plaintiffs—four individuals who don’t want to be forced to buy ObamaCare—argue that under the explicit terms of the ACA, subsidies enabling that purchase can only be distributed in exchanges “established by the State.” The court is expected to rule by the end of June, and the plaintiffs have a good chance of convincing a majority that the subsidies are unlawful. (Scott Gottlieb and Tevi Troy, 2/5)

Plainly wounded by the Plum Line’s mockery, some congressional Republicans have finally unveiled a plan to replace the Affordable Care Act with their own health care reform. Is it serious? It’s certainly serious enough to examine and judge on its merits. Will it become the plan around which Republicans will unite? I doubt it, just because it’s hard to imagine Republicans ever uniting around a plan to do anything proactive on health care, though that’s always possible. (Paul Waldman, 2/5)

Wow, the breakup between President Obama and his former corporate health-care partners must have been bad. The deal he cut with the pharmaceutical industry to pass ObamaCare didn’t even last as long as his Presidency. We can’t wait for the memoir. The news is that Mr. Obama’s new budget proposal for 2016 reneges on the quid pro quo that some of the dumber drug makers cut in return for supporting ObamaCare in 2009. That transaction was supposed to buy political protection against the left-wing wish list of price controls, weakened patents and other extortion that Mr. Obama now endorses in his budget. (2/5)

Medicare, the government health insurance program for those 65 and over or the disabled, pays one price to independent doctors and another to doctors who work for large health systems — even if they are performing the exact same service in the exact same place. This week, the Obama administration recommended a change to eliminate much of that gap. Despite expected protests from hospitals and doctors, the idea has a chance of being adopted because it would yield huge savings for Medicare and patients. (Margot Sanger-Katz, 2/6)

“We owe female service members the same access to contraception and family planning services as the women they fight to protect,” said Representative Jackie Speier of California, summing up the principle behind a bill she and another Democrat, Senator Jeanne Shaheen of New Hampshire, introduced on Wednesday. Their modest but important measure — the Access to Contraception for Women Servicemembers and Dependents Act of 2015 — would bring contraceptive coverage in the military into line with the coverage afforded to civilian federal employees and required in most health insurance plans under the Affordable Care Act. (Dorothy J. Samuels, 2/5)

Around 11:00 a.m. on January 20, 2015, Stephen Pasceri arrived at the cardiovascular center at Boston's Brigham and Women's Hospital, where he had an appointment to speak to Michael Davidson, a 44-year-old surgeon who had performed valve surgery on Pasceri's mother a few months earlier. Davidson entered an exam room and greeted Pasceri, who fired two shots at the surgeon at close range before killing himself. A team of Brigham surgeons spent 9 hours in the OR in a futile attempt to save Davidson's life. ... Tragedy can have meaning without having reason, and that's as true for us as it is for our patients. To seek reasons for the tragic loss of Michael Davidson is to become afraid. To seek meaning is, in a sense, to do the opposite. To be like Mike is to fear not threats to one's own safety, but the possibility of hurting others and of failing to sustain life when there is still life to be sustained. And it is to help our patients make meaning of their losses. (Dr. Lisa Rosenbaum, 2/4)

Focus, I tell myself, as I consider the mild-mannered woman sitting before me, her gainfully employed, well-educated husband leaning on the guardrail of his son's hospital bed. I'm finding all this hard to reconcile. The parents of this damaged infant seem so pleasant, even charming, their docile demeanors juxtaposed with multiple injuries without known cause. Detach the facts from the people, I remind myself. I'm here to tell his parents I've called child protective services, and they're under investigation for child abuse. (Stephanie A. Deutsch, 2/5)

In 2003, the Agency for Healthcare Research and Quality (AHRQ) released 20 patient safety indicators (PSI) to facilitate measurement of adverse events. Though intended for internal quality measurement and improvement, ... CMS began using AHRQ’s Patient Safety for Selected Indicators (PSI-90) as a core metric in 2 of its pay-for-performance programs: the Hospital-Acquired Condition (HAC) Reduction program and the Hospital Value-Based Purchasing (VBP) program. ... numerous problems exist with the current PSI-90 composite measure .... These flaws may incorrectly identify problem areas for hospitals to address, unfairly penalize hospitals financially, and adversely influence clinician engagement in quality improvement. However, there are opportunities to improve this measure. (Ravi Rajaram, Cynthia Barnard and Karl Y. Bilimoria, 2/5)