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The House on Thursday easily backed repeal of a tax on the medical device industry. But President Obama has threatened to veto the bill, which would add more than $24 billion to the deficit over the next 10 years. With not all House members voting Thursday, that chamber's 280-140 vote fell one vote shy of a veto-proof majority to repeal the tax, which helps pay for the expansion of health insurance under the 2010 Affordable Care Act. (Groppe, 6/18)

The House defied a White House veto threat and voted Thursday to abolish a tax on medical device makers as a group of Democrats uncharacteristically joined Republicans in moving to kill part of President Barack Obama's health care law. Thursday's 280-140 House vote was exactly the two-thirds margin that supporters would need to override a presidential veto. The real suspense will come in the Senate, which voted overwhelmingly to repeal the levy in 2013, but in a nonbinding roll call lacking the political pressures of a veto showdown. (Fram, 6/18)

The House on Thursday voted to repeal a medical device tax that Minnesota’s medical technology sector lobbied extensively to kill. ... The legislation’s lack of an alternative revenue source is a sticking point with President Obama and many Democrats because the device tax helps pay for the Affordable Care Act. Without another funding stream, repeal would add a projected $24.4 billion to the federal deficit over 10 years. (Spencer, 6/18)

Supporters of the bill say the 2.3 percent tax, which affects about 7,000 manufacturers nationwide, is holding back innovation on important devices like X-ray machines and ventilators. “Only in Washington would you impose a tax on life-saving medical technology and think you will actually reduce healthcare costs," said Rep. Erik Paulsen (R-Minn.), the bill’s lead sponsor. The House first voted to repeal the tax passed in 2012. While the bill does not include a plan to make up for the lost revenue from repealing the tax, supporters believe it stands a chance of clearing both chambers now that the Senate is controlled by Republicans. (Ferris, 6/18)

The nation’s health insurers, including leading companies like Aetna, are hoping the Supreme Court does not strike down a provision of the Affordable Care Act that has brought them millions of new policyholders and provided new growth opportunities for the industry. (Radelat, 6/19)

The future of same-sex marriage and President Obama's health care law hang in the balance as the Supreme Court's 2014 term draws rapidly to a close this month. But those aren't the only big issues on the justices' plate. Fair elections, racial discrimination, clean air, capital punishment: All await rulings over the next two weeks as the court completes action on 11 cases remaining this term. The next decisions will come Monday morning. (Wolf, 6/18)

The Supreme Court is expected to rule on health care subsidies soon. As the country awaits the decision, PBS NewsHour interviewed people who would be personally affected by the ruling, and Julie Rovner of KHN answers their concerns. You can watch it here. (6/18)

Obamacare is a wildcard, as well. The president could win outright in a legacy-clinching decision by the Supreme Court or be dealt a stinging loss. But even if the court votes to remove a vital piece of the 2010 health care law, Obama still could have room to maneuver. Republicans are scrambling to come up with an alternative if millions of Americans suddenly lose their government-backed health insurance. The burden may fall on Republican governors to find a way out of the mess. (6/19)

Speaker John Boehner (R-Ohio) is pushing back against the idea of Republicans simply continuing ObamaCare subsidies if the Supreme Court cripples the law. At a press conference Thursday, Boehner was asked why a House GOP plan included repeal of the individual mandate, which would just be “veto-bait” for President Obama, and why Republicans would not just extend subsidies through the presidential election while looking for concessions elsewhere in exchange. (Sullivan, 6/18)

One of the House’s most conservative lawmakers wants to prevent Congress from rescuing ObamaCare insurance subsidies if the Supreme Court strikes them down this month. Rep. Paul Gosar (R-Ariz.) rolled out a bill Thursday that would repeal most parts of ObamaCare if the court rules against the government in King v. Burwell. Unlike recently unveiled plans from House leadership, Gosar’s plan does not include any extension of the subsidies. That approach was immediately praised by Heritage Action, which has strongly opposed the continuation of the subsidies because they said it will “simply cover up the law’s costs while giving the impression Republicans believe subsidies are necessary for Americans to afford health insurance.” (Ferris, 6/18)

More than 220,000 Oregonians who buy their own health insurance are poised to pay higher premiums next year -- some of them a lot higher. State regulators on Thursday announced rates for people who aren't covered by their employers or government programs. And the news is not good. ... the least expensive "silver" plan premium available to a 40-year-old next year will run $271 per month under the new rates. That's up $49 per month over this year's low rate. ... the rates released by the state won't become final until after public hearings later this month. (Budnick, 6/18)

Health insurance premiums are poised to go up for 220,000 Oregonians who buy their own coverage, according to the state's proposed rates unveiled Thursday. In some cases, insurance companies proposed rates that were similar to or better than the current rates, but they were told by the state that they must be raised. The state says the cost of medical care has far outstripped revenue, forcing insurers to dip into reserve funds. (6/18)

An Affordable Care Act provision intended to protect health insurers from excessive medical costs received a boost from the CMS late Wednesday, a move that will directly help the finances of insurers that have enrolled sicker members. Reinsurance payments to health insurers that offer ACA-compliant individual plans inside and outside the exchanges will rise for the 2014 benefit year, according to a CMS memo. Reinsurance, along with risk corridors and risk adjustment, are the ACA's “market stabilization” provisions. (Herman, 6/18)

The United Auto Workers is looking to create one large health insurance pool for workers at Detroit’s Big Three auto makers, a move aimed at helping the companies better leverage their size to win cost savings from medical providers. UAW President Dennis Williams said Thursday he aims to bring the proposal to the bargaining table next month when the union starts negotiations for a new four-year contract with Ford Motor Co., General Motors Co. and FCA US LLC, the U.S. unit of Fiat Chrysler Automobiles NV. He said the insurance pool could include active hourly workers, as well as salaried employees and hourly retirees, a group that would combined have more than 1 million members. (Rogers, 6/18)

United Auto Workers President Dennis Williams said on Thursday he wants to enter talks with the three major U.S. automakers to pool active union and nonunion workers and UAW retirees to bargain for lower healthcare costs. Such a pool of about 900,000 people connected to Detroit's three automakers would not mean a single healthcare plan, but instead a collective to wield more leverage in negotiations with drug companies, hospitals and insurance companies, he noted. (6/18)

Traditionally, non-union salaried employees for General Motors, Ford and Chrysler have had separate benefits than hourly workers who are represented by the UAW. But Williams said that a health care trust created in 2007 to insure UAW retirees is well-managed and could pave the way for the inclusion of blue-collar workers and white-collar employees. (Gardner, 6/18)

Although the recent frenzy of speculation about health insurance mergers hasn’t yet resulted in any deals, market watchers say the conditions are just right for a major industry shakeup. In recent weeks, Humana has sought bids from the other major players in the marketplace, and Cigna has so far rebuffed takeover attempts by Anthem, according to reports in The Wall Street Journal. The other two industry behemoths, UnitedHealth Group and Aetna, are also in the mix. (Demko, 6/18)

Will the Trans-Pacific Partnership trade agreement really be bad for your health? The trade pact is under negotiation to lower tariffs and open markets by 12 countries in the Asia and Pacific regions. But over the past several months, portions of the text have been leaked—courtesy of WikiLeaks—and each disclosure has raised fresh questions about the extent to which the pharmaceutical industry might benefit at the expense of consumers. (Silverman, 6/18)

Teladoc Inc., an early player in the field of telemedicine, said in a securities filing Thursday that it plans to raise up to $136.9 million in its initial public offering. The company had confidentially filed IPO paperwork in April. According to a regulatory filing, the company plans to sell 7 million shares for $15 to $17 a share. Underwriters have the option to purchase up to 1.05 million additional shares, Teladoc said. (Beilfuss, 6/18)

Charlotte-based Premier Inc. has introduced a new technology that it says uses clinical outcomes to predict the financial impact of federal payment programs on health care systems. Premier Quality Cycle Management analyzes which facilities, clinicians and clinical outcomes impact reimbursements, as well as how similar health care systems perform. According to a statement from the company Thursday, the new technology also offers Premier’s advisory services on how the system can improve. (Peralta, 6/18)

Charles Welty began seriously worrying about his heart health at the gym. The 78-year-old retired civil engineer said that while running on a treadmill, he saw something startling on the machine’s heart monitor. “My pulse rate was undetectable,” Welty said during a recent interview in his Lenexa home. A visit to his doctor revealed that his worries were not unfounded. His doctor’s diagnosis: atrial fibrillation, a condition in which the heart’s chambers beat out of sync with each other. Fortunately for Welty, earlier this year the Food and Drug Administration approved a new device to help atrial fibrillation patients. (Smith, 6/18)

The Department of Veterans Affairs is moving to outsource care nationwide for up to 180,000 veterans who have hepatitis C, a serious blood and liver condition treated with expensive new drugs that are costing the government billions of dollars. (Wagner, 6/19)

Hillary Clinton, the Democratic front-runner for the 2016 presidential race, said on Thursday she opposes blanket privatization of military veterans' healthcare but realizes that vets need choices. In her first substantive comments on the campaign trail about veterans' affairs, Clinton vowed to win a better deal for vets and protect their education funding benefits. She told a campaign event at a Veterans of Foreign Wars post in Reno, Nevada, that private medicine cannot compete with the Department of Veterans Affairs' expertise in post-traumatic stress disorders, traumatic brain injury and prosthetics. (Conlin, 6/18)

Ending years of wait, the government agreed Thursday to provide disability benefits to as many as 2,100 Air Force reservists and active-duty forces exposed to Agent Orange residue on airplanes used in the Vietnam War. The new federal rule, approved by the White House Office of Management and Budget, takes effect Friday. It adds to an Agent Orange-related caseload that already makes up 1 out of 6 disability checks issued by the Department of Veterans Affairs. The expected cost over 10 years is $47.5 million, with separate health care coverage adding to the price tag. (6/18)

Republicans on the Senate Business, Labor and Technology Committee Monday defeated a bill with a party-line 5-4 vote that would have protected patients from unexpectedly high, uncovered bills from doctors. Bill opponents said it would give insurance companies unfair leverage in negotiations with health care providers. (6/18)

The Iowa Supreme Court is expected to rule whether a state medical board overstepped its authority by requiring doctors to be in the room when a woman receives abortion-inducing medication rather than allowing it to be administered remotely via video conferencing. The court indicated on its website that it would issue an opinion Friday in Planned Parenthood of the Heartland's lawsuit against the Iowa Board of Medicine. An opinion that effectively supports the board's restrictions could have big implications for women who live far from Iowa's clinics that provide abortion services, which are all in bigger cities. (Rodriguez, 6/18)

Iowa's Supreme Court is to decide Friday whether to shut down Planned Parenthood of the Heartland's controversial telemedicine-abortion system. The case, which is being watched nationally, is believed to be the Iowa court's first direct consideration of an abortion issue in more than 40 years. More than 7,200 Iowa women have used the system to obtain abortion-inducing pills since 2008. The first-in-the-nation system allows Planned Parenthood doctors in Des Moines or Iowa City to interact via video with patients in outlying clinics, then dispense the pills to the women. (Leys, 6/18)

A troubled Massachusetts managed-care program for low-income people who are dually eligible for Medicaid and Medicare will continue despite one of its leading plans dropping out of the program. Nearly two years ago, Massachusetts became the first state to enter into an agreement with the CMS to offer dual-eligible beneficiaries coverage plans that combined Medicaid and Medicare benefits into one plan to better coordinate their care. Enrollment in the so-called One Care program began Oct. 1, 2013. Participation is optional, but beneficiaries must explicitly opt out. (Dickson, 6/18)

Citing higher drug prices, the California Public Employees' Retirement System said its HMO premiums are rising by 7.2% next year. Rates for PPO, or preferred provider organization, plans are going up even more at 10.8%, on average, for 2016. (Terhune, 6/18)

An attorney for the state of Tennessee told a federal appeals court Thursday that a court order is not needed to protect TennCare applicants because they are no longer being left in indefinite limbo. The state wants the court to dismiss on technical grounds a lawsuit filed last July by applicants for TennCare, the state's version of Medicaid. (Loller, 6/18)

A trio of deadly afflictions is ripping through a rural county in southern Indiana. More than 130 patients in Scott County, Ind., tested positive for HIV in less than a year, making the community of about 24,000 people the site of one of the worst outbreaks in decades. (Shepherd, 6/18)

To offset new taxes that have rankled business groups, Gov. Dannel P. Malloy proposed trimming up to 1.5 percent of discretionary spending in the new state budget. But the administration’s proposal shows the bulk of the cuts would be likely to fall on education, municipal aid, health care and social services. (Levin Becker and Phaneuf, 6/19)

A federal judge in Nashville has approved a $3 million settlement in a case brought by nurses for Guardian Home Care who said they were not properly being paid overtime. The nurses said Guardian violated the federal Fair Labor Standards Act. Their attorneys said Guardian did so using a scheme that also is used at other health care companies. (Barchenger, 6/18)

[Tax-exempt] hospitals must engage in community benefit activities, such as providing care to indigent patients and participating in Medicaid. The congressional Joint Committee on Taxation estimated the value of the nonprofit hospital tax exemption at $12.6 billion in 2002—a number that included forgone taxes, public contributions, and the value of tax-exempt bond financing. In this article we estimate that the size of the exemption reached $24.6 billion in 2011. The Affordable Care Act (ACA) brings a new focus on community benefit activities by requiring tax-exempt hospitals to engage in communitywide planning efforts to improve community health. (Rosenbaum et al., 6/17)

We surveyed nearly 3,000 low-income adults in late 2014 to compare experiences in three states with markedly different policies: Kentucky, which expanded Medicaid, created a successful state Marketplace, and supported outreach efforts; Arkansas, which enacted the private option and a federal-state partnership Marketplace, but with legislative limitations on outreach; and Texas, which did not expand Medicaid and passed restrictions on navigators. We found that application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. ... Fewer than half of adults had heard some or a lot about the coverage expansions. ... Twice as many respondents felt that the ACA had helped them as hurt them (although the majority reported no direct impact). (Sommers et al., 6/11)

[If the Supreme Court strikes down premium subsidies in federal insurance marketplaces and states and the federal government fail] to re-instate the assistance, our analyses indicate that: In 2016, the number of uninsured people would be 8.2 million higher than it otherwise would have been. ... The size of the private nongroup insurance markets in the affected states would drop by about 70 percent. ... Of those losing nongroup insurance and becoming uninsured, three-fourths are low or middle income, but are not poor; over 60 percent are white, non-Hispanic; over 60 percent live in the south; two-thirds have at least one family member employed by a small firm; and more than three fourths of the adults are workers. ... Health care spending on behalf of those becoming uninsured would fall by 35 percent, (Blumberg, Buettgens and Holahan, 6/16)

A looming question for policy makers is how growing diversity of the US elderly population and greater use of home and community-based services will affect demand for long-term care workers. We used national surveys to analyze current use and staffing of long-term care, project demand for long-term care services and workers through 2030, and assess how projections varied if we changed assumptions about utilization patterns. If current trends continue, the occupations anticipated to grow the most over the period are counselors and social workers (94 percent), community and social services workers (93 percent), and home health and personal care aides (88 percent). ... Policy makers and educators should redouble efforts to create and sustainably fund programs to recruit, train, and retain long-term care workers. (Spetz, Trupin, Bates and Coffman, 6/11)

[H]ealth plans and providers have begun to develop, implement and evaluate a range of financing reforms. These new models use reimbursement that seeks to reward value rather than volume in order to give providers greater support for delivering care that promotes higher quality and lower costs. ... the adoption of these value-based payment models appears to be accelerating. The Catalyst for Payment Reform estimates that 40% (a 29% increase from 2013) of payments are tied to quality or financial performance or intended to reduce waste. Of these value-based payments, slightly more than half (53%) put providers at risk for costs going up (downside risk) ... To accelerate this transformation, we have described ways to address the obstacles, and to bring these steps together in the concept of a value-based insurance product. (McClellan, Patel, Latts and Dang-Vu, 6/16)

Large bills from an out-of-network health care provider can be an unexpected surprise to consumers who did not knowingly decide to obtain health care outside the plan’s provider network. ... Several states have acted to protect consumers from the need to pay balance bills, at least in emergency situations. ... But the approaches have different levels of effectiveness. The most effective protections appear to share two common elements. First, they do not require active intervention by the consumer. Second, they have a mechanism, acceptable to both plans and providers, for determining the amount of payment. (Hoadley, Ahn and Lucia, June, 2015)

Most employers that offer health benefits today also offer at least some wellness programs in an effort to promote employee health and productivity and reduce health related costs. Workplace wellness programs vary in the services and activities they include, and about one-in-five use financial incentives to encourage employees to participate. ... A proposed regulation recently issued by the Equal Employment Opportunity Commission (EEOC) would change standards applicable to certain workplace wellness programs ... These new rules are intended to be more consistent with other standards implementing requirements in the Affordable Care Act (ACA) ... Both rules seek to balance employer interest in incentivizing workers to participate in wellness programs against requirements that prohibit discrimination ... This brief summarizes key regulatory standards. (Pollitz and Rae, 6/15)

Congress has extended funding for [the Children's Health Insurance Program] CHIP for two years (through 2017), but longer-term there will be additional debate about how best to ensure coverage to children in low and moderate income families. ... This study examined what parents value in children’s coverage. Affordability was a primary concern often followed by broad coverage. Most thought the costs of private coverage were too high and often unpredictable and that CHIP was affordable. Across private and CHIP coverage, families valued comprehensive benefits (including dental and vision coverage) and were generally satisfied with providers available through their coverage. ... parents often reported gaps in coverage and periods of being uninsured when they were in between jobs. Coverage under the same plan with their children was not a priority for parents. (Rudowitz, 6/15)

About three-quarters of the 2.5 million people who die during the year in the US are ages 65 and older, making Medicare the largest insurer of health care provided during the last year of life. In fact, roughly one-quarter of traditional Medicare spending for health care is for services provided to Medicare beneficiaries in their last year of life—a proportion that has remained steady for decades. ... In recent years, Medicare’s role with respect to end-of-life care has come to the forefront as policymakers and the Administration grapple with whether or not physicians and other health professionals should be reimbursed for talking to patients about their options. ... In addition to defining relevant terms, and explaining Medicare coverage for end-of-life care, these FAQs also describe policy proposals being considered by the Administration and Congress. (6/18)

Drug overdose deaths continue to increase in the United States and are now the leading cause of deaths from injury in the United States, a new report shows. Every year, nearly 44,000 people die from drug overdoses. Deaths due to drug overdose have more than doubled in the past 14 years, and half of them are related to prescription drugs (22,000 per year), the report shows. During the past 4 years, the number of overdose deaths rose significantly in 26 states and Washington, DC, and decreased in only six states. In 36 states and Washington, DC, overdose deaths now exceed motor vehicle–related deaths. (Brooks, 6/17)

Hospice enrollment may depend more on the physician than on the individual circumstances of the patient. A new study published in the June issue of Health Affairs found that physician characteristics are the strongest predictor of whether a patient will be referred to hospice care, outweighing other known drivers, such as geographic location, patient age, race, sex, and comorbidities. (Nelson, 6/17)

Drug companies generally don’t disclose all the reasons new medicines fail to win U.S. marketing approval, even though regulators often reject treatments over concerns about safety or effectiveness, a study finds. Researchers compared the details companies made public in press releases with confidential documents from the U.S. Food and Drug Administration known as complete response letters, which explain why a new medicine can’t be sold. Often, companies made no announcement when a drug was rejected, or omitted most of the reasons the FDA cited for denying approval, the study found. (Rapaport, 6/16)

Not all U.S. stroke patients eligible for a clot-busting treatment actually receive it -- and the odds of getting this therapy may depend on where they live, a large study finds. Researchers found wide variation in treatment for ischemic stroke, which results from an obstruction in a blood vessel supplying the brain. (Rapaport, 6/17)

Training staffers at reproductive health clinics to educate women about birth control options ultimately cut pregnancy rates in half, according to a new study. "Our impetus for doing this study is that unintended pregnancy has been extremely high in the U.S. for decades," said Cynthia Harper, the study's lead author from the Bixby Center for Global Reproductive Health at the University of California, San Francisco. (Seaman, 6/16)

Less than half of U.S. shops where milk is sold carry lower-fat or skim varieties, and this healthier option is most scarce in poor and minority communities that tend to have higher rates of obesity, a large study found. Part of the problem, researchers say, is a lack of supermarkets in poor communities, leaving residents reliant on smaller convenience stores and drugstores, where any milk is more expensive and low-fat varieties are less often available. (Rapaport, 6/15)

Just how important is it that everybody in the United States be able to get health insurance? Conservatives are ambivalent, at best, about that goal. Many of them think that it is more important to restrain the growth of health-care costs; many of them worry that putting insurance within reach for everyone would involve excessive government power. They are right to be concerned about costs and about big government. They should nevertheless overcome their ambivalence. There are good reasons to embrace a conservative health-care policy that enables coverage for all Americans who seek it — not the least being that in the present political context, that policy might be the best way to restrain both costs and government. (Ramesh Ponnuru, 6/15)

House Republicans have been cheering on the lawsuit currently before the Supreme Court that, if successful, would cut off Affordable Care Act tax credits to more than 6 million people. Now a new report suggests the impact would fall disproportionately on their own constituents, rather than those in Democratic districts -- by a margin of 2-to-1. The research comes from FamiliesUSA, an advocacy and consumer support organization that is among the Affordable Care Act's loudest champions. The report's subject is the potential geographic impact of King v. Burwell, the lawsuit that the court heard in March and on which it is likely to rule by the end of the month. (Jonathan Cohn, 6/18)

The Republican budget takes credit for about a $2 trillion reduction in spending from repealing ObamaCare. But it ignores the roughly $1 trillion in additional revenue that ObamaCare is estimated to bring in from added taxes and fees by 2025. If you eliminate the program, you lose the revenue, too. Beyond repealing ObamaCare, the Republican budget seeks to save an additional $2 trillion-plus by imposing pretty severe cuts on other entitlement programs—mainly Medicare, Medicaid, SNAP (the name for food stamps), and other programs that benefit mostly low- and moderate-income Americans. (Alan S. Blinder, 6/18)

We’ve said it again and again – it’s time to expand Medicaid in Wyoming. But lawmakers have recently said it’s unlikely that the issue will be considered again until the 2017 policy session of the Wyoming Legislature. No matter how you feel about it, they said, it would need a two-thirds majority vote to be introduced in next year’s budget session, and that’s very unlikely. This is a problem for many reasons. First, the 17,600 Wyomingites who would benefit from expansion will continue to go without. These are our working poor, people for whom insurance and regular care could stave off bankruptcy. They will never be able to improve their situations without Medicaid expansion. Second, it just doesn’t make financial sense. (6/18)

The special session of the Florida Legislature that concludes this week has been like a summer blockbuster movie that, rather than resolving all the plot points, merely sets the stage for a sequel. Unfortunately, it’s one that most Floridians probably would rather not see. Legislators were forced to go to overtime after failing to agree on a balanced budget during the regular session that ended May 1. The sticking point then was disagreement over how to fund health care for the uninsured. (6/18)

The study, from MIT’s Amy Finkelstein, Nathaniel Hendren, and Erzo F.P. Luttmer, used data from an Oregon health insurance experiment—in which some low-income citizens received access to Medicaid and some did not, based on the results of a random lottery—to estimate the utility of Medicaid coverage. They found that beneficiaries valued Medicaid at 20 cents to 40 cents on the dollar; in other words, for every $1,000 the states and federal government spent on health coverage, the average beneficiaries felt like they were receiving goods or services valued at $200 to $400. (Chris Jacobs, 6/18)

I am often asked whether we could constrain health-care costs by trimming only end-of-life care. After all, the argument goes, so much money is spent on treating people in their last year of life. The problem with this perspective – leaving aside the complicated ethical issues involved – has always been the difficulty of predicting which year will be a person’s last. If you don’t know, what exactly do you change in practice? But now research has revealed something else: The share of health-care spending that goes to end-of-life care is not as large as we’ve thought. Using Medicare survey data, a team of researchers led by Mariacristina De Nardi of the Federal Reserve Bank of Chicago examined health-care spending on Medicare beneficiaries. (Peter R. Orszag, 6/18)

California lawmakers are, again, getting close to adopting the state's first system to regulate medical marijuana. Even if they're 20 years late and it's difficult to craft laws for a largely lawless industry, legislators must not let another session end without passing a comprehensive bill to license and control medical marijuana. (6/18)

ED waiting rooms impose a substantial time cost on people seeking care, yet more patients visit the ED every year. Burdening patients with a bill if the cause of their visit is retroactively deemed not to have been an emergency will probably prove neither equitable nor effective in directing patients to alternative settings and could lead to unintended consequences if patients avoid care out of fear of economic hardship. Given these ramifications and the ineffectiveness of past attempts to impose costs on Medicaid patients seeking ED care, the Obama administration's decision to approve demonstration projects involving high cost sharing and loss of transportation coverage is troubling. Instead, CMS might encourage state initiatives to develop robust ED alternatives. (Ari B. Friedman, Brendan Saloner and Renee Y. Hsia, 6/18)

Reproductive and sexual health morbidity in the United States continues to far exceed that of other developed nations. ... This morbidity has substantial national economic implications: each year STIs, including HIV infection, cost nearly $16 billion; teen childbearing an estimated $11 billion; and rape and other sexual assaults an estimated $12 billion. ... In 2010, Swartzendruber and Zenilman highlighted the need for change and promoting a shift from the longstanding and stigmatizing focus on morbidity toward a national sexual health–oriented strategy focused on health rather than disease. Five years later there has been little change despite steady accumulation of evidence in favor of shifting from a categorical, stigmatizing morbidity focus to a broadly integrated, health-promoting approach to sexual health. (David Satcher, Edward W. Hook III and Eli Coleman, 6/18)