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A popular middle class tax benefit could become one of the first casualties of the Affordable Care Act’s so-called Cadillac tax, affecting millions of voters. Flexible spending accounts, which allow people to save their own money tax free for everything from doctor’s co-pays to eyeglasses, may vanish in coming years as companies scramble to avoid the law’s 40 percent levy on pricey health care benefits. (Faler, 8/31)

The union representing thousands of film, television and digital media writers is seeking an exemption for all unions from the Affordable Care Act’s “Cadillac tax” on high cost health plans. In a letter to the Department of Treasury and Internal Revenue Service on Thursday, the Writers Guild of America East argued that health care plans negotiated under collective bargaining agreements should be exempted from the tax on high cost plans, which takes effect in 2018. (Chasan, 8/28)

Most insurance companies selling health plans in the state’s individual market will get to raise customers’ premiums in 2016, but not by as much as they proposed, and one major carrier will have to lower its rates, according to decisions released by the Connecticut Insurance Department Saturday. (Levin Becker, 8/29)

America’s Olympians now have officially qualifying health insurance, after the federal government and the U.S. Olympic Committee reached an agreement last week on the status of their coverage. That news may come as a surprise to some of the 850 athletes and 225 dependents enrolled in the special health plan through USOC, who already had been receiving an array of health benefits under it. (Radnofsky, 8/29)

A state judge said Friday that Alaska Gov. Bill Walker’s administration could expand the Medicaid health care program beginning next week, dismissing a request by the state Legislature to temporarily block enrollment while attorneys argue lawmakers’ underlying legal challenge. The ruling by Judge Frank Pfiffner was a decisive victory for the Walker administration, but it may only be temporary: By the end of the day, the Alaska Supreme Court had already received the Legislature’s request for emergency review and ordered Walker’s attorneys to respond by Monday at noon. (Herz, 8/28)

Judge Pfiffner spoke for more than 45 minutes in court, unpacking the complicated legal arguments each side presented to make its case. To win a restraining order to stop Medicaid expansion, the Legislative Council had to prove the legislature would face “irreparable harm” if the program went ahead on September 1. In denying that argument, the judge made several points, including the fact that the state won’t spend any money expanding Medicaid. (Feidt, 8/28)

To have won an injunction against Walker, Pfiffner said the Legislature's legal team would have had to prove irreparable harm to the state and a likelihood that they would win their lawsuit. Throughout the delivery of his motion, Pfiffner picked apart the Legislature's argument, calling the $450,000 lawsuit "long on argument but short on facts." (Buxton, 8/28)

Alaska’s governor won a legal victory Friday that, at least for now, will allow the state to begin next week to sign up more low-income residents for Medicaid — despite objections from state lawmakers. The dispute in Alaska has emerged as the latest political and legal skirmish over the Affordable Care Act, lingering even after the Supreme Court two months ago upheld the constitutionality of a core aspect of the law that requires most Americans to have health insurance. (Goldstein, 8/28)

In a statement, House Speaker Mike Chenault, R-Nikiski, said the lawmakers who supported the lawsuit "continue to feel very strongly about our constitutional argument that was presented. We are by no means looking for a way to stop Medicaid expansion; we are trying to do it the right way so that we have a reliable, sustainable system." ... Pfiffner's ruling "ensures 20,000 working Alaskans will have access to health care on September 1st," Walker said in a statement. State-commissioned estimates released earlier this year indicate that nearly 42,000 Alaskans would be eligible for coverage under expanded Medicaid the first year and about 20,000 would enroll. (Bohrer, 8/29)

Planned Parenthood is using virtually every tool in its lobbying arsenal to defend against attacks from conservatives and anti-abortion activists. Lawmakers will raise the stakes when Congress returns next week by threatening to defund the group through the federal appropriations process. (Ho and Snell, 8/31)

Republican leaders in Congress are considering a pledge to hold a separate vote on defunding Planned Parenthood as a way to keep the issue from derailing legislation to keep the government running, said congressional aides with knowledge of the discussions. In private discussions, the leaders are looking at using reconciliation procedures to let a Planned Parenthood bill come up for a filibuster-proof Senate vote, the aides said. (Rowley, 8/28)

A ruling Thursday by the National Labor Relations Board could complicate relations between healthcare organizations and their workers employed by staffing agencies. The board ruled that workers employed by a staffing agency are jointly employed by the agency and the organization where they're working. That means those organizations should be involved in any collective bargaining with the temporary workers and could be held liable for unfair labor practice cases filed with the federal government. (Rubenfire, 8/28)

Patients are increasingly turning to nurse practitioners instead of physicians for a less expensive healthcare alternative. Some experts say the trend is a solution to the staggering cost of medical treatments and the shortage of physicians, which is expected to exceed 46,000 within the next decade, according to the Association of American Medical Colleges. (Fryer, 8/29)

When Tom Essenpreis first signed up for his company's Anthem Blue Cross health plan, he checked out its website and came across a service that enables him to visit with a doctor online 24 hours a day. He downloaded it right away. "I immediately saw the utility of it," said the 35-year-old aerospace engineer from Hawthorne. The service came in handy one Saturday when his 2-year-old daughter had what he said was "goopy stuff clogging up the corner of her eye." (Zamosky, 8/28)

Now that the Food and Drug Administration has given the OK to two pricey drugs that treat high cholesterol, health insurers and pharmacy benefit managers are evaluating if one drug should receive preferred coverage over the other. In exchange for the preferred designation, drugmakers offer price discounts on their products. A flurry of these types of deals occurred this year with high-cost hepatitis C drugs. (Herman, 8/28)

When Dr. Kelly Kyanko was giving birth to her second son a couple of years ago, there were signs her baby was facing a higher risk of complications after delivery. A pediatrician was called in, and everything turned out fine for mother and newborn baby. But after she left the hospital, Kyanko faced a surprise $636 bill from the pediatrician that her insurer, UnitedHealthcare, did not cover. Before her delivery, she had checked to make sure the hospital and the OB-GYN were in her plan's network. She had no way of knowing, however, that the consulting pediatrician was out-of-network. (Herman, 8/28)

When it comes to "bill shock," a surprise medical expense can be particularly damaging. Over the past two years, nearly one-third of privately insured Americans has received an unexpected medical bill where their health plan paid less than expected, according to a May survey from the Consumer Reports National Research Center. (Grant, 8/28)

Nearly a third of the roughly 50 million elderly Americans who depend on Medicare for their physician care and other health services could see their premiums jump by 52 percent or more next year. That’s because of a quirk in the law that punishes wealthier beneficiaries and others any time the Social Security Administration fails to boost the annual cost of living adjustment. (Pianin, 8/30)

Planned Parenthood Southeast filed a lawsuit against Gov. Robert Bentley Friday, saying his recent decision to to cancel Medicaid contracts with the organization violated federal law. ... Bentley canceled Medicaid contracts with Planned Parenthood on Aug. 6, after videos released by an anti-abortion group, which claimed the video showed Planned Parenthood staffers discussing the sale of fetuses and fetal parts. In a statement, the governor called the practices “deplorable.” (Lyman, 8/28)

Planned Parenthood says in the lawsuit that it provides family planning services and other preventative health services to women in Mobile and Birmingham with coverage through the Medicaid program. The services include abortions, but the group states in the lawsuit that Alabama Medicaid does not pay for abortions "except in narrow circumstances." Among the lawsuit's claims are that the governor's cancellation of the agreement violates the first and fourteenth amendments of patients' rights to associate with the group and to seek abortions. It also states that it violates a section of the Social Security Act by denying Planned Parenthood patients' rights to choose any willing, qualified healthcare provider in the Medicaid program. (Faulk, 8/28)

The complaint, filed in federal court in Montgomery, Ala., was brought by Planned Parenthood Southeast Inc. and the American Civil Liberties Union. It will be followed next week by a request for a preliminary injunction to preserve Medicaid funding, according to Planned Parenthood Federation of America. (Armour, 8/28)

The organization said Bentley’s effort penalizes low-income women who seek contraceptive and preventative health care services at the clinics. (Chandler, 8/28)

The lawsuit will be Planned Parenthood’s second legal move in response to the undercover video controversy spurred by anti-abortion-rights activists this summer. The group announced earlier this week that it would sue Louisiana Gov. Bobby Jindal (R), who took the same step as Bentley to cut off Medicaid funding for Planned Parenthood services. The Obama administration has already warned the move by Alabama and Louisiana would be illegal because Medicaid enrollees are entitled to the healthcare provider of their choice. (Ferris, 8/28)

Let's be clear about what the federal Centers for Medicare and Medicaid Services (CMS) told the Arkansas Department of Human Services last week: The state was not in compliance with federal law. The state violated federal regulations in imposing a 10-day deadline for Medicaid beneficiaries to respond to confusing letters the state sent as part of its troubled income-verficiation-and-renewal process. Medicaid rules require an annual renewal process and clearly demand that beneficiaries get 30 days to respond. This is the issue that the Arkansas Blog and others have been noting for weeks while the Asa Hutchinson administration has insisted that the state was perfectly in compliance with the law. CMS has now settled the dispute. (Ramsey, 8/30)

Arkansas officials on Friday suspended a push to terminate coverage for thousands of people on Medicaid for the second time this month after the federal government told the state to give beneficiaries more time to prove they're eligible. The Department of Human Services said the federal government has told the state to give beneficiaries 30 days to prove they qualify for coverage, rather than the 10 days the state had been using. DHS spokeswoman Amy Webb said the state is revising its notices to reflect the new deadline, and didn't know when they would resume. (DeMillo, 8/28)

The state’s Department of Community Health is asking for additional state funds to cover projected Georgia enrollment for Medicaid and PeachCare, which for the first time will exceed 2 million. The budget proposal also requests $23 million to cover the high cost of drugs to treat hepatitis C patients in both the midyear fiscal 2016 budget and in the 2017 plan. (Miller, 8/28)

California lawmakers hope to tackle major issues in the state’s health care program for the poor over the next two weeks, starting with how to ensure the state doesn’t lose $1 billion in federal funding. The potential billion-dollar loss comes as critics say Medi-Cal is already struggling to meet the needs of the 12.5 million people who rely on the system. (Gutierrez, 8/30)

The U.S. Department of Health and Human Services said New Jersey should repay the federal government $32.2 million after a federal audit found medical records and other documents missing when state officials submitted claims for Medicaid reimbursement. The findings, detailed in a report obtained by The Record to be released today, mark the second time in four years that federal officials have raised concerns about questionable claims for care provided to homebound elderly or low-income residents. After the earlier audit, they called for $145 million to be returned. (Rizzo and Layton, 8/31)

Some of Iowa’s top elected officials — most notably Gov. Terry Branstad — have accepted tens of thousands of dollars in campaign contributions from some of the companies that vied for lucrative contracts to manage Iowa’s annual $4.2 billion Medicaid program. Lobbyists and political action committees representing the four companies whose proposals were selected earlier this month donated nearly $68,000 to those campaigns since 2010, a Des Moines Register investigation shows. At least another $57,000 flowed in from companies that submitted bids but failed to win the contracts. (Clayworth, 8/29)

Roughly 40 people are waiting for drug addiction treatment at Serenity Place, a center in Manchester [N.H.] with just eight available beds. Serenity Place's efforts to expand in recent years have been held up by non-responsive landlords and unfriendly neighbors. Now, an inability to comply with state licensing requirements needed to collect insurance payments is leaving Serenity Place in a bind as it seeks to stay open and help more people. (Ronayne, 8/29)

A cap on the number of opiate addiction patients that doctors can treat means many who want to take Suboxone can't get access to it. In Maine, the governor has reduced funding for the treatment. (Sharon, 8/29)

Following the catastrophic hurricane, health care administrators and providers strategized to make their public health system more resilient in a disaster, and focused on improving patient delivery to the city's indigent population—a change that studies since have shown is remarkably better for patients. "In the aftermath of Katrina, few could have predicted that the next 10 years would bring a profound transformation to the health system here in New Orleans," says Charlotte Parent, director of the New Orleans Health Department. (Marsa, 8/29)

Thousands of Minnesotans with disabilities have been forced needlessly to wait months and even years for community-based services because the state has underspent more than $1 billion in public funds, according to a lawsuit filed Friday in federal court in St. Paul. Attorneys representing a group of people with disabilities allege that for nearly two decades, the Minnesota Department of Human Services (DHS) has mismanaged money set aside under Medicaid, the state and federal health insurance program, for services intended to help people with disabilities live more meaningful and integrated lives in their communities. (Serres, 8/29)

Two South Florida bankers with strong local connections top a list of nominees that will be forwarded to Miami-Dade commissioners in September to fill a single vacancy on the Public Health Trust that governs the county’s $1.8 billion-a-year hospital network, Jackson Health System. The bankers, William “Bill” Heffernan and Adolfo Henriques, received the highest ranking from a nominating committee made up of Jackson trustees, Miami-Dade Commissioner Audrey Edmonson and others who met this week to interview a group of four finalists for the opening. (Chang, 8/29)

It's one of the few public health arenas in which Ohio can justifiably boast of its position on a national stage. In only a year, the state has jumped from among the worst to among the best in the percentage of kids receiving the measles, mumps and rubella (MMR) vaccine on time. The state also outpaces the national average on most other childhood vaccinations, according to the most recent statistics from the Centers for Disease Control and Prevention's National Immunization Survey, released today. (Zeltner, 8/28)

Heart-attack patients whose ambulances were diverted from crowded emergency rooms to hospitals farther away were more likely to be dead a year later than patients who weren’t diverted, according to a recent study published in the journal Health Affairs. The study, conducted by researchers at the University of California-San Francisco and the National Bureau of Economic Research, looked at ambulance diversions affecting nearly 30,000 Medicare patients in 26 California counties from 2001 to 2011. (Feder Ostrov, 8/31)

At least six San Quentin State Prison inmates were ill with Legionnaires’ disease and dozens more under observation Sunday, prompting a weekend halt to visitors, no hot meals and limited drinking water supplies at California’s oldest prison. At least 51 inmates are under observation for respiratory illness at the prison’s medical unit, said Dana Simas, a spokeswoman with the California Department of Corrections and Rehabilitation. (8/30)

California is looking to restore its reputation for agenda-setting tobacco regulation with measures to raise the smoking age to 21, triple per-pack taxes and regulate e-cigarettes the same as conventional products. The American Cancer Society and other supporters contend California, which passed the first smoke-free workplace law in 1994, has slipped behind other states in regulating and taxing tobacco use. (Nash, 8/28)

The metro-east soon will have fewer beds available for people suffering a mental health crisis, even as advocates say they need more inpatient beds for mentally ill patients in Madison and St. Clair counties. In 2013, St. Elizabeth’s Hospital and Touchette Regional Hospital joined forces with Southern Illinois Healthcare Foundation to build a new 30-bed behavioral health services center. It is intended to expand Touchette’s ability to help mentally ill patients who arrive in the emergency room with a need for inpatient treatment. Currently, Touchette has 12 beds available for mental health services, so the new facility will more than double Touchette’s capability. (Donald, 8/30)

Fox Valley Older Adult Services is a bustling place, with seniors intently honed in as they design jewelry, create art, play games, take exercise classes and engage in conversation over savory hot lunches. But Executive Director Cindy Worsley hustles to keep these doors open with the Rauner vs. Madigan budget battle dragging on in Springfield. In her almost 30 years with Fox Valley Older Adult Services — whose mission has always been to keep seniors in the Kane, Kendall and DeKalb areas in their homes as long as possible — Worsley insists this Springfield stalemate "is the biggest threat" she's ever encountered. (Crosby, 8/30)

A northwest suburban couple who own a home-healthcare business paid kickbacks to employees and marketers in exchange for referring elderly and disabled patients for unnecessary treatment that was funded by Medicare, according to a 23-count indictment unsealed Thursday. Estrellita and Miguel Duquilla, ages 58 and 60, own HCN Home Healthcare Inc., 6288 N. Cicero Ave., and were charged with conspiracy to pay and receive healthcare kickbacks, according to a statement from the U.S. Attorney’s office. (8/28)

Yawn. That is the proper response to the latest health-care reform proposals from Sen. Marco Rubio (Fla.) and Gov. Scott Walker (Wis.). They are retreads of the Burr-Coburn-Hatch proposal of 2014 and the John McCain plan in the 2008 election. All have the same fatal flaw — for average Americans, the price of health insurance jumps thousands of dollars. (Ezekiel J. Emanuel, 8/28)

The Affordable Care Act served dessert first, offering subsidized health coverage across the country before some of its less popular provisions were scheduled to take effect. But the government soon will start asking the country to eat its vegetables as cost-control measures phase in — and a lot of powerful lobbies are going to fight back. A formidable alliance has formed against one of the government’s best policies that few want to defend: The ACA’s so-called Cadillac tax, a provision scheduled to take effect in 2018 that is meant to whittle down overly generous employer health-care plans. (8/30)

By cutting taxes and controlling spending in Ohio, [Gov. John Kasich] proved his conservative bona fides, at least on fiscal issues .... He has expressed openness to some kind of path to citizenship for immigrants who came here illegally. He has shown little appetite for the culture wars that other Republicans gleefully fight .... Most strikingly, he broke with Republican orthodoxy and with most other Republican governors and accepted the Medicaid expansion under Obamacare, a decision he defended in a way that illuminated his skills as a tactician and a communicator. (Frank Bruni, 8/29)

The promise of free money is hard to turn down, and so when Obamacare offered the states a cheap way of expanding Medicaid, Gov. Rick Snyder found it hard to resist. Yet just a year into Michigan’s expansion, it’s not such a bargain. ... here’s why some business groups that once supported the expansion are starting to get worried: They fear the savings will soon become a loss, and they’ll have to cover the difference. Snyder had wanted the Legislature to set aside a portion of the annual savings into a “lockbox” that the state could start drawing on in 2017, when it will have to contribute toward the expanded Medicaid program. Between 2014 and 2015, the governor wanted $225 million placed into safekeeping. Unfortunately, that savings account was never created. (8/30)

If you think Medicaid is a health insurance program for the poor, you’re only partially correct — it’s also critical to the health care infrastructure of our state. Alabama Medicaid provides health coverage for eligible children, pregnant women and severely disabled and impoverished adults, about 1 million Alabamians. Should Alabama Medicaid be anything but fully funded, one-quarter of our state’s population — rural, suburban and urban — could lose access to health care. Despite having so many people dependent on Medicaid, benefit-wise Alabama runs the most bare-bones program in the country. (Buddy Smith, 8/30)

Since taking control of the General Assembly following the 2010 election, Republicans have been intent on reducing or at least freezing the cost of Medicaid. ... Legislative leaders want a system in which the state writes a check for Medicaid and leaves it to providers to meet the medical needs of the 1.8 million people covered by Medicaid. Providers would absorb any cost overruns. ... Senate leaders are pushing to have the system taken over by private managed-care companies. ... The House should hold out for a Medicaid system run by providers, a group whose primary interest is preventing illness and helping the sick, not making profits for stockholders. (8/29)

States from coast to coast are using public funds to help their medical schools recruit scientific stars from other states or to prevent their own stars from being lured away by lucrative offers. There have long been recruitment battles among academic institutions, but today we’re in the midst of what The Chronicle of Higher Education calls a “boom in academic poaching.” (8/29)

Brittany Maynard was soon to die. The question was whether she could do so on her own terms, as a last act of autonomy. Dr. Lynette Cederquist, who regrets that Maynard had to move to Oregon in order to do so, is working with others to change California law to allow physician assistance in dying. ... Cederquist says the most common reason for requesting assistance in dying is not “intolerable physical suffering.” Rather, it is “existential suffering,” including “loss of meaning,” as from the ability to relate to others. The prospect of being “unable to interact” can be as intolerable as physical suffering and cannot be alleviated by hospice or other palliative care. (George F. Will, 8/28)

Only in Albany can a bill pass the Assembly with overwhelming bipartisan support, be sponsored by a majority of the State Senate, be endorsed by Gov. Andrew M. Cuomo, and yet never come up for a final vote. That happened to Lavern’s Law, a bill that would have helped grievously injured victims of medical malpractice have their day in court. This summer, the Senate majority leader, John J. Flanagan, a Republican, wouldn’t allow the bill to be voted on, effectively killing it. (Thomas Moore and Steve Cohen, 8/31)

Planned Parenthood of the Rocky Mountains (PPRM) has proudly provided reproductive health care to women and their families for nearly a century. Last year, we served over 80,000 Coloradans, providing life-saving cancer screenings, HIV and STD testing, and treatment, contraception and abortion care. We are committed to ensuring Coloradans have access to the high-quality, compassionate reproductive health care they deserve, no matter their income, ethnicity, sexual identity, or geography. No matter what. (Vicki Cowart, 8/29)

Most of what we know about prescription drugs and medical devices comes from industry-funded clinical trials. Does the source of funding affect study findings? The question is at the heart of a longstanding debate about financial conflicts of interest in medicine and what to do about them. That debate was recently reinvigorated by a three-part series of articles on the subject in The New England Journal of Medicine. For many years that journal has, as have other medical journals, required study authors to disclose such conflicts. (Austin Frakt, 8/31)

A 24-year-old athlete from Columbia, a teenage girl from Glen Burnie who wanted to become a medical examiner and a 21-year-old brother of two from Pasadena. What do these three individuals have in common? Each died from a drug overdose. The Centers for Disease Control and Prevention (CDC) reports that in 2013, nearly 44,000 Americans died from drug overdose, referring to the situation as an "epidemic" as it eclipsed the number of deaths from auto accidents for the fifth year in a row. (Rep. Donna F. Edwards, D-Md., 8/28)