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After President Obama’s Affordable Care Act was enacted in 2010, Republicans at both the state and federal levels seemed to speak with one voice in flatly rejecting it. But in subsequent years, though most Republican governors remained critical of the health care law, nine accepted a central but optional element, expanding Medicaid programs to cover many more low-income residents of their states. At least four others, urged on by hospitals and business groups, will try to do so this year. And now, briefs filed last month in support of a major legal challenge to the law — King v. Burwell, which is now before the Supreme Court — are raising new questions about divisions within the Republican Party over the law. (Goodnough, 1/11)

Uncle Sam could take a bigger bite at tax time for consumers who received too much government help last year with their Obamacare premiums. That may be just one of several surprises for millions of Americans in advance of the first tax deadline involving the Affordable Care Act. The majority of Americans who get their health insurance at work should see few changes when filing their taxes. Most will just need to check a box on their tax return indicating they had coverage in 2014. (Terhune, 1/9)

[Genesis Matos] Rodriguez was born with asthma and Middle Lobe Syndrome, which causes mucus to build in her lungs. Two years ago, her right lung collapsed; surgeons removed half. Her monthly medical bill to ward off fluids, including Pulmozyme and Albuterol, can hit $4,000. ... Her mother, legally the head of their household, made $9,000 last year working part-time — a few thousand dollars short of qualifying the family for premium subsidies under the Affordable Care Act. Nearly 4 million Americans and 800,000 Floridians live in this limbo of patchwork health care: They are not eligible for Medicaid; they don’t make enough money to afford ACA coverage. Florida, like many states that recently elected (or reelected) Republican governors, has decided not to expand Medicaid eligibility under the Affordable Care Act. (Paquette, 1/9)

Hospitals across Illinois will receive $400 million in federal funding under the Affordable Care Act. Gov. Pat Quinn said Saturday he traveled to Washington last month to lobby for the funding bump. It will allow the state to increase its funding to hospitals to care for more inpatient and outpatient clients and cover a greater volume of people newly enrolled in the Affordable Care Act. (1/11)

Starting this month, state-run insurance exchanges are legally required by the healthcare reform law to be financially self-sustaining. But that mandate is being ignored across the country, and there do not appear to be any immediate consequences for the states. Many of the 16 states and the District of Columbia that run their own marketplaces will continue to rely on leftover federal funds to pay for operations this year. The Obama administration issued a guidance last year that states can continue to use federal grant dollars this year if the CMS grants permission. Some uses of the funds are prohibited, such as for rent and software maintenance. (Tahir and Demko, 1/10)

A multi-million dollar IT system that Colorado officials promised would make signing up for health coverage simple has instead snagged thousands of customers and now will cost several hundred thousand dollars — if not millions — to fix. (Kerwin McCrimmon, 1/9)

Officials with the state's health insurance exchange say they need $322,000 to fix technical problems with the website that have kept thousands of people from enrolling for coverage. Staff plan to make a request for the funding to Connect for Health Colorado's board of directors on Monday. (Draper, 1/9)

The push to get more Washington residents health insurance scored big time with a new public service announcement featuring Seahawks star players Russell Wilson and Richard Sherman. The PSA being released Friday is a no-frills, 30-second production in which Wilson and Sherman make the case for getting health insurance and urge people to act soon. The delivery is flat, but at least spares viewers a slew of bad sports puns. (Stiffler, 1/9)

Republicans are looking to an unlikely ally in their bid to repeal a controversial piece of ObamaCare: Sen. Elizabeth Warren. The Massachusetts Democrat, who has emerged as a liberal hero, has shown support for efforts led by the GOP and business groups to scrap Obamacare's medical device tax, a 2.3 percent levy on medical devices and supplies projected to raise almost $30 billion over the next decade. (Cirilli, 1/10)

A group of conservative scholars, under the banner of the YG Network, a group affiliated with GOP leaders in the House, published a collection of essays last year to address middle-class concerns, from K-12 education to lower-cost health care. “One of the weaknesses Republicans have had during the Obama years is that they have struggled at times to talk to the middle class, particularly how they can boost low-wage workers,” said Yuval Levin, a fellow at the Ethics and Public Policy Center, a conservative think tank, who outlined a new vision for government in the essays’ introduction. (O'Connor, 1/11)

Skilled nursing facilities are launching a new campaign to avoid cuts and offer policy proposals ahead of Congress's debate over the next fix for Medicare doctor payments. The American Health Care Association (AHCA), which represents nursing homes, assisted living facilities and other subacute care providers, is blanketing Washington in multimedia advertisements starting Monday to shore up its position ahead of deliberations. (Viebeck, 1/12)

A sweeping rules package the House approved at the start of the 114th Congress includes a provision that has set off a war of words about the future of Social Security and benefits for disabled workers. The measure would stop House lawmakers from transferring money from Social Security’s Old-Age and Survivors Insurance Trust Fund to the program’s Disability Insurance Trust Fund unless lawmakers took steps to “improve the actuarial balance” of both funds. (Carey, 1/12)

More than a dozen physicians representing two hospitals have been named as defendants in federal lawsuits that allege they acted in bad faith by allowing a spine surgeon to perform surgery at the hospitals. The doctors in question served on the committees that approved surgical privileges at Avera Sacred Heart and Lewis & Clark Specialty Hospital, both in Yankton, according to the lawsuits. The doctors are accused of extending Dr. Allen Sossan privileges to perform complex spine surgeries, despite knowing that Sossan had a history of performing unnecessary surgeries and unprofessional conduct. Both Avera Sacred Heart and Lewis & Clark also are defendants. (Ellis, 1/11)

A cardiac-biomarker laboratory under federal investigation cut ties with its sales-and-marketing contractor, ending a joint enterprise that has collected hundreds of millions of dollars from Medicare. The lab, Health Diagnostic Laboratory Inc., and the sales contractor, BlueWave Healthcare Consultants Inc., are the focus of a Justice Department civil probe into whether they paid kickbacks to doctors to induce them to prescribe HDL’s advanced blood tests. (Carreyrou, 1/11)

Roche Holding AG agreed to pay $1.03 billion for up to a 56.3% stake in Foundation Medicine Inc. in a collaboration that underscores the growing importance of genetic diagnostics in the treatment and development of drugs for cancer. (Winslow, 1/12)

The Swiss pharmaceutical giant Roche said on Monday that it would acquire a majority of the tumor-testing company Foundation Medicine for more than $1 billion, in a deal aimed at improving both cancer treatment and drug development. (Pollack, 1/12)

HCA Holdings Inc. said it would report better-than-expected 2014 results, bolstered by an increase in admissions and emergency room visits along with a one-time adjustment from Medicaid payments in Texas. The hospital operator said it now expects Ebitda for the year of $7.4 billion, topping its previous projection of $7.25 billion to $7.35 billion. (Armental, 1/9)

A growing number of hospitals are buying robots that kill bacteria such as C-difficile as they seek new tools to stop costly and deadly hospital-acquired infections. But there are questions about how best to use the new disinfection robots. The University of Vermont Medical Center, a health system based in Burlington, is one of hundreds of U.S. hospitals that have purchased a disinfection robot. Sally Hess, U-V's manager of infection prevention, said the two Xenex Disinfection Services robots purchased last year add an “extra level of protection” to the hospital's infection-control program. It removes the element of human error, she said. (Lee and Rice, 1/10)

Physicians at the U.S. Department of Veterans Affairs are using Watson to help them treat veterans with post traumatic stress disorder. The VA has launched a two-year pilot program to study new ways of searching electronic medical records and medical literature. The pilot, which will rely on simulations but use actual patient records, is intended to evaluate how the IBM technology can speed up clinical decisions. IBM is trying to transform the game-playing system into a commercially viable technology, and the VA is exploring whether doctors at all VA medical centers and clinics should eventually be linked to it. (Mirabella, 1/10)

Over the past decade, smartphones have radically changed many aspects of our everyday lives, from banking to shopping to entertainment. Medicine is next. With innovative digital technologies, cloud computing and machine learning, the medicalized smartphone is going to upend every aspect of health care. And the end result will be that you, the patient, are about to take center stage for the first time. (Topol, 1/9)

Electronic wristbands that count footsteps and calories produce imprecise data. But that’s beside the point. The devices are motivational tools to promote fitness, and the numbers they generate are good enough for that. Initially embraced by fitness fanatics, activity trackers, such as the Fitbit, Jawbone and FuelBand, have become popular among mainstream users, many of whom are wearing the accouterments as part of New Year’s resolutions to get in shape. How well do they work? (McGinty, 1/9)

It's not just about how many steps you've taken or how many calories you've burned in a day. Wearable fitness trackers and health monitors are becoming more commonplace and diverse, but just what do you do with all of that data? ... Health monitors aren't just for fitness buffs. Startups and big tech companies at the gadget show promoted all kinds of uses for the data generated by wearable sensors — from mindfulness exercises to figuring out the best time to get pregnant. Other companies aim to offer value by aggregating data from different sources, so it can be viewed and interpreted together. That could be useful, but it also raises a host of privacy concerns. (Bailey, 1/11)

Republicans are more united than they have been in years on a national strategy to roll back abortion rights, using state legislatures and the new GOP Congress to push for banning the procedure after 20 weeks of pregnancy — a platform that also has the backing of the party’s presidential candidates. (Everett and French, 1/11)

This year, Texas anti-abortion groups are pushing lawmakers to exclude Planned Parenthood from the screening program. The combined federal and state-funded program provides free cancer screening and diagnostic tests for women aged 21 to 64 who are uninsured or underinsured and meet low-income requirements. Planned Parenthood saw about 3,300 of the nearly 33,600 women screened through the program in 2014. (Martin, 1/10)

A Kansas doctor scrutinized for referring young patients for late-term abortions remains barred from practicing medicine after a state board declared Friday that her inadequate record-keeping justified the revocation of her license. The State Board of Healing Arts stripped Dr. Ann Kristin Neuhaus of her license to provide charity care in 2012, finding she had performed substandard mental health exams in 2003 for 11 patients ages 10 to 18 before referring them to the late Dr. George Tiller's clinic in Wichita. (Hegeman and Hanna, 1/9)

McAuliffe (D) bagged big economic development wins in his freshman year, resulting in $5.5 billion in private economic investments in the state — more than double, he says, what any previous Virginia governor pulled off in his first year. But he also lost a bitter fight with the Republican-controlled General Assembly to expand Medicaid under the Affordable Care Act, his marquee campaign issue and chief legislative priority. As the legislature prepares to return to Richmond on Wednesday as resolute as ever about opposing Medicaid expansion, McAuliffe’s renewed call for such a change is widely seen as symbolic. He has promised to try a more hands-on approach with lawmakers who bucked him last year, but he has decided that jobs, an issue with broad bipartisan appeal, will be his chief cause in the session. (Vozzella and Portnoy, 1/10)

After losing a bruising battle over his top campaign promise of expanding Medicaid to 400,000 Virginians last year, the governor again included the issue in the amended budget proposal he unveiled in December. At the same time, he seemed to acknowledge how little chance the proposal has of passing by failing to factor the financial savings into his overall spending plan. (Portnoy, 1/10)

Taking advantage of a growing economy, Gov. Jerry Brown proposed a $164.7-billion budget Friday that would boost funding for schools, community colleges, courts and home care for the elderly and disabled. ... The governor is also grappling with higher costs as more Californians sign up for Medi-Cal, which provides healthcare to the poor, under President Obama's signature law. But Brown did not propose higher payments for doctors who participate in the program or set aside money to provide coverage for immigrants who are in the country illegally — two priorities for activists and some top lawmakers. Nor did he include money for the long-term expense of providing healthcare to retired public workers, although he said he would work with unions to address the issue. (Megerian, 1/9)

Brown warned of rising health care obligations that, without proper funding, could leave the state hundreds of billions of dollars in the red. Medicaid expansion under the Affordable Care Act has added more than 4 million new low-income residents to California’s program, and Brown said he would begin negotiating with state public employee unions over the amount of money they contribute to their own health-care costs, a significant and rising portion of the budget. (Reid, 1/9)

Yet that pragmatism is likely to be tested in the 24 states where Republicans also control the legislature and where bills are expected that would further restrict abortion, roll back the Common Core education standards and ensure that the president’s health care law does not gain a foothold in any more states. Many conservative lawmakers in these states see a turn toward moderation by Republican leaders as being at odds with the public mood, particularly after such a decisive electoral sweep. (Robertson and Gabriel, 1/11)

Kaiser Permanente's 2,600 California mental health clinicians are expected to begin a weeklong strike Monday to highlight what they say is inadequate staffing and long wait times for appointments. (Parr, 1/10)

Hundreds of Kaiser Permanente's mental health professionals plan to start a weeklong strike throughout California Monday to protest a lack of staffing they say is affecting care. Kaiser Permanente's 2,600 psychologists, therapists and social workers will launch the walkout to demand the health care provider offer timely, quality mental health care at its psychiatry departments and clinics, said Jim Clifford, a union member and San Diego psychiatric therapist. Clifford said some patients have to wait up to two months for follow-up appointments, which prolongs the recovery process and at times even truncates it. (1/12)

An advisory panel is recommending that the state of Arkansas explore offering Medicare managed care plans to retired state and public school employees who are covered by the federal program for the elderly and disabled. About 18,000 retired state and school employees are enrolled in state plans that supplement traditional Medicare coverage. Under the recommendation by the State and Public School Life and Health Insurance Board's benefits subcommittee, the board would solicit proposals from companies that offer Medicare Advantage plans. (1/10)

Unlike its counterparts in other states, the Georgia Hospital Association has not been seen as actively advocating for Medicaid expansion. A number of states have expanded their Medicaid programs, making more low-income people eligible for benefits and thus helping hospitals financially by reducing their numbers of uninsured patients. But expansion has gone nowhere in Georgia. (Miller, 1/11)

Top Illinois health officials say too many communities don't have access to trauma care. The agency on Sunday released a study recommending ways the state can increase access to emergency medical care in so-called "trauma center deserts." The report says the centers increase a person's odds of survival. (1/11)

A federal judge ruled Dec. 22 in a civil case challenging the wait lists that holding mentally ill people in jails without treatment violates their constitutional rights, but Washington has yet to implement changes. Hundreds of people like Karen Hellmuth remain jailed awaiting competency evaluations, some up to 13 weeks. (Bellisle, 1/10)

Since May, a string of states have passed laws that give critically ill patients the right to try medications that have not been approved by the Food and Drug Administration. Deemed “Right to Try” laws, they have passed quickly and often unanimously in Colorado, Michigan, Missouri, Louisiana and Arizona .... The laws do not seem to have helped anyone obtain experimental medicine, as the drug companies are not interested in supplying unapproved medications outside the supervision of the F.D.A. But that seems almost beside the point to the Goldwater Institute, the libertarian group behind legislative efforts to pass Right to Try laws. (Turkewitz, 1/10)

Oregon began covering the cost of reassignment surgery for transgender people on Medicaid in January. It also covers things like hormone therapy and puberty suppression. (Foden-Vencil, 1/10)

Rita Gorenflo’s 7-year-old son Nathaniel was in severe pain from a sinus infection. But since the boy was covered by Medicaid, she couldn’t immediately find a specialist willing to see him. After days of calling, she was finally able to get Nathaniel an appointment nearly a week later near their South Florida home. That was in 2005. Last month, ruling in a lawsuit brought by the state’s pediatricians and patient advocacy groups, a federal district judge in Miami determined Nathaniel’s wait was “unreasonable” and that Florida’s Medicaid program was failing him and nearly 2 million other children by not paying enough money to doctors and dentists to ensure the kids have adequate access to care. The Florida case is the latest effort to get federal judges to force states to increase Medicaid provider payment rates for the state and federal program that covers about 70 million low-income Americans. (Galewitz, 1/12)

The push to legalize medical marijuana in Florida continues with a two-pronged campaign, supporters said on Friday, sharing plans to mount another ballot drive in 2016 as a way to pressure state lawmakers to consider legislation permitting prescription pot. A constitutional amendment to legalize medical marijuana in Florida last year fell just short of the 60 percent approval needed to pass in the state. (Cotterell, 1/9)

Christina Swentzell was homeless, sleeping in a shelter and volunteering at Father Woody's Haven of Hope when the nausea gripped her. "If I had been employed and had insurance, I would have gone to the doctor, but I just hoped for the best," she said. Eventually, she sought help at a 37-foot-long mobile clinic, operated by the Colorado Coalition for the Homeless' Health Outreach Program, and called the HOP. (McGhee, 1/11)

Gov. Bobby Jindal got only good news when the federal Medicaid agency signed off on financing plans for his LSU hospital privatization deals. But the result was more mixed for lawmakers and future governors, who learned Jindal's deals will leave them with a lingering budget worry after he's gone. Approval from the U.S. Centers for Medicare and Medicaid Services, known as CMS, will keep money flowing to pay for the privatization contracts and ensure care for the uninsured won't be upended. (DeSlatte, 1/11)

The Medical College of Wisconsin has paid $840,000 to settle claims it billed Medicare for neurosurgeries at which teaching physicians weren't overseeing residents to the degree required by law. The payment, announced Friday by the U.S. attorney's office, resolves a False Claims Act lawsuit claiming the college billed for surgeries between 2006 and 2013 as though teaching physicians were always present. The whistle-blower who first filed the False Claims action under seal, a surgeon in residency at the college, will be entitled to a percentage of the recovered amount. (Vielmetti, 1/9)

These days, treatment is widely available at pharmacies, grocery stores and discount retailers. For many consumers, the convenient option comes at the right time, given dramatic increases in out-of-pocket health care costs. (Zdechlik, 1/12)

More than 40 percent of South Florida hospitals fell below national standards for preventing certain types of common infections in their patients in 2013, according to federal data. At the same time, 56 percent of local hospitals performed better than expected in controlling infections, according to the same data, information that South Florida consumers could use when choosing a hospital. (Nehamas, 1/11)

Some of the most notable federal policy innovations of the last generation have originated in the states, including school vouchers, energy efficiency standards, welfare reform and the Affordable Care Act. Governors like Bill Clinton and George W. Bush leveraged their state policy successes as springboards to the Oval Office. The problem is, just when we need their innovative energies, the states are looking less and less likely to be fountainheads of new federal policy over the next generation. What has changed? (Aaron Chatterji, 1/11)

If you think Obamacare is bad, just wait until the Supreme Court dismembers it. The Urban Institute has gamed out what would happen if the justices ended health insurance subsidies for people in 34 states, a plausible result from the court’s current term. Urban’s results ... predict a national policy disaster. (Stephen Stromberg, 1/9)

Lawsuits aimed at eviscerating the Affordable Care Act have been lining up in federal courts like airliners on America's taxiways. Most are frivolous or partisan or both, and some have already been tossed. The Supreme Court on Friday will ponder whether to hear one that actually has some merit. Half of it has merit, anyway. Coons v. Lew is a double-barreled attack on Obamacare's individual mandate and its Independent Payment Advisory Board, or IPAB. The latter is a board empowered to hold Medicare spending below an inflation-indexed ceiling, chiefly by imposing cuts on provider reimbursements. The constitutionality of the individual mandate has already been considered and settled by the Supreme Court, so that part of Coons v. Lew is a loser. But IPAB hasn't been examined, and it should be -- and quite possibly eliminated. (Michael Hiltzik, 1/9)

What I am arguing is that weakening the employer mandate is not going to get [Republicans] any closer to repealing Obamacare. Indeed, the reverse is true. If they actually succeeded in getting this bill passed into law, all they would do is further entrench the 2010 health-care bill. After all, a weaker employer mandate will push more people onto the exchanges. Many of those people would be receiving subsidies. The more people who receive subsidies, the harder repeal of the whole law will be. And since the exchanges, and the associated regulations, are the law's most problematic part, it's hard to see why Republicans want to push more people into that part of the system (Megan McArdle, 1/9)

Today, as one of 1.6 million Americans living in Europe, I instead face hard questions about our nation. Wherever I travel, Europeans, Asians and Africans ask expatriates like me to explain everything odd or troubling about the conduct of the United States. ... At the absolute top of the list: "Why would anyone oppose national healthcare?" Many countries have had some form of national healthcare since the 1930s, Germany since 1880. Some versions, as in France and Britain, have devolved into two-tier public and private systems. Yet even the privileged would not begrudge their fellow citizens government-funded comprehensive healthcare. That so many Americans do strikes Europeans as baffling, if not brutal. (Ann Jones, 1/11)

It would be stupidly optimistic to assume [Gov.-elect Greg] Abbott, who has spent the last several years fighting the ACA, is suddenly willing to negotiate with the federal government on Medicaid expansion, particularly with the very conservative Legislature about to convene. But momentum for some kind of solution for covering uninsured Texans seems to be building, and even he can’t avoid being caught up in it. (1/9)

The decision by the state Supreme Court that dissident legislators have standing to contest the constitutionality of Medicaid expansion has put Gov. Doug Ducey in quite a pickle. ... During the campaign, Ducey expressed opposition to the Medicaid expansion. And the two-thirds vote requirement for increases in state revenues is a fiscal conservative totem. So Ducey will be under pressure from the right to stop defending the lawsuit and admit its unconstitutionality. Ducey, however, probably doesn't really want to see the lawsuit go away, at least just yet. For one thing, if the assessment goes away, it will rip another big hole in the state budget, since the assessment pays not only for the Obamacare expansion population but childless adults already covered by Medicaid under a ballot proposition approved by voters. (Robert Robb, 1/9)

The ACA has made it possible for roughly 12 million Americans to gain health coverage. Maddening to Republican critics, it has not exploded the federal deficit as they predicted. That deficit has been declining. Nor has it blown up medical costs. North Carolina’s spending on Medicaid has declined. The insurance industry, which has long opposed any health care reform that might reduce its profits, has benefited from having more people covered with private insurance, which is what Obamacare mandated. But North Carolina, along with some other states controlled by Republicans, has stubbornly refused to do the humanitarian thing by half a million people who need coverage and the financially sensible thing by allowing expansion of Medicaid. (1/10)

The $164.7-billion budget that Gov. Jerry Brown proposed Friday for the coming fiscal year highlights the glass-half-empty nature of California's improving fortunes. ... One consequence of the high poverty rate is that a huge chunk of the state budget — more than 30% — is projected to be spent on safety net programs. The biggest of those is Medi-Cal, the joint federal-state health insurance program for the poor, which covers almost a third of all Californians. Driven in part by increased enrollment in Medi-Cal, the administration expects to spend $1.4 billion more on health and human services in the coming fiscal year than in 2014-15. And that's not even factoring in the cost of extending Medi-Cal, in-home supportive services and other health benefits to low-income immigrants who recently gained temporary legal status through President Obama's executive action. (1/11)

We went from one extreme to the other, and I’ve lived through the whole thing. It’s like I moved from California to Louisiana without moving. Without lifting a finger, I changed states. I was trained as a family physician here in Phoenix. I rotated through Planned Parenthood here in Phoenix, and I liked what I was doing, so I continued training and working there for the first five years until 1999, and then I opened my own office, Camelback Family Planning. At the time, it was a doctors office. And then I started doing abortions in my office. ... Literally I needed a pulse oximeter to monitor their vitals, a vacuum machine and staff and a recovery room, and the knowledge and skills to do it. That could never happen now. You have to be a licensed abortion clinic, and have inspections, and all kinds of things that didn’t exist in the year 2000. (Lydia DePillis, 1/9)