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The Supreme Court in the next two weeks will announce whether the Affordable Care Act survives a challenge to the subsidies that millions of people use to purchase health insurance, and whether gay couples have a legal right to marry nationwide. In a gentle interview with her former law clerk and now California Supreme Court Justice Goodwin Liu, there was no discussion of Obamacare. (Barnes, 6/14)

Three years ago this week, Justice Ruth Bader Ginsburg chided the news media for “publishing a steady stream of rumors and fifth-hand accounts” predicting how the court would rule on a constitutional challenge to President Obama’s health care law. “At the Supreme Court,” Justice Ginsburg said, quoting the journalist Joan Biskupic, “those who know don’t talk, and those who talk don’t know.” But perhaps those who know do hint. Those same remarks, for instance, contained a playful clue. (Liptak, 6/15)

Justice Anthony Kennedy was furious when a majority on the U.S. Supreme Court upheld President Barack Obama’s healthcare law. As he read the dissenting opinion from the bench three years ago, his anger was palpable. ... Now, as the country awaits a ruling in the second major challenge to Obama's signature Affordable Care Act, a question is whether the justice who was the voice of the opposition then could provide the critical fifth vote to uphold the law on the nine-justice court now. ... During oral arguments Justice Kennedy suggested the challengers' view of the law could put unconstitutional federal pressure on states, because if they failed to set up exchanges, they would lose subsidies .... Kennedy also does not rigidly interpret the words of a statute. He considers how a decision may play out, and he noted that if “people pay mandated taxes” and are denied tax credits, “the cost of insurance will be sky-high.” (Biskupic, 6/14)

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. Free speech and fair elections. Religious liberty and racial discrimination. Clean air and capital punishment. All await rulings over the next three weeks as the court completes action on 20 cases remaining this term. The next decisions will come Monday morning. (Wolf, 6/14)

Senate Finance Committee Chairman Orrin Hatch (R-Utah) wants to make it clear that his party will not pass the one-sentence fix that President Obama has said could save his healthcare law from a potential Supreme Court ruling this month. “The never-ending negative side effects of ObamaCare are so convoluted and intertwined that one sentence can’t fix this latest problem without continuing the others,” Hatch wrote Friday in an op-ed for FoxNews.com. The case, King v. Burwell, is centered around one disputed clause in the Affordable Care Act, which President Obama said Monday could be resolved by a one-sentence piece of legislation. (Ferris, 6/12)

Nearly 57,000 Nebraskans who bought subsidized health insurance could see their premiums soar and many would likely have to drop their coverage if the newest legal challenge to the federal health care law succeeds. The U.S. Supreme Court is expected to rule this month on a lawsuit that could wipe out federal tax credits in 34 states, including Nebraska, which chose not to create their own health insurance markets. (Schulte, 6/14)

About 1 million Texans will probably lose their health coverage if the Supreme Court prohibits federal subsidies in states that did not set up a health insurance exchange, according to a study released Friday. (Garrett, 6/12)

Within the next 15 days, almost 460,000 North Carolinians will learn whether they get to keep the federal subsidies that help them pay for health insurance. A ruling on King v. Burwell, a lawsuit challenging Affordable Care Act subsidies in 34 states, is expected by the end of June. Only two states, Florida and Texas, have more people at risk than North Carolina. If the court upholds the federal program that provides roughly $145 million a month to help North Carolinians buy private insurance, the lawsuit will fade to a footnote in the history of the American health care reform. (Helms, 6/14)

[Danny] Wilson fears his new coverage may soon be ripped away too. He is one of roughly 413,000 Georgians who are at risk of losing their Obamacare insurance, depending on how the U.S. Supreme Court rules on a lawsuit later this month. (Williams, 6/13)

Republicans across the country, and especially in Georgia, are united in their hope that the Supreme Court will gut a key section of the Affordable Care Act when the court rules on the health law later this month. What they can’t agree on is the future for 413,000 Georgians who would lose their health insurance subsidies. (Bluestein and Malloy, 6/14)

With a Supreme Court ruling that could pull subsidies from millions of newly insured Americans expected within two weeks, new data indicates those with coverage are happy and getting the health care they need. Eighty-six percent of Americans receiving coverage under the Affordable Care Act from either government-run exchanges. (Japsen, 6/14)

The Florida House on Friday attacked and changed regulations that it says make it too expensive for people to see a doctor or go to the hospital. Six bills passed Friday are the Republican-controlled chamber’s answer to rising — and often prohibitively expensive — healthcare costs. Their move comes one week after the House voted down a Senate plan to accept federal Medicaid expansion money to pay for insurance for poor Floridians. Among the most significant changes contemplated under the House’s plan is a proposal to end the “certificate of need” program. Through certificates of need, the state regulates the number of hospital, nursing home and hospice beds, requiring approval for new facilities and expansions. (Auslen, 6/13)

The biggest piece of Florida's budget puzzle fell into place Friday as state legislators divvied up $2 billion to hospitals for the costs of treating millions of people with no health insurance. Working through the night, they split a pot of federal, state and local tax money among 134 hospitals for charity care in the low-income pool or LIP that's being cut back by the Obama administration. ... To make up for the federal cut, the state will pump nearly $400 million into LIP in next year's budget, eating up nearly half of a projected $1 billion surplus. That $400 million will draw an additional $600 million in matching federal money. (Bousquet, 6/12)

The Alaska Legislature plans to hire a consultant to help lawmakers separate “fact from fiction” in the debate over expansion and reform of the public Medicaid health care program. The Legislative Budget and Audit Committee, chaired by Rep. Mike Hawker, R-Anchorage, on Friday issued a request for proposals for what it called an “independent professional policy resource.” ... The request for proposals issued Friday says that the consultant will analyze Medicaid reform and expansion bills being considered by the Legislature, and make presentations to committees and answer lawmakers’ questions. Committee hearings are expected to occur during special legislative sessions this fall, as well as during the next regular legislative session, beginning in January, the request says. (Herz, 6/12)

Wyoming lawmakers rejected Medicaid expansion in each of the past three years and appear unlikely to pass the Obamacare initiative in 2016, legislators and advocates say. Meantime, 17,600 Wyomingites remain without health coverage. ... the 2016 session will only last four weeks, and most of the focus will be on passing a two-year budget. Due to the time crunch, legislative rules require nonbudget bills receive two-thirds vote to be introduced. ... [State Sen. Charlie] Scott and [state Rep. Elaine] Harvey said that their committees ... [are] also keeping an eye on a Supreme Court case that will be decided in coming weeks that could affect another aspect of the ACA -- federal subsidies to Wyomingites who receive insurance on the exchange. That’s a different population than the 17,600 in the expansion gap. The court could end the subsidies, which could create other health care challenges in Wyoming, Harvey said. (Hancock, 6/13)

The cost of setting up the Massachusetts health insurance website under the rules of Obamacare is rising again, this time by $47.2 million. Additional fixes bring the total price tag for the Connector site that failed two years ago and the new flawed replacement to $281 million. And this isn’t the final bill. (Bebinger, 6/12)

The 2016 health insurance rates filed by carriers under the Affordable Care Act will be available for public viewing Monday on the Colorado Division of Insurance website. Carriers filed their rates and plans with the division May 29. Officials are reviewing them to ensure plans meet ACA requirements and proposed rates are neither excessive or inadequate. (Draper, 6/12)

A judge on Friday dismissed as frivolous a case filed by Oracle America against five staffers and advisers to former Gov. John Kitzhaber over the Cover Oregon technology debacle. (Budnick, 6/12)

A government data warehouse stores personal information forever on millions of people who seek coverage under President Barack Obama's health care law, including those who open an account on HealthCare.gov but don't sign up for coverage. At a time when major breaches have become distressingly common, the vast scope of the information — and the lack of a clear plan for destroying old records — have raised concerns about privacy and the government's judgment on technology. (Alonso-Zaldivar, 6/15)

The Affordable Care Act was designed to help people like David Elson. He had a box full of unpaid medical bills, a result of uncontrolled diabetes and all the health complications that came with it. He badly needed health insurance, but as a self-employed alarm installer, he could not afford it — especially since insurers could charge chronically ill people much more before the new law took effect. (Cott, Woo and Goodnough, 6/14)

Democratic Sen. Patty Murray’s introduction of the Affordability is Access Act this week has renewed debate nationwide about birth control access and affordability. The proposed bill would require health insurance companies to cover birth control pills if they become available over-the-counter. The bill builds on the Affordable Care Act, which requires that most private insurance plans provide coverage for female contraception. (Zukic, 6/14)

When fast-track authority faced obstacles in the Senate last month, GOP leaders won over some Democrats by coupling it with extended funding for retraining American workers hurt by foreign competition, a program known as Trade Adjustment Assistance. But in the House, Democrats balked at the plan to pay for worker training with what they viewed as cuts to Medicare. After negotiations this week between Pelosi and Speaker John A. Boehner (R-Ohio), House GOP leaders split the measure into two bills, one for fast-track and another for the retraining funds. They also agreed to find an alternative funding source for the retraining program. (Mascaro and Lee, 6/12)

Promising a more hopeful, inclusive America ready to take on the big challenges facing the country, Hillary Rodham Clinton said Saturday that she wants to be the champion the nation needs as well as its first female president. ... In a series of attacks that drew applause from the crowd, Clinton hit Republicans for wanting to repeal the Affordable Care Act, deport immigrants and take away “reproductive-health decisions.” Clinton said Republicans “turn their backs on gay people who love each other.” (Gearan and Rucker, 6/13)

In one passage she sequentially took on Republican presidential contenders on the issues of climate change, inequality, healthcare, abortion and contraceptive rights, immigration and gay rights. Those are threshold issues for many of the voters whose support Clinton is seeking .... "They want to take away health insurance from more than 16 million Americans without offering any credible alternative. They shame and blame women, rather than respect our right to make our own reproductive health decisions." (Decker, 6/13)

The latest example of the rising opposition comes from the Club for Growth, a free-market advocacy group, which is criticizing former Florida Gov. Jeb Bush for overseeing state spending increases that included $310 million to lure a biomedical research institute to Florida. The Club’s appraisal of Mr. Bush’s economic record, reviewed by The Wall Street Journal ahead of its release, says the effort to spur the biotech industry didn’t generate as many jobs as promised. (Reinhard, 6/12)

Sophisticated drugs are opening the door, scientists say, to an era of "precision medicine." They're also ushering in an age of astronomical prices. New cancer drugs are routinely priced at more than $100,000 a year -- nearly twice the average household income. Experimental cholesterol drugs – widely predicted to be approved this summer – could cost $10,000 a year for life. That's a huge increase from the price of statins, the dominant cholesterol-lowering drugs, whose generic versions cost just $250 a year. ... Even with insurance, patients may pay thousands of dollars a month out of pocket. (Szabo, 6/14)

The nation’s largest drug-testing laboratory, Millennium Health LLC, is negotiating a major settlement over allegations it billed the federal government for unnecessary tests, the latest sign of a crackdown on the fast-growing industry. Settlement talks come as the federal Medicare agency is proposing broad changes to the way it pays for urine drug tests that could save taxpayers money and cut into drug testers’ revenue. Such tests can search for drugs including narcotic pain pills and illegal substances such as angel dust and club drugs like MDMA. (Weaver and Wilde Mathews, 6/14)

The [feminists] together with a public relations company, Blue Engine Message & Media, are central players in the unusual story of how a female libido pill that had been twice rejected by the F.D.A. achieved a surprise success on June 4, when a panel of experts recommended the agency approve it. The F.D.A. has not yet made a final decision. ... Less noticed were women’s groups that refused to join the campaign, contending that waving the flag of gender bias would undermine what should be an impartial process based on science. ... The campaign divided the normally cohesive women’s health community, which has long fought together for access to birth control and for abortion rights. (Tavernise and Pollack, 6/13)

When health-care giant Johnson & Johnson told Renold Capocasale in October 2009 that he was losing his job, he got very quiet, which was not the norm for a friendly, chatty guy. "That was absolutely the lowest day of my life," Capocasale said recently. "I really questioned my self-worth. I had published many things and been promoted lots of times, but I thought, 'Why me?' " Scroll forward to the present, and Capocasale has more than recovered. In March, he celebrated the fifth anniversary of incorporating his small biotech company, FlowMetric. He will join about 15,000 people when BIO, the national biotech trade association, holds its annual convention at the Pennsylvania Convention Center on Monday through Thursday. (Sell, 6/14)

When it comes to long-term care, two facts stand out. First, an estimated 70% of people will need such care, which will be costly. And second, most of them refuse to buy insurance to cover it. The question is, why? Part of the explanation, no doubt, is that long-term-care insurance is expensive. Some people also may be assuming, incorrectly, that they will qualify for government assistance to help them pay for nursing-home care. Rules are in place to disqualify many who won’t meet the strict conditions required. (Mitchell and Gottlieb, 6/14)

In 2010, [Grace] Silva was diagnosed with anaplastic thyroid cancer, an aggressive and rapidly fatal disease with no effective treatment. Despite surgery, chemotherapy and radiation, the cancer spread to her lungs. As a last resort, she enrolled in a small clinical trial the following year. ... Silva got a drug called everolimus, approved for advanced kidney cancer and some types of breast and pancreatic cancer. The other patients died, but Silva’s tumors virtually vanished, to the astonishment of her doctors. Such inexplicable reversals have always existed in medicine, but until recently, outliers such as Silva remained little more than hopeful anecdotes. That could be changing. (Dennis, 6/13)

With a family history of breast cancer, Marcie Jacobs decided in June 2001 that an MRI screening was her best preventive option. As is common with MRIs, Jacobs was injected beforehand with a contrast agent, a drug that helps sharpen the resulting images. But after a few of these treatments, she began noticing some strange cognitive effects. Jacobs began missing meetings. Over the next several years she had additional MRIs. The math skills that were crucial to her job as finance manager started deteriorating, she said. Jacobs eventually wound up on disability. She stopped worrying about cancer – and started worrying about imaging drugs. (Gerth, 6/11)

According to the latest CDC HIV surveillance report released this spring, metro Atlanta has the fifth-highest rate of new HIV diagnoses. And that statistic may understate the problem. Patrick Sullivan, an Emory researcher and former CDC director of HIV surveillance, says, “Atlanta has one of the most intense epidemics in the country.” Three of the five core metro Atlanta counties – DeKalb, Fulton and Clayton – are among the top counties nationally in rates of new HIV diagnoses. (Vangala, 6/12)

A year-long battle to decrease discrimination toward HIV patients by health insurers reached another milestone in late March when the Florida Office of Insurance Regulation announced it would limit HIV patient costs and screen 2016 Affordable Care Act plans for discriminatory practices. In a memo to insurers, Florida’s insurance regulation office noted it will “ensure the plan’s benefit design is not unfairly discriminatory” for all prescription medications and will particularly take close notice of the way plans price HIV medications, which can have co-pays of more than $1,000 a month. (Herrera, 6/12)

Two North Carolina teenagers are petitioning the Food and Drug Administration to treat gay men the same as heterosexuals when donating blood. Last month, the FDA proposed new rules that would roll back the lifetime ban on blood donations from gay and bisexual men, acknowledging that the policy is perceived by some as discriminatory. (Wheeler, 6/12)

Millions of Americans rely on rural hospitals for emergency medical care. But in the last five years, these facilities have been shutting down more frequently than in previous years. A group of activists from across the country are walking nearly 300 miles from North Carolina to Washington, D.C. to draw lawmakers' attention. (Huntsberry, 6/14)

The vast majority of patients who arrive at California hospitals with a psychiatric emergency are not admitted, a situation that has prompted some mental health advocates to ask whether enough is being done to help those who may pose a threat to themselves or others. (Gafni, 6/14)

Saint Agnes Hospital plans to open this week an emergency department for seniors, which officials say is the first in Baltimore and the second in Maryland.The hospital plans to train staff in the complexities of care for older people and tailor the physical environment to better meet their needs, officials said. The hospital already care for more than 8,000 seniors in its emergency department annually and wanted to make the experience better for them. (Cohn, 6/15)

The company that recently opened Summit Medical Center in Casper, which doesn’t accept Medicare or Medicaid, is expanding to other parts of the state, said Eric Boley, president of the Wyoming Hospital Association. That’s a problem, said Boley, whose organization is mostly comprised of hospitals that accept Medicaid and Medicare. By taking only patients with insurance, Wyoming’s other hospitals will have a disproportionate number of patients on Medicare and Medicaid, and will financially struggle, he said. The government health programs reimburse at lower rates than private insurance. Boley asked the Joint Labor, Health and Social Services Interim Committee, which met in Casper on Monday and Tuesday, to consider imposing a moratorium on licensing of new hospitals that don’t take Medicare and Medicaid. (Hancock, 6/12)

Two hospitals serving Camden are at odds over a proposal to give facilities designated as Level 1 trauma centers control over local paramedic services. A bill, S-2980/A-4526, would give hospitals classified as Level 1 trauma centers exclusive authority to provide advanced life support (ALS), or paramedic, services in the municipality where they’re located. The legislation would basically affect Camden, where Cooper University Health Care could potentially gain control over ALS, since the state’s two other Level 1 trauma centers – University Hospital in Newark and Robert Wood Johnson University Hospital in New Brunswick – already operate the local paramedic services. (Kitchenman, 6/12)

No one wants to make a repeat visit to the emergency room for the same complaint, but new research suggests it's more common than previously thought and surprisingly, people frequently wind up at a different ER the second time around. Already some ERs are taking steps to find out why and try to prevent unnecessary returns. A Philadelphia hospital, for example, is beginning to test video calls and other steps to link discharged patients to primary care. (Neergaard, 6/13)

The Legislature is expected to approve a budget Monday that bets on California's economy to continue growing and sets the stage for higher state spending in coming years. The plan, which is not supported by Gov. Jerry Brown, includes $749 million more in discretionary spending than the governor has proposed. ... The lawmakers' budget plan, for example, would allocate $40 million, starting Jan. 1, to make public healthcare available to children who are in the country illegally. ... There's also $45 million to expand dental benefits for adults enrolled in public healthcare starting Jan. 1. Annual costs would be double that amount. ... A proposal to partly roll back a recession-era cut in state payments to doctors who serve poor patients is slated to cost about $37 million in the next budget. (Megerian, 6/14)

With state legislatures across the country passing dozens of abortion restrictions for the fifth year, access is becoming more limited than at any time since the Supreme Court's landmark decision legalizing the procedure in 1973. The current legislative session is shaping up to be among the most active, and abortion rights advocates point to what they call an alarming result of the steady flow of new laws: In some states, so many limitations have piled up that the procedure, while technically legal, is nearly impossible to obtain. (La Ganga, 6/13)

A new report from a legal aid organization for the poor accused the Pennsylvania Department of Health of failing to properly investigate complaints about nursing homes or enforce regulations that are designed to protect residents' safety. The report by Community Legal Services of Philadelphia said the department dismissed 92 percent of complaints from 2012 through 2014 for about 46 nursing homes that operated in Philadelphia. It also said the department minimized the severity of violations, and never found violations in follow-up inspections. (Levy, 6/12)

Courtney Cargill’s suicide proved to be the final straw for government regulators, who decertified South Pasadena Convalescent in January and yanked its Medicare and Medi-Cal funding. The move marks one in a series of harsh regulatory actions officials have taken in recent months against a California-based nursing home chain that has quickly become the state’s largest, with facilities stretching from San Diego to Roseville to Eureka. (Lundstrom and Reese, 6/13

It looks like North Carolina House and Senate Republicans are nearing the same impasse they reached a year ago over the best way to overhaul how the state Medicaid program pays to treat its 1.8 million patients. As House leaders began running through committees last week their preferred Medicaid proposal — one very similar to what they voted for in 2014 — Senate budget-writers prepared this week to unveil a government spending plan expected to contain Medicaid reforms like those the chamber's Republicans strongly backed last year. (Robertson, 6/14)

Olive Chase has built a thriving catering business on Cape Cod, arranging everything from cheeseburger buffets on the beach to five-course meals for wealthy museum donors. In her nearly 30 years at the helm of the Casual Gourmet, Chase has had to adapt to some major shifts in business regulations, but the complex sick time law going into effect July 1 is turning out to be the biggest challenge yet. (Johnston, 6/15)

A group called ColoradoCare is petitioning for a 2016 ballot question, Initiative #20, to establish universal health coverage under a state-run single-payer system that would increase state taxes by $25 billion. The ballot initiative seeks to establish a constitutional right to health care in Colorado. The proposed system, which the state would create in 2017 under a provision of the Affordable Care Act called Section 1332, "innovation waivers," would do away with the state health insurance exchange, Connect for Health Colorado, and private insurance carriers. However, the state would still receive federal assistance, including Medicare and Medicaid. (Draper, 6/12)

A decades-old practice of dispensing birth control to students in Baltimore is generating new debate as schools are again offering a long-acting hormone implant as an option. After Baltimore schools became the first in the nation to provide Norplant to students more than 20 years ago, city leaders say they continue to be pioneers in adolescent reproductive health. The school birth control program now offers an array of contraceptives and has been credited with reducing the city’s teen pregnancy rates to a record low. But the ability of city students to obtain contraceptives on their way to class — including condoms, birth control pills and the morning-after pill — remains controversial. (Green and Richman, 6/13)

Three groups selected by the state to operate New Hampshire’s first medical marijuana dispensaries are still a long way from being open for business next year. Although there is still more to come in what has been a lengthy approval process, the groups have at least preliminary clearance to move forward and work out the locations of the dispensaries and who will be working there. (Alden, 6/14)

Cell phones are the newest tool an East Dundee healthcare center is using to help enhance its care for behavioral health patients. Aaron Bush, 7 Hills Healthcare Center administrator, said as the behavioral health program has progressed, with more than 1,000 home and inpatient visits being performed, staff realized that the mental health of patients is greatly affected by a lack of communication due to having limited minute phones or no phone at all. (Saunder, 6/14)

Before the Affordable Care Act, it wasn't unusual for people in the LGBT community to be locked out of health insurance. Insurers could legally deny coverage based on a person's sexual orientation, gender identity, or pre-existing health condition. "It was everything from transsexual men and women being denied health coverage because their health history was confusing to a hospital or an insurance company, to young LGBT people not being able to afford coverage," said Brian Sims, a Pennsylvania state representative, lawyer, and LGBT civil rights activist. (Calandra, 6/12)

By the end of this month, the Supreme Court is expected to decide whether to throw out a crucial piece of the 2010 healthcare law: the insurance subsidies for lower-income Americans in the 34 states that have insurance-buying marketplaces operated by the federal government. The prospect that the subsidies might be eliminated has some Obamacare critics in the GOP tingling in anticipation, but others are rightly worried about the potential for health insurance chaos and harm to their constituents. The problem for the latter is coming up with a plan that wouldn't leave people worse off than they were before Obamacare. (6/12)

Regardless of how the U.S. Supreme Court decides King v. Burwell -- a case regarding the Obama administration’s issuance of health insurance subsidies in violation of their own law -- the negative consequences for patients and taxpayers will continue absent thoughtful, patient-centered reform. The latest numbers don’t lie. Earlier this month, the administration announced proposed rate hikes of 10 percent or more for health insurance plans enrolling more than six million people in 41 states. This sizeable premium increase on top of prior hikes threatens the financial health of both American families and taxpayers generally, and is evidence that the health care law failed to hold up to the president’s key promise to lower costs. (Sen. Orrin Hatch, R-Utah, 6/12)

The depiction of the Affordable Care Act as a driver of huge increases in health insurance rates refuses to die, even though the record thus far shows that premium rate increases have shrunk since open enrollment for individual plans began in 2014. The drumbeat is sounding again, based on early and incomplete filings by insurers. The drum majors typically are conservative news sources anxious to show that sticker shock hasn't been eliminated, just deferred. But numerous general news agencies fomented the panic as well. (Michael Hiltzik, 6/12)

[Sen. John] Thune's tweet is devoid of logic: His argument is that Obama denies that Obamacare is bad even though terrible consequences will ensue for millions of beneficiaries if Republicans destroy Obamacare. A dishonest muddle may work for Republicans in the short term, though after five years of vowing to murder Obamacare it will take some effort to convince voters that the knife was in Obama's hand all along. But Republicans won't be able to hide their true position forever. They've never developed a viable alternative to Obamacare for the simple reason that they do not support a viable alternative. They are unwilling to do what is necessary to make health insurance accessible to the millions who can't afford it. (Francis Wilkinson, 6/12)

Last week, the White House released a report outlining the economic benefits to states of expanding Medicaid. The report continues a line of argument the Obama administration has used in encouraging states to expand Medicaid under the Affordable Care Act, the president’s health-care law. The administration faces several obstacles in attempting to sell this argument to reluctant states. (Chris Jacobs, 6/12)

There's been no shortage of back and forth when it comes to the successes -- and failures -- of the Affordable Care Act, better known as Obamacare. I'm not here to offer my opinions on the program, just to point out that the program has a huge unintended consequence: it can make your prospects for early retirement much rosier. In its place, many early retirees find their level of "enough," and refuse to adjust their spending habits just because they get a raise or new high-paying job. (Brian Stoffel, 6/14)

Later this month, the Supreme Court will issue its ruling in King v. Burwell, a case that could have far-reaching effects on American health care. The Court will decide whether the Affordable Care Act (otherwise known as Obamacare) allows the government to provide subsidies for purchasing insurance in the 34 states, including Pennsylvania, that rely on Healthcare.gov, the federally-facilitated marketplace. In Pennsylvania, the Wolf Administration has announced that it will move forward with a supported state-based marketplace in the event that the Supreme Court takes away tax credits from people in state like ours. This is a commonsense approach that will protect hundreds of thousands of Pennsylvanians, who could otherwise lose their health insurance. (Antoinette Kraus, 6/12)

The world is relearning a painful lesson in combating infectious disease: an outbreak caused by a virus or by bacteria is not only a challenge for medicine but also demands a rapid response based on real information, good detective work and a certain alacrity. Ebola showed how a small outbreak can mushroom into a global concern. Now the same dynamics are playing out in South Korea, struggling with the sudden appearance of the Middle East respiratory syndrome, or MERS, a coronavirus for which there is no known vaccine or effective treatment. (6/12)

In the 50 years since Griswold vs. Connecticut — in which the U.S. Supreme Court struck down a Connecticut law banning contraception for married couples — the right to birth control for all has become a cornerstone of women's healthcare and reproductive freedom. But making it affordable to all women has not been easy. ... Now there are new efforts to make it easier for some oral contraceptives to be to be sold over the counter, like aspirin, rather than by prescription only. Wouldn't that guarantee the most accessibility? Theoretically, yes, but not if women are stuck buying it without benefit of insurance. (6/14)

What led [Sen. Lindsey] Graham to believe himself on history’s side was his introduction of legislation banning all abortions after five months. But while the verdict of the ages has yet to be returned, Graham, a GOP presidential candidate, certainly is not on the right side of logic. The procedures Graham seeks to ban account for less than 1.5 percent of all abortions in the United States, and those are often the most difficult cases, such as the woman who discovers late in pregnancy that she has cancer. ... By contrast, if Graham were to support efforts to make contraception cheaper and more widely available, the number of abortions would almost certainly plummet. Alas, politics gets in the way. (Dana Milbank, 6/14)

But in this new moment in history, “abortion” is back. The coded language of the older guard is giving way to frank talk from a younger generation of activists, who cut their teeth in LGBT work and online feminist spaces. Advocating “choice” didn’t stop the recent wave of losses for reproductive rights. Today, activists are realizing that the only way to erase the stigma is to talk about it. ... Younger activists are shaping the dialogue, taking cues from the Internet, where conversational norms reward unabashed honesty about the female experience — sometimes to maximal shock value. (Jill Filipovic, 6/12)

Insurers, hospitals, and physicians likely recognize that out-of-network billing is a looming public relations nightmare, particularly with more Americans in health plans with limited provider networks. States that recently have adopted or considered measures to protect patients from surprise out-of-network bills include New York, Texas, and Florida. Nevertheless, the American Medical Association's new president-elect, Dr. Steven Stack, an emergency physician in Lexington, Ky., told Modern Healthcare last week that the problem is mostly or entirely the fault of insurers. He argued that current state legislative and regulatory efforts “misrepresent” the problem. “The real crux of the problem is health insurers are refusing to pay fair market rates for the care and services provided,” he said. (Harris Meyer, 6/14)

The federal government spent $2.8 billion compensating employees, including U.S. Postal Service workers, who make up by far the largest group of workers’ comp claimants, for work-related illness and injury in the year ending June 30, 2014 (the most recent year for which data exist). Unquestionably, this is a vital government responsibility, but the law governing federal workers’ comp has not been fundamentally revised in four decades — and there is mounting evidence, presented most recently in a report from the Postal Service’s inspector general, that the program operates much less efficiently than it could or should. (6/13)

As doctors, we usually base the timing of follow-up visits on some mix of habit and a gestalt of patient need, all within the arbitrary structure of the lunar calendar. Not surprisingly, then, Dartmouth researchers have shown that visit rates vary tremendously. ... Patients tend to have more visits per year if they are sicker, the study found, but also if they live in an area with more doctors or with doctors who tend to ask patients to come in more often, even when adjusting for factors such as health status. What the patient prefers seems to have no significant association with visit rates. The timing of follow-up visits, in other words, has tended to fall under the art, rather than the science, of medicine. (Ishani Ganguli, 6/12)

Federal drug-enforcement officials have made it a serious felony for doctors to overprescribe painkillers or, as the applicable law states, to prescribe controlled substances “other than for a legitimate medical purpose and in the usual course of professional practice.” But the line between legitimate and illegitimate prescription—as drawn by the Drug Enforcement Administration (DEA) and the Justice Department—is far from clear. This puts physicians in great legal jeopardy, and too often leaves their patients to suffer needless agony. (Harvey Silverglate, 6/12)

Students training to be doctors and other health care professionals need practice, and at some schools, that means practicing on other students. But examining and being examined by classmates brings up significant privacy issues that schools need to address. (6/12)

It is the convention to use an electric sander before painting exteriors of old houses in New Orleans. Some of the old paint contains lead. If that dust gets on the hands of infants, and their hands reach their mouths, it can adversely affect their brain development. Remarkably, this seems to trouble almost no one, except for two groups of people: the scientists who for years have tried to raise awareness of the menace, and the parents of children with elevated levels of lead in their blood. (Thomas Beller, 6/13)

Imagine a woman in labor goes to the hospital with a delivery plan she made in consultation with her obstetrician; yes to antibiotics in labor; no to epidural for pain control; yes to neonatal circumcision; and yes to having an intrauterine device (IUD) placed immediately after childbirth. Along with contraceptive implants, IUDs are a form of long-acting, reversible contraception (LARC) that is safe, effective and convenient, and whether placed after childbirth or at any other point. And more and more, obstetricians are offering placement of IUDs and implants while women are admitted to the hospital for childbirth. Despite the woman's wishes, she does not get the IUD she wanted. Due to the way insurers pay for long-acting methods, hospitals often don't have IUDs and implants readily available. (Pooja Mehta and Melissa Weiler Gerber, 6/12)

I’ve written here many times about how American women are dying during pregnancy and childbirth at twice the rate they were 30 years ago. The U.S. Centers for Disease Control and Prevention (CDC) reports that pregnancy-related deaths increased from 7.2 deaths per 100,000 live births in 1987 to 17.8 deaths per 100,000 live births in 2011. A Lancet study published last year put the 2013 U.S. maternal death rate even higher, at 18.5 deaths per 100,000 live births. That, of course, is a shocking and disturbing trend. But, according to an article published online this week in Scientific American, much of that sharp increase in the pregnancy-related death rate may be the result of a change in how death certificates are filled out today compared to 30 years ago. (Susan Perry, 6/12)