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A House vote expected this week will be the first test of whether leaders of the two parties can win support for small structural changes in how the costs of Medicare are covered—a significant political shift for Congress, which has for years been at an impasse over entitlement programs. (Hughes, 3/22)

Lobbyists will descend on Congress this week as lawmakers near a bipartisan agreement to finance health care for the oldest and youngest Americans, by revamping the payment of doctors under Medicare and by extending the Children’s Health Insurance Program. The agreement, negotiated by Speaker John A. Boehner and the House Democratic leader, Nancy Pelosi, would repeal a Medicare formula that threatens to cut doctors’ fees each year. In its place, Congress would establish an “incentive payment system” to reward doctors who receive high performance scores from the government. Scores would be based on factors like the ability to keep patients healthy while controlling costs. (Pear, 3/22)

It’s make-or-break time for a Medicare 'doc fix' replacement. The House is likely to vote this week on a proposal to scrap Medicare’s troubled physician payment formula, just days before a March 31 deadline when doctors who treat Medicare patients will see a 21 percent payment cut. Senate action could come this week as well, but probably not until the chamber completes a lengthy series of votes on the GOP’s fiscal 2016 budget package. (Carey, 3/23)

A budding bipartisan deal to shelter physicians from Medicare cuts, championed by the House's two top leaders, is drawing powerful allies including the American Medical Association and a rainbow of conservative and liberal groups. ... The proposal is also attracting powerful foes and its fate is not guaranteed. ... On Saturday, all 12 Democrats on the Senate Finance Committee released a letter suggesting they might oppose the plan unless House leaders change it. They said a package extending the children's health program "would go a long way to achieving bipartisan support," and listed other concerns like its increased costs for some beneficiaries. (Fram, 3/21)

Democrats on the Senate Finance Committee on Saturday issued a joint statement saying the emerging deal in the House to avert cuts to doctors under Medicare currently does not pass their "test." “Though we have not been part of negotiations in the House on the total package, we want to be clear that any legislation of this magnitude sent to the Senate must be balanced," the senators said. "Unfortunately, our current understanding of what the House is negotiating does not sufficiently pass that test." (Schroeder, 3/21)

Congress is closer than ever to finally repealing and replacing the Medicare physician-payment system. But with the March 31 deadline to act on the sustainable growth-rate formula a week away, there are at least six potential landmines that could derail the surprise $200 billion-plus deal negotiated by House Speaker John Boehner and Minority Leader Nancy Pelosi. (Demko, 3/21)

House Democratic Leader Nancy Pelosi is trying to head off an abortion dispute so it doesn’t derail a bipartisan permanent solution to the flawed Medicare pay formula for doctors, which Congress for years has been trying to repeal and repair. But she faced sharp words Friday from abortion rights groups who have been her traditional allies. ... Included in the tentative deal outlined Friday is $7.2 billion for community health centers — but it’s tied it to language banning the federal funding of abortions at the clinics, the so-called Hyde Amendment. ... Pelosi circulated a “Dear Colleague” letter Friday, saying that the abortion language regarding the community health clinics is basically how the centers operate now and that it’s important to get them the funds. (Pradhan and Mershon, 3/21)

Abortion politics in the U.S. Congress, already holding up a human trafficking bill and a key Obama administration nomination, are now also complicating bipartisan talks on a deal that would spare physicians from Medicare pay cuts. Senate Minority Leader Harry Reid and another senior Democrat, Senator Ron Wyden, say they're worried that an emerging House of Representatives deal to rewrite Medicare's flawed doctor-pay formula will include anti-abortion language. One of the country's most divisive issues, abortion has been a flashpoint in Congress for decades. Democrats on Friday expressed concern that Republicans may be mounting a renewed anti-abortion push. (Cornwall, 3/20)

The charged politics of abortion have returned with a vengeance in the Senate, creating a bitter impasse over a human trafficking bill that has galvanized outside groups ahead of the 2016 elections. Senators for two weeks have debated a provision in an anti-trafficking bill that Democrats charge would expand the Hyde Amendment, which for decades has restricted the use of federal funds for abortions. The debate over the provision has been unusually rancorous, with Democrats accusing Republicans of misleading them about whether the language was in the bill. (Carney, 3/21)

The Senate's 100 members don't agree on much. They agreed they wanted legislation to help the victims of sex trafficking. Then the bill got caught up in the emotional and uncompromising politics of abortion. Now the Justice for Victims of Trafficking Act is stalled, its outlook uncertain. Democrats are insisting Republicans remove an abortion funding provision. Republicans are refusing to do so and demanding that Democrats back down. (Werner, 3/21)

Facing a difficult election map in 2016, Senate Republicans are steering clear of entitlement reform changes that their House counterparts are demanding. Republicans in both chambers unveiled budgets earlier this week, with an eye towards negotiating a single fiscal plan in April. But while both budgets would balance within a decade by making trillions of dollars in cuts, their approach to Medicare is markedly different. (Schroeder and Becker, 3/21)

The new House and Senate Republican budgets make a big boast: They both balance the federal budget within 10 years, without raising taxes. Their own numbers, however, say millions of American families and businesses would have to pay more in taxes to make the math work — about $900 billion more over the next decade. Both budgets also claim big savings by repealing President Barack Obama's health law. But at the same time, they rely on more than $1 trillion in tax revenue from the health law that would supposedly be repealed. (Ohlemacher, 3/21)

House Republicans will vote this week on a budget resolution as well as a rare bipartisan compromise by Speaker John Boehner (R-Ohio) and House Minority Leader Nancy Pelosi (D-Calif.) designed to resolve a long-running problem over how much doctors are paid by the Medicare program. (Bresnahan and Kim, 3/22)

Senior White House adviser Brian Deese on Friday challenged Republicans in the House and Senate to say precisely how they would change Medicare and Medicaid. Deese’s comments come after Sen. Chuck Grassley (R-Iowa), a senior member of the Senate Budget panel, said earlier this week that Republicans should put the baseline figures allocated to the programs in the budget and not list the reforms. (Cirilli, 3/20)

Cruz, who was elected to the Senate in 2012, soon established himself as an uncompromising conservative willing to take on Democrats and Republicans alike. He promises to repeal the federal health care law, abolish the Internal Revenue Service and scrap the Education Department. (3/23)

The Federal Bureau of Investigation has been investigating Mr. Menendez for more than two years, these people said. The specific charges weren’t immediately clear, but the agency has been probing whether Mr. Menendez took things of value from a friend and donor Salomon Melgen, a prominent Florida eye doctor who is facing a probe into his billing practices, according to people familiar with the probe. After the investigation began, Mr. Menendez paid Dr. Melgen back nearly $60,000 for two round-trip flights on a private plane to the Dominican Republic, trips that the senator didn’t initially report on disclosure forms, aides have said. The FBI has also examined whether the senator improperly sought to help the doctor in his billing probe and whether Mr. Menendez may have improperly used his influence with the Department of Homeland Security on behalf of the doctor on an unrelated issue, according to people familiar with the investigation. (Barrett, 3/22)

A decision to file criminal charges against Menendez and a Florida doctor, Salomon Melgen, is expected soon, according to government officials briefed on the case. Menendez is suspected of receiving gifts in return for helping Melgen's business interests in the Caribbean. Both men deny any wrongdoing. Supporters of the anti-corruption unit say it has learned from its mistakes. It has sharpened its prosecutorial skills with dozens of state and local cases, and shifted its focus away from plea bargains toward winning cases at trial. The [Sen. Ted] Stevens case unraveled in part because the defense moved for a quick trial, catching the prosecution by surprise. (Serrano and Phelps, 3/22)

Charges are expected against Mr. Menendez in the next few weeks, and comparisons to the Stevens case are sure to follow. But officials and others close to the investigation say Mr. Menendez’s case diverges in crucial ways from the one brought against Mr. Stevens, which was dismissed after prosecutors were found to have withheld evidence. Most important, prosecutors never charged Mr. Stevens with doing anything in return for his gifts. The Justice Department’s case against Mr. Menendez, by contrast, appears to be going much further. Prosecutors believe Mr. Menendez used his office to help Salomon Melgen, a Florida eye surgeon who was a major donor to Mr. Menendez and the national Democratic Party. The department is weighing charges of bribery or accepting gratuities, according to people close to the case. (Apuzzo, 3/23)

When President Barack Obama signed the Affordable Care Act five years ago, he visualized a time when the political hyperbole would be silenced and ordinary people would see that the health care law improved their lives. The White House ceremony on March 23, 2010, was an applause-filled celebration. "When I sign this bill," Obama said, "all of the overheated rhetoric over reform will finally confront the reality of reform." (Alonso-Zaldivar, 3/22)

With more than 50 congressional repeal votes, a near-death Supreme Court experience and a botched marketplace debut to its credit, the Affordable Care Act has had a tortured five-year existence as the Republican Party’s legislative enemy No. 1. And since President Barack Obama signed the health care measure into law on March 23, 2010, its troubled legislative history isn’t close to being fully written. (Pugh, 3/20)

More than 90 new health-care companies employing as many as 6,200 people have been created in the U.S. since Obamacare became law, a level of entrepreneurial activity that participants say may be unprecedented for the industry. (Wayne, 3/20)

Challenges remain, including another court case that could unravel a key part of the law. But regardless of future problems, Obama’s signature domestic achievement has already left its footprint on the health care sector. Designed to expand access to affordable health insurance, curb the cost of care and make Americans healthier, the law has probably irreversibly changed how consumers interact with the industry. (Shapiro, 3/22)

The number of new diabetes cases identified among poor Americans has surged in states that have embraced the Affordable Care Act, but not in those that have not, a new study has found, suggesting that the health care law may be helping thousands of people get earlier treatment for one of this country’s costliest medical conditions. (Tavernise, 3/23)

Low-income patients with diabetes are getting better access to medical care in states that have expanded Medicaid coverage through the Affordable Care Act, suggests a new study that provides one of the first indications of the sweeping law's health effects. Residents of other states are at risk of being left behind. The number of Medicaid patients with newly identified diabetes surged 23% in states that expanded their programs, an option provided by the law, but there was virtually no increase in states that declined to expand coverage, researchers found. (Levey, 3/23)

For the study, researchers analyzed test results, stripped of identifying information, of Medicaid recipients diagnosed with diabetes in the first half of 2014. They found that diabetes cases jumped 23 percent from the year before in the 26 states and the District of Columbia, all of which expanded their Medicaid programs. In the nonexpansion states, the increase was less than 1 percent. The analysis is being published online in Diabetes Care, the official publication of the American Diabetes Association. (Sun, 3/23)

More than 11 million Americans have joined the Medicaid rolls since the major provisions of the Affordable Care Act went into effect, and health officials are searching for ways to contain the costs of caring for them. Some of the most expensive patients have medical conditions that are costly no matter what. But a significant share of them — so-called super utilizers like Mr. Pate — rack up costs for avoidable reasons. Many are afflicted with some combination of poverty, homelessness, mental illness, addiction and past trauma. (Tavernise, 3/22)

More than 11 million more people have health insurance under Medicaid or the Children's Health Insurance Program (CHIP) compared to when the core of ObamaCare took effect in 2013, according to data the administration released Friday. (Sullivan, 3/20)

The Affordable Care Act's Medicaid expansion has had a positive impact on health insurers' business, but now plans are looking for other ways to grow. Medicaid plans experienced an initial bump of 10.8 million new enrollees in 2014 because of the healthcare reform law. But future growth among those newly eligible members in the 28 states that have approved expansion won't be as large, some experts say. (Sandler, 3/21)

Rep. Paul Ryan urged state lawmakers to resist setting up state insurance exchanges if the Supreme Court rules that key parts of the Affordable Care Act can only continue if they do so. “Oh God, no…The last thing anybody in my opinion would want to do, even if you are not a conservative, is consign your state to this law,” the Wisconsin Republican told state legislators Thursday during a conference call organized by the Foundation for Government Accountability, a conservative think-tank. The foundation provided a recording of the call. (Radnofsky, 3/20)

After two years marked largely by disappointment, lawmakers and health care experts warily are eyeing Minnesota's health insurance exchange as it nears its toughest test yet. The federal money MNsure heavily has leaned on will be gone by the end of the year, and it will have to keep afloat from the fees it pulls in from private plan sign-ups. Health care consultants and academics say it's too early to declare MNsure and other state-run exchanges unsustainable, but they see troubling signs. (Potter, 3/22)

This filing season, for the first time, millions of Americans are facing tax implications — and new forms that even seasoned preparers are finding confusing — related to their health insurance status. The changes are not only complicating things for tax filers, but also costing many of them money. Under the Affordable Care Act, people who remained uninsured last year must either pay a penalty with their taxes, one of the most contentious elements of the law, or claim an exemption. ... And people who did get insurance but, like Mr. Ciesielski, underestimated their income for 2014 — the figure on which subsidies are calculated — are being required to pay back part of their subsidy. (Goodnough, 3/21)

A special enrollment period to obtain health insurance for millions of uninsured people who owe a tax penalty under the Affordable Care Act is off to a slow start. The health law requires most Americans to have insurance or pay a fine at tax time. The open enrollment period under the health law ended Feb. 15, but the Obama administration said it would allow people who discover they owe a fine to sign up for coverage through April, at the end of the tax season. Major tax-preparation firms say many customers are paying the penalty and not getting health insurance. (Armour, 3/20)

Complying with the health care law is costing small businesses thousands of dollars that they didn't have to spend before the new regulations went into effect. Brad Mete estimates his staffing company, Affinity Resources, will spend $100,000 this year on record-keeping and filing documents with the government. He's hired two extra staffers and is spending more on services from its human resources provider. (Rosenberg, 3/22)

The Obama administration said Friday it's making progress trying to correct a tax-form error that affected 820,000 customers of HealthCare.gov. Administration officials said 740,000 corrected forms have gone out to consumers in the federal insurance marketplace, and another 80,000 will be mailed next week. (3/20)

Last year, the fallout from a string of breaches at major retailers like Target and Home Depot had consumers on edge. But 2015 is shaping up to be the year consumers should be taking a closer look at who is guarding their health information. Data about more than 120 million people has been compromised in more than 1,100 separate breaches at organizations handling protected health data since 2009, according to Department of Health and Human Services data reviewed by The Washington Post. (Peterson, 3/20)

The task of investigating medical data breaches falls to the Office for Civil Rights, a small agency within the Department of Health and Human Services. Its staff of about 200 investigates thousands of complaints every year, large and small. Last month, ProPublica reported how, as the number of breaches has increased, the office infrequently uses its authority to fine organizations and health providers that fail to safeguard patient records. ... [The office’s director, Jocelyn Samuels,] sat down with ProPublica to talk about the current state of health privacy. (Ornstein, 3/20)

Insurance regulators in states including Washington and Alaska are launching an investigation into the cyberattack on health insurer Premera Blue Cross. State watchdogs will look into “what happened, how it happened, and what the end result or consumer impact is,” Lori Wing-Heier, director of Alaska’s Division of Insurance, said Friday. (Tracer, 3/20)

California public health leaders are joining an open data movement that is igniting enthusiasm nationwide for its potential to improve health care delivery. The hope is that health care policymakers, tech-savvy entrepreneurs, advocacy groups, coders – or anybody with a computer and Internet access – will mine the data to identify gaps, and fixes, in California’s public and private health care systems. (Craft, 3/20)

Staph infections are common problems in health care facilities, and many Staphylcoccus aureus bacteria are now resistant to drug treatment. ... But wouldn't it be cool to track in detail how staph moves from person to person in the real world? Some French researchers tested a way to do it. They outfitted 261 health care workers and all 329 patients in a long-term care hospital with wireless sensors that recorded their interactions with one another every 30 seconds. (Henley, 3/20)

Tenet Healthcare Corp. is nearing a deal to buy United Surgical Partners International Inc., as a number of hospital networks seek mergers amid sweeping changes in the U.S. health-care system. A deal between the companies, which could be valued at more than $2.5 billion, including debt, might be announced as early as Monday, according to people familiar with the matter. It is also possible the deal could fall apart at the last minute. (Tan and Cimilluca, 3/22)

Fee-for-service medical care, in which providers charge fees for specific services, is a prime battleground for policy makers in health care. If providers stand to make more money the more tests and procedures they perform, critics of the system say it’s no wonder that health-care costs have skyrocketed in recent years. Efforts are under way to reimburse providers based on the value, not the volume, of care—including paying doctors to keep patients healthy. Medicare plans to shift 50% of its payments to such programs by 2018. (3/22)

The push to pay for quality, not quantity in health care is rapidly accelerating. Doctors and hospitals are being evaluated on myriad quality metrics by rating services, insurance companies, professional groups and government programs—with results increasingly tied to financial penalties or bonuses. But payers, providers and patients don’t always agree on what quality means, and there is no official set of standards. (Beck, 3/22)

As recently as 1969, delivering a baby in Morristown, N.J., could cost parents as little as $235.65 — a flat, all-inclusive rate for a three-day hospital stay and doctors' fees. I know this because that was the price on the receipt from my birth at Morristown Memorial Hospital. My father recently found it in a pile of old papers. ... The simple, one-page document lists my parents' names, the total cost of care and just three options for payment: cash, check or money order. There were no co-pays, co-insurance or deductibles to meet. My parents didn't receive an onslaught of bills once they left the hospital. (Zamosky, 3/22)

Over the past three years, the number of people covered under Eastern Maine Healthcare Systems' value-based payment contracts has swelled from 9,400 to 100,000. In that period, the eight-hospital not-for-profit system has seen emergency department visits decline 2.8 percent, admissions drop as much as 21 percent, and primary-care visits jump 23.7 percent. The system calculates that it has lowered its per-member, per-month Medicare cost trend by 4.7 percent, and healthcare costs for its employees have grown less than 5 percent. (Kutscher, 3/21)

Gilead Sciences Inc. said nine patients taking its hepatitis C drugs Harvoni or Sovaldi along with the heart treatment amiodarone developed abnormally slow heartbeats and one died of cardiac arrest. Three required a pacemaker to be inserted. The patients were all taking amiodarone, with three also using Harvoni, five receiving Sovaldi with Bristol-Myers Squibb Co.’s daclatasvir and one on Sovaldi with Johnson & Johnson’s Olysio. Gilead said the combinations aren’t recommended and it will update its product labeling. (West, 3/21)

A Biogen Idec Inc. drug that targets plaque buildup in the brain slowed cognitive decline in patients with early and mild forms of Alzheimer’s disease in a small, early-stage study, lifting the company’s stock to all-time highs and adding to the debate on how to treat the debilitating disease. (Walker, 3/20)

An experimental drug for Alzheimer’s disease sharply slowed the decline in mental function in a small clinical trial, researchers reported Friday, reviving hopes for an approach to therapy that until now has experienced repeated failures. The drug, being developed by Biogen Idec, could achieve sales of billions of dollars a year if the results from the small trial are replicated in larger trials that Biogen said it hoped to begin this year. Experts say that there are no really good drugs now to treat Alzheimer’s. (Pollack, 3/20)

Medical devices can save lives, but in recent years it has become clear how hazardous they are when they malfunction: metal hips that fail; bloodstream filters that fracture and prove lethal; defibrillator wires that break down. The Food and Drug Administration works at striking the proper balance between insisting on safety but not standing in the way of innovative products that promote health and well-being. In doing so, it’s dealing with increasingly complex products of the software and digital age, including some aimed directly at consumers, such as medical apps. (Burton, 3/22)

Mari Velar, who has lupus and osteoporosis, has bones as fragile as butterfly wings. To keep them from breaking, she depends on an IV drip of a bone-strengthening fluid, which costs a lot more than pills. Whenever she has a new plan or new doctor, she has to switch to the cheaper therapy until she begins to itch. “In order to appease the doctor, I have to try the drug and show them the hives and prove to them that I cannot take the drug,” says the 54-year-old Tampa woman. Florida Sen. Don Gaetz says that what happens to patients like Velar is an abuse of managed care. Gaetz, a Republican from the Panhandle town of Niceville, is sponsoring the “Right Medicine, Right Time Act” to fight it. (Gentry, 3/20)

The number of medical malpractice claims fell to a record low in Wisconsin last year as the state-managed insurance fund for the doctors grew to more than $1.2 billion, newly released records show. (Spivak, 3/22)

It could have happened anywhere, but it was on the high plains of Guthrie, Texas — 90 miles east of Lubbock — where Dannie Tiffin suddenly collapsed of a heart attack last spring. No one knows for certain, but doctors and hospital staff in this rural area say they’re pretty sure the 62-year-old electrician could have made it, had he gotten care in time. (Walters, 3/20)

Less than two weeks after Prime Healthcare Services abandoned its $843 million bid for the nearly bankrupt Daughters of Charity Health System, several potential buyers are expressing interest in one or all six of the hospitals, according to the nonprofit Catholic chain. (Seipel, 3/22)

Nonprofit insurer Blue Shield of California, already under scrutiny for its huge cash reserves and lack of disclosure, is refusing to say how much it's spending to acquire a Monterey Park insurance company and is seeking confidentiality from state regulators. The California Department of Managed Health Care said Friday it was still weighing Blue Shield's request for confidentiality after receiving a public-records request from The Times and being asked to hold a public hearing on the deal by a former company official. (Terhune, 3/20)

As the recession decimated Sacramento County’s revenue in 2009, supervisors voted to end health care for undocumented immigrants. For some it was a painful decision. For others it was overdue. Today the county’s finances are in better shape, and supervisors are cautiously looking at restoring some level of health care services to thousands of low-income residents who are not here legally. State lawmakers also are considering policy changes that would broaden health care assistance for undocumented residents. (Sangree, 3/20)

Nearly three months after the launch of new rules banning the warehousing of mentally ill patients in Washington state and after millions in new spending to boost care, experts in psychiatric evaluation and those on the front lines say the revamped system is off to an uncertain start. The state Supreme Court ruled last August that it is unconstitutional to detain and hold psychiatric patients in settings such as emergency rooms without providing appropriate treatment. In the wake of that decision, critics charge that some detained patients are receiving only “Band-Aid” mental-health care — while others who should be held are being turned away, even when they might pose a danger to themselves or others. (Aleccia, 3/21)

In response to a scathing report released Thursday by the Minnesota Office of the Legislative Auditor, the University of Minnesota has announced that it is suspending enrollment into interventional drug studies being overseen by its psychiatry department until independent reviewers can determine that the studies fully protect all patients. The new report is a stunning rebuke of the university’s handling of the tragic and troubling case of Dan Markingson, a mentally ill young man from St. Paul who committed suicide in 2004 while enrolled in a U of M industry-sponsored clinical trial of the antipsychotic drug quetiapine (Seroquel). (Perry, 3/20)

The Arizona House has again scheduled debate on a bill barring women from buying any health care plan through the federal marketplace that includes abortion coverage after two previous delays. Debate on the proposal backed by the Center for Arizona Policy is now set for Monday. (3/23)

A federal judge on Friday struck down a Wisconsin law requiring doctors performing abortions to get hospital admitting privileges, ruling that any benefits to women's health from the requirement are "substantially outweighed" by restricting women's access to abortion. U.S. District Judge William Conley, who earlier had put the law on hold, ruled that the 2013 law is unconstitutional. He issued a permanent injunction blocking its enforcement. (3/20)

Like most mothers, Julie Krashin was preparing for her twin babies to be delivered on their due date. But the twins came eight-and-a-half weeks early and had to be rushed to the neonatal intensive care unit (NICU) at Saint Luke’s Hospital in Kansas City. Three days into their stay, Julie and her husband Jeremy lost their daughter Ilana. (Booker, 3/20)

A rural Western North Carolina clinic offers care to those who’ve ‘fallen through the cracks in the system.’ (Sisk, 3/23)

Federal experts are being brought in to try to contain a southern Indiana HIV outbreak that has grown to 55 confirmed cases and 13 other preliminary positive cases, the Indiana State Department of Health said Friday. A medical team from the Centers for Disease Control and Prevention will arrive in Scott County on Monday to help state staff with follow-up contacts of HIV-positive individuals and data analysis, the agency said. (3/20)

Congress is within reach of trashing the old and unworkable formula that Medicare uses to pay doctors. By itself, this is what it sounds like -- a bureaucratic maneuver that matters little to anyone but the doctors who treat Medicare patients. The system that Congress replaces it with, however, could represent a big step forward in improving the quality, and lowering the cost, of everyone's health care. (3/20)

House Republicans have no qualms about leaving millions of low-income Americans without health coverage, as evidenced by their repeated votes to repeal Obamacare. But they're so skittish about reducing access to Medicare, the federal insurance program for senior citizens and the disabled, that they may vote for a bill to shore up the program in defiance of their party's deficit hawks. It's past time they did. (3/20)

House leaders filed “doc fix” legislation Thursday afternoon, but they have not yet released the legislative language surrounding the parts of the bill that would be paid for. A summary circulating among lobbyists in Washington suggests as one of the “pay-fors” a Medicare Advantage timing shift—a budget gimmick that would shift plan payments into a future fiscal year, masking overall Medicare spending levels. (Chris Jacobs, 3/20)

President Obama signed the Patient Protection and Affordable Care Act into law five years ago Monday, an anniversary that congressional Republicans will soon observe with another symbolic vote to repeal it. The general public isn't as eager to do away with the law, widely known as Obamacare, but surveys show little love for it — a view that hasn't shifted much over time. Meanwhile, the Supreme Court is considering a legal challenge that could render the law's landmark insurance reforms unsustainable in most states. So it's not exactly a happy birthday for Obama's landmark legislative achievement. Despite the relentless attacks, however, the act has been a notable success on one front: It has helped millions of Americans obtain insurance coverage that would otherwise be out of their reach. (3/22)

Kevin Drum, whose penetrating blog posts at Mother Jones are must-reading for anyone with a serious interest in economics and public policy, was diagnosed last year with multiple myeloma, a cancer of the blood plasma cells. Since then, he has allowed his readers to traverse the healthcare landscape with him via regular updates. This week he connected the dots between his medical condition and the Republican Party's oft-expressed determination to repeal the Affordable Care Act. Drum wrote that, because of his condition, Republican healthcare policy sharply raises the stakes of the 2016 election for people in his position. By undoing the Affordable Care Act, he observed, a Republican Congress and Republican president could leave millions of Americans without access to affordable coverage. (Michael Hiltzik, 3/20)

Republicans are wrong on Obamacare, and they are hypocrites in the way they oppose the law. The House GOP’s latest budget is yet another example. Republican opposition to Obamacare, at its core a centrist health-care reform, stepped out of the realm of the rational and into the realm of the theological long ago. One indication has been the hysteria over the law’s “death panels.” Experts and professional fact-checkers have debunked the notion that the Affordable Care Act would empower a faceless government board to deny critical health-care procedures, the Obama-era equivalent of pushing inconvenient seniors onto ice floes. But the GOP’s death-panel nonsense still has a hold on the party, its illogic written explicitly into the House’s budget. (Stephen Stromberg, 3/22)

From Social Security to Medicare, Republicans have pushed to privatize government entitlements. Now Gov. Terry Branstad seeks to hand over management of Iowa’s $4.2 billion Medicaid program to a few private companies. The public should be skeptical. The more than 500,000 poor and disabled individuals and families in Iowa who rely on Medicaid should be asking questions. The federal government should be reluctant to approve the waiver that Iowa needs to privatize a program funded by state and federal dollars. (3/22)

Kansas Gov. Sam Brownback recently traveled to Jefferson City to tutor Missouri legislators on tax cuts. But while visiting the neighboring state’s capital, he made a stunning remark that had nothing to do with his controversial supply side experiment. Brownback said he was neither for nor against expanding Medicaid, the health care program for the poor, “if it meets his own personal financial concerns.” But he said if he was presented with a proposal to expand Medicaid in Kansas, he would likely sign the bill. This is a complete turnabout for Brownback and a thrilling one, indeed. (Steve Rose, 3/21)

If I were to tell you there was a pipeline project that would generate 4,000 permanent jobs and have a 28 to 1 return on investment, and that certain elected officials were stopping it, Alaskans might teeter on the verge of riot. Well, this project isn’t a pipeline with all its inherent obstacles to fruition; it is much simpler than that. This project can be done with a simple vote of 21 members of the Alaska State House and 11 members of the Alaska State Senate. So what is this can’t miss project? Medicaid expansion. In addition to all the benefits listed above, this bill would allow about 40,000 Alaskans to access badly needed health care. (Vince Beltrami, 3/22)

The Supreme Court has not even decided King v. Burwell, and the case is already producing new legal scholarship. For instance, Chapman law professor Ronald Rotunda has a new paper discussing King v. Burwell, “King v. Burwell and the Rise of the Administrative State.” (Jonathan H. Adler, 3/22)

In the past five years about $30 billion of federal incentive payments have succeeded in rapidly raising the adoption rate of electronic health records. This computerization of health care has been like a car whose spinning tires have finally gained purchase. We were so accustomed to staying still that we were utterly unprepared for that first lurch forward. Whopping errors and maddening changes in work flow have even led some physicians to argue that we should exhume our three-ring binders and return to a world of pen and paper. This argument is utterly unpersuasive. (Robert M. Wachter, 3/21)

[At Noah's funeral, a] minister read the poem “There Are Men Too Gentle to Live Among Wolves.” That was Noah. Gentle, and then the disease sunk in its claws. Sometimes, I think of the ones who brought the drugs as wolves, because a dark part of me hates them. But maybe they are just broken boys. One has a father who is an addict. Another lost a sister to drugs. One of the wolves is now clean, and I learned that he'd made amends to Noah. Did the wolf make amends to Noah's parents, who lost their only child? Are parents worthy of amends? Or are we the ones who need to make amends for not protecting our children? (Kerry Madden, 3/20)