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The Supreme Court is scheduled to issue decisions Thursday, with six major cases remaining on the docket, and is expected to release opinions again on Friday and perhaps next week. Still to be decided are the health-law subsidies and gay-marriage cases, along with closely watched rulings involving congressional redistricting and power plant emissions. Here’s a list of the remaining cases. ... King v. Burwell Issue: Whether the Affordable Care Act authorizes tax credits for insurance bought on healthcare.gov, as well as on state-operated insurance exchanges. The case turns on a single word in the 2,000-plus-page statute, in a clause authorizing the tax credits for policies purchased on an exchange established “by” the state. Only 13 states and the District of Columbia currently run their own exchanges. The court could potentially strike down subsidies in as many as 37 states that depend on HealthCare.gov. (6/24)

The future of President Obama's health care law is on the line for the second time in three years, and it's anyone's guess how the court will rule. Passed in 2010 and narrowly upheld by the court in a 5-4 ruling in 2012, the law has extended health insurance to 12 million Americans. But four words in its lengthy text — "established by the state" — now endanger federal subsidies relied upon by 6.4 million participants in 34 states that did not create their own exchanges or marketplaces. The justices must decide whether the law prohibits that financial aid. (Wolf, 6/25)

The Supreme Court is preparing to hand down a decision in the all-important King v. Burwell case, and Justice Anthony Kennedy could again play a key role in deciding the fate of healthcare reform. Kennedy made a comment during the case's oral arguments that led some observers to speculate that he was leaning toward siding with the Obama administration in the case, which centers on a key provision of the Affordable Care Act. (Logiurato, 6/24)

The health care industry was hoping this would be the year it could move beyond the Obamacare fight in Washington and on to new priorities, such as improving drug development and patient care. But the Supreme Court’s upcoming ruling in King v. Burwell threatens to derail those ambitions. (Ho, 6/25)

If the court rules against the Obama administration, millions of people in states using the federal exchange could lose their subsidies. Enter entrepreneurs, who think they’ve found a way to help states set up exchanges almost immediately. Sanjay Singh is one of them. He's CEO and co-founder of hCentive, a tech start-up that supplies the software for state health care exchanges. hCentive helped Kentucky and New York set up their exchanges. They're two of the more glitch-free state marketplaces. (Marshall-Genzer, 6/24).

Michigan's popular Medicaid expansion program will face an uncertain future if the U.S. Supreme Court strikes down a key plank of the Affordable Care Act this month. A case before the nation's highest court seeks to invalidate premium tax credits that more than 225,000 Michigan residents have used to purchase private health insurance through a federal exchange. Those same tax credits are featured in a pending waiver the state must win from the Obama administration in order to continue Healthy Michigan, a federally-funded Medicaid expansion program that has enrolled roughly 600,000 low-income residents since implementation but could be rolled back in 2016. (Oosting, 6/24)

The expansion of medical insurance to 828,000 Michigan residents under two major components of the federal health care law is unsettled at the U.S. Supreme Court and inside the Obama administration. The court will rule in the coming days on the legality of tax subsidies for 228,000 residents who have bought private insurance through a federal marketplace. Michigan, where participants' premiums are offset by an average $273 monthly tax credit, is among 34 states that could be affected. (Eggert, 6/24)

Since Colorado created its own exchange, you might think that the relevance of the King v. Burwell boils down to one word for you: “whatever.” Think again. The King case is likely to have profound reverberations throughout the U.S. Without subsidies in a majority of states, the “individual mandate,” which requires people to buy health insurance, likely would fall apart. And if fewer healthy people buy health insurance, prices could shift dramatically — even in states with their own exchanges. (Kerwin McCrimmon, 6/25)

Tens of thousands of Connecticut residents who receive federal subsidies to help pay for health insurance won’t be affected immediately by the latest challenge to the Affordable Care Act before the U.S. Supreme Court. But experts say there’s a good chance Connecticut residents will experience some political fallout from the court decision challenging the validity of federal premium tax credits to those in states with federally-operated insurance marketplaces (also known as exchanges). The ruling could come as soon as Thursday. (Olivero, 6/24)

With a ruling for "the plaintiff, King, we could find a short-term drop in health care stocks. The for-profit providers and health insurers? (The exchanges have) been good for them," said Fletcher Lance, managing director at consulting firm North Highland. "This could be a short-term blip." The ruling for Team King may have an immediate impact on stock prices of health care companies, but its long-term implications could reverberate far beyond those who invest in stocks or even those who receive tax credits. "It may not impact you directly, but it's going to impact everyone indirectly. Those marketplaces are key to having a fair and just health system that helps those of modest needs get covered," said Peter Leibold, chief advocacy officer for Ascension Health. (Fletcher, 6/24)

A U.S. Supreme Court decision due as early as Thursday could end health care subsidies for nearly 6.4 million residents of states that take part in the federal health insurance exchange under the Affordable Care Act, but most experts say Californians who have subsidized insurance under the state’s own exchange needn’t worry – at least in the short term. (Sangree, 6/24)

If the Supreme Court strikes down Obamacare subsidies in two-thirds of the country, President Barack Obama won't be the only leader offering to assist states that want to undo the damage. Officials in states that created their own health insurance exchanges under the Affordable Care Act -- thereby shielding their residents from the possible consequences of the lawsuit currently pending before the high court -- are standing by to help their counterparts in other states get marketplaces up and running that would allow subsidies in those states to flow again. (Young, 6/24)

There's a chance some of the health insurance premium increases requested by insurers won't be enough [to] cover losses, a state official testified in Washington, D.C. Julie Mix McPeak, commissioner of the Tennessee Department of Commerce and Insurance, said raising rates by 30 percent or more might not even be "sufficient" to cover the soaring costs of medical claims. (Fletcher, 6/24)

North Carolina’s uninsured rate dropped 13 percent in 2014, the first year that most Americans were required to have health insurance under the Affordable Care Act. The new information from the National Center for Health Statistics is the first official government tally of the federal health law’s effect on the uninsured. Government statistics on uninsured rates lag by about year-and-a-half, so that last year’s data from the U.S. Census Bureau is not expected to be issued until September. (Murawski, 6/24)

Views on President Barack Obama's federal health-care law remain unchanged ahead of an upcoming Supreme Court decision that could potentially gut the law, according to a new NBC News/Wall Street Journal poll. (Murray, 6/24)

The American public strongly favors the prospect of the Supreme Court legalizing same-sex marriage nationwide but remains split over the 2010 health law, a Wall Street Journal/NBC News poll finds just ahead of expected high-court rulings on both matters. ... The court is also expected soon to rule on whether low-income residents of states that didn’t set up insurance marketplaces under the 2010 health law are entitled to the same subsidized health insurance as those in states that created their own marketplaces. Support for the law has improved since the disastrous rollout of the new marketplaces in the fall of 2013. The latest poll, which surveyed 1,000 adults between June 14 and 18, found Americans almost evenly divided on the law. (O'Connor, 6/25)

Most Americans want the Supreme Court to side with the government when it decides whether the feds can continue subsidizing insurance premiums in all 50 states under President Barack Obama's health care law, according to polls in recent months. Few, however, have much confidence that the court can rule objectively in the case, King v. Burwell. (Swanson, 6/25)

The Affordable Care Act’s employer mandate doesn’t appear to be driving more employees into part-time work, according to a new ADP study released Wednesday. The findings seem to contradict a frequent criticism from the law’s opponents — that businesses will cut back workers’ hours or add more part-time employees to avoid triggering the Obamacare requirement to offer health insurance to full-time employees. (Karlin, 6/24)

The Supreme Court will decide within days whether federal health insurance subsidies for people in more than 30 states are allowed by law. A broader question is, To what extent are the subsidies responsible for the expansion of health care coverage to millions of Americans under the Affordable Care Act? In short, Have the subsidies succeeded? By many measures, the answer is yes. More than seven million people are enrolled in the federal health insurance marketplaces, and a majority of them — 87 percent — receive subsidies in the form of tax credits to help pay their premiums, the government says. Without subsidies, many would be unable to buy insurance. The subsidies also appear to have drawn substantial numbers of younger, healthier Americans into the new insurance markets... (Pear and Sanger-Katz, 6/25)

Some states are grappling with higher insurance costs for consumers while others are seeing record-low requests for premium increases in 2016 because of the Affordable Care Act, state insurance commissioners told Congress Wednesday. The health law has led to challenges and uncertainty in Tennessee, which is one of three dozen states using the federal health insurance exchange, Julie Mix McPeak, commissioner of the state’s Department of Commerce and Insurance, testified at a House Ways and Means oversight subcommittee hearing. She said the ACA has resulted in less competition and higher costs. (Armour, 6/24)

The Affordable Care Act has a perplexing problem: Many uninsured Americans prefer their old ways of getting health care. For millions, arranging treatment through cash, barter and charity is still better than paying for insurance. They include Lisa Khechoom of Glendale, Calif., who refuses to buy coverage. She says she pays a flat $35 for a doctor visit and often substitutes prescriptions with cheaper natural remedies for herself, her husband and their children. (Radnofsky, 6/24)

The landmark 2010 Affordable Care Act was passed on the premise that more than 50 million Americans didn’t have health insurance, and needed it. Five years in, it’s helped some, and passed over others–some of whom have chosen not to get insurance even thought the law makes it possible for them to do so... (Radnofsky, 6/24)

Republican lawmakers are raising questions about a report from the nonpartisan Congressional Budget Office (CBO) that says repealing ObamaCare would increase the deficit. The report says repeal would add $137 billion to the deficit over 10 years — a huge sum that could complicate the GOP’s response to the looming Supreme Court King v. Burwell ruling on the healthcare law, which is expected as early as Thursday. (Sullivan, 6/25)

The House Appropriations Committee on Wednesday advanced a $153 billion bill funding the Departments of Health and Human Services (HHS), Education and Labor for the next fiscal year, which begins Oct. 1. It marks the first time in six years the full committee advanced a funding measure for those departments, which would receive $3.7 billion less than current funding levels and $14.6 billion less than President Obama’s request for fiscal 2016. (Shabad, 6/24)

For three years, more than $43 million the Department of Veterans Affairs had set aside to inform veterans about their benefits sat in an account, not a penny spent, until an agency financial manager happened to notice. By then, it may have become too late for the cash-strapped agency to spend the money, a new report says. Acting Inspector General Richard Griffin’s audit comes as top VA officials prepare to tell House lawmakers Thursday that they’re facing a $2.6 billion budget shortfall that’s partly responsible for a new explosion in wait times for medical care. Senior leaders say they may have to start a hiring freeze or furlough employees unless funding is reallocated for the federal government’s second-largest department. (Rein, 6/25)

Obamacare could put Republicans in a bind in the run-up to the 2016 U.S. presidential election if the U.S. Supreme Court in the next week upends part of the law designed to make healthcare accessible to all Americans, leaving millions to fend for themselves for health insurance. The court is due to decide by the end of June whether to jettison tax subsidies in 34 states that help low- and moderate-income people buy medical coverage. A political flashpoint since it was signed into law by President Barack Obama in 2010, the Affordable Care Act (Obamacare) makes federal subsidies available to people who cannot afford to pay for health insurance. (Whitesides, 6/24)

If the U.S. Supreme Court strikes down health care subsidies available under federal law, it's up to President Barack Obama and Congress to fix it — not the states, Wisconsin Gov. Scott Walker said Wednesday. Walker, who is expected to launch his run for president in mid-July, wrote an opinion piece and answered questions about the issue following a bill signing ceremony in Milwaukee. The Supreme Court is expected to rule this month on whether subsidies under the 2010 law can continue to go to Wisconsin and 33 other states that use the federal HealthCare.gov website and don't run their own insurance exchanges. (Bauer, 6/24)

Senator Ted Cruz, R-Texas, told viewers Wednesday on "Special Report with Bret Baier" that he would not extend health care subsidies to six million Americans who face the very real possibility of losing them when the Supreme Court issues a ruling on King v. Burwell. (6/24)

The justices will rule any day now in King v. Burwell, a case that could eliminate health insurance subsidies for 6.4 million Americans, including more than 166,000 Wisconsinites. And few Republicans have done more to prepare for the ensuing uproar than [Sen. Ron] Johnson, just as he heads into a closely contested reelection race that could determine the next Senate majority. Johnson is the lead author of legislation aimed at responding to the Supreme Court decision, a bill that has been embraced by 31 colleagues, including Senate Republican leaders. Yet, Democrats already are bashing his plan as nothing more than a political message that has no chance of becoming law — while conservatives believe it is too generous because it temporarily extends those subsidies for up to two years. (Raju and Haberkorn, 6/25)

When Jindal took the stage (to Garth Brooks’s “Callin’ Baton Rouge”), he said he would try to slash the size of the federal government, show strength to American enemies overseas, secure the U.S. border, and try to reform Medicare and Social Security. ... A native of Baton Rouge, he was born Piyush Jindal in 1971 but renamed himself “Bobby” after the youngest son on the “Brady Bunch” sitcom. He became a Rhodes Scholar, a McKinsey consultant and — still in his early 20s — the head of the massive Louisiana health department. (Fahrenthold, 6/24)

Gov. Bobby Jindal of Louisiana has announced his candidacy for the Republican presidential nomination. The first Indian-American governor in the United States, he came to the job in 2008 after three years in Congress. He had previously been president of the nine-member University of Louisiana System and has run the state’s Department of Health and Hospitals. Here are his positions on important issues. ... Mr. Jindal has urged the repeal of the Affordable Care Act. He instead favors “premium support,” a voucherlike program in which the government would give Medicare beneficiaries a fixed amount of money to buy coverage from competing private plans. (Mullany, 6/24)

With Louisiana’s Gov. Bobby Jindal formally launching his presidential bid on Wednesday, 13 high-profile Republicans have officially entered the campaign for the party’s 2016 nomination. Only three major prospects remain: Ohio’s Kasich, Wisconsin’s Walker and New Jersey’s Christie, each planning to announce his intentions in the coming weeks. ... All three appeal to the party’s more moderate voters. Kasich and Christie were among the few Republican governors to expand Medicaid eligibility as part of President Barack Obama’s health care law, they have prioritized treatment for drug addicts and the mentally ill, and both have shown a willingness to stand up to those in the farthest reaches of the party’s conservative base. (Beaumont and Peoples, 6/25)

Mr. Kasich, who said he was still weighing whether to enter the race, is barely registering in Iowa polls. His formidable hurdles in the state include a lack of time visiting it, and a list of center-right policies he has supported that conservative caucusgoers are likely to reject, from expanding Medicaid under the Affordable Care Act to voting for an assault weapons ban while in Congress. (Gabriel, 6/24)

DaVita HealthCare Partners Inc. has been subpoenaed by the U.S. Department of Health and Human Services, in connection with how the company codes diagnoses for Medicare Advantage patients. In a regulatory filling, the Denver-based company said the subpoena covers the period from Jan. 1, 2008, through the present and seeks documents from the company and its subsidiaries. DaVita specializes in kidney care and is one of the largest U.S. providers of dialysis services. (Beilfuss, 6/24)

DaVita Healthcare Partners Inc, the largest provider of dialysis services in the United States, has agreed to pay $450 million to resolve claims that it violated the False Claims Act, the U.S. Justice Department said on Wednesday. It said the Denver-based company, whose largest shareholder is Warren Buffett's Berkshire Hathaway Inc., knowingly created unnecessary waste in administering the drugs Zemplar and Venofer to dialysis patients, and then billed the federal government. (Beech, 6/24)

Denver-based DaVita HealthCare Partners Inc. disclosed Wednesday that it was subpoenaed by the U.S. Department of Health and Human Services for how patient diagnoses were coded under Medicare. The subpoena, which covers the period from Jan. 1, 2008, to the present, relates to HealthCare Partners, the medical and doctors network that DaVita acquired for $4.4 billion in 2012, and HealthCare Partners' subsidiaries, DaVita said Wednesday in a regulatory filing with the U.S. Securities and Exchange Commission. (Wallace, 6/24)

The federal government has expanded its investigation into DaVita HealthCare Partners' Medicare Advantage risk-adjustment practices, DaVita revealed in a Securities and Exchange Commission filing Wednesday. DaVita said in the filing that HHS' Office of Inspector General recently issued a subpoena seeking documents related to DaVita and its subsidiaries' services to Medicare Advantage plans and organizations and “related patient diagnosis coding and risk adjustment submissions and payments” from 2008 to present. The company operates a large multispecialty medical group in addition to its main dialysis business. (Schencker, 6/24)

Many kidney failure patients continue to receive critical dialysis treatments through catheters, a vein access method that is widely known to increase the risk of serious infections, blood clots and even death. The best method (an arteriovenous fistula) is not always the first resort, despite more than 20 years of evidence and national best-practice campaigns encouraging its use. It's a problem some associate with poor access to care, misaligned reimbursement incentives and geographic disparities. (Rice, 6/24)

High-deductible plans are changing the way health systems interact with their patients, from where they get care to how they're presented with their bills. The changing healthcare environment was a significant focus of the Healthcare Financial Management Association's annual National Institute this week in Orlando, Fla. (Kutscher, 6/24)

The story of Renaissance offers a view inside the intoxicating brew of hype and hope in the field of genetic testing. All over the country, labs and research firms are popping up, eager to study strands of DNA to better identify who is at risk for developing a disease, to guide existing treatments and to develop new ones. But the troubles at Renaissance speak volumes about how difficult it is for Medicare and private insurers to keep up with the proliferation of tests being offered. (Abelson and Creswell, 6/24)

Oscar's website and app hammers that point home. Signing up is as easy as answering a few multiple choice questions. There are discounts for being active, which is tracked by a free wearable. Customers get two free primary care visits a year and free generic drugs. All plans are the same, except that a higher premium gets you a lower deductible. As for doctor responsiveness, [co-founder Joshua] Kushner – a Manhattan real estate scion whose brother, Jared, is married to Ivanka Trump – taps the Oscar app to request a call from his doctor, then minutes later grins as his physician's voice comes on the line. (della Cava, 6/24)

A panel of health experts stopped short of recommending that all American adolescents and young adults be vaccinated against a dangerous strain of meningitis that has caused outbreaks at Princeton University and the University of California campus in Santa Barbara, opting instead to let doctors decide whether to give the vaccine. (Tavernise, 6/24)

Teens and young adults should get new vaccines to prevent potentially deadly meningitis B infections, but only through individual decisions, not routine recommendations, a federal panel of experts decided Wednesday. The 14-1 vote by the Advisory Committee on Immunization Practices (ACIP) falls short of the broad recommendation urged by parents whose children died from the disease and victims left disfigured or disabled. They said they feared the limited advisory will curtail wide access to the lifesaving shots. (Aleccia, 6/24)

Thinking he would be too groggy to recall a doctor's post-op instructions after a routine colonoscopy, a Virginia man turned on his cellphone to record them. When he replayed the conversation on his way home, however, he heard more than his gastroenterologist's instructions. The man had inadvertently recorded his anesthesiologist and doctor disclosing his private health information during the 2013 procedure, as well as openly mocking him and laughing at his fear of needles. (Schachar, 6/25)

NPR's Rachel Martin interviews Katie Watson, a professor of medical humanities at Northwestern University, about the doctors who made inappropriate jokes about a sedated patient. (6/24)

A group of religious institutions is considering an appeal of a federal court ruling this week that found certain birth-control provisions of the Affordable Care Act don't violate the religious rights of faith-based groups. A three-judge panel of the 5th U.S. Circuit Court of Appeals in New Orleans delivered its ruling Monday, which was a consolidation of several cases brought by Texas-based religious institutions, including universities and charities, and a Pennsylvania seminary. (6/24)

If your health insurance is covered by UnitedHealthcare, you may soon opt to connect with a doctor virtually, without leaving your house. The nation's largest health insurer announced in April that it's expanding coverage for video-based doctors visits. (6/24)

An abortion rights group will ask a Kansas judge Thursday to block the state's first-in-the-nation ban on what it says is the most common method for terminating second-trimester pregnancies, contending that the new law would force some women to either accept higher medical risks or forgo abortions. (6/25)

At the hands of the Texas Legislature, the last four years have been long for supporters of abortion rights. The next blow lands on July 1, when a new law will go into effect in Texas and drastically reduce access to abortion services — likely leaving just nine clinics that perform abortions open in the entire state. The controversial law, passed in 2013, requires clinics to meet tougher building standards and doctors to have admitting privileges at a nearby hospital. (Goodwiyn, 6/24)

After fervent feedback from the medical community, state Medicaid leaders decided they will not reduce provider rates as part of the cuts they will make to balance the agency's budget. ... Agency leaders say they must make about $40 million in budget cuts to balance their budget. (Cosgrove, 6/24)

Legislative analysts are warning that the growing price tag for providing health care to low-income New Mexicans will put more pressure on the state’s finances going forward unless steps are taken to control costs. After a lengthy review of the state’s Medicaid program, analysts with the Legislative Finance Committee found that New Mexico won’t save as much money as first projected because cost-containing measures have proven difficult to implement during the program’s first year. Changes in the way data is now collected also left analysts questioning whether participants in the program – known as Centennial Care – are receiving more or less care than previously. (Bryant, 6/25)

While radiologists are appealing to legislators to roll back their rate cut, some patient advocates are raising a broader concern, warning that cuts to providers who treat Medicaid patients could become more common as state leaders look to squeeze costs from the growing program. The result, they fear, is that it could become harder for the more than 725,000 state residents with Medicaid to find specialists to treat them, undermining the effectiveness of the expansion of Medicaid coverage that took place as part of the federal health law. (Levin Becker, 6/25)

Future state employees could lose one of the biggest perks of government work: Free health insurance in retirement. The proposed change appears deep within the Senate’s 500-page budget bill and attracted little notice when the budget was debated last week. Senate leaders say the state must rein in rising costs associated with retiree health coverage. (Campbell, 6/24)

Operators of surgery centers across Connecticut are working to persuade state lawmakers to scrap a new tax in the Democratic budget they claim will prompt some facilities to close. The centers provide colonoscopies, cataract removal and other outpatient procedures. The Connecticut Association of Ambulatory Surgery Centers says about 15 of the group's 61 member centers will be forced to close if the 6 percent "provider tax" included in the two-year, $40.3 billion budget becomes law. (Haigh, 6/24)

Gov. Jerry Brown signed a new $167.6-billion budget Wednesday that expands child care, boosts funding for public schools and opens the state's public healthcare program to children in the country illegally, but leaves some key issues unresolved. (Megerian, 6/24)

Households may find medical bills absorb an increasing share of their income, but as consumers, their ability to shop among hospitals and clinics remains limited. For more than a year, Massachusetts hospitals and clinics have been required to respond within two business days to consumers' request for a price. That proved to be difficult for some Massachusetts hospitals surveyed by the public policy think tank Pioneer Institute, which surveyed 22 hospitals and 10 clinics on the price of a common and uncomplicated imaging service, an MRI without contrast. (Evans, 6/24)

The provider of ambulance and paramedic services in Camden could change abruptly if a bill that's moving quickly through the state Legislature is adopted. The move would benefit Cooper University Hospital, where the chairman of the board is Democratic powerbroker George Norcross. Supporters of the change said it could also improve public health, but the hospital that now provides paramedics in the city said it's not the way a change should be made. (Mulvihill, 6/24)

As the Oak Park River Forest Infant Welfare Society Children's Clinic looks after the area's most needy patients, the clinic still hopes it can offer even more.The clinic is one of three organizations in the running for a $100,000 grant offered by the Delta Dental Foundation, and clinic officials have big plans for the award if they are the lucky recipients. In addition to providing health services, the clinic, located at 320 Lake St. in Oak Park [Illinois], offers its patients dental and behavioral health services as well. (Schering, 6/24)

State laws have played a big part in boosting the number of hospitals where specialized stroke care is available, a new study shows. During the study, the increase in the number of hospitals certified as primary stroke centers was more than twice as high in states with stroke legislation as in states without similar laws. At these hospitals, a dedicated stroke-focused program staffed by professionals with special training delivers emergency therapy rapidly and reliably. (Doyle, 6/24)

From their work as benefit consultants, Jennie Korth and Melissa Marrero sensed an opportunity in an emerging trend, and they had enough confidence in their instincts to strike out on their own. Korth and Marrero, who worked for Towers Watson, one of the country's largest benefit consulting companies, started Health Exchange Resources, a consulting firm that specializes in private exchanges, in February 2013. (Boulton, 6/24)

Charlotte business leaders and public officials arrived in Nashville on Wednesday to learn economic development do’s and don’ts from a city that officials said outperforms Charlotte in some ways but lags it in others. Officials from Charlotte also discussed how more collaboration within its own health care sector could help it grow, in the same way the industry has expanded in Nashville. Roughly 130 Charlotte leaders, including Mayor Dan Clodfelter, were estimated to be part of the first day of the Charlotte Chamber’s annual intercity visit, which runs through Friday. It marks the first time it’s been in Nashville since 2004. (Roberts, 6/24)

In 2011, the North Carolina youth smoking rate hit an all-time low. In 2013, the state hit a different kind of low — legislators reduced funding for tobacco control and prevention programs to zero, and it’s stayed there ever since. Tobacco use rates among high school students rose from 25.8 percent to 29.7 percent between those two years, according to the North Carolina Youth Tobacco Survey. (Herzog, 6/25)

A key portion of President Barack Obama's health-care policy could fall at the U.S. Supreme Court this week. Just when Republicans are close to achieving one of their top goals, however, the party is in disarray. As a result, I'd bet that Obamacare is going to survive this challenge -- whatever the court decides -- pretty much unscathed. ... Republicans should have been prepared to respond. Ideally, they'd be ready to advance a bill that would ensure that Obamacare's regulations -- such as its required package of essential benefits -- no longer apply in the affected states while offering tax credits to people who could lose their insurance and who lack access to employer coverage. Then Congress would pass the bill and Obama would sign it. But after months of observing and talking to Republicans, I don't expect this to happen. Instead, I expect Obama to get most of what he wants. (Ramesh Ponnuru, 6/24)

I guess people with strong political preferences have always had a hard time accepting facts that are at odds with those prejudices; but I do also think that it has gotten worse in modern America thanks to the closed information loop of movement conservatism and the incestuous amplification it brings. You see it in things like the rise of inflation trutherism; you also see it in the inability of many on the right to accept the reality that Obamacare really has covered a lot of previously uninsured Americans. (Paul Krugman, 6/24)

With only three decision days still scheduled for this Supreme Court Term (Thursday, Friday, and Monday), the waiting for the Court’s decision in King v. Burwell will soon be over. Can there still be something new to say or think about at this point? Remarkably, the answer is yes. Lost in these discussions – especially those that have focused on the potential for immediate disarray in state insurance markets – has been the procedural posture of the litigation now pending before the Supreme Court. Sometimes, and this is one of those times, analysts have to view the courts as, well, courts – governed by procedural rules that normally apply to courts and that govern their behavior and outcomes. (James Blumstein, 6/24)

It's a little awkward to defend something that doesn't yet exist. But the Independent Payment Advisory Board is in danger of being killed before it's born, thanks to a vote in the House Tuesday, and that would be a mistake -- an extremely costly one both for Medicare, the program it's meant to support, and for the entire federal budget. The payment board is meant to apply a brake on rising Medicare spending. If costs grow beyond a certain level, the IPAB is to come up with cuts to bring them down. (6/24)

In 1990, federal spending equaled about 21 percent of the economy, gross domestic product (GDP). Social Security and major health programs (mainly Medicare and Medicaid) represented a little less than one-third of all spending. The rest was defense, domestic “discretionary” programs (homeland security, environment regulation, law enforcement and the like) and non-elderly “entitlements” (unemployment insurance, welfare). In 2015, the federal government is still spending 21 percent of GDP, but now Social Security and major health programs consume about half the budget, according to the CBO report. Most health spending goes to the elderly. (Robert J. Samuelson, 6/24)

Health insurance companies in Maryland are asking the state for premium increases that are way out of line with the actual cost of providing health care and it's the people who pay for that care whose wallets would be hit hardest.... The state's largest insurer, CareFirst, is asking for rate hikes that would raise by more than 30 percent the cost of a policy for people purchasing health plans at the state's health benefit exchange, Maryland Health Connection. This contrasts with much smaller increases — even decreases — proposed by other insurers. If CareFirst's rates are approved, a 40-year-old Baltimore-area non-smoker would pay $134 more each month for the lowest-cost preferred provider silver plan from CareFirst compared to Kaiser's comparable plan. (Leni Preston and Carmela Coyle, 6/24)

I'd suggest that the best model is exactly the one I suggested when health-care reform was being debated: Get rid of all of our government's existing health insurance programs and make the government the insurer of last resort for all medical expenses above 15-20 percent of adjusted gross income. Allow very generous tax-free savings in health savings accounts that can be passed on to heirs, but spent only on medical expenses. Make the deductible percentage lower, or provide some sort of subsidized gap insurance, for people with very low incomes. (Megan McArdle, 6/24)

While the federal government stalls on immigration reform, some states have begun acting on their own. Much attention in the last decade has focused on Republican-dominated areas that have tightened enforcement. Meanwhile, more quietly, California moved in the opposite direction, encouraging integration rather than deportation. California has passed more than a dozen laws on immigrant integration between 2001 and the present. In mid-June, the state expanded healthcare access to all undocumented children and boosted spending for naturalization assistance. These various laws collectively produce a kind of state-level citizenship — call it "the California Package." (Karthick Ramakrishnan and Allan Colbern, 6/24)

At last, there’s a growing recognition that the long-term sustainability of the US health care system depends on improving the health of populations. Unfortunately, this recognition is not yet accompanied by sustainable sources of funding to achieve this goal, such as support for such initiatives as community-based tobacco control, antiviolence programs, comprehensive home visiting programs, and environmental changes that help improve diet and promote exercise. These efforts can have benefits for health at far lower cost than medical interventions. Although many take credit for investing in “population health,” the vast majority of such spending is directed to traditional quality improvement and care coordination efforts within the health care system. Many people running successful public health programs are losing sleep thinking about options to keep the doors open after grant funding has gone away. (Joshua Sharfstein, 6/24)