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House Republicans beat back protests from fiscal hawks and narrowly passed a budget that increases war spending but slashes domestic programs and begins to privatize Medicare with a goal of balancing the federal books in nine years. ... That triumph for more military spending was an anomaly in the budget blueprint, which would cut spending $5.5 trillion over the next decade. It also includes parliamentary language, called reconciliation, that orders House committees to draft legislation repealing the Affordable Care Act. Under budget rules, that reconciliation repeal bill cannot be filibustered in the Senate and would need only a majority vote to pass. The budget would turn Medicaid into block grants to the states, cutting health care spending for the poor by $900 billion. (Weisman, 3/25)

After two weeks of backroom negotiations with fiscal conservatives and defense hawks, the House approved a spending blueprint that would balance the budget in a decade, transform Medicare and Medicaid, prevent tax increases and repeal Obamacare. ... With only 188 members, Minority Leader Nancy Pelosi of California and her fellow Democrats had little hope of derailing the GOP resolution once Boehner was able to pacify both defense and fiscal hawks. But it didn’t stop Democrats from trying. Pelosi was especially critical of Republican plans to hold another vote to repeal Obamacare, noting there is no way for such an effort to succeed while Obama sits in the Oval Office. (Bresnahan, Sherman and Bade, 3/25)

The vote in favor of the plan was 228-199. The blueprint itself is non-binding, but sets Republicans on a path to pass legislation that repeals the health care law, remakes Medicare and overhauls the tax code, in addition to other steps to implement their plan. The GOP-controlled Senate is at work on a slightly different budget plan, with a vote expected by week's end. (3/25)

House Republicans pushed past their internal divisions to approve a budget blueprint Wednesday, putting the new Congress on track to notch a significant achievement once Senate Republicans pass their version by the end of the week. The ambitious but largely symbolic spending proposals adhere to Republican ideas for slashing social safety-net programs and lowering tax rates. ... The House and Senate must reconcile their different versions, which could prove difficult. The House plan overhauls Medicare by creating a voucher-like option for seniors to purchase private health insurance. Senate Republicans have distanced themselves from that approach and did not include it in their budget. (Mascaro, 3/25)

The Senate is working toward passing its own budget plan later in the week. It has begun voting on a heap of amendments, a process that could keep lawmakers at work late Thursday into Friday morning. Once both chambers pass a budget, they will have to hash out the differences in a conference. If they reach a compromise, it would pave the way for a simple majority vote in the Senate on repealing President Obama's signature health-care law under a process known as reconciliation. The Price budget calls for repealing the law. While Obama would be certain to veto such legislation if it ever made it to his desk, it would be a vehicle for conservatives to register their lingering frustration with the law without facing a filibuster. (Sullivan, 3/25)

Passage of the House GOP budget overcomes the first—and likely the highest—hurdle in Republicans’ quest to clear a unified spending blueprint through both chambers of Congress. ... Hard-fought passage of the budget marked a moment of vindication for House Republican leaders, who have suffered a series of embarrassments this year when they were forced to pull GOP bills from the floor and pass legislation with the help of Democrats. (Peterson, 3/25)

Overcoming internal divisions on defense spending, Republicans in the U.S. House of Representatives on Wednesday narrowly approved a non-binding federal budget plan calling for $5.5 trillion in domestic spending cuts over 10 years. The vote meant that House Speaker John Boehner avoided what could have been another embarrassing rebuke from his party's right flank. Instead, a complex series of votes engineered by Boehner succeeded and moved the budget issue to the Senate. (Lawder, 3/25)

The Senate is up next after House Republicans pushed through a boldly conservative budget eliminating deficits over the next decade by cutting deeply into Medicaid, food stamps and welfare, and repealing the president’s health care law. ... Both plans squeezed trillions by undoing so-called Obamacare and cutting Medicaid and other programs, but there were differences. House Republicans would convert Medicare into a voucher-like program, while Senate Republicans, eyeing the 2016 campaign in which they must defend their newly won majority, omitted such an approach. (Werner and Espo, 3/26)

Senators blocked a Democrat-led Medicare amendment Wednesday from being included in the budget, but passed a Republican amendment on the health plan. Senators voted 46-53 on procedural motion, after Democrats tried to override the decision of Budget Committee Chairman Mike Enzi (R-Wyo.) to block the Dems' amendment. (Carney, 3/25)

Lawmakers on Wednesday closed in on passage of a measure to permanently replace an 18-year-old formula for reimbursing doctors for Medicare patients, as support in the House swelled ahead of a vote Thursday and resistance faded among Senate Democrats. The speed with which the package advanced marks a doubly rare moment for this Congress, as it involves a bipartisan agreement and the most contentious of subjects: a change to an entitlement program. ... The House package also would provide two years of funding for a program that provides health insurance to children from low-income families. (Hughes, 3/25)

Doctors who treat Medicare patients will face a huge cut, 21 percent, if Congress doesn't act by the end of the month. This isn't a new problem. While Democrats and Republicans on Capitol Hill agree that the formula that pays doctors who treat Medicare patients has long been broken, over the years they've been unable to pass more than temporary patches. But the leaders of the House from both parties have come up with a plan that they think can fix a problem that has bedeviled Congress since 1997. On Thursday, it goes to the House floor for a vote. (Summers, 3/26)

President Obama also endorsed the compromise. "I've got my pen ready to sign a good, bipartisan bill, which would be really exciting," he said at a White House event Wednesday with national healthcare leaders. "I love when Congress passes bipartisan bills that I can sign." (Levey, 3/25)

President Barack Obama said on Wednesday he was ready to sign bipartisan legislation to change the formula for reimbursing Medicare physicians, while the U.S. Senate's top Democrat appeared open to allowing a vote on the measure. Both developments signified growing support for a bipartisan effort to address a persistent problem and make small adjustments in Medicare costs. (Cornwell, 3/25)

Obama's remark, made a day before the House is expected to approve the measure, seemed to add political momentum to the package's prospects in the Senate, where Minority Leader Harry Reid and others had complained about abortion curbs and other provisions. The overall bill is a compromise worked out by House Speaker John Boehner, R-Ohio, and Minority Leader Nancy Pelosi, D-Calif. (Fram and Pickler, 3/25)

Leaders of both parties in the House expressed confidence on Wednesday that their chamber would soon approve sweeping changes in Medicare, even though the Congressional Budget Office released figures showing that the bill could add more than $140 billion to federal budget deficits in the coming decade. ... The measure has drawn support from many diverse organizations, including the American Medical Association, the American Hospital Association and liberal groups like Families USA, the Center for American Progress and the Center on Budget and Policy Priorities. (Pear and Steinhauer, 3/25)

President Barack Obama put pressure on Democrats on Wednesday when he said he looks forward to signing a “good bipartisan bill” to change the Medicare formula and permanently put an end to the “doc fixes” that Congress has passed for years. ... Senate Democrats had two big objections. They wanted to double the House’s two-year extension of the Children’s Health Insurance Program, and they didn’t want to include Hyde Amendment abortion restrictions to the bill’s funding for community health centers. Also, the Senate was not involved in the negotiations, which has frustrated Democrats. Senate Republicans are much more supportive, but some have expressed concern that the package is not fully paid for. (Haberkorn, 3/26)

The $200 billion House deal on Medicare is drawing support from family health advocates, despite concerns from Democrats who say the legislation deprives funding for a children's health program. Leaders of the infant health advocacy group March of Dimes endorsed the bill Wednesday, praising lawmakers for acting "well in advance of the scheduled expiration" of the program. Their letter, addressed to House leadership, called for the bill's passage despite “disappointment” that the Children's Health Insurance Program (CHIP) is only funded for two years. (Ferris, 3/25)

The nonpartisan Congressional Budget Office estimated Wednesday that the bipartisan bill preventing cuts in doctors' fees for treating Medicare patients would total $214 billion in costs over the coming decade. (3/25)

The House-negotiated package to scrap Medicare’s physician payment formula would increase the federal deficit by $141 billion over 11 years, $900 million less than it would cost to freeze doctors’ payment rates over that period, the Congressional Budget Office estimated on Wednesday. (Attias, 3/25)

Pretty much everyone agrees that scrapping Medicare's sustainable growth-rate formula for paying doctors is a laudable goal. But if Congress can actually pass a permanent doc fix this week—and that prospect remains decidedly up in the air—what exactly would be put in its place? (Demko, 3/25)

Tennessee hospitals are set to gain hundreds of millions of Medicaid dollars due to a provision tucked into the House’s package to do away with the SGR. (Pradhan, 3/25)

U.S. Rep. Ron Kind says he hopes to establish regional pain management boards through the Department of Veterans Affairs to help prevent problems like those that occurred at a Tomah medical center. Kind introduced the bipartisan bill Wednesday saying he hopes the accountability boards would deter overmedicating. The Tomah hospital is under investigation for allegations of overprescribing practices and retaliatory behavior. (3/25)

A VA medical center in Tomah accused of rampantly overprescribing painkillers was expected to be a focus of a U.S. Senate hearing Thursday, with several Department of Veterans Affairs officials scheduled to testify. In written testimony released in advance of the hearing in Washington, interim VA Undersecretary for Health Carolyn Clancy said she is deeply concerned about allegations of overprescribing practices and retaliatory behavior at the center in Wisconsin, where investigations are ongoing. She said if employee misconduct is found, those responsible will be held accountable. (Ferguson, 3/26)

Cherokee Nation Principal Chief Bill John Baker has testified before a U.S. House subcommittee on the need for increased funding from Indian Health Services. Baker testified Wednesday before the U.S. House Interior Appropriations Subcommittee that the Cherokee Nation has committed $100 million to improve its health care facilities and said Indian Health Services should pay a share to help staff the facilities with doctors and nurses. (3/25)

A bipartisan House plan introduced Wednesday would require insurers to charge patients who use expensive specialty drugs and biologics a fixed co-payment instead of a percentage of the cost. The bill by Reps. David B. McKinley, R-W. Va., and Lois Capps, D-Calif., is a version of legislation that was introduced in 2014 and 2013 and gained some steam last year with 142 bipartisan cosponsors. (Gustin, 3/25)

President Obama marked the fifth anniversary of the Affordable Care Act by mocking the law’s longtime critics as wrong about their predictions that its passage would doom America’s health care system. In an event at the White House on Wednesday, Mr. Obama said the law had decreased the ranks of the uninsured by a third, having enabled 16 million people to sign up for health coverage through the government marketplaces. (Shear, 3/25)

President Obama delivered a staunch defense of the Affordable Care Act on the week of its fifth anniversary Wednesday as he continues his bid to frame the health care law as a success in the face of legal and political challenges from Republicans. ... More than 16 million people who were previously uninsured now have medical coverage under the law, which is generally viewed as the president's signature legislative achievement. But the law, passed by Congress in 2010, is facing a Supreme Court ruling this spring that could wipe out subsidies for millions of them. The administration has not announced a backup if the court rules portions of the law unconstitutional. (Nakamura, 3/25)

President Barack Obama took a victory lap Wednesday, celebrating the fifth anniversary of his signature health care law and proclaiming that it’s succeeded despite persistent Republican efforts to “repeal, undermine, defund and defame” the law. (Clark, 3/25)

President Obama's health care law is 5 years old, and so is the political debate surrounding it. Obama again praised the law Wednesday for insuring more people, reducing costs and saving lives, while Republicans continued to cite rising insurance prices and canceled policies for many. "In a lot of ways, it's working better than many of us, including me, anticipated," Obama said during an event at the White House. (Jackson, 3/25)

Paying doctors, hospitals and other providers for improved care rather than treatment volume will benefit patients and lower U.S. health-care spending, President Barack Obama said Wednesday. As the Affordable Care Act reaches milestones in expanding coverage—nearly 11.7 million people had signed up through late February—the Obama administration is turning its focus to revamping the way providers and health systems are paid. (Armour, 3/25)

Sen. Ted Cruz hasn’t made a final decision on whether he will sign up for Obamacare but will make up his mind “in the coming days,” a spokesman said Wednesday. Rick Tyler, national spokesman for the Texas Republican’s newly-launched presidential campaign, also defended Cruz against charges of hypocrisy for suggesting that he might enroll in Affordable Care Act health exchanges. (Topaz, 3/25)

A third panel approved the Senate's proposed alternative to Medicaid expansion and now the measure is headed to a floor vote. But things got dicey Wednesday when the Senate Appropriations Committee discussed SB 7044. As Health Policy Chairman Aaron Bean, R-Fernandina Beach, walked his colleagues through the proposal, several senators became engaged in intense side conversations. The discussions grew so large that the committee went into an impromptu recess. Appropriations Chairman Tom Lee, R-Brandon, later explained that some members had expressed concerns because the plan would temporarily put some beneficiaries into Medicaid Managed Care plans until the state creates a new private health insurance marketplace. (McGrory, 3/25)

A revived version of Gov. Bill Haslam's proposal to extend health coverage to 280,000 low-income Tennesseans on Wednesday cleared its first full Senate committee. (Schelzig, 3/26)

A $45 million hole in this year’s budget is the result of a disagreement between state and federal officials over how much the federal government should reimburse Connecticut for Medicaid spending for clients who became eligible under Obamacare. ... Connecticut was the first state in the country to expand Medicaid as part of the health law, beginning the coverage expansion in 2010. The federal reimbursement rate for their care rose from 50 percent to 100 percent as of Jan. 1, 2014. But what if one of those clients went to the hospital in 2013, but the state didn’t pay the bill until 2014? (Levin Becker, 3/25)

Predictions that expanded coverage through the ACA would flood physicians’ offices with new and sick patients haven’t come true yet, according to a report released Wednesday by athenahealth. (Villacorta, 3/25)

Physician practices have largely not been overwhelmed since the Affordable Care Act's individual mandate went into effect last year, contrary to concerns raised by ACA critics about the potential flood of new patients the law would bring. (Rubenfire, 3/25)

Dr. Savita Gopal, a 27-year-old resident physician at the Family Health Center of Harlem, sat in front of a computer last Thursday, peppering Jacob Doble, a 10-year-old from Harlem, with questions for 20 minutes. ... Dr. Gopal’s residency is supposed to last three years, but its future is uncertain. Her training is paid for by a provision of the Affordable Care Act called the Teaching Health Center Graduate Medical Education program, which is up for renewal this year. The program has allocated $230 million nationwide over five years to try to tackle a worsening shortage of primary care physicians and draw eager young doctors to places where they are sorely needed. (Slotnik, 3/25)

Employers have ratcheted up the financial incentives they offer workers to participate in wellness programs to a record $693 per employee, on average, this year from $594 in 2014 and $430 five years ago, found a report released on Thursday. And fewer employers are imposing penalties such as charging more for insurance if workers do not participate or achieve goals such as losing weight. (3/26)

Got a high-deductible health plan? The kind that doesn’t pay most medical bills until they exceed several thousand dollars? You’re a foot soldier who’s been drafted in the war against high health costs. Companies that switch workers into high-deductible plans can reap enormous savings, consultants will tell you — and not just by making employees pay more. Total costs paid by everybody — employer, employee and insurance company — tend to fall in the first year or rise more slowly when consumers have more at stake at the health-care checkout counter whether or not they’re making medically wise choices. (Hancock, 3/26)

Cigna Corp. and SCAN Health Plan agreed to an alliance Tuesday in which both health insurers will provide retiree Medicare Advantage benefits to California employers. Each company will remain independent. Insurers may view these types of loose partnerships more favorably as a way to get a piece of growing markets like Medicare without having to overpay in a full acquisition. (Herman, 3/25)

Arizona lawmakers on Wednesday passed a controversial measure blocking women from buying insurance that includes abortion coverage through the federal health care exchange. The fiercely-debated bill also requires doctors to tell women they could possibly reverse the effects of a drug-induced abortion, a claim that critics called "junk science." (Schwartz, 3/25)

Arizona lawmakers approved legislation that requires abortion providers to tell women they can reverse the effects of a drug-induced abortion and bars women from buying any health care plan through the federal marketplace that includes abortion coverage. (3/26)

The state Assembly is set to pass legislation to codify in New York the abortion rights established by the U.S. Supreme Court, moving it separately this year from a group of bills intended to ensure other women's rights in the workplace and courts. (3/25)

Kansas legislators Wednesday approved a proposed ban on a common second-trimester procedure described by abortion opponents as dismembering a fetus, making their state the first to adopt a national group's model policy. (Hanna, 3/26)

President Obama's executive actions on immigration, which have sparked a fierce political backlash nationwide, could also provide an unlikely boost for another of his goals: increasing health insurance signups. Immigrants living in the U.S. without permission can't enroll in Obamacare, but an unusual policy in California allows those granted temporary relief from deportation to sign up for Medi-Cal. That means up to half a million more Californians could apply for the state's low-income health program, according to data released Wednesday by UC Berkeley and UCLA. (Karlamangla, 3/25)

The HIV epidemic that now grips Austin, Ind., seemed to come out of nowhere. Since the first diagnosis in mid-December, the number of infected there and in the surrounding region has skyrocketed — 26 by the beginning of March, 72 as of this Wednesday. It’s the worst HIV outbreak in state history, and has local and federal officials scrambling to stem the spread of the disease. (Kaplan, 3/26)

Progress has been made in clearing a huge backlog of nursing home complaints, and steps have been taken to ensure it won't happen again, according to testimony on Tuesday at a joint legislative hearing. (Gorn, 3/25)

After initially stalling last week, a bill that would let nurses see patients without having the oversight of doctors, finally got moving Tuesday. House Bill 547 was the final proposal heard by the Health Innovation Subcommittee, and even though lawmakers approved it on a 9-to-4 vote, unclear whether the bill is enough of a priority, or even if it has enough support—to get through the House. Still, Republican Rep. Cary Pigman says he wants fellow lawmakers to hear him out and, “to recognize it’s a work in progress. It’s likely a multi-year work in progress.” (Hatter, 3/26)

In some states, the cuts have been so drastic that injured workers have plummeted into poverty, losing their cars and even their homes. In others, workers spend years battling insurance companies for the surgeries, prescriptions and basic help their doctors recommend. The five case studies below are emblematic of the bewildering labyrinths injured workers have to navigate as a result of these cutbacks. (Grabell, 3/25)

By day, Tanya Lemon was a 35-year-old single mother who took care of her four children. By night, she worked 12-hour shifts as a nurse at a state group home in suburban Syracuse, paid to watch over vulnerable residents as they slept. That's also when she got her own sleep, prosecutors say — a routine that led to felony charges when Dennis Dattalo, a 25-year-old disabled man who couldn't speak, ran low on oxygen while on her watch and later died. The case has brought renewed attention in New York to the problem of fatigue among health care workers — and in particular highlights the low-paid nurses, aides and others who care for vulnerable people at night, when sleeping can all too often become part of the job. (Virtanen, 3/26)

Representatives of hospitals, doctors and nursing homes joined with patient advocates Wednesday to urge the Iowa House to pass a bill giving legislators some oversight of the state's shift to privately managed Medicaid. "If managed care is done right, it can do some important and innovative measures to improve quality and access, as well as reducing costs," said Mary Nelle Trefz, a lobbyist for the Child and Family Policy Center. "But that's an important caveat: If it's done right." (Leys, 3/25)

The Iowa Legislature should have more oversight of this year's plans to transition the state's Medicaid program into private managed care, representatives for several medical groups told a House panel Wednesday. (Rodriguez, 3/25)

Hospitals in Maryland are seeing impressive gains in reducing readmission rates and preventing patient harms from hospital-acquired infections, medication errors and other safety events, according to a report released Wednesday by the state's hospital association. (RIce, 3/25)

Physician-assisted suicide would be legal for terminally ill patients in California under a bill passed on Wednesday by a committee of the state Senate. The bill, passed by the Senate Health Committee, would allow patients who are mentally competent and have fewer than six months to live to obtain prescriptions for medication to end their lives. (Bernstein, 3/25)

California lawmakers pursuing right-to-die legislation on Wednesday aired a posthumous video of Brittany Maynard, a 29-year-old San Francisco Bay Area woman with brain cancer whose move to Oregon to legally end her life last year drew wide attention. In the video, Ms. Maynard, who ended her life on Nov. 1, appeals to state legislators, and lawmakers elsewhere, to pass laws that allow terminally ill patients to end their lives with the assistance of doctors. Ms. Maynard said in the video she was “heartbroken” to have to leave behind “my home, my community and my friends in California” to take advantage of Oregon’s Death with Dignity Act. (Lazo, 3/25)

When it comes to standard measures of health, Kansas is a laggard. Whether we’re talking about obesity rates, incidence of diabetes, acute or chronic diseases, or childhood mortality, the Sunflower State typically ranks in the bottom half of state health rankings – and in recent years it’s been sinking even lower. That’s bad enough. But there are vast disparities within the state itself. Averages only give a rough-and-ready sense of the state’s overall health picture; dig deeper – down to the county level – and you’ll find that some counties actually perform quite well while others perform poorly. Nowhere is that more apparent than in two counties that sit cheek by jowl, both in metropolitan Kansas City: Johnson and Wyandotte counties. (Margolies, 3/25)

Each year, County Health Rankings releases a report and an interactive website with detailed health data for every county in the United States. Most of the data available, however, are several years old. For example, for the 2014 report, measures for risk behaviors were based on data from 2006 through 2012, premature death on data from 2008-2010, and preventable hospitalization on data from 2011. America’s Health Rankings publishes annual data for health in states. For the 2014 report, infant mortality rates were based on data from 2011 and 2012, premature death rates from 2012, and rates of insurance from 2012 and 2013. (Sharfstein, 3/25)

Administrators at the state Mental Health Institute at Clarinda have started transferring mentally ill senior citizens from the institution to private nursing homes, a spokeswoman confirmed Wednesday. The transfers will affect only about a dozen patients in a geriatric mental health program, but they are considered some of the toughest cases among the residents of two mental institutions that the state plans to close by July 1. (Leys, 3/25)

The Iowa Health Care Association, which represents most of the state's nursing homes, has shown interest in helping set up a small private facility for senior citizens with mental illnesses that make them aggressive. Although no such program has been formally proposed, the association recently sent the Iowa Department of Human Services an estimate of what it might cost. (Leys, 3/25)

Until the federal health insurance marketplace opened in late 2013, farmers and ranchers were more likely to be uninsured than many other occupational groups. The Affordable Care Act changed that by requiring them — and most other U.S. citizens — to buy insurance. But it also gave them coverage options they didn’t have before. Jon Bailey, of the Nebraska-based Center for Rural Affairs, said it’s hard to make sweeping generalizations about how the health care law is working for farmers and ranchers. (Thompson, 3/25)

The House of Representatives is on course to pass a major piece of Medicare legislation with strong support from the leadership and rank and file of both parties. Yes, you read that right: On Thursday, the House is scheduled to vote on a package that permanently eliminates the expensive annual budgetary charade known as the “doc fix,” while enacting tens of billions of dollars worth of structural reforms to the massive program for seniors — and providing a two-year, $5.6 billion dollop of funding to an important children’s health-care program to boot. ... There’s also this quibble: According to the Congressional Budget Office, the bill will add roughly $141 billion to the federal deficit over the next 10 years. (3/25)

The Congressional Budget Office has released its score of the Medicare “doc fix” legislation scheduled for consideration Thursday in the House. Among other things, the score provides some sense of the difficulty in enacting reforms to improve Medicare’s solvency. (Chris Jacobs, 3/25)

The moments when Congress appears to function effectively are rare and fleeting these days. So it's proper to recognize that the House is on the verge of taking the right steps on the Children's Health Insurance Program, or CHIP, which was on the cusp of losing its funding later this year. (Michael Hiltzik, 3/25)

It’s a bipartisan plan cooked up by John Boehner and Nancy Pelosi. (Question: What do you imagine when you think of those two cooking? Macbeth or Cupcake Wars?) The subject was another fiscal cliff. Next week, Medicare payments to doctors are scheduled to drop by 21 percent. The formula for reimbursement is all screwed up, and Congress is always having to put in a last-minute fix. But this bill does not just kick the can down the road. It actually solves the problem. It fixes the formula and pays for the solution by raising the cost of Medicare for the wealthiest recipients. Plus, it’s got money for community health clinics and the CHIP health care program for children. (Gail Collins, 3/26)

Sen. Ted Cruz (R-Tex.), who announced his run for president on Monday, had a mixed bag of second-day campaigning. On the one hand, he raised $1 million. On the other hand, the right’s champion of “no compromise” assault on Obamacare and much of the rest of the federal government admitted that, yes, he would be going on Obamacare. (James Downie, 3/25)

The charge of hypocrisy is rather baffling. Normally such accusations are made against those who espouse rules they don’t apply to themselves—an adulterer who preaches chastity, say, or a wealthy school-choice opponent who sends his own children to an elite private school. Cruz’s position is more analogous to that of a nonwealthy school-choice supporter who sends his children to the local public school because the law gives him no alternative. If anything, the law that gives the Cruzes no alternative is evidence of Democratic hypocrisy. Before ObamaCare, members of Congress received traditional health benefits like other federal employees. But as the Register notes, Iowa’s Sen. Chuck Grassley, a Republican, “pushed through an amendment on the [Patient Protection and] Affordable Care Act . . . that requires members of Congress to obtain their coverage via health insurance exchanges.” (James Taranto, 3/25)

Promising health care delivery and payment reforms are under way that may have contributed to the slower rates of growth in health care spending seen in recent years. Delivery reform alone, however, is unlikely to slow cost growth over the long run: it is important to address the social, economic, and environmental determinants that contribute to the increasing burden of poor health and chronic illness. ... we suggest that a modest reorientation of hospital community benefit programs could help accelerate the development of successful regional health improvement initiatives. (Janet Corrigan, Elliott Fisher and Scott Heiser, 3/24)

On the fifth anniversary of the signing of the Affordable Care Act, I ponder how non-Americans view our momentous and controversial health reform law. ... have traveled to Brazil, Australia, and South Africa, and also addressed foreign audiences here in the US, to explain what they should they know about the law and why they might care. I offer them two conclusions, and believe Americans might benefit by knowing them. They are: we remain laggards in providing access to health care coverage, and we are now real leaders in global efforts to improve health care’s quality, efficiency, and effectiveness. (John E. McDonough, 3/23)