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As congressional Republicans move toward another vote on repealing the Affordable Care Act, new evidence was published Wednesday about the dramatic expansion of insurance coverage made possible by the law. Nearly 17 million more people in the U.S. have gained health insurance since the law's major coverage expansion began, according to a study from the Rand Corp., a Santa Monica nonprofit research firm. (Levey, 5/6)

As a result of the landmark health-reform law known as the Affordable Care Act, nearly 17 million previously uninsured Americans now have health coverage, a new analysis reveals. (Reinberg, 5/6)

Nearly 17 million Americans got health insurance under the Affordable Care Act after the new insurance exchanges opened up, according to an independent analysis published Wednesday. (Fox, 5/6)

The Affordable Care Act has been a catalyst for a net increase of 16.9 million Americans gaining health insurance in the last two years via Medicaid expansion and subsidized private coverage with even more people accessing employer-sponsored plans. A new study by the RAND Corp., which looked at a sampling of 1,600 Americans and their “transitions” to and from forms of health coverage between September 2013 and February 2015 and found 22.8 million Americans gained coverage. There were 5.9 million people who also lost coverage, leaving a net increase of 16.9 million, according to the analysis, published in the journal Health Affairs. (Jaspen, 5/6)

Health plans offered through Covered California have narrower hospital networks than commercial insurance plans but they don’t appear to have lower-quality providers or differences in geographic access, according to a study published in the May issue of Health Affairs. (Vesely, 5/6)

Accountability means taking responsibility for an action or result. Lately, it’s taken on a new connotation in the field of health care. The Affordable Care Act provides a way for health care networks to get bonus payments by providing better care and keeping Medicare patients healthier through accountable care organizations that are about to have a larger presence in Kansas. (Thompson, 5/6)

From the Medical College Admissions Test to post-graduate residencies, the way U.S. doctors are taught is changing in the wake of health care reform. (Stockey, 5/6)

The Obama administration snubbed Florida's proposal to extend federal funds for hospitals that treat low-income and uninsured patients, a dispute that has paralyzed the state budget. Health and Human Services Secretary Sylvia Burwell gave Gov. Rick Scott the news when she met with him in Washington on Wednesday. The Republican governor wants the administration to extend $1 billion in low-income pool funds for hospitals, but the federal government wants Florida to expand Medicaid, arguing its more efficient to give people insurance than to pay hospitals for caring for the uninsured retroactively. (Kennedy and Alonso-Zaldivar, 5/6)

Florida Gov. Rick Scott’s high-stakes visit to Washington Wednesday to persuade the Obama administration to keep the federal government’s $1 billion in annual funding for hospital care of the poor produced no breakthrough. 'We had a good conversation … but we don’t have a resolution,' the Republican governor told reporters after an hour-long meeting with U.S. Health and Human Services Secretary Sylvia Burwell. (Galewtiz, 5/6)

Gov. Rick Scott's meeting Wednesday with the Obama administration's top health care official failed to resolve a funding standoff, prompting him to say he will prepare an emergency "base" budget to keep state government operating after June 30. "We had a good conversation . . . but we don't have a resolution," Scott said after talking about an hour with Health and Human Services Secretary Sylvia Burwell about renewing a $2.2 billion hospital funding program. HHS has told Florida the Low Income Pool, or LIP, is being phased out, and the government wants the state to expand Medicaid to cover an additional 800,000 uninsured residents. The agency said Wednesday that Scott's alternative proposal "falls short." (Leary, 5/6)

Florida Governor Rick Scott is once again suing President Barack Obama and his health secretary, Sylvia Mathews Burwell, over Obamacare. That didn’t stop the Republican from coming to Washington today with his palm out, trying to salvage more than $1 billion in hospital funding that’s at the center of his lawsuit. “This program shouldn’t be going away,” Scott told reporters Wednesday after meeting with Burwell at her agency’s headquarters. “The federal government shouldn’t be trying to force us to expand Obamacare.” (Olorunnipa, 5/6)

Florida Gov. Rick Scott came to Washington to demand that the Obama administration drop its threat to cut off billions of dollars in special funding for Florida hospitals — a fight that’s gotten wrapped up into the larger battle over Florida’s refusal to expand Medicaid under Obamacare. (Pradhan, 5/6)

The standoff also has implications for eight other states, including Texas, which draw billions of dollars from the same pool of hospital funds. And like Florida, several are also refusing to expand Medicaid coverage. Republican leaders in those states are adamant about not expecting any federal money tied to Obama's Affordable Care Act. ... The Obama administration also noted in its statement that Florida and other states have known for well over a year that the funds were ending and Florida was granted an extension last year on the condition it seek alternative funding. It's unlikely the federal government will drop the hospital funds entirely, but the Obama administration has been clear that those states will get less funding because the Obama administration will not pay for health care for low-income individuals that would be covered in a Medicaid expansion. (Kennedy, 5/7)

Another Medicaid expansion effort died Wednesday at the hands of a state Senate panel. Voting largely along party lines, the Senate Health and Welfare Committee voted 5-3 to defer action on a measure calling for a statewide vote on the issue. Senate Bill 10 sought to amend the Louisiana Constitution to require the state health agency to expand state Medicaid eligibility to 138 percent of the federal poverty level. That’s $27,700 for a family of three. (Shuler, 5/7)

The vote was 5-3 Wednesday against the proposal (Senate Bill 10) by Sen. Karen Carter Peterson, D-New Orleans. Peterson's constitutional amendment would have bypassed the governor's desk and allowed the state's voters to decide on the expansion. Supporters of the Medicaid expansion say it would extend health insurance coverage to nearly 300,000 working poor, with the federal government picking up nearly all the cost. They also say it would help health care providers burdened with uninsured patients. (5/6)

Johnson & Johnson has appointed a nationally known bioethicist to create a panel that will make decisions about patients’ requests for lifesaving medicine, responding to an emotional debate over whether companies should allow desperately ill people to have access to the drugs before they are approved. (Thomas, 5/7)

Under increasing pressure to expand access to experimental medicines, Johnson & Johnson has arranged for an independent panel to review requests from seriously ill patients who want to try an unapproved drug even if they aren’t participating in the drug’s testing. The committee of doctors, bioethicists and patient representatives organized by the New York University School of Medicine will consider the hundreds of requests that J&J receives each year from patients who believe an experimental drug can help them. The panel will recommend a course of action to J&J. (Rockoff, 5/7)

Johnson & Johnson will ask an independent panel to recommend who gets a breakthrough drug that’s still under development, a plan that could help the company contend with the phenomenon of desperate patients using social media to campaign for early access to medications. The collaboration between the world’s largest maker of health-care products and the division of medical ethics at New York University Langone Medical Center will start with one medicine. If successful, the company will expand the initiative, said Chief Medical Officer Joanne Waldstreicher. (Cortez, 5/7)

Patient advocacy groups are urging the Food and Drug Administration to reconsider how it reviews copycat biologic therapies, saying the current structure doesn’t provide for adequate expertise in the area. Patients for Biologics and Access, comprised of 20 patient advocacy groups representing chronic and rare illnesses, sent a letter to acting FDA commissioner Stephen Ostroff Wednesday, asking the agency to issue final approval standards for biologic copycats. (Adams, 5/6)

New therapies that clinical data show can eliminate blood cancers such as leukemia and lymphoma in 40 percent to 90 percent of patients may have to be genetically modified to include a switch that shields healthy cells from attack. The therapies could generate tens of billions of dollars in annual sales for drugmakers including Kite Pharma and Juno Therapeutics Inc, once they are approved. (Pierson, 5/7)

British-based drugmaker GlaxoSmithKline opted Wednesday to keep its stake in its stand-alone HIV business as it set out its strategy following a big deal with Switzerland's Novartis. GSK said it has cancelled an initial public offering of its holding in the HIV business, ViiV Healthcare, opting instead to retain its full holding in the joint venture with equity partners Pfizer and Shiongi. (Kirka, 5/6)

Alexion Pharmaceuticals Inc on Wednesday said it agreed to buy Synageva BioPharma Corp for $8.4 billion, more than twice its market value, to expand its offering of potentially high-priced medicines for rare diseases. Alexion's willingness to pay an eye-popping premium for Synageva demonstrates that the appetite for large acquisitions in healthcare continues unabated. It also highlights the attraction of medicines for rare diseases that can command exceptionally high prices with little payer pushback because of the limited number of patients. (Berkrot and Grover, 5/6)

Alexion Pharmaceuticals will pay a huge premium to buy Synageva BioPharma in an $8.4-billion deal for a rare disease treatment maker that lost nearly $60 million in the first quarter and has no products on the market. Alexion made the deal, announced Wednesday morning, more for what Synageva can offer rather than what it already provides. That includes access to a potential blockbuster drug and stronger footing in lucrative field where drugmakers can command top dollar for treatments without facing fierce negotiations from insurers and other payers. (Murphy, 5/6)

WellCare Health Plans Inc. on Wednesday posted better-than-expected profit in the first quarter as its Medicaid membership grew. In February, the company gave downbeat guidance for the year after an unexpectedly severe flu season. WellCare reiterated its full-year earnings guidance Wednesday. (Dulaney, 5/6)

A rise in cyber attacks against doctors and hospitals is costing the U.S. health-care system $6 billion a year as organized criminals who once targeted retailers and financial firms increasingly go after medical records, security researchers say. Criminal attacks against health-care providers have more than doubled in the past five years, with the average data breach costing a hospital $2.1 million, according to a study today from the Ponemon Institute, a security research and consulting firm. Nearly 90 percent of health-care providers were hit by breaches in the past two years, half of them criminal in nature, the report found. (Pettypiece, 5/7)

A bipartisan pair of senators introduced a bill Wednesday that would create a new “national nurse” position tasked with preventing diseases like obesity and heart disease. Senator Jeff Merkley (D-Ore.) and Sen. Shelley Moore Capito (R-W.V.) said the national nurse would focus on education to help to curb the growing epidemics of obesity, heart disease and cancer. (Ferris, 5/6)

Reps. Jim Cooper (D-Tenn.) and Cynthia Lummis (R-Wyo.) have introduced new bipartisan legislation to require medical researchers to study female animals and cells in addition to male ones. The bill, which would apply to research funded by the National Institutes of Health, would allow for new treatments to be tailored to differences in women, something that is lost when researchers only use male animals, the lawmakers argue. (Sullivan, 5/6)

A new bid to delay the national switchover to the ICD-10 medical billing codes addresses the complaints of doctors in small medical practices but runs counter to the arguments that hospital and insurance trade groups have made for sticking with an Oct. 1 deadline. Rep. Ted Poe of Texas has quickly drawn the support of six fellow Republicans for his bill (HR 2126), introduced April 30, which seeks to block Health and Human Services Secretary Sylvia Mathews Burwell from replacing the ICD-9 medical codes now in use. In a statement, Poe called the ICD-10 codes is a “burdensome bureaucratic system” that will “put an unnecessary strain on the medical community.” His measure would leave the existing codes in place. (Young, 5/7)

That's because the budget itself is nonbinding and, on its own, has no effect on spending. And also because Republicans have decided against using unique budget rules for follow-up legislation to save the trillions of dollars from food stamps, Medicaid and other benefit programs that would be needed to erase red ink. To do that would spark a pitched political battle with Democrats, a veto from President Barack Obama — and a possible backlash from the voters in 2016. (5/6)

The Obama administration has nominated Karen DeSalvo to become the Department of Health and Human Services (HHS)'s assistant secretary for health, a position that she has held on an interim basis since last fall. DeSalvo was first named as the department’s acting assistant secretary for health in October 2014, shortly after she became the national coordinator for health information technology. (Ferris, 5/6)

The nursing home industry plans to announce on Thursday that it will expand a 2012 initiative to improve quality, in a move that could feed into an upcoming federal regulation that the Centers for Medicare and Medicaid Services is developing. New goals include further reducing the number of patients who are readmitted to a hospital after a stay, decreasing staff turnover, reducing the off-label use of antipsychotics in long-term residents and increasing the number of facilities that report data from patient satisfaction surveys. (Adams, 5/6)

Conventional wisdom has been that hospice care at the end of life will improve someone’s final days and save money. It’s certainly cheaper to have a team of caregivers check on someone a few times a day compared to stays in intensive care units. But it turns out that was wrong, according to a New England Journal of Medicine report out Wednesday. (Gorenstein, 5/6)

The popularity of hospice care grew between 2004 and 2009 but that didn't bring down Medicare costs for people dying in nursing homes, according to a new study of three quarters of a million U.S. nursing home residents. "We found that although hospice use was associated with a reduction in aggressive end-of-life care, it was also associated with a net increase of $6,761 in Medicare expenditures per decedent in the last year of life,” writes the research team, led by Dr. Pedro Gozalo of Brown University. (Emery, 5/6)

Federal judge has rescheduled a court hearing as attorneys for an Ohio group and the state work to settle a lawsuit involving people terminated from the Medicaid health care program. Judge Algenon Marbley said in an order on Wednesday that the parties have told the court they have agreed to settlement terms but need more time to finalize a decision. (5/7)

The federal government is urging the U.S. Supreme Court to reject Republican Gov. Paul LePage's request to decide whether Maine can eliminate Medicaid coverage for thousands of low-income young adults. LePage's administration asked the court to review the case in February after a federal appeals court denied its plan to remove about 6,000 19-and-20-year-olds from Maine's Medicaid program. (Durkin, 5/6)

Missouri’s Gov. Jay Nixon has until Friday to decide whether to allow an expansion of Medicaid managed care to become law. Advocates are urging him to reject the measure. The expansion would shift 200,000 parents and children from traditional Medicaid, the government-funded insurance for low-income residents, to private managed care plans. It was included in the Legislature’s budget proposal for the state fiscal year that begins July 1. (Shapiro, 5/6)

The decision settles one part of the budget battle between Hogan and the Democratic-controlled legislature, which balked when the governor introduced a budget in January that eliminated the pay raises for state workers, reduced proposed funding levels for 13 of the state’s largest school systems where the cost of education is more expensive and reduced spending for several health-care initiatives. ... Hogan still must decide whether to spend the $133 million that the General Assembly set aside to fully fund high-cost school systems and to pay for some Medicaid-related programs that the governor cut. (Wiggins, 5/6)

A change to the state’s new autism coverage insurance mandate moved Wednesday to the Senate, despite evidence of a lack of communication between legislators and the Kansas Insurance Department. Alterations were expected after legislators, autism advocates and insurance companies came together on a bill in the 2014 session to mandate that health insurance plans for businesses with more than 50 employees include limited coverage of childhood autism treatments. (Marso, 5/6)

Despite increases in the number of Massachusetts residents covered by health insurance, barriers to mental health care remain — including low insurance reimbursement rates and clinicians who increasingly rely on clients paying out of pocket. That's according to a report released Wednesday by the Donahue Institute at the University of Massachusetts. (5/6)

For the third time since 2013, California's managed-care regulator has criticized health insurance giant Aetna Inc. for imposing an excessive rate hike on small employers. The nation's third-largest health insurer is raising rates by 19.2%, on average, for about 16,000 people covered by small employers. This change in premiums took effect last month. (Terhune, 5/6)

Here in Massachusetts, where coverage is near universal, costs stand in the way of needed health care for more than a quarter of residents, according to new findings from the state’s Center for Health Information and Analysis. (Goldberg, 5/6)

The health insurer Highmark has agreed to pay about 30,000 outstanding medical claims filed by rival UPMC providers. Gov. Tom Wolf announced the development Wednesday and commended Highmark for working with his administration to resolve the outstanding claims as the two western Pennsylvania health care giants compete for patients and coverage. (5/6)

Under federal law, insurance plans that cover mental health must offer benefits that are on par with medical and surgical benefits. Twenty-three states also require some level of parity. The federal law, approved in 2008, and most of the state ones bar insurers from charging higher copayments and deductibles for mental health services. Insurers must pay for mental health treatment of the same scope and duration as other covered treatments; they can’t require people to get additional authorizations for mental health services; and they must offer an equally extensive selection of mental health providers and approved drugs. (Ollove, 5/7)

Gov. Steve Bullock signed a bill Wednesday to close the Montana Developmental Center and move most of the 53 people with severe intellectual disabilities, mental health issues and personality disorders to community-based settings in the next two years. The Democratic governor said in a letter that he has concerns about the bill's approach to closure but he decided to defer to the Legislature's decision. (Baumann, 5/7)

The city of St. Louis has updated, localized information about how many residents are overweight. According to 2014 driver’s license data provided by the Missouri Department of Motor Vehicles, about 61 percent of St. Louis residents are overweight or obese. The St. Louis Health Department released a report analyzing the data on Wednesday. (Phillips, 5/6)

Johnson County was one of four communities nationwide introduced Tuesday as initial participants in a broad effort aimed at reducing the number of mentally ill individuals in local jails. Dubbed “Stepping Up,” the initiative is a combined effort of the National Association of Counties, the Council of State Governments Justice Center and the American Psychiatric Foundation. (Sherry, 5/6)

For the past several years, public health officials in Minnesota have been well aware that the state is facing a disturbing uptick in cases of opioid addiction. These addictions often start with prescription pain medications and escalate to highly addictive injectable drugs like heroin, a drug that’s ready accessibility at relative low cost that has created a problem in many cities and towns across the state. In 2014, for instance, a record high 14.6 percent of admissions to state addiction treatment programs were for heroin addiction, according to “Drug Abuse Trends in Minneapolis/St. Paul: 2015,” a report authored by Carol Falkowski, CEO of Drug Abuse Dialogues, an educational training organization. (Steiner, 5/6)

Crane High School in Crane, Tex., is experiencing an outbreak of the sexually transmitted disease chlamydia. The number of cases reported appears to be in dispute. While numerous stories in the Texas media say there have been 20 cases, with the MySanantonio reporting “nearly two dozen,” the school superintendent told the Washington Post and CBS7 in Texas that there have been a total of 8 cases during the year in the county as a whole but that more people are being tested. Crane Independent School District Jim Rumage had sent a letter home to parents, saying the number of cases reported have been “significant.” (Moyer, 5/7)

Lakewood Hospital is this community’s biggest employer, with 1,000 workers. It has been a rich source of municipal revenues even as manufacturing jobs left the region. But the hospital, operated for the city by the large nonprofit Cleveland Clinic system, has lost money since 2005. Executives say they need to close it and replace it with a smaller outpatient health center and emergency room. (Tribble, 5/7)

If the Supreme Court holds in King v. Burwell that the Affordable Care Act—also known as ObamaCare—does not allow subsidies for health coverage to flow through federal insurance exchanges, Republicans better be ready to say what to do next. Under such a decision, roughly eight million Americans in three dozen states would lose subsidies worth thousands of dollars. Many would suddenly find it impossible to pay for the insurance plan they’re on now. ... Fortunately, congressional Republicans have been thinking about the GOP’s response. The challenge will be to build consensus for one bill, choosing from the many ideas now being discussed. (Karl Rove, 5/6)

What will the market for individual insurance look like once Obamacare is in full effect? Policies for 2016 will be the first ones priced after insurers have a full year of claims data. The prices will increasingly also reflect the disappearance of a safety net: the reinsurance and risk corridor programs that were designed to protect insurers from unexpectedly high claims. ... Republicans complained that this amounted to a slush fund to pay off insurers for keeping premiums low (at taxpayer expense), the administration promised to make sure the risk corridors didn't pay out more than they took in .... A new report from Standard & Poor's shows just how much difference that could make: S&P expects there will be enough money to pay only 10 percent of claims. This suggests that at least a substantial minority of insurers are expecting to lose a lot of money on the policies they have already written. The typical response of insurers who lose money is to raise premiums in future years. (Megan McArdle, 5/6)

You’ve got a nasty head cold, or maybe your kid is home with the flu. If you’re a waitress and you call in sick, should the law forbid your employer from withholding your day's wages? A big debate over that question is taking place in Pennsylvania, pitting conservative state lawmakers in Harrisburg against liberal city officials in Philadelphia. It's the latest in a series of such clashes that have taken place across the country. Underscoring the high stakes of the outcome, the battle is also drawing attention from high-profile Democrats, including Hillary Clinton, in what could be the early stages of an argument that will play out during the 2016 presidential campaign. (Jonathan Cohn, 5/6)

By now we have heard the stories about unconscionable medical bills causing financial harms for patients. ... We have accepted that healthcare costs are out of control and causing real constraints on every level from individuals to communities to businesses to states to our nation. OK, but now, what are we supposed to do about it? For starters, we can supply a pipeline for change by embedding the principles of value-based care into the apprenticeship of health professional education. (Chris Moriates, Vineet Arora and Neel Shah, 5/5)

Sir Elton John, Knight Commander of the Order of the British Empire, flew into Washington to testify Wednesday before members of the United States Senate — or, as they might more accurately be described, the Madmen Across the Water. He had been called before an Appropriations subcommittee to speak about the importance of foreign aid, and particularly international AIDS spending. But, as might be expected of a 68-year-old rocker who did a large quantity of banned substances in his day, the witness occasionally veered off message — as when he described his life before he took up the cause of AIDS. (Dana Milbank, 5/6)

When elected officials play chicken, the state’s most vulnerable residents are at risk. For instance, although people like to blame Gov. Bruce Rauner for draconian cuts that would affect the disadvantaged, the General Assembly could ignore Rauner’s proposals and look elsewhere. But every year there’s a standoff and, as always, social service programs are targets. (Mary Mitchell, 5/6)

Just recently, a study published in JAMA once again confirmed that the measles, mumps, and rubella (MMR) vaccine is not related to autism. The study’s findings, widely covered in the media, are considered robust and important. But it may be time to question how much good continued research in this area is doing. (Aaron Carroll, 5/6)