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For the second year, Obamacare enrollment isn’t exactly over when it’s over. The regular open enrollment season ended at midnight Sunday but the Department of Health and Human Services on Monday announced a one-week “special enrollment” period ending Feb. 22 for people trying to enroll through HealthCare.gov who encountered technical glitches or faced long waits through the call center on the final weekend. Most states have outlined similar policies. There’s also a growing chorus urging a separate special enrollment period around the April 15 tax filing deadline. (Villacorta, 2/16)

Washington state on Monday became the first state to extend the sign-up deadline for health insurance until mid-April, allowing uninsured people to get health plans while filing their tax returns. Other states and the federal government’s HealthCare.gov insurance exchange, which serves 37 states, said they, too, are considering extending through the tax season the sign-up period that officially ended Sunday night. (Radnofsky and Armour, 2/16)

Americans who couldn't enroll in federal Obamacare insurance plans over the weekend because of computer glitches or long waits will now have until next Sunday to sign up, federal officials announced early Monday. "We are pleased that the vast majority of consumers were able to apply and pick a plan through HealthCare.gov or its call center without a problem," said Aaron Albright, spokesman for the U.S. Centers for Medicare and Medicaid Services. "For those consumers who were unable to complete their enrollment because of longer than normal wait times at the call center in the last three days or because of a technical issue such as being unable to submit an application because their income could not be verified, we will provide them with a time-limited special enrollment period for March 1 coverage." (Ungar, 2/16)

Americans who couldn't enroll in federal health care insurance plans over the weekend because of computer glitches or long waits will now have until next Sunday to sign up, federal officials announced early Monday. (Ungar, 1/16)

The Affordable Care Act’s second open enrollment period ended on Sunday. Well, almost. Some computer problems over the weekend have led the administration to give a one-week extension to people who tried and failed to sign up. But its tax penalty season has just begun. ... for people who don’t understand how Obamacare works, unpleasant surprises are likely. Say you didn’t buy insurance last year, because you missed the deadline or you were unaware that subsidies would help make it affordable. You let this year’s enrollment period slide by for similar reasons. Only after it’s too late to sign up will you learn that you’ve been hit with a hefty fine for last year and will face a bigger one for next year. (Margot Sanger-Katz, 2/17)

Senate Democrats urged President Obama on Sunday to allow extra time for some people to sign up for health insurance as hundreds of thousands of Americans raced to beat the enrollment deadline. More than 10 million people selected or were assigned to health plans in the latest enrollment period. Federal officials reported a final surge over the weekend, with more than 60,000 people using HealthCare.gov at times on Sunday. (Pear, 2/16)

The official sign-up season for President Barack Obama's health care law may be over, but leading congressional Democrats say millions of Americans facing new tax penalties deserve a second chance. Three senior House members strongly urged the administration Monday to grant a special sign-up opportunity for uninsured taxpayers who will be facing fines under the law for the first time this year. (Alonso-Zaldivar, 2/16)

A technical problem that had been interfering with sign-ups for President Barack Obama's health care law has been fixed, officials say. Any consumer whose enrollment was hampered by the glitch will be provided with a special enrollment period. The problem popped up the day before a Sunday deadline to sign up for subsidized private health insurance. It had been intermittent, meaning some people were able to complete their applications and submit them, Health and Human Service Department spokeswoman Katie Hill said. (Alonso-Zaldivar, 1/14)

Consumers had difficulty submitting their applications for health insurance on Healthcare.gov just one day before this year's deadline, a Health Department official said Saturday. (Barron-Lopez, 1/14)

In the final day leading up to Obamacare’s sign-up deadline, the website was once again hit with technical glitches that prevented people from signing up for health insurance. (Ehley, 2/16)

Obamacare enrollment draws to a close Sunday night, and all signs point to the White House easily meeting its target of getting 9 million Americans covered in 2015 — a drama-free ending to a season that proved a 180-degree turnaround from last year’s many problems. (Pradhan, 2/13)

Five Republican state governors say they will not rescue a crucial part of Obamacare if it is struck down by the Supreme Court, underlining the prospect for a chaotic aftermath to a ruling that could force millions of Americans to pay much more for coverage or lose their health insurance. ... In its ruling expected by June, the high court could bar the federally run insurance marketplace from providing the subsidies in at least 34 states. That could throw the insurance system into turmoil as states respond in starkly different ways. In response to Reuters' queries, spokespeople for the Republican governors of Louisiana, Mississippi, Nebraska, South Carolina and Wisconsin said the states were not willing to create a local exchange to keep subsidies flowing. (Morgan, 2/17)

House Republicans won’t agree to fix Obamacare if the U.S. Supreme Court rules that the law bars health-insurance subsidies for millions of people, said House Ways and Means Committee Chairman Paul Ryan. Republicans are developing a “contingency plan” to address the states whose residents would lose subsidies while lawmakers work on a full replacement for the Affordable Care Act, Ryan, a Wisconsin Republican, told reporters Friday in Washington. (Rubin and Cook, 1/13)

Erin Meredith, a fifth-generation Republican who lives in Austin, was no fan of President Obama’s Affordable Care Act, which she considered just another wasteful government handout. She didn’t sign up for a health plan until late last year, when she felt she had no other choice. ... Now that she has coverage, she doesn’t want to lose it. ... Meredith is one of about 6 million people whose subsidized insurance hangs in the balance as the Supreme Court takes up a case that poses the most serious challenge to the Affordable Care Act since the court found the law constitutional more than two years ago. (Sun and Chokshi, 2/16)

The simmering debate about ObamaCare reemerged in Washington this week amid questions about the plaintiffs in the upcoming Supreme Court case on the health law and Republicans sounding more urgent about preparing for the ruling. (2/15)

If the Supreme Court strikes down federal subsidies for Obamacare in the much-anticipated case of King v. Burwell, millions of Americans will lose their health coverage, insurance premiums will skyrocket, and hospitals would be forced to absorb higher costs for a surge in uncompensated care.That’s according to a gloomy new study from the Urban Institute, which analyzed what could happen if the Court rules against the Obama administration and deems millions of Obamacare enrollees ineligible for federal subsidies. (Ehley, 2/15)

Mounting questions about whether four plaintiffs have a legal right to challenge Obamacare in the Supreme Court have injected an aura of uncertainty around the high profile case. (Haberkorn, 2/13)

Despite questions about four challengers' legal right to bring their lawsuit, the Supreme Court probably will not be deterred from deciding whether millions of people covered by the health care overhaul are eligible for the subsidies that make their insurance affordable. ... given its decision to take up the health law even in the absence of the usual requirement that lower courts be divided on an issue, several legal experts doubted the plaintiffs' situations would derail the case. (Sherman, 2/14)

A look at the four Virginia residents who are suing the Obama administration over the health care overhaul. They all are eligible for subsidies that would significantly reduce the cost of their health insurance premiums, but say they would rather not have to purchase the insurance. (2/14)

With Sunday's deadline to enroll through the exchange looming, [Stephanie] Daugherty met with an exchange adviser, or navigator, at her Fort Worth community college to see if she might qualify for federal subsidies. She doesn't, but she also learned she may not have had to pay the penalty, after all. Daugherty and millions of other low-income, working adults who fall into a so-called coverage gap — ineligible for either federal subsidies or Medicaid — may qualify for an exemption to the penalty. In Texas and nearly two dozen other conservative states that chose not to expand their Medicaid coverage under the federal health care overhaul, nonprofit groups and volunteer tax advisers are trying to help people avoid the penalty for not having insurance. (Schmall, 2/14)

What’s new this tax season? In a word: Obamacare. That’s the answer given by many tax professionals. People who overcame the challenges of Healthcare.gov and succeeded in buying health insurance under the Affordable Care Act last year now face a new set of hurdles in the form of daunting tax forms. So do business owners who offer coverage to employees under the law’s Small Business Health Options Program. But the good news for both is that they may receive a tax credit that reduces taxes dollar for dollar. (Rosen, 2/14)

CoOportunity Health was one of 23 nonprofit cooperatives created under the Affordable Care Act to generate more competition and choice in insurance markets dominated by huge for-profit companies. Many of these newcomers to the industry, seeded with hundreds of millions of dollars in federal loans, struggled to attract customers after the law’s online insurance exchanges opened in 2013. But CoOportunity had seemed to flourish, with over 120,000 customers in Iowa and Nebraska — far more than the 15,000 it had anticipated — by the end of last year. Its success apparently helped doom it. CoOportunity’s many customers needed more medical care than expected, according to Nick Gerhart, Iowa’s insurance commissioner, and it had priced its plans too low. (Goodnough, 2/16)

As President Obama fights in Congress and the courts to preserve the nation's sweeping healthcare law, the Affordable Care Act faces still another threat to its viability: Republicans in statehouses, many bucking governors of their own party eager to accept its flow of federal dollars. [The state lawmakers] have proved far more effective at thwarting the 2010 healthcare law than their Republican counterparts in Washington, who have voted more than 50 times to repeal all or part of the program many call Obamacare, largely to no avail. (Barabak and Levey, 2/16)

Sen. Bernie Sanders (I-Vt.) says that single-payer healthcare did not fail in Vermont and could be revived, amid speculation that flailing efforts in that regard could hurt his 2016 presidential hopes. Sanders, a self-described socialist, has been a champion of nationwide government-provided health insurance for everyone, known as single-payer healthcare. (Sullivan, 1/16)

The top Obamacare official is making inroads deep in enemy territory. Health and Human Services Secretary Sylvia Mathews Burwell has spent more time selling the health care law in Texas than virtually anywhere else. And while many of the politicians here may hate the law, the Obama administration strategy is clear: If it can get upwards of 1 million Texans covered, it can prove the law is a success even in the most unfriendly climates. (Haberkorn, 2/14)

There are a lot of reasons sign-ups for individual health insurance are falling below expectations as the deadline for 2015 strikes on Sunday. One big one may be that many people are finding they just can’t afford to pay for a policy, even if it means a potential penalty. (Stiffler, 1/13)

A day before the release of an expansive MNsure audit, Republicans and officials with the state health insurance exchange skirmished over pay for MNsure managers. (Snowbeck, 2/16)

MNsure is about to get its report card, and the results might not be pretty. Minnesota's embattled health care exchange endured high-profile tech problems and struggled to sign people up for private plans in its first year, though it did help hundreds of thousands find insurance. (Montgomery, 1/15)

A top Wyoming lawmaker says the debate over whether to expand the federal Medicaid system in the state this year isn't over yet. House Speaker Rep. Kermit Brown, R-Laramie, said House members will bring up amendments to a budget bill this week seeking to expand Medicaid to offer insurance coverage to thousands of low-income adults. ... The Senate this month shot down a Medicaid expansion bill. That prompted House committee considering a similar bill to drop the matter, and many lawmakers pronounced the issue dead. (Neary, 2/15)

Since California embraced the federal health care overhaul, the state's Medicaid program for the poor has added more than 2.7 million people, a surprisingly high number that has left the state to grapple with making sure there are enough doctors to care for all of them. Medi-Cal, the $95 billion joint federal-state program, covers 12 million people — nearly one in every three residents — for their doctor visits, hospital care, pregnancy-related services, as well as some nursing home care, making California the largest health care purchaser in the state. (Lin, 1/15)

Wisconsin could save $345 million over the next two years if it adopts a full expansion of Medicaid under the federal Affordable Care Act, according to a new estimate prepared by the nonpartisan Legislative Fiscal Bureau. The revised estimate comes as the Legislature gears up to consider Gov. Scott Walker's $68 billion biennial budget, which cuts $300 million from the University of Wisconsin System among other austerity measures in the face of a more than $2 billion shortfall. (Defour, 1/15)

Shirley Fulton, a retired Superior Court judge from Charlotte, presided Monday over a mock grand jury hearing designed to shame North Carolina legislators into expanding Medicaid. Activists assembled in the legislative office building at noon to make arguments for extending government health insurance to impoverished adults who lack access to Medicaid or subsidized private plans. (Helms, 1/16)

An investigative committee in Congress is looking into the role Gov. John Kitzhaber's campaign advisers played in shutting down the troubled Cover Oregon technology project to move to the federal health insurance exchange. (Budnick, 2/14)

A Congressional panel investigating Cover Oregon has asked departing Gov. John Kitzhaber to preserve all documents related to the shutdown of the dysfunctional health insurance exchange. A letter submitted Friday by four members of the House Committee on Oversight and Government Reform asks for a slew of documents in hopes of understanding whether campaign advisers played a role in the decision to switch to the federal health insurance exchange. (2/14)

Veterans and some VA doctors say that the new “choice card” program, meant to reduce long patient wait times, is confusing and causing more stress. The choice card issued by the embattled Department of Veterans Affairs was meant to end long wait times for veterans after last summer’s scandal revealed that those who fought for their country were dying while waiting for care. The card gives veterans who have been waiting more than 30 days for appointments or who live more than 40 miles from a VA facility the chance to see a private doctor. (Wax-Thibodeaux, 2/16)

Seven months after taking the helm of the embattled Department of Veterans Affairs, Robert McDonald insisted during his first Sunday show interview that he has already brought new accountability measures to a scandalized department. “We’re making fundamental changes in the department…900 hundred people have been fired since I became secretary,” McDonald told Meet the Press’s Chuck Todd on Sunday morning. “We’ve got 60 people who we’ve fired who have manipulated wait times, we’ve got about 100 senior leaders who are under investigation now…so we’re holding people accountable.” (Lowery, 2/15)

Department of Veterans Affairs (VA) Secretary Robert McDonald said Sunday that he is holding employees of his agency more responsible for their treatment of veterans after a scandal that engulfed the department last year. “Nine-hundred people have been fired since I became secretary…so we’re holding people accountable,” McDonald said during an interview on NBC’s “Meet The Press.” (Laing, 2/15)

Now, with a measles outbreak that has affected 121 people in 17 states and Washington, D.C. — and an unusually high number of cases last year, 644 — people who refuse to vaccinate their children have become a focus of resentment and concern. Laws that allow parents to opt out of immunization are also coming under scrutiny. Can the government go further? Can officials require that citizens receive vaccines? The answer, legal experts say, is yes. The authority to require vaccination belongs to the states. (Grady, 2/16)

As pediatricians struggle to confront the emergence of diseases such as measles and pertussis, or whooping cough, many are re-evaluating how best to respond to parents at a time when the culture of medicine has shifted from doctors as patronizing know-it-alls to listeners who engage parents as partners. Some like Dr. [Paul] Offit say that when it comes to a public-health issue such as vaccines, the matter is black and white. Doctors need to be more assertive about insisting on the vaccine schedule outlined by the Centers for Disease Control and Prevention, they say. (Reddy, 2/16)

It’s an epidemic that has killed 32 babies and infected at least 100,000 Americans — most of them children — since 2012. But vaccine-averse parents aren’t the real culprits behind the spread of whooping cough. Inadequate vaccines are. The disease has returned in recent years with a ferocity that’s unlikely to abate anytime soon. Even Americans who thought they were protected have fallen ill. Yet whooping cough’s resurgence hasn’t triggered the public attention and congressional hearings that several dozen measles cases traced to Disneyland provoked in barely a month. (Allen, 2/15)

Millions of Americans with mental illness are hearing a loud and clear message: Get help. There’s still one question: Who is going to treat them? The shortage of mental-health providers in the U.S. has long been considered a significant problem. But it is becoming more acute as people are encouraged to seek treatment, or find they are able to afford it for the first time as a result of new federal requirements that guarantee mental-health coverage in insurance plans. (Radnofsky, 2/16)

Maybe she was trying to commit suicide. She’s not sure. The hydrocodone and ibuprofen the 18-year-old downed that morning last fall in her south Kansas City home would at least make her very sick. The senior made it to her school bus. Made it through her first hour at Center High School. But when assistant principal Sharon Ahuna saw the overdosed student in the hall between classes, she had sunk to the floor against the wall with her arms clutching her legs. The adults who swept in to her aid were sped by fear but swollen with frustration over the fractured network of mental health services struggling to help the nation’s children. (Robertson, 1/14)

For [Diane] Rehm, the inability of the dying to get legal medical help to end their lives has been a recurring topic on her show. But her husband’s slow death was a devastating episode that helped compel her to enter the contentious right-to-die debate. “I feel the way that John had to die was just totally inexcusable,” Rehm said in a long interview in her office. “It was not right.” (Rosenwald, 2/14)

It's been more than 15 years since Dick Israel's body started to revolt. His booming voice has become a rumble, his clever words tumbling out slowly in a nearly undecipherable growl. A hospital gown has replaced his trademark straw hat and bow tie. Richard E. Israel, 72, spent more than two decades behind the scenes in Annapolis guiding lawmakers. Now he plans to spend his final months alive lobbying them from afar, advocating for the right to die when he chooses, a final act of control over a disease that robbed him of it. (Cox, 1/15)

[Liver cancer patient Janet] Colbert’s end-of-life options would expand under a bill in the New Jersey Legislature that would allow doctors to help terminally ill patients end their lives. Similar legislation is emerging this year in New York and Connecticut. While the bills in the three states reflect a growing movement in the U.S., their outcomes are far from certain. Such measures have drawn opposition from the Roman Catholic Church, the American Medical Association and some groups that represent people with disabilities. (De Avila, 2/16)

Palliative care is increasingly used to help seriously ill adults and seniors. Now medical centers are creating teams that specialize in a more challenging task: delivering palliative care for young children. Despite a popular misconception, palliative care isn’t just about keeping patients comfortable until they die. Rather, palliative-care teams complement the usual array of physicians, specialists and clinicians, helping patients by managing pain, treating symptoms and ensuring that they have the best possible quality of life. Pediatric palliative care is modeled on the principles of adult palliative care. But because so much about treating seriously ill children is different from caring for adults, it presents its own unique set of challenges. (Sadick, 2/16)

Los Angeles County officials are allowing the use of powerful psychiatric drugs on far more children in the juvenile delinquency and foster care systems than they had previously acknowledged, according to data obtained by The Times through a Public Records Act request. The newly unearthed figures show that Los Angeles County's 2013 accounting failed to report almost one in three cases of children on the drugs while in foster care or the custody of the delinquency system. (Therolf, 2/16)

Planned Parenthood began construction here last year on a clinic that would perform abortions and provide other medical services for women. “High-Quality, Affordable Health Care for New Orleans,” a sign promised. “Seeing Patients Early 2015.” That sign is now crumpled on the ground behind a chain-link fence at the project’s abandoned construction site, victim of efforts by Gov. Bobby Jindal (R) and other abortion opponents to block the clinic. The push against the project began last year, when the Catholic archbishop of New Orleans wrote a public letter threatening to blacklist contractors on the clinic from any of the church’s numerous real estate projects. (Bridges, 2/14)

It’s a long way from being a done deal, but if it happens it will shake up metro Atlanta health care. Emory University and WellStar Health System announced last week that they are discussing a merger of their medical assets, a fusion that would face regulatory and logistical challenges. Completion of a deal is at least a year away. (Miller, 2/15)

Gov. Terry Branstad's plan to have private companies manage Medicaid would affect most of the 564,000 Iowans covered by the $4 billion program, administrators said Monday. The Department of Human Services released a formal "request for proposals" Monday afternoon. The idea is to have two to four managed-care companies oversee patients' care. Proponents say such an arrangement can help ensure that participants get the most effective, efficient care, which should help them avoid critical, expensive illnesses. (Leys, 1/16)

When the state rolled out new software to track Medicaid treatment and payments, some physician practices went months without getting reimbursed for their work. (Ferris, 1/16)

Former Kansas Gov. Kathleen Sebelius didn’t mince words when asked about the direction of Kansas politics during an event Thursday night at the Dole Institute of Politics. Making one of her first Kansas public appearances since stepping down in June as secretary of the U.S. Department of Health and Human Services, Sebelius called the re-election of Republican Gov. Sam Brownback “a low point” in the state’s political history. ... Finally, Sebelius said Kansas’ refusal to expand Medicaid has deprived tens of thousands of low-income Kansans of coverage they need. “Folks who are in states not expanding Medicaid are in terrible trouble,” she said. (McLean, 1/15)

It was a difficult decision, made with love. After the fire, when Eva Bonilla’s father was released from the hospital, she quit her job, loaded his wheelchair and oxygen tank into her car and made a home for the 84-year old man in her living room. ... The circumstances of Bonilla's father's decline, from 2008 until his death in 2010, were unique. But her story is one version of an oft-told tale in Texas, where an aging population is living longer but requiring more expensive and sophisticated care, often provided at home. Shifting demographics paint a troubling picture for the future of at-home caregiving. Growth of the state's elderly population is expected to outpace other age groups at a time when the cost of long-term care is projected to rise. Experts say experiences like Bonilla's will become even more common, as family members end up bearing much of the responsibility — and cost — of caring for their loved ones. (Walters, 1/15)

Iowans with serious chronic medical conditions gave emotional testimony Monday at the Statehouse in favor of expanding the state's fledgling medical marijuana bill, but they have a heavy lift ahead in trying to get more legislation passed this year. A bill passed last spring was designed to legalize possession of a marijuana extract for treatment of serious epilepsy. Critics say that it's unworkable because it doesn't allow distribution of the oil. They also want to expand the law to allow people with other conditions to try marijuana products. (Leys, 1/16)

For victims of a high-speed automobile crash, every second counts. Researchers at the University of Iowa were disturbed to learn a few years ago that, on average, personnel at UI Hospitals and Clinics only had seven to eight minutes of warning before an ambulance arrived at the emergency room with a crash victim. (Charis-Carlson, 1/16)

Mental health and substance abuse treatment providers are losing out on more than $5 million budgeted for them this year because the state hasn’t yet received federal approval to spend the money. That’s led some who oversee the public mental health coverage system to warn of dire consequences, including reduced access to services. (Levin Becker, 2/17)

Gov. Dannel P. Malloy will release his proposed two-year budget Wednesday, an attempt to fill a $1.3 billion deficit while keeping his campaign pledge not to raise taxes. Many people who work in or advocate for health care and social services are bracing for a tough year, even as some make pitches for increased funding. (Levin Becker and Phaneuf, 2/16)

Last May, as controversy mounted over a surgical device called the power morcellator, a professional association for surgeons issued a report defending the tool. A month earlier, the U.S. Food and Drug Administration had warned the device risked spreading cancer in surgeries such as hysterectomies. ... Doctors read the report closely for guidance on use of morcellators, which cut up and remove tissue through small incisions. What they didn’t know: An AAGL executive officer who received consulting fees from a morcellator maker had weighed in before publication. (Walker and Levitz, 2/16)

Surgeons sometimes fly blind when operating on hard-to-reach anatomical parts or hard-to-see conditions. For visual references inside the brain or body, they often rely on images and scans taken before an operation. A growing number of hospitals are equipping operating suites with magnetic resonance imaging, CT scanners and other technology that enables surgeons to scan a patient in real time, without having to move them from the operating table. The resulting real-time 3D visuals—known as “intraoperative imaging”—help surgeons excise tumors and tissue with greater accuracy, reducing risks such as nicked nerves from an errant knife and the potential need for repeat surgery. (Landro, 2/16)

[A] merging of wireless technology and medical care is still in its infancy, but health systems that began pilot programs with the technology in recent years say they see signs that it is keeping patients healthier. By enabling doctors to continuously monitor patients, they say, the systems can detect problems well before they grow serious. (Rockoff, 2/16)

Surgery can be risky by its very nature, and the possibility of error or negligence makes it even more so. According to an analysis last year in the journal Patient Safety in Surgery, 46% to 65% of adverse events in hospitals are related to surgery, especially complex procedures. Despite years of prevention efforts, procedures are still performed on the wrong body part and surgical tools are sewn up in patients. Now the movement to make things safer is taking on new urgency, as advocates inside and outside the surgical community push for a range of changes, and the cost of mishaps mounts. (Landro, 2/16)

Critics have long faulted U.S. medical education for being hidebound, imperious and out of touch with modern health-care needs. The core structure of medical school—two years of basic science followed by two years of clinical work—has been in place since 1910. Now a wave of innovation is sweeping through medical schools, much of it aimed at producing young doctors who are better prepared to meet the demands of the nation’s changing health-care system. (Beck, 2/16)

Now a handful of companies have received emergency clearance from the U.S. Food and Drug Administration to market faster diagnostic tools for Ebola that were in the works when the epidemic in West Africa erupted. One of the tools, from a company called BioFire Defense, uses the same kind of machine—polymerase chain reaction, or PCR—as the test that Ms. Meyler underwent. But BioFire’s system automates much of the process, so results are available in about an hour, instead of the usual four to six. ... Other companies are crafting machines to seek out common diseases. Alere Inc. of Waltham, Mass., has a flu test that delivers results in about 15 minutes, versus about 90 minutes for other tests. (McKay, 2/16)

“Is this doctor in my insurance network?” is part of the litany of questions many people routinely ask when considering whether to see a particular doctor. Unfortunately, in some cases the answer may not be a simple yes or no. (Andrews, 2/17)

House Energy and Commerce Chairman Fred Upton along with Senate Finance Chairman Orin Hatch and Senator Richard Burr have outlined what will be the leading Republican alternative to Obamacare. They have offered lots of good ideas. But by insisting on repealing and replacing Obamacare they have also refused to fix it and muddied the waters by giving people a huge and complicated take it or leave it health care plan of their own. (Robert Laszewski, 2/15)

While several Republicans in Congress have offered serious proposals to replace Obamacare, debating a wholesale replacement of the Affordable Care Act would take months, even years. But it is essential for Congress to move fast on a short-term solution. About 85 percent of people who bought plans on the exchanges receive subsidies, and most could not afford the policies without them. If fewer people are enrolled and new enrollments decline, premiums will rise, leading to the breakdown of the exchange markets. ... Fortunately, there is a way out, one that President Obama, forced by the court to the negotiating table, might be willing to accept. (Grace-Marie Turner and Diana Furchtgott-Roth, 2/13)

Obamacare's goal to expand access to health care has been only half a success: More Americans have insurance, but a rise in cost sharing means fewer can use it. Copayments -- those predetermined charges you pay at the doctor's office -- are a big part of the problem. In recent years, they've risen to the point where they no longer work as they're meant to. (2/16)

Obamacare's employer mandate requires firms that employ 50 or more people to pay for group coverage of employees who work at least 30 hours a week. Republicans have long criticized this as a de facto tax that will drive companies to reduce hours for part-timers; that is, those who can least afford the lost income. So there was a bit of an uproar when Buzzfeed reported that part-time employees of Staples, the office-supply chain, believe that the company is strictly enforcing a post-Obamacare rule against any part-timer putting in more than 25 hours per week. (2/14)

It isn't exactly surprising that all four individual plaintiffs in the King v. Burwell case have dubious legal standing to pursue their challenge to Obamacare's premium subsidies before the U.S. Supreme Court, as the Wall Street Journal has reported. Similar legal standing questions arose in 2011 about the two individual plaintiffs challenging the constitutionality of the Affordable Care Act in the case that ultimately led to the Supreme Court narrowly upholding the law in 2012. ... The irony is that all four of the plaintiffs in the pending case and at least one of the plaintiffs in the earlier case are people who very likely would benefit from Obamacare's premium subsidies to make coverage affordable and its rules against insurers' denying coverage based on pre-existing conditions. (Harris Meyer, 2/13)

The debate over ObamaCare has obscured another important example of government meddling in medicine. Starting this year, physicians like myself who treat Medicare patients must adopt electronic health records, known as EHRs, which are digital versions of a patient’s paper charts. If doctors do not comply, our reimbursement rates will be cut by 1%, rising to a maximum of 5% by the end of the decade. I am an unwilling participant in this program. In my experience, EHRs harm patients more than they help. (Jeffrey A. Singer, 2/16)

It seems impossible to believe that smoking is even more harmful to health than we had thought. Yet that is exactly what a large and authoritative study published last week has revealed. The findings provide stark evidence that the need to reduce smoking is more important than ever. ... The latest surgeon general’s report in 2014 estimated that there are 480,000 deaths each year in the United States from 21 diseases caused by smoking, including 12 types of cancer, acute myeloid leukemia, diabetes, heart disease, stroke and atherosclerosis. Now comes evidence that the toll is actually much worse than that. A study by researchers at the American Cancer Society, the National Cancer Institute and four universities — published in The New England Journal of Medicine on Wednesday — adds several more diseases and 60,000 deaths a year to the total. (2/14)

Most discussion about PTSD thus far has been about fear and the conquering of fear. But, over the past few years, more people have come to understand PTSD is also about exile — moral exile. We don’t think about it much, but in civilian life we live enmeshed in a fabric of moral practices and evaluations. We try to practice kindness and to cause no pain. People who have been to war have left this universe behind. That’s because war — no matter how justified or unjustified, noble or ignoble — is always a crime. It involves accidental killings, capricious death for one but not another, tainted situations where every choice is murderously wrong. (David Brooks, 2/17)

We believe so strongly that vitamins are always good for us, and that the more we get the better, that we fail to notice that food marketers use synthetic vitamins to sell unhealthful products. Not only have we become dependent on these synthetic vitamins to keep ourselves safe from deficiencies, but the eating habits they encourage are having disastrous consequences on our health. (Catherine Price, 2/14)

If you or a loved one is having a heart attack, your most pressing concerns probably include how quickly you can get to the hospital and the quality of care you’ll receive. You’re probably not thinking about the hospital’s board room, even though quality of care for heart attacks and many other conditions may be determined in large part by decisions made there. Several studies show that hospital boards can improve quality and can make decisions associated with reduced mortality rates. But not all boards do so. (Austin Frakt, 2/16)

My father was one in 5 million. That’s the probability of getting polio after being in contact with someone who has received the oral polio vaccine. I got the vaccine as an infant. And somehow the weakened form of the virus within it managed to infect my father. He spent nine months in intensive care, eventually becoming entirely paralyzed except for one eyelid with which he agonizingly communicated with my mother. A year after I was born, he was dead. As the debate over vaccines rages on, it’s difficult for me not to identify, at least in part, with the fears that drive parents to not vaccinate their children. (Nuria Sheehan, 2/12)