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America's uninsured rate plummeted last year, with the improvement driven by states that have fully implemented the Affordable Care Act, a new nationwide Gallup survey indicates. Led by Arkansas and Kentucky, which both had double-digit declines, seven states saw the percentage of adults without insurance fall by more than 5 percentage points between 2013 and 2014. (Levey, 2/24)

The share of Americans without health insurance dropped to its lowest level in seven years in 2014 as President Barack Obama's overhaul took full effect, according to an extensive survey released Tuesday. The Gallup-Healthways Well-Being Index found that the trend appears likely to continue this year, since 55 percent of those who remained uninsured told the pollster they plan to get coverage rather than face escalating tax penalties. (2/24)

The Supreme Court has developed elaborate tests to determine if plaintiffs have standing to sue. But their essence, Justice Antonin Scalia once observed, is a four-word question: “What’s it to you?” To get into court, it is not enough to be unhappy about something. Only people with a direct stake in a dispute have standing to sue. Which brings us to the four plaintiffs in the latest threat to President Obama’s health care law, to be heard next week. (Liptak, 2/23)

The Supreme Court next week hears a challenge to President Barack Obama's health care overhaul that hinges on just four words in the massive law that seeks to dramatically reduce the ranks of the uninsured. The argument threatens subsidies that help make insurance affordable to consumers in about three dozen states. (Sherman, 2/23)

Three years ago, Supreme Court Chief Justice John Roberts cast the tie-breaking vote in a ruling that saved President Barack Obama’s signature healthcare reform. As the high court prepares to weigh another challenge that could shatter Obamacare, a review of Roberts’ recent votes and opinions suggest he could again sway the case the government’s way. (Hurley, 2/24)

Back in 2010, Sen. Charles E. Grassley proposed a minor amendment to a massive health care bill, requiring that federal lawmakers and their staffs start buying coverage through new insurance marketplaces that would – if the legislation ever passed – be set up by the government. In doing so, the Iowa Republican set into motion a strange series of events, entangling both city and federal officials in Washington, triggering one of the most stubbornly resilient legal challenges to the Affordable Care Act, and ultimately giving rise to a bizarre question: Can Congress be considered a small business? (Harrison, 2/23)

The potential legal liabilities from the unprecedented breach of some 80 million individuals' records at Indianapolis-based insurance giant Anthem could entangle nearly 60 health insurance plans from Hawaii to Puerto Rico, legal experts say. More than 50 class-action lawsuits related to the breach already have been filed in less than a month. (Conn, 2/23)

Over 10 million people enrolled in Medicaid and the children's health insurance program since ObamaCare's launch a year and a half ago, the administration announced Monday. The numbers show that through the end of December 2014, 10.75 million more people are enrolled in Medicaid or the CHIP children's health program compared to before ObamaCare's coverage expansion took effect in 2013, about a 19 percent increase. (Sullivan, 2/23)

Utah Republican Gov. Gary Herbert said Monday that hospital operators volunteered to pick up the state’s share of costs for people who enroll under a Medicaid expansion plan. But he added he doesn’t believe he will need to take the industry up on its offer during the first two years of the program. Herbert indicated that hospitals understand that they may benefit from an expansion more than other groups and would be “willing to pay their share if in fact we need it.” (Adams, 2/24)

Republican candidate for governor Matt Bevin said he would undo the expansion of the state's Medicaid system, a move that would take away health insurance from nearly 400,000 people. Bevin is the first candidate to promise this, ensuring the Affordable Care Act will play a prominent role as four Republicans try to woo the state's conservative voters ahead of the May 19th primary. (Beam, 2/23)

Republican Matt Bevin Monday said that he would he undo the state's expansion into Medicaid and shut down the state-run health insurance exchange program known as Kynect as part of his "blueprint" for the state if he were to win the governor's mansion. ... Bevin is one of four Republicans seeking the GOP nomination – the primary is scheduled for May 19. (Pilcher, 2/23)

Obamacare-loving California led the nation in embracing the health-care law, and in enrolling its citizens for 2014 coverage. This year, however, sign-ups for private health plans in California, New York and other states that opted to build and run their own insurance markets has stagnated. Yet in more conservative parts of the country that declined to participate and where enrollment is run by the federal government, sign-ups have surged. (Wayne, 2/23)

Florida managed to sign up or renew 1.6 million people by the end of open enrollment this month, in spite of state leaders’ unabashed disdain for the health care law. The figure is the highest in the country, even ahead of Texas, which has a larger population and a higher uninsured rate, and big states like California and New York, which are running their own exchanges but have seen new enrollment level off. (Pradhan, 2/23)

Monday was the last day of open enrollment to buy health insurance through the Massachusetts Health Connector, the state agency that serves people who don’t get coverage from an employer. But Connector officials say their work is far from over. (Freyer, 2/24)

Thousands of people are still waiting for tax forms from MNsure, but health exchange officials say the final batch of delayed documents soon will be in the mail. MNsure is in the final stages of sending about 35,000 forms that list the value of tax credits for those who bought private health plans through the exchange for 2014. (Snowbeck, 2/23)

Just over 110,000 people signed up for private insurance plans through the state’s health insurance exchange, Access Health CT, during the open enrollment period that ended Feb. 15, according to figures released by the exchange Monday. (Levin Becker, 2/23)

Senate Finance Committee Chairman Orrin Hatch is backing a Supreme Court challenge to one of the keystones of President Barack Obama's health care law. Now, he says he's preparing a plan to help people who might be hurt if his side wins the case. The Supreme Court is scheduled to hear arguments next week in a case by conservatives and Republicans that says many subsidies the law provides for millions of people are unconstitutional. They argue that the law only allows such subsidies for the 13 states that set up their own marketplaces to sell health insurance, not the 37 states that use the federal HealthCare.gov website. (2/23)

Democrats laid down a marker on health spending this month when they simultaneously introduced bills in the House and Senate to renew funding for the Children's Health Insurance Program through fiscal 2019. It was the opening gambit in what could be a months-long battle with Republicans over a program serving at least 8 million children that once provided a rallying cry for bipartisanship. Although the parties have time to find common ground before funding expires Sept. 30, children's health advocates say the issue, as a practical matter, needs to be resolved before states approve their budgets. And they are pressing to add a funding extension to "doc fix" legislation Congress is expected to pass in March that would block scheduled cuts to doctors participating in Medicare. (Attias, 2/23)

Big changes are in store later this month at the Centers for Medicare and Medicaid Services after Administrator Marilyn Tavenner officially steps down. Andy Slavitt, CMS' principal deputy administrator and a top spokesman for the dramatically improved Affordable Care Act rollout this year, takes over for Tavenner, the agency said last month. On Monday the agency announced Slavitt will be replaced in an acting capacity by Patrick Conway, a doctor who is chief medical officer at CMS. (O'Donnell, 2/23)

Humana Inc. and Aetna Inc. said Monday that they expect their Medicare funding to drop in 2016, after federal regulators last week proposed slight decline in payments for insurers that offer private Medicare plans. The Centers for Medicare and Medicaid Services estimated that the Medicare Advantage rate proposal represented a decline of 0.95% on average for 2016, though the agency said the insurers would likely see overall revenue increase about 1.05% as they deliver, and bill for, more intense services. (Dulaney, 2/23)

Tenet Healthcare Corp. swung to a profit in the fourth quarter, as the hospital operator recorded higher admissions and revenue. The company, which in recent quarters had seen improved results from the U.S. health-care policy overhaul as newly insured patients sought treatment, attributed most of its admissions growth in the fourth quarter to operational adjustments. In the current quarter, the Dallas company expects to make five cents to 55 cents a share and revenue of $4.3 billion to $4.5 billion, compared with the consensus of 42 cents a share and $4.28 billion, according to Thomson Reuters. (Armental, 2/23)

Across the country, the health care industry is pouring billions of dollars into new hospitals and medical centers. And the new hospitals of today are very different than the ones they're replacing. (Silverman, 2/23)

For decades, hospital executives across the country have justified expensive renovation and expansion projects by saying they will lead to better patient reviews and recommendations. ... Patient judgments have become even more important to hospitals since Medicare started publishing ratings and basing some of its pay on surveys patients fill out after they have left the hospital. [Dr. Zishan] Siddiqui’s study, published this month by the Journal of Hospital Medicine, contradicts the presumption that better facilities translate into better patient reviews. (Rau, 2/24)

Prompted by the UCLA superbug outbreak, a federal lawmaker is calling on Congress to investigate what the U.S. Food and Drug Administration and device makers are doing to prevent further patient deaths and infections. In a letter sent Monday to the House Committee on Oversight and Government Reform, Rep. Ted Lieu (D-Torrance) said outbreaks related to contaminated medical scopes “have national security ramifications.” (Terhune, 2/23)

Congress should launch an investigation into what the U.S. Food and Drug Administration is doing to prevent additional superbug infections after a deadly outbreak at a Los Angeles hospital linked to tainted medical scopes, a lawmaker said Monday. (2/23)

A senior Food and Drug Administration official voiced reservations about the new method UCLA's Ronald Reagan Medical Center is using to clean medical scopes linked to an outbreak of antibiotic-resistant bacteria. The official also said Monday that the agency will require makers of any new devices to show that they can be cleaned more reliably. In the aftermath of the outbreak at UCLA, which contributed to the deaths of two patients, university officials began sterilizing the instruments, known as duodenoscopes, using a toxic gas. (Willman and Terhune, 2/23)

Seven medical specialty societies, the American Bar Assn. and the American Public Health Assn. on Monday joined forces to declare gun-related injuries, which annually kill an average of 32,000 Americans and harm nearly twice that number, "a public health crisis" that should be studied and solved "free of political influence or restriction." (Healy, 2/23)

The state Attorney General last week approved the sale of six California safety-net hospitals to Prime Healthcare after a long and contentious approval process. (Gorn, 2/23)

Take it or leave it. That's the message to a Southern California for-profit company from Attorney General Kamala Harris who late last week laid out a dozen requirements for Prime Healthcare Services' $843 million deal to buy six cash-crunched nonprofit hospitals. (Seipel, 2/23)

A special state panel created by Gov. Nathan Deal has proposed a pilot program that would use telemedicine and other techniques to bolster rural health care in Georgia. The Rural Hospital Stabilization Committee report, released Monday, supports a “hub and spoke’’ model to relieve the burden on rural hospital emergency rooms. It would use telemedicine-equipped ambulances to facilitate remote diagnoses of patients in rural areas. (Miller, 2/23)

A panel studying Georgia's rural health issues on Monday recommended a pilot program pairing four hospitals with other providers in their area, creating a "hub and spoke" model aimed at cutting down on expensive emergency room visits to struggling hospitals. Members of the Rural Hospital Stabilization Committee said in their report that four rural facilities have closed in recent months and 15 are financially fragile — including six operating on a "day-to-day basis." (2/23)

House and Senate budget negotiators announced on Monday that they have struck a deal that rejects the fee increases and Medicaid expansion sought by Gov. Terry McAuliffe, but embraces some of the governor’s other spending priorities for mental health and economic development. Negotiators quickly struck the agreement after working over the weekend — a dramatic change from last year, when a months-long standoff over Medicaid delayed passage of a budget until the state was on the verge of a government shutdown. (Vozzella, 2/23)

People with serious mental illness but no health insurance would get help under the state budget agreement that emerged Monday from the House of Delegates and Senate. (Martz, 2/23)

Medicaid is one of the state’s largest expenses, and a big target for savings in Gov. Dannel P. Malloy’s proposed two-year budget. But health care providers and social service advocates say the way Malloy would cut Medicaid is financially short-sighted and threatens to undermine recent progress in a program that has added thousands of new members as part of the federal health law, expanded the network of providers willing to treat them, and reduced its per-client costs. (Levin Becker, 2/24)

North Dakota's Senate has killed a bill that would allow dental hygienists with advanced training to conduct certain procedures now done by dentists.The Senate defeated the bill 40-6 on Monday. Supporters of the measure say the legislation was aimed at improving access to dental care in rural North Dakota and on American Indian reservations in the state. (2/23)

Some New York City Council members are proposing a change to the city charter to help pay for future health care obligations for municipal workers. The city is projected to eventually pay $92.5 billion in health care obligations for current and retired city workers. (2/23)

Three weeks after ordering four major retailers to pull store-brand herbal supplements off their shelves following DNA tests that found little or none of the listed herbs, New York's attorney general is targeting the manufacturers of the popular products. Attorney General Eric Schneiderman sent letters Monday to four manufacturers in New York, California and Utah, demanding detailed ingredient and quality control information on every herbal supplement they sell in New York state. (Esch, 2/24)

Philadelphia's public school system is asking the state Supreme Court to reverse a lower court ruling that bars it from unilaterally imposing health care costs on unionized teachers. The School District of Philadelphia and its School Reform Commission said Monday that the Commonwealth Court erred when it sided with a teachers' union that argued imposing costs must be negotiated during collective bargaining. (2/23)

Months after he landed in Florida’s Manatee County Jail, Jovon Frazier’s pleas for treatment of intense pain in his left shoulder were met mostly with Tylenol. Four months later, after Frazier’s 13th request resulted in hospitalization and doctors diagnosed bone cancer, his arm was amputated, according to a lawsuit by his family. (Geller, 2/24)

A northern New Jersey doctor stands accused of fraudulently billing Medicare, Medicaid and private health care insurance companies for hundreds of thousands of dollars for office visits that were never rendered. Federal prosecutors say Albert Ades from 2005 through June 2014 fraudulently billed insurers for face-to-face office visits. They claim he wrote prescriptions, authorized refills or performed other tasks without ever seeing those patients on the billed dates. (2/24)

Citing the projected demand for primary care physicians in underserved areas, a California-based foundation is donating $6.6 million to Saint Louis University’s School of Medicine. The donor, the Everest Foundation, is the charity arm of a Los Angeles-based consulting firm for medical students called Residents Medical Group. Over a 10-year period, the gift will fund a visiting research fellowship program, five residency positions and a scholarship for family physicians returning to pursue a master’s degree. Of the seven positions filled annually, the donor would select the candidates for one of them. (Bouscaren, 2/23)

Geisinger Health System, which is viewed as a national model in providing both high-quality and cost-effective medical care, announced on Monday that it had chosen Dr. David T. Feinberg, the president of the UCLA Health System, as its next chief executive. (Abelson, 2/23)

A top aide to Gov. Peter Shumlin is defending the administration's handling of a contract with Massachusetts Institute of Technology health economist Jonathan Gruber, after criticisms were lodged by the state auditor. (2/23)

On March 4 the Supreme Court will hear oral arguments in King v. Burwell, with a decision expected in late June. If the court strikes down the payment of government subsidies to those who bought health insurance on the federal exchange, Republicans will at last have a real opportunity to amend ObamaCare. Doing so, however, will be politically perilous. ... Republicans need a strategy that is easy to understand, broadly popular and difficult to oppose. ... I believe that strategy is what I would call “the freedom option.” Every American should have the right to decide not to participate in ObamaCare: If you like ObamaCare and its subsidies, you can keep it. If you don’t, you are free to buy the health insurance that fits your needs. (Phil Gramm, 2/23)

One of the biggest myths pushed in statehouses across the country is that Obamacare’s Medicaid expansion will be an engine of economic growth. The Obama administration promises that more than 350,000 jobs would be created nationwide in 2015 if all states opted into Obamacare expansion. But the truth is that expanding Medicaid to able-bodied adults will discourage work, create massive new welfare cliffs and ultimately shrink the economy, not grow it. (Jonathan Ingram, Nic Horton and Josh Archambault, 2/24)

Sometime next year Social Security’s $150 billion disability-insurance program will become insolvent. The program, which offers income supplements to those who cannot work full time due to physical or mental disabilities, has buckled as the number of beneficiaries has soared to more than 11 million in 2014, from 3.8 million in 1984. The bipartisan Social Security Advisory Board has urged reforms. Yet the Obama administration’s 2016 budget proposes the opposite of reform: an unconditional transfer of revenues from Social Security’s retirement program. (Andrew G. Biggs, 2/23)

The bacteria are winning. Every year, according to the Centers for Disease Control and Prevention, at least two million people are infected with bacteria that can’t be wiped out with antibiotics, and as a result, 23,000 people die. Direct health care costs from these illnesses are estimated to be as high as $20 billion annually. ... The development of antibiotics has been glacial. We need a completely new approach. (Ezekiel J. Emanuel, 2/24)

At a health center [in Tanzania], a young woman is in the recovery room after a Caesarean section. A nurse takes the newborn to a table for cleanup. We (a group organized by the Center for Strategic and International Studies) are allowed to enter and see the child. But she starts struggling for breath. Three more nurses enter. One briefly applies bag-and-mask ventilation. Yet the infant’s breathing grows weaker and weaker as she turns a horrible shade of gray. (MIchael Gerson, 2/23)

When reviewing the recent and entirely preventable measles epidemic that began in, of all places, Disneyland, I was reminded of many things. The first was the Centers for Disease Control and Prevention’s ranking of the Ten Great Public Health Achievements in the 20th Century, a list based entirely on reproducible scientific data. The No. 1 achievement, without doubt, was the development of effective immunizations against a battery of infectious scourges such as measles, polio, whooping cough and diphtheria. Yet as physicians treating measles in poorer nations already know and, most recently, those in California are learning, this disease is no weakling in the pantheon of infectious diseases. (Howard Markel, 2/24)