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The Congressional Budget Office on Monday sharply reduced its estimate of how many people would get health insurance this year through the Affordable Care Act’s public marketplaces, to 13 million, from a prior estimate of 21 million. ... The budget office now estimates that 11 million people a month, on average, will receive subsidies this year, down from its prior estimate of 15 million. The lower estimates are not necessarily bad news for President Obama’s signature domestic accomplishment. (Pear, 1/25)

Fewer people than expected are purchasing health insurance under President Barack Obama's health care law, a report confirmed on Monday. ... The new estimates reflect a growing consensus that it's going to take longer for the online insurance markets to achieve their full potential. The latest numbers also recognize that many unsubsidized customers still prefer to buy their coverage directly from insurers, instead of going into the government market. (Taylor and Alonso-Zaldivar, 1/25)

Reflecting slower than anticipated enrollment growth in health insurance purchased through the Affordable Care Act, the nonpartisan Congressional Budget Office has lowered its estimate of how many people will get coverage through the law in 2016. The lower enrollment number brings the budget office closer in line with the Obama administration, which scaled back its own enrollment targets for 2016, citing the difficulty of reaching new consumers who have not so far taken advantage of the marketplaces. (Levey, 1/25)

Once Sunday’s open enrollment deadline has passed, shoppers will no longer be able to purchase coverage for the rest of the year through the federal and state-run health insurance exchanges or directly from health insurance companies or brokers unless there are mitigating circumstances that qualify for a special enrollment period. (O'Hare, 1/26)

Before venturing out this week to meet with someone who can help you sign up for coverage through healthcare.gov, a little homework is in order. (Sutherly, 1/26)

This is the second year that the Affordable Care Act and taxes will collide, and two changes this year could make the cumbersome tax filing process a bit more complicated. But let’s start with what has stayed the same. (Herron, 1/25)

One new report on Alaska’s expanded Medicaid health care system repudiates lawmakers who raised fears about its unintended consequences, while another provides new ideas to control spending on the $600 million program. ... [Gov. Bill] Walker, a Republican-turned-independent, ultimately used his executive power to expand the program unilaterally — a move that’s now subject to a legal challenge from the Legislature. But as attorneys prepare for oral arguments in that case next week, a new report commissioned by the Legislature itself dismisses some of the challenges that lawmakers themselves made against expansion, which now covers about 8,000 low-income Alaskans. (Herz, 1/25)

A group of health care experts acknowledged Monday that Medicaid expansion is at least a year away from serious consideration in General Assembly. However, they stressed at a forum at Wake Forest University Law School that expansion for an additional 500,000 North Carolinians doesn’t have to wait until the potential completion of Medicaid reform. There are options outside expansion, such as providing vouchers, to help the working poor escape the coverage gap, said state Rep. Donny Lambeth, R-Forsyth, a key writer of the reform bill that passed the legislature in September. The big question is whether there is any support among Republican legislative leaders. (Craver, 1/25)

A conservative organization is launching an ad campaign against Gov. Dennis Daugaard’s plan to expand Medicaid, targeting conservative voters to mobilize against the plan. Americans for Prosperity, a heavyweight among conservative grassroots organizations, started the campaign this morning by running radio ads on KELO Newstalk radio in Sioux Falls and KOTA-AM in Rapid City. Ben Lee, the group’s state director, said the ad buy would run for at least a week, and could be expanded. Expanding Medicaid, the ad says, would drive up the federal debt, which is a big concern to many fiscal conservatives in South Dakota. (Ellis, 1/25)

[I]n the lead up to the November presidential election, supporters of the ACA aren’t holding out much hope that more states will join in extending Medicaid coverage to more people .... After a new president is elected, the situation could change and more states could join in expanding coverage, predicted Joan Alker, executive director of Georgetown University’s Center for Children and Families, which advocates for greater health care coverage for the poor. ... Many Republican governors and lawmakers have rejected the deal, fearing they would lose their jobs if they were seen cooperating with President Barack Obama on a law most conservatives abhor. With Obama out of office, that could change. (Vestal, 1/26)

A Texas grand jury looking into alleged misconduct by Planned Parenthood Federation of America cleared the group and instead indicted two antiabortion activists who made covert videos of the organization. ... The move represented a surprise twist in the case, which was spurred by undercover videos of Planned Parenthood made in April by Mr. Daleiden, founder of the antiabortion group the Center for Medical Progress, and Ms. Merritt. Abortion opponents said the videos showed Planned Parenthood illegally profiting from fetal tissue and changing abortion procedures to obtain better specimens. The health group said it broke no laws, that the videos were edited to be misleading and that the clinics legally received money to cover the cost of procuring, storing and transporting tissue. (Frosch and Armour, 1/26)

A grand jury here that was investigating accusations of misconduct against Planned Parenthood has instead indicted two abortion opponents who made undercover videos of the organization. ... The record-tampering charges accused Mr. Daleiden and Ms. Merritt of making and presenting fake California driver’s licenses, with the intent to defraud, for their April meeting at Planned Parenthood in Houston. (Fernandez, 1/25)

Texas Gov. Greg Abbott [says] that the inspector general of the state’s Health and Human Services Commission and the Texas attorney general’s office [will] continue to investigate Planned Parenthood’s actions. “Nothing about today’s announcement in Harris County impacts the state’s ongoing investigation,” Abbott said in a statement. “The State of Texas will continue to protect life, and I will continue to support legislation prohibiting the sale or transfer of fetal tissue.” (Paquette, 1/25)

A grand jury in Texas on Monday indicted two anti-abortion activists behind the undercover Planned Parenthood videos -- and cleared Planned Parenthood of any wrongdoing. ... [A] two month investigation cleared Planned Parenthood of any misconduct and turned to the makers of the videos. "We were called upon to investigate allegations of criminal conduct by Planned Parenthood Gulf Coast," said Devon Anderson, Harris County’s district attorney. "As I stated at the outset of this investigation, we must go where the evidence leads us.” (McCaskill and Haberkorn, 1/25)

A Harris County grand jury on Monday indicted the videographers behind undercover recordings of a Planned Parenthood clinic in Houston and cleared the women's health provider of any wrongdoing. ... The two people who visited the Houston facility — including a center where abortions are performed — identified themselves as executives with Biomax Procurement Services, a shell company created by Daleiden's Center for Medical Progress. The undercover video, released in August, shows the two videographers and Planned Parenthood staff discussing the administrative costs of harvesting fetal organs at various stages of gestation. (Ura, 1/25)

A Harris County grand jury, investigating undercover videos depicting Planned Parenthood’s handling of fetal tissue, cleared the organization of wrongdoing Monday and instead indicted two abortion opponents involved in shooting the video in a Houston clinic last April. (Lindell, 1/25)

A U.S. judge granted Planned Parenthood class action status on Monday for its challenge to Arkansas' ban on Medicaid funding to the health care provider over videos secretly recorded by an anti-abortion group. The approval by U.S. District Judge Kristine Baker strengthens Planned Parenthood's bid to reverse the state's decision in August to halt funding after the videos surfaced in July, claiming to show the nonprofit group's officials negotiating the sale of fetal body parts for profit. (Barnes, 1/25)

Former Louisiana Gov. Bobby Jindal became embroiled in three high-profile lawsuits involving issues targeted by conservatives during his failed bid for the Republican presidential nomination: Planned Parenthood, Common Core and same-sex marriage. His Democratic successor, Gov. John Bel Edwards, however, appears to be in no rush to wade into the controversies. ... Jindal's health department cut off Medicaid funding for Planned Parenthood clinics in the state after videos were released by an anti-abortion group claiming Planned Parenthood illegally sells fetal tissue. The organization denied the allegation and said the videos were misleading. (1/25)

Democratic U.S. Senator Edward Markey of Massachusetts said on Monday he placed a hold on President Barack Obama's nominee to head the Food and Drug Administration until the agency agrees to reform its process for approving opioid painkillers. Markey wants opioid-approval matters to be reviewed by an FDA advisory committee and believes the committee should consider the risk of addiction and abuse during the approval process. He also wants the agency to rescind approval of OxyContin for children and convene an advisory panel to guide that process. (Clarke and Berkrot, 1/25)

Sen. Edward J. Markey (D-Mass.) said Monday that he has placed a hold on the confirmation of former Duke University researcher and cardiologist Robert Califf, President Obama's nominee to head the FDA, until the agency agrees to several measures related to the use of opioid painkillers such as oxycodone and hydrocodone. "Expert after expert has warned about the real world dangers of abuse of and dependence on these new supercharged opioid painkillers, but the FDA has willfully blinded itself to the warning signs," Markey said in a statement Monday. (Dennis, 1/25)

Congressional Republicans have promised to include deep spending cuts in their upcoming budget proposals and new data showing rising federal health care costs and a looming deficit increase will likely add to conservatives hunger for big funding reductions. Federal health care costs are expected to jump to $936 billion in 2016, outpacing the $882 billion projected spending on Social Security, according to a report released Monday by the Congressional Budget Office. (Snell, 1/25)

The government spent $936 billion last year on health programs including Medicare, Medicaid and subsidies related to the Affordable Care Act, a jump of 13 percent from 2014, according to the Congressional Budget Office. Spending on Social Security, in contrast, totaled $882 billion, the Congressional Budget Office (CBO) reported. The swelling cost of health programs is likely to ignite an election-year debate on the right over ObamaCare and its impact on the budget. (Ferris, 1/25)

In 2015, the U.S. federal government spent more on healthcare than on Social Security for the first time. The Affordable Care Act's expansion of Medicaid and the growing availability of subsidies for exchange plans are driving much of the higher spending. (Herman, 1/25)

House lawmakers have rescheduled a hearing to question former pharmaceutical CEO Martin Shkreli, reviled for hiking the price of a lifesaving drug, due to the weekend blizzard that has paralyzed travel on the East Coast. Staffers for the House Committee on Oversight and Government Reform said the hearing, which had been set for Tuesday, will take place Thursday Feb. 4 instead. (Perrone, 1/25)

A Senate investigation recently found that 16 hospitals around the U.S. failed to file mandatory paperwork with the federal government after patients at their hospitals became infected or died from the use of tainted medical scopes. Kaiser Health News' Chad Terhune spoke with Madeline Brand on KCRW’s Press Play about the investigation and steps the scope maker is taking to stop the infections. (Terhune, 1/25)

Democrats made their final arguments to Iowans on Monday night, with Hillary Clinton and Senator Bernie Sanders of Vermont offering contrasting views about whose vision would best move the country forward. ... Taking questions from an audience of mostly undecided voters, Mr. Sanders defended his plan for universal health care and made the case that his agenda to fight income inequality was not “pie in the sky,” as Mrs. Clinton has described it on the campaign trail. ... Mrs. Clinton also tried to take back the progressive mantle that Mr. Sanders has latched on to, reminding voters that she was fighting for universal health care decades ago and that she has scars from fights against drug companies and the health insurance industry. (Rappeport, 1/26)

With Iowa kicking off the 2016 election season in one week, Democratic presidential front-runner Hillary Clinton tried to erase doubts about her judgment raised by rival Bernie Sanders on Monday while digging deep into her years of governing experience. At a CNN town hall meeting, Sanders argued that his own judgment, not Clinton's experience, is the most crucial quality for the next commander-in-chief. (1/26)

Sen. Bernie Sanders uttered a handful of words that are likely to hang over his campaign -- and he probably doesn't mind it at all. "Yes, we will raise taxes," Sanders said during the CNN Democratic forum in Iowa on Monday night. ... Sanders has staked his entire candidacy on his willingness to bluntly declare that he will not only raise taxes on the wealthy, but his universal health-care plan requires increased taxes that would be offset by cost savings by eliminating monthly premiums and annual deductibles. (Phillip, 1/25)

With just a week to go before the critical Iowa Caucuses, Bernie Sanders Monday night acknowledged in the most clear terms yet that his single-payer health care plan would raise taxes. ... Sanders went on to say that a focus on taxes entirely misses the point, because his plan would reduce health insurance premiums by even more than it would raise taxes. (Seitz-Wald, 1/26)

Judging by the force of his answers, [Bernie] Sanders has zeroed in on two issues that could prove to be his downfall in the Democratic primary: gun control and his dismissal of Planned Parenthood as part of the “establishment." ...it was on Planned Parenthood that he made his most impassioned plea, after Democrats have lambasted him for labeling the organization — as well as NARAL and the Human Rights Campaign — as the “establishment” following their endorsements of Clinton. ... It wasn’t nearly enough -- NARAL sent out a press release before the end of the evening describing him as a “an ally, not a champion." (Debenedetti, 1/26)

Democratic presidential hopeful Bernie Sanders got personal with supporters in Iowa Monday in the final days before the state's lead-off caucuses. Alden, Iowa resident Carrie Aldrich teared up as she told Sanders about the hardships of living with a disability on less than $10,000 a year. Others discussed a spike in the cost of prescription drugs or the problems they face when an insurer doesn't cover their medication. Sanders thanked the group and touted his pledges to expand Social Security and create a single-payer style health care system. (1/25)

Donald Trump and Bernie Sanders have virtually nothing in common except for outsider status and pie-in-the-sky policy priorities, which they sell with highly charged emotional appeals targeted at voters’ economic and social anxieties. ... Sanders, the self-described democratic socialist, hews more closely to legal realities than Trump, but he still campaigns on an aspirational platform of political longshots. He vows to break up the big banks. He wants to give every student the option of going to college without paying for it. He envisions a health care system in which everyone is covered, including undocumented immigrants. (Viser and Linsky, 1/25)

Donald Trump said tonight he could save Medicare billions of dollars by allowing it to negotiate drug prices directly with pharmaceutical companies -- embracing a position Democrats have championed and Republicans have opposed for years. The Associated Press quotes Trump as telling a crowd in Farmington, N.H., that Medicare, a huge buyer of prescription drugs, could "save $300 billion" a year if it negotiated discounts. (1/25)

The wary and aggressive tenor of questions at a state hearing set a high bar for approval of the proposed $6.8 billion purchase of health insurance company HealthNet by Centene. The hearing Friday in the Capitol Building convened by the California Department of Insurance lasted six hours. It delved into the esoteric details of the large financial transaction and it also hit on some of the broader questions about what might happen to market competition and premium costs when health insurance companies consolidate. (Gorn, 1/25)

Health insurer Centene Corp. said on Monday that six hard drives containing sensitive information of about 950,000 members are “unaccounted for,” leading the company to launch an internal search. The Medicaid-focused insurer said that while it doesn’t believe this information has been used inappropriately, it is disclosing the search “out of abundance of caution.” (Minaya, 1/25)

Marilyn Tavenner was hired last year to take over leadership of America's Health Insurance Plans, the industry's leading advocacy group. Its members were struggling to get their bearings in the fledgling insurance marketplaces erected through the Affordable Care Act while Medicare Advantage and Medicaid managed-care programs were surging as business lines. Tavenner had recently left her post as administrator of the CMS, an agency intimately involved in those arenas. Now, Tavenner is faced with the task of coaxing two of the largest U.S. health insurers back to the fold. UnitedHealth Group, the largest health insurer in the nation, dropped out of AHIP just before she was hired, and Aetna quit this month. (1/23)

For many Americans, the days of paying a $10 or $20 copay for a doctor visit and leaving the medical bills to their insurance companies are long gone. Instead, many are paying a larger share of their medical bills, often through deductibles that leave people to pay the full cost of care until they hit a certain dollar limit. And that means not just higher potential costs, but more to understand – from figuring out how much care costs to handling bills that aren’t always clear. What can people do to better manage their high-deductible plans? Here are some tips from experts. (Levin Becker, 1/26)

Under the health law, most people are required to have insurance that meets minimum standards or pay a fine. Limited benefit policies such as short-term, critical illness, accident, dental and vision plans don’t qualify. In 2016, the penalty is $695 per adult and $347.50 per child, or 2.5 percent of household income, whichever is greater. ... Faced with sky-high premiums and high deductibles for traditional plans, it’s not surprising that some people are looking at other options, experts say. (Andrews, 1/26)

Geriatrics is one of the few medical specialties in the United States that is contracting even as the need increases, ranking at the bottom of the list of specialties that internal medicine residents choose to pursue. According to projections based on census data, by the year 2030, roughly 31 million Americans will be older than 75, the largest such population in American history. There are about 7,000 geriatricians in practice today in the United States. The American Geriatrics Society estimates that to meet the demand, medical schools would have to train at least 6,250 additional geriatricians between now and 2030, or about 450 more a year than the current rate. (Hafner, 1/25)

For many people struggling with opioid use, a key to success in recovery is having support. Some are getting that support from an unlikely place: their health insurer. ... Insurers typically cover some inpatient substance use treatment and detox, says CeltiCare's president and CEO Jay Gonzalez, but those are only short-term solutions. After a patient is discharged, relapse — and readmission — are likely without follow-up support. That's why CeltiCare assigns social workers to some of the people it insures. (Becker, 1/25)

An annual screening test for colon cancer that can be done at home showed strong effectiveness over several years, and patients who were sent the kits in the mail were very likely to participate year after year, a large study from Kaiser in both Northern and Southern California found. (Aliferis, 1/25)

A drop in the number of newly-diagnosed diabetes cases is good public health news. But for the Type 1 diabetes community it's a source of frustration, because the numbers hide their story. While it's certainly the right direction for the more common Type 2 diabetes, the findings don't apply to Type 1, a different condition that appears to be on the rise and that is not caused by obesity or lifestyle factors. (Tucker, 1/25)

GlaxoSmithKline Plc is concluding feasibility studies evaluating whether its vaccine technology is suitable for the Zika virus, which has been linked to brain damage in thousands of babies in Brazil, a spokeswoman told Reuters. There is no vaccine or treatment for Zika, which typically causes mild fevers and rashes, although about 80 percent of those infected show no symptoms. "We're concluding our feasibility studies as quickly as we can to see if our vaccine technology platforms might be suitable for working on Zika," Glaxo spokeswoman Anna Padula said in an email. (Grover and Penumudi, 1/25)

The virus has affected as many as 1.3 million in Brazil, reports the Associated Press, where Olympics venues in Rio de Janeiro will undergo daily inspections to prevent the virus from spreading at this summer's games. South American governments including Brazil and Colombia are asking also women to avoid pregnancy, according to AP. In El Salvador, authorities have asked women to not get pregnant until 2018. (Hafner, 1/25)

Physicians in Flint, Mich., sounded the alarms early last fall about possible lead poisoning. Now, local healthcare providers and insurers are helping the city respond to the crisis. When the city switched to the Flint River in April 2014, residents immediately complained about the water's smell, taste and color, said Kirk Smith, CEO of the Flint Area Health Coalition, which is coordinating the local health effort. (Greene, 1/25)

The water crisis in Flint, Michigan – in which the city’s drinking water became contaminated with lead, bacteria and other pollutants – has come to national attention in recent weeks. President Obama declared a federal emergency in Flint, freeing up $5 million in federal aid, but Flint’s water problems have been unfolding for almost two years. (Gordy, 1/25)

Michigan’s attorney general named a former prosecutor on Monday to spearhead an investigation into the process that left Flint’s drinking water tainted with lead, though Democrats questioned whether the special counsel would be impartial. Republican Bill Schuette said Todd Flood, a former assistant prosecutor for Wayne County, which includes Detroit, will lead the probe and be joined by Andy Arena, a retired head of Detroit’s FBI office. (Eggert and Householder, 1/24)

With six weeks to go before Iowa’s Medicaid program is tentatively scheduled to become privately managed, Medicaid Director Mikki Stier says she's "very confident" Iowa will be ready. The federal government delayed the state's plans to privatize Medicaid on New Year's Day, despite Gov. Terry Branstad and Iowa's Department of Human Services insisting the state was ready to make the switch. (Boden, 1/26)

The head of Iowa's Medicaid program on Monday said she's "very confident" the $4.2 billion system will be ready for private management beginning March 1, though some lawmakers expressed lingering concerns about the looming deadline. Mikki Stier from the Iowa Department of Human Services told lawmakers her confidence came from more signups of Medicaid health providers to join the new managed care system, as well as better communication to Medicaid recipients about the switch. (Rodriguez, 1/26)

A new computer system for enrolling Kansans in Medicaid and other public assistance programs will generate far less than the expected $300 million in savings, a Legislative Post Audit report found. The Kansas Eligibility Enforcement System (KEES) was intended to be a central portal where people could apply for benefits like Medicaid, food stamps and cash assistance, and the state could automatically verify their eligibility. (Hart, 1/25)

A House committee passed a bill Monday that would ban nearly all abortions in Florida, but even backers of the bill say its chances of passage, or of surviving a court challenge if it became law, likely are slim. House Bill 865 defines human life as beginning at conception, and would make it a crime to perform an abortion unless two physicians certify in writing that it's needed to prevent death or serious, permanent injury to the mother. (March, 1/26)

Hawaii lawmakers introduced legislation that would make it easier for adult women in Hawaii to get birth control. Right now, women can only get certain contraceptives through a physician. If passed, the bill would allow women older than 18 to get hormonal contraceptives such as birth control pills, patches and rings directly from pharmacists without having to visit a doctor. (Riker, 1/25)

Forty-two years ago Friday, the Supreme Court established constitutional protection for a woman's right to have an abortion in Roe v. Wade. Yet it remains a hotly debated topic in Ohio. This week the issue will heat up again, with an Ohio Senate Committee slated to take up the topic. (Higgs, 1/26)

Massachusetts is ending its longstanding practice of sending women with alcohol or substance abuse problems but who have committed no crimes to the state prison for women in Framingham. Republican Gov. Charlie Baker on Monday signed a bill approved last week by the Democratic-controlled Legislature that will give women access to addiction treatment services at Shattuck and Taunton state hospitals. (LeBlanc, 1/25)

When Bonita "Bonnie" Hudak had a hysterectomy three years ago after being diagnosed with endometrial cancer, she recovered faster and suffered less pain than when she delivered a child by cesarean section many years before. The C-section required a large cut that took weeks to heal and left an unattractive scar. For the hysterectomy, Hudak's doctor performed a robotic surgery that required only small incisions. (McDaniels, 1/24)

The new era of affordable health care bypassed Terri Newland. She runs a small land-use planning business with her husband, who has diabetes and needs hearing aids. She lives in one of the most expensive places anywhere to get medical care. For people buying their own policies, health insurance premiums in her western Colorado region jumped by an average of 25.8 percent this year. Her premium costs alone shot up more than $300 to $1,828 per month, or nearly $22,000 a year. Her policy also contains a $4,000 deductible each for her and her husband, and she's still trying to figure out what it will pay when he needs medical equipment. (Olinger, 1/24)

Florida leads the nation in new HIV infections, but it’s not being treated as a crisis by Gov. Rick Scott or the state’s top health officer, Dr. John Armstrong. As the disease has spread, Scott and Armstrong have imposed four years of personnel cuts in the Department of Health that have shrunk the size of county health departments. State lawmakers are now asking whether the spending decisions have produced a sicker population in a state where HIV infections have risen each year since 2012 as they’ve declined across the country. (Bousquet and Auslen, 1/24)

Nearly 5,000 people will lose services ranging from mental health counseling to senior day care after the state's largest social service provider said it will have to eliminate programs and lay off workers due to the state's ongoing budget impasse. Lutheran Social Services of Illinois said that the state owes it more than $6 million, and as a result, will have to shut down 30 programs and eliminate 750 positions. Programs that will be cut include treatment for drug and alcohol addition, housing for recently released prisoners and their families and a children’s shelter. (Bott, 1/25)

Republican Gov. Bruce Rauner said Monday that there is "no good excuse" for major cuts to social service programs that have resulted from the budget impasse, blaming Democrats he said could have struck a deal but are content to cause chaos in an effort to force a tax increase. The governor's comments came just days after Lutheran Social Services of Illinois, the state's largest social services agency, announced it would close 30 programs and cut 750 positions because it's owed more than $6 million by the state. (Garcia and Bott, 1/25)

A federal judge on Monday questioned Washington state's efforts to comply with her order requiring it to provide timely competency services to mentally ill defendants who have been forced to wait in jails for weeks or months. (Bellisle, 1/25)

Lobbying groups that represent Kansas doctors are urging legislators to join a multi-state medical licensing agreement. Kansas would join 12 other states that have approved the agreement, which would streamline the process for a physician licensed to practice medicine in one state to get licensed in other states in the compact. (Marso, 1/25)

Some Kansas health insurers are seeking legal permission to sell network-only plans — with the help of the state’s top insurance regulator. The office of Kansas Insurance Commissioner Ken Selzer supports a bill that would allow insurers to sell “exclusive provider organization,” or EPO, plans that provide no reimbursement for out-of-network health care except in the case of emergency. (Marso, 1/25)

State health officials are reporting progress curbing Medicaid costs for 6.3 million New Yorkers, telling lawmakers annual spending growth has dropped to 1.4 percent. Testifying Monday at a budget hearing, Health Commissioner Dr. Howard Zucker says overall quality of care has improved along with growing enrollment. (1/25)

Hawaii lawmakers are introducing a bill to require all doctors practicing in Hawaii to treat Medicare patients. Democratic House Speaker Joe Souki introduced the bill Friday, saying it would ensure that all people get medical treatment, regardless of their income. Souki says that if passed, physicians who refused to take Medicare patients wouldn't be able to reapply for their state medical license, which must be renewed every two years. (Riker, 1/23)

A House committee passed a bill Monday to regulate sober living homes after hearing testimony from Prescott residents about problems the homes are creating in their communities. Rep. Noel Campbell, R-Prescott, is pushing new standards for sober living homes even as Gov. Doug Ducey vows to cut regulations and the Legislature passes measures to take control away from cities and towns. (Velzer, 1/26)

Susan DeSimone has visited the hospital in Chestertown so many times "she could drive there blindfolded." She and her husband moved to the Heron Point retirement community in 2013 in large part because it was just blocks from the University of Maryland Shore Medical Center at Chestertown. ... The DeSimones and others in this town of about 5,300 on the Eastern Shore have been worried about the hospital ever since learning that University of Maryland Shore Regional Health, which oversees the medical center, might be considering turning it into an outpatient care center. (McDaniels, 1/24)

Baltimore Health Commissioner Dr. Leana Wen said city staffers have been working with local, state and private partners to make sure residents get life-sustaining medical care [following the weekend snowstorm]. Patients needing important medical treatments, such as kidney dialysis, are being transported by fire truck and the National Guard as snow-covered roads continue to create hazardous driving conditions. In Baltimore for example, the fire department and National Guard are traveling down rough roads to pick up patients and take them to Maryland Transit Administration vehicles. (Puente, 1/25)

Lawmakers are seeking assurances a computerized system to determine eligibility for state social service and Medicaid programs that has been fraught with delays will eventually be completed. The Kansas Eligibility Enforcement System, or KEES, has experienced numerous setbacks and is now more than 2½ years behind schedule — and set to exceed its original budget by at least $46 million. (Shoreman, 1/23)

It takes more than one hand to count the number of women in the Hansen family diagnosed with breast cancer. Joan Willenbring. Her mother. Her grandmother. Her aunt. Her first cousin. Her twin sister. Yes, the family drew a bad ticket in the genetic lottery. Willenbring and her siblings witnessed the death of their 56-year-old mother, who moved from a breast cancer diagnosis to death in just 13 months. (Dickrell, 1/24)

Each year, in the United States, millions of patients are harmed while receiving care in hospitals. They get infections, experience adverse reactions to drugs, develop dangerous bed sores, or come down with pneumonia from the very ventilators meant to help them breathe. The estimates of the number of people who die each year as a result of hospital errors have ranged from as many as 98,000 in a landmark Institute of Medicine report from 1999 to as many as 440,000 in a 2013 study. It’s believed that most of these deaths could be prevented if health care providers always adhered to evidence-informed practices. (David Bornstein, 1/25)

Separation of powers in government is one of the most basic concepts in our democracy. Iowans frustrated with Gov. Terry Branstad’s plan to privatize administration of Medicaid understandably turn to the Iowa Legislature for help. Lawmakers, however, seem to be at a loss for what to do. Short of holding the state budget hostage, they don’t have many options. The Obama administration is the only hope for stopping the governor by denying his application for a waiver needed to move forward. (1/25)

The Legislature now has to decide whether to continue the Medicaid expansion. The program sunsets on Dec. 31. Without reauthorization, it dies and all those who became medically insured would become uninsured again. The state would also lose an enormous amount of federal money: hundreds of millions of dollars per year moving forward. So far, New Hampshire has taken quite an independent path in crafting a Medicaid expansion that fits our state. ... Simply put, the Medicaid expansion is a win-win. Providers get paid and consumers get coverage. Considering the mental health and opioid crisis in our state, this coverage could not be more timely. (Jonathan P. Baird, 1/24)

Once again, the Affordable Care Act is helping bail out the Kansas budget. Gov. Sam Brownback has proposed using a $25.5 million increase in federal funding for the Children’s Health Insurance Program, per ACA, to free up state money to go toward covering the budget shortfall next fiscal year, the Kansas Health Institute News Service reported. Brownback wants to do the same thing with $17.7 million in federal CHIP funds this current fiscal year. In December 2014, Brownback used $55 million from a Medicaid drug rebate program that was made possible by the ACA to help plug the state budget (Phillip Brownlee, 1/25)

Former Secretary of State Hillary Clinton and Sen. Bernie Sanders continue to spar over health care and Mr. Sanders’s single-payer plan. Have you noticed that Republican presidential candidates have spent far less time debating differences between their proposals? One reason: Republicans care less about detailed policy plans than do Democrats. (Drew Altman, 1/26)

Clinton made clear her vision of her presidency: She’d try to push through incremental improvements in job creation (through a program of infrastructure projects), health care (through tweaking Obamacare so more people could benefit) and education (through making community college more accessible). In one of her few mentions of Sanders, she said the two of them had a common goal -- universal health care. But, she said: "He wants to start over, and I want to build on our achievements. It's a shorter distance to 100 percent from 90 percent than from zero." ... [Bernie Sanders] was talking about the same things as Clinton -- paying for universal health care and free college education by closing tax loopholes used by the wealthy and corporations. Yet his message seemed to have more impact, his credibility enhanced by his pride in collecting 2.5 million campaign contributions averaging $27 apiece and by the evangelical zeal behind his belief that the most ambitious goals were achievable through collective action, not backroom dealing. (Leonid Bershidsky, 1/25)

When the Affordable Care Act was drafted, the Congressional Budget Office expected people to sign up quickly for new health insurance. Now, two years into the law, it’s clear that progress is going to be slower. The Obama administration acknowledged as much in late 2014, and again in October, when it presented its own modest predictions. Monday, the budget office also agreed, slashing its 2016 estimate by close to 40 percent. (Margot Sanger-Katz, 1/25)

Sen. Bernie Sanders (I-Vt.) jumped at a chance to talk about mental health care during a presidential town hall event in Iowa hosted by CNN on Monday. “Mental health should be treated as part of health care, and should be available to all people,” he said. That may not sound like a controversial position and, within the Democratic Party, it isn’t. Democrats, including Hillary Clinton, have long championed treating mental health on the same footing as physical health. But historically, health insurers have not treated mental and physical health the same way. Insurers routinely capped psychiatric benefits -- by limiting inpatient hospital days or therapy sessions, or putting dollar caps on mental health benefits. (Jonathan Cohn, 1/25)

This month’s edition of Health Affairs features an article focusing on patients with high mental health costs — and how they incur 30 percent more costs than other high-cost patients. This research helps to make the increasingly compelling case for earlier identification and intervention to address mental illnesses — if we’re concerned about saving money. (Paul Gionfriddo, Theresa Nguyen, and Nathaniel Counts, 1/25)

Thirteen years ago, I started a pharmaceutical sales career for Wyeth Pharmaceuticals, peddling samples out of my bag near the lush beautiful beaches of Newport and Laguna beaches in California. I threw ornate dinners for local psychiatrists to boost the sales of Effexor XR for depression and anxiety, even though it was clear that the physicians I sold to — the "pain docs"— prescribed Effexor off-label for pain. Almost a decade later, I parked my sporty Infiniti company car in Beverly Hills and traded my $200,000-plus salary, which I was then receiving from a boutique firm called Medicis, for a used epidemiology textbook at the Johns Hopkins Bloomberg School of Public Health in Baltimore, where I started a master of public health program in 2011. What I did not realize at the time was that my own actions in closing a drug sale, without any bioethical considerations of what I was doing, helped contribute to the over prescription of powerful psychotropic drugs much like that of OxyContin, a powerful pain killer. (Nate Hughes, 1/25)

I am a disabled woman, a mother, an attorney and a business owner. I am a parent to four children with disabilities, two of whom are dependent on medical technology to live. I represent two organizations that exist to protect the rights and lives of disabled persons: Not Dead Yet and Disabled Parents' Rights. I am also strongly opposed to legalizing assisted suicide and the bills introduced in the Colorado legislature that would do so. (Lucas, 1/25)