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Speaker John A. Boehner may be having trouble with conservative House Republicans, but he is on a bit of a roll in the federal lawsuit brought against the Obama administration over the new health care law. Judge Rosemary M. Collyer of Federal District Court on Monday denied the Obama administration’s request for an immediate appeal of her ruling that the House had the standing to sue the administration. The House says the law includes billions of dollars for new health insurance subsidies that were never authorized by Congress. (Hulse, 10/20)

A federal judge has rejected a request by the Obama administration for permission to immediately appeal last month’s ruling that allowed House Republicans to pursue their lawsuit against the 2010 health-care law. Last month U.S. District Judge Rosemary Collyer allowed House Republicans to proceed with parts of their Obamacare lawsuit, ruling that the House has legal standing to bring claims alleging the Obama administration overstepped its bounds in how it’s paying for portions of the health law. In doing so, the judge rejected the Obama administration’s argument that the court should not referee such a dispute between the legislative and executive branches. (Gershman, 10/19)

House Republicans called Monday's ruling a victory. "It's another important step toward holding the president accountable for his unconstitutional actions," House Speaker John Boehner, R-Ohio, said in a written statement. The Obama administration has said the courts should not get involved in a political dispute between the executive and legislative branches, arguing that judges have never done so. White House spokeswoman Katie Hill said the GOP lawsuit was a "taxpayer-funded political stunt" and expressed disappointment with Monday's ruling. (Fram, 10/19)

The district court judge, Rosemary Collyer, a Republican appointee of President George W. Bush, last month gave the House GOP a big win by ruling that their lawsuit against the administration could move forward. ... Collyer wrote that a ruling on the substance of the case would not take much more time — “a matter of months” — and that the appeals court “will be best served by reviewing a complete record” on both the standing issue and the substance of the case. (Sullivan, 10/19)

At issue in the case is the so-called "cost sharing" provisions that require insurance companies offering health plans through the law to reduce the out-of-pocket costs for policy holders who qualify. The government offsets the added costs to insurance companies by reimbursing them, but the lawmakers say that Congress did not properly approve the money for those reimbursements. (de Vogue, 10/19)

The House argues that Congress never specifically approved spending that money, and in fact denied the administration's request for it. The Obama administration insists it is instead relying on previously allocated money that it is allowed to use. (10/19)

With the Affordable Care Act’s third open enrollment period to begin in less than two weeks, federal officials are racing to fix new features of HealthCare.gov that are supposed to make it easy for consumers to find insurance plans that cover their doctors and prescription drugs. (Pear, 10/19)

With sign-up season starting in less than two weeks, the Obama administration indicated on Monday that some long-awaited upgrades to the government's health insurance website could take more time before they're customer-ready. At issue is a new doctor look-up tool for HealthCare.gov, as well as another feature that would allow consumers to find out whether a particular health plan covers their prescription drugs. Up to now, digging out that information has required additional steps. (Alonso-Zaldivar, 10/20)

When Billy Sewell began offering health insurance this year to 600 service workers at the Golden Corral restaurants that he owns, he wondered nervously how many would buy it. Adding hundreds of employees to his plan would cost him more than $1 million — a hit he wasn’t sure his low-margin business could afford. His actual costs, though, turned out to be far smaller than he had feared. So far, only two people have signed up. (Cowley, 10/19)

For years executives at Brocade Communications Systems Inc. were treated to a full day of physical exams and assessments in the high-end, spa-like setting of Stanford University’s executive medicine program at a cost of several thousands of dollars per executive. But the firm ended the perk in 2013, in an effort to eliminate inequalities in its employee benefits package and avoid taxes and penalties associated with the Affordable Care Act. (Chasan, 10/19)

The state's online marketplace for the uninsured estimates 150,000 will enroll in private health plans in 2016, up from 115,000 this year, though the marketing budget is down and it might be a tougher sell. "It's a semi-aggressive number, but it's what we're shooting for," said Andrew Ratner, the exchange's director of marketing and strategic initiatives, during the last exchange board meeting before open enrollment, which runs from Nov.1 to Jan. 31. (Cohn, 10/19)

A major provider of health insurance in Kansas is pulling out of the Affordable Care Act marketplace. Two companies under the Aetna corporate umbrella — Coventry Health & Life Insurance Co. and Coventry Health Care of Kansas Inc. — are withdrawing from the marketplace just two weeks before the Nov. 1 start of the next open enrollment period. Coventry merged with Aetna in 2013. (McLean, 10/19)

An analysis of health insurance data shows more than 16,000 Kentucky children obtained health insurance during the first year of the Affordable Care Act. The Foundation for a Healthy Kentucky and the State Health Access Data Assistance Center say the Kentucky's uninsured rate among children dropped 4.3 percent during the first year of the federal Affordable Care Act. Their analysis revealed more than 10 percent of the private insurance plans purchased on the state health exchange were for children. (10/19)

Troubled nonprofit insurer Colorado HealthOP on Monday sued for the right to continue selling policies in 2016 as it explored solutions to its financial problems. But at the eleventh hour — and after a closed-door court hearing from which reporters were removed — the low-cost insurer said it will begin shutting down. HealthOP filed a request in Denver District Court seeking to reverse a decision by state regulators to remove the co-op from Connect for Health Colorado, the state health-insurance exchange. (Wallace, 10/19)

Colorado's largest nonprofit health insurer went down swinging Monday, trying but failing to challenge a state decision to close it because of precarious finances. Colorado HealthOP, a nonprofit insurer set up under the federal health care law, unsuccessfully challenged the decision in a closed-door, two-hour hearing. (Wyatt, 10/20)

Health insurer Aetna's proposed $37 billion acquisition of smaller rival Humana Inc was approved by the shareholders of both companies. The companies continue to expect the deal to close in the second half of 2016, they said in separate statements on Monday. Aetna in July said it would buy Humana to become the largest provider of Medicare plans for the elderly. (Grover, 10/19)

The merger between Aetna and Humana moved one step closer to the finish line Monday as shareholders from both companies voted to approve the deal. Shareholders gave their overwhelming approval to the transaction with 99% of the votes in Connecticut and New York cast in favor of the deal. Aetna shareholders voted in the early afternoon with Humana shareholders voting two hours later. (Kutscher, 10/19)

Gerard van Grinsven has resigned as president and CEO of Cancer Treatment Centers of America “to pursue other interests,” the company announced Monday afternoon. A Modern Healthcare investigation last year found that three of the company's facilities were among the nation's leaders in receiving Medicare supplemental “outlier” payments, which are intended to compensate hospitals for unusually expensive episodes of care. The payments are derived in part from hospitals' retail prices, which typically exceed the actual cost of care. The company has also been criticized for broadcasting commercials that promote false hope and cherry-picking patients to skew its outcomes. (Rubenfire, 10/19)

The pain reliever Duexis is a combination of two old drugs, the generic equivalents of Motrin and Pepcid. If prescribed separately, the two drugs together would cost no more than $20 or $40 a month. By contrast, Duexis, which contains both in a single pill, costs about $1,500 a month. ... Horizon Pharma, has figured out a way to circumvent efforts of insurers and pharmacists to switch patients to the generic components .... Instead of sending their patients to the drugstore with a prescription, doctors are urged by Horizon to submit prescriptions directly to a mail-order specialty pharmacy affiliated with the drug company. The pharmacy mails the drug to the patient and deals with the insurance companies .... Horizon is not alone. Use of specialty pharmacies seems to have become a new way of trying to keep the health system paying for high-priced drugs. (Pollack, 10/19)

There is a new price surge in the pharmaceutical industry—for a limited number of government-issued vouchers that drug makers including AbbVie Inc. and Sanofi SA are buying to speed products to market. Legal provisions enacted in 2007 and 2012 require the U.S. Food and Drug Administration to issue “priority review vouchers” as rewards to developers of drugs for rare pediatric conditions or tropical diseases like malaria. Congress intended the vouchers to encourage more research into underfunded diseases. Companies receive them when the FDA approves their drug for sale, and can redeem them to speed FDA consideration of a subsequent drug for any disease. (Loftus, 10/20)

In the latest indication that government spending on costly new specialty drugs is soaring, a new analysis by ProPublica finds that Medicare has already spent $4.6 billion this year on two breakthrough drugs for treating the deadly hepatitis-C virus – or almost as much as the hepatitis treatment program spent during all of last year. ... Those two drugs, Sovaldi and Harvoni, manufactured by Gilead Sciences, are in hot demand for treating the serious liver disease thanks to a success rates of well over 90 percent. The new specialty drugs are far superior to older drug treatments and in many cases obviate the need for costly and dangerous liver transplants. But the pills can cost as much as $1,000 a day – or $84,000 for a 12-week course of treatment, before rebates. (Pianin, 10/19)

The most important trade deal of Barack Obama’s presidency could hinge on a single provision that’s reigniting a years-old debate on monopoly rights for drugmakers. The exact details of the pharmaceutical provision, which involves a class of drugs called biologics, won’t be made public until later this month. Still, it’s already threatening to drag out — and possibly derail — the approval process for a deal reached by a dozen nations that together make up 40 percent of the world’s gross domestic product. (Ferris, 10/20)

U.S. Senator Marco Rubio (R-Fla.) became the latest presidential candidate to speak out on prescription drug prices, saying that some pharmaceutical companies are engaging in “pure profiteering” and that high prices threaten to “bankrupt our system.” At a campaign event in New Hampshire last week, a member of the audience asked Sen. Rubio to characterize his “free-market solution” to bringing down the high-cost of lifesaving medicines, according to a video of the event posted online. A spokesman for Sen. Rubio said the exchange occurred at a campaign house party on October 14. (Walker and Haddon, 10/19)

As hospitals have acquired more doctor practices, prices for outpatient medical services have gone up, according to a new study that will fuel debate over the impact of the merger boom sweeping through health care. The new study, in the journal JAMA Internal Medicine, looked at what happened to the cost and volume of health-care services as physicians became more integrated into hospitals, by working for them or selling their practices to hospital systems. Overall, outlays for inpatient stays didn’t change significantly, but spending on outpatient care increased. (Wilde Mathews, 10/19)

In communities with the sharpest increase in financial integration between doctors and hospitals over the study period, average annual outpatient costs for each person with private health insurance increased by $75, while the amount of outpatient services they used was little changed. (Rapaport, 10/19)

The cost of visiting the doctor is climbing as hospitals scoop up a growing number of physicians’ groups, according to a Harvard Medical School study. Researchers found that when small doctors’ practices join large hospitals, their patients pay an average of $75 more every year for outpatient services like check-ups, even though the number of appointments stays the same. With data from cities across the United States, the study is the first to document the cost of physician acquisitions by hospitals on a national scale. (Boodman, 10/19)

Millennium Health agreed to pay $256 million to resolve government allegations that it billed Medicare for unnecessary tests. The company’s owners, including private-equity firm TA Associates Management LP and company founder James Slattery, plan to cover the federal settlement and make a separate payment to creditors, according to people familiar with the matter. (Jarzemsky and Weaver, 10/19)

Millennium Health LLC has agreed to pay $256 million to resolve claims it misrepresented the need for procedures and offered gifts to doctors in exchange for referrals. The biggest US lab-testing company plans to file for bankruptcy protection by Nov. 10, enabling it to turn over control of the company to its lenders, according to a person with knowledge of the matter. (Keller and Schoenberg, 10/20)

A drug testing lab has agreed to pay the federal government $256 million following allegations it billed federal healthcare programs for medically unnecessary testing. U.S. Attorney for Massachusetts Carmen Ortiz announced Monday that Millennium Health will pay $227 million to resolve allegations it billed Medicare, Medicaid, and other federal healthcare programs for unnecessary urine drug testing from Jan. 1, 2008 through May 20, 2015. (10/19)

Community Health Systems Inc and seven of its hospitals violated employees' rights to discuss working conditions, punished labor organizing and refused to bargain with unions, a U.S. labor agency alleged on Monday. The National Labor Relations Board's Office of General Counsel said it issued a consolidated complaint involving 29 charges at hospitals in California, Ohio, Kentucky and West Virginia owned by Tennessee-based Community, the second-largest publicly traded U.S. hospital operator. (Wiessner, 10/19)

Speaker John Boehner is facing growing pressure to start work this week on a bill to increase the federal borrowing limit as the debt ceiling deadline fast approaches amid the continuing uncertainty over who will succeed the Ohio Republican at the end of the month. ... Republicans in both the House and Senate have pushed for changes to mandatory spending programs — such as Social Security, Medicare and Medicaid — in exchange for a long-term debt limit increase. But time for those negotiations is running short and Democrats, including President Barack Obama, have made clear they will only support a clean increase. (Snell, 10/19)

Rep. Paul Ryan (R-Wis.) is more open than ever to becoming the next House speaker, following a contemplative week at home with his family. But before he makes a final decision, friends say, he will seek assurance from Republican hard-liners that he will have their full support should he win the gavel. (10/20)

Sen. Ben Sasse (R-Neb.) is throwing up roadblocks to the confirmation of two top Department of Health and Human Services (HHS) nominees over what he describes as “systematic failures” of an ObamaCare program for start-up insurers. The Senate has two pending nominees for high-level HHS positions: Andy Slavitt to be head of the Centers for Medicare and Medicaid and Karen DeSalvo to be an assistant secretary. (Ferris, 10/19)

More than two million people in the United States have a diagnosis of schizophrenia, and the treatment for most of them mainly involves strong doses of antipsychotic drugs that blunt hallucinations and delusions but can come with unbearable side effects, like severe weight gain or debilitating tremors. Now, results of a landmark government-funded study call that approach into question. (Carey, 10/20)

Quickly identifying people who have suffered a first schizophrenic episode and treating them with coordinated, sustained services sharply boosts their chances of leading productive lives, according to a major study being published Tuesday. And the treatment can be provided in a typical community mental health setting, the researchers concluded. (Bernstein, 10/20)

A federal judge has blocked Louisiana from expelling a regional affiliate of Planned Parenthood from Medicaid. The judge’s order dealt a setback to Republican Louisiana Gov. Bobby Jindal’s effort to strip the group of Medicaid funding following the release of videos on fetal tissue research. (Gershman, 10/19)

A federal judge has blocked Louisiana's efforts to defund Planned Parenthood clinics in the state, finding that more than 5,000 low-income patients would have their healthcare disrupted by a move he ruled likely ran afoul of the law. U.S. District Judge John deGravelles issued a temporary restraining order late on Sunday requiring Louisiana to continue providing Medicaid funding to the reproductive health organization's clinics for the next two weeks as the legal fight over the payments continues. (Grimm, 10/19)

Louisiana must wait at least two more weeks to cut Medicaid funding from Planned Parenthood’s two in-state clinics as a federal judge sought more information and cast doubt on the legal justification for the move. (Calkins, 10/19)

Louisiana must continue providing Medicaid funding to Planned Parenthood clinics for 14 more days while a legal battle continues over Gov. Bobby Jindal's recent order to block the funding, a federal judge ruled. (McGill, 10/19)

Aiming to drain the last few drops of state funding from Planned Parenthood, Texas officials announced Monday that they have taken steps to exclude the contentious organization from the state’s Medicaid program, citing violations observed in recently released undercover videos. The move targets about $3 million, most of it federal money, paid to clinics that provided health services to poor Texas women. Planned Parenthood officials vowed to fight the cuts but did not say whether they would go to court over the matter. (Martin, 10/19)

A Texas health official on Monday informed Planned Parenthood that it is being dropped as a Medicaid health care provider, saying undercover videos of fetal tissue practices show that the organization does not operate in a “professionally competent, safe, legal and ethical manner.” Planned Parenthood has 30 days to respond or be automatically severed from the program, according to the letters sent by the Health and Human Services inspector general. (Lindell, 10/19)

Texas health officials say they are kicking Planned Parenthood out of the state Medicaid program entirely over what they called "acts of misconduct" revealed in undercover videos filmed earlier this year. Republican state leaders, who vehemently oppose abortion, have worked for years to curb taxpayer funding of Planned Parenthood — despite the fact that its clinics may not receive such funding if they perform the procedure. (Walters and Ura, 10/19)

In letters to all Planned Parenthood affiliates in the state, the state health department’s inspector general said the videos persuaded them that the organization was “no longer capable of providing medical services in a professionally competent, safe, legal, and ethical manner.” (Somashekhar, 10/19)

The letter sent to Texas clinics attempted to address the issue of access to other services. The five-page letter was sent by the Texas Health and Human Services Commission’s Office of Inspector General. “Your termination and that of all your affiliates will not affect access to care in this state because there are thousands of alternate providers in Texas, including federally qualified health centers, Medicaid-certified rural health clinics, and other health care providers across the state that participate in the Texas Women’s Health Program and Medicaid,” the letter said. (10/19)

Planned Parenthood's affiliate in Texas has repeatedly stated that none of its clinics participate in fetal tissue donation programs. In 2010, Planned Parenthood Gulf Coast collaborated with the University of Texas Medical Branch, a publicly funded hospital, on a miscarriage study that involved fetal tissue. (Lachman, 10/19)

Republicans have called for Planned Parenthood to be defunded at the federal level. Democrats have maintained federal dollars are already prohibited from going to abortions, and that Planned Parenthood provides important health care for women. Planned Parenthood on Monday blasted the decision to cut Medicaid contracts for providing birth control, cancer screenings, HIV tests and preventative care, noting that a federal judge in Louisiana on Monday blocked a similar move. (Kopan, 10/19)

Saying it’s how his administration always has projected the state’s annual Medicaid costs, Gov. Terry Branstad on Monday defended a $51 million estimate for Medicaid savings next year, even though the state has produced no documents showing how it arrived at that figure. The state is transitioning to private management of its Medicaid program. Branstad’s administration said the move will save $51 million in the first year, a figure that was calculated into the current state budget. (Murphy, 10/19)

A key Democratic legislator is pressing Gov. Terry Branstad for details that spell out an estimated $51 million in cost savings for a shift of Iowa's Medicaid health care program from state government oversight to private management. State Sen. Robert Hogg, D-Cedar Rapids, chairman of the Iowa Senate Government Oversight Committee, said Monday he is skeptical about Branstad's plans .... Hogg's inquiry follows statements by Iowa Department of Human Services officials last week that they have no documents or even a list of experts consulted to support their estimates that a controversial plan to hire private companies to manage the Medicaid health insurance program will save taxpayers money. (William Petroski, 10/19)

The CMS has granted California permission to change the hospital admission process for some Medicaid beneficiaries in the state. Under a newly approved waiver, California will launch a two-year process for hospitals to voluntarily transition to a more streamlined process for admitting Medicaid patients. Currently, all hospitals except for public safety net hospitals have to get pre-authorization from the program before admitting fee-for-service Medicaid patients. (Dickson, 10/19)

A federal official initially denied Arkansas' request for records related to a Medicaid application that a Brickeys woman said she submitted more than 10 months ago, a state Department of Human Services official testified Monday. ... In a lawsuit filed Oct. 9, [Anita] Walker, 53, said she's been waiting for word on her eligibility since Nov. 24, 2014, when she applied through the federal healthcare.gov website. Federal rules require the state's Medicaid program to determine eligibility within 45 days of an application being made. Human Services Department officials testified that they never received any records on Walker's application from the federal Centers for Medicare and Medicaid Services, which runs the enrollment website. (Davis, 10/20)

North Carolina is in the process of overhauling its Medicaid program. The governor and state lawmakers are using a mixture of health care models to put the major players — doctors, hospitals and insurers — all on the hook to keep rising costs in check. For many of the Republicans who control the state legislature, the reason for the change is simple: budget predictability. (Tomsic, 10/20)

Lawmakers in some states mulling Medicaid expansion are tacking on a new stipulation: more money from the federal government to serve clients of the Indian Health Service. Republican South Dakota Gov. Dennis Daugaard met with Department of Health and Human Services officials last month to push the federal agency to pick up the full cost of serving Medicaid-eligible Indian Health Service patients who go to non-IHS facilities. (Evans, 10/19)

A new report to Congress on the transparency of Medicaid demonstration waivers is doing little to quell concerns that the CMS needs to beef up its oversight of the policy experiments. Experts say the document fails fully explain how the federal government decides whether to approve or reject a state's application. (Dickson, 10/19)

After narrowly avoiding closure last month, metro Detroit's last remaining independent hospital could be on a path out of bankruptcy and toward new private ownership. Doctors' Hospital of Michigan in Pontiac filed for Chapter 11 in July and, until recently, faced a nearly week-to-week struggle to meet payroll and pay vendors. A low point came in September, when a patient care ombudsman recommended moving patients out of the hospital because of a looming cash crunch. (Reindl, 10/19)

One of the largest hospital systems in the Tampa Bay area is expanding its reach with the purchase of a Polk County hospital. BayCare Health System is acquiring the 72-bed Bartow Regional Medical Center from the for-profit Community Health Systems (CHS) chain. According to a statement, the changeover should be complete by the end of the year. (Shedden, 10/29)

Three Atlanta hospitals are among the top-rated in the state, according to a data analysis by HealthGrove.com. Emory University Hospital, Emory University Hospital Midtown and Piedmont Hospital were ranked at Nos. 1, 3 and 9, respectively, according to HealthGrove's "smart rating." (Carlson, 10/19)

Women going in for their mammograms might encounter a fairly new technology: 3D. Also called breast tomosynthesis, the technology was approved by the Food and Drug Administration in 2011. In recent years, as more hospitals purchase the equipment, it’s gradually arriving in front of more patients. Jim Culley, a spokesman for Boston-based Hologic, which sells the 3D mammography units, said his company has noticed a significant increase in recent years and shipped out a record number in the last fiscal quarter, although he declined to release figures. (Bowen, 10/18)

Telling horror stories of long hours and stressed, overtired nurses caring for patients on the verge of death, lawmakers and nurse advocates on Thursday called for a state law establishing mandatory nurse-to-patient ratios and prohibiting mandatory overtime. Nurses around the country say they’re frequently asked to work double shifts to cover staffing shortages. Several nurses from the five state-run psychiatric hospitals, for example, told the State Journal earlier this month they're worked to the point of exhaustion because of excessive mandatory overtime. (Hinkley, 10/17)

As Dean Cole's dementia worsened, he began wandering at night. He'd even forgotten how to drink water. His wife, Virginia, could no longer manage him at home. So after much agonizing, his family checked him into a Minnesota nursing home. "Within a little over two weeks he'd lost 20 pounds and went into a coma," says Mark Kosieradzki, who was the Cole family's attorney. Dean Cole was rushed to the hospital, says Kosieradzki, "and what was discovered was that he'd become totally dehydrated. They did get his fluid level up, but he was never, ever able to recover from it and died within the month." (Jaffe, 10/19)

Like all healthcare disciplines, the Georgia’s home health industry is rife with hot topics. If you ask Mark Oshnock, president and CEO of Visiting Nurse Health System, the need for clinicians sits high atop the list. “Probably the most significant topic in the Atlanta market area is the shortage of skilled registered nurses” he said. “For the 35 years I’ve been in health care, we’ve always talked about the shortage of nurses. But it has never been more acute as it is today in Atlanta.” (Waterhouse, 10/19)

A Florida-based health care company is apologizing to the Haitian community after it posted what many are calling a discriminatory job ad in upstate New York. Interim Healthcare, which has its corporate office in Sunrise, offers health care services across the country through 300 different franchises. In an Oct. 15 ad looking for nurses in Rockland County, N.Y., it explicitly states “no Haitians" should apply. (Green, 10/19)

A national home health company apologized Monday for a job ad it called "offensive," but offered no explanation about how the discriminatory notice made it into a local New York newspaper. Interim HealthCare Inc. published a "help wanted" ad last week in a Rockland County, N.Y., Pennysaver, saying it was looking for a nurse and that "no Haitians" need apply for the position. ... Democratic State Sen. David Carlucci said the ad represented a "blatant form of employment discrimination" and called on an investigation by the New York State Department of Labor and the federal Equal Opportunity Employment Commission. (Corbin, 10/19)

But a grand experiment is underway in Sparta, one that health care experts, state legislators, local leaders, Mercer University School of Medicine officials and concerned citizens hope will become a model for the nation. The Hancock Rural Healthcare Initiative, an ambitious telemedicine program, equips ambulances with computers, cameras, electrocardiogram leads and 4G cards that allow EMTs to share patient information in real time with hospital emergency room doctors in neighboring counties. (Holman, 10/19)

Blue Cross and Blue Shield of Illinois and Advocate Health Care are teaming up to create a low-cost health plan in which the neediest patients will have access to more than 4,000 primary and specialty physicians across five Chicago-area counties. BlueCare Direct will be the insurer’s lowest-cost insurance offering for individuals and families in terms of monthly premiums and out-of-pocket costs, according to Blue Cross and Advocate. It will be offered both on and off the Get Covered Illinois exchange and also will be available for small-group customers. (Sfondeles, 10/19)

The discussions, if successful, would set up a special legislative session to approve the spending cuts to balance the budget. ... In September, the governor’s budget office said it revised its revenue estimates on capital gains taxes due to a poorly performing stock market and proposed closing the $103 million shortfall in part by cutting $63.5 million in Medicaid reimbursements to hospitals. In addition to hospitals, both Democrats and Republicans criticized those cuts, saying they would hurt health care in Connecticut. Mr. Malloy’s budget office responded by providing another $14.1 million to six smaller hospitals in the state. (DeAvila, 10/19)

Parents urged Nevada officials to pay more to therapists who work with children with autism, saying low rates could lead to a shortage of workers. Several people gave tearful testimony Monday at a Division of Health Care Financing and Policy meeting. One woman brought her son and said he would not be able to speak were it not for interventions when he was younger. (Rindels, 10/20)

Rather than cut $4.7 million from mental health and substance abuse treatment providers, as Gov. Dannel P. Malloy called for last month, the state Department of Mental Health and Addiction Services plans to shift the cut elsewhere in its budget and delay the start of new programs. The tradeoff drew both criticism from proponents of one of the delayed programs and praise from those whose funding is being spared. (Levin Becker, 10/19)

Eventually, the law will permit doctors to prescribe life-ending drugs to terminally ill patients who meet certain requirements: California residency; repeated requests, both verbal and written, for the drugs; and a determination that the patient is mentally fit to make such a decision. Its passage was a major victory for a movement that has sought for decades to gain traction in state legislatures. The California law quadruples the share of Americans living in states where physician-assisted suicide is permitted. The others are Oregon, Montana, Vermont and Washington. (Chokshi, 10/19)

The number of youth suicides in North Carolina increased by more than one-third between 2013 and 2014 and has doubled since the start of the decade, a child safety panel reported Monday in its annual review of child deaths in the state. Forty-six children died by suicide last year, compared to 34 the year before and 23 in 2010, according to data collected by state public health and statistics agencies and released by the North Carolina Child Fatality Task Force. (Robertson, 10/19)

Lawmakers are reviewing expenses of a state program that provides services to intellectually and developmentally disabled children and adults ahead of next year’s legislative session, when they will decide how much money to spend on it. State law requires a review of costs every two to four years for the Medicaid Home- and Community-Based Waivers program. The program pays for services such as respite care for families and aides that help developmentally disabled people shop or work on a particular skill, said Joe Simpson, administrator in the Behavioral Health Division of the Wyoming Health Department. (Hancock, 10/18)

The Michigan Department of Health and Human Services has been awarded more than $980,000 to develop certified community behavioral health clinics. Michigan is among 24 states chosen to receive a planning grant from the Substance Abuse and Mental Health Services Administration. The state health department will use the funding to develop criteria for certified community behavioral health clinics, establish a payment system and prepare an application to participate in a two-year demonstration program. (10/20)

All newborn babies in North Carolina will be tested for severe combined immunodeficiency under a bill that Gov. Pat McCrory signed Monday. Known as SCID or “bubble boy disease,” the disorder can leave infants vulnerable to deadly infections. Without early detection and a bone marrow transplant, babies with SCID have a life expectancy of only two years. (Campbell, 10/19)

In a retrofitted garage in his suburban backyard, Mike Eacker tends to his marijuana plants while he waits to see whether his crop will continue to turn a profit. For Eacker and other growers here in Montana, there is uncertainty as they anticipate the outcome of a state Supreme Court case that could effectively end commercial sales of medical marijuana and render their businesses unprofitable. Montana is among several vanguard states whose voters eagerly legalized medical cannabis by passing broad ballot initiatives as many as 19 years ago, but left lawmakers struggling to regulate an industry that grew quickly with few rules. (Breitenbach, 10/19)

Adults ages 50 and older who live in South Los Angeles now have help to get healthy and "HAPPI." Instead of waiting for seniors to access and receive no-cost preventive health services, the new Healthy Aging Partnerships in Prevention Initiative meets them "where they are." Approximately 1.1 million people of all ages live in South L.A., and roughly 20% are 50 or older, said project leader and research scientist Kathryn Kietzman at the UCLA Center for Health Policy Research. (Stephens, 10/19)

The more Ohio State University employees make, the more they will pay for health benefits next year. Ohio State, which spends nearly $300 million per year on medical benefits for its faculty and staff members, is moving to a tiered contribution approach in 2016 to lessen the impact of rising health-care contributions on lower-paid workers. (Sutherly, 10/19)

A board that oversees a children's health insurance program in Iowa says it's waiting for more information from state officials over the board's legal authority as the program's services are switched to private care. ... The hawk-i program provides health insurance to more than 37,000 children from low-income families. Plans to switch the program to managed care have been questioned by board members, who say they weren't consulted. (10/19)

Under the health law, young adults who age of out of the foster care system are eligible for free Medicaid coverage until they turn 26. The provision was an attempt to give them the same opportunity as other young people who can stay on their parents’ insurance until their 26th birthday. But these young adults are encountering a major barrier: They are only guaranteed coverage in the state where they were in foster care. States have the option of extending the benefit to all former foster youths, but only about a dozen have done so. (Gorman, 10/20)

In recent months, several nonprofit insurance plans that were created to compete with for-profit insurance plans under the Affordable Care Act have run into financial difficulties. Republicans and other critics of health care reform are cynically pointing to their problems as evidence that the whole reform effort is a waste of money that ought to be repealed. They neglect to mention that the nonprofit plans, known as health insurance cooperatives, were created as a weak, underfunded alternative to a much stronger option that the Republicans blocked from passage. (10/20)

Ever since passage of the Affordable Care Act in 2010, opponents have warned that it would be a job killer. At that time, with the national unemployment rate above 9 percent and the economy still struggling to recover after the Great Recession, this was a particularly worrisome concern. But five years later, though the unemployment rate now is around 5 percent, that argument still is being made. (Robert Kaestner and Bowen Garrett, 10/19)

Obamacare has undoubtedly produced a large drop in the number of uninsured. But if the administration is correct, then that decline will be less than half of what was originally expected, both because of the underenrollment in exchange policies and because so many states didn’t expand their Medicaid programs. The program may be shaping up as a modest expansion of Medicaid, coupled with a more robust version of the old high-risk pools. Obamacare's architects can justifiably say that this is more than we had before. But it is less than anyone expected. (Megan McArdle, 10/16)

Open enrollment on the Affordable Care Act insurance exchanges starts in less than two weeks. Coverage expansion supporters are worried about whether the exchanges will succeed in luring a large number of new enrollees for 2016. Despite the law's partial successes, there is lingering uncertainty about its effectiveness in establishing affordable, universal healthcare and about its political future heading into the 2016 elections. (Harris Meyer, 10/17)

Last week, former Florida Gov. Jeb Bush put forward a healthcare proposal as part of his campaign for the Republican presidential nomination. The plan, which has many moving parts, is intended as a replacement for the Affordable Care Act. If you don't anticipate getting sick, you might like it. (Dean Baker, 10/19)

When the United States is the only major country on earth that does not guarantee health care for all, or paid family and medical leave, we end that international embarrassment. A Medicare-for-all, single-payer health care system would be less expensive than our current system. We also pay for family and medical leave with a very modest increase in the payroll tax. It is time to create an economy that works for all Americans, not just the people on top. (Bernie Sanders, 10/19)

According to an estimate by The Wall Street Journal, [Sen. Bernie] Sanders’ spending plans would cost $18 trillion over 10 years, increasing the federal government’s size by roughly a third. ... To be sure, fully $15 trillion of the $18 trillion would come from Sanders’ health plan, which seems unlikely to cost that much. Bringing all Americans under the umbrella of a single-payer system would create enormous power to hold down prices. Even so, there’s no doubt that Sanders, who's running a surprisingly strong second to Hillary Clinton in the latest polls, is talking serious money. (10/19)

This month, Bernie Sanders took his vision for the future of American health care to a national television audience in the first Democratic presidential debate. “We should look to countries like Denmark, like Sweden and Norway and learn from what they have accomplished,” Sanders said. He wants the United States to copy Denmark’s single-payer healthcare system. This idea electrifies his supporters. ... But a closer look demonstrates that single-payer — in Denmark or anywhere else — devastates a nation’s healthcare system. (Sally Pipes, 10/19)

I recently decided to select a medical service strictly on price. This is something many economists think ought to happen more, to lower health spending. I was ready to do my part. Most patients, though, don't do this, even when they have to spend way more out of pocket to get the more expensive care. In retrospect, I wish I hadn't either. The lower-cost procedure — in this case, an MRI — did indeed save my insurance plan money. But it created a worse medical experience for me, and was helpful in highlighting the trade-offs that patients must make in the shopping experience. (Sarah Kliff, 10/19)

For all the hissy fits about Obamacare and the feds interfering with the sacred doctor-patient relationship, over the past few years, state-level politicians have orchestrated far more egregious intrusions. (Catherine Rampell, 10/19)

Texas, eager to plunge with both feet into the yodeling, pitchfork-waving Planned Parenthood defund-a-thon, gleefully told the women’s health agency Monday: Get ready to shut your doors. We’re pulling the plug. Only they’re not. The announcement by the Texas Office of the Inspector General that it intends to cut off Medicaid reimbursement to Planned Parenthood affiliates for routine women’s health services is a legal maneuver, not an eviction notice. States dominated by religious conservatives, like ours, have had an extra big bag of harassment tricks to pull on Planned Parenthood since the summer, when a splashy series of undercover videos was released by pro-life activists. (Jacquielynn Floyd, 10/19)

As states throughout the nation work to change how health care is delivered and paid for, New York is undertaking its largest effort yet to transform the state’s Medicaid health care delivery and payment system through the Delivery System Reform Incentive Payment (DSRIP) program. One of six states in the United States to implement a DSRIP initiative, New York has a program designed to move its delivery system from a place that’s fragmented and overly focused on inpatient care in hospitals toward an integrated system that proactively focuses on patients and the community. Organizations and agencies are working together to address the same goals and to care for each patient. Should be a piece of cake, right? (Katharine McLaughlin, 10/19)

In 2015, after 50 years of Medicare and Medicaid, mental health reform bills in both houses of Congress (House HR 2646, the Helping Families in Mental Health Crisis Act; Senate S 1945, the Mental Health Reform Act of 2015) may help to reduce mental health coverage gaps in these programs. When established, Medicare and Medicaid provided new mental health benefits and new processes for delivery of care.1 However, these programs also created significant coverage gaps in both inpatient and outpatient care. For many of these mental health coverage gaps, the proposed legislation marks a meaningful attempt at closure. (Thomas R. Blair and Randall T. Espinoza, 10/19)