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Top Obama administration officials said Tuesday they were anticipating their toughest sign-up season yet for insurance coverage under the health law. Officials aim to make a dent in the number Americans still uninsured in the law’s third enrollment period. They are eyeing about 10.5 million people who could buy coverage through HealthCare.gov or state sites, often with federal subsidies to offset premiums, but who have resisted signing up as the law rolled out. (Radnofsky, 9/22)

With the third open enrollment season under the Affordable Care Act beginning in about six weeks, Obama administration officials said Tuesday that they would focus efforts to expand health coverage to the uninsured in Dallas, Houston, northern New Jersey, Chicago and Miami. (Pear, 9/22)

Health and Human Services Secretary Sylvia Burwell on Tuesday gave three reasons why the 2016 sign-up season will be a bigger challenge: The most eager customers have already signed up; many of the remaining uninsured are young adults who may not see the value of coverage and those who remain are juggling tight household budgets. (9/22)

Citing just-released federal data, Burwell said the 17.6 million people who gained coverage included children up to age 26 who were able to stay on their parents plans, the expansion of Medicaid and the availability of the state and federal insurance exchanges. Speaking at Howard University in Washington — one of the historically black colleges and universities — Burwell also noted that the uninsured rate dropped 10.3% among African-Americans as 2.6 million gained coverage. Four million Latino adults also became insured, representing an 11.5% decline in the rate of uninsured Hispanics. (O'Donnell, 9/22)

According to estimates released Tuesday by Health and Human Services Secretary Sylvia Mathews Burwell, that is the size of a group — disproportionately young adults or minorities — that lacks health coverage and qualifies to buy health plans through insurance exchanges created by the law. (Goldstein, 9/22)

Affordability continues to be a challenge, she said. Even with the law’s financial help to pay for premiums and out-of-pocket costs, some uninsured may simply not have the money to pay for coverage. Almost 40 percent of the uninsured who qualify for marketplace coverage earn between 139 and 250 percent of the poverty level, about $30,000 to $60,000 a year for a family of four, Burwell said. Nearly 60 percent of the uninsured are either confused about how the tax credits work or don’t know that they are available, and about half of the uninsured have less than $100 in savings, Burwell said. (Carey, 9/22)

Some controls New York state relied on to make sure people were eligible for health-insurance coverage and subsidies on the state-run exchange were deficient, potentially letting some consumers get benefits they weren’t entitled to, an audit found. The inspector general for the Department of Health and Human Services reviewed a sample of 45 randomly selected applicants and analyzed their supporting documentation to see if the New York exchange followed federal regulations in determining eligibility for coverage and subsidies. (Armour, 9/23)

Vermont officials said Tuesday they're cautiously optimistic the state's health insurance exchange will meet next week's deadline for smooth operations. State officials had promised in the spring that Vermont Health Connect would meet key benchmarks by Oct. 1, ahead of the Nov. 1 start to an open-enrollment period when new customers can sign up for health coverage through the exchange. (Gram, 9/22)

There have been weeks, even months, of warnings and notices, but starting Thursday, the 155,000 people enrolled in the Washington Health Benefit Exchange (WHBE) must pay their insurance companies directly instead of sending premiums to the state-run program. “After Wednesday at 5 p.m., we’ll no longer be aggregating premiums or accepting payments,” said Michael Marchand, spokesman for WHBE, which operates the state’s health insurance marketplace under the Affordable Care Act (ACA). WHBE officials voted last December to stop managing customer invoices and payments, partly to simplify the process — eliminating a middleman — and partly to halt glitches that left hundreds of enrollees with missed payments, lapsed insurance and incorrect bills. (Aleccia, 9/22)

Gov. Steve Beshear, in a statement Tuesday Morning, ripped Republican gubernatorial nominee Matt Bevin for suggesting that he would save money by seeking a waiver from the federal government to revamp Kentucky's Medicaid expansion. Bevin has wavered on how he would attack the the expansion while continually saying that Kentucky can't afford it. On some days, he says he would do away with the expansion, on others he has called for seeking a federal waiver to redesign the system and on one occasion, he said he would "tweak" it. But in a statement released by the Kentucky Democratic Party, Beshear said that the system his administration has designed is the most cost effective and helps more people in Kentucky, one of the sickest state's in the country. (Gerth, 9/22)

Vermont is tied with Massachusetts for having the lowest rate of uninsured residents in the country. But that success might be coming at a high price. An unexpected spike in Medicaid costs has put the program and its thousands of new enrollees under heightened scrutiny. It's been less than three months since the start of the state fiscal year, but analysts say it already looks like Medicaid costs could come in as much as $60 million over budget in the 2016. (Hirshfeld, 9/23)

As [New Hampshire] lawmakers prepare for next year's political battle over Medicaid expansion, supporters said the state's ability to tackle a growing drug abuse problem will be dramatically reduced if the program comes to an end. "Medicaid expansion kind of allowed substance misuse providers to go from 0 to 60 from a service standpoint," said Abby Shockley, executive director of the New Hampshire Alcohol and Other Drug Service Providers Association. (Ronayne, 9/22)

Plans to avert a U.S. government shutdown began taking shape in the Senate on Tuesday, but it was still far from certain whether a dispute over funding for women's healthcare group Planned Parenthood could be overcome. With only days remaining before an Oct. 1 deadline, Senate leaders said they were pursuing a stop-gap funding bill to extend the present federal budget for about 10 weeks beyond the Sept. 30 end of the fiscal year. (Cowan and Cornwell, 9/22)

Conservatives in both chambers have been wrestling for weeks with how to respond to videos released by an antiabortion group showing Planned Parenthood officials discussing procuring fetal tissue from abortions to provide to third parties for medical research. Senate Majority Leader Mitch McConnell (R., Ky.) began setting up the votes expected to create a path for a spending bill to clear Senate procedures before the government runs out of money. But the bigger question is whether House Speaker John Boehner (R., Ohio) will be willing to go along with a plan unpopular among many of his most conservative lawmakers, who say the must-pass spending bill should strip federal funding from Planned Parenthood. (Peterson and Armour, 9/22)

Nearly a dozen House GOP freshmen are urging their colleagues to avoid a government shutdown next week and pass a short-term spending bill a week before federal agencies run out of money. In a “Dear Colleague” letter, eleven new Republicans urged their fellow GOP lawmakers to pass a continuing resolution by Sept. 30 - and not hold any stopgap spending bill hostage over funding for Planned Parenthood. (Bresnahan and Bade, 9/23)

When Republicans took control of Congress, Senate Majority Leader Mitch McConnell vowed there would be no federal government shutdown on his watch. Now, with barely a week to go before the Sept. 30 fiscal-year deadline, the GOP leader is in a familiar struggle to prevent that outcome. (Mascaro, 9/22)

The Senate on Tuesday blocked a bill banning abortions after 20 weeks of pregnancy, thwarting one component of a Republican antiabortion push sparked by the release of undercover videos. A group of 40 members of the Democratic caucus and 2 Republicans defeated the 20-week abortion ban in a 54-42 procedural vote Tuesday. The measure, already approved by the House in May, needed 60 votes to advance in the Senate. But the vote didn’t douse the abortion debate still roiling both chambers of Congress. (Peterson and Armour, 9/22)

The vote on the "fetal pain" bill was 54-42, short of the 60 needed to move ahead. Two Republicans — Sens. Susan Collins of Maine and Mark Kirk of Illinois — and three Democrats — Sens. Joe Manchin (W.V.), Bob Casey (Penn.) and Donnelly (Ind.)—crossed party lines. None of those five votes were surprising, given the lawmakers' stance on abortion and their statements about this legislation. Four senators, including Lisa Murkowski (R-Ak.) Barbara Boxer (D-Calif.) Parry Murray (D-Wash.) and Elizabeth Warren (D-Mass.) did not vote. (Ehley, 9/22)

The chief executives of two of the nation’s largest health insurance companies told skeptical senators on Tuesday that consumers would benefit if the federal government approved their plans to acquire two other big insurers. But Consumers Union, a consumer advocacy group, expressed doubts about the deals, and Senator Richard Blumenthal, Democrat of Connecticut, objected to the mergers, saying they could cause harm by reducing competition. (Pear, 9/22)

The chief executives of Aetna Inc. and Anthem Inc. defended their merger deals before a Senate subcommittee, facing sharply critical testimony that raised questions about the impact of health-insurance consolidation. Aetna is seeking to acquire Humana Inc., in a $34 billion transaction focused largely on the private Medicare plans known as Medicare Advantage. Anthem aims to take over Cigna Corp. in a $48 billion deal. The two deals together would shrink the top five U.S. health insurers to a big three, each with annual revenue of more than $100 billion. The third player would be UnitedHealth Group Inc. (Wilde Mathews and Kendall, 9/22)

Proposed mega-mergers between health insurance giants prompted by the Affordable Care Act won’t harm the level of competition in the market, two chief executives pledged Tuesday to skeptical lawmakers. The recent plans by Aetna Inc. to acquire Humana Inc., and by Anthem Inc. to buy Cigna Corp., have raised concerns over the economic impact that such mergers, which would eliminate two of the five largest insurers to create three companies, would have on consumers. The Justice Department is investigating the deals. (Howard, 9/22)

Leaders of two major health insurers planning multibillion dollar acquisitions made their case to Congress that bigger can mean better in their industry, but concerns are being raised in Washington about how these deals will affect consumers and competition. Blue Cross-Blue Shield insurer Anthem plans to buy Cigna for $48 billion, and rival Aetna is looking to acquire Medicare Advantage coverage provider Humana for about $35 billion in a wave of consolidation that swept through the industry this summer. The deals came under scrutiny Tuesday at a Senate Judiciary subcommittee hearing. (9/22)

Skeptical members of the Senate Judiciary Committee on Tuesday questioned Aetna CEO Mark Bertolini and Anthem CEO Joseph Swedish about their plans to merge with other large insurers, citing concerns about the consolidation’s impact on consumers. (Radelat, 9/22)

Republican and Democratic lawmakers expressed concern about two multi-billion dollar insurance mergers on Tuesday, using a Senate hearing to take issue with the companies' arguments that they face expanding competition from new rivals. Senator Mike Lee, a Republican from Utah who chairs the Senate Judiciary Committee's antitrust subcommittee, said he was worried that consumers would be "locked into the offerings of a few dominant companies." (Bartz, 9/22)

With voter fury rising over the high cost of prescription drugs, Hillary Rodham Clinton proposed capping out-of-pocket drug expenses at $250 a month on Tuesday while a rival for the Democratic presidential nomination, Senator Bernie Sanders of Vermont, extolled his own plan and long record for pushing to lower drug costs. While Republican candidates for the White House want to repeal the Affordable Care Act and generally oppose interfering with the drug industry, Mrs. Clinton and Mr. Sanders are competing fiercely with each other to press for greater competition and new regulations to rein in pharmaceutical companies. (Healy and Sanger-Katz, 9/22)

Hillary Clinton, laying out her health-care agenda, is trying to shift the national debate surrounding the divisive Affordable Care Act to focus squarely on rising out-of-pocket costs of care. In Iowa on Tuesday, the Democratic presidential contender put forth ideas to control prescription-drug spending. On Wednesday, she’ll talk about other consumer costs, such as high copayments and deductibles. (Meckler, 9/22)

Hillary Clinton on Tuesday unveiled a plan to rein in prescription drug costs by forcing pharmaceutical companies to reinvest their profits into research and allowing for more generic and imported drugs. The proposal, which she outlined in a speech in Iowa on Tuesday, would also allow Medicare to negotiate lower drug costs and cap out-of-pocket expenses for individuals with chronic health problems. (Przybyla, 9/22)

Clinton’s plan has several moving parts, some aimed at directly curbing profits of pharmaceutical companies and others to give the government a stronger role in constraining drug prices or making lower-priced medicine more available. She would allow Americans to reimport U.S.-made drugs from countries where they tend to be sold at lower prices. She would also allow the Medicare program to negotiate prices with drug manufactures. (Gearan and Goldstein, 9/22)

Hillary Clinton's campaign promise on Tuesday to cap prescription drug costs for U.S. consumers lends weight to efforts by health insurers, doctors' groups and consumers to address skyrocketing prices, industry experts said. Clinton, in the lead among Democratic presidential candidates, unveiled a plan that includes a $250 monthly cap on out-of-pocket costs prescription drugs, allowing the Medicare plan for the elderly to negotiate drug pricing and permitting Americans to purchase drugs from other countries at lower cost. (Berkrot, 9/22)

It's almost an afterthought, but the last two bullet points dangling at the end of Hillary Rodham Clinton's manifesto against high drug prices are its linchpin: She wants to allow the government to flex its muscle and negotiate lower drug prices from pharmaceutical companies. (Johnson, 9/22)

With a new poster child for prescription drug price gouging to swing at, Hillary Clinton unveiled a wide-ranging proposal on Tuesday designed to rein in the skyrocketing drug costs that are draining government budgets and the pocketbooks of many Americans. (Pianin, 9/22)

Hillary Clinton‘s prescription drug proposals are likely to get mixed reactions from the insurance lobby — and drugmakers already have come out swinging. The new head of the America’s Health Insurance Plans industry group said in an interview shortly before Mrs. Clinton’s plans were released that insurers have identified pharmaceutical price surges as a key threat to health costs, and that they plan to continue fighting on the issue. (Radnofsky, 9/22)

The leading pharmaceutical lobbying group is lashing out against Hillary Clinton’s soon-to-be-released plan to combat rising drug prices. The head of the Pharmaceutical Research and Manufacturers of America (PhRMA) released a statement Tuesday rebuking her proposals, which he warned would kill jobs, risk patient safety and halt investment in new cures for diseases such as Alzheimer’s, Parkinson’s and cancer. (Ferris, 922)

Vice President Joe Biden surged in a new national Bloomberg Politics poll of Democratic voters and independent voters leaning toward the Democratic Party released Wednesday morning, even though he has not announced his intentions for the presidency. Hillary Clinton earned a plurality of 33 percent, followed by Biden at 25 percent and independent Vermont Sen. Bernie Sanders at 24 percent. Other candidates are polling within the margin of error. (Gass, 9/23)

It looks like John Kasich got himself a new campaign donor last night. The Ohio governor had a tame appearance last night on NBC's "Late Night with Seth Meyers," getting a chance to explain his positions on the economy, faith, Medicaid expansion and debate strategy. (Thompson, 9/23)

It may not seem like much — just an extra hundred dollars or so a year. But the steady upward creep in health insurance deductibles has easily outpaced the average increase in a worker’s wages over the last five years, according to a new analysis released on Tuesday by the Kaiser Family Foundation. (Abelson, 9/22)

The average cost of employer health coverage passed $17,000 for a family plan this year, despite continued muted growth on a percentage basis, according to a major survey. The average annual cost of an employer family plan rose 4%, to $17,545, from $16,834 last year, according to the annual poll of employers performed by the nonprofit Kaiser Family Foundation along with the Health Research & Educational Trust, a nonprofit affiliated with the American Hospital Association. The share of the 2015 family-plan premium borne by employees was 29% of the total, the same percentage as last year. (Wilde Mathews, 9/22)

Health care costs continue to rise, and workers are shouldering more of the burden. The big reason? Skyrocketing deductibles. More companies are adding deductibles to the insurance plans they offer their employees. And for those who already had to pay deductibles, the out-of-pocket outlays are growing. (Kodjak, 9/22)

Forty-six percent of covered workers have a deductible of at least $1,000 this year for single coverage as employers shift to “consumer-directed” plans that give members incentives to seek less-costly care. Deductibles are more than $2,000 for single coverage for almost a fifth of covered workers. (Hancock, 9/22)

American workers saw their out-of-pocket medical costs jump again this year, as the average deductible for an employer-provided health plan surged nearly 9% in 2015 to more than $1,000, a major new survey of employers shows. The annual increase, though lower than in previous years', far outpaced wage growth and overall inflation and marked the continuation of a trend that in just a few years has dramatically shifted healthcare costs to workers. (Levey, 9/22)

[Kaiser Family Foundation CEO Drew] Altman calls this cost shift a “quiet revolution in health insurance,” obscured in recent years by the health care overhaul’s coverage expansion for people who don’t have coverage through work. “It’s funny, we used to think of $1,000 as a very high deductible, and now it’s almost commonplace,” he said. (Murphy, 9/22)

Despite some dire predictions, Obamacare isn't having much of an impact on hiring by businesses so far, according to a new study. Employers with at least 100 full-time workers must offer health insurance to full-time employees who work 30 or more hours a week or pay a penalty, as of this year. This mandate will start applying to smaller companies with 50 or more full-timers in 2016. (Luhby, 9/22)

The employer-sponsored insurance market has remained relatively stable overall despite the changes required by the federal health law, the authors wrote. But many employers are making or considering changes to their benefits that could bring significant changes in the coming years. Those include emphasizing wellness programs, assessing employees’ health risks – in some cases using biometric screenings that measure blood pressure, weight and other factors – and considering using private exchanges that allow employees to pick their own plans with a certain amount of money provided by the company (Levin Becker, 9/22)

The costs of health insurance benefits have increased at a slower pace for a decade now, but that does not mean that the high costs of the U.S. health care system have become less of a burden for individuals and families. (Boulton, 9/22)

Altman described the shift to higher deductibles, and in some cases companies previously without deductibles adopting them, as “striking.” “That explains why in our separate August Kaiser tracking poll, people named deductibles as their top health cost problem,” Altman said. “There could be a further spurt in deductibles as the ‘Cadillac tax’ goes into effect.” That tax, scheduled to go into effect in 2018, will subject high-cost health plans — those that cost more than $10,200 for single coverage and $27,000 for family coverage — to a tax of 40 percent of the excess amount. (Smith, 9/22)

Turing Pharmaceuticals CEO Martin Shkreli announced Tuesday night that the company will roll back the price of the drug Daraprim, but did not commit to a specific price. The company had faced intense criticism in recent days from patient advocacy groups, doctors, politicians -- as well as from within its own industry -- after it raised the price of the 62-year-old drug from $18 to $750 or more than 4,000 percent after it purchased rights to the drug last month. The medication is a critical treatment for a parasitic infection that can be fatal to those with compromised immune systems due to conditions like AIDS/HIV and cancer. (Cha, 9/22)

Martin Shkreli has been called everything from a boy genius to a vulture. Now he's earned the title "most-hated man in America." The 32-year-old CEO of Turing Pharmaceuticals is at the heart of a controversy this week over alleged "price gouging" by drug makers. (Long and Egan, 9/22)

Bankrupt Patriot Coal Corp asked a U.S. judge to allow it to end its obligation for retiree healthcare for its non-union employees, saying no potential buyer of its assets would agree to take on the cost. The company filed for Chapter 11 bankruptcy in May, its second in three years, due to plunging prices for its coal and tighter regulations. The company began an auction on Monday for the bulk of its assets, which includes mines in West Virginia and reserves in other states. Patriot has not said if the private auction had concluded. (Hals, 9/22)

The big three automakers, faced for years with looming health care expenses for their workers and retirees, are trying to figure out new ways to lower costs. Ford, which spends $7 an hour on health care for its current hourly workers, is expanding an experimental wellness program that it launched two years ago for chronically ill employees. The 1,200-1,500 workers selected at first were chronically ill workers and retirees who are not eligible for Medicare. (Craver, 9/22)

This critical type of health-care error is far more common than medication mistakes or surgery on the wrong patient or body part. But until now, diagnostic errors have been a relatively understudied and unmeasured area of patient safety. Much of patient safety is focused on errors in hospitals, not mistakes in diagnoses that take place in doctors’ offices, surgical centers and other outpatient facilities. (Sun, 9/22)

Almost every American will experience a medical diagnostic error, but the problem has taken a back seat to other patient safety concerns, an influential panel said in a report out today calling for widespread changes. Diagnostic errors — defined as inaccurate or delayed diagnoses — account for an estimated 10 percent of patient deaths, hundreds of thousands of adverse events in hospitals each year and are a leading cause of paid medical malpractice claims, a blue ribbon panel of the Institute of Medicine (IOM) said in its report. (Appleby, 9/22)

Most people will experience at least one wrong or delayed diagnosis at some point in their lives, a blind spot in modern medicine that can have devastating consequences, says a new report that calls for urgent changes across health care. Getting the right diagnosis, at the right time, is crucial, but Tuesday’s Institute of Medicine report found diagnostic errors get too little attention. (Neergaard, 9/22)

The researchers concluded the "inattention" and "neglect" paid to these mistakes have resulted in unacceptable harm to patients, and they projected the errors will probably worsen as health care becomes more complex. (Bonifield, 9/22)

Tackling misdiagnosis will require a drastic rethinking about health care delivery and about payment. The IOM report recommends comprehensive malpractice reform, involving new efforts to come up with alternative dispute resolution and potential safe harbors for providers who adhere to clinical guidelines. Those approaches could avoid the longtime stalemates in Congress over caps on damages — and should be a priority as wrong diagnoses are the leading cause of malpractice suits, the authors conclude. (Mershon, 9/22)

The Department of Veterans Affairs continues to retaliate against whistleblowers despite repeated pledges to stop punishing those who speak up, a group of employees said Tuesday. One called the department's office of inspector general a "joke." VA whistleblowers from across the country told a Senate committee that the department has failed to hold supervisors accountable more than a year after a scandal that broke over chronic delays for veterans seeking medical care and falsified records covering up the waits. (Daly, 9/23)

But testimony at a Senate hearing Tuesday demonstrated that despite vigorous efforts from the new VA leadership, the department remains a dangerous place for whistleblowers who report wrong doing. ... Christopher Kirkpatrick was a VA psychologist and whistleblower who complained about over-medication of patients at the Tomah VA Medical Center in Wisconsin when he committed suicide in 2009. His brother, Sean Kirkpatrick, spoke for him at the hearing. “Our brother felt helpless and hopeless with the obstacles he encountered at the Tomah VA Medical Center,” Sean Kirkpatrick told the hearing. “He wanted to improve the quality of care for our nation’s veterans through holistic options and continuously questioned the over-medication practices which hindered his ability to treat his patients. (Davidson, 9/22)

The state began moving toward managed care for Medicaid recipients Tuesday despite a persistent group of dissenters who argue that the plan rejects a system run by doctors that for years has helped hold down costs. The Senate passed House Bill 372, which overhauls Medicaid, in a 33-15 vote. There was less than five minutes of debate, though the topic has been the subject of months of discussion in Raleigh and beyond. The House then debated the bill for more than an hour before approving it 65-40. The bill now goes to Gov. Pat McCrory for his signature. (Bonner, 9/22)

North Carolina's $14 billion Medicaid health insurance system for the poor and disabled will be overhauled under a bill that cleared the General Assembly on Tuesday. The measure, House Bill 372, moves the system from a fee-for-service model in which doctors are paid for each service they provide to a managed care system and is the result of more than three years of negotiations between the House, the Senate and Gov. Pat McCrory. (Binker and Leslie, 9/22)

In a legislative session where it could be argued that most of the sharp words have been hidden behind closed doors, the General Assembly’s House of Representatives was the scene of some pointed exchanges Tuesday, as one leading Republican lawmaker picked apart a compromise Medicaid bill that had been negotiated by his own party. After the final version of the Medicaid overhaul bill had been introduced on the floor of the House of Representatives by Rep. Donny Lambeth (R-Winston-Salem), Rep. Nelson Dollar (R-Cary) stood up to oppose the bill. (Hoban, 9/22)

Far-reaching legislation designed to change how North Carolina government bills Medicaid patient treatment is going to Gov. Pat McCrory after the General Assembly approved Tuesday a final compromise measure that was years in the making. The legislation, voted for separately by the Senate and House, lays out the pathway by 2018 or 2019 to end the current fee-for-service system in which Medicaid in North Carolina reimburses doctors and hospitals for each service performed on a patient. Medicaid critics contend the practice has led to cost overruns and uncertainty. (Robertson, 9/22)

A state judge in Travis County indicated Tuesday that he’ll probably block Texas’ plan to sharply reduce Medicaid payments to therapists next week. After two days of testimony on the proposed cuts, state District Court Judge Tim Sulak announced he’s inclined to grant several home-care companies’ request that he stop the new rates from taking effect Oct. 1. (Garrett, 9/22)

Deep cuts to a therapy program for poor and disabled children will not take effect Oct. 1, a state district judge ruled Tuesday afternoon — the second such delay in recent weeks. (Walters, 9/22)

A Travis County judge said Tuesday he will block the state from cutting $350 million in Medicaid funding scheduled to take effect on Oct. 1. After two days of testimony, state District Judge Tim Sulak said the cuts represented an “imminent and irreparable injury” to children with disabilities. Parents told the judge the cuts would put their children’s therapy providers out of business. (East, 9/22)

When Texas lawmakers drafted a budget for the next two years that included deep cuts to therapy services for poor and disabled children, they ordered state bureaucrats to perform a tricky balancing act: figure out how to slash payments to therapists, but consider sustaining “access to care” while doing so. The state's Health and Human Services Commission, charged with pulling off the feat, admitted in court on Monday that it did not study how the program cuts it came up with will affect children’s access to medically necessary therapy treatments — and appeared to place the blame for that on Texas A&M University. But Tuesday, representatives for the university denied the state’s account, saying Texas A&M researchers were never told to study access to care at all. (Walters, 9/22)

Minority Republicans in the state legislature called Tuesday for bipartisan negotiations to reverse last week’s $190 million cut to hospitals. And House Minority Leader Themis Klarides, R-Derby, also called for Gov. Dannel P. Malloy to approach state employee unions for concessions to help balance the current budget and mitigate a deficit approaching $1 billion that must be resolved shortly after the 2016 state elections. (Phaneuf and Levin Becker, 9/22)

A labor union says Tufts Medical Center is running an aggressive campaign to stop hospital employees from organizing, holding meetings and showing videos to discourage workers from obtaining union cards. The Service Employees International Union, Local 1199, which represents 52,000 health care workers in Massachusetts, said hospital administrators in some cases made threats to replace workers who show interest in joining the union, which would be a violation of federal law. Tufts Medical Center disputes the claims. (Dayal McCluskey, 7/22)

At the old King/Drew Medical Center, guards used Tasers on psychiatric patients. Trauma surgeons mistakenly slit the throat of an 18-year-old shooting victim and a woman contracted HIV after she was infused with virus-infected blood. The public facility was forced to shut down in 2007, in large part because of serious breakdowns in patient care. Now a new hospital, known as Martin Luther King Jr. Community Hospital, has opened in its place and administrators say that they aim for it to be one of the best facilities on the West Coast. (Karlamangla, 9/22)

The former owner of a bankrupt Chicago hospital that was at the center of a federal health-care fraud probe has admitted to hiding millions in an offshore account to evade more than $188 million in civil penalties. Peter George Rogan, 69 years old, of Canada, pleaded guilty Tuesday in Chicago federal court to lying about the account in the Bahamas. Under the terms of the plea deal, Mr. Rogan faces a year to 21 months in prison. He is scheduled to be sentenced Oct. 14. (Armental, 9/22)

On Monday, a state agency released a report that rates 270 hospitals across California for how well those hospitals handle ischemic stroke -- including outcomes, mortality and the ability to prevent hospital readmission. The report from the Office of Statewide Health Planning and Development (OSHPD) ranked acute care hospitals on stroke care in 2012-2013 using risk-adjusted numbers. Hospitals with higher-risk patients were given more leeway than hospitals with a younger, healthier population, according to Merry Holliday-Hanson, manager of the administrative data program at OSHPD. (Gorn, 9/22)

Planned Parenthood went to court Tuesday and asked a federal judge to prevent Gov. Robert Bentley’s administration from ending Medicaid payments to the organization’s two Alabama clinics. (Chandler, 9/22)

A bill banning certain types of research using fetal tissue from abortions and allowing others likely lacks the votes needed to pass the state Assembly, Speaker Robin Vos said Tuesday. The Rochester Republican said changes will likely be needed to the bill before the GOP Legislature can pass the proposal, which narrowly made it out of committee this month. (Gallagher and Stein, 9/22)

Samantha McVey brought her 4-month-old daughter, Ruby, to The Children’s Clinic for a routine check-up and vaccinations. But within minutes of sitting down with Dr. R.J. Gillespie, McVey was describing her turbulent childhood with a drug-addicted father who spent time in prison. “How do you think that affects your parenting now?” Gillespie asked. "I don’t want my kids to have to go through that," said McVey, 23. (Gorman, 9/23)

The federal government’s authority to spend money on discretionary programs expires at midnight on Sept. 30 — just a week from Wednesday . As we write, no one can be sure that Congress will pass a law keeping the government funded beyond that date and thereby enable it to avoid a partial shutdown. In the Senate, Republican leader Mitch McConnell (Ky.) reportedly has a plan that would permit his caucus to stage a symbolic vote against Planned Parenthood without risking a shutdown. The bigger problem is in the House, where Speaker John A. Boehner (Ohio) is struggling — once again — to rein in far-right conservatives who are willing to pass a funding bill only if it reflects their priorities, in this case, by “defunding” Planned Parenthood. That is, they prefer grandstanding, on behalf of a cause most Americans don’t support, to governing the country. (9/22)

The CBO found that the one-year defunding would produce about $235 million in federal savings, barely a rounding error in the federal budget, but that the real costs would be borne by low-income and rural women. In human terms, the CBO's bottom line is that as many as 650,000 women, chiefly in low-income neighborhoods or communities "without access to other health care clinics," would lose at least some access to care. The measure would hamper Planned Parenthood's ability to provide low-income women with "contraceptive education and counseling; pregnancy diagnosis and counseling; cervical and breast cancer screening; and education, testing, and referral services associated with sexually transmitted diseases." Several thousand unwanted pregnancies and births would occur. (Michael Hiltzik, 9/22)

It's hard to understand a strategy in which no paths lead to victory, so it's hard to figure exactly what Congressional Republicans are aiming for in their latest attempt to shut down the American government. Latest, because this kind of thing has become a biennial affair in Washington D.C., something that should be food for serious, pessimistic thought in and of itself. This time, women's health organization Planned Parenthood is the putative cause, a GOP claim that would carry much more weight if this kind of thing hadn't become a stock move in the Republican playbook. (Nancy Kaffer, 9/22)

Republicans who want to use the coming government funding fight to defund Planned Parenthood — a strategy that GOP leaders have denounced as hopeless folly — like to argue that the GOP won’t take the blame if the government does shut down. Senate Dems would filibuster, or President Obama would veto, any government funding bill that defunds Planned Parenthood. So Republicans can argue that Obama and Dems are refusing to fund the government because of their commitment to keeping Planned Parenthood in business, even after the fetal tissue videos shocked the country. (Greg Sargent, 9/22)

Fiorina’s dishonesty is flagrant and unapologetic. Called on her misstatements, Fiorina doesn’t cede ground, she attacks critics. Exhibit A is her evocative description, at the most recent GOP debate, of a nonexistent Planned Parenthood video. ... The sting video, released by an anti-abortion group, features a former technician for a fetal tissue procurement company describing how a Planned Parenthood employee “taps the heart and it starts beating,” then instructs her to remove the brain. As Factcheck.org concluded, “The video does contain images of what appear to be intact fetuses, but they don’t fit Fiorina’s description.” (Ruth Marcus, 9/22)

Fiorina's description of what takes place in the videos has come under withering attack. Sarah Kliff of Vox.com labels Fiorina's version of the scene as "pure fiction." Politifact says it is "mostly false." And they have a point. The exact scene, exactly as Fiorina describes it, is not on the videos. But anybody who has watched the videos would find Fiorina's account pretty accurate. (Jonah Goldberg, 9/22)

The political blaze over drug costs that kicked up a year ago over the Hepatitis C cure Sovaldi has moved on to therapies for more diseases—and beyond white heat too. Now Hillary Clinton and others upset with the price of medical progress are proposing government remedies, including price controls. (9/22)

When critics complain about the high cost of a prescription drug, drug makers tend to have two main defenses. One is that developing drugs is an expensive, risky endeavor, and so companies need high prices to cover the cost of medical research. ... Hillary Rodham Clinton ... has taken aim squarely at that first defense: If companies really need high prices to spend it on science, then they should be required to spend a set amount of their revenue on research and development costs. ... But when I ran [Clinton's proposal] by some health economists and other health policy experts, several strongly disliked the idea because it misunderstands the diversity of companies in the pharmaceutical industry. They say it would create perverse incentives that could raise instead of lower the costs of developing new drugs. (Margot Sanger-Katz, 9/22)

With drug prices up 12 percent last year, and some drug companies applying astronomical markups on life-saving drugs, the former secretary of state Hillary Rodham Clinton and Senator Bernie Sanders of Vermont, her chief rival for the Democratic presidential nomination, have proposed plans to help lower drug prices. They would include allowing the government to negotiate for Medicare drug costs, eliminating corporate restrictions on generics, requiring a minimum investment for research and capping the out-of-pocket cost of many drugs for serious health conditions. (9/23)

There’s a mounting crusade to impose price controls on prescription pharmaceuticals. Democratic presidential hopefuls Hillary Clinton and Bernie Sanders have called for deep price discounts for drugs sold through Medicare, importation of drugs from countries like Canada that have price controls, and limiting drug companies’ marketing exclusivity rights. “Cancer treatment shouldn’t bankrupt patients” is the gist of their emotional argument. That politicians with no medical training or business experience would have a myopic understanding of drug pricing is unsurprising. But such misconceptions also afflict leading cancer specialists. (Thomas P. Stossel, 9/22)

Until now, the fight over health-care reform has mostly been a battle over two numbers: how many Americans have insurance, and how much they pay in premiums. It may be time to think more seriously about a third number: out-of-pocket costs. On Tuesday, the Kaiser Family Foundation released its annual survey of employer-sponsored health plans. ... If premiums have jumped, deductibles have been strapped to the side of a rocket. ... while premiums for single coverage have grown roughly in line with overall health-care costs over the past decade, deductibles have increased almost three times as much. (Christopher Flavelle, 9/22)

Employer health insurance premiums rose 4% this year, according to the 17th annual employer health benefits survey from the Kaiser Family Foundation and the Health Research and Educational Trust, published Tuesday. That caps a (remarkable) 10-year run of moderate increases, averaging 5%. But the slowdown in health-care cost growth has been all but invisible to average consumers because their out-of-pocket costs have been rising at a time when their wages have been relatively flat. (Drew Altman, 9/22)

The California legislature this month approved a bill that would give terminally ill adults the option to request medication to end their lives. It was a landmark moment in an effort dating to 1995 to pass legislation that allows for death with dignity. Whether the measure takes effect is up to Gov. Jerry Brown (D). He has given no clue as to what action he will take. We hope he signs the measure into law. (9/22)

Most health care professionals have had little to no training in the care of older adults. Currently, 97 percent of all medical students in the United States do not take a single course in geriatrics. Recent studies show that good geriatric care can make an enormous difference. Older adults whose health is monitored by a geriatrician enjoy more years of independent living, greater social and physical functioning and lower presence of disease. In addition, these patients show increased satisfaction, spend less time in the hospital, exhibit markedly decreased rates of depression and spend less time in nursing homes. (Marcy Cottrell Houle, 9/22)

In the matter of legislatively mandated cuts to Medicaid for therapy services and the uproar this has sparked among the parents of children with special needs and their care providers, the Texas Health and Human Services Commission says it is simply following orders. No, it isn’t. ... Yes, Rider 50, contained in that budget, compels the agency to reform Medicaid reimbursements for “acute care therapy services,” but it also says that it should do this “while considering stakeholder input and access to care.” Access to care. That’s the key. (9/22)

Shameful. There is no other way to describe the Medicaid rate cuts proposed by the Health and Human Services Commission, or HHSC. But to be clear, HHSC is merely acting at the direction of certain lawmakers and state leaders who imposed this draconian budget cut without any real policy justification. In June, lawmakers left Austin with one of the richest balance sheets I have seen in my 15 years of service. The state budget left $2 billion unspent for the state’s priorities like education, health care and veterans. Another $8.5 billion sits in our savings account. With all that available revenue, why did Republican leaders in the Senate insist on cutting $350 million in state and federal funds, targeting children who don’t have a voice and are among the most medically fragile Texans? (State Rep. Trey Martinez Fischer, 9/22)