The Wall Street Journal: U.S. Recoups Funds From States That Faltered On Health Exchanges
The Obama administration on Tuesday said it has recouped more than $200 million in funding given to states that faltered in setting up their own health-insurance exchanges. Government officials are seeking to collect more of the original grant funding, an effort that they said shows they are closely monitoring taxpayer dollars that state-run exchanges received under the Affordable Care Act. (Armour, 12/8)

The New York Times: Americans Who Don’t Buy Health Coverage Face Heftier Fine In ’16, Analysis Finds
Americans who remain uninsured in 2016 despite having the option of buying health coverage through an Affordable Care Act marketplace will owe an average tax penalty of $969 per household, a new analysis has found. That amount is substantially higher than the average estimated penalty of $661 for those who went uninsured in 2015, according to the analysis by the Kaiser Family Foundation. But it remains to be seen how effective the rising fine will be in persuading the roughly 10.5 million uninsured Americans who are eligible for marketplace coverage to buy it. (Goodnough, 12/9)

Kaiser Health News: Uninsured People Eligible For Obamacare Face Average $969 Penalty In 2016
The penalty for failing to have health insurance is going up, perhaps even higher than you expected. Among uninsured individuals who are not exempt from the Affordable Care Act penalty, the average household fine for not having insurance in 2015 will be $661, rising to $969 per household in 2016, according to a Kaiser Family Foundation analysis. Individuals will pay the penalty when they complete their federal taxes the following spring. (Galewitz, 12/9)

Kaiser Health News: State Obamacare Exchanges ‘Sustainable’ Without Federal Aid, Official Tells Congress
State insurance exchanges are healthy financially even without the federal funding that ran out this year, a top Obama administration official told a House subcommittee Tuesday. “All states are sustainable today,” said Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid Services. He refused to predict if any of the remaining 13 state exchanges would eventually need to shift to the federal exchange. (Galewitz, 12/9)

NBC News: No Obamacare Break This Year, Government Warns
People who don't have health insurance yet for next year need to hurry up and get it or risk a fine, the federal government warns. And the fine's going up this year. Although the Health and Human Services Department offered a special extension last year to sign up, because many people may not yet have fully understood the requirements, there will be no such break this coming year. (Fox, 12/8)

The Fiscal Times: Obamacare Won’t Really Cost The U.S. 2 Million Jobs
The Congressional Budget Office released a new working paper this week predicting that the Affordable Care Act will have a negative effect on the size of the U.S. labor supply over the coming decade. ... But the CBO isn’t looking specifically at job loss. It’s making projections about aggregate hours worked and the total number of workers who choose to stay in the workforce: “The labor force is projected to be about 2 million full-time-equivalent workers smaller in 2025 under the ACA than it would have been otherwise,” the agency wrote. That is, fewer work hours will be logged and paid for, the rough equivalent of 2 million jobs. But those two things — reduced hours across the economy and total jobs — are different things. (Pianin, 12/8)

Health News Florida: What Happens When Marriage Makes Health Insurance Affordable
Not long after Sherry Poulin married her husband Louis last year, the newlyweds sat in their kitchen with health insurance information laid out in front of them. Before getting married, Poulin paid $50 a month for a subsidized plan through Obamacare. Now, for a plan offered through her husband’s employer, she was looking at about $500 a month. Poulin married into what’s known as the “family glitch”: when she got married, she lost her subsidy to buy insurance in the individual marketplace. (Mack, 12/8)

The Associated Press: Important Deadline Ahead For Health Insurance Marketplace
Less than a week remains for Illinois consumers to buy private health insurance for coverage starting Jan. 1 on the marketplace created by President Barack Obama's health care law. Tuesday is an important enrollment deadline. Consumers who want their coverage to start at the first of the year need to choose a health plan by that date. (12/9)

In other news, The New York Times reports on the impact of a small legislative provision slipped into a major piece of legislation last year by Sen. Marco Rubio, R-Fla., a GOP presidential hopeful -

The New York Times: Marco Rubio Quietly Undermines Affordable Care Act
A little-noticed health care provision that Senator Marco Rubio of Florida slipped into a giant spending law last year has tangled up the Obama administration, sent tremors through health insurance markets and rattled confidence in the durability of President Obama’s signature health law. So for all the Republican talk about dismantling the Affordable Care Act, one Republican presidential hopeful has actually done something toward achieving that goal. (Pear, 12/9)

Wichita Eagle: Study: Medicaid Expansion Would Be Budget Neutral, Possibly A Moneymaker
A study released Tuesday shows Medicaid expansion could not only be budget neutral but could potentially turn into a moneymaker for the state. The study runs contrary to popular belief by some Kansas politicians who say expansion is too expensive and therefore not possible given the state’s budget problems. ... Six Kansas health foundations – including the Wichita-based Kansas Health Foundation – commissioned Manatt Health Solutions to study the financial impact of Medicaid expansion in Kansas. Manatt evaluates Medicaid expansion for states and foundations across the country. (Dunn, 12/8)

Kansas City Star: Consultants Think Kansas Could Expand Medicaid Without Additional Cost; GOP Lawmaker Claims Bias
Kansas could expand Medicaid coverage in the state through 2020 without spending any additional state money, a new study concludes. The study was conducted by Manatt Health, a consulting firm. It says the costs of expanding Medicaid would be covered by reduced state spending on mental health treatment, prisoners’ care, and other savings. ... House Speaker Ray Merrick said in a statement that the survey was conducted by a “left wing” law firm. “The ‘study’ is not objective or a scholarly effort; it (is) designed to lobby an agenda and should be treated as such,” the statement said. (Helling, 12/8)

SDPB Radio: Daugaard Proposes Medicaid Expansion In $4.8-Billion Budget
For the first time in three years, Governor Dennis Daugaard says South Dakota’s budget may be able to handle additional Medicaid patients. He says if things work out, he would look at including eligible state residents into Medicaid, if they make too much for traditional help, but still don’t have access to health care. “My budget proposes $373-million in additional federal fund expenditure authority, and 55 full-time equivalencies to handle the new eligible. No state general funds are proposed. I also want to be clear this is not a done deal. Our talks with the federal government have been promising, but there’s still work to be done, and there’s still the potential for this to fall through. Expansion costs must be covered by our current general fund budget or I will not support it." (Bultena, Ellenbolt, Hetland and Ray, 12/8)

Sioux Falls (S.D.) Argus Leader: Daugaard Encourages Medicaid Expansion
Tens of thousands of low-income South Dakotans could gain access to subsidized health care plans if the federal government agrees to a plan by Gov. Dennis Daugaard. Daugaard announced a plan to expand Medicaid in the state Tuesday during an address to unveil the Republican governor's $4.8 billion budget plan. ... Daugaard said he wouldn't move forward with expansion if it required additional state general fund dollars. And he said the state's Native American tribes and South Dakota legislators would also have to agree to the deal. (Ferguson, 12/8)

Arkansas News: Hutchinson Says He Favors Assets Test, Other Restrictions On Medicaid Expansion
Any new version of Arkansas’ Medicaid expansion should include an assets test, among other restrictions, Gov. Asa Hutchinson said Tuesday. In a speech at the 2015 Arkansas Medicaid Education Conference in Little Rock, Hutchinson gave an updated list of items he wants to see included if Arkansas is to continue accepting federal money for Medicaid expansion. The state’s current Medicaid expansion program, known as the private option, is slated to end Dec. 31, 2016. (Lyon, 12/8)

Arkansas Online: In Plan, No Care For Nonpayers; Governor Also Wants Review Of Private-Option User Assets
Gov. Asa Hutchinson said Tuesday that he wants Arkansas to impose "lockout" periods for private-option participants who fail to pay their insurance premiums. The state also should "fight" to gain federal approval to consider applicants' assets, as well as income, in determining eligibility for coverage, the governor said. And he expressed support for offering vision and dental benefits to certain enrollees to encourage work or healthy behavior and for charging premiums or copayments to enrollees with incomes below the poverty level. (Davis, 12/9)

Politico: No Budget Deal In Sight As Deadline Looms
Right now, there's no deal in sight to fund the federal government. ... In all likelihood, the House will vote Friday on a short-term government funding measure to avoid a shutdown, giving Speaker Paul Ryan and House Minority Leader Nancy Pelosi more time to negotiate. (Sherman, French and Bresnahan, 12/8)

The Washington Post: Republicans Eye Short-Term Spending Bill As Shutdown Deadline Approaches
Brady also said he is considering adding language to the bill that would delay for two years the implementation of two provisions of the Affordable Care Act, a tax on medical device manufacturers and a levy on high value health plans known as the Cadillac Tax. Several negotiators and aides said that prospects for the broader bill were increasingly positive despite frustration from House Democrats. (Snell, 12/8)

The Wall Street Journal: Nancy Pelosi Drives Hard Bargain With Paul Ryan On Spending, Taxes
In case House Speaker Paul Ryan (R., Wis.) was in any doubt, Minority Leader Nancy Pelosi (D., Calif.) has made it clear this week that she drives a hard bargain. The two House leaders are facing their first serious battle of wills over Congress’s pile of year-end legislation.On the spending bill, she has sought to block all GOP policy measures, or “riders,” that Democrats don’t like. Republicans have already opted not to seek an end to federal funding for Planned Parenthood or to repeal portions of the 2010 health law in the legislation, aides said. Now, Democrats are working to beat back GOP provisions aimed at curbing financial, environmental and labor regulations. (Peterson, 12/8)

The Wall Street Journal: How Pfizer Set The Cost Of Its New Drug At $9,850 A Month
Days before Pfizer Inc. was to set the price for a new breast-cancer drug called Ibrance, it got a surprise: A competitor raised the monthly cost of a rival treatment by nearly a thousand dollars. Three years of market research—a stretch that started almost as soon as the new treatment showed promise in the laboratory—was suddenly in doubt. After carefully calibrating the price to be close to rivals and to keep doctors and insurers happy, Pfizer was left wondering if its list price of $9,850 a month for the pills was too low. (Rockoff, 12/9)

CQ Healthbeat: Senate Panel's Opening Move On Drug Costs Picks Soft Target
Lawmakers may be easing toward a serious discussion about containing rising drug costs, starting Wednesday with an easy target for the first major Senate hearing this year on generic pharmaceutical prices. The Senate Special Committee on Aging will delve into how small firms, including Martin Shkreli’s Turing Pharmaceuticals, can raise prices dramatically for generics. Turing boosted the price from $13.50 to $750 per pill for an antifungal drug used by AIDS patients. To his critics, Shkreli’s unrepentant position has made him the poster boy for greed on the part of sellers of medicines. (Young, 12/8)

The Philadelphia Inquirer: GSK Exec: More Voices Make Drug Healthcare Cost Debate Different From 1990s
The ever-more public debate about the price of prescription drugs and healthcare overall is not the first such debate. But GlaxoSmithKline's Jamey Millar, senior vice president for managed markets and government affairs, said Thursday in Philadelphia that this discussion feels different from the early-to-mid 1990s when then-First Lady Hillary Clinton led an effort to reform how America's expensive, inefficient, gap-ridden, dysfunctional healthcare system operates. And the difference, Millar said, is only partially a function of Clinton running for president. (Sell, 12/5)

The Washington Post: Burnout Increasing Among U.S. Doctors
Burnout among U.S. doctors is getting worse, according to a study that shows physicians are worse off today than just three years earlier. Mayo Clinic researchers, working with the American Medical Association, compared data from 2014 to measures they collected in 2011 and found higher measures on the classic signs of professional burnout. More than half of physicians felt emotionally exhausted and ineffective. More than half also said that work was less meaningful. (Sun, 12/8)

Kaiser Health News: Medical Training So Dark Many Students Depict Supervisors As Monsters – Literally
The study by researchers from several leading medical schools, including Harvard, Yale, and Cambridge in England, added to a body of work showing that the stress of training can cause depression. And it’s not just the doctors themselves who suffer – patients should worry, too. Depression in residents 'has been linked to poor-quality patient care and increased medical errors,' the researchers note. (Rovner, 12/8)

In other physician news, a group of advocates and doctors is asking the Food and Drug Administration to reconsider a ban on a device the group says would save tens of thousands of women a year from invasive surgery --

The Philadelphia Inquirer: Top Gynecologists Oppose FDA Advice On Morcellators
A group of physicians and women’s health advocates on Tuesday sent a letter asking the U.S. Food and Drug Administration to rescind or revise its 2014 warning that curtailed the use of a tissue-slicing device in minimally-invasive gynecological surgeries. The device, an electric morcellator, enables uterine tissue to be cut up and removed through tiny abdominal incisions. But the FDA concluded the device could accidentally spread and worsen a hidden uterine cancer called leiomyosarcoma in as many as 1 in 350 women who have a hysterectomy to treat fibroids – common benign growths that can cause abnormal bleeding. The FDA recommended against the use of power morcellation in most women, prompting most hospitals and insurers to restrict or ban it. (McCullough, 12/8)

Los Angeles Times: To Foster Public Health, Track Law Enforcement-Related Deaths, Researchers Urge
The death of people at the hands of police officers affects not only the individuals involved but the well-being of the community at large, and a tally of such fatalities can and should be maintained for public health purposes, a group of Harvard University researchers has written. Wading into the intersection of several highly charged public debates, a group of public health researchers has written that law enforcement-related deaths -- both of police officers and of members of the public -- are not strictly a criminal justice concern. (Healy, 12/8)

NPR: Congress Still Limits Health Research On Gun Violence
Mass shootings and police shootings have spurred calls for authorities to take action to reduce the violence. But policymakers may be stymied by the dearth of public health research into both gun violence and deaths that involve the police. One big obstacle: congressional restrictions on funding of such research at the Centers for Disease Control and Prevention. Right now, the CDC studies all kinds of violence. There's a program on child abuse and youth violence, and the public health agency collects data on suicides and sexual assaults. (Kodjak, 12/8)

USA Today: Top U.S. Lab Regulator Replaced In Wake Of Incidents With Bioterror Pathogens
The Centers for Disease Control and Prevention has replaced its longtime director of national lab regulation in the wake of several high-profile incidents involving bioterror pathogens and an internal review that identified areas of improvement for the oversight program, USA TODAY has learned. (Young, 12/8)

Reuters: U.S. CDC Replaces Lab Director After Pathogen Incidents
Dr. Daniel Sosin is now serving as acting director of the select agent division, according to a CDC statement. The CDC's Division of Select Agents and Toxins is charged with developing regulations for hundreds of labs that work with select agents and with investigating the mishandling of these substances. (Steenhuysen, 12/8)

The Washington Post: Will Wrongdoers At VA Ever Be Held Accountable? Lawmakers To Press Top Brass.
House lawmakers plan to press top Veterans Affairs officials this week to explain why, after a series of scandals, they have had limited success holding employees accountable for misconduct. At a hearing Wednesday, the Committee on Veterans’ Affairs says it will examine VA’s “continued and pervasive lack of accountability” for employees who deceived taxpayers and veterans by covering up long waiting times for treatment at 100 medical centers. (Rein, 12/7)

St. Louis Public Radio: Veterans Treatment Courts, Growing In The U.S., Offer An Alternative To Incarceration For Local Vets
Veterans Court Technology Clinic students and supporters watched as seven of their colleagues took part in the clinic’s first formal graduation ceremony. The clinic is part of a special drug court in St. Louis that provides an alternative to incarceration for veterans. It provides job skills for participants in the program. The first such court started in 2008 in Buffalo, NY, and the program has expanded to 220 locations across the country—including in St. Louis, St. Louis County and Jefferson County locations. (Moffitt, 12/8)

Iowa Public Radio: Path Unclear For Iowa's Medicaid Privitization
The Department of Human Services says it is not sure exactly how many of the nearly 30,000 Medicaid providers in Iowa have signed with at least one of the four for-profit companies that will take over Iowa’s Medicaid management on Jan. 1. This lack of information was one of the points Democrats used in a failed effort to delay the transition during Monday's Health Policy Oversight Committee meeting. (Boden, 12/8)

Des Moines Register: UI Hospitals Give Mixed Messages On Medicaid Contracts
University of Iowa Hospitals employees continued to tell patients Tuesday that their organization had not yet signed contracts with any Medicaid managed care companies, five days after the governor announced that UI had done so. Two Medicaid recipients contacted the Des Moines Register on Tuesday expressing confusion about the matter. They had read in the newspaper that their hospital and clinic system had signed contracts to provide care to people covered by two of the four managed care companies that soon are to start running Iowa’s Medicaid program. (Leys, 12/8)

The Philadelphia Inquirer: Kane To Join FTC In Penn State Hershey Hospital Antitrust Fight
Pennsylvania Attorney General Kathleen G. Kane said her office will join the Federal Trade Commission in a bid to block the proposed merger of Penn State Hershey Medical Center and PinnacleHealth System. Combined, the two systems would control 64 percent of the market in the Harrisburg region, including Dauphin, Cumberland, Perry and Lebanon Counties, Kane's office said. (Brubaker, 12/9)

The Charlotte Observer: Carolinas HealthCare Sets Goal To Spend $3B On Capital Projects Over Six Years
On Tuesday, Carolinas HealthCare System officials announced plans to spend $3 billion on capital projects as part of a six-year “reinvestment” plan. At the system’s quarterly board meeting, Chief Financial Officer Greg Gombar described the goal to spend 10 percent of net operating revenue annually on capital projects – such as buildings, technology and programs – to meet consumer demand. (Garloch, 12/8)

The Associated Press: Report: 3 California Health Organizations Had Data Risks
Three Medi-Cal health providers risked having data stolen on thousands of patients because of security problems ranging from outdated anti-virus software to retaining the computer passwords of fired workers, according to a federal study released Tuesday. The Department of Health and Human Services reviewed information system controls for three managed-care organizations from 2012 to 2015 and found 74 potentially high-risk vulnerabilities, according to a report from the inspector general's office. (Jablon, 12/8)

The Wall Street Journal: Connecticut Legislature Approves Budget Cuts
Lawmakers in Connecticut on Tuesday approved a $350 million plan to address a shortfall in the state’s budget. ... Medicaid funding for hospitals took the biggest hit with a $34.2 million reduction. The Department of Developmental Services had cuts of $4.3 million and the Department of Correction $8.6 million. (De Avila, 12/8)

The Connecticut Mirror: Bill Closing Deficit, Cutting Business Taxes Heads To Malloy
The House of Representatives gave final legislative approval to a bill Tuesday night that closes the current budget deficit, mitigates bigger problems in the future, offers modest tax relief to businesses and restores a portion of funds cut this fall from hospitals and social services. (Phaneuf and Levin Becker, 12/8)

Georgia Health News: Network Deal OKs Bonuses For Pediatric Performance
A pediatric network has inked its first major contract with a health insurer that will pay the doctors based on incentives in meeting quality-of-care standards. The Children’s Care Network, which has more than 1,100 pediatricians in Georgia, has signed a two-year agreement with WellCare Health Plans that will include bonus pay if the provider organization achieves improvements on medical quality standards in its care for children. (Miller, 12/8)

Kaiser Health News: Drug Cocktails Fuel Massachusetts’ Overdose Crisis
In a brick plaza next to the Chelsea, Massachusetts city hall, Anthony, a bald but still-youthful man in grey sweats, tells me he spent the previous night in the hospital for what he says was his twelfth overdose. Anthony and other users of illegal drugs agreed to speak to NPR for this story on the condition that we use only their first names. He blames his overdose on what his dealer told him was a particularly strong bag of heroin laced with Fentanyl — or something like it. (Bebinger, 12/9)

St. Louis Public Radio: Health Clinics At Metro Stops? Researchers Take A Look
Two Metro passes and a flu shot, please. The parent company of Metro Transit St. Louis is looking into the possibility of building health clinics at Metro stops, particularly in north St. Louis County. Project manager John Wagner says the concept makes sense; transit stops are easy to get to, there’s parking and they get a lot of foot traffic. The Missouri Foundation for Health has awarded a $41,900 grant to the Bi-State Development Agency, of which Metro is a part, so its research arm can conduct a feasibility study for the concept. Wagner says he is looking into which stops would work best, where funding could come from and what services would be provided. (Bouscaren, 12/7)

Stateline: State, Local Officials Push Manufacturers To Pay For Drug Disposal
Each month Monty Scheele, a pharmacist in Lincoln, Nebraska, sends a big box of unused medications to be incinerated. He collects the drugs at his three pharmacies from customers who may be cleaning out their medicine cabinets or abandoning a prescription after an adverse reaction. His effort is part of a program using state funds to keep medications from polluting water supplies and out of the hands of people who might misuse them. But drug disposal is expensive — the Nebraska program spends $10 per pound to ship and destroy medication — and some states and municipalities want drug companies to pick up the tab. (Breitenbach, 12/4)

Health News Florida: WellCare Fires Chief Medical Officer
Tampa-based WellCare Health Plans Inc. announced Monday it is terminating Senior Vice President and Chief Medical Officer Steven Goldberg, according to a document filed with the U.S. Securities and Exchange Commission. WellCare said Goldberg, who has been with WellCare since since July 2013, is as of Monday no longer an executive officer of the company. (10/8)

Health News Florida: Supreme Court Cancels Medical Pot Arguments
Oral arguments over a petition to put medical marijuana in the constitution was canceled by the Florida Supreme Court Monday. The Court is examining if a medical marijuana constitutional amendment is clear enough to be put on the ballot. Attorney General Pam Bondi’s office said in a statement it didn’t challenge the current amendment, but is concerned the ballot would expand the use of marijuana in Florida, particularly among youth. (Aboraya, 12/8)

The Huffington Post: The Biggest Blow To Obamacare Yet Could Come From Democrats
Congress is on the brink of taking a big bite out of the Affordable Care Act, after more than five years of mostly futile efforts by Republicans to weaken or repeal the law. Both houses now seem intent on approving a two-year delay in the introduction of the law’s “Cadillac tax” -- a controversial levy on expensive health insurance plans -- as part of must-pass legislation now moving through Congress. But while Republicans are happily supporting the delay as a blow to Obamacare, multiple sources privy to negotiations say it's the Democratic leaders in Congress, responding to pressure from labor unions, who have insisted on acting now. (Jonathan Cohn and Jeffrey Young, 12/8)

Real Clear Policy: The Senate's Historic ACA Vote
Last week, the U.S. Senate approved legislation that would repeal the majority of Obamacare. The bill will almost certainly pass the House. From there, it will go to the president's desk, where it faces an even more certain veto. Even so, we are witnessing a historic moment. The House and Senate have held dozens of votes to repeal Obamacare in whole or in part. Congressional Republicans have even worked with President Obama to repeal or curtail portions of the law. But while full-repeal legislation has passed the House, nothing like the bill that just passed the Senate has come anywhere near the president's desk. (Michael F. Cannon, 12/8)

Forbes: Hillary Clinton: The Conservative Obamacare Reformer
Individual tax credits to help pay for healthcare expenses have long been a mainstay of conservative healthcare reform. Whether solely as premium supports or as a combination of premium and HSA credits, the idea of giving people money to purchase healthcare or health insurance is a core pillar of any serious conservative healthcare reform. And it looks like Hillary Clinton might be embracing the tax credit approach. In a recent proposal (which is incomplete thus far), the presidential candidate offered support for a tax credit to help pay for out-of-pocket costs. While this might be pure politics to distinguish herself from Bernie Sanders’ single-payer proposals, the idea has serious merits. (Yevgeniy Feyman, 12/9)

Los Angeles Times: One-Sixth Of Americans Have Trouble Paying Medical Bills. That's Good News.
The U.S. government reported Tuesday that some 44.5 million Americans experienced problems paying their medical bills in the first half of this year. That may not sound encouraging, but perspective is everything: In 2011, the figure was 56.5 million. Overall, the percentage of people living in families facing trouble with their medical bills fell to 16.5% in the first six months of 2015 from 21.3% in 2011. The reason for the steady, linear drop in financial stress in strain from medical bills is inescapable. It's the Affordable Care Act. (Michael Hiltzik, 12/8)

Real Clear Health: Congress Must Stop The Flow Of Corporate Welfare To Insurers
This could be a very merry Christmas for Blue Cross and Blue Shield (BCBS) of Texas. The Obama administration wants to stuff its stocking with $257,172,917.34 – at your expense – to compensate the company for losing scads of money last year selling Obamacare policies in the Lone Star State. That would bring that single company’s total corporate welfare haul for the 2014 plan year to $843.3 million. That is, unless Congress decides this week to play the Grinch that stole the corporate welfare Christmas. (Doug Badger, 12/8)

New Orleans Times-Picayune: Louisiana Legislators Getting On Board The Medicaid Expansion Train
John Bel Edwards may not officially have the badge just yet, but clearly there's a new sheriff in town. How else do you explain the warp speed reversal by legislators on the subject of Medicaid expansion in Louisiana? Edwards, the governor-elect who loses the "elect" title Jan. 11, has made it clear he wants to expand Medicaid to more than 300,000 uninsured state citizens, and legislators — as they're wont to do — are doing everything necessary to make the Democrat's campaign pledge a reality. So after years of just saying "no" to the expansion of Obamacare under the rule of Gov. Bobby Jindal, the Republican-controlled Legislature is now screaming, "hurry up and go." (J.R. Ball, 12/8)

Sioux Falls (S.D.) Argus Leader: Medicaid Expansion And Obamacare
Amid all the mumbo-jumbo budget talk on Tuesday, there came a white flag. Dennis Daugaard, the state’s second-term governor, was the one holding the flag. Near the end of an annual budget address that went about one hour and ten minutes, Daugaard talked about a plan to expand Medicaid, the state/federal health program for the poor. For nearly six years now, Republicans have fought – seemingly to the last man – to overturn the Affordable Care Act, also known as Obamacare. They’ve failed at every level. (Jonathan Ellis, 12/8)

The New York Times' Opinonator: Imagine A Medicare ‘Part Q’ For Quality At The End Of Life
My father, and others like him, suffered because, at the tail end of life, Medicare continues to pay well for fix-it treatments focused unrealistically on cure and underpays for care and desperately needed home support. In his last six years, it paid more than $80,000, all told, for treatments that included a hernia repair, a pacemaker, and $24,000 for the injectable drug Lucentis which, sadly, failed to arrest the macular degeneration that was robbing him of sight. It covered a series of ambulance rides, emergency room visits and a hospital stay after he fell repeatedly on throw rugs and down the stairs, once breaking his wrist, falling on my mother, and leaving her black and blue from toe to hip. But it paid very little for home health aides to give my mother respite and cut off, far too soon, the speech and physical therapies that helped maintain his ability to function and take pleasure in life. Under fee-for-service medicine, Medicare paid to patch him up after he fell but not to keep him from falling. (Katy Butler, 12/9)

The New York Times' Opinionator: Decriminalizing Drugs: When Treatment Replaces Prison
If one of my children were a drug addict, what would I want for him? I would want what any parent would: for his addiction to be treated as a health problem, not a criminal matter, and for him to have every kind of help possible to get him off drugs. Until that happened, I would want him to be able to manage his addiction and live a normal life by taking methadone or another substitute opioid. And until that happened, for him to stay as safe as possible from overdosing, developing H.I.V., or going to prison, which would irrevocably alter the course of his post-addiction life. (Tina Rosenberg, 121/8)

The New York Times: No Reason To Exclude Transgender Medical Care
A decade ago, when she was starting to transition genders, the artist known as Our Lady J steeled herself as she called endocrinologists, seeking one who would prescribe hormones. “I couldn’t find a doctor,” said the classical pianist and singer, who is currently a writer for the television series “Transparent.” “I was treated like a freak.” Since then, the medical community in the United States has resoundingly concluded that transgender care — which includes hormone replacement therapy, counseling and surgical procedures — is medically necessary and should be covered by insurance. (12/9)

Forbes: Explaining The Decline, Fall (And Possible Rebirth) Of Doctors' House Calls
“Connected care” refers to a large and growing portfolio of digital tools, from video consultations with psychiatrists to in-home sensors passively detecting when a senior falls to devices that measure diabetics’ blood glucose and send messages to their families’ or doctors’ smartphones when intervention might be needed. ... However, we should not fall into the trap of all-or-nothing thinking, expecting patients only to see their doctors either in the office or remotely. With a little creativity, we can envision mobile health technology leading to the restoration of an almost forgotten medical tradition: The house call. (John Graham, 12/9)

The New York Times: For Immigrants, America Is Still More Welcoming Than Europe
The United States has some of the most hostile policies toward an immigrant population found in the developed world. Start with the special police forces dedicated to persecuting and deporting over a quarter of the nation’s immigrants, the estimated 11 million who entered the country without authorization. Then there is the lack of labor laws to shield them from wage theft and perilous jobs. And don’t get me started on America’s stingy social insurance: even legal permanent residents are barred from a host of government programs, including Medicaid, food stamps and other welfare programs. (Eduardo Porter, 12/8)

JAMA: Merging The Health System And Education Silos To Better Educate Future Physicians
The Affordable Care Act (ACA) is shifting physician reimbursement from volume to value. Academic medical centers (AMCs) are responsible for educating future physicians so that they will acquire the skills to practice value-based care. However, the linkages between the leaders of health systems and leaders of residency education may be tenuous, primarily because these leaders exist in separate silos in AMCs. (Reshma Gupta and Vineet M. Arora, 12/8)