Donald Trump’s health secretary was on fire during a March 5 address to the Federation of American Hospitals. Alex Azar, the former Eli Lilly executive now charged with overseeing everything from Medicare to the Centers for Disease Control & Prevention, outlined plans to achieve nothing less than the “value-based transformation” of American health care.

“Today’s healthcare system is simply not delivering outcomes commensurate with its cost,” he said. And Azar put his biggest finger on a commonly blamed problem: the fact that American health care is “paying for procedures and sickness” instead of “outcomes and wellness.”

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New health-insurance legislation in Iowa will become the latest test of the ability of states to allow coverage that doesn’t comply with the federal Affordable Care Act.

Iowa Gov. Kim Reynolds is expected to soon sign into law a bill that would allow the Iowa Farm Bureau, a nonprofit, to offer health coverage that would fall outside the ACA’s rules. The new coverage, which the legislation calls “health benefit plans,” would be administered by the state’s largest insurer, Wellmark Blue Cross & Blue Shield . The product would officially not be considered health insurance, according to the legislation—leaving details of the coverage unclear.

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Earlier this month, the Trump administration shot down a plan from Idaho to sell health insurance that doesn’t comply with Affordable Care Act (ACA) regulations.

“If a state fails to substantially enforce the law, the Centers for Medicare & Medicaid Services (CMS) has a responsibility to enforce these provisions on behalf of the State,” wrote CMS Administrator Seema Verma in her rejection letter.

Three weeks later, another state — Iowa — is on the verge of making a similar move.

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More Democrats than ever have signed on to a proposal that would shift every U.S. resident onto Medicare, but a large proportion remain uncertain about heading into a completely government-run system as an immediate sequel to Obamacare.

The Medicare for All Act that has been introduced would move everyone in the U.S. onto Medicare, even if they have private healthcare coverage. It is backed by Sen. Bernie Sanders, I-Vt., and an unprecedented 16 Democratic senators. Among them are possible 2020 presidential hopefuls Sens. Cory Booker, D-N.J., Kamala Harris, D-Calif., Elizabeth Warren, D-Mass., and Kirsten Gillibrand, D-N.Y. Most Democratic lawmakers in the House have co-sponsored a similar bill.

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The Iowa Senate gave final approval Tuesday to controversial legislation that would exempt certain health plans from Affordable Care Act mandates.

The legislation combines two proposals backers say would reduce health insurance costs, but critics worry could undermine consumer protections.

Senate File 2349 was approved 37-11, sending it to Gov. Kim Reynolds, whose spokeswoman said she was “eager” to sign it. The measure passed the House last week.

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  • Healthcare edges out crime, guns and deficit as top problem
  • Healthcare or economy has typically been top worry since 2001
  • Worries about unemployment, economy continue to decline

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California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services’ chief watchdog.

In a Feb. 21 report, the HHS’ inspector general estimated that California spent $738.2 million on 366,078 expansion beneficiaries who were ineligible. It spent an additional $416.5 million for 79,055 expansion enrollees who were “potentially” ineligible, auditors found.

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In tiny Marion, North Carolina, the Buchanans decided that $1,800 a month was too much to pay for health insurance, and are going without it for the first time in their lives.

In Harahan, one bend of the Mississippi River up from New Orleans, the Owenses looked at their doubling insurance premiums and decided no, as well. “We’re not poor people but we can’t afford health insurance,” Mimi Owens said.

And in a Phoenix suburb, the Bobbies and their son Joey will go uninsured so the family can save money to cover their nine-year-old daughter Sophia, who was born with five heart defects.

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California Assembly Speaker Anthony Rendon is refusing to advance this year a controversial single-payer health care bill that would dramatically reshape the state’s health care financing and delivery system. Instead, he’s orchestrating an alternative, narrower approach that seeks to achieve universal coverage and make Obamacare more affordable.

Rendon this year gave lawmakers in his house “autonomy to come up with a package” of health care bills, he said in a recent interview. Now, without engaging the other side in the Senate, the Assembly has unveiled a major legislative push on health care that would expand coverage and lower consumer costs while laying the groundwork for a future system financed by taxpayers.

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Everybody on Capitol Hill agreed: If anyone could break the deep-rooted partisan logjam over Obamacare in Congress, it was that deal-making duo Patty and Lamar. But in the end, it was Obamacare that broke their alliance.

Just seven months after Sens. Patty Murray (D-Wash.) and Lamar Alexander (R-Tenn.) heralded the beginning of a new bipartisan era on health care following the collapse of Obamacare repeal efforts, their lofty ambitions ended in much the same way as every Obamacare-related negotiation over the last eight years — with claims of betrayal, warnings of political fallout and no progress toward bridging the deep divide over the nation’s health care system.

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