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Health care is fast becoming an unsustainable expense for American families. This year the total cost of insurance for the typical family of four eclipsed $28,000, according to the Milliman Medical Index. Rising insurance premiums are also eroding worker compensation, as companies shift increased costs to employees.

Health care in the U.S. suffers symptoms of what Justice Louis Brandeis once termed the problem of “Other People’s Money.” Often a patient ordering and receiving medical care mistakenly believes he is not the one paying for it. This misconception is due in large part to the employer tax exemption for health insurance, which conceals the true cost of coverage from most workers.

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Sen. Dianne Feinstein of California, for instance, has officially endorsed a public insurance option, as have other Democrats running in swing districts in Kentucky and Illinois. Meanwhile, single-payer advocates have won Democratic congressional primaries in New York, Nebraska, Texas, and Pennsylvania, among other places.

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A federal judge on Friday blocked Kentucky’s closely watched plan to require many Medicaid recipients to work, volunteer or train for a job as a condition of coverage.

The state had been poised to start carrying out the new rules next week and to phase them in fully by the end of this year.

Judge James E. Boasberg of Federal District Court for the District of Columbia, an Obama appointee, ruled that the Trump administration’s approval of the plan had been “arbitrary and capricious” because it had not adequately considered whether the plan would “help the state furnish medical assistance to its citizens, a central objective of Medicaid.”

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California’s leading progressives are currently debating — amicably, for the moment — when the right time will arrive to destroy the state’s healthcare system.

The frontrunner in the race for the governor’s mansion, current Lieutenant Governor Gavin Newsom, has long championed single-payer health care. But he recently softened his support. “[Single-payer] is not an act that would occur by the signature of the next governor,” he recently said. “There’s a lot of mythology about that.”

The Las Vegas Metro Chamber of Commerce would like to get back into the health insurance business.

Such a move became more likely Tuesday when the Trump administration announced a rule that would let small businesses or associated groups band together to purchase what are known as association health plans. The U.S. Department of Labor said the move will enable groups that share a commonality — such as an industry or geographic location — to obtain more affordable coverage.

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This year will be the last in which uninsured Americans are forced to pay ObamaCare’s penalty for lack of coverage. The change—part of the GOP’s tax reform—comes as relief on the demand side of health insurance. Yet nothing has changed on the market’s supply side. Without additional reforms to ObamaCare’s restrictions on insurers, millions of Americans will continue to choose from a limited range of lackluster plans.

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The Affordable Care Act’s regime of regulations, penalties, mandates and subsidies has accomplished a remarkable feat: It has produced unaffordable insurance coverage that often doesn’t finance care for those who need it most.

The federal government should therefore give states flexibility to permit the sale of alternative policies.

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Michigan Gov. Rick Snyder (R) on Friday signed a bill to impose controversial work requirements on Medicaid recipients.

If the plan is approved by the Trump administration, Michigan would become the fifth state to add work mandates to its program.

In January, Trump officials released their guidelines for work requirements on Medicaid, a move that has drawn a sharp outcry from Democrats, who say the change will lead to people losing health coverage.

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Why it matters: Health care costs are one of the top issues voters say they care about, but any plan to address them would likely need to be bipartisan.

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What to watch: The Senate health committee will begin a series of cost hearings this week. The House isn’t far behind, now that it has wrapped up a marathon of opioids bills.

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