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Like an avalanche, the Affordable Care Act has swept through the Rocky Mountain State, leaving a trail of destruction in its wake. At the end of 2013, 335,000 cancellation notices went out to customers whose plans were now deemed illegal by federal regulators. ... As for Colorado HealthOP, the state’s co-op, which was the largest insurer on the ObamaCare exchange, it shut down in October .... Huge premium increases loom for the remaining exchange plans .... It shouldn’t be a surprise that many Coloradans want to abandon ObamaCare and replace it with something new. What’s worrying is that the state’s liberals and progressives have been mobilizing to replace it with a single-payer system. (Nathan Nascimento, 12/11)

More than five years ago, the Affordable Care Act—what most of us call Obamacare—was passed into law with two big declared goals: to reduce the number of Americans who lack health insurance and to cut health spending that doesn’t give good value for money. Has the law been a success? The country is sharply divided. The most recent Gallup and Kaiser Family Foundation tracking polls show public opinion almost evenly split, with Democrats largely supporting the law and Republicans opposing it. ... What is different now is that we have a few years of direct experience of Obamacare. The most recent research on the law’s real consequences is more ambiguous than either side usually lets on. (Daniel P. Kessler, 12/11)

Senator Marco Rubio of Florida is boasting about his efforts to sabotage a program intended to keep health insurance markets stable and premiums low during the start-up years of the Affordable Care Act. He claims to be the only Republican presidential candidate who has scored a victory over Obamacare. There is a smidgen of truth to that — his sabotage effort actually became law and was not just a symbolic vote to “repeal Obamacare.” His blow will cause temporary inconvenience for hundreds of thousands of people covered by small insurers. Fortunately, it will not undermine the viability of health insurance markets for the long haul. (12/14)

Mr. Kasich is trying to merge traditional conservative economics with his social gospel. “I’m the hardest person to beat,” he says, “because I’m the hardest person to label.” He frequently speaks of the homeless, the mentally ill and the sick, of drug addicts and ex-cons, of “people living in the shadows.” He challenges Republicans to show sympathy for Americans who aren’t like them, especially the poor and minorities. “If you look at the record,” he says, “the record is loud and clear about who I am, and what I believe, and what my values are, and the conservative nature of how I’ve solved problems.” (Joseph Rago, 12/11)

The cost of prescription drugs is the hot health-care issue, but almost every discussion about it includes this caveat: As big a problem as rising drug prices have been for consumers and payers, drug spending represents only 10% of national spending on health. Yet ... drug spending represents almost double that share of health spending (19%) in employer health insurance plans. That is not too much less than the 23% employers spend on inpatient hospital care. (Drew Altman, 12/13)

Many Native Americans in South Dakota are not able to be served by [the Indian Health Service], however. This can be because there is no IHS facility in their area or IHS lacks specialists or because IHS funding for the fiscal year is exhausted. No matter the reason, when a Native American who is Medicaid eligible does not seek care through IHS part of the cost is shifted to the state. If more Native American health-care expenditures could be 100 percent federally funded the state could save up to $67 million per year — enough to cover the state’s costs to expand Medicaid. (South Dakota Gov. Dennis Daugaard, 12/14)

On Jan. 1, 31 days before Iowa caucus-goers cast the first votes of the 2016 presidential race, the state will gain another national distinction, but of a dubious variety: It plans to launch the most sweeping and radical privatization of Medicaid ever attempted. (Dana Milbank, 12/11)

Seasonal flu caused as many as 55,000 deaths in 2014, according to the Centers for Disease Control and Prevention (CDC). It may surprise you to know that some of these deaths are likely the result of health-care workers transmitting the influenza virus to their patients. Hospitals have begun requiring their staff to get vaccinated, or wear masks if they cannot or will not get vaccinated. The mandates work: A CDC survey this year showed that hospitals, physician offices, long-term care facilities and other clinics with mandatory vaccination achieved 96% coverage for their workers, compared with 44% coverage in institutions that don’t. (M. Todd Greene and Sanjay Saint, 12/13)

Imagine this: You have a child with a disability. Perhaps he’s on the autism spectrum. Or maybe she didn’t get enough oxygen during birth. To get on with life, you might need to find someone to change your child’s feeding tube at 3 a.m. so that you can sleep, and get to work the next morning, and keep a roof over your family’s head. Or you might need a therapist who can help put words into your child’s mouth. There are many offices and bureaus that can help. But the layers of bureaucracy present an impenetrable wall. (Margaret Mikol, 12/13)

The enormity of the news didn't sink in fully, not at first, even after my doctor uttered the words: “I'm sorry, we did find cancer.” My husband, Dave, and I had only the faintest sense that evening that our lives had been hijacked forever. Early 2014 brought major surgery, then six weeks of chemotherapy and radiation. Eight months later they found cancer again, so it was Christmas surgery and more of the same. When a scan in June showed new tumors, the outlook turned bleak. The cancer, a rare type — metastatic squamous cell head and neck carcinoma of unknown primary — had gone systemic. ... I have turned my attention to the question How do I best spend the time I have left? (Melinda Welsh, 12/11)

As Americans debate how the country should respond to gun violence, they should not lose sight of the biggest category of firearm deaths: suicides. About two-thirds of people killed by guns, or 20,000 a year, kill themselves. The rate at which Americans commit suicide with guns has been increasing for several years, even as the rate of gun homicides has declined. Research shows that the increase is correlated with higher gun ownership. (12/14)

When a key player in a merger proclaims “This is an exciting new chapter,” as Dr. Steve Tarnoff, president of Group Health Physicians, said of Kaiser Permanente’s pending acquisition of Group Health Cooperative, one must always ask, exciting for whom? Oh, and define exciting. Adding Group Health and its 600,000 members in Washington and northern Idaho to its portfolio would be a coup for Kaiser Permanente, a large, complex and storied managed-care organization. (Jon Talton, 12/12)

These data seem to show a country whose wealth is highly concentrated. But the true picture is hardly as stark as critics of inequality claim, because it leaves out the large amount of wealth held in the form of future retirement benefits from Social Security and Medicare. Moreover, the public’s traditional financial wealth is depressed because the current entitlement programs lower people’s real incomes and deny them the higher returns available through investment-based retirement savings like IRAs or 401(k)s. (Martin Feldstein, 12/13)