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In case you were keeping score at home: In Donald Trump’s America, you’re allowed to refuse to make me a cake, because pastry is free speech. But if you’re a researcher studying medicine at the leading national public health institute of the United States, you can’t say “science-based” in a budget request. Because science, apparently, is a less protected form of communication than buttercream frosting. (Jennifer Finney Boylan, 12/18)

Comedian George Carlin famously crafted a routine around “Seven Words You Can Never Say on Television,” a piece so far over the line for a newspaper that you’re just going to have to look it up yourselves. But the Trump administration has gone one better and has listed seven words and phrases the Centers for Disease Control and Prevention is now banned from using in budget documents. (Scott Martelle, 12/16)

Health insurers are not the most beloved companies. They deny claims, bury people in paperwork, and generally make life more difficult. But a good case can be made that America’s health care woes lie more with its providers than its insurers. Some communities are served by a single hospital or group of specialists. Some patients are reliant on a single drug. That gives these businesses enormous leverage to hike prices. (12/17)

American consumers aren’t the only ones struggling with higher health-care costs. CVS Health’s proposed $69 billion purchase of health insurer Aetna is driven in part by the companies’ efforts to get control over more of the costs they face, and to make their operations more efficient. The question for regulators, though, is whether the combination results in a company that uses its clout to help consumers or squeeze more dollars out of them. (12/17)

In its failure to repeal Obamacare this fall, Congress should have learned a simple lesson: Americans want the government to see that everyone has health insurance. Instead, the Republican majority tirelessly insists on moving in the opposite direction. Thus, their shambles of a tax bill repeals Obamacare's requirement that everyone have health insurance. (12/15)

I’ve worked at Preble Street in Portland, Maine, for 26 years and never thought I’d see the day when our social workers are reversing opioid overdoses on a regular basis. In my first 22 years here, we had no overdoses. Zero. Now every eight days we find someone on a bathroom floor, lips blue, not breathing. (Mark R. Swann, 12/16)

The opioid epidemic’s disproportionate impact on women is the latest, and most destructive, symptom of wider gender-based disparities that leave millions of American women in worse health than men. Data show that deaths among women from opioid overdose have increased at a much faster rate than for men, 400% compared with 265%. And states where doctors write the most opioid prescriptions per 100 residents are also the states with the widest overall disparities between men’s and women’s health. (Ken Sagynbekov, 12/18)

Making California the first state to guarantee health care for every resident has become a touchstone issue – and a divisive one – for the state’s dominant Democrats. ...It’s not necessary for the state to seize control of California’s entire medical care system if the real bottom line goal is covering those undocumented immigrants. It could be done for about $10 billion a year, which is a lot less than $100 billion. However, advocates would have to publicly acknowledge that covering them is what this conflict is all about and take whatever political heat it generates. (Dan Walters, 12/17)    

The Patient Protection and Affordable Care Act (ACA) has polarized policymakers since its initial stirrings in the Obama administration’s first term. In Michigan, state lawmakers embraced one of its most significant elements – the expansion of Medicaid we now know as Healthy Michigan – but inserted language that makes Healthy Michigan’s future contingent on an unorthodox cost-vs-savings mechanism that now threatens its survival. (Eric Lupher,12/17)

For those who are ailing but hope to stay out of nursing homes or hospitals — and who wouldn’t? — there’s an increasingly popular alternative: home health care providers. These are doctors, nurses and other medical staffers who visit patients at home, with the goal of treating chronic conditions and keeping people healthy enough to avoid costly long-term stays in more intensive facilities. That saves patients, and the health care system, money. (12/15)

Missouri’s sad history of ignoring the dangers of tobacco use was reinforced this week when a coalition of health groups released a new study of state spending on the problem. ...Missouri will spend $48,500 on smoking cessation efforts this fiscal year, the report says. That’s 49th out of 50 states and the District of Columbia. (12/17)