The Legislature’s inability to agree means that more than a million low-income Floridians will remain without insurance, at least in the short term. Florida has one of the nation’s highest rates of uninsured people. Public hospitals also will suffer because they will continue to have to care for those one million uninsured who seek treatment in their emergency rooms.

Two nights a year, Tennessee holds a health care lottery of sorts, giving the medically desperate a chance to get help.

State residents who have high medical bills but would not normally qualify for Medicaid, the government health care program for the poor, can call a state phone line and request an application. But the window is tight — the line shuts down after 2,500 calls, typically within an hour — and the demand is so high that it is difficult to get through.

There are other hurdles, too. Applicants have to be elderly, blind, disabled or the “caretaker relative” of a child who qualifies for Medicaid, known here as TennCare. Their medical debt has to be high enough that if they paid it, their income would fall below a certain threshold. Not many people end up qualifying, but that does not stop thousands from trying.

“It’s like the Oklahoma land rush for an hour,” said Russell Overby, a lawyer with the Legal Aid Society in Nashville. “We encourage people to use multiple phones and to dial and dial and dial.”

Last week I attended an initiation to a secret club. The admission criteria are tough. One does not choose admission but still must pass a rigorous selection process. No one asks to get in this club and no invitations are issued. If you meet the qualifications you are in. Forever. The club membership consists of those of us who have watched, waited, cried, cursed, promised, loved, and hated a parent who suffers from Alzheimer’s.

Deans of public health schools in the United States have sent the following letter to President Obama, in which they criticize the use of a vaccination campaign by the Central Intelligence Agency in Pakistan to hunt for Osama bin Laden.

The full text of the letter outlining the complaints about the CIA’s ruse can be found at the link. Glad to see the public health school deans from Tulane, Emory and the University of North Carolina were among those who signed.

Well, no one could have seen this one coming. Last year Texas Republicans took $73 million away from family planning services to protect taxpayers from the evils of Planned Parenthood’s non-existent abortion services. And now?

”The latest Health and Human Services Commission projections being circulated among Texas lawmakers indicate that during the 2014-15 biennium, poor women will deliver an estimated 23,760 more babies than they would have, as a result of their reduced access to state-subsidized birth control. The additional cost to taxpayers is expected to be as much as $273 million —”

One Democratic representative said of her Republican colleagues, “in retrospect they did not fully grasp the implications.” Well, sure. Who could have predicted it? After all, it’s not like they had any estimates of the potential impact of the cuts ahead of last year’s vote. Well, except for this:

“Last legislative session, while lawmakers debated the cuts, the nonpartisan Legislative Budget Board estimated that they would lead 284,000 women to lose family planning services, resulting in 20,000 additional unplanned births at a cost to taxpayers of $231 million.”

Now that the Affordable Care Act really is the law, the battle ground has moved to the individual states, and the combatants are now all Republicans.

Mississippi Insurance Commissioner Mike Chaney informed HHS Secretary Kathleen Sebelius Nov. 14 that he will oversee the creation of a health insurance exchange despite the objections of Gov. Phil Bryant. On Monday, in a previously unreleased letter, Bryant wrote Sebelius to say he “feels compelled to notify you of my complete disagreement with this move.” […]

“The governor asked me, ‘What authority do you have to do this?’” Chaney told POLITICO. “And I said, ‘Phil, what authority do you have to stop me?’” […]

Mississippi’s only abortion clinic will have to close unless a federal judge halts a new state law requiring its physicians to obtain admitting privileges to local hospitals, according to a court motion filed on Wednesday. In the motion, the Jackson Women’s Health Organization renewed its request for a federal judge to prevent state officials from enforcing a law which went into effect on July 1.

Gov. Rick Scott, one of the most vocal critics of the federal health care overhaul, is dropping his staunch opposition to the law. Scott said in an interview Tuesday with The Associated Press that he now wants to negotiate with the federal government. He said it’s time for Republicans to offer solutions to help families after they lost their bid to defeat President Barack Obama.

“The election is over and President Obama won,” Scott said. “I’m responsible for the families of Florida … If I can get to yes, I want to get to yes.”

Scott had previously stated that he would not go along with any parts of the health care overhaul that the state controls. But his newfound willingness to have a “conversation” about putting it in place in Florida comes at a critical time. States have until Friday to notify federal authorities whether they plan to set up health insurance exchanges, a marketplace where individuals and smalls businesses can shop for the most affordable coverage and where many will get help from the government to pay their premiums.

A curious development. We’ll be watching to see how it turns out.