The U.K.’s government-run healthcare system, the National Health Service, turns 70 this month. There’s not much to celebrate. The NHS is collapsing. Patients routinely face treatment delays, overcrowded hospitals, and doctor shortages. Even its most ardent defenders admit that the NHS is in crisis.

States are testing the waters with Medicare-for-all type plans while waiting for federal solutions. The cost of single-payer plans could be the biggest hurdle.”Medicare for all” is becoming a rallying cry in state elections, with state legislators coming up with their own versions of single-payer healthcare despite, or possibly because of, the stagnation of similar ideas at the federal level.

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A federal judge’s decision to bar Kentucky from imposing a work requirement on Medicaid recipients won’t discourage the Trump administration from considering similar requests from other states, CMS Administrator Seema Verma said Tuesday at the POLITICO Pro summit.

The U.S. House Ways and Means Committee has advanced 11 bills, including three introduced by U.S. Rep. Peter Roskam (R-IL), to expand access to Health Savings Accounts (HSA), which currently provide healthcare coverage to more than 25 million Americans.

Premiums in California’s health insurance exchange will rise by an average of 8.7% next year. The average increase in California is smaller than the double-digit hikes expected around the nation, due largely to a healthier mix of enrollees and more competition in its marketplace. Still, health insurance prices keep growing faster than wages and general inflation as a result of rising medical costs overall, squeezing many middle-class families who are struggling to pay their household bills.

Voters in Idaho will get to decide in November whether the state will expand Medicaid, Secretary of State Lawerence Denney announced Tuesday. Denney certified that an activist group collected the required 56,192 signatures needed to place the measure on the ballot. Supporters of the measure say it would provide coverage for up to 62,000 Idahoans who now fall into a coverage gap, making too much to qualify for Medicaid but not enough to qualify for subsidized health insurance through the state insurance exchange. Idaho is one of 18 states that have yet to expand coverage under Obamacare using federal money. Idaho joins Utah as red states where Medicaid expansion will be put to a vote.

The legal dispute over Medicaid expansion came before the Maine Supreme Court Wednesday afternoon. Maine Equal Justice Partners and other consumer advocacy organizations are suing the state to force the LePage administration to implement the voter-approved law, and a lower court had ordered the state to file an expansion plan with the federal government. The administration appealed, arguing before the court that it can’t implement expansion or comply with the order without funding. Funding has been the central issue with Medicaid expansion politically in Maine, and it’s the central issue before the state Supreme Court. The court must decide whether a temporary stay on a lower court order should remain in place.

Candidates who advocate single-payer on the campaign trail are increasingly balking once they actually get their hands on the levers of power. That’s because single-payer is cost-prohibitive. Even the most dyed-in-the-wool leftists admit as much, after they take office and have to figure out how to pay for their campaign promises. Single-payer’s champions generally paint a lovely picture of health care utopia. Patients go to see the doctor of their choice whenever they like, get treatment, and leave the clinic without paying a cent. No copays, no deductibles, no cost-sharing, and no referrals—health care is “free” at the point of service. In reality, health care doesn’t magically become free; people just pay for it outside the doctor’s office, in the form of higher taxes.

House Democrats are launching an official Medicare for All Caucus in an effort to promote a single-payer health care bill. The caucus, which was officially announced on Thursday, comes as an increasingly larger number of Democrats warm to the idea. The idea, championed by Sen. Bernie Sanders (I-VT), is now favored by many potential 2020 Democratic presidential contenders. The caucus will launch with about 60 members and will be led by Democratic Reps. Pramila Jayapal (WA), Debbie Dingell (MI) and Keith Ellison (MN), with more expected to sign on in the coming weeks.

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The long-anticipated surge of retiring baby boomers is upon us. The Medicare trustees recently estimated that Medicare Part A (the hospital insurance trust fund) will go bankrupt in 2026, only eight years from now—and three years sooner than they predicted in last year’s report. Consumer decisions and behavior provide important clues about where policymakers can go from here. For decades the debate in Washington has centered on benefit expansion, benefit reduction, or tax increases. In the real world, consumers are offering a fourth way to preserve Medicare: choice and competition.