A new study examines the connection between the states with the most restrictive anti-choice laws and the states with the most aggressive levels of harassment against abortion doctors, providers, and clinics. Although the researchers couldn’t point to causation, they did find an association between more restrictive state-level abortion legislation and increased harassment of abortion providers.

Salon’s Irin Carmon speculated that the increased media spotlight on the states that pass restrictive anti-choice laws could incite the Americans who are obsessively, passionately anti-abortion to take action against abortion providers. Or, as one of the study’s authors told Salon, anti-abortion activists could take their cues from state governments. As she put it, when state legislators target abortion providers, it “probably in some way sanctions targeting us for harassment.”

Although the study’s authors focused on what they deemed to be nonviolent protests — such as vandalism of clinics and intimidation of patients — because acts of anti-abortion violence were relatively rare during their data collection in 2010, they do note that acts of serious violence against abortion providers has been on the rise over the past two decades. Perhaps the most famous symbol of the violence leveled against abortion providers is Dr. George Tiller, a Kansas-area women’s health advocate and abortion doctor who was murdered at his clinic in 2009 — a clinic that was recently purchased by a women’s health group that hopes to re-open it to once again provide abortion services to women in the area.

Underneath the potentially dry data involved with health care reporting are millions of untold human stories — the Americans saved by the social safety net, the Americans left in destitution when the safety net is cut, and the Americans sometimes struggling to receive help from that net even when it is in place.

Harold Pollack, a University of Chicago Professor, sits at the intersection of those two realities. While blogging on health care and public policy for The Incidental Economist, Pollack and his wife Veronica also spent the last eight years caring for Veronica’s brother Vincent, who is intellectually disabled and suffers a variety of other medical conditions requiring regular and expensive treatment. Medicare and Medicaid played a crucial role in the Pollacks’ ability to care for Vincent without sacrificing their family’s economic security or the academic future of their two daughters.

To illustrate the human costs of the GOP’s proposed cuts to these social services — in addition to their plan to shift Medicare into a premium support system, Mitt Romney and Paul Ryan have proposed to cut Medicaid by a third over the next decade — Pollack recently produced a video to tell his family’s story. Watch it:

Vincent is one of the 9 million “dual eligibles” who receive support from both Medicare and Medicaid. Those who are eligible for both programs are the poorest and sickest of Americans, and Medicaid in particular helps them cover premiums, co-payments, dental care, and of course the long-term and nursing home care so many of the elderly rely on. Slashing Medicaid by $810 billion through 2022 would cut this support off at the knees. Medicaid’s reimbursement rates are already significantly lower than Medicare’s, making it a stringently spartan program. Romney and Ryan’s cuts would drive these rates still lower, or force 14 to 27 million Americans out of the program entirely. (That’s not counting the other 17 million who would be forced out be their repeal of Obamacare’s Medicaid expansion.)

As much of America’s politics remains fixated on lower taxes and shrinking government, it’s worth remembering the Pollacks and the millions like them — and remembering that the care they receive is the care we as a country are willing to pay for.

Continuing the post-Obamacare trend toward efficient cooperation between governments, private insurers, and care providers, Arkansas is kicking off a first-of-its kind Medicaid reform program. The state will partner up with its two largest insurers, Blue Cross Blue Shield and QualChoice, in an attempt to provide medical cost transparency to practitioners, increase the efficiency and quality of care for the state’s low-income residents, and hopefully stave off a projected $400 million deficit in the program.

As Kaiser Health News reports, the new plan — dubbed the Healthcare Payment Improvement Initiative — hopes to lower costs by providing doctors with up-to-date data on the average cost of treating Arkansas’ most common medical conditions, as well as creating an incentive structure for doctors’ Medicaid reimbursements:

The Health Care Payment Improvement Initiative is a shared-savings plan that begins to move the state and private insurance market away from a traditional fee-for-service payment system, to one in which providers are paid based on how well they deliver care and manage their costs. But it isn’t a move toward managed-care, either. Instead, it’s taking the health care delivery system that is already in place and adding new incentives and accountability. [...]

“It’s actually been very gratifying,” [Arkansas Department of Health and Human Services Director John M.] Selig said. “We’ve had providers call us and say, ‘Can you tell me what these other services cost that I’ve been ordering because I’ve never really worried about that.’ Now they are seeing their reports and some of them are saying, ‘I actually want to understand these costs and if I can manage those costs better and still provide good care, I’m happy to do that.’”

By collaborating with the private plans, Medicaid is able to accomplish changes on a scale it may not have been able to do alone, said Selig. The goal, he added, is not to set prices. Instead, he said, “we are all just trying to give consistent signals to the providers,” so they can monitor their spending.

“It’s a work in progress,” Governor Mike Beebe told Stateline news service. “It could be that we need to tweak it and make changes as we see the need. We don’t in any way want to direct doctors or hurt their ability to deliver quality care.” But doing nothing, he says, is not an option.

The Healthcare Payment Improvement Initiative tackles a major source of medical inflation and health care inefficiencies — namely, the lack of transparent information in the medical field. Simply by consistently releasing information about care costs, Arkansas may be able to goad its medical practitioners into cutting costs while maintaining the flexibility to provide quality care. If successful, this effort could go a long way towards fortifying the state’s Medicaid program, which currently insures over a fourth of the state’s residents.

Low-income women in Texas are more likely to get pregnant thanks to their state legislature’s crusade against abortion.

This year, Texas Gov. Rick Perry (R) stopped state funds from going to clinics he considers abortion “affiliates.” That disqualified the state from receiving any federal Women’s Health Program funding, destabilizing the entire program. Around the same time, the state legislature voted to cut overall family planning services for publicly-funded clinics in the state. In the end, Texas clinics were left high and dry and looking for cash.

The result? A new study from the New England Journal of Medicine reveals that cash-strapped Texas clinics are now unable to provide the most effective types of birth control to the women who need public assistance for contraception. Instead, they’re forced to use methods that are less effective at preventing pregnancy:

To continue serving as many clients as possible, clinics now rarely offer IUDs or implants, reserving these methods for women with medical contraindications to other contraceptives. Some providers have started waiting lists for IUDs and implants in the unlikely event that they can purchase them with money left over at the end of a funding period. In addition, as more women are steered toward contraceptive pills, they are being provided with fewer pill packs per visit, a practice that has been shown to result in lower rates of continuation with the method and that may increase the likelihood of unintended pregnancy — and therefore that of abortion.

The cognitive dissonance in the Texas legislature’s plan is apparent. Although GOP lawmakers intend to target health clinics like Planned Parenthood for providing abortion services, their move to slash funds for women’s health services have far-reaching effects that actually undermine their goal of lowering the abortion rate in the state. Higher rates of unplanned pregnancy lead to higher rates of abortions. And less funding for women’s health leads to more unintended pregnancies — particularly among women in poverty for whom having a child is not a viable economic option, and especially as the legislature in Texas simultaneously makes it harder to afford kids.

After Arizona’s Republican-controlled legislature pushed to privatize health care for the inmates in their state, they auctioned off the job of providing prisoners with health services to the highest-bidding company. Wexford Health Sources Inc. won a $349 million, three-year contract with the state prison system and took over inmate care on July 1.

But just a few short months after the Pittsburgh-based company took over, the Arizona Department of Corrections (DOC) is stepping in to correct issues with the inadequate care it has provided to state inmates. The DOC is leveling a $10,00 fine on the company for its negligence in dispensing proper medication to prisoners in Arizona’s state prison facilities, outlining Wexford’s damaging effects on sick prisoners’ quality of life in a strongly-worded letter to the company’s officials:

An inmate was found hanging from a sheet in his housing unit in Florence on Aug. 23. The state determined that the inmate had not received his psychotropic medication for the entire month of August, prior to his hanging, and Wexford’s failure to deliver the medication was a “significant, non-compliance issue.” Records do not indicate if the inmate survived.

On Aug. 27, a nurse hired by Wexford contaminated a vial of insulin, potentially exposing roughly 100 inmates at the state prison in Buckeye to hepatitis C. Another Wexford nurse was aware of the problem Aug. 27, but she did not file an incident report until Sept. 4, violating policy. The state was forced to deploy additional compliance monitoring staff to correct the problem. It said Wexford failed to follow established nursing protocols, mismanaged documents and engaged in inadequate and inaccurate communication.

At the Goodyear prison, meanwhile, a known case of whooping cough, a reportable infectious disease, went unreported to DOC staff and Wexford’s state-level management for 30 days, indicating a “lack of urgency” and a “lack of awareness of the situation’s potential seriousness.”

Even aside from the most egregious examples, the DOC also discovered last month that “a significant number of inmates may not have been receiving their medications as prescribed due to expired prescription(s) and inappropriate renewals or refills,” and Wexford showed a “lack of urgency” to correct the problem. Since Wexford employees didn’t make moves to address the issue, Arizona had to deploy extra staff “to identify inmates in need of medication renewals.”

Unfortunately, the situation in Arizona’s prisons is a predictable effect of privatizing the state’s prison health care. A recent Kaiser Family Foundation report found that privately-run health care programs in prisons often lead to “inhumane” conditions as officials work to cut costs and skimp on inmates’ care. Arizona inmates sued the state last March over inadequate care in state prison facilities that, in some cases, contributed to prisoners’ deaths after they were denied proper medical treatment. Arizona touts its efforts to privatize its prison system as an effective cost-saving measure for the state, but private prisons actually cost Arizona $3.5 million more each year than state-run prisons.

The latest major Obamacare provisions to go into effect will require hospitals to modify their care-delivery and medical treatment services in order to improve clinical quality measures, consumer assessments of care, and curb excess readmission rates. These goals are under two separate provisions of the law, though both will involve monetary and funding incentives in an effort to encourage higher quality, more-efficient hospital care.

The first part of the program, called the “Hospital Value-Based Purchasing Program,” will redistribute 1 percent of the total Medicare funding that about 3,000 acute-care hospitals receive by tying the funding to patient assessments and standard quality metrics. As Politico reports, the second part of the program — which addresses readmissions rates by withholding up to 1 percent of Medicare payments to hospitals that have high rates of readmission — is a bit more of a concern for public health advocates, who warn that the changes could put impossible burdens on safety-net hospitals if improperly implemented:

“I think we all see these programs as the first steps towards the way the system will be structured in the future and the way incentives will be structured in the future,” said Mindy Steinberg, director of government relations for the Association of Academic Health Centers. “But everyone needs to recognize that this is the first step in a long, complicated process.”

Blair Childs, a vice president at Premier health care alliance, told POLITICO that he thinks hospitals should be held accountable for readmissions but that “the policy is badly flawed.”

“It relies on insufficient risk-adjustment and will adversely impact at-risk communities,” Childs wrote in an email. Premier believes the readmissions program should be part of the value-based purchasing program, with fixed targets that hospitals can try to meet, rather than past performance.

Most health professionals seem to agree that Values-Based Purchasing Program is a positive, modest program that will eventually expand and encourage hospitals to increase efficacy. But penalizing hospitals based on readmissions has the risk of affecting the chronically ill or those with long-term mental health needs. Professionals argue that the specter of such adverse results merits careful implementation of the reforms and flexibility from the government on balancing patient needs with reducing wasteful readmissions. “If all the safety net hospitals get hit on readmissions, then we need to learn from that and make adjustments going forward,” Childs said.