Michigan Republicans introduced a mandatory ultrasound bill this week with a carefully-worded clause that threatens to stir up controversy that first erupted during the height of last year’s “War on Women.” By stipulating that the ultrasounds must use the “most technologically advanced equipment on site,” Michigan lawmakers would require women seeking abortions to undergo an invasive transvaginal probe.

Transvaginal ultrasound bills, which require doctors to insert a wand into a woman’s vagina before proceeding with an abortion procedure, were introduced last year in Virginia and Alabama. Widespread public outcry — including considerable derision from the national media — forced GOP lawmakers to back away from the extreme legislation, but Talking Points Memo reports that Michigan lawmakers are now ready to revive the fight:

The bill requires the use of ultrasound equipment “providing the most visibly clear image of the gross anatomical development of the fetus and the most audible fetal heartbeat.” As a practical matter, that requires transvaginal ultrasounds, said Donna Crane, the policy director of NARAL Pro-Choice America.

“It does lay bare that the real motive is to make abortion providers continue to acquire more and more and more equipment before they’re even eligible to perform an abortion,” Crane told TPM. “They’re trying to make it harder for doctors to do their jobs.” [...]

Crane said NARAL and its allies are prepared to fight to sink the legislation.

“Women should be up in arms over these types of laws,” she said. “Unfortunately they’re not new. But the fact that politicians just went through an election cycle and got spanked over how they treat women and reproductive freedoms and still introduce bills like this really boggles the mind. It’s not clear that the sponsors haven’t been living under rocks since November.”

But unfortunately for the women in Michigan, this is hardly the only recent attack on their reproductive rights. Their lawmakers already capitalized on the lame duck session at the end of last year to push through extreme anti-abortion legislation that limits abortion access for women who live in rural areas, requires doctors to prove that mentally competent women haven’t been “coerced” into their decision to have the procedure, and enacts unnecessary, complicated rules for abortion clinics and providers.

Abortion opponents often use mandatory ultrasounds as a tactic to impose additional barriers to reproductive care, as well as convince women to change their minds about having an abortion. But they don’t work. Studies have shown that nearly 90 percent of women feel “very confident” about their decision to have an abortion before they approach a doctor, and forcing them to look at an ultrasound doesn’t change their mind.

A Georgia Senate health committee has unanimously passed a bill “that would allow licensed professional counselors to involuntarily commit to an institution for 72 hours patients who appear to be mentally ill and a danger,” the Atlanta Journal Constitution reports.

While doctors and psychologists in Georgia already possess the authority to involuntarily commit mentally ill patients they deem to be a “danger,” licensed counselors do not share that power. The bill — SB 65 — looks to change that, with supporters arguing that the additional authorities will ease the burden on Georgia’s mental health institutions:

Giving licensed professional counselors the authority to involuntarily commit patients would fill a need and ease the strain on Georgia’s mental health system, promoters of SB 65 testified Tuesday. Georgia has roughly 4,800 licensed professional counselors.

“We need more investment in our mental health services,” Sen. Nan Orrock, D-Atlanta, told members of the Senate Health and Human Service Committee. “This is one piece of the puzzle.”

The bill is under discussion at a time when Georgia is struggling to provide more community-based mental health services, including mobile crisis teams, as part of a 2010 agreement with the U.S. Department of Justice that stemmed from an investigation into the abuse and death of patients in state mental hospitals.

The history of mental health institutionalization in America is fraught with controversy, but advocates for the mentally ill generally agree that community-based mental health services are medically preferable — and more humane — than institutionalized services. The fact that SB 65 was spurred by Georgia’s dearth of community-based practices suggests that the bill is simply treating a symptom of Georgia’s mental health woes, rather than addressing the issue’s root cause — namely, that the state does’t have nearly enough funding allocated for its mental health care system.

While the temporary institutionalization of mentally ill Americans who might be a danger to themselves or others is a relatively uncontroversial status quo, such laws may add to existing stigmas about mental health care and dissuade Americans with violent thoughts from seeking the care they need. For example, New York’s sweeping new gun safety law was met with reticence by mental health professionals for what some perceived to be draconian provisions requiring care providers to “report” potentially violent patients to a state board.

But Georgia’s law goes even further than that, adding institutionalization to the powers that a doctor has over patients. That’s pretty significant for the over half a million Georgians suffering from a severe mental disorder, as studies have shown that over a third of the mentally ill do not seek care due to social stigmas and the fear of being committed.

Michigan Gov. Rick Snyder (R) is set to announce his support for Obamacare’s optional expansion of the Medicaid program at a press conference on Wednesday afternoon. The announcement, which comes a day before the governor will address his budget priorities for the upcoming legislative session, will make Snyder the sixth Republican leader to agree to the health law’s Medicaid expansion.

Implementing this aspect of President Obama’s health reform law will be particularly impactful in Michigan, where an estimated 470,000 uninsured residents will gain health coverage. The health policy groups that provided Snyder’s office with research about expanding Medicaid — including the fact that the state could save up to $1 billion over the next decade by accepting the federal funding to increase their Medicaid rolls — are welcoming the governor’s decision:

Snyder’s support for Medicaid expansion “really is a big deal,” said Marianne Udow-Phillips, director of the Ann Arbor-based Center for Healthcare Research & Transformation, which provided research to the governor’s office. CHRT concluded Michigan would save more than $1 billion in the next ten years as the federal government picks up the cost for health care for those who currently are not covered by insurance.

Moreover, most primary care doctors reported to CHRT that they are able to accept new patients who now would have insurance, she said.

“What’s really powerful about this is that the governor did come at this from a very objective, analytical approach,” she said. “He looked at the facts, he pulled research from our center and … lots of people,” Udow-Phillips said. “I don’t want to say we’re surprised, but we’re very pleased that the facts did speak for themselves.”

The state’s Medicaid expansion will still have to be approved by Michigan’s legislature, where conservative opponents of Obamacare could present a roadblock. State-level resistance to health care reform has considerably slowed the implementation of the Affordable Care Act — but, as Snyder joins the growing list of Republican leaders who are conceding that implementing Obamacare makes sense for their constituents, the tide may be about to turn.

Some Americans may try to cut down on a few calories by using diet soda as a mixer in their alcoholic drinks. But new research suggests that mixing a diet rum and coke could actually carry an unexpected risk: since diet soda contains less sugar, it may cause greater intoxication than full-calorie soda, even though the difference is barely noticeable while drinking it.

Sugar slows down alcohol’s absorption from the stomach to the bloodstream — so diet mixers can actually make people drunker than full-calorie mixers, even when combined with the same amount of alcohol, because they have less sugar in them. That’s why the new study’s lead researcher, Cecile Marczinski, found significant differences in Breath Alcohol Concentrations (BrAC) among people who mixed their alcohol with a full-calorie soda and those who used a diet soda:

So what was the motivation for the new study? “I wanted to know if the choice of a mixer could be the factor that puts a person above or below the legal limit,” writes Marczinski, who’s a professor at Northern Kentucky University.

And it turns out, diet soda might just push you past that tipping point. Marczinski’s study found that the average BrAC was .091 (at its peak) when subjects drank alcohol mixed with a diet drink. By comparison, BrAC was .077 when the same subjects consumed the same amount of alcohol but with a sugary soda.

“I was a little surprised by the findings, since the 18% increase in BrAC was a fairly large difference,” Marczinski tells [NPR's] The Salt via email.

Marczinski also wanted to see if the participants in the study could feel a difference between the two mixers — essentially, whether or not they could tell that diet soda was making them drunker — and it turns out they couldn’t. Participants didn’t report that drinking the diet drinks made them feel any more impaired or intoxicated than they did after drinking the more sugary drinks. That could put them at an increased risk of drinking and driving, since they may not realize diet soda could have pushed their BrAC over the legal limit.

Of course, sugar isn’t the only ingredient that has a potentially hidden effect on alcohol consumption. Mixing alcohol with high levels of caffeine — typically present in popular energy drinks — also tricks consumers into thinking they’re less impaired than they actually are. Alcohol and energy drink combinations are increasingly sending young adults to the hospital, and the American Academy of Pediatrics recently began recommending that doctors attempt to mitigate the dangerous trend by talking to their adolescent patients about the risks of drinking alcohol with caffeine.

Say goodbye to the doctor’s office, and hello to your personal computer. According to a new report released by the Commonwealth Fund, “telehealth” — programs in which doctors and nurses use electronic medical data to remotely monitor and check in with their patients — has led to significant reductions in hospital re-admissions and bed days among early adopters such as the U.S. Department of Veterans Affairs (VA).

The study’s authors emphasized that effective telehealth programs “take time” to implement, citing the training needed to familiarize care providers with the new technology. But by improving patient monitoring, telehealth has the potential to keep Americans healthier by making sure they’re complying with their treatment regimens:

Followers also are counseled to be patient. “Successful programs can take time to scale successfully,” the authors said. “It takes time to integrate technology into care delivery and allow staff to adapt.” The VA’s Care Coordination/Home Telehealth program targeting chronically ill veterans, for example, was launched in 2003. Now, with 70,000 veterans receiving home telehealth care, the program boasts patient satisfaction levels greater than 85%.

In a data sample from 2004 through 2007, the VA reported reductions in bed days of care across all eight targeted chronic conditions, ranging from a 20% drop for the nearly 9,000 enrolled diabetes patients to a 56% decrease for the nearly 340 patients then receiving home health monitoring for depression, and a 45% drop for nearly 140 patients with post-traumatic stress disorder.

Partners [HealthCare] has had 1,200 patients enrolled thus far in its Connected Cardiac Care Program since its launch as a pilot study in 2006. It has “consistently experienced an approximate 50% reduction in health failure-related readmission rates for enrolled patients,” according to the Commonwealth reporters, with an estimated savings in utilization of about $10 million.

In recent months, an increasing number of hospitals and government institutions have turned to technology in an effort to reduce health costs while improving patient care. Minnesota recently established an online “bulletin board” tracking the available flu shots in the state; studies have shown that telemedical procedures for women taking abortion-inducing medication are just as effective as having a doctor physically present; and a large part of the way that Obamacare seeks to reduce national health expenditures is through the institutionalization of electronic medical records.

But telehealth procedures targeted towards patient monitoring hold particular promise for improving patients’ health by curbing unnecessary hospitalizations — particularly for elderly Americans. That’s because studies have shown that a large portion of excessive medical spending stems from patients taking their medications incorrectly or not following their treatment regimens. By allowing health workers to have up-to-the minute access to their patients, telehealth could go a long way towards reversing that trend.

Over the past several years, it’s seemed like Republicans would never give up the fight against Obamacare. Even after the health care reform law survived a Supreme Court challenge, dozens of repeal efforts in Congress, and a presidential election, GOP governors across the country stubbornly resisted moving toward implementing health care reform — even at the expense of their state’s low-income residents. But that tide may finally be turning.

As Politico reports, some Republican governors are starting to resist the pull of the rest of their party and move ahead with key parts of President Obama’s health law. Five Republicans governors have now agreed to Obamacare’s optional Medicaid expansion, and three GOP leaders are pursuing state-run insurance markets. The growing number of Republicans who are beginning to cooperate with health care reform, as well as the fact that repeal efforts aren’t gaining much traction in Obama’s second term, may signal that the partisan fight over Obamacare is finally past its prime:

These state moves represent a turning point in the fight over Obamacare. Outside the Beltway, GOP governors are living with the reality that there’s nothing they can do to stop the law, so some are trying to carry it out on their own terms. And Republicans back home and in Washington aren’t giving their governors hell for giving in to the ACA — even if The Wall Street Journal editorial page doesn’t like it. [...]

Dan Derksen, who used to oversee Affordable Care Act implementation in New Mexico and is consulting on Arizona Gov. Jan Brewer’s Medicaid expansion plan, called the governors’ decision to implement major pieces of Obamacare “courageous,” given the partisan opposition to the law.

“I just think that when you look at the data and what it means to the constituency they represent, they’re making a data-driven, evidence-based, informed decision,” said Derksen, a Republican. “I admire the courage of governors like Sandoval, Martinez and Brewer.”

With the exception of New Mexico, all the GOP-led states that have indicated support for implementing Obamacare were part of a lawsuit against the health law challenging the constitutionality of its individual mandate. But the political reality is different now, particularly since public support for Obamacare is growing now that Americans are beginning to experience the positive effects of some of its new provisions.

However, that doesn’t mean every Republican leader in the country is on board. Ten GOP governors have already rejected Obamacare’s Medicaid expansion, even though some of their states have the highest rates of uninsurance in the nation. And some Obamacare opponents are keeping the fight alive on a state level, proposing legislation to block state officials from implementing health reform.

Republicans in Mississippi are already working hard to shut down the last abortion clinic in the state, imposing unnecessary, complicated regulations that may drive the clinic out of business and leave women with few options for surgical abortions. But that’s not enough for Mississippi’s anti-abortion lawmakers. Now, a GOP-sponsored bill also seeks to limit women’s access to medication-induced abortions as well.

The state’s Senate Health committee has approved a bill that would impose additional hurdles for women seeking to terminate a pregnancy with the abortion-inducing drugs mifepristone and misoprostol. The new measure would force women to make additional trips to the doctor’s office, as well as impose an outdated method of prescribing abortion-inducing medications that women’s health advocates warn will simply obstruct abortion access:

“The FDA protocol for medical abortion is an outdated procedure and it’s not commonly used,” said Felicia Brown-Williams, who lobbies for Planned Parenthood in Mississippi.

The measure would also require a woman to return to a doctor’s office to take a dose of misoprostol, instead of taking it at home, as is often now the practice. That would mean a total of four visits — one before prescription, one for the first course of mifepristone, one for the misoprostol, and then a follow-up visit 14 days later. [...]

“The reasons for these bills are to do everything possible to restrict abortion services,” Brown-Williams said. Her organization prescribes the drugs in other states, but not in Mississippi.

Only a doctor could prescribe the drugs under the proposed law, and the physician would have to report every prescription to the state Department of Health. Physicians would also have to report every “adverse event” to the FDA and the state Board of Medical Licensure. Any doctor who violates the law could face lawsuits, lose their licenses and be convicted of a misdemeanor.

Mississippi’s proposed bill is similar to legislation in Ohio that began restricting access to medication abortions in 2011. Because the outdated requirements require doctors to unnecessarily increase the dosage of mifepristone for their patients, Ohio’s law actually started raising the cost of the abortion pill for the women who need it — which could soon be the situation in Mississippi as well.

Making medication abortion services widely available helps lower the rate of later term abortions, since it gives women the opportunity to get the reproductive care they need as soon as possible. Of course, surgical abortions are an extremely safe medical procedure — but many women prefer the additional privacy that medicine-induced abortions allow them as they terminate a pregnancy, since they can take the RU-486 pill at home.

But the women in Mississippi may soon have very few places to turn for their abortion care. If GOP lawmakers successfully shutter the last remaining abortion clinic, there won’t be anywhere in the state to obtain a surgical abortion. And as politicians slowly chip away at access to medication abortions, women seeking reproductive health services — particularly the economically disadvantaged women who struggle to make multiple trips to the clinic, and may not be able to afford increasingly expensive RU-486 pills — may not have any safe abortion options left.