Gov. Scott Walker (R-WI) announced on Wednesday that he will turn down Obamacare’s optional expansion of the Medicaid program, which makes him the thirteenth Republican leader to refuse to extend public health insurance to additional low-income Americans. Six GOP governors — in Arizona, Michigan, New Mexico, North Dakota, Ohio and Nevada — have expressed support for expanding Medicaid, and the rest still need to decide what they want to do about that particular provision of the health reform law.

And even though most GOP leaders claim that expanding Medicaid would be too costly, they’re actually being lobbied by hospital companies, economists, and health care experts who all say the financial benefits — since the federal government will fully fund the first several years of expansion — are too good to turn down:

“It’s fascinating, because on the political level, it’s a classic clash between money and politics,” said Dan Mendelson, CEO of Avalere health advisory company. He said he and his 170 advisers working with the health care industry are hearing plenty about expansion.

“It sets up a really difficult tension between the Republican governors and the hospitals, but there’s an increasing level of political cover being given to the governors to expand their programs,” Mendelson said. [...]

In Florida, a recent poll found that 60% of residents would like to see Medicaid expanded, Mendelson said. Several economic studies have found the states may benefit both by federal funds going into local economies, as well as taxes from those sales going back into the coffers of local government.

The significant federal funds allocated to states that choose to expand Medicaid led the hospital industry to wonder if governors were bluffing about rejecting the expansion. That quickly proved not to be the case, as stubborn GOP politicians in some of the states with the highest rates of uninsurance in the nation still refused to cooperate with the health care reform law.

Diverse coalitions across the country have partnered to pressure resistant lawmakers to expand their Medicaid programs. The growing list of GOP governors who have accepted the optional expansion over the past few weeks seemed to signal that political deadlock may soon give way to reality, but the remaining Republican leaders may buck that trend when they eventually announce their own decisions.

A new study released Wednesday by the Institute of Medicine concludes with a dire warning: start effectively tracking and monitoring medication, or face the devastating worldwide public health consequences of a market littered with counterfeit products.

According to the Associated Press, researchers and global health advocates are deeply concerned about the effects that diluted — and even poisonous — drugs can have on patient health. Particularly troubling is the fact that, superficially, imitation drugs appear to be indistinguishable from real ones, making step-by-step tracking procedures of utmost importance:

“There can be nothing worse than for a patient to take a medication that either doesn’t work or poisons the patient,” said Lawrence O. Gostin, a professor of health law at Georgetown University who led the IOM committee that studied how to combat the growing problem.

A mandatory drug-tracking system could use some form of barcodes or electronic tags to verify that a medication and the ingredients used to make it are authentic at every step, from the manufacturing of the active ingredient all the way to the pharmacy, he said. His committee examined fakes so sophisticated that health experts couldn’t tell the difference between the packaging of the FDA-approved product and the look-alike.

“It’s unreliable unless you know where it’s been and can secure each point in the supply chain,” Gostin said.

Patient safety advocates have pushed for that kind of tracking system for years, but attempts to include it in FDA drug-safety legislation last summer failed.

The report goes on to suggest various approaches to combating the scourge of counterfeit drugs, including “licensing requirements for the wholesalers and distributors who get a drug from its manufacturer to the pharmacy, hospital or doctor’s office,” and “wider promotion of the National Association of Boards of Pharmacy’s online accreditation program” aimed at helping consumers locate legitimate drugs from online vendors — one of the biggest sources of counterfeit medicine today.

The real world effects of counterfeit drugs are already rampant, with tuberculosis gaining resistance to antibiotics largely due to watered-down versions of the drugs peddled to patients in developing nations and a fake Adderall scandal right here in America.

A federal tracking system was in the pipeline for a landmark food and drug safety overhaul passed last summer with bipartisan support — but the amendment did not make it into the final bill despite support from both the FDA and the pharmaceutical industry due to Congress’ inability to sketch out an effective digital tracking regime.

After Republicans won big gains in the Arkansas legislature in the 2012 elections, they’ve wasted no time pushing their anti-abortion agenda in the state. Arkansas Gov. Mike Beebe (D) has already signed one new abortion restriction into law already, and he hasn’t specifically confirmed whether or not he’ll sign the other proposed anti-choice legislation in the works — including a radical “fetal heartbeat” bill that would ban abortions as early as 12 weeks of pregnancy.

But as RH Reality Check points out, the heartbeat bill could pass regardless of whether Beebe decides to support it. Under Arkansas law, a simple majority in the legislature can override the governor’s veto — so even if Beebe correctly concludes that the legislation is unconstitutional, the state senators who support the bill could vote again to override him. And, assuming that all of the legislators who have already voted in favor of the bill don’t change their minds, there are enough of them to assure its passage into law.

And the bill’s sponsor, Arkansas Sen. Jason Rapert (R), is already hard at work making the legislation more palpable for his fellow lawmakers. After women’s health advocates pointed out that Rapert’s original bill would mandate invasive probes for all women seeking abortions — since a transvaginal ultrasound is the only way to detect a fetal heartbeat in the first trimester of pregnancy — Rapert pushed back the cut-off to ban abortions after the point when a heartbeat can be detected with an abdominal ultrasound, usually around 12 weeks. The GOP lawmaker is also working to remove criminal penalties for the abortion doctors who perform the procedure after 12 weeks, and include additional exemptions in cases when women discover fetal abnormalities.

Rapert hopes those changes will sufficiently appease his party. “We feel like that we definitely now have a bill that has even broader support than it did a few weeks ago when it came out of the Senate,” he said on Tuesday. But regardless of Rapert’s edits to his heartbeat bill, it still represents the most stringent abortion ban in the nation, going far past the 20-week abortion bans that currently have that distinction. Thanks to Arkansas’ legislative process, however, not even the governor may be able to stop it at this point.

Arkansas isn’t the only state where anti-choice lawmakers could push abortion restrictions past the governor. The legislatures in Alabama, Indiana, Kentucky, and Tennessee may also override vetoes with a simple majority vote.

In the current debate about gun violence, the weapon manufacturers’ lobby has pushed the myth that the federal government has no role to play in stemming the tide of gun violence. In reality, it is the federal government’s responsibility to enact common-sense measures to protect its citizens. In fact, such measures have already been established for items as seemingly innocuous as cold medicine — but similar measures to regulate guns have faced a politicized battle, funded and led by the gun manufacturing lobby with little regard for the safety of civilians.

In 2006, then President George W. Bush signed the Combat Meth Act as part of the Patriot Act. The purpose of this legislation is to track and prevent potential drug manufacturers from obtaining pseudoephedrine, a common treatment of nasal congestion, but also a key ingredient for manufacturing meth. The act contains three key provisions:

1. A person is limited in how much pseudoephedrine he or she can purchase per month.

2. Retailers must keep personal information about these customers for at least two years after the purchase of these medicines.

3. Information for the purchase logbook must be verified against the photo ID, and recorded along with the amount of medication purchased.

While every American adult, who suffers an average of 2 to 4 colds per year, must strictly obey these regulations to receive treatment for his or her cold symptoms, he or she is not obliged by the federal government to follow them in order to buy a gun:

1. Under federal law, it’s prohibited to buy more than nine grams of pseudoephedrine in one month, but there is no limit on how many firearms an individual can purchase for the same time period. State laws regarding the number of firearm purchases are becoming harder to find. Currently, only three states and the District of Columbia limit the number of sales per month. In 2002, Virginia made headlines when it repealed its one-handgun-a-month law.

2. Information about the purchaser of a decongestant must be recorded for a minimum of two years, but thanks to the Tiahrt Amendments (provisions added to federal spending bills by former U.S. Representative Todd Tiahrt (R-KS) that weaken the federal government’s ability to track and pursue criminals who buy and sell illegal guns) the Justice Department must destroy the record of a gun buyer whose background check was approved within 24 hours.

3. Cold medicine retailers must log information about the purchaser and amount of pseudoephedrine purchased, but not all states require gun retailers to do the same. Despite the tragic massacre at Virginia Tech, the Commonwealth does not require gun retailers to submit records of their sales and forces them to destroy all prior records they have. Of course, the purpose of cold medicine purchaser information is to update the national database of pseudoephedrine users for law enforcement, but no such national database exists to help track gun purchases.

So what does this tell us about the government’s role in preventing gun violence?

The federal government has a moral responsibility to address potentially dangerous items, and when they fail to live up to that responsibility, our communities suffer negative consequences. When instances of meth abuse were on the rise, the federal government took necessary steps to curb a threat to public safety. As the death toll of gun massacres also rises, the government — empowered by the Heller decision — has a similar duty to support sensible gun violence prevention measures.

In the same way that the government requires cold medicine sellers to know the purchasing history of pseudoephedrine buyers, the government could require that all gun sellers run background checks to know the criminal and mental health history of firearms purchasers. As it stands now, 40 percent of gun transactions are completed through private, unlicensed gun dealers who are not required by law to run a background check. But if we accept that the federal government places a limit on the amount of cold medicine we buy per month to prevent meth manufacturing, can’t we easily understand a limit on the number of bullets in a magazine to prevent an increasing number of massacres?

While the Combat Meth Act of 2005 was highly effective immediately following implementation, over time the initial impact of the law wore off. The Obama administration, recognizing that legislation should keep pace with criminals as they find loopholes in the law, is continuing Bush’s effort against meth abuse. And if these evolving regulations on pseudoephedrine can start to sweep meth off our rural community roads, it stands to reason that common-sense gun violence prevention measures could help stem the tide bloodshed in our houses of worship, schools, movie theaters, and urban community streets.

Our guest blogger is Hillary Anderson, an External Affairs intern with the Center for American Progress.

After surviving a Supreme Court challenge, dozens of repeal attempts in Congress, and a presidential election, Obamacare is here to stay — and even some of the staunchest opponents of the health care reform law are finally starting to take steps to implement its provisions in their states. But that doesn’t mean anti-Obamacare Republicans aren’t still dreaming up new ways to create roadblocks to health care reform. In the battle to implement the health law on a state level, GOP officials have seized on an opportunity to hide behind Obamacare to limit women’s access to abortion services.

This week, Arkansas became the latest state to ban Obamacare’s state-level health insurance markets from offering any type of abortion coverage. Michigan and New Jersey are currently considering the same type of legislation. Eighteen other states already have similar bans in place, and two more — Kentucky and North Dakota — have laws on the books to mandate the exact same restriction on abortion coverage, even though they don’t mention the health reform law itself.

All told, the American Civil Liberties Union has mapped out 20 states where at least some women who are seeking to terminate a pregnancy can’t get insurance coverage for that legal medical procedure — including eight states where women can’t get any coverage whatsoever for abortion care:

Abortion services are simply another aspect of women’s reproductive health care — along with other potentially expensive services such as HPV vaccinations, regular gynecological exams, family planning services, and maternity care. Because of the range of gender-specific health services that women rely on, they already tend to pay significantly more for their basic health care than men do. Obamacare takes big steps to address the gender-based disparities in health insurance costs, partly by eliminating co-pays for many of women’s essential preventative services, like contraception.

But since the health reform law leaves abortion services up to each state to determine, anti-choice lawmakers are twisting Obamacare’s provisions to punish the women who seek abortions by forcing them to pay huge out-of-pocket costs in order to make their own medical decisions. “Abortion coverage restrictions were a nonissue for an incredibly long amount of time,” Elizabeth Nash of the Guttmacher Institute explained to Politico. “That law really encouraged states to go in and pass these abortion coverage restrictions in their own health exchanges.”

And now, women’s health advocates worry that — even though Obamacare itself doesn’t prohibit abortion coverage in its insurance marketplaces — anti-choice activists are successfully construing the health law so it appears to be a vehicle for restricting women’s reproductive rights. Fortunately, that’s not the case in every state. Connecticut lawmakers have taken the opposite approach to the issue and opted to classify elective abortion services as an “essential health benefit” under Obamacare, ensuring that insurers will have to cover the procedure.

John Alleman, a 52-year-old unofficial spokesman for the Heart Attack Grill — a restaurant notorious for exorbitantly and intentionally high-calorie fare such as “the Triple Bypass Burger” — has died of a heart attack, according to owner John Basso.

As CBS News reports, the restaurant has come under scrutiny for previous incidents in which regular patrons died of heart-related complications, and the flippant attitude that Basso has demonstrated towards critics of his restaurant’s active encouragement of obesity and unhealthy lifestyles:

[Basso] told the paper the man was not heavy, weighing about 180 pounds, and may have had a genetic predisposition to cardiac problems because both his parents died from heart attacks in their 50s.

The death comes about a year after a man suffered a heart attack while eating one of the restaurant’s 6,000-calorie “Triple Bypass Burgers.” Last February, patrons thought they were witnessing a publicity stunt for the restaurant that says it has a “Taste Worth Dying For” and took out their cell phone cameras, but were ultimately seeing a patron around his 40s having a cardiac episode being wheeled out by paramedics. [...]

“I’m here to tell you straight up that I’m here to make a buck,” Basso told CBS This Morning last February. “Anything that’s legal that you want to eat or drink that’s fun, that enriches your life at the moment, I will sell it to you. If I could put danger back into hamburgers, all the better.”

The restaurant also offers free meals to patrons who weigh over 350 pounds.

As CBS points out, the restaurant literally rewards patrons who lead extremely unhealthy — and medically costly — lifestyles. Studies have shown that health care costs directly and indirectly associated with obesity have ballooned alongside Americans’ waistlines, constituting “8.5 percent of Medicare spending, 11.8 percent of Medicaid spending, and 12.9 percent of private-payer spending.”

In an era when public health advocates and some food companies — though not all — are actively looking to improve Americans’ health by curbing unhealthy content in their products and making caloric information readily available, establishments such as the Heart Attack Grill are defiantly moving in the opposite direction. Patronizing such “novelty” restaurants is, of course, a luxury afforded by freedom of choice. But as John Alleman’s story shows, that freedom can come at a steep price to Americans and national health care expenditures.

As anti-choice politicians seek to narrow the definition of sexual assault to “forcible rape” or “legitimate rape,” lawmakers in New York State are taking the opposite approach — and actually may be prepared to advance a bill that would expand the definition of rape to encompass additional acts of sexual violence.

Assemblywoman Aravella Simotas (D) first introduced the legislation last year after Lydia Cuomo, a Bronx schoolteacher who was raped by a city cop, discovered that her assaulter wasn’t going to be charged with “rape.” Since Cuomo’s rapist didn’t vaginally penetrate her, his crimes fell outside of New York’s current definition of rape — but Simotas’ bill seeks to change that by widening the state’s rape statues to officially include forced oral and anal sex. Cuomo traveled to Albany on Tuesday to use her own personal experience to help advocate for the proposed legislation, urging state lawmakers to make sure an outdated legal definition won’t continue to deny survivors the justice they deserve:

Cuomo wants to use what happened to her to spur lawmakers to act this year. The legislative push is also part of her healing process. [...]

Last week, she recounted how she sat nervously with her family in the 15th-floor office of the district attorney that day last March when she found out the 12-person jury couldn’t agree that she had been raped — an option she said never once entered her mind as a possibility.

“When we found out the reason why, it just seemed so ludicrous to me,” Cuomo now says. “I think, quite frankly, it’s insulting.”

“Ultimately I was being told, ‘Oh, you were anally raped and orally raped, but we don’t believe you were raped; you were sexually assaulted.‘”

At the beginning of 2012, the FBI updated its definition of rape for the first time in 80 years to include forced anal and oral acts. But, while that’s an important step to update the way the agency measures trends in crime, it doesn’t impact federal or state legal codes. Twenty five states, the District of Columbia, and the federal government have eliminated the word “rape” from their codes in order to use the more inclusive terms “sexual assault” or “sexual abuse” — but in the remaining states, including New York, the official definition of what’s considered to be rape can vary widely.

Cuomo wants to encourage all policymakers to use more specific language because, even though it may seem like quibbling to them — in New York, the crimes defined as a “criminal sexual act” and a “predatory sexual assault” both lead to essentially equivalent sentences — it can mean all the difference in the world to survivors of sexual violence. Creating distinctions between different types of penetration ultimately serves to rank sexual crimes against each other, which can make survivors feel like their individual experiences are also being ranked on a scale of ranging levels of seriousness. Cuomo and Simotas want to emphasize that “rape is rape.”

“I think a lot can come from calling something what it is and talking more openly about it,” Cuomo told Salon. “Some people say, ‘Oh, it’s just semantics.’ And I do think it is semantics at the end of the day, right? But I think the semantics are important.”

As the the New York Daily News reports, state lawmakers are beginning to agree. Senate co-leader Jeffrey Klein (D) said the legal code “definitely needs to change” since, as it’s currently written, it represents “an insult to not only the victims of these horrendous crimes, but to our legal system.” And Assembly Speaker Sheldon Silver (D) confirmed that he’s “inclined” to pass Simotas’ bill.