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Montana leads the country in the proportion of people who have signed up for the health law's insurance program for those with pre-existing conditions. But that amounts to only 198 people.

Businesses and people pushing for changes in Medicaid policies are taking advantage of strained state budgets to make their case. Some of the suggestions are offbeat.

Some primary care doctors have decided to bypass the health insurance system entirely and charge patients a monthly fee. By doing so, the physicians say, they can afford to spend more time seeing fewer patients.

Most hospitals don't have a psychiatric unit, which means mentally ill patients often wait in emergency rooms for several days — sometimes even a week or more — before they can be moved to a psychiatric hospital. ERs are the wrong place for someone in the midst of a psychiatric crisis, an expert says.

Mississippi Gov. Haley Barbour recently asked Congress to give states a lump sum of money, known as a "block grant," to let them run Medicaid, the health care program for the poor and disabled. But Democrats argue that millions could lose health insurance as a result.

Children help grow fruits and vegetables outside a California health clinic where they are patients. Once harvested, the kids get to eat the fruit of labor, with tips on preparation from weekly cooking demonstrations. The project is part of the clinic's work to combat childhood obesity.

Mitch McConnell may well wish to wash his hands of this year's blood-letting over the debt limit and all it entails. But he knows it will not be that easy. He may know that better than anyone.

Patients in those places gave some of the lowest evaluations of their hospital stays, Medicare data show. The surveys asked patients how well their doctors and nurses communicated, whether their pain was always handled welland whether their rooms were clean and quiet.

At small companies, a high-deductible option, often served with a tax-preferred savings account, may be the only health insurance choice. Now even some big companies are starting to move all their employees into high-deductible plans.

The nation's biggest retailer is planning to offer a wide range of medical care in U.S. stores. A Wal-Mart document seeking partners for the effort says the company aims to become a major provider of primary care. Later, an executive with the retailer said the company document was "overwritten and incorrect."