Gov. Peter Shumlin signed the measure in a state House ceremony in Montpelier, capping a decade-long effort on the issue in Vermont.

Vermont is the first state to pass such a law through the legislative process. Oregon and Washington enacted their laws by referendum; in Montana, it was legalized by the courts.

“This historic achievement is a political breakthrough that will boost support for death-with-dignity bills nationwide,” said Compassion & Choices President Barbara Coombs Lee. The group describes itself as the nation’s leading advocacy group for end-of-life decisions.

The law, which went into effect Monday, allows for an end-of-life procedure with the consent of a patient’s doctor after the patient has made more than one request for help in ending life. The bill also stipulates that the patient has a chance to retract the request.

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Without a firm timeline in place for returning to the gun measure, senators who have introduced mental health proposals have to decide how long they’ll wait before attempting to move their bills forward separately. And for some, the end of that waiting period is approaching.

“We think it’s a very important part, with or without a full package,” said Alaska Democratic Sen. Mark Begich, referring to legislation he has introduced on mental health first-aid training (S 153). “So we’re giving it a little breathing room, but then we’re going to move forward.”

Like gun control and school safety, mental health received renewed attention after the December elementary school shooting in Newtown, Conn. President Barack Obama included mental health provisions in his plan to reduce gun violence, and lawmakers on both sides of the Capitol have honed in on the issue with bipartisan support.

Begich’s bill, for example, was one of several measures that was incorporated into mental health legislation (S 689) approved by the Senate Health, Education, Labor and Pensions Committee last month, which won inclusion in the gun package (S 649) by a vote of 95-2.

But Senate leaders on mental health do not see the gun measure as the only path forward for their priorities, particularly now that the chamber has turned away from the package.

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The legislation as written would save $23 billion over the next decade by tightening restrictions on the country’s food stamps program and cutting direct payments to farmers, but lawmakers are hoping to add their own cost-shaving provisions to the bill as well.

Here are three amendments to watch for:

Repealing the so-called Monsanto Protection Act
Sen. Jeff Merkley, D-Ore., will introduce an amendment to the farm bill, which would repeal the Farmer Assurance Provision, a bill that allows farmers who use biotech seeds to keep planting them even as courts reassess whether the USDA followed protocol when it approved the use of the seeds. The legislation attracted the ire of conservative and liberal lawmakers in March as well as voters because it was an anonymous, unrelated and last-minute add on to a critical continuing resolution to keep the government funded. Critics said that the bill allowed Monsanto to keep selling seeds that may pose health risks to consumers. More than 300,000 Americans signed a petition calling on lawmakers to repeal the section. While the provision will expire in September if lawmakers do nothing, food-rights and free-market groups are applauding Merkely’s farm bill amendment as a courageous move.

“The American people are tired of legislation being written in back room deals. The Monsanto Protection Act was the last straw,” says Dave Murphy, the founder and executive director of Food Democracy Now, a progressive group that fights for food transparency.

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On top of the troubles the administration is facing over its handling of the attack on the Benghazi mission, the Internal Revenue Service’s targeting of conservative groups, and the Justice Department’s seizure of Associated Press phone records, Republicans hope to target Health and Human Services Secretary Kathleen Sebelius.

They are questioning her soliciting of funds on behalf of a non-profit group, called Enroll America, from two private entities, a practice which if not unprecedented is at the very least unusual. Federal law bars officials from soliciting any organization or individual with whom they do business or regulate.

Enroll America is run by the president’s former campaign backers to do something Congress refused to fund: sell “Obamacare” to the public.

An HHS statement last week said that since March Sebelius solicited financial donations for Enroll America from H&R Block Inc, the tax preparation company, and the Robert Wood Johnson Foundation, a philanthropic entity devoted to public health issues. Asked Monday for a list of all solicitations before or after March, an HHS spokesman referred Reuters to the department’s original statement.

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In January, health insurance companies will begin sending out tax documents containing essential information about each American’s health insurance coverage which then must be properly and accurately inserted into “Form OBMA.” There will be questions like “What type of qualifying health insurance plan were you covered by?” “Did your employer offer affordable qualifying coverage?” “Were you able to purchase affordable health insurance?” “Are you claiming a religious exemption from the individual responsibility mandate?” and (perhaps tongue-in-cheek) “Are you an illegal immigrant and therefore exempt from the personal mandate?”

But if Americans will be frustrated and confused and angered by yet another form to complete for the IRS, the view from inside the IRS is scarcely any better. Computer problems delayed tax refunds this year by the amount of $20 billion which, combined with the increase in the payroll tax, have been blamed for causing Walmart’s sales in February to turn in their worst performance in seven years.

The ongoing scandal over the “conservative charity targeting” by the IRS isn’t helping any. More than 60,000 applications for tax-exempt status were received early in 2010 following the Supreme Court’s decision in Citizens United that caused delays — up to 27 months in some cases — in obtaining approvals, especially among applications which had “Tea Party” or “Patriots” in their titles. As a result, the esteem and regard with which Americans hold the IRS continues to decline.

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• Job creation. Many state-level studies project that adopting the Medicaid expansion will generate new jobs and other favorable economic effects. However, those studies don’t measure the countervailing economic drag that will result from funding the expansion through increased taxation and borrowing. That drag will come both locally—from increased state taxes to pay the state’s share of expansion costs as well as the share of Obamacare’s new federal taxes paid by individuals and businesses in the state—and nationally from increased federal taxes in all the other states and increased federal borrowing.
• State savings. The increased federal contribution percentage for the expansion is stepped down in future years. That means that, over time, state costs grow faster than state savings in all but a handful of states. Thus, even if a state is projected to achieve significant savings in the first few years, within ten years the trend lines for projected cost versus projected spending cross. From that point on the expansion becomes an ever-growing net fiscal burden on the state. Studies that use a budget window of less than 10 years, or provide only aggregated multi-year estimates obscure the reality that the fiscal trends are unfavorable to states. Indeed, even a 10-year window doesn’t fully capture the long-term costs to states. Studies that cut the budget projection window to as little as five years, or even eight years, produce a highly distorted picture of the true costs to states.

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Months after the president’s reelection, a variety of unions are publicly balking at how the administration plans to implement the landmark law. They warn that unless there are changes, the results could be catastrophic.

The United Food and Commercial Workers International Union (UFCW) — a 1.3 million-member labor group that twice endorsed Obama for president — is very worried about how the reform law will affect its members’ healthcare plans.

Last month, the president of the United Union of Roofers, Waterproofers and Allied Workers released a statement calling “for repeal or complete reform of the Affordable Care Act.”

UNITE HERE, a prominent hotel workers’ union, and the International Brotherhood of Teamsters are also pushing for changes.

In a new op-ed published in The Hill, UFCW President Joe Hansen homed in on the president’s speech at the 2009 AFL-CIO convention. Obama at the time said union members could keep their insurance under the law, but Hansen writes “that the president’s statement to labor in 2009 is simply not true for millions of workers.”

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Before I get to the feature of this case that will really scare the pants off you, a little more background: This tawdry tale began in 2011 with an IRS investigation concerning one former employee of “John Doe Company” pursuant to which a search warrant was obtained. This warrant didn’t authorize the seizure of anyone’s medical records, but the IRS agents “threatened to ‘rip’ the servers containing the medical data out of the building if IT personnel would not voluntarily hand them over.” They proceeded to seize the records “without making any attempt to segregate the files from those that could possibly be related to the search warrant.”

The leadership of “John Doe Company” attempted to make the IRS people understand that they had violated at least one federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and that “unreasonable searches and seizures” violate the Fourth Amendment of the Constitution. The agents were unimpressed. As the complaint phrases it, “After being put on notice of the illicit seizure, the IRS agents refused to return the records, continued to keep the records for the prying eyes of IRS peeping toms, and keep the records to this very day.” The IRS also refuses to reveal who has seen the records or where they are located.

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The minimum coverage qualifies as acceptable under the new healthcare reform law, so benefit advisers and insurance brokers are pitching minimum plans nationally, reports the Wall Street Journal.

Employers who offer the plans are recognizing they can avoid a $2,000-per-worker penalty by doing so, even though the plans often don’t cover basics like surgery, X-rays or prenatal care, let alone hospitalization.

The employers could still face other penalties, but they expect them to cost less than the $2,000 per worker fine for opting out of Obamacare. As a result, the Journal reported, more companies are seeking minimum coverage plans helping to create what amounts to a new industry of basic insurance brokers and benefit administrators pushing the plans to clients.

Some of the low-benefit plans will cost employers only between $40 and $100 per employee monthly, quite a savings over the $2,000 fine, the Journal noted.

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A respected scientific society says your doctor should tell you, but the group is receiving criticism for its recommendation that “incidental findings” of genetic tests be shared with patients.

Incidental findings are unexpected results, unrelated to the reason for testing. What to do with these findings has been a controversial issue for adults undergoing genetic testing, as well as children.

In March, the American College of Medical Genetics and Genomics (ACMG) released guidelines saying that when patients receive genetic testing for any medical reason, they should be screened for mutations in an additional 57 genes, including mutations that strongly increase the risk of breast, ovarian and colon cancer.

The ACMG argues that doctors have an obligation to look for and report these mutations because there are ways that people can act to reduce their of developing a medical disorder.

However, some researchers and bioethicists say the new recommendations go too far, and take away patients’ rights to refuse medical information they do not wish to know.

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