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On Nov. 1, a new sign-up period for health insurance under the Affordable Care Act will begin .... But even as those efforts begin, the public insurance exchanges, also known as marketplaces, created by the law are facing another challenge: keeping the customers they already have. About 9.9 million people were enrolled in the federal and state marketplaces at the end of June, a drop of about 15 percent from the 11.7 million who the Obama administration said selected plans during the open enrollment period that ended in February. ... enrollment counselors, health care providers and consumers say cost is a factor. ... Experts also point to another factor behind dropping or losing coverage: confusion. Some who signed up for coverage this year lost it within months because they did not understand what information they had to supply or even that they were required to make monthly payments, according to counselors. (Goodnough, 10/11)

Before the Affordable Care Act went into effect last year, critics claimed it would lead to job losses and cuts in employee hours. But how is it really playing out? The dire predictions have so far proved to be unfounded, according to a new research paper from Federal Reserve Bank of New York economist Maxim Pinkovskiy. (Picchi, 10/12)

Responding to criticism from civil liberties advocates, the Obama administration said Friday it has strengthened consumer privacy protections on the government's health insurance website as a new sign-up season nears. HealthCare.gov CEO Kevin Counihan said in a blog post that the web page will have a new 'privacy manager' that lets consumers opt out of embedded connections to third-party advertising, analytics and social media sites. (Alonso-Zaldivar, 10/9)

HealthCare.gov is going to honor Do Not Track requests this enrollment season. The Center for Medicare and Medicaid Services, which runs the ObamaCare website, said that it would not track users who toggle a setting in their browser that sends the requests to the website. Websites are not currently required to honor Do Not Track requests, although every major browser gives users the option of turning on the setting. (McCabe, 10/9)

For years America’s gold-plated healthcare system has provided little bang for the buck. In 2013, the U.S. outspent 13 other high-income countries on medical care – including Australia, Canada, Germany and Great Britain. Yet the U.S. had comparatively poor health outcomes, including a shorter life expectancy and greater prevalence of chronic conditions, according to a new study by the Commonwealth Fund. (Pianin, 10/11)