�鶹Ů��

Who will be the new health care leaders for Democrats? Sens. Chris Murphy of Connecticut and Ben Cardin of Maryland want more delivery system reforms. Sen. Patty Murray of Washington wants better contraceptive coverage and more doctors. All three want to beef up mental health coverage. And Sen. Ron Wyden of Oregon and Rep. Frank Pallone of New Jersey aren’t even saying what’s on their agenda — they want the Republicans to go first. It’s all smaller bore stuff — a real comedown from the visions of the past. (Nather, 12/7)

Last week, the Department of Health and Human Services welcomed its third group of “entrepreneurs-in-residence” — mainly private-sector tech experts and start-up founders who are spending a year advising the agency on its health IT projects. Two are working on data collection and analysis. Paula Braun, a data scientist with Charlottesville, Va.-based consulting firm Elder Research, is embedded in the Centers for Disease Control and Prevention to devise a better Electronic Death Registration System, so that the CDC can refine its analytics and predictive modeling. (Ravindranath, 12/7)

At 61, Ken Helms of Charlotte would love to have health insurance. Based on what he earned directing traffic this year, he’s eligible for federal help paying premiums and out-of-pocket costs under the Affordable Care Act. But he worried that his unpredictable income could leave him in the lurch. The subsidies are designed to provide more help to those with smaller paychecks. But in North Carolina, the floor drops out when a wage-earner falls below the poverty level, a distinct possibility for Helms. His fear: Getting health insurance – and long-delayed care – could leave him worse off if he loses his coverage and has to repay Uncle Sam. Experts say that won’t happen, but his trepidation is understandable. People who rely on tips, commissions or jobs with variable hours can have a tough time predicting annual income, which is the basis for ACA subsidies. In a recent Federal Reserve survey, almost one-third of Americans said their income fluctuates from month to month. (Helms, 12/7)

North Carolina’s rates for individual insurance vary significantly across the state and are among the highest in the nation. The state’s high insurance costs have been blamed on a grab bag of causes, including entrenched market dominance by Blue Cross, the state’s decision last year not to expand Medicaid, and a decades-long race among hospital companies to build one of the nation’s best health care networks. The Affordable Care Act has been blamed and credited for lots of things, but one of the legacies of the federal health law is greater transparency for insurance costs, which for years had been treated as a closely guarded secret. Today anyone with Internet access can get on healthcare.gov and compare rates within their own state or with other states. (Murawski and Raynor, 12/7)

Fewer uninsured Californians are seeking treatment in the state’s emergency rooms, a decline that experts say is a direct result of the federal Affordable Care Act. The trend represents welcome news for previously uninsured patients who had trouble affording a trip to the emergency room. But it has not brought down ER treatment costs for everyone else, health care experts said, nor has it slowed a years-long increase in overall emergency room traffic. (Reese, 12/6)

What happens when you break a leg and you live hundreds of miles from the nearest hospital? Or when you can't afford to get a new pair of glasses because you don't have health insurance? For many, the answer is to go without help. That's why the organization Remote Area Medical was conceived. As we've reported before, the team travels across the United States and abroad to provide health care to those in need. That's a lot of people — about 16 percent of Americans are uninsured, according to the latest Gallup poll. (Bruzek, 12/5)

A Supreme Court challenge that poses a grave threat to President Obama's health care law had its genesis precisely four years ago as a power-point presentation by a self-proclaimed pessimist from South Carolina. The idea was picked up by an Ohio law professor, given a policy and public relations push by a Washington health economist and turned into a lawsuit by an Oklahoma attorney general. Three more lawsuits followed. Nearly five years after the law was passed, their effort has reached the Supreme Court, which saved the president's signature domestic policy achievement in 2012 but now could deal Obama a significant setback. (Wolf, 12/7)