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[I]t was surprising this week when Sylvia Mathews Burwell, the secretary of health and human services, predicted only slim gains [in health law marketplace enrollment] in the coming year, millions below earlier projections. ... Why did the Obama administration set such a modest goal? It was part of an elaborate numbers game played for several years by proponents and opponents of the health law. On the one hand, administration officials want to manage expectations in a presidential election year, when surpassing the goal will be better for Democrats than falling short. ... On the other hand, health policy experts said, the enrollment goal for 2016 may be realistic. (Pear, 10/16)

The big health news last week was that the Affordable Care Act appears to be losing steam and the Obama administration is predicting a modest increase at best in the number of Americans who will enroll with private insurers next year. Health and Human Services Secretary Sylvia Mathews Burwell announced on Thursday that an estimated 10 million Americas would be covered by Obamacare by the end of 2016, an increase of roughly 100,000 over the current year’s enrollment. That’s a lot lower than many were expecting. The Congressional Budget Office in June predicted 20 million Americans would be covered by the end of next year. (Pianin, 10/18)

The math is harsh: The federal penalty for having no health insurance is set to jump to $695, and the Obama administration is being urged to highlight that cold fact to help drive its new pitch for health law sign-ups. That means the 2016 sign-up season starting Nov. 1 could see penalties become a bigger focus to motivate millions of people who have remained eligible for coverage, but uninsured. They’re said to be more skeptical about the value of health insurance. (Alonso-Zaldivar, 10/19)

If you are looking for sympathetic plaintiffs to headline a major Supreme Court battle — well, it never hurts to have on deck an order of nuns called the Little Sisters of the Poor. That seems especially true when the subject is the Affordable Care Act’s contraceptive requirement. Out of an avalanche of litigation, those urging the court to take up the latest challenge to Obamacare have rallied around the petition filed by the Little Sisters of the Poor Home for the Aged. (Barnes, 10/18)