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Last year's final enrollment numbers under President Barack Obama's health care law fell just short of a target the administration had set, the government reported Friday. The report from the Health and Human Services Department said about 8.8 million consumers were still signed up and paying premiums at the end of last year. HHS Secretary Sylvia M. Burwell had set a goal of having 9.1 million customers by then. So the administration didn't miss its target by much — about 3 percent. (Alonso-Zaldivar, 3/11)

The Affordable Care Act's health insurance co-ops absorbed deep financial losses last year, and 2016 is shaping up to be a make-or-break year for these nonprofit alternatives to traditional insurers. Officially called Consumer Operated and Oriented Plans, these still-fledgling insurers were devised during the ACA's creation to inject competition into insurance markets. But they have struggled from the start to build a customer base from scratch and deal with higher-than-expected expenses, among other problems. (3/11)

Year 2 of the Affordable Care Act was another financial flop for the Chicago-based parent of Blue Cross and Blue Shield of Illinois but hints of a turnaround are emerging. Health Care Service Corp.'s financial losses in its individual business, which includes ACA plans, worsened in 2015. The company, which owns Blue Cross affiliates in Illinois and four other states, said it lost $1.5 billion in its individual business, up from $767 million in 2014, the first year of the health law's state exchanges for buying coverage. (Sachdev, 3/11)

In the latest round of policy battles between Democratic presidential opponents Hillary Clinton and Sen. Bernie Sanders (I-Vt.), Clinton diminished Sanders’ record on healthcare on Saturday, raising the ire of the Sanders campaign. In pledging to take on the power of the healthcare and pharmaceutical industries if she becomes president, Clinton accused Sanders of being absent in her fight for health care reform in the 1990s. (Fang, 3/13)

[The] concern about the cost of prescription drugs has emerged as a big issue in the presidential campaign, prompting candidates in both parties to sharpen their rhetoric against pharmaceutical companies and put curbing drug prices at the center of their healthcare plans. The message is particularly resonant here in Florida, which holds its primary Tuesday and where people over 60 make up more than a third of registered voters. At the Democratic debate in Miami on Wednesday, Sen. Bernie Sanders repeatedly castigated drug companies for “ripping off” the American public. Hillary Clinton has vowed to rein in drug prices and is running an ad in Florida specifically focusing on the “predatory” pricing of one embattled pharmaceutical company, Valeant. (Mason, 3/11)

At a time when genetic testing and genetically personalized treatments for cancer are proliferating, buoyed by new resources like President Obama’s $215 million personalized medicine initiative, women with breast cancer are facing a frustrating reality: The genetic data is there, but in many cases, doctors do not know what to do with it. ... Doctors have long been tantalized by a future in which powerful methods of genetic testing would allow treatments to be tailored to a patient’s genetic makeup. Today, in breast cancer treatment, testing of tumors and healthy cells to look for mutations has become standard. But ... “our ability to sequence genes has gotten ahead of our ability to know what it means,” said Eric P. Winer, the director of the breast oncology program at Harvard’s Dana-Farber Cancer Institute. (Kolata, 3/11)

One in three American adults who have private health insurance coverage are hit with surprise medical bills they thought were covered by insurance, which can range from a few hundreds dollars to tens of thousands for an operation. Time Magazine's Haley Sweetland Edwards joins Hari Sreenivasan to discuss.

For years, federal and state governments have shied away from the problem of providing long-term care for ailing seniors – and for good reason. While mounting costs of Social Security, prescription drugs and federal health care programs get a lot of attention, the staggering costs of providing community based social services and nursing home facilities and in-home care to seniors are draining the savings of average Americans and posing frightening long-term fiscal challenges for government officials. (Pianin, 3/13)

Wearable devices, like the Fitbits and Apple Watches sported by runners and early adopters, are fast becoming tools in the workplace. These devices offer employers new ways to measure productivity and safety, and give insurers the ability to track workers’ health indicators and habits. For companies with large workforces, the prospect of tracking people’s whereabouts and productivity can be welcome. But collecting data on employees’ health and their physical movement can trigger a host of potential ethical and legal headaches for employers. (Haggin, 3/13)

Starting on March 27, the way prescriptions are written in New York State will change. Gone will be doctors’ prescription pads and famously bad handwriting. In their place: pointing and clicking, as prescriptions are created electronically and zapped straight to pharmacies in all but the most exceptional circumstances. New York is the first state to require that all prescriptions be created electronically and to back up that mandate with penalties, including fines and imprisonment, for physicians who fail to comply. Minnesota has a law requiring electronic prescribing but does not penalize doctors who cling to pen and paper. (Otterman, 3/14)

A bustling economy. Record-low unemployment. A ballooning heroin problem. That’s how Mayor Svante Myrick describes Ithaca, New York, where he hopes to open the nation’s first safe injection facility — a place where heroin users could shoot their illegal drugs under medical supervision and without fear of arrest. His proposal, part of a plan to address drug abuse in the 31,000-person college town in central New York, is not a novel idea. Safe injection sites, which also connect clients to treatment programs and offer emergency care to reverse overdoses, exist in 27 cities in other parts of the world. Some have been around for decades. (Breitenbach, 3/11)

A growing number of states, alarmed by the rising death toll from prescription painkillers and frustrated by a lack of federal action, are moving to limit how these drugs are prescribed. On Thursday, Massachusetts lawmakers passed a bill expected to be signed next week that would sharply restrict the number of pain pills a doctor can prescribe after surgery or an injury to a seven-day supply. Officials in Vermont and Maine are considering similar actions, and governors across the country are set to meet this summer to develop a broad approach that could reduce the use of painkillers like OxyContin, Percocet and Vicodin. (Meier and Tavernise, 3/11)

The number of American babies born going through withdrawal from prescription painkillers and heroin used by their mothers during pregnancy, a condition called Neonatal Abstinence Syndrome, increased fivefold between 2000 and 2012. (3/12)

The epidemic of opioid abuse that's swept the U.S. has left virtually no community unscathed, from big cities to tiny towns. In fact, drug overdose is now the leading cause of injury death in this country: more than gun deaths; more than car crashes. There were more than 47,000 drug overdose deaths in the U.S. in 2014, according to the Centers for Disease Control and Prevention. That includes unintentional overdoses and suicides. More than half of those were from opioids, including painkillers and heroin. (Block, 3/12)

Twenty community health centers in Massachusetts will share $6.8 million in grants to expand substance abuse services, particularly treatment of opioid addiction, the US Health and Human Services Department announced Friday. (Freyer, 3/11)

Community health centers in Washington state have been awarded nearly $3 million of some $94 million in federal funding to fight opioid abuse and addiction, health officials announced Friday. The money was allocated through the Affordable Care Act (ACA) to address the growing problem of addiction to opioids, including prescription painkillers and illicit drugs such as heroin. (Aleccia, 3/11)

The federal government on Friday moved to clear the way for the release of genetically engineered mosquitoes into the wild for the first time in the United States, tentatively approving a field test that might help slow the spread of the Zika virus. The genetically engineered insects, which contain a gene that will kill their offspring, have already shown effectiveness in small tests in Brazil and other countries in suppressing the populations of the mosquitoes that transmit both Zika and dengue fever. (Pollack, 3/11)

U.S. health regulators said a genetically engineered mosquito being used in the fight against Zika will not have a significant impact on the environment, possibly paving the way for the technique to be used in the country. The self-limiting strain of the Aedes aegypti mosquito was developed by Oxitec, the U.K.-subsidiary of U.S. synthetic biology company Intrexon Corp. The male mosquitoes are modified so their offspring will die before reaching adulthood and being able to reproduce. (3/12)

The Centers for Disease Control and Prevention now says pregnant women can safely travel to Zika-affected countries if they stay at elevations higher than 6,562 feet, where they’ll find few mosquitoes that could spread the virus. But the agency’s revised travel advisory, released Friday, continues to recommend that trips to lower-elevation areas be avoided because the greater presence of mosquitos increases the risk of infection. (Sun, 3/11)

Puerto Rico’s Health Department is reporting 201 confirmed Zika cases amid warnings the U.S. territory could face an epidemic of the mosquito-borne virus. Officials said Friday that 21 of those cases involve pregnant women. This concerns health authorities because Zika may be linked to microcephaly, which causes babies to have unusually small heads and brain damage. The director of the U.S. Centers for Disease Control and Prevention visited the island on Tuesday as federal officials stepped up efforts to help prevent the spread of Zika in Puerto Rico. (3/11)

Gov. Mike Pence stressed his anti-abortion convictions on Friday, leaving fellow conservatives to believe he will sign a measure making the state the second to ban abortion in cases in which a fetus has a genetic abnormality, such as Down syndrome. In addition, the bill would ban abortions because of race, gender or ancestry. Mr. Pence, a Republican, co-sponsored legislation as a member of the United States House in 2011 that would have prohibited abortions sought because of gender. (3/11)

Georgia would provide state-funded grants to "pregnancy resource centers" that offer medical care, counseling and other services to pregnant women while discouraging abortion, under legislation that easily passed the state House on Friday. The state Senate approved the measure on party lines last month. Senators must agree to some minor changes before the proposal can head to Gov. Nathan Deal's desk. To be eligible, facilities cannot encourage or discuss abortions as an option or refer women to clinics that perform abortions, except when the mother's life is threatened. (3/11)

Missouri lawmakers' effort to strip Planned Parenthood of any state money faces an uncertain path forward. While the House passed a budget this week that bars any entity that provides or counsels a woman to get a non-emergency abortion from receiving Medicaid reimbursements, courts have blocked similar attempts in other states and the Senate's budget writers have so far declined to endorse the effort. (Aton, 3/12)

Michigan Gov. Rick Snyder on Friday called for an investigation of how his health department handled an outbreak of Legionnaires’ disease in the Flint area as well as high lead levels among residents who were drinking tainted water from the Flint River. Snyder was briefed on an “internal review” of the Department of Health and Human Services and now wants the agency’s inspector general and Michigan’s auditor general to quickly launch a broader investigation, spokesman Ari Adler said. (White, 3/11)

Michigan auditors will probe the state's Department of Health and Human Services over its handling of elevated lead levels in Flint drinking water and a rise in Legionnaire’s disease cases, Governor Rick Snyder said Friday. Snyder called for the state’s Auditor General and the health agency's inspector general to investigate the problems in Flint and surrounding Genesee County, and they agreed, the state said. (Shepardson and Klayman, 3/11)

Puerto Rico is losing people. Due to a decade-long recession, more than 50,000 residents leave the U.S. territory each year—most for jobs and new lives on the mainland. This issue is especially affecting healthcare, where it's estimated that at least one doctor leaves Puerto Rico every day. The mass exodus of doctors is creating vacancies that are hard to fill and waiting lists for patient care. Dr. Antonio Peraza is among those doctors who recently left for the mainland. He specializes in internal medicine and for nearly 14 years, had a private practice in Bayamon, Puerto Rico. (Allen, 3/12)

Rejecting critics and community concern, voting members of Seattle’s Group Health Cooperative have overwhelmingly agreed to join with the California health-care giant Kaiser Permanente. Voting 8,824 to 1,586 in mailed-in ballots, the members approved the move that essentially dissolves the iconic, home-grown cooperative, founded nearly 70 years ago with the mission of providing integrated health care and health coverage to Northwest residents. (Aleccia, 3/10)

Virginia lawmakers finished their work late Friday one day ahead of schedule and sent Gov. Terry McAuliffe (D) a budget that would give teachers raises and increase spending for education and economic development. ... For the third straight year, the Republican-controlled General Assembly denied McAuliffe and Democrats expansion of Medicaid and rejected the governor’s plan to tax hospitals and use the revenue to fund the state’s share of the federal health-care program. “We don’t have any answer for the 400,000 Virginians who don’t have any health-care coverage,” Del. Marcus B. Simon (D-Fairfax) said. (Portnoy, 3/12)

Money from the sale of the Indiana University LaPorte Hospital was used to create a nonprofit foundation that will focus on trying to improve the health of the northern Indiana county. A deal to sell an 80 percent stake in the hospital to Community Health Systems, a for-profit hospital system based in Franklin, Tennessee, was finalized Tuesday. IU Health will retain a 20 percent stake in the hospital. The deal also includes the 50-bed IU Health Starke Hospital in Knox. (3/13)

Tobacco industry lobbyists threatened to scuttle unrelated ballot initiatives if California lawmakers passed sweeping anti-smoking measures, health advocates said on Friday. While lawmakers said bills now on Gov. Jerry Brown’s desk to raise the tobacco-buying age to 21 and to regulate electronic cigarettes as tobacco products drew fierce industry opposition, they characterized the effort as a hard-to-trace background campaign. Assembly Speaker-elect Anthony Rendon, D-Lakewood, last week told reporters lawmakers had received “threats involving electoral efforts.” (White, 3/11)

A Chicago doctor who was once the nation's most prolific prescriber of the risky antipsychotic drug clozapine was sentenced to nine months in prison Friday for taking cash, vacation trips and other kickbacks from the drug's manufacturers. Dr. Michael Reinstein, the subject of a 2009 Tribune-ProPublica joint investigation, admitted to pocketing nearly $600,000 in benefits over the years for prescribing various forms of clozapine, known as a risky drug of last resort, to hundreds of mentally ill patients in his care. (Meisner, 3/11)

The Iraq vet fitted a blood-pressure wrap around the Vietnam vet's arm, checked the gauge and announced, "Nice blood pressure today. Right in the range we want." Andrew Bisbee, a former Army medic, then checked his patient's heart, throat and swollen feet. "I know I'm not a spring chicken anymore," said the patient, Gerald Bowles, 65, of Cleveland. (Albrecht, 3/13)

Gateway Ambulatory Surgery Center in Concord stays busy. Local surgeons perform more than 10,000 outpatient procedures a year there, according to the healthcare organization. Still, employees there make time to maintain an upbeat atmosphere at the workplace. They celebrate holidays, hold baking contests and put their own spin on the bring-your-child-to-work theme. (Smith, 3/12)

Here’s a simplified explanation of how Medicaid expansion is funded. Imagine an optional program available to 10 members for a shekel a year. All the members will share in the funding regardless of whether they participate. If five members participate, the cost of five shekels is divided among the members at a cost of half a shekel each. In other words, the non-participating members send their half-shekel to the participants. If all members sign up for the optional program, the cost for each goes up to a shekel each, and all receive the benefits of the program. (3/12)

The future of the local public mental health agencies that have successfully served this population for decades is now in jeopardy thanks to Gov. Rick Snyder’s latest annual budget proposal, which would would transfer mental health funding to for-profit health insurance firms. (Hair, 3/12)

Everyone is in favor of value-based reimbursement in healthcare, right? If you're still wearing those rose-colored glasses, take a closer look at last week's reaction to Medicare's proposal to test new ways of paying for drugs administered in physician offices and hospital outpatient departments. (Merrill Goozner, 3/12)

Arizona has the highest rate of uninsured children among the families who would benefit most from the restoration of the program. Restoration would allow KidsCare to once again bring health care to children whose families make too much to qualify for the state’s Medicaid program, but too little to buy insurance on their own. These are children of the working poor. (3/12)

More than a year after I led the fight in Congress to pass major bipartisan legislation that enacted the most significant VA reform in a decade, the system is still not working for our veterans. I am frustrated and outraged by the slow nature of change at the VA. I know our veterans are, too. (John McCain, 3/13)

When California lawmakers voted last week to raise the smoking age from 18 to 21, the debate featured optimistic rhetoric that fines and bans would sharply reduce the number of young adults buying or using tobacco. This seemingly common-sense approach, however, doesn't work. There is virtually no systematic research showing that increasing the smoking age prevents a teen from picking up the habit. The Institute of Medicine acknowledged as much in a 2015 report, even as it optimistically projected a 12% decline in adult smokers if the minimum legal age for buying tobacco were 21 nationwide. (Mike Males, 3/11)

Late last year while playing tennis I reached up to serve and I felt a painful pop in my shoulder. The inflammation got worse over the next few months. Now anytime I try to put my arm above my head, pain shoots up my arm. I often wake up at night with an agonizing throb in my shoulder. So I finally and reluctantly went to the orthopedic surgeon and he said that I had a rotator cuff tear and I probably would need surgery. Ugh. He scheduled me for an MRI but the day I was set to go, the hospital called to tell me my insurance company declined to pay for the scans. The insurance company, CIGNA, tersely sent me a note: “You will need to complete six weeks of conservative treatment, such as physical therapy and anti-inflammatory medication. Once that has been completed and you have been re-evaluated, we can try to have the MRI re-authorized.” Gee, thanks. You guys are the best. (Stephen Moore, 3/13)

Now lawmakers at the state level are joining in on the demagoguery, with legislation that would punish employers for bad federal tax policy. In response to Pfizer’s November announcement that it is buying Allergen and moving its headquarters to Ireland, where the 12.5 percent corporate rate is less than one half of the 35 percent imposed by the United States, the New Jersey Assembly passed legislation that prohibits inverted companies from receiving state contracts or development tax credits. (Grover G. Norquist and Patrick Gleason, 3/14)

The forefront of the healthcare profession is a continually moving target. But what isn't changing are the characteristics that distinguish excellent leaders: They invest in themselves, in others and in their communities. The need for healthcare executives to invest in and expand their professional competencies and leadership capabilities has never been greater. (Edward Lamb, 3/12)

In 1999 Brandi Chastain scored the winning shootout goal in the World Cup soccer final against China, then stripped off her jersey and sank to her knees in exultation, arms thrust skyward. Another image of Chastain recently emerged: Now 47, a mother and a coach, the soccer star announced that at death she will donate her brain to the Concussion Legacy Foundation at Boston University, where researchers study chronic traumatic encephalopathy, the degenerative brain disease linked to concussions and head trauma. (3/11)

In the Land of the Falling Moms, every obstacle beckons with a kind of gravity. The curled corner of a rug. The slightly raised entryway. The uneven sidewalk. The slick tile. In the Land of the Falling Moms, the difference between upright and upended is measured in inches, but the consequences are calculated in months. (Stephen J. Lyons, 3/11)

Almost every day seems to bring more bad news about the Zika virus: babies born with malformed brains; adults suffering the progressive paralysis of Guillain-Barré syndrome; Americans diagnosed after traveling to the tropics; active transmission of the disease in U.S. territories. Several companies are working on a vaccine, but primarily because of regulatory requirements none is likely to become commercially available before the end of the decade. (John J. Cohrssen and Henry I. MIller, 3/13)