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About 36,000 people have taken advantage of a second chance to sign up for coverage under the president's health care law, the Obama administration said Wednesday. That's not a lot, considering that an estimated 4 million people are potentially eligible. (4/1)

Nearly 11.7 million people have either signed up or re-enrolled for insurance coverage under the U.S. healthcare reform law, more than the 9.1 million predicted by the Obama administration, health officials said on Tuesday. As of Feb. 22, about 8.8 million signed up in one of the 37 states that use online exchanges operated by the federal government and 2.85 million were in the 14 states, and Washington, D.C., that operate their own exchanges, the Department of Health and Human Services said in a statement. (Abutaleb, 4/1)

Could 50,000 people have not died in hospitals because of the Affordable Care Act? That seemed rather extraordinary, even given the size of the United States. We’ve spent time digging around on this issue and here are the results of our inquiry. It turns out that preventing hospital-related deaths is one of the least controversial aspects of the much-attacked law. (Kessler, 4/1)

Beginning in 2017, states will be able to apply for waivers for flexibility in implementing many of the Affordable Care Act's key requirements -- an opportunity that some see as a catalyst for health reform. The promise of broad flexibility under such waivers could be particularly appealing to states that have been reluctant to back the ACA and its requirements. In fact, some stakeholders argue that such waivers should be made available as early as this year so states can begin making progress. (Stuckey, 4/1)

Jonathan Gruber, the Massachusetts Institute of Technology economist whose comments about the U.S. health law earlier had ignited a political furor, says federal subsidies to lower insurance premiums were intended for all those who qualify, regardless of whether they get coverage through a state or federal exchange. A suit before the Supreme court seeks to halt the use of tax credits to offset the cost of insurance premiums for residents in about three dozen states that don’t operate their own insurance exchanges and use the federal HealthCare.gov website instead. Challengers in the case argue the law allows the tax credits only for insurance buyers in states with their own exchanges—currently just 13 states and the District of Columbia. (Armour, 4/1)

The landmark 2006 Massachusetts health-care law that inspired the federal overhaul didn't lead to a reduction in unnecessary and costly hospitalizations, and it didn't make the health-care system more fair for minority groups, according to a new study that may hold warnings for the Affordable Care Act. Massachusetts’ uninsured rate was cut by half to 6 percent in the years immediately following the health-care law signed by then-Gov. Mitt Romney. Blacks and Hispanics, who have a harder time accessing necessary medical care, experienced the largest gains in insurance coverage under the Massachusetts law, though they still were more likely to be uninsured than whites. (Millman, 4/1)

The Cleveland Clinic, one of the largest hospitals in the country, has cut its charity care spending — or the cost of free care provided to patients who can’t afford to pay — to $101 million in 2014 compared with $171 million in 2013. Hospital officials credited the federal health law for the improvement. “The decrease in charity care is primarily attributable to the increase in Medicaid patients due to the expansion of Medicaid eligibility in the State of Ohio and the resulting decrease in the number of charity patients,” the hospital’s year-end financial statement reported. (Tribble, 4/2)

The House and Senate advanced competing budgets Wednesday, setting up what could be a weekslong showdown between the two chambers over Medicaid funding. The Senate's $80.4 billion spending plan is about $4.2 billion more than the House version. That's largely because the Senate includes a Medicaid expansion plan that draws $2.8 billion from the federal government and an alternative Low Income Pool program within Medicaid of $2.2 billion. ... Senate leaders pushed back against the House and advocacy groups such as Americans for Prosperity, which launched an ad campaign this week slamming senators for their support of Medicaid expansion. (Rohrer and Sweeney, 4/1)

As the state House and Senate considered their respective budget proposals on Wednesday, two of Florida’s top Democrats traveled to Tallahassee to keep the pressure on lawmakers to expand Medicaid. U.S. Rep. Debbie Wasserman Schultz, who also chairs the Democratic National Committee, said she had "direct conversations" with federal health care officials -- and that Florida shouldn't expect to have the $2.2 billion Low Income Pool program renewed unless it expands Medicaid. ... U.S. Sen. Bill Nelson said he, too, was doubtful that the federal government would continue funding LIP. He said he met with House Speaker Steve Crisafulli, R-Merritt Island, on Wednesday to make that point. (McGrory, 4/1)

Florida officials said late Wednesday that the federal government is suspending negotiations over the potential loss of more than $1 billion in money now flowing to the state's hospitals. The move comes at a critical time: The Florida Legislature is trying to finalize a new state budget between now and the end of the session on May 1. Senate Republicans have vowed that they will not vote for a budget if it requires large cuts to hospitals. (Fineout, 4/2)

A Republican-controlled House committee Tuesday night easily moved forward Gov. Bill Walker's bill to expand the public Medicaid health program, but the measure still has many more stops in the Legislature, including some in hostile territory. Six of the seven legislators on the House Health and Social Services Committee supported House Bill 148, a measure Walker introduced last month after the Legislature rejected his initial attempt to expand Medicaid using the state's annual budget package. (Herz, 4/1)

Governor Walker’s Medicaid Expansion bill has passed it’s first committee in the House. HB 148 was approved by the House Health and Social Services Committee Tuesday night with a 6 to 1 vote. The bill would allow the state to accept at least 145 million dollars in federal funds to provide health insurance to low income, childless adults. The federal government is funding 100% of expansion until the end of 2016, then the match gradually decreases to 90% in 2020. Four Republican lawmakers voted for it, but not Liz Vazquez. The Anchorage Republican says the committee didn’t hear enough expert testimony on how Medicaid expansion would impact the state budget. (Feidt, 4/1)

Kentucky’s Commissioner of Agriculture and Republican gubernatorial candidate James Comer said Monday in a press conference in Louisville President Barack Obama’s health care law was “the worst piece of legislation in my lifetime.” The lifelong Kentuckian and career farmer also unveiled a health care policy platform which assumed “Obamacare” would be something the next governor of Kentucky would ultimately have to face. (Foley, 4/1)

Thousands of Utahns received a notification this week that their Medicaid benefits were coming to an end immediately. But state officials said late Wednesday those people will have coverage after all. Utah Department of Workforce Services spokesman Nic Dunn confirmed about 12,000 recipients of the 12-month transitional Medicaid benefit received the letter because Congress did not approve funding beyond March before going into recess late last week. “If Congress reauthorizes the funding for the program after you receive this notice, your transitional Medicaid benefits may be reopened,” the letter stated. (Adams, 4/1)

Speaking before a conservative audience Wednesday, Gov. Scott Walker suggested he would not allow Wisconsin to set up a health care exchange if the U.S. Supreme Court strikes down a portion of Obamacare. "We're going to push back," the likely Republican presidential candidate said of President Barack Obama's signature health care law. (Marley, 4/1)

Eliminating a public health care program called MinnesotaCare could end up being a critical part of the budget plan adopted by the Republican-controlled Minnesota House. But at least one Republican legislator says he doesn’t support a bill to get rid of MinnesotaCare. In committee he voted against the legislation, which is sponsored by Rep. Matt Dean, R-Dellwood. ... MinnesotaCare is more than two decades old. It provides state subsidies to help people buy health insurance when they make too much money to qualify for Medical Assistance, but don’t get coverage through an employer and can’t afford to buy their own plan. Dean’s plan would move these participants to MNsure, the state’s health insurance exchange, (Richert, 4/1)

The Connect for Health Colorado board Wednesday named a health care executive with 30 years' experience, Robert C. Malone, as its candidate for chief executive. Under state law, the board posts the name of the finalist, takes public comment on the selection for 14 days, and then seeks approval from the Legislative Health Benefit Exchange Implementation Review Committee before formally offering the job. (4/1)

Leaders at Connect for Health Colorado said Wednesday that they welcome new, more intense scrutiny by the Colorado Legislature, and Sen. Ellen Roberts, R-Durango, promised to deliver at a meeting of the Legislative Health Benefit Exchange Implementation Review Committee. (Carman, 4/1)

The indictment, the first federal bribery charges against a sitting senator in a generation, puts Mr. Menendez’s political future in jeopardy. He faces a possible sentence of 15 years in prison for each of the eight bribery counts. ... The charges revolve around Mr. Menendez’s relationship with Dr. Salomon E. Melgen, a wealthy Florida eye surgeon and political benefactor. (Apuzzo, 4/1)

According to the indictment, between January 2006 and January 2013 Menendez accepted close to $1 million in “lavish gifts and campaign contributions” from Melgen in exchange for helping Melgen in contractual and Medicare billing disputes worth tens of millions of dollars to the doctor. (Serrano, Phelps and Mascaro, 4/1)

Mr. Menendez allegedly pushed the Centers for Medicare and Medicaid Services to get a more favorable ruling in Dr. Melgen’s Medicare billing dispute. Beginning around June 2009, the indictment said, Mr. Menendez and his staff began advocating on behalf of Dr. Melgen. Mr. Menendez and his staff met directly with the Department of Health and Human Services and CMS, according to the complaint. In July 2009, Mr. Menendez had a call with the acting principal deputy of CMS about the matter, according to the complaint. (Grossman and Dawsey, 4/1)

Menendez allegedly pressured federal health officials to drop an $8.9 million fine against the eye doctor for overbilling Medicare, used his influence to advance a lucrative port-security deal in the Dominican Republic for a firm owned by Melgen, and threw his weight around to help three of Melgen’s foreign girlfriends get help entering the United States. (Caputo, 4/1)

In early June 2012, Melgen issued a check for $300,000 for the Majority PAC. ... That same month, the senator went to bat for Melgen again, this time on behalf of his eye clinics, with top officials in the Department of Health and Human Services who oversaw Medicare reimbursements and whose auditors had concluded Melgen had overbilled the federal health program for eye medications he used in his clinic. Menendez, using talking points created by Melgen’s lobbyist, talked by phone on July 2 to the acting administrator at the Centers for Medicare and Medicaid Services about her agency’s policy for reimbursing physicians such as Melgen, who used a single vial of medication multiple times, sometimes for multiple patients. ... The senator next had his staff arrange a meeting with then-HHS Secretary Kathleen Sebelius, which occurred in August 2012 at the behest of Sen. Harry M. Reid (D-Nev.), who was majority leader at the time. (Kane and Leonnig, 4/1)

Congress will get a little extra time to prevent a threatened 21 percent cut in Medicare payments to doctors. Technically, the cut was to take effect Wednesday. But the Department of Health and Human Services said it will hold off processing claims at the lower rate until April 15. (4/1)

The CMS is delaying enforcement of the controversial “two midnight” payment policy for short hospital stays until the end of April. The postponement allows Congress time to pass the package repealing Medicare's sustainable growth-rate formula when it reconvenes on April 13. That legislation includes a six-month delay in enforcement of the payment rule, which hospitals argue is unfair and undermines their clinical decisions. (Demko, 4/1)

Margaret Hamburg ended her run this week as one of the longest serving Food and Drug Administration commissioners in recent decades. NPR's Robert Siegel speaks with her about her accomplishments and challenges while in office. (4/1)

The Food and Drug Administration released long-awaited guidance on how it wants drugmakers to study the efficacy of abuse-deterrent painkillers, but has punted on the thorny issue of generics for now. The document comes more than two years after the agency issued draft guidance, amid mounting pressure from Congress to speed up the process. An amendment from Rep. Hal Rogers, R-Ky., in the year-end spending package called for the agency to release the guidance by June of this year or face the removal of $20 million in funds for salaries and expenses from the commissioner’s office. (Gustin, 4/1)

Between December and February, vaccinations to prevent measles jumped 27 percent compared with the same period last year in Washington. A high-profile outbreak at Disneyland may have contributed, health officials said. (Aleccia, 4/1)

The horrifying crash last week of the Germanwings flight operated by Lufthansa has put a spotlight on what the airline knew — and what it should, or could have done — about its pilot's mental health. Lufthansa could face unlimited liability, after the pilot allegedly brought the plane down deliberately. Here in the U.S., employment experts say monitoring employees' mental health status raises a thicket of complicated issues. (Noguchi, 4/1)

As investigators and transportation officials try to determine why a young airline pilot with a history of depression might have deliberately crashed a Germanwings plane into the French Alps last week, the incident has raised questions about how much employers should know about their employees’ mental health. (Silverman and Feintzeig, 4/1)

A new report out today from the National Alliance for Mental Illness says the health insurance industry discriminates against the mentally ill. That’s in spite of a 2008 federal law, requiring insurers to provide the same level of coverage for the mentally ill. And the Affordable Care Act hasn’t helped either. (Herships, 4/1)

Local VA officials shut down a specialized treatment program for veterans just days after its director went public with concerns that suicidal patients are being endangered by inappropriate care at the Phoenix hospital. (Wagner, 4/1)

Sen. Joe Donnelly (D-Ind.) says more needs to be done to prevent military suicides, following a report that showed a rise in the number of active-duty troops taking their own lives. There were 268 confirmed suicides among active-duty military personnel in 2014, up from 254 in 2013, according to a Defense Department report released Tuesday. While the number of suicides among active-duty troops increased between 2013 and 2014, last year’s totals are less than the 320 active duty suicides confirmed in 2012. (Carney, 4/1)

For the first time in nearly three decades, Seattle’s Veterans Affairs (VA) hospital campus is poised to expand, with construction of a new mental-health and research building set to start later this month amid a booming veteran population seeking treatment. By the time it’s finished in late 2017, the six-story, 219,000-square-foot building will house more than 250 mental-health staff members and 60 researchers and offer improved services for patients, VA officials say. (Kamb, 4/1)

The U.S. government has reached a settlement with Phoebe Putney Health Systems, dropping an objection to its merger with Palmyra Park Hospital that was initially issued four years ago. The Federal Trade Commission said Tuesday that Phoebe Putney had agreed to a consent decree that did not require any asset sales, but would require the hospital company to notify the agency before making other healthcare acquisitions in the region. (Bartz, 4/2)

The Federal Trade Commission and a South Georgia health system have reached a settlement in a four-year hospital antitrust case that drew national attention and was the subject of a U.S. Supreme Court ruling. (Miller, 4/1)

Arizona will now require doctors to tell women who use the so-called abortion pill that the procedure can be reversed. We asked NPR health correspondent Rob Stein whether that's true. Here's his report. (4/1)

Arizona, a battleground for anti-abortion legislation, has become the first state to pass a law requiring doctors to tell women that drug-induced abortions may be reversible. Arizona Gov. Doug Ducey (R) signed the controversial Senate Bill 1318 into law on March 30, 2015. Herrod, who has lobbied to restrict abortion rights for years, was a main proponent of the law. Advocates who support abortion rights are furious over several provisions in the bill — in particular, the provision that requires physicians performing an abortion to inform the woman “it may be possible to reverse the effects of a medical abortion.” But the method itself is still experimental, and doctors and advocates say it is not responsible to present women with the option. (Lee, 4/2)

A bill filed Wednesday tweaks North Carolina’s abortion laws, creating new restrictions and requirements on doctors, and a longer waiting period. (Hoban, 4/2)

Texas lawmakers are considering a bill that would keep a person's gun ownership status from being listed in their medical records, a move health providers worry would be an unnecessary government intrusion that harms their consultations with patients. The bill would make Texas at least the second state to enact similar restrictions, following a 2011 Florida law on hold because of legal challenges. (Warren, 4/2)

Mayor Bill de Blasio’s administration for the first time laid out its plan to save $3.4 billion in employee health-care costs over the next four years. The strategy addresses a long-standing fiscal challenge and sheds light on how the city hopes to help offset raises negotiated over the past year with municipal unions. The planned cost-cutting includes the city paying less than previously projected for employee health insurance, newly negotiated rates with insurers and greater incentives for preventative care. (Gay, 4/1)

A health insurer in Florida last week agreed to lower the price of some HIV medications, moving them from a specialty tier to a generic medication tier. The change will reduce copayments from roughly $1,000 a month for some medications to anywhere from $5 to $100, according to advocates. (Gorn, 4/1)

Donald Spicer slowed his police car to a crawl as he pointed out “shooting galleries” — paint-chipped houses with broken windows and rotting wood, where addicts inject liquid painkillers and lose all sense of time. Used needles often lie in plain sight, in the cracked streets, in the garbage-filled gutters, on patchy lawns. “This is a common problem,” the police chief said. “This isn’t anything new to us.” Spicer now finds his rural hometown at the core of the state’s worst-ever outbreak of HIV, one so grave that Gov. Mike Pence declared a health emergency last week. Pence also authorized a short-term needle exchange to fight the virus’ spread, an exception to Indiana’s conservative anti-drug policy that bars programs to trade dirty needles for clean ones. (Parvini, 4/1)

During the past decade, Vermont has spent $675 million setting up Medicaid managed-care programs but has done such a spotty job monitoring them that they can’t even be audited. That’s the upshot from a letter state Auditor of Accounts Douglas Hoffer sent to lawmakers last week. It followed up on an internal report in January by the Agency of Human Services detailing gaps in answers to this question: Have the state and federal governments — and taxpayers — been getting their two-thirds of a billion dollars’ worth? (Gram, 3/31)

State regulatory boards may want to change their ways to avoid antitrust liability following a recent U.S. Supreme Court decision against a North Carolina dental board, Federal Trade Commissioner Maureen Ohlhausen said in a speech Tuesday. Ohlhausen, however, said she doesn't think such changes will be overly burdensome. (Schencker, 4/1)

A Somali immigrant mother’s relentless campaign to expand care for poor children with autism has achieved a major triumph, as Minnesota becomes one of the first states in the nation to subsidize a broad range of intensive therapies for the developmental disorder. (Serres, 4/1)

Besides living with a sense of panic and staying up at night worrying, Marina Derman has been in advocacy mode lately – testifying, writing emails, trying to convince lawmakers to salvage the program she says saved her family from crisis. She’s one of many people making appeals as legislators try to come up with a new two-year budget. In her case, it’s for the state’s voluntary services program for young people with both mental health diagnoses and autism or an intellectual disability, many of whom receive intensive services to allow them to live with their families. (Levin Becker and Phaneuf, 4/2)

The Montana Legislature has passed a measure urging school employees to complete suicide awareness and prevention training. The proposal recommends that public school employees partake in two hours of suicide prevention training every five years. (4/1)

A Las Vegas psychiatric hospital is now reaccredited after an embarrassing patient busing scandal in 2013. The Southern Nevada Adult Mental Health Services agency announced Tuesday that the Rawson Neal Psychiatric Hospital won accreditation from the national Joint Commission. In 2013, the hospital faced allegations of "patient dumping" after James F. Brown was put on a bus alone and sent on a 15-hour trip to Sacramento, Calif. Brown knew no one in the area and suffers from schizophrenia and depression. (4/1)

A conference committee agreed Wednesday to adopt a budget bill that cuts $378,000 from a grant program that supports safety net clinics throughout the state. (Ranney, 4/1)

A group of 14 attorneys general has asked Congress to launch an investigation of the herbal supplements industry and to consider giving the U.S. Food and Drug Administration stronger oversight of the industry, New York Attorney General Eric Schneiderman announced. (4/2)

It’s going to only get worse over the next two weeks – not only because April 15 is approaching, but also because this year brought new reporting requirements under President Obama’s healthcare law. “This really looks like a perfect storm,” Brookings Institution scholar Elaine Kamarck warns. “We face a terrible combination: the addition of new forms for ACA [the Affordable Care Act, popularly known as Obamacare] and the subtraction of IRS capacity to help.” And those new forms are – like many IRS forms -- daunting. (Doyle McManus, 4/1)

Successful Medicare payment reform could transform health care delivery, but missteps could set back meaningful change for the foreseeable future. Clinicians, hospitals, and other providers need Medicare, Medicaid, and private insurers all pulling in the same direction so that they avoid a situation (beyond a transition period) in which a large proportion of their patients is under a fee-for-service (FFS) payment system and a large share under reformed payment approaches—leaving them, figuratively, as many have pointed out, standing with each leg in a separate boat. So payment reform will not succeed without success by Medicare. (Paul B. Ginsburg, 4/1)

Speak the words “dementia” and “nursing home,” and you’ve exposed two great fears among people in developed countries, where living until 80 or 90 is increasingly common. Despite efforts to keep frail elders in their own homes, increasing numbers of people with dementia are likely to spend time in a nursing home. There is widespread fear about nursing home care, which in many cases is warranted. However, there are national efforts to change nursing home culture, and many facilities have made strides in creating homelike environments .... We need to examine what works in the best nursing homes and apply their methods to all facilities. (Mary Ersek, 4/1)

An agreement announced Monday by the New York State attorney general and GNC, the nation’s largest specialty retailer of dietary supplements, should provide protection against fraudulent herbal products that don’t contain the ingredients listed on their labels or contain unlisted ingredients that are potentially dangerous. (4/1)

Alaska's hospitals face considerable economic risk if we opt out of Medicaid expansion, and thousands of Alaskans remain without basic coverage. As president of the Greater Fairbanks Community Hospital Foundation, I support the expansion of coverage because it makes good economic sense and it is vital to Alaska hospitals' collective mission of improving their communities' health. Patients without coverage often have no alternative but the emergency room for basic care. So Alaska's hospitals often treat complex, chronic conditions -- at great economic and social cost -- because the uninsured are often forced to delay what could have been inexpensive treatment. (Jeff Cook, 4/1)

The U.S. Supreme Court has severely limited the ability of healthcare providers to sue state Medicaid agencies over the adequacy of rates. But in handing down that decision Tuesday, the high court seemed to flatly contradict itself on the power of the feds to tell states how to run their Medicaid programs. (Harris Meyer, 3/31)