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California's health insurance exchange said 144,178 people have newly enrolled in Obamacare coverage during the first month of sign ups. During the initial rollout of the federal health law, 1.2 million people purchased a private health plan through the Covered California exchange. State officials are trying to hold on to most of those existing policyholders during the renewal process now and add about 500,000 more to finish open enrollment Feb. 15 with 1.7 million consumers. (Terhune, 12/17)

California’s health insurance exchange signed up more than 144,000 people in the first month this year and determined that another 157,000 were eligible for coverage. Another 216,423 enrolled in the state’s healthcare program for low-income residents and 75,000 were determined likely eligible for Medi-Cal, officials said Wednesday. (Cadelago, 12/17)

About 86,000 people are slated to receive private insurance coverage through Connecticut’s health insurance exchange, Access Health CT, as of Jan. 1, acting CEO Jim Wadleigh said Wednesday. Of those, about 66,000 are people who currently have coverage through the exchange and had their policies automatically renewed. The other 19,402 are people signing up for plans through the exchange for the first time. (Levin Becker, 12/17)

Colorado's health insurance exchange reported Wednesday that in the first month of open enrollment for 2015, it signed up 108,077 people for private plans and 27,306 for Medicaid. Despite technical problems that slowed or stopped many would-be consumers, Connect for Health Colorado enrolled 12,600 people on Monday, a single-day record. It was the deadline for those who want their coverage to begin Jan. 1. The exchange reported on Dec. 11 that 24,811 people had signed up for private health plans, with about a third of those as new customers. (Draper, 12/17)

Total enrollment in public and private health plans through MNsure jumped 32 percent between Dec. 13 and Dec. 16, the health plan exchange said Wednesday. The total enrollment figure through Dec. 16 is 49,366, MNsure reported. Of those, 23,797 signed up for commercial plans, 7,681 enrolled in MinnesotaCare, and 17,888 signed up for Medical Assistance through the exchange. (Zdechlik, 12/17)

About 135,000 Minnesota adults ages 18 to 64 years old secured health coverage between 2013 and 2014, a jump that cut the uninsured rate for that group to 6.7 percent. That's the lowest rate of uninsured measured for that population in Minnesota, the state Health Department said Wednesday. (12/17)

MNsure reported progress Wednesday on hitting its enrollment goal for 2015, but an insurance industry official said the exchange still isn’t getting workable information to health plans about those who are signing up. (Snowbeck, 12/17)

Washington state’s health-insurance exchange is withholding payments to its primary technology contractor, Deloitte, as a result of repeated problems with the Washington Healthplanfinder website and the exchange’s payment and accounts systems. While Healthplanfinder — at wahealthplanfinder.org — has been more stable during the current open enrollment period than in the first enrollment last year, glitches continue to plague the site. Officials of the Washington Health Benefit Exchange, which manages the exchange, say many of those problems resulted from errors made by Deloitte. (Marshall, 12/17)

Obamacare’s technical issues seem to have been solved—at least on the sign-up side for Healthcare.gov. The second year of signups is relatively glitch-free on the newly revamped Healthcare.gov. (Ehley, 12/17)

A temporary bump in Medicaid fees paid to primary care doctors, an Affordable Care Act provision intended to get more physicians to accept Medicaid patients, will expire at the end of this month. Congress did not extend the higher rates, so unless states take action themselves or the new Congress revisits the issue, primary care doctors in Medicaid will see their fees fall by an average of nearly 43 percent starting in January, according to a new report from the Urban Institute. Whether the expiration of the fee increase will make a difference in physician participation in Medicaid is unknown. That is because there hasn’t been enough time to analyze whether the hike actually convinced primary care doctors to take Medicaid patients. (Ollove, 12/17)

Arkansas became the first Southern state to expand its Medicaid program in a way that many Republicans found acceptable. The state bought private insurance for low-income people instead of adding them to the rolls of the Medicaid system, which GOP lawmakers considered bloated and inefficient. Now Arkansas could be on the brink of another distinction: becoming the first to abandon its Medicaid expansion after giving coverage to thousands of people. (DeMillo, 12/17)

The model, developed over 18 months of negotiation between the state, medical providers and the four largest health insurers in Ohio -- Anthem, Aetna, United Healthcare and Medical Mutual -- attempts to shift the focus from quantity of services to quality of care. If the model works, doctors will be rewarded for providing better, more efficient care to their patients while keeping overall costs down. (Higgs, 12/17)

Colorado has won a $65 million federal grant to dramatically increase the number of patients who can access blended care for medical problems, mental health challenges and substance abuse treatment. (Kerwin McCrimmon, 12/17)

The latest Kaiser Family Foundation tracking poll shows 60 percent of Americans have a favorable view of the Affordable Care Act’s “employer mandate,” while 38 percent view the provision negatively. The mandate requires large businesses with 100 or more workers to provide affordable health insurance for full-time workers or face a penalty of $2,000 per employee beginning in 2015. The rules allow these employers to cover only 70 percent of eligible employees in 2015 and 95 percent in 2016 and beyond. (Pugh, 12/17)

Just days before the requirement for most large employers to provide health insurance takes effect, a new poll finds the public easily swayed over arguments for and against the policy. Six in 10 respondents to the monthly tracking poll from the Kaiser Family Foundation (Kaiser Health News is an editorially independent program of the foundation) said they generally favor the requirement that firms with more than 100 workers pay a fine if they do not offer workers coverage. But minimal follow-up information can have a major effect on their viewpoint, the poll found. (Rovner, 12/18)

Americans like the Obamacare mandate that large employers offer workers health insurance a lot more than the law’s requirement that most people must buy insurance, according to a Kaiser Family Foundation poll released Thursday. The poll, which comes on the eve of the twice-delayed employer mandate taking effect next month for businesses with more than 100 full-time employees, found that 60 percent of people support the requirement. The individual mandate, by comparison, still drew support from just 35 percent. (Norman, 12/18)

Obamacare’s employer mandate looks a whole lot different during a job-growing economic recovery. The cost of compliance when the mandate takes effect Jan. 1 doesn’t seem quite as onerous when compared to the need to attract and retain workers. Alternative coverage strategies offer businesses a better chance to keep budgets in check without risking the law’s penalties. (Norman, 12/18)

In what appears to be an about face, the Centers for Medicare & Medicaid Services has revised a controversial provision of the Open Payments program and will now require companies to report payments to physicians who speak at, or attend, continuing medical education seminars. The change comes less than two months after the agency declared there are circumstances in which such payments would not have to be disclosed. In fact, this marks the fifth time that CMS has offered yet another interpretation of its final rule on disclosing CME payments. (Silverman, 12/17)

The federal government recently unveiled a website called Open Payments that provides details about payments made by pharmaceutical and medical device companies to physicians. Initial news stories noted some interesting details. During the last 5 months of 2013, these companies paid physicians almost $3.5 billion in speaking and consulting fees, with some physicians earning more than half a million dollars in that period. The Open Payments site was immediately criticized for multiple problems, including the difficulty people have in navigating the site and the fact that there might be misattribution of some payments. Government officials said they plan to improve the site, and later introduced a search tool, making it easier for consumers to find their physician. Meanwhile, drug and device manufacturers and physician groups continue to complain that patients might misinterpret the data on the site. (Thacker, Kesselheim and Campbell,12/17)

UnitedHealth Group and Humana enroll more Medicare Advantage members than any other insurers, and it really isn't that close, according to the latest government data. More than 16.6 million people had a Medicare Advantage plan as of Dec. 1. Medicare's open-enrollment period ended Dec. 7, so that figure is likely to be even larger once the CMS releases its next monthly enrollment report. The private Medicare program has been a boon for insurers the past several years, offering sizable volumes and steady profit margins. Some companies have said the growth in Medicare Advantage, spurred in part by the aging baby boomer population, will be fundamentally important to earnings growth in 2015 and beyond. (Herman, 12/17)

Shares of Genworth Financial Inc. are taking another dive after the insurer delayed the completion of an annual review of its reserves for the long problematic line of long-term-care insurance. Some Wall Street analysts interpreted the delay as bad news, following the worse-than-expected third-quarter charge disclosed in November for the initial part of the annual review. (Scism, 12/ 17)

Credit ratings agencies are forecasting trouble for the U.S. hospital sector in 2015 as federal reimbursements decrease and Republicans float a variety of changes to ObamaCare. Standard & Poor's Ratings, Moody's Investors Services and Fitch Ratings all predicted that the healthcare world will face challenges in the form of rising costs and uncertainty surrounding the healthcare law. (Viebeck, 12/17)

Gov. Peter Shumlin of Vermont announced on Wednesday that his state would not pursue single payer health care in this coming legislative session. Shumlin blamed a sluggish economy for his decision. The taxes required for single payer would prove too burdensome for Vermont, a state that has downgraded its revenues twice this year. (Alpert, 12/17)

Vermont Gov. Peter Shumlin on Wednesday dropped his plan to enact a single-payer health care system in his state — a plan that had won praise from liberals but never really got much past the framework stage. “This is not the right time” for enacting single payer, Shumlin said in a statement, citing the big tax increases that would be required to pay for it. (Wheaton, 12/17)

Calling it the biggest disappointment of his career, Gov. Peter Shumlin said Wednesday he was abandoning plans to make Vermont the first state in the country with a universal, publicly funded health care system. Going forward with a project four years in the making would require tax increases too big for the state to absorb, Shumlin said. The measure had been the centerpiece of the Democratic governor's agenda and was watched and rooted for by single-payer health care supporters around the country. (Gram, 12/17)

Fourteen officials, pharmacists and technicians tied to the Massachusetts company involved in a 2012 meningitis outbreak that killed 64 people were indicted by a federal grand jury on charges including racketeering, conspiracy and second-degree murder. The New England Compounding Center's tainted drugs, including a steroid administered by spinal injection to treat pain, infected more than 700 people in 20 states, U.S. officials have said. The outbreak was caused by sloppy clean-room practices, including routine failure to properly sterilize drugs, according to the indictment unsealed Wednesday in Boston. (Larson and Lawrence, 12/17)

Fourteen former owners or employees of the New England Compounding Center were charged in connection with a 2012 meningitis outbreak that killed 64 people nationwide and was traced to tainted drug injections made by the pharmacy, according to a federal indictment. (Silverman, 12/17)

Fourteen people connected to a Massachusetts compounding pharmacy have been arrested on charges stemming from the 2012 meningitis outbreak that killed 64 people who received tainted drugs, officials said Wednesday. In the high-profile criminal case involving contaminated medicine, Barry Cadden, a co-founder of the New England Compounding Center of Framingham, Mass., and Glenn Adam Chin, a pharmacist who was in charge of the sterile room, face the most serious charges, according to the 131-count indictment. (Muskal, 12/17)

More than 750 people in 20 states were sickened and 64 died after they contracted fungal meningitis and other illnesses from tainted steroids made by the company. The steroids given were for medical purposes, not for body building; most received the injections for back pain. Cadden and Chin are charged with causing the deaths of patients in several states, including Michigan, Tennessee and Indiana. The others charged in an indictment unsealed Wednesday face charges ranging from mail fraud to the introduction of adulterated and misbranded drugs into interstate commerce. (12/17)

Federal and local law enforcement officials are investigating a healthcare data-for-ransom security breach at 18-bed Clay County Hospital in Flora, Ill. The hospital received an e-mail ransom demand Nov. 2 containing patient names, addresses, Social Security numbers and dates of birth, but no clinical information, according to a release. The sender threatened to make the patient information public unless “a substantial payment from the hospital” was made, the hospital statement said. (Conn, 12/17)

Florida's elder guardianship program is meant to help vulnerable elders. But Sarasota Herald-Tribune reporter Barbara Peters Smith recently published a series that shows the rapidly expanding system run in Florida’s probate court system ignores the rights of some. She spoke with Health News Florida Editor Mary Shedden about the year-long investigation. (Shedden, 12/17)

Macomb County commissioners today approved a resolution to issue up to $300 million in bonds to finance the county's unfunded retiree health care liability. The board, during a finance committee meeting, also approved sending a comprehensive financial plan to the state for approval. The state must review and approve the plan for the county to issue the bonds. (Hall, 12/17)

Nine months before Jack Stick resigned as the top lawyer for the Texas Health and Human Services Commission amid concerns over a $110 million no-bid contract awarded on his watch, he urged the same vendor to contact a sister agency — the Texas Department of Family and Protective Services — for related work. DFPS, which includes the mammoth Texas Child Protective Services agency, ultimately did sign a $452,000 no-bid contract with the company, 21 Century Technologies Inc., for a pilot program to help it better track families investigated for child abuse. That contract was abruptly canceled by DFPS's parent agency — HHSC — on Wednesday, one day after The Texas Tribune began asking about it. (Langford and Blanchard, 12/17)

A bipartisan group of governors from 39 states is supporting extended federal funding of the Children's Health Insurance Program, or CHIP, which covers more than 8 million kids and their families nationwide, including about 400,000 children in Florida. But Gov. Rick Scott has not joined the chorus. Scott's office declined to explain why the governor has been silent on the issue after ranking members of the U.S. House Committee on Energy and Commerce and the U.S. Senate Finance Committee sent letters to governors of all 50 states in July asking for their input on the future of CHIP. (Chang, 12/17)

In a year when many state legislatures reduced or cut spending for mental health care, a report by the National Alliance on Mental Illness (NAMI) found that Minnesota stands out as having remained strong in its commitment to supporting individuals and families in psychological distress. The report, titled "State Mental Health Legislation in 2014: Trends, Themes, and Effective Practices," showed that in comparison to 2013, when 36 states acted to restore funding to mental health budgets in reaction to the tragedy at Sandy Hook Elementary in Newtown, Connecticut, 2014 was marked by a reduction in such funding. Only 29 states and the District of Columbia increased funding for mental health services this year. (Steiner, 12/17)

New York officials have proposed authorizing coverage for transgender treatment under the state's Medicaid program for low-income New Yorkers. Regulations proposed Wednesday would cover hormone therapy and gender reassignment surgery. For surgery, patients would need a medical referral and to have counseling and document a year of hormone therapy and living in the gender role consistent with his or her identity. (12/17)

A North Texas physician has been sentenced to 10 years in federal prison for his role in a $3 million Medicare billing scam. Dr. Joseph Megwa of Arlington was sentenced Wednesday in Dallas. The 60-year-old doctor in May was convicted of conspiracy to commit health care fraud and three counts of health care fraud. Megwa was also convicted of four counts of making false statements over Medicare claims in cases since 2006. (12/17)

WNYC's Fred Mogul, working in partnership with Kaiser Health News and NPR, reports: "But despite evidence that hospices can greatly relieve discomfort, extend life and save money, and despite a generous hospice benefit available through both Medicare and Medicaid, relatively few people in New York take advantage of it, compared to elsewhere in the country. The reasons for this local gap are complicated, but Jeanne Dennis, senior vice president of hospice and palliative care at the Visiting Nurse Service of New York, says one place to start is with patients’ fears." (Mogul, 12/17)

The Supreme Court’s decision to hear arguments in King v. Burwell next year poses an enormous danger to Obamacare, but it also presents an urgent challenge to the law’s opponents. The outcome might result in many thousands of residents in more than half the states being unable to afford health insurance. The next Congress must be ready to respond with a consumer-oriented health reform. That means preparing now. (Yuval Levin and James C. Capretta, 12/17)

The New York Democrat noted that the Affordable Care Act “was aimed at the 36 million Americans who are not covered” and asserted that “to aim a huge change in mandate at such a small percentage of the electorate made no political sense.” Schumer says he was surprised that nine paragraphs in a 6,600-word speech got all the attention. He shouldn’t have been. (E.J. Dionne Jr., 12/17)

About 10 million people have gained coverage in 2014, and notably, that’s not just the finding from this data source but from various other coverage surveys as well. Now, since trends in economic variables, including the share of those without health insurance coverage, by definition have some persistence, when you see a shift in a trend of this magnitude, your strong suspicion is that an “exogenous” change has occurred, i.e., something new entered the system that had a large impact on the variable in question. (Jared Bernstein, 12/17)

In the struggle between pragmatism and ideology over Medicaid expansion in red states, pragmatism may slowly be winning. Gov. Bill Haslam‘s announcement Monday of his plans to expand Medicaid under the Affordable Care Act makes Tennessee the 10th state with a Republican governor to expand the program (if the state legislature approves the plan). ... The governors of Indiana, Wyoming and Utah have also announced plans to expand. Many of these states are or will be negotiating with the Obama administration to expand Medicaid coverage for adults in ways that match their more conservative policy preferences and allow elected officials who opposed the health-care law to continue to distance themselves from Obamacare. (Drew Altman, 12/18)

Put differently, Democrats and Republicans have done precious little to resolve their basic differences over how large government should be, what it should do and who should pay for it. Both have benefited politically from outside events. They have claimed success while evading the hardest choices. In a letter with the report, outgoing Budget Committee Chairman Patty Murray (D-Wash.) urges Republicans to abandon their “partisan, cuts-only approach” and to accept tax increases. But the advice works both ways. Though Republicans have resisted new taxes (an exception: higher rates on the wealthy enacted in 2013), Democrats have been as adamant in resisting benefit cuts to Social Security and other “entitlements,” including Medicare. Not surprisingly, Murray’s letter does not mention benefit cuts. (Robert J. Samuelson, 12/17)

The Massachusetts Health Connector has 99 problems, but Jonathan Gruber isn’t one. The four GOP state senators who have called for the respected MIT economist to resign from the connector’s board are aiming at the wrong target. Last year’s bungled rollout of the state’s health website, which is intended to connect citizens with health insurance plans, cost taxpayers still-uncounted millions. Legislators would be better off demanding auditor Suzanne Bump and Governor-elect Charlie Baker get to the bottom of what happened, rather than joining a frivolous right-wing vendetta against Gruber. (12/17)

Last week the regional transportation authority in this area, SEPTA, filed suit against pharmaceutical company Gilead for its “exorbitant pricing” of Sovaldi, a product to treat hepatitis C. SEPTA is a self-funded organization that covers the health benefits for its employees and their families, so Gilead's $84,000 per person price tag for a course of treatment represents a jolt to the agency's health care costs. SEPTA's lawsuit raises the question of why there has been no consortium of large, self-funded companies to act in unison and haul pharma to the woodshed for its pricing? (Daniel R. Hoffman, 12/17)

The Ebola epidemic is testing virtually every aspect of the public health and healthcare systems in the U.S., including healthcare institutions’ public service commitments. Although the number of cases in the U.S. remains very small, an extraordinary amount of public and hospital resources have been devoted to preparing for new cases domestically. In contrast, although US hospital and medical professional organizations have called for an “enhanced focus” on containing Ebola in West Africa, there is a striking absence of public commitments on the part of US healthcare institutions to contribute to the containment effort. (Michelle Mello, Maria Merritt and Scott Halpern, 12/17)