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Spending on health care in the United States grew in 2013 at the lowest rate since the federal government began tracking it in 1960, the Obama administration said Wednesday. It was the fifth straight year of exceptionally small increases in the closely watched indicator. The data defied critics who had said such slow growth would not continue for long once the recession ended in mid-2009. (Pear, 12/3)

National health spending grew 3.6 percent in 2013, the lowest annual increase since the Centers for Medicare and Medicaid Services (CMS) began tracking the statistic in 1960, officials said Wednesday. Spending slowed for private health insurance, Medicare, hospitals, physicians and clinical services and out-of-pocket spending by consumers. However, it accelerated for Medicaid and for prescription drugs, according to the report, published online by the journal Health Affairs. (Carey, 12/3)

Americans increasingly have to dig into their own pockets to pay for medical care, a shift that is helping to curb the growth in health spending by employers and the government. The trend is being accelerated by the Affordable Care Act because many private plans sold by the law’s health exchanges come with hefty out-of-pocket costs, which prompt some people to delay or put off seeking care. (Armour, 12/3)

U.S. health care spending grew by the slowest rate in more than a half-century last year, government analysts said Wednesday. But a speed-up is coming as the economy gets traction and the new health care law covers more people. The nation's health care tab grew by just 3.6 percent in 2013, nonpartisan economic experts with the Health and Human Services department said in their report. That's the lowest annual increase going back to 1960, when the government began measuring. (Alonso-Zaldivar, 12/3)

Health spending in the U.S. grew in 2013 at the slowest rate ever recorded, a new government study indicates, marking the extension of a historic slowdown in medical spending that began after the last recession. Total spending on healthcare increased just 3.6 percent last year to $2.9 trillion, according to the study from independent analysts at the Department of Health and Human Services. That is down from 4.1% percent in 2012 and way down from 2002, when health spending increased by nearly 10%. (Levey, 12/3)

Health care spending in the U.S. grew last year at the lowest rate ever recorded, due in part to the Affordable Care Act, the Centers for Medicare and Medicaid Services said Wednesday. The slowing growth in health care spending to 3.6 percent from 4.1 percent in 2012 was attributed to factors including relatively slow economic growth and more gradual increases in private health insurance and Medicare spending, the CMS said. (Ungar and O'Donnell, 12/3)

America spent more than $2.9 trillion on health care in 2013, or about $9,255 per person, according to a government report released Wednesday. The 3.6 percent increase – from roughly $2.8 trillion in 2012 – was the smallest annual percentage hike since the data was first tracked in 1960, according to the Department of Health and Human Services. (Pugh, 12/3)

U.S. healthcare spending grew at the lowest rate ever recorded last year, in defiance of predictions that it would surge this year with Obamacare, experts said Wednesday. But it's still the highest per capita spending in the world, at $2.9 trillion for 2013, or $9,255 per person. (Fox, 12/3)

Health care spending increased 3.6 percent last year, the lowest rate of increase since the amount was first calculated in 1960, federal officials announced Wednesday. The cost of care reached $2.919 trillion last year, or a spending average of $9,255 per person. The final tally for 2013 was a slowdown from 2012, when spending grew 4.1 percent, and marked the fifth year in a row of low growth, said officials with the federal Centers for Medicare and Medicaid Services. (Landers, 12/3)

U.S. health care spending continued to grow slowly in 2013, largely because of Medicare and private insurance trends as well as a slowdown in hospital and physician spending. Officials with CMS’ Office of the Actuary said Wednesday that national health spending increased by 3.6 percent last year, following 4.1 percent growth in 2012. Total spending last year was $2.9 trillion, or $9,255 per person. (Pradhan, 12/3)

Health care spending grew at its lowest rate on record last year amid a relatively sluggish economy that has prompted consumers to spend more cautiously. A new report published in the journal Health Affairs Wednesday by the Centers for Medicare and Medicaid Services shows health spending grew by just 3.6 percent in 2013 — the lowest year-to-year increase ever recorded. This is down from the already low average growth rate of 3.9 percent for the previous four years. (Ehley, 12/3)

After a laundry list of glitches popped up last year, Obama administration officials set to work to fix the health law’s online insurance marketplace for small businesses. Now, two weeks after re-launching the federal exchange, it appears they have ironed out most of the technical problems. Now they have a different problem on their hands, one that no team of software engineers can solve: Disinterest from small employers. (Harrison, 12/3)

Snafus processing federal tax credits for 2014 health exchange customers have left Colorado insurance carriers waiting for payments totaling at least $20 million, exchange managers revealed on Monday. At the same time, an enrollment manager for Connect for Health Colorado in the western part of the state warned board members that she and fellow workers are having major problems enrolling people for 2015. The deadline to enroll for coverage that starts on Jan. 1 is Dec. 15. (Kerwin McCrimmon, 12/3)

MNsure is cutting its projection for commercial enrollment next year by one-third and says it will make up the lost revenue by cutting costs and spending federal grant money at a faster pace. Earlier this year, MNsure projected that about 100,000 people would buy private health plans through the state exchange by the end of 2015 — an estimate that amounted to a reduction from initial projections for commercial enrollment. (Snowbeck, 12/3)

MNsure on Wednesday said it was cutting by about one-third the number of people it expects will enroll in private health plans through the exchange for 2015. That means MNsure will also see a drop in revenue, although officials say they expect to end the fiscal year next June with no red ink. (Zdechlik, 12/3)

A player for the Frederick Keys baseball team will be featured in a radio ad to urge Maryland residents to enroll in health insurance under the Affordable Care Act. Maryland Health Care for All and the Frederick Keys are announcing the ad campaign on Thursday at the Keys’ stadium in Frederick. (12/4)

A story on NPR earlier this week described the “family glitch” in the Affordable Care Act. That’s when people can’t afford their insurance at work but make too much to qualify for subsidies in the new insurance exchanges. Many of these mostly middle-income Americans will remain uninsured. It also got us wondering, who else is being left out by the health law? And who is getting coverage? (Rovner, 12/4)

The nation’s second-largest health insurer has changed its corporate name to Anthem from Wellpoint to reflect a label familiar to consumers shopping for coverage. The Blue Cross Blue Shield insurer sells insurance in several states under the Anthem brand, which was the company’s corporate name before it bought WellPoint Health Networks a decade ago. It sells no plans under the WellPoint name. ... Anthem Inc. is one of the biggest players on the health care overhaul’s public insurance exchanges. These exchanges are pushing insurers to sell more coverage directly to consumers instead of through employers. (12/3)

If Medicaid expansion began in Virginia on July 1, Virginia would take in more than $230 million in federal offsets that would alleviate 71 percent of the state’s $322 million budget gap, according to Bill Hazel, the state secretary of Health and Human Resources. (Cain, 12/3)

More than 10 million people got covered by health insurance over the past year, bringing the rate of uninsured down from 17.7 percent to 12.4 percent, a new survey shows. The data from the left-leaning Urban Institute shows 10.6 million people gained health insurance between September 2013 and September 2014, thanks in large part to new health insurance exchanges and the expansion of Medicaid in 27 states plus Washington, D.C. (Fox, 12/3)

As a software engineer in this outer suburb of Washington, Sanjay Singh was literally and figuratively outside the Beltway in 2008 when the Affordable Care Act was finalized on Capitol Hill. That didn't matter to the self-described "public policy geek." He pored over the Senate Finance Committee's markup of the legislation and sat riveted in front of C-Span during the Senate markup of the health law. ... Six years later, a guy who made less than $200 a month in 1991 writing software code in India has a company with multimillion-dollar contracts with Massachusetts for its insurance marketplace and the federal government to run the Small Business Health Options Program (SHOP) exchange. (O'Donnell, 12/3)

Health insurance sign-ups through HealthCare.gov slowed over Thanksgiving week, the Obama administration said Wednesday. But they’re not hitting the panic button yet. A Thanksgiving slowdown was expected, because consumers are traveling, spending time with family, and going shopping. (12/3)

Earlier this year, the Obama administration quietly moved nearly $4 million in health insurance subsidy payments from one Treasury account to another. The budget director explained action in terms of "efficiency." But the House of Representatives says the transfer skirted the law and violated the Constitution — and is asking a court to strike down part of the Affordable Care Act as a result. That argument comes from a lawsuit filed by the House of Representatives last month as it attacks Obamacare on two fronts. The first, long-debated claim is that Obama did not have the power to delay a provision requiring large employers to provide health insurance for full-time employees. (Korte, 12/3)

President Obama and his closest aides have determined that their best chance of success in the next two years will depend on improved relationships on Capitol Hill, but their behind-the-scenes efforts are more focused on Obama’s own party rather than the Republicans who are about to take full charge of Congress in January. ... On the Republican side, much of the outreach has come from Cabinet members and other senior administration officials. Health and Human Services Secretary Sylvia Mathews Burwell hosted a November breakfast for the top Republicans and Democrats on committees that oversee her agency. (Eilperin, 12/3)

Veteran Democratic Sen. Tom Harkin (Iowa) has a less-than-glowing review of the Affordable Care Act — which he helped write and pass in 2010 — and in his final days in Congress is suggesting that Democrats should have considered scrapping the bill altogether. (DelReal, 12/3)

In an interview with POLITICO on Wednesday, the Wisconsin Republican said he’s going to use his new perch in the House to pursue what he calls “phase one” of tax reform — focusing only on the business Tax Code — while understanding that he’s not going to get it all while President Barack Obama is in office. But that doesn’t mean he’s giving up on the big ideas he’s pitching to shape the Republican Party’s agenda for 2016 — and possibly keep his options open for a White House run of his own. He’ll keep talking up his Medicare premium support plan and repeal of Obamacare, even though he doesn’t expect either has a shot before the end of Obama’s term. (Faler and Haberkorn, 12/3)

In a bipartisan show of unity, the House overwhelmingly approved a bill Wednesday to allow Americans with disabilities to open tax-free bank accounts to pay for expenses from education to housing and health care. The 404-17 vote approves the most sweeping legislation to help the disabled since 1990, affecting as many as 54 million disabled people and their families who often struggle to pay for intensive forms of care. It now goes to the Senate, where it was expected to move quickly to passage in the coming days. (Yen, 12/4)

Supporters of legislation that would allow Americans with disabilities to open tax-free savings accounts to pay for long-term expenses are urging a swift vote in the Senate after the House overwhelmingly passed the bill. (12/4)

Jawanda Mast is a mom on a mission. Every year, the 53-year-old Mast boards a plane from her home in Olathe to Washington, determined to persuade Congress to create tax-free savings accounts for people with disabilities. Her daughter Rachel, 15, was born with Down syndrome. For more than half her daughter’s life, Mast has made her annual pilgrimage to Capitol Hill and returned home disappointed. Despite bipartisan support from 85 percent of Congress, the so-called Achieving a Better Life Experience Act, or ABLE, has stalled short of a vote in either chamber for eight years — until now. (Wise)

The Children’s Health Insurance Program got a big boost under the Affordable Care Act, which called for an increase in federal funding for the program and required states to maintain 2010 enrollment levels through 2019. But in the waning days of the lame-duck Congress, it is still not clear when or whether funding for the federal-state, low-income children’s health plan known as CHIP will be authorized beyond Sept. 30, when it is set to expire. (Vestal, 12/4)

The Children's Health Insurance Program (CHIP) received a ringing endorsement from states that urged Congress to extend the program's funding at least through the end of 2019. Thirty-nine governors and state health officials wrote to lawmakers to praise CHIP as the House and Senate begin debate over the program's budget, which expires on Sept. 30, 2015. (Viebeck, 12/3)

The Office of Special Counsel (OSC) honored three Department of Veterans Affairs (VA) whistleblowers Wednesday, all physicians who had key roles in uncovering major issues at VA facilities. Because they and other whistleblowers came forward, problems such as the cover-up of long wait times for veterans seeking medical care were exposed. The wait-time scandal led to the resignation of the VA secretary and legislation providing the department with additional resources to meet patient needs. (Davidson, 12/3)

The Veterans Affairs office of inspector general announced Wednesday that it has begun investigating alleged misconduct at a Hibbing VA outpatient clinic. Numerous former clinic workers have claimed they were ordered to manipulate the schedules for veterans’ appointments to make it appear they were being seen within their desired appointment date when they were actually being seen as much as six to eight weeks out. (Brunswick, 12/3)

When Rob Arthur was diagnosed with brain cancer back in January, the gaunt, gray-haired Vietnam veteran decided to wed his longtime girlfriend, Debbie Shafer, in a hospital room. The marriage has been a source of comfort for this couple as they face the challenges of an unforgiving disease, deemed terminal, in a trailer home set by the steep flanks of the North Cascade mountains. It also has been a big source of stress in their dealings with the federal Department of Veterans Affairs (VA). Last summer, the VA ruled that Arthur — his earnings boosted by his wife’s wages as a nurse’s aide — was no longer eligible for an income-based pension and would have to repay $6,324 in checks mailed out during the more than six months that the department took to make this decision. (Bernton, 12/3)

Gov. Jerry Brown is considering expanding state-funded Medi-Cal coverage to residents shielded from deportation under President Obama’s new immigration policies. Nancy McFadden, the governor’s top policy aide, said that possibility is under review by the Brown administration, but implied that the potential cost would be a factor in the decision. (Willon, 12/3)

Mothers of children with mental illnesses gathered at the Capitol on Wednesday to urge the state to get serious about helping them. "If any other childhood disease killed at the rate of mental illness, people would demand the government intervene," said Tammy Nyden of Iowa City. "Do we not care about these children because their disorders happen to be of the brain, and not of the kidney or the heart? Really?" Nyden's 12-year-old son, Cole, has a range of mental disorders and has spent more than two years on a waiting list for services under a special state program. (Leys, 12/3)

This week, state health officials launched a new phase in the rural expansion of Medi-Cal managed care, moving about 24,000 medically complicated seniors and the disabled into managed care plans. (Gorn, 12/3)

It would have seemed the stuff of fantasy in the dark days of the 1980s, when an AIDS diagnosis was tantamount to a death sentence: a pill, taken daily, that could protect against HIV infection. But today, such a drug exists. The blue tablet, marketed as Truvada, has been available to people at risk of being exposed to HIV since 2012. ... It could have a dramatic effect in Los Angeles County, where about 47,000 people are known to live with HIV. Contracting the virus is no longer a death sentence because of a cocktail of drugs that suppress it, but the county still reports more than 1,000 new HIV infections each year. (Brown and Flores, 12/3)

The Kansas Department for Aging and Disability Services has suspended voluntary admissions to Osawatomie State Hospital, one of the state’s two inpatient facilities for people with serious mental illnesses. The decision, according to a memo sent to the state’s 26 community mental health centers late Tuesday afternoon, was driven by “ongoing and critical census challenges” at the state hospital. The memo also outlined procedures for handling patients who are involuntary admitted. In recent months, the 206-bed hospital has admitted record and near-record numbers of patients, causing dozens of patients to be triple-bunked in rooms meant for two. (Ranney, 12/3)

After several months of hearing testimony from providers and family members of people with traumatic brain injuries, North Carolina is recommending that lawmakers appropriate $2.2 million in recurring state dollars that would cover a wide array of services to Medicaid recipients with TBI. That money would also trigger federal dollars that match state dollars at a rate of two to one, meaning there could be as much as $6.6 million in services for TBI patients under a proposed Medicaid waiver. (Hoban, 12/4)

Gov. Terry McAuliffe (D) on Wednesday appointed a former lawmaker and abortion rights advocate to the Board of Health in time for a vote Thursday on whether the commonwealth will begin to overhaul regulations of abortion providers. (Portnoy, 12/3)

Thirty-four-year-old Karim works long days as an investment adviser, and when he doesn’t burn the midnight oil, he plays basketball or goes to the gym, hangs out with friends, or heads to coffee shops. You wouldn’t know he has an especially tough-to-treat illness. “I have multiple-drug-resistant tuberculosis,” he explains. It’s called that, because at least two of the most potent drugs conventionally used to squelch the tuberculosis bacterium don’t work on the strain of the illness that Karim has. So he needs to take a combination of drugs, with harsher side effects, for 18 months. That’s two to three times longer than the traditional treatment for tuberculosis. (Mogul, 12/3)

In September 2006, a pregnant woman named Peggy Young sent her bosses at United Parcel Service a doctor's note advising her not to lift anything heavier than 20 pounds for the first 20 weeks of her pregnancy, and then no more than 10 pounds until she gave birth. ... Young was told she couldn't continue to work as a delivery driver while pregnant. UPS also rejected Young's request for a temporary reassignment to duties with less physical stress. ... Women should not be penalized or forced out of the workplace simply because they become pregnant. UPS, in fact, has come around to that position. It now offers light-duty accommodations to pregnant women who need them. At the very least, the Supreme Court should rule that pregnant women deserve to be treated as well as workers who are injured on the job. (12/3)

In some ways, the pregnancy discrimination case argued today at the U.S. Supreme Court has turned out to be a beautiful thing. Groups that are usually at each other’s throats over reproductive rights are working together to persuade the justices that women should not be penalized by their employers when a pregnancy temporarily limits their ability to perform all aspects of a job. (Robin Abcarian, 12/3)

Some experts have counseled a zen-like patience while awaiting the Supreme Court's consideration of the King case, which involves federal subsidies for Affordable Care Act insurance plans and is expected to yield a decision sometime in July. We've observed that the prospect of subsidies being overturned in as many as three dozen states could or should spur action in those states, or in Congress, to head off the consequences. Julie Rovner of Kaiser Health News has made her own tour d'horizon of expert opinion, and finds that things may not be so simple. An adverse ruling by the Court could be very hard to counteract in the affected states, she finds. That's worrisome, especially because the data showing the effects of the ACA are very encouraging. (Michael Hiltzik, 12/3)

Inside the continuing slowdown in the growth in health spending is evidence that the American health care system may be changing in ways that could make it more affordable in the years to come. (Margot Sanger-Katz, 12/3)

Whatever else might be said of him, Chuck Schumer is not in the habit of self-immolation. But progressives have been lining up to vilify New York’s senior senator as the Democratic Party’s village idiot for saying before Thanksgiving that ObamaCare was a political mistake. He even said that focusing on health care, the party’s magic mountain, was “the wrong problem.” David Axelrod accused Sen. Schumer of being, ugh, a professional politician, whose “abiding principle” is how to win elections. That’s an understatement. (Daniel Henninger, 12/3)

Was heathcare reform a fatal political blunder by the Democratic Party? That thesis of Sen. Charles Schumer of New York, the third-ranking Democrat in the Senate, received a respectful airing this week from the veteran political journalist and New York Times columnist Thomas B. Edsall. Edsall observes that hostility to Obamacare from white voters is a menacing counterweight to the party's demographic advantages in the next presidential election. "Whatever you think of Senator Schumer," he writes, "you begin to understand why he spoke out as forcefully as he did." (Michael Hiltzik, 12/3)

In the four years since the Affordable Care Act was passed, health care in our country has become more complicated and expensive. The law has many troubling aspects, but the Independent Payment Advisory Board is among the worst and most dangerous. This is why, on Thursday, several members of the House will file an amicus brief asking the U.S. Supreme Court to take up Coons v. Lew. This lawsuit, filed by the Goldwater Institute on behalf of Dr. Eric Novack, an orthopedic surgeon, and Nick Coons, an Arizona businessman, challenges the constitutionality of IPAB. (Sen. Tom Coburn, R-Okla., and Rep. Phil Roe, R-Tenn., 12/3)

It's 's not always easy for restaurant-goers to figure out which options are the least fattening. Some diners at a California Pizza Kitchen, for example, might order the Moroccan-spiced chicken salad rather than a pizza, unaware that the salad packs 1,500 calories — three-fourths of the recommended allowance of calories for the average adult in an entire day. Few people would guess that pretty much any pizza on the CPK menu has significantly fewer calories, or that the restaurant offers a different salad with chicken that contains about half as many. (12/3)

The tragedy of the 20 schoolchildren and six educators massacred in Newtown, Conn., two years ago has only deepened with a state investigation’s finding that the mother of Adam Lanza, the 20-year-old shooter, rejected recommendations from psychiatric experts that her son be treated with medication and intense therapy for obsessive-compulsive disorder, anxiety and anorexia in years before the carnage at Sandy Hook Elementary School. (12/3)

I was working on the hospital infectious-disease service when our team was asked to see a young girl with a mysterious illness that no one had been able to diagnose. She had come to the emergency room with a fever and runny nose and had a rash spreading across her body. ... But when the senior doctor on our team, Frank Berkowitz, an expert in pediatric infections—arrived at her room, he knew the diagnosis immediately: She had measles. ... Measles is making a terrifying comeback in the U.S., with some 600 cases reported this year, more than in any year in the past two decades. There are two reasons: the ease of international travel, and an increasing number of people refusing vaccinations, usually on behalf of their children. (Haider Javed Warraich, 12/3)

Volunteer dentists and hygienists at the Dental Access Days clinic saw more than 1,400 patients and gave away more than $950,000 in care. If not for these free care clinics, many of these individuals would be seeking help at hospital emergency departments. Between 1.3 percent and 2.7 percent of all ER visits nationwide that don’t result in a hospital admission are dental emergencies, according to a 2010 Health Resources and Services Administration report. ... On Monday, the S.C. Department of Health and Human Services implemented an adult preventive dental benefit for members age 21 and older who have full Healthy Connections benefits. Covered services include preventive care such as cleanings, minor fillings and x-rays. These most common services help catch disease early and keep mouths healthy. (Rebekah Matthews, 12/4)

As a nurse, I know to rely on primary care providers who understand my health risks and will talk with me about what tests and treatments I should avoid, as well as those I need. But what do people do who are not health professionals? Choosing Wisely (www.choosingwisely.org), an initiative of the American Board of Internal Medicine Foundation, is designed to spark conversations among patients, physicians, and other health professionals about appropriate tests and procedures—those “supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary.” That sounds like common sense, but our system doesn’t always support a common-sense approach. (Diana Mason, 12/3)

Although complex interactions between neighborhood-level determinants of health and individual patient characteristics occur primarily outside the delivery system, they have a profound effect on how patients interact with the system and ultimately on the quality of the care they receive and their health outcomes. The likelihood of hospital readmissions, for example, depends more on characteristics of individual patients and the surrounding community than on features of the discharging hospital. A promising approach to achieving this linkage is community-based performance measurement — reporting and acting on clinical performance measures at the community level, rather than at the level of delivery-system units such as hospitals or physicians. (Drs. Thomas D. Sequist, and Elsie M. Taveras, 12/4)

[T]he time has come to reimagine quality measurement. ... quality measurement should be integrated with care delivery rather than existing as a parallel, separate enterprise; it should acknowledge and address the challenges that confront doctors every day — common and uncommon diseases, patients with multiple coexisting illnesses, and efficient management of symptoms even when diagnosis is uncertain; and it should reflect individual patients' preferences and goals for treatment (Elizabeth A. McGlynn, Eric C. Schneider and Eve A. Kerr, 12/4)