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With a month to go in the 2015 open enrollment season, the Obama administration says sign-ups under the president's health care law are edging higher. The Health and Human Services Department says at least 163,000 people signed up last week for subsidized private health insurance. (1/14)

With only a month left to sign up for online-marketplace health insurance this year, the Obama administration and support groups are ramping up their outreach efforts as the Feb. 15 deadline nears. (Pugh, 1/14)

Obamacare enrollment groups are working to “double down” on tactics to get Latinos covered, but they’re not saying whether their effort is yielding the same degree of results. (Wheaton, 1/14)

The federal government says more than 290,000 Michiganians have signed up for the Affordable Care Act's Health Insurance Marketplace, one day ahead of Thursday's enrollment deadline. The U.S. Department of Health and Human Services said Wednesday that 290,439 people had signed up by Friday. Thursday is the deadline for people to get insurance starting Feb. 1. (1/14)

Consumers have through Thursday to enroll in a health plan on HealthCare.gov in order for their coverage to take effect on Feb. 1. Missouri and Illinois residents will still have one month to enroll in 2015 coverage after Thursday's deadline, but it won't start until March if they wait. The online marketplace has been emailing reminders to consumers with accounts ahead of the deadline. (Shapiro, 1/14)

Almost 400,000 Georgians are signed up for coverage in the 2015 health insurance exchange, federal officials announced Wednesday. The Georgia signup total as of Jan. 9 greatly exceeds the state’s 316,543 enrollees during the first open enrollment last year. The enrollment period this year ends Feb. 15. (Miller, 1/14)

A growing number of Texans are selecting insurance plans under the federal Affordable Care Act, according to federal officials Wednesday. (Jacobson, 1/14)

Colorado's state-run health insurance exchange is going before state lawmakers to answer questions about mismanagement allegations in a recent state audit. Connect For Health was scheduled to brief lawmakers Thursday afternoon. The presentation gives lawmakers their first chance to grill the exchange managers since a report last month criticized some management decisions at the exchange. (1/15)

Senate DFLers have introduced a bill that would eliminate the MNsure board, and create a new state department to manage Minnesota’s health insurance exchange. Coupled with MNsure legislation last week from leaders of the new Republican majority in the House, the bill from top Senate Democrats helps establish the terms of debate over reforming the health exchange during this year’s legislative session. (Snowbeck, 1/14)

Not only do more Americans have health insurance, but the number struggling with medical costs has dropped since President Barack Obama's health care law expanded coverage, according to a study released Thursday. The Commonwealth Fund's biennial health insurance survey found that the share of U.S. adults who did not get needed care because of cost dropped from 43 percent in 2012 to 36 percent last year, as the health care law's main coverage expansion went into full swing. (Alonso-Zaldivar, 1/15)

From 2012 to 2014, the share of consumers delaying a recommended test or treatment or not filling a prescription fell by nearly a third. And the percentage who reported problems with medical bills fell by almost a quarter. Those are the first declines ever recorded by the biennial national survey by the nonprofit Commonwealth Fund, which began asking Americans about the affordability of medical care a decade ago. (Levey, 1/14)

Taxpayers are facing the worst service from the Internal Revenue Service since at least 2001, with more than half of callers unlikely to get through to the agency and average hold times of 30 minutes or more, according to a new government report. ... In addition to congressional budget cuts pushed by conservative Republicans in recent years, the agency also faces heavier workloads stemming from Mr. Obama’s signature Affordable Care Act, as well as new reporting requirements for foreign financial accounts, the report said. (McKinnon, 1/14)

The IRS is cutting taxpayer services just as President Barack Obama's health law is making filing a tax return more complicated. The agency blames budget cuts enacted by Congress. An IRS watchdog says service problems at the tax agency will make complying with the law harder for well-intentioned taxpayers. (1/15)

Elizabeth MacDonough holds no elected office. Few people outside of Capitol Hill even know her name. And forget about knowing her political leanings or loyalties. But she may very well be the most powerful person in Washington in determining how far Republicans can go in trying to repeal Obamacare. (Haberkorn, 1/14)

Republicans head to an annual retreat this week wrestling with a subject that many within the caucus have preferred to avoid: whether to use a divisive procedural tool to attempt to repeal President Barack Obama‘s signature health law. On Thursday, the chairmen of the six relevant committees–Senate Finance, Senate Commerce, and the Senate Health, Education, Labor and Pensions committees, and their House counterparts–will headline a panel discussion about health policy. (Hughes, 1/14)

HHS Secretary Sylvia Mathews Burwell plans to extend a hand today to the new Republican-controlled Congress to work together on health care issues, sans Obamacare repeal. It’s an effort to move beyond the contentious politics of the Affordable Care Act and onto issues where both parties typically agree, such as improving health care quality, strengthening global health security and improving research capabilities and innovation. (Haberkorn, 1/15)

The head of the U.S. Chamber of Commerce made a pitch Wednesday to repeal multiple taxes under ObamaCare as well to change the law's much-criticized definition of a full-time employee. “In healthcare, we support congressional efforts to restore the 40-hour workweek to define who must be covered under the employer healthcare mandate," the group’s president and CEO, Thomas Donohue, said during the annual State of American Business address. (Ferris, 1/14)

Republicans and Democrats alike want Congress to pass an annual budget, drive down college costs and preserve Medicare for future generations. Splits emerge over more divisive issues like approving the Keystone XL pipeline, changing the Affordable Care Act, or repealing it entirely. Those are just some of the conclusions from a recent nationwide poll commissioned by Crossroads GPS and the American Action Network, two groups that back congressional Republicans. (O'Connor, 1/15)

Republicans are reviving efforts to replace Medicare’s oft-criticized physician payment formula before scheduled cuts take effect April 1, with plans to discuss the path forward at their retreat this week and a two-day House hearing the next. (Attias, 1/14)

Women’s reproductive rights are in danger of being rolled back with a new Republican-led Congress, Planned Parenthood says — as House lawmakers prepare to vote on abortion curbs the same day as an annual anti-abortion rally next week. (Zanona, 1/14)

Republican Sen. Rand Paul said Wednesday that some people “game the system” to receive disability payments they don’t deserve and later criticized the federal government for not doing an adequate job policing a system he says needs reform. During a meeting with Republican state lawmakers, Paul said fraud is a widespread problem in disability programs that help people who are injured at work. He joked that “half the people on disability are either anxious or their back hurts.” (1/14)

Obama will also sign a presidential memorandum granting federal employees six weeks paid leave after the birth of a child and six additional weeks of unpaid administrative leave, Jarrett said, adding that Obama would call on cities and states to adopt similar measures. The president will outline a new plan to help states create paid leave programs, and provide new funding through the Department of Labor for feasibility studies that will help other states and municipalities figure out the best way to implement programs of their own, Jarrett said. (Mufson, 1/14)

President Barack Obama will outline a plan Thursday to help states create paid leave programs and to fund Labor Department feasibility studies on paid leave. “This is not a partisan issue; this is a family issue, and it’s an economic issue,” senior adviser Valerie Jarrett said in a conference call with reporters. (Levine, 1/14)

The ruling issued Wednesday by Judge Richard Leon on the U.S. District Court for the District of Columbia is a blow to the Obama administration and worker advocacy groups that fought for the added protections and a victory for trade groups that challenged the rule on behalf of third-party home care providers. “The department is trying to do through regulation what must be done through legislation,” wrote Judge Leon, who struck down another key portion of the rule in December. “I cannot help but conclude that Congress’s intent in 1974 to exempt from minimum and overtime wage requirements domestic workers providing services—including care to the elderly and disabled—is still as clear today as it was forty years ago,” he said. (Trottman, 1/14)

A federal judge on Wednesday overturned Labor Department regulations requiring overtime and minimum wage protection for 2 million home health care workers. In his decision, U.S. District Judge Richard Leon said that the Labor Department's concerns about wages for home care providers are understandable, but that Congress is the appropriate forum in which to debate a complex issue affecting so many families. (Yost, 1/14)

Federal agents on Wednesday raided the offices of a Boca Raton, Fla., medical-equipment supplier with an executive who was the inspiration for a “Wolf of Wall Street” character. Daniel Porush, an executive at Med-Care Diabetic & Medical Supplies Inc., was a former associate of Jordan Belfort, the stockbroker whose boiler-room tactics ultimately landed both men prison sentences. The 2013 film, “The Wolf of Wall Street,” was based on their exploits and starred Jonah Hill as the character inspired by Mr. Porush. (Weaver, Stewart and Carreyrou, 1/14)

FBI agents and other investigators spent hours Wednesday apparently collecting evidence at a South Florida medical supply firm with links to “The Wolf of Wall Street” film amid accusations of Medicare fraud. FBI spokesman Jim Marshall confirmed that the bureau was “conducting law enforcement activity” at the offices of Med-Care Diabetic and Medical Supply Inc. in Boca Raton. News media photos and video showed agents from the FBI and other agencies carting out boxes of files and other materials from the office. (1/14)

A federal watchdog has warned - yet again - that financial incentives in Medicare may be warping the ways that hospice care works in the U.S. In a report released Wednesday, the inspector general for the Department of Health and Human Services warns that some hospices appear to have sought higher profits by focusing on patients living in assisted living facilities. (Whoriskey, 1/14)

The world's biggest drugmakers face a new reality when it comes to U.S. pricing for their products as insurers use aggressive tactics to extract steep price discounts, even for the newest medications. Big Pharma executives acknowledged the depth of change this week during public presentations and interviews with Reuters at the J.P. Morgan Healthcare conference in San Francisco. Drugmakers have long relied on their ability to charge whatever they deemed appropriate in the U.S., the world’s most expensive health care system. (Beasley and Humer, 1/15)

Gov.-elect Greg Abbott has enlisted two state government veterans to quickly review contracting practices and oversight in Medicaid and social services programs. The incoming GOP chief executive asked former deputy comptroller Billy Hamilton and Agriculture Department financial officer Heather Griffith Peterson to conduct an independent review of “management, operations, and contracting” at the Health and Human Services Commission. (Garrett, 1/14)

Fallout over $110 million in no-bid state contracts widened Wednesday when Republican Gov.-elect Greg Abbott ordered a review into Texas' sprawling health agency that is already under criminal investigation. Leading the newest round of scrutiny is Billy Hamilton, a journeyman in state government who was called to mend the Cancer and Prevention Research Institute of Texas in 2013, when that $3 billion agency also unraveled because of questionable contracts. (Weber, 1/14)

The California Department of Public Health this week released a draft of its strategic plan to cut down on the disparities in mental health care for minorities and other groups. (Gorn, 1/14)

Two Upper Manhattan elected officials released a report Wednesday sharply criticizing New York-Presbyterian/Columbia University Medical Center in Washington Heights for what it dubbed substandard care for poor patients in the hospital’s emergency room. State Sen. Adriano Espaillat and New York City Council Member Ydanis Rodriguez, who represent the Washington Heights area, released the report, with Mr. Espaillat calling the emergency room’s services “a tale of two hospitals,” referring to different levels of care provided to patients with private insurance and those “for poor people, people who come to the emergency room on a regular basis.” (Janos, 1/14)

The Business Health Care Group, a coalition that includes several of the largest employers in southeastern Wisconsin, will be taking a new approach to controlling health care costs starting next year. The group has reached a multiyear agreement with UnitedHealthcare that will enable coalition members to offer a health plan that gives employees and their family members a financial incentive to get care from physicians the insurance company says provide quality care at a lower cost. (Boulton, 1/14)

Two Colorado legislators plan to introduce their Dying with Dignity bill this week, setting the stage for what likely will be one of the most intense and emotional debates of the session. (Carman, 1/14)

For the last two years, Landrum has been working without an office, but he’s happy to meet his patients wherever they are. Sometimes, the meetings occur in a home; sometimes they take place in a parking lot. Other patients meet the doctor on the side of a quiet country road — or inside his 2007 Toyota Camry. The location doesn’t matter because Landrum, a World War II veteran who has been in private practice for more than 55 years, believes it’s his duty to help anyone who calls on him. ... But his work may soon come to an end. Landrum said he’s being asked by the Mississippi State Board of Medical Licensure to surrender his medical license, which he’s carried in his pocket with pride since Dwight D. Eisenhower was president. The reason for the request, according to Landrum, is that the board balked several months ago upon learning that he was operating his practice out of a car. (Holley, 1/14)

Neva Holt stood in a kitchen for years whipping up coconut cake and patting out hamburgers — food she sold from her Lyles, Tenn., cafe that generated sales tax revenue for the state — but when she got old and needed nursing home care, Tennessee didn't give anything back. She got kicked out of a nursing home because TennCare, the state's Medicaid agency, wouldn't pay. TennCare determined she didn't qualify for coverage, contending she had owned land that she transferred to her grandchildren — assets that should have been used to cover the cost of a nursing home. The family appealed and ultimately had TennCare's determination overturned this month. It was a hollow victory. Holt died at age 88 — six days before the decision came down. (Wilemon, 1/14)

Almost two-thirds of people with HIV have the illness fully in check, with the virus at extremely low levels in their blood. The measures taken by the state to control the virus — near-universal health coverage and a robust network of social services — could serve as a national model. (Freyer, 1/15)

The Republicans seem determined to "repeal and replace"Obamacare. They simply cannot bring themselves to consider fixing what they have come to revile. Being against the president's namesake legislation has been a big winner in at least two out of the past three elections. But now that Republicans are in charge of the Congress, just attacking Obamacare won't work. They have to put something on the table. (Robert Laszewski, 1/14)

Health insurance reform can and should be fixed. Obamacare is an overregulated monster of an insurance marketplace reform that violates a basic marketplace rule ­­­­–– it doesn't meet most customers' needs because of its individual mandate and penalties, its limited choices, high deductibles, still high premiums and narrow provider networks. But there are many parts of it that should be kept and built upon. (Robert Laszewski, 1/14)

On Medicaid expansion, Sen. Charles Scott needs to get on board or get out of the way. At the moment, the Casper Republican is trying to play the spoiler. He's lambasting a reasonable expansion plan as some lunatic European-like scheme and pushing his own expansion version, a retread of a plan Scott long has pushed but the state doesn't want. It's a tired, dog-whistle approach, and we expect better from Scott. We're not the only ones who feel this way. (1/14)

The Affordable Care Act is raising costs, restricting patient choice and doctor freedom, and putting bureaucrats in the treatment room. It isn’t good—but it’s here to stay, largely intact, at least until a Republican president can work with a Republican-controlled Congress. But that doesn’t mean nothing can be done. The onus is now on physicians to innovate and improve patient outcomes within the restrictive confines of an ObamaCare world. (Gerard J. Gianoli, 1/14)

After rising for a decade, the number of Americans experiencing financial distress from their medical bills has started to decline, a new survey has found. The result provides new evidence that the Affordable Care Act, by providing uninsured people with health insurance, is also improving their financial security, a major goal of the law. (Margot Sanger-Katz, 1/15)

The real problem in the out-years comes with automatic spending that makes up the biggest portion of the federal budget. Social Security and Medicare are popular middle-class programs, and it’s politically risky for Republicans to tinker with them. The GOP usually tries to root out waste and fraud in welfare programs aimed at helping the poor; but in the process, Republicans are often accused of being insensitive to the needs of the poor. Yet you can’t balance the budget by not touching entitlements. (John Feehery, 1/14)

Eli Lilly charges more than $13,000 a month for Cyramza, the newest drug to treat stomach cancer. The latest medicine for lung cancer, Novartis’s Zykadia, costs almost $14,000 a month. Amgen’s Blincyto, for leukemia, will cost $64,000 a month. Why? Drug manufacturers blame high prices on the complexity of biology, government regulations and shareholder expectations for high profit margins. In other words, they say, they are hamstrung. But there’s a simpler explanation. (Peter B. Bach, 1/14)

University of Pennsylvania bioethicist Dr. Ezekiel Emanuel struck again the other day with a recommendation that many Americans might see as a message from the Ivory Tower: Skip your annual physical because it's “worthless.” This after the healthcare reform law he played a role in crafting made such exams available to many Americans free of charge under their insurance. ... Actually, there are practical reasons why such exams are necessary, at least for now. (Harris Meyer, 1/14)