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About 150 million taxpayers are expected to file returns during the coming tax season, said Mark Mazur, assistant secretary for tax policy at the Treasury Department. The tax-filing process this year is expected to be trickier because Americans will, in some cases, have to pay a penalty or get smaller refunds because credits they received to offset insurance premiums were too large. Up to 20% of tax filers—or about 30 million—who weren’t insured for most or any of last year likely will request and receive an exemption from the penalty, officials said. Many exemptions can be applied for during the tax-filing process. (Armour, 1/28)

The Obama administration estimates that up to 29 percent of U.S. taxpayers could have to take the law known as Obamacare into account as they complete their 2014 income tax returns, officials said on Wednesday. (1/28)

An estimated 3 million to 6 million households that file 2014 income tax returns might incur penalties this tax season for failing to secure health insurance last year under the Affordable Care Act. Senior officials at the Treasury and Health and Human Services departments wouldn’t confirm the estimates during a telephone briefing Wednesday. They did, however, say that 2 percent to 4 percent of an estimated 150 million taxpayers are likely to be penalized. (Pugh, 1/28)

Two to 4 percent of taxpayers will end up paying a fine because they didn't have health insurance last year, federal health officials predicted Wednesday. This is the first year that Americans will have to worry about health insurance at tax time. The 2010 Affordable Care Act requires that just about everyone have health insurance or else pay a fee in the form of some extra income tax. (Fox, 1/28)

Up to one in five tax filers may claim an individual mandate exemption, and between two and four percent of taxpayers are likely to pay fines for not having insurance under Obamacare, a top Treasury official said Wednesday. (Dixon, 1/28)

Recalcitrant red states have done little — or nothing — to promote Obamacare. Yet their residents are getting health coverage by the millions. Across the country, efforts to resist or undermine the law persist. Calls for repeal haven’t died down. Most of the states with Republicans in control aren’t running their own insurance exchanges, but their residents are still getting covered and still getting subsidies — unless the Supreme Court in an upcoming case rules that the subsidies are illegal in states using healthcare.gov. (Pradhan, 1/29)

The challengers in the latest Supreme Court battle over the Affordable Care Act point to former Nebraska Sen. Ben Nelson as evidence of their claim that Congress intended that tax credits go only to qualified recipients in states that had established their own insurance exchanges. Nelson, a Democratic holdout as Congress debated the bill, insisted that states take the lead in establishing the exchanges. And the challengers use that to support their theory that Congress was using the tax credits to induce states into establishing the exchanges, rather than having the federal government do it. But Nelson, who announced his retirement in 2011, speaks for himself in a brief filed by Democratic congressional leaders and others. (Barnes, 1/28)

California officials say more than 90 percent of Obamacare customers renewed their policy for 2015, but the state still faces an uphill climb to reach its goal of 1.7 million enrolled before next month's sign-up deadline. The state's insurance exchange reported renewal figures for the first time Wednesday along with an update on new enrollment. (Terhune, 1/28)

When it comes to health insurance, Californians seem to value consistency. Of the 944,000 people who were could renew their coverage for 2015 through Covered California, the state’s health insurance exchange, 94 percent stayed in the same plan that they were in last year. About a third of them shopped for other plans available on the exchange, but few ended up making a change. The other two-thirds took no action and were automatically re-enrolled in their plan from last year. (Gold, 1/29)

Maryland health exchange officials told the Senate Finance Committee of the General Assembly Wednesday that 191,000 people had signed up for public and private insurance during open enrollment, which lasts until Feb. 15. The exchange, created under the Affordable Care Act for people who do not get insurance through employers, enrolled more than 96,000 in private plans, and there were 95,000 new Medicaid enrollees. (McDaniels, 1/28)

Gov. Mark Dayton's new budget calls for more Department of Human Services funding to help DHS cover its share of MNsure's expenses. Dayton wants lawmakers to allocate an additional $11.6 million to the department. (Zdechlik, 1/28)

County government officials voiced frustrations Wednesday over their struggles to use MNsure for people who need help from government social service programs. (Snowbeck, 1/28)

Republican lawmakers Tuesday passed two bills out of the Senate to beef up scrutiny of the state health insurance exchange by reviewing executives' bonuses and expanding its performance audit. A bill requiring any pay bonus for Connect for Health Colorado executives to be approved by the Legislative Health Benefit Exchange Implementation Review Committee passed on a party-line vote, 24-11. A bill giving the state auditor authority to conduct an expanded performance review of Connect for Health operations passed unanimously, 35-0. (Draper, 1/28)

Colorado’s health exchange likely will be subject to much more intense financial scrutiny after a bill calling for a full audit passed the Colorado Senate unanimously on Tuesday. (Kerwin McCrimmon, 1/28)

Nearly half of Americans lacking health insurance during the first year of the health law’s marketplaces appeared to be eligible for government assistance, but two-thirds of them said they found the health plans too expensive or were told they didn’t qualify, according to a survey released Thursday. Far fewer cited reasons often mentioned in political circles: a philosophical opposition to the 2010 health law or sign-up difficulties cause by the early technical problems experienced by the government’s healthcare.gov enrollment website, according to the Kaiser Family Foundation survey of 10,502 non-elderly adults. (Rau, 1/29)

One of the greatest promises of the Affordable Care Act is that if you are sick or get sick, health insurers can no longer charge you more or avoid covering you altogether. They have to provide coverage to anyone who wants it, and they're not allowed to cherry pick healthier customers over sick customers. But patient groups say they've spotted an alarming trend of some health insurance plans designing drug benefits to purposefully keep out sicker, costlier patients. It's currently the subject of a federal complaint, and a new study offers evidence this is happening across the country. (Millman, 1/28)

Insurance companies, perhaps more than previously thought, may be charging the sickest patients extra for drugs under the federal health law, in an effort to discourage them from choosing certain plans, according to a study released Wednesday. One of the cornerstones of President Obama's signature health law forbids insurance companies from turning away people with pre-existing conditions such as diabetes or cancer. Yet hundreds of patient advocacy groups say insurance companies have found a way to discriminate against these people, who are more expensive to cover because they require life-long treatments. (Kennedy, 1/28)

Drugs to treat H.I.V. and AIDS are being priced out of reach for many patients enrolled in insurance plans through the new health care exchanges, despite warnings that such practices are illegal under the Obama administration’s health care law, according to a new analysis by Harvard researchers. (Thomas, 1/28)

Some insurance companies may be using high-dollar pharmacy co-pays to flout the Affordable Care Act's (ACA) mandate against discrimination on the basis of pre-existing health problems, Harvard researchers claim. These insurers may have structured their drug coverage to discourage people with HIV from enrolling in their plans through the health insurance marketplaces created by the ACA, sometimes called "Obamacare," the researchers contend in the Jan. 29 issue of the New England Journal of Medicine. (Thompson, 1/28)

Lawmakers in Wyoming are working toward an agreement that would allow the state to accept hundreds of millions of federal dollars to expand the state’s Medicaid program. Members of the Republican-dominated legislature will meet Wednesday to craft a compromise between two competing measures that would allow an estimated 17,600 low-income Wyoming residents to gain coverage. (Wilson, 1/28)

California’s Medi-Cal program has grown to cover nearly half of the state’s children, causing policymakers and child advocates to question the ability of the taxpayer-funded program to adequately serve so many poor kids. In the past two years alone, the program has added nearly 1 million young people up to age 20, including those newly eligible for Medi-Cal coverage under the Affordable Care Act. The increase brings the total number of young people on Medi-Cal to 5.2 million, more than ever before. (Ostrov, 1/29)

In a rare show of bipartisanship over President Barack Obama's health care law, a Senate committee voted unanimously Wednesday to exclude veterans from the 50-worker threshold that triggers required coverage for employees under that statute. The Senate Finance Committee vote was 26-0, a departure from the usual party-line fights over Obama's showcase 2010 law. (Fram, 1/28)

The first Obamacare bill to get a vote in the new GOP-controlled Senate is not going to be legislation to repeal the law, defund the law or otherwise undermine the law. Instead, it’s an overwhelmingly bipartisan measure to exempt veterans from the law’s employer mandate count. (Haberkorn and Mershon, 1/28)

Division in Washington is nothing new, but gridlock and inaction seems not to be an option this year. A series of fiscal showdowns will be coming, starting with an end to Department of Homeland Security funding on Feb. 28, a sharp cut in physician payments under Medicare on March 31, the depletion of the highway trust fund on May 31, a debt-ceiling showdown this summer or fall and the return of across-the-board mandatory cuts known as sequestration on Oct. 1. (Weisman, 1/28)

Sen. Dick Durbin (D-Ill.) is renewing his effort to boost funding for the National Institutes of Health (NIH) at a time when he says declining research dollars is “threatening our standing as a leader” in scientific innovation. The bill, the American Cures Act, would create a mandatory funding stream to support research by the NIH, the Centers for Disease Control and Prevention and other agencies. (Ferris, 1/28)

The medical device industry released a survey of its members Wednesday suggesting that 18,500 American jobs were lost due to the direct effects of a 2.3 percent excise tax on manufacturers that the companies want Congress to repeal. The Advanced Medical Technology Association President and CEO Stephen J. Ubl said the trade group, also known as AdvaMed, would use the survey to help increase support for repeal legislation. (Adams, 1/28)

The trade group for makers of generic medicines is objecting strongly to a provision regarding product exclusivity in a sweeping House proposal for overhauling regulation of health products, although it says it supports other items in the draft bill from Energy and Commerce Chairman Fred Upton. The response from the Generic Pharmaceutical Association may illustrate some of the challenges ahead for Upton and colleagues in crafting what they call the committee's "21st Century Cures" initiative. (Young, 1/28)

Lawyers for the White House are urging a federal judge to dismiss a lawsuit filed by the Republican-led House of Representatives that alleges President Barack Obama illegally rewrote the new health law. The president in public comments has attacked the lawsuit as a stunt, but a court brief drafted by a team of Department of Justice lawyers marks the first time the White House has articulated to a judge why the case shouldn’t be heard. (Gershman, 1/28)

Anthem has hiked its quarterly cash payout to shareholders by nearly 43 percent to keep up with its rising stock price after edging past Wall Street forecasts for the recently completed fourth quarter. ... Investors have been warming up to health insurance stocks for a few years now after watching the sector weather taxes, fees and other changes brought by the health care overhaul, the massive federal law that aims to cover millions of uninsured people. They now see much less uncertainty ahead for the industry. (1/28)

The country’s second-largest health insurance company said Wednesday that it far outpaced its enrollment expectations last year, with most of that growth coming from the expansion of Medicaid in dozens of states. Insurance giant Anthem enrolled 1.8 million new customers in 2014, with nearly half of the new plans coming from Medicaid programs, its chief executive told reporters Wednesday. (Ferris, 1/28)

Several of the nation's largest health systems and insurers are joining together in a new task force with the goal of shifting 75% of their business to contracts with incentives for quality and lower-cost healthcare. The Health Care Transformation Task Force includes some of the largest U.S. health systems, including Ascension, St. Louis, and Trinity Health, Livionia, Mich., and insurance giants Aetna and Health Care Service Corp. Employer Caesars Entertainment and the Pacific Business Group on Health also are involved. (Evans, 1/28)

The battle for market share in the booming business for hepatitis C drugs is shifting to state Medicaid programs, which are busy negotiating discounts and supply deals with pharmaceutical companies. Missouri and Connecticut are among the states that are either negotiating or securing discounts on expensive new hepatitis C drugs in exchange for making them the preferred options for their state’s Medicaid recipients. (Loftus, 1/28)

UnitedHealth Group Inc., the biggest U.S. health insurer by sales, picked Gilead Sciences Inc.’s Harvoni as its preferred hepatitis C treatment, according to a person familiar with the matter. The decision applies to UnitedHealth’s fully insured commercial customers, as well as to Medicaid and Medicare members. The Minnetonka, Minnesota-based insurer has about 45 million U.S. health-plan customers, though not all follow the company’s drug picks. (Tracer, 1/28)

The California-centered measles outbreak has spread to Michigan, as the number of cases climbed to 95 in eight states and Mexico, officials said Wednesday. The California Department of Public Health confirmed that there are now 79 cases in the state, of which 52 can be linked directly to Disneyland. Some people who were contagious visited in January as well as December. (Xia, 1/28)

The measles outbreak that originated in California’s Disneyland has now spread to seven people in Arizona, with up to 1,000 people in the state potentially exposed to the disease, including nearly 200 children. According to public health authorities, there are now 79 confirmed cases in California, 52 that have been linked to Disneyland. In addition to Arizona, cases have been reported in Colorado, Michigan, Nebraska, Oregon, Utah and Washington state — all connected to California, according to state health officials. (Bever, 1/29)

Most of the cases are in California and most of those infected were not vaccinated. (Neighmond, 1/28)

A bipartisan bill that would bolster telehealth across Colorado by preventing insurance plans from requiring in-person care to patients when it can be appropriately provided remotely passed the House Wednesday. The bill, which now moves to the Senate, would expand current state law on telehealth — care delivered remotely via computers, cameras, smartphones and other devices. Insurance companies can require in-person health care delivery, as a condition of coverage, for patients residing in counties with more than 150,000 residents. (Draper, 1/28)

Four years after an aggressive legislative effort to keep Planned Parenthood from receiving state dollars for health care for low-income women, the Texas Senate is back at it — this time over funding for breast and cervical cancer screenings. The proposed Senate budget would change how funding is distributed from the joint federal-state Breast and Cervical Cancer Services program, which provides cancer screenings for uninsured women. (Ura, 1/28)

The movement to transform the way medical care is paid for — by rewarding the quality of care over the quantity — received a big push Wednesday from a national coalition of health organizations, including three major players in Massachusetts. (McCluskey, 1/28)

Maryland Gov. Larry Hogan (R) said Wednesday that he would allow three late-hour regulations drafted by his Democratic predecessor to move forward, including a measure that prohibits discrimination in the state Medicaid program on the basis of sexual orientation and gender identity. (Wagner, 1/28)

A bill aimed at giving young women free or low-cost IUDs and dramatically cutting the teen birth rate in Colorado is expected to be introduced in the Colorado House by the end of this week. (Kerwin McCrimmon, 1/28)

Last month, a Miami child welfare judge ordered the state to find beds at mental health treatment centers for two siblings, both of whom had become grievously ill from abuse or neglect. When administrators from the Department of Children & Families returned to court Wednesday, they had met the judge’s order half-way. One of the two children, DCF said, had been admitted to a residential treatment center for psychiatric care. The other was still waiting for a bed. Miami-Dade Circuit Judge Michael Hanzman chided lawyers and administrators at both DCF and the Agency for Health Care Administration — which runs the state Medicaid program for needy Floridians, and is responsible, at least indirectly, for securing treatment beds — for making children like the siblings wait for necessary care. (Miller, 1/28)

Nearly one year after lawmakers and small-business owners cast a critical eye at the contractor managing mental health and substance treatment for Idaho's poor, company officials say approval ratings remain high and problems are few. Executives from Optum, a unit of UnitedHealth Group, told the House Health and Welfare Committee on Wednesday that they had a 95 percent satisfaction rating among members who receive services from Medicaid mental health providers. (Kruesi, 1/28)

While Forest Health Medical Center [in Ypsilanti, Mich.] appeared on a list of hospitals and clinics penalized by the Centers for Medicare & Medicaid Services, its administration says the hospital actually was rated very well. The Centers for Medicare & Medicaid Services (CMS) rated hospitals across the country and penalized those with high rates of potentially avoidable mistakes known as hospital-acquired conditions by reducing their Medicare payments by 1 percent over the 2015 fiscal year. (Baird, 1/28)

Dallas has some of the most expensive hospitals in the country for patients getting surgeries covered by private insurance, the U.S. Government Accountability Office reported Wednesday. (Landers, 1/28)

As the popularity of electronic cigarettes continues to grow, California’s top public health official warned residents Wednesday about their dangers and announced a new campaign to reduce their use. Dr. Ron Chapman, director of the California Department of Public Health, said he feared that the increased use of e-cigarettes could chip away at the gains California has made in reducing smoking rates and changing the culture of smoking. The state has the second-lowest adult smoking rate in the nation, he said. (Gorman, 1/29)

The Affordable Care Act was supposed to simplify Medicaid’s myriad programs across the country to provide a more uniform medical safety net for poor Americans in every state. It hasn’t worked out that way. In fact, Medicaid programs now vary more widely state to state and even within states than they did before. (Margot Sanger-Katz, 1/28)

Conservatives in Washington are increasingly confident that the Supreme Court will rule this summer that the White House has gone beyond its legal authority in implementing the Affordable Care Act. ... It's true that taking away the subsidies now would be disruptive, but the court can't let itself be swayed by that argument. Otherwise, it would be saying that the more people a lawless presidential action affects, the more untouchable it should be. Congress and state legislatures are the proper forums for resolving this problem. Both will be under enormous pressure to do so if the court rules against the IRS and people lose their subsidies. That's why a lot of the commentary about the case as a death knell for Obamacare is overstated. (Ramesh Ponnuru, 1/28)

So what does it take to ruin your reputation around Washington these days? The question comes to mind after learning that one of the capitol’s most corrupt bureaucracies has decided to hire one of its most incompetent contractors—and the answer explains a lot about accountability in government. (1/28)

Several aspects of public opinion on the Affordable Care Act have remained unchanging virtually since its inception: most people don't know what it does or how it affects them personally, but when asked about it in the most general terms they say they're against it. The resulting confusion has been consistently exploited by the law's political opponents, who continue to call for repeal of the whole law, even though that's favored by a minority of Americans. Even fewer think that will happen or that the Republican Party has offered a serious alternative to the law. (Michael Hiltzik, 1/28)

The Barack Obama administration has announced plans to tie 90 percent of all Medicare fee-for-service payments to some sort of quality or value measure by 2018. Sounds exciting! Who wouldn't like to ensure that their doctors are paid for delivering value, rather than just randomly sticking needles into us? Unfortunately ... there is less to this announcement than meets the eye. ... actually doing this, rather than just saying it, turns out to be really hard. (Megan McArdle, 1/28)

Now comes the Congressional Budget Office with a useful reality check, in the form of its annual 10-year fiscal forecast. The report contains one solid piece of news in support of the president’s rosy attitude: The cost of health-care reform, once projected by the CBO to be $710 billion between 2015 and 2019, is now slated at $571 billion, a reduction of 20 percent. To be sure, some of that savings appears to be caused by the refusal of many states to join in the Affordable Care Act’s expansion of Medicaid; but much of it reflects declining health-care inflation, which is the opposite of what the law’s critics predicted. (1/28)

Health and Human Services Secretary Sylvia Mathews Burwell announced a bold initiative Monday aimed at moving half of all Medicare payments away from traditional fee-for-service reimbursement by 2018 and replacing it with incentive-based payments encouraging higher quality and lower costs. The plan also establishes a network to accelerate adoption of payment reforms in the private sector. As the secretary herself suggested, accelerating payment reform is more easily said than done. Time will tell how rapidly changes are adopted, which reimbursement models work best, and payment reform’s overall impact on quality and health spending. Of broader significance than this initiative, potentially, is a shift in Medicare’s role from a bill payer to a more proactive force, with the program using its purchasing power and leverage to drive positive change not only through Medicare but also in the private sector. (Drew Altman, 1/29)

President Obama's new budget is expected to include hundreds of millions of dollars for so-called precision medicine. The initiative, which he introduced last week in his State of the Union address, has bipartisan support and is a bright spot in the otherwise tight funding environment for medical research. Unfortunately, precision medicine is unlikely to make most of us healthier. (Michael J. Joyner, 1/29)

The continuing and spreading outbreak of measles traced originally to visitors to Disneyland and Disney's California Adventure park revives the questions of who should be held responsible, and how they should be made to pay for the injury and illness they've caused. Here's one suggestion, offered Thursday by science writer Alex Berezow in a USA Today op-ed: "Parents who do not vaccinate their children should go to jail." That may be an extreme remedy, but Berezow's notion that non-vaccinating parents should shoulder the responsibility for their actions is widely shared among legal experts and bioethicists. (Michael Hiltzik, 1/28)

Almost 50 rural hospitals have closed their doors since the beginning of 2010, with over half of those closures occurring in the past two years alone, leaving more Americans to trek long distances to obtain health care — sometimes with dire consequences. ... Colorado may soon add to this tally, with Leadville's St. Vincent Hospital facing closure if it does not find a partner, buyer or management relationship together with an infusion of resources. Should St. Vincent close, Leadville will lose its only emergency room and ambulance service, and the county's only nursing home. Leadville's community of 2,600 people would be required to overcome 33 snowy, mountainous miles to reach the nearest hospital in Frisco. (Michael King, 1/28)