�鶹Ů��

Milwaukee, Detroit and Philadelphia have done the best among 20 cities competing to sign up people for health insurance under the Affordable Care Act, while Dallas, Denver and Las Vegas are lagging, the White House said Monday ahead of Tuesday’s deadline to enroll for coverage that takes effect on Jan. 1. A surge of callers temporarily overwhelmed the government’s capacity to enroll consumers on Monday, prompting officials to record telephone numbers so they could return calls later to arrange for coverage. (Pear, 12/14)

Tuesday's the last day for people to sign up for health insurance on the Obamacare exchanges if they want coverage to start Jan. 1, and federal officials are making a last-minute push. This is the third year people will be able to buy federally subsidized health insurance on the government-sponsored exchanges, and while no one expects people to sign up in the millions like they did during the disastrous first-year rollout, officials said the websites were busy. (Fox, 12/14)

Consumers anxious to beat the midnight Tuesday deadline to enroll on the federal insurance exchange overwhelmed call center lines Monday, federal officials said. Some people were being asked to leave their names so they could be called back after the deadline to be enrolled. The Centers for Medicare and Medicaid Services said they would still be able to have coverage effective Jan. 1 if they left their contact information before the deadline. (O'Donnell, 12/14)

Tuesday is the last day to choose a health plan under the Affordable Care Act if you want insurance coverage to begin by Jan. 1. And officials who have spent the last two years using the carrot of persuasion to get people to buy insurance through the state or federal exchanges say the time has come for the stick. That stick is a hefty fine. (Kodjak, 12/15)

The nation’s top health services official stood in the middle of the produce section at an H-E-B grocery store on San Antonio’s East Side Monday to talk about affordability and access. U.S. Department of Health and Human Services Secretary Sylvia Burwell’s reason for venturing into the store was clear. She wanted to remind consumers of today’s enrollment deadline for those wanting their health insurance policies to become active Jan. 1. And she wanted to spotlight the new and improved HealthCare.gov enrollment website and its low-cost options for Texans. (O'Hare, 12/14)

After rejecting Medicaid expansion in each of the past three years, state lawmakers are being asked to reconsider the proposal once again. Wyoming Department of Health Director Tom Forslund briefed the Joint Appropriations Committee on Monday on the governor’s plan to use Medicaid expansion to cover rising costs in the Department of Health’s budget. Forslund said accepting the expansion would extend health coverage to an estimated 20,000 low-income adults -- a 14 percent increase from past projections -- and send $268.4 million in federal funds to the state over the next two years. (Brown, 12/15)

Gov. Dennis Daugaard said he knows he'll have a tough sell in convincing a majority Republican Legislature to approve Medicaid expansion. The Republican governor took his plan on the road Monday, meeting with legislators and business leaders in Sioux Falls. In an interview with Argus Leader Media, Daugaard said he's crafted a plan designed to defend it against those who don't think it's "conservative enough." (Ferguson, 12/14)

Gov. Bobby Jindal said his administration is willing to provide information to Gov.-elect John Bel Edwards on anything he might need, but Jindal won't actively ready the Louisiana Department of Health and Hospitals for Medicaid expansion -- one of Edwards' top priorities -- before the governor leaves office. ... Edwards has said he wants to implement Medicaid expansion as quickly as possible once he is sworn in on Jan. 11. The move could cause Louisiana's enrollment in the federal health care program to swell by as many as 500,000 additional people, according to state health officials. Legislators worry how the current Medicaid program would handle such a surge in participation. (O'Donoghue, 12/14)

Lobbyists say bargainers had tentatively agreed to postpone the launch of a tax on high-value health insurance plans from 2018 to 2020. There may also be a two-year pause in the existing 2.3 percent medical device tax and a one-year suspension of a levy currently imposed on health insurers, which the companies generally pass on to customers as higher premiums. (Fram, 12/15)

Speaker Paul Ryan told House Republicans on Monday night that the yearlong $1.1 trillion government-funding bill contains policy victories for the GOP, but not as many as lawmakers will want. (Sherman and Bresnahan, 12/14)

Rep. Joe Courtney expects to soon have at least a partial victory in his effort to eliminate a provision in the Affordable Care Act that has been attacked by both labor and business groups. The controversial measure in the ACA would impose a “Cadillac tax” on high-cost health plans provided by employers to their employees. (Radelat, 12/14)

Mr. McConnell can tick off the bills he sees as victories — a budget, a long-sought solution to a perennial problem with Medicare doctor fees, the first changes to Social Security in decades, a cybersecurity bill, a reconciliation measure undercutting the health care law, Keystone XL oil pipeline approval, the Iran nuclear review law and, most recently, major transportation and education bills. He admits he could not have compiled those achievements without significant help from an unlikely quarter — the Senate Democrats he so frustrated in his position as minority leader. (Hulse, 12/14)

Florida Sen. Marco Rubio says he’s the only Republican running for president who’s actually notched a win against President Barack Obama’s health care law, widely loathed on the political right. But other Republicans who quietly worked to outwit the Obama administration say Rubio is taking credit for a victory he didn’t deliver alone. (Alonso-Zaldivar and Sergio Bustos, 12/15)

It's always interesting when a politician links a political stance with a large swath of American voters, evidently without citing any poll. This is a timely topic that Congress has debated for months, and may come up again during the GOP and Democratic debates this week. Our friends at FactCheck.org have written about this, and we wanted to explore it as well using the Post’s polling research and standards. How accurate is Fiorina’s claim? (Lee, 12/15)

Republican U.S. Rep. Charles Boustany launched his campaign Monday for Louisiana’s U.S. Senate seat, a race that appears likely to become jam-packed with GOP contenders. ... "We deserve a senator who will take on big challenges like fixing our broken health care system," the cardiovascular surgeon said in a statement. (Deslatte, 12/14)

Three of the nation’s largest insurance companies – Aetna, Humana and UnitedHealth – have let researchers have a look at the negotiated prices they pay for services and procedures like C-sections, MRIs and hospital stays. All told, we’re talking about claims data for 88 million customers, some $682 billion of healthcare bills. (Gorenstein, 12/15)

HealthSpan, the insurance arm of Catholic health system Mercy Health, is getting rid of its medical group and halting sales of Affordable Care Act policies just two years after acquiring Kaiser Permanente's Ohio subsidiary.The move represents a failure of one health system trying to replicate the much-heralded Kaiser model of healthcare, which integrates the payment and delivery sides. HealthSpan has been severely hurting the finances of Mercy Health, and executives felt they had to address “the operational challenges,” according to recent financial documents. (Herman, 12/14)

The percentage of those entering American nursing homes who are moderate and severely obese — with a body mass index of 35 or greater — has risen sharply, to nearly 25 percent in 2010 from 14.7 percent in 2000, according to a recent study, and many signs suggest the upward trend is continuing. But as demand from severely obese patients surges, nursing home administrators say they cannot afford to care for them. (Varney, 12/15)

Irwin Weiner felt so good after heart surgery a few weeks before turning 90 that he stopped for a pastrami sandwich on the way home from the hospital. Dorothy Lipkin danced after getting a new hip at age 91. And at 94, William Gandin drives himself to the hospital for cancer treatments. Jimmy Carter isn't the only nonagenarian to withstand rigorous medical treatment. Very old age is no longer an automatic barrier for aggressive therapies, from cancer care like the former president has received, to major heart procedures, joint replacements and even some organ transplants. (Tanner, 12/14)

When clots block your heart arteries, you have a heart attack. So it only makes sense that an angioplasty to widen your narrowing arteries before you have a heart attack should prevent it from ever happening and even save your life. Plenty of patients, and even some heart specialists, still think so. But study after study has been showing that the conventional wisdom is wrong – in most cases, the operation won’t protect you from a future heart attack. The mounting evidence, along with new treatment guidelines, has been causing a quiet revolution in the treatment of coronary heart disease, shifting patients away from angioplasty in favor of medications, exercise and better diets. (Bavley, 12/15)

Mental health courts are popular in many communities, and it’s easy to understand why. ... But research is still scanty on the courts’ effectiveness at addressing offenders’ mental health problems or discouraging offenders from relapsing into criminal behavior. (Andrews, 12/15)

A gun club owner and a gun dealer are among those telling a congressman Monday that closing loopholes in federal background checks and increasing mental health help would reduce gun violence. California U.S. Rep. Mike Thompson, chairman of House Democrats’ Gun Violence Prevention Task Force, held the hearing less than two weeks after 14 people were fatally shot in San Bernardino. (Thompson, 12/14)

The government on Monday urged primary-care physicians who prescribe opioids for pain relief to rein in their use of the drugs, proposing new guidelines that call for a more conservative approach than the one that has led to a crippling epidemic of addiction to the powerful narcotics. Just a few days after a new report showed a surge of drug-related overdoses in 2014, the Centers for Disease Control and Prevention suggested in draft recommendations that physicians tackle chronic pain with other methods. (Bernstein, 12/14)

There’s a prescription drug abuse problem sweeping the United States, but fixing it will require a systematic change focused on how most health professionals prescribe drugs, rather than changing the practices of a few bad apples. At least, that’s the recommendation put forth in a research letter published Monday in JAMA Internal Medicine. (Luthra, 12/15)

Maryland pharmacists will no longer require that people have a prescription to obtain a drug that can reverse the effects of opioid overdoses. The Maryland Department of Health and Mental Hygiene issued an order Monday authorizing pharmacists to dispense naloxone to thousands of individuals who have been trained and certified through the state’s Overdose Response Program. (Hicks, 12/14)

Taking antidepressants during the second or third trimester of pregnancy may increase the risk of having a child with autism spectrum disorder, according to a study of Canadian mothers and children published Monday in JAMA Pediatrics. But scientists not involved in the research say the results are hard to interpret and don't settle the long-running debate about whether expectant mothers with depression should take antidepressants. (Hamilton, 12/14)

Reproductive rights supporters need to fully realize how health care choices for women continue to be eroded, Kathleen Sebelius said Monday in Kansas City. “What is happening at the state level is frightening,” the former U.S. Health and Human Services secretary and Kansas governor told 150 health care officials, medical students and others during a Planned Parenthood of Kansas and Mid-Missouri conference. ... Sebelius also said the refusal by Kansas and Missouri lawmakers to expand Medicaid represents “playing politics with peoples’ lives, I think, in the most irresponsible way possible. It is morally repugnant and economically stupid policy for both Missouri and Kansas.” (Burnes, 12/14)

A federal judge on Monday temporarily blocked Ohio officials from taking legal action against Planned Parenthood to enforce fetal tissue disposal rules, and Republican state lawmakers proposed new regulations for such disposal. The actions at the Ohio Statehouse and Columbus federal court comes after state Attorney General Mike DeWine’s investigation into Planned Parenthood facilities. (Sanner, 12/14)

Ending almost two years in limbo, the financially beleaguered Daughters of Charity Health System on Monday announced it has closed a $260 million investment deal with an East Coast hedge fund that will keep one of the Bay Area's oldest hospital chains afloat for at least three more years. The news came 11 days after California Attorney General Kamala Harris gave her conditional approval for the largest nonprofit hospital transaction in state history, and the first to involve a hedge fund. (Seipel, 12/14)

Nineteen groups led by the American Civil Liberties Union sent a letter Monday to drugstore chain Walgreens expressing concerns about the company's plans for a Catholic hospital to run its in-store health clinics in Washington state and Oregon. In the letter, the organizations asked if the clinics would allow access to contraception, abortion drugs and prescriptions to help terminally ill patients end their own lives, which is legal in both states. (Blankinship, 12/15)

Four hospitals in the Charlotte region will be docked 1 percent of Medicare payments in 2016 because they exceeded federal standards for infections and other safety factors. The penalty, in its second year, is part of the Affordable Care Act’s punishment-and-reward system created to keep down unnecessary medical spending and control health care costs. (Garloch, 12/14)

Michigan's tax on health insurance would be continued until 2025 under legislation scheduled for a vote in the Legislature. The Senate plans to vote on Tuesday on extending the 0.75 percent health insurance claims assessment, which helps pay for Medicaid coverage for low-income residents. The tax will go away in two years if legislation is not enacted. (12/15)

Even as Massachusetts continues to lead the nation with the highest rate of insured residents, some barriers to obtaining care persist. Those barriers are most acute among some minority and vulnerable populations, including Hispanics, those with lower incomes, people in fair or poor health, and individuals who are limited in their activities. That's according to a 2015 survey by The Center for Health Information and Analysis, created by a 2012 state law. (Leblanc, 12/14)

The future funding of Vermont's Medicaid program will be one of the biggest issues facing lawmakers during the upcoming Legislative session. On Monday, the House Appropriations Committee started its review of this ever-expanding program. ... A recent decision to expand Medicaid eligibility will be under review and some legislators also want to look at the full scope of the Medicaid benefit package. These questions are being raised because the state faces a roughly $30 million shortfall in the Medicaid program in the current fiscal year and a projected $60 million shortfall in next year's budget. (Kinzel, 12/14)

There will be new job opportunities in California because of the Affordable Care Act, but likely more of a shift in the nature of those jobs and not necessarily an increase in the number of them, according to a new study released last week by researchers at UC-San Francisco. (Gorn, 12/14)

A federal judge on Monday rejected the Texas Medical Board's request to jettison a lawsuit filed against it by Teladoc over the board's new restrictions on the practice of telemedicine in the state. The judge's decision means the case, which has implications for medical boards and telemedicine across the country, will continue to move forward. Teladoc sued the board in April over a rule that requires physicians to either meet with patients in person before treating them remotely or treat them face-to-face via technology while other providers are physically present with them when treating them for the first time. (Schencker, 12/14)

When Florida's Office of Compassionate Care named five nurseries to grow and distribute medical marijuana in the state, many expected there would be a few challenges filed — but not the more than a dozen that had landed by Monday's deadline. Department of Health officials said in an email that 13 administrative challenges across all five regions have been received. Lobbyists and officials who have been following the process had estimated there would be eight at the most. (Reedy, 12/14)

Soon there will be a gaping hole in hospital psychiatric services in St. Francois County, about 70 miles south of St. Louis. No acute adult psychiatric beds will exist in this county of 66,000 people after BJC HealthCare closes an in-patient facility at the former Mineral Area Regional Medical Center in Farmington, Mo. (Liss, 12/14)

Among the holy grails of would-be healthcare reformers, the holiest and grailiest quest is for the "empowered consumer." This creature, armed with discernment about his or her medical needs and free choice of doctors and hospitals, will bring us to the paradise of low-cost medical care and uncompromisingly good health. Too bad that in the real world, empowered consumers and "consumer-driven healthcare," the instrument through which they achieve these goals, are mythical. ... The empowered consumer is a star of the latest conservative alternative to the Affordable Care Act, issued earlier this month by the American Enterprise Institute. (Michael Hiltzik, 12/14)

As part of his push for the Affordable Care Act in 2009, President Obama came to Central High School [in Grand Junction, Colo.] to laud this community as a model of better, cheaper health care. “You’re getting better results while wasting less money,” he told the crowd. His visit had come amid similar praise from television broadcasts, a documentary film and a much-read New Yorker article. All of the attention stemmed from academic work showing that Grand Junction spent far less money on Medicare treatments – with no apparent detriment to people’s health. The lesson seemed obvious: If the rest of the country became more like Grand Junction, this nation’s notoriously high medical costs would fall. But a new study casts doubt on that simple message. (Kevin Quealy and Margot Sanger-Katz, 12/15)

There's a Cuban American first-term senator running for president who has done more than any Republican to stop the Affordable Care Act. No, I'm not talking about Ted Cruz, R-Texas. I'm talking about Marco Rubio, R-Fla. The battle against President Barack Obama's health care act has been Cruz's signature struggle. In 2013, Cruz took to the Senate floor and promised to speak out against the Affordable Care Act, also known as Obamacare, "until I am no longer able to stand." ... But while the shutdown may have helped boost Cruz into the top tier of Republican presidential contenders, it had zero impact on undermining Obamacare. Rubio, by contrast, didn’t read Dr. Seuss on the Senate floor, but he has quietly pushed Obamacare into what may prove to be a death spiral. (Marc A. Thiessen, 12/14)

Like it or not, someone other than your doctor is in the business of recommending your medical treatments. That job falls to a little-known group called the U.S. Preventive Services Task Force. It has been the subject of increasing controversy, not because it guides decisions, but because some of its recommendations have shifted from encouraging expensive and expansive screening to discouraging its overuse. As with many things in medicine, it’s much more popular to do stuff than to tell people “no.” (Aaron E. Carroll, 12/14)

Despite bipartisan approval and popular support, a bill assisting first responders who have illnesses resulting from 9/11 has been stalled by Republican leaders in Congress. The James Zadroga 9/11 Health and Compensation Act of 2010 provides emergency medical care, monitoring and compensation programs to thousands of first responders nationwide, but will expire this month unless Congress acts. (Phoebe Lett, 12/14)

As the abuse of opioids, including prescription painkillers and heroin, has risen in Tennessee, the number of babies born dependent on drugs has skyrocketed, increasing fifteenfold during the last 10 years. In an effort to combat this troubling trend, the state approved a controversial new law in 2014 to allow women who give birth to babies “harmed by” illegal drug usage to be charged with misdemeanor assault. ... Legislators saw the law as a way to push women into getting treatment. But that's not what is happening, say critics .... They say the law has had the perverse effect of making pregnant women afraid to get prenatal care, lest they be arrested down the road. (12/14)

Every few years we are told about a new “drug plague” in which the drug use of pregnant women supposedly dooms their children – unless, of course, we take the children away. The media said it about crack, and they were wrong. They said it about methamphetamines and they were wrong. Now there’s a new epidemic of hype around pregnant women who use drugs both legal and illegal, from heroin to prescription painkillers. Those stories are wrong, too. (Richard Wexler, 12/14)

I’ve spent much of the last year in constant pain – all because my health insurance company decided it wouldn’t cover the medication that my doctor prescribed to treat my chronic rheumatoid arthritis. I was diagnosed early last year after collapsing at work. My doctor prescribed a biologic infusion treatment, but my health insurer required me to first fail on six other drugs before I could gain access to the biologic. (Arloishia Israel, 12/14)

It’s a quick drive from Scottsdale to south Phoenix, but when it comes to health the two communities are worlds apart. If you are born in Scottsdale, you can expect to see your 85th birthday. In south Phoenix, children are likely to only reach their 71st. (Suzanne Pfister, 12/14)