�鶹Ů��

President Barack Obama is targeting 20 cities, including Kansas City, to boost enrollment in the Affordable Care Act. The White House’s goal is to finally get total enrollment above the 10 million mark. The 20 cities Obama has singled out have the most uninsured people eligible for coverage, the White House said. The sign-up campaign is called the “Healthy Communities Challenge.” (Kraske, 11/8)

The White House has set its sights on Dallas’ poor rate of health insurance coverage, just two weeks after the U.S. secretary of health and human services called Dallas County an area ripe for improvement in enrollment. (Ayala, 11/9)

More than a half-million applications to buy health insurance under the Affordable Care Act were submitted nationwide to healthcare.gov during the first four days of enrollment for next year, the U.S. Department of Health and Human Services said Monday. (Deam, 11/9)

Such one-by-one life changes are the ground-level stakes ushered in by the election last week of businessman Matt Bevin as Kentucky’s next governor. The second Republican elected to the office in 48 years, he wrapped his campaign around a pledge to dismantle Kynect, the state’s response to the federal health-care law. If he follows through, the Bluegrass State would go from being perhaps the nation’s premier ACA success story to the first to undo the law’s results, razing a state insurance exchange and reversing its considerable expansion of Medicaid. During his first news conference since his unexpected victory, Bevin named abolishing Kynect as a top priority, again contending that the state can’t afford it. He said change would come in “a thoughtful way” and made it clear that he intends for people on Medicaid to pay more for their care — but left other details of his intentions blurry. (Goldstein, 11/9)

In this season of open enrollment for health insurance under the Affordable Care Act, there’s a group of people who might be uninsured: nursing students. Nursing schools frequently require, or highly recommend, that students be enrolled in a health insurance plan before participating in clinical work at local hospitals. Because the Missouri legislature has turned down Medicaid expansion three years in a row, students who work part-time or don’t have insurance through their parents may fall into a coverage gap: Their incomes are too high for Missouri’s Medicaid program, and too low for income-based subsidies to help them buy insurance on Healthcare.gov. (Bouscaren, 11/9)

New York state authorities say they are taking additional steps meant to protect people covered by Health Republic Insurance as it shuts down. The Department of Financial Services and Department of Health say about 100,000 individual members in the cooperative can select a new insurance plan for the rest of this year through the state Health Exchange by Nov. 30. (11/9)

Like the U.S. overall, Texas saw a decline in the number of children without health insurance in 2014. But supporters of the federal health care law say hostility to the 2010 overhaul is preventing the state — which still has the nation’s biggest population of uninsured kids — from making faster progress. The number of uninsured children in Texas fell by 11.7 percent to about 784,000 in 2014, down from around 888,000 in 2013, according to a Georgetown University Center for Children and Families report released in October. (Evans, 11/9)

Renewal dates are fast approaching for many employers’ group health insurance policies, and while it’s difficult to discern a common trend for 2016, it appears some businesses will not face the steep rate hikes of years past. In some cases, independent brokers in San Antonio have successfully negotiated to reduce the suggested price hikes for large employers so their health insurance premiums will stay the same or go up only slightly next year. (O'Hare, 11/9)

A key health policy goal of the new Ways and Means chairman – changes to the treatment of people recovering from serious illnesses, injuries and surgeries - is moving forward in an influential advisory panel. The work ultimately could result in an overhaul of one of Medicare's fastest-growing expenses. An overhaul of so-called post-acute care, a roughly $60 billion annual expense for Medicare, has been a top priority for Rep. Kevin Brady, R-Texas, and has the support of the Obama administration. Medicare's spending on post-acute care more than doubled between 2001 and 2012, with different payment rates set for the four main settings for this treatment. Lawmakers are looking for ways to better direct people toward the best sites for post-acute care, while also keeping this spending in check by flattening payments. Decisions about post-care settings now often are based on factors such as a hospital's relationship with a particular center, according to the Medicare Payment Advisory Commission. (Young, 11/9)

New York lawmakers are calling on new House Speaker Paul Ryan to extend a law renewing health benefits for Sept. 11 first responders. Members of the city's congressional delegation joined Mayor Bill de Blasio at City Hall on Monday to rally for renewal. (11/9)

William A. Ackman, the activist investor, has described his billion-dollar bet and continuing crusade against the nutritional supplements company Herbalife as a “moral obligation.” In at least one presentation, he nearly cried onstage and said that if his Herbalife trade was successful, he would give the profits to charity because he would consider them “blood money.” (Sorkin, 11/9)

U.S. prosecutors plan to ask the Canadian and British governments to extradite officials with an online pharmacy on charges of smuggling $78 million worth of mislabeled, unapproved and counterfeit cancer drugs into the country to sell to doctors. Fourteen companies and individuals from Canada, the United Kingdom, Barbados and the U.S. are accused of participating in the conspiracy that involved falsifying customs declarations for shipments from the U.K., according to the criminal indictment. (Volz, 11/9)

Republican presidential hopefuls are slowly starting to break up the Democratic monopoly on ideas to rein in prescription drug prices.Hillary Clinton and Vermont Senator Bernie Sanders have made lowering drug costs a central part of their campaign platforms, but the GOP contenders have begun getting in on the game.Last month, the former governor of Florida Jeb Bush rolled out a health care plan that included overhauling the Food and Drug Administration; Florida Senator Marco Rubio railed against pharmaceutical “profiteering” in videotaped remarks; and Texas Senator Ted Cruz called for reforming the FDA in an op-ed. (Scott, 11/10)

The images reflected a strategic choice by her campaign: In a year in which outsiders Sanders and Republican Donald Trump are surging, Clinton is opting instead to highlight her government and political experience and vowing to continue Obama's work. She described herself as a "proud Democrat" who would protect Obama's agenda and prevent Republicans from dismantling his signature health care law and guard against tax breaks that would benefit the wealthy. (11/9)

Veterans Affairs Secretary Robert McDonald said the government’s second-largest agency is serving millions more veterans faster after a scandal over fudged wait times for medical appointments, but he acknowledged that the sprawling health-care system is struggling to keep up. (Rein, 11/9)

Overhauling the VA became a major political topic last year after revelations of an appointment-scheduling scandal at VA hospitals led to the resignation of top VA officials, including then-Secretary Eric Shinseki. Congress passed a multi-billion-dollar emergency funding measure to help overcome problems at the VA. The department’s budget has more than doubled in the past decade, hitting $163.9 billion in 2015, but demand for services is expected to keep growing as troops from recent conflicts leave the service. (Kesling, 11/10)

Veterans Day is when America stops to thank those who have sacrificed to keep the country safe and free. This year, gratitude for their service includes a significant step to help keep them healthier. Most former servicemen and women (and their families) get their health care at civilian facilities, where only rarely do health professionals ask patients if they or close relatives have a military background. But not only do veterans suffer from a disproportionate share of ailments like post-traumatic stress disorder and brain injury, many who were in combat zones may also have been exposed to hazards such as the defoliant Agent Orange in Vietnam, or huge burn pits in Iraq and Afghanistan that produced toxic fumes. (Rovner, 11/10)

Half of Californians in the country illegally would be eligible for the state’s healthcare program for the poor if it were expanded under a proposal by legislators, a new report finds. Some California politicians are pushing to open up the $91-billion Medi-Cal program to people here illegally, since such immigrants are not allowed to sign up for insurance under Obamacare. (Karlamangla, 11/9)

Half of California's undocumented immigrants -- about 1.4 million -- have incomes low enough to qualify for full Medi-Cal benefits should California legislative proposals to offer coverage to the undocumented ever be enacted. That is among the key findings of a Public Policy Institute of California report released Monday night which examines current policy options to provide health coverage to the state's undocumented immigrants. (Seipel, 11/9)

Two recent independent studies gave Ohio high marks for efforts to allow Medicaid patients to stay in home and community settings rather than in institutions. The studies focused on care for those needing long term support services -- generally the elderly -- and those needing mental health services. Options that allow Medicaid clients to remain in community settings generally cost less than institutions. (Higgs, 11/9)

A bipartisan commission says New Hampshire lawmakers should consider adding comprehensive dental benefits to the state's Medicaid program for adults. The commission, which was created last year to analyze barriers to dental care in New Hampshire, released its final report on Monday. It found that the state does well on some measures, such as having the lowest percentage of third-graders with untreated tooth decay, but did worse on others. For example, about a quarter of New Hampshire adults haven't visited a dentist in the last year. (11/9)

Texas spends less per capita on mental health care than all but a couple states in the nation. Seventy percent of Texas counties do not have a single practicing psychiatrist. Forty percent of children experiencing emotional, developmental or behavioral problems do not get any help. And the state's biggest provider of treatment is the Harris County Jail. (Rosenthal, 11/9)

Texas House Speaker Joe Straus announced Monday he's formed a select committee on mental health to take an all-encompassing look at the state's behavioral health system. The committee will review and make recommendations on issues including substance abuse, care for veterans, identifying illnesses early and improving delivery of mental health care, the speaker said in a news release. (Silver, 11/9)

Seventy percent of Texas counties do not have a single practicing psychiatrist. Forty percent of children experiencing emotional, developmental or behavioral problems do not get any help. And the state’s biggest provider of treatment is the Harris County Jail. Now, state lawmakers are making their most deliberate effort in two decades to address the problems. (Rosenthal, 11/9)

People claiming to have no income have been able to get Medicaid in Virginia — no questions asked, according to a new audit, which also found the state wasted at least $21 million last year on benefits for recipients who no longer qualified. The audit, released Monday and conducted by the Joint Legislative Audit and Review Commission, also faulted Virginia’s “passive” approach to recovering money owed from the estates of certain deceased Medicaid patients. (Vozzella, 11/9)

Virginia officials don’t verify that applicants are telling the truth when they say that they have no earned income, according to the report from the Joint Legislative Audit and Review Commission, which is in the midst of a two-year review of the state’s Medicaid program. (Durkin, 11/9)

Virginia’s Medicaid program has a backlog of applications for eligibility that has cost the state and federal governments up to $38 million in benefits to ineligible recipients, according to a new report that identifies gaps in the $8 billion system. (Martz, 11/9)

Supporters of universal health care have gathered enough signatures to put on next year's ballot a plan to make Colorado the first state to opt out of the federal health law and replace it with taxpayer-funded coverage for all. Proponents submitted 158,831 qualified signatures, about 60,000 more than required to put the measure on the ballot, Secretary of State Wayne Williams said Monday. The question would make Colorado the first state to opt out of the federal Affordable Care Act and replace it with universal health care. (11/9)

Health insurance giant Blue Shield of California sued its former public policy director and accused him of disclosing confidential company information. The nonprofit insurer filed the breach of contract complaint against Michael Johnson in Los Angeles County Superior Court on Friday, eight months after he resigned from the company. (Terhune, 11/9)

The Connecticut Department of Public Health has launched a comprehensive background check program for employees of nursing homes and other long-term care agencies that strengthens protections for the elderly and disabled residents. The background check program helps nursing homes and other providers identify whether a job seeker has a disqualifying criminal conviction or other patient abuse or neglect information that could make him or her unsuitable to work directly with residents. (Cuda, 11/9)

Gov. Charlie Baker on Monday defended his proposed legislation to deal with the state’s opioid crisis, and the package gained support from Massachusetts county sheriffs. The bill — which includes proposals to limit first prescriptions of pain pills to enough for 72 hours, and to allow doctors to involuntarily hold a substance abuse patient for 72 hours — has been criticized by doctors groups and been met with skepticism from some legislative leaders. (11/9)

Washington state health officials said Monday they have found no source for the E. coli outbreak related to Chipotle, and the chain's Pacific Northwest restaurants could reopen later this week. All the tests of food from Chipotle stores in Washington and Oregon came back negative for E. coli, Washington state epidemiologist Dr. Scott Lindquist said. Chipotle did its own testing, and those results came back negative as well. (Blankinship, 11/10)

An expansion at Novant Health Huntersville Medical Center, a new outpatient surgery center and two new kidney dialysis centers have been proposed for the Charlotte area, according to the North Carolina Division of Health Service Regulation. Novant Health wants to expand its Huntersville hospital by relocating 48 acute-care beds and one operating room from Presbyterian Medical Center in Charlotte. Upon completion of the $44.6 million project, the Huntersville hospital would be licensed for 139 acute-care beds and six operating rooms. (Garloch, 11/9)

The state of Missouri is on the line to repay about $100 million in to the federal government, unless the state’s Department of Social Services wins a lawsuit that’s brewing in district court. Every year, states are given federal funding to allocate to what is called Disproportionate Share Hospitals (DSH—pronounced “dish”). In general, this funding cares for large percentages of patients who are uninsured or covered by Medicaid. Because the hospitals aren’t being reimbursed as well as they would if those patients had private insurance, the government reimburses them for some of the costs for the uncompensated care they provide. (Bouscaren, 11/9)

Minnesota Health Commissioner Ed Ehlinger must decide by year's end whether to add severe, incurable pain to the list of qualifying conditions for medical marijuana. A state advisory panel recommended last week against such a move, saying there's too little medical research on pot as a pain treatment. (Sepic, 11/10)

On Monday, federal prosecutors in Mr. Silver’s corruption trial turned to a relatively obscure staff member on the Assembly Ways and Means Committee whose title seemed as bland as the job he held — deputy budget director for budget studies — to open a window into the seemingly impenetrable world of state finances that Mr. Silver controlled. The staff member, Victor E. Franco, in his second day of testimony at the trial in Manhattan, elaborated on the budgetary process, as prosecutors sought to illustrate that Mr. Silver controlled it all with little transparency or accountability, particularly on the Health Department grants that are the focus of the case. (Weisner and Craig, 11/9)

Joseph Valcourt, 14, and Taylor Testo, 11, are learning to be health-literate. Over the last four weeks, they've gotten important lessons about taking care of themselves, including the need for regular medical checkups and vaccinations, as well as how to handle anxiety. Their lessons came in the form of games led by educators from perhaps an unusual source: a health insurer. CDPHP completed its first health literacy program for kids, #Healthy4Life, at the Rotterdam Clubhouse of the Schenectady Boys & Girls Club. (Hughes, 11/9)

In an eye-catching study last week, Nobel Prize winner Angus Deaton and his co-author Anne Case found that deaths among middle-aged white men are spiking — and concluded that alcohol and substance abuse are at least partly to blame. The finding is "shocking," health care historian Paul Starr wrote at the American Prospect. ... But here's an even bigger surprise: The federal agency that oversees the nation's largest trove of health data won't let researchers study the problem. In an unusual move, the Centers for Medicare and Medicaid Services in 2013 began quietly deleting substance use disorder data from the files they share with researchers. (Dan Diamond, 11/9)

Every day, 44 Americans overdose and die after taking opioid painkillers. Every year, 2 million people abuse or misuse the drugs. And as addictions and deaths mount nationwide, authorities are struggling to cope. ... the most sweeping initiative comes from the US Centers for Disease Control and Prevention, which has prepared preliminary prescribing guidelines for primary care physicians. The recommendations, outlined in a webinar in September and subsequently leaked online, call on doctors to prescribe opioids only after other therapies have failed.This is a crucial effort. (Ed Silverman, 11/10)

The famous video of New Jersey Gov. Chris Christie talking about addiction is a sign of how much Republican Party attitudes toward vulnerable people have changed. It’s also a reminder of how much those attitudes have stayed the same. ... Of course, Christie could have used those same sentences to describe other people. ... Spend time in a community medical clinic and you’ll find people who opted not to buy health insurance that they could have afforded -- or put off medical care when they had a chance to get it. Alongside them, you’ll see people unable to get coverage because it was too expensive or unavailable to them because of pre-existing medical conditions. But you rarely hear Republicans invoke Christie's forgiving, empathetic language when describing these people. (Jonathan Cohn, 11/9)

It’s currently “open enrollment” season, the one time of year when most Americans are allowed to change their health insurance. Yet relatively few choose to do so. It’s little wonder why. Insurance plans are complicated, with more moving parts and narrower doctor networks than in the past. Insurers don’t exactly go out of their way to make price comparisons easy, either. Plus, consumers have to go through the rigmarole of figuring out whether their preferred doctors participate in competing plans (though of course these preferred doctors could always drop out of their current plans, too). ... Multiple economic studies have found that insurers jack up rates on those too lazy or inattentive to investigate other options. (Catherine Rampell, 11/9)

The majority of ObamaCare’s insurance co-ops—12 of 23—have now folded, and their $1.24 billion in federal loans has all but vaporized. More will fail, nearly a million Americans may lose coverage, and now the contagion from their failures is spreading. The co-ops are government-sponsored nonprofits that were supposed to increase competition, but instead they’re causing the greatest insurance disruption in decades. The co-ops aren’t merely jilting their displaced members or the taxpayers who supplied their “seed money.” Local regulators are defying the feds to close them because other insurers are liable for their toxic balance sheets. (11/9)

So the saga of the Little Sisters of the Poor and their challenge to ObamaCare’s birth-control mandate will be resolved by the Supreme Court. A more humane Administration would have long ago found a way to abide the convictions of this order of nuns, but that’s not how the Obama crowd rolls. (11/9)

So the Little Sisters of the Poor will get their day in court. In the Supreme Court, that is. This past Friday, the justices agreed to hear the Little Sisters’ argument that not only would ObamaCare’s contraceptive mandate force them to violate their beliefs, the Obama administration’s “accommodation”—to have them sign a paper that would empower the sisters’ insurer to provide the birth control—is just an accounting gimmick. (William McGurn, 11/9)

Republican opponents of Medicaid expansion seized on a state report last month showing Virginia’s Medicaid program eating a substantial and growing portion of the state budget. The response, of course, was predictably partisan and shrill, steeped in half-truths .... Critical context is missing. Namely, the growth of Medicaid has been driven almost entirely by a program that Republicans and Democrats have willingly expanded: long-term, critical care. (11/10)

The heart of Obamacare is the array of online shopping centers it created, dubbed Health Benefit Exchanges by the 2010 Affordable Care Act, where people who don’t get their insurance through their employer can go to buy coverage. ... The U.S. has set a low bar for the enrollment season that opened Nov. 1, aiming to get about 10 million people paying for coverage by the end of 2016. That’s less than a million more than the 9.1 million people the Obama administration expects will be paying for Obamacare policies at the end of 2015. (Alex Nussbaum and Zachary Tracer, 11/9)

In the past, stark differences between the pluralistic, market-driven health system in the United States and the single-payer, centrally managed system in the United Kingdom have resulted in rich opportunities for those interested in comparative health system analysis. These differences are real but look like they are becoming less marked as a consequence of recent trends toward direct governmental intervention in the United States and the use of market forces in the English National Health Service (NHS). (Martin Marshall and Andrew B. Bindman, 11/9)

For many people, fall means pumpkin-flavored lattes, hayrides and apple orchards. But for the 46 million Americans over age 65, there’s another important annual event – the Medicare Open Enrollment Period – which is Oct. 15 to Dec. 7. During the open enrollment period, it is crucial for Medicare beneficiaries to take charge of their healthcare and understand the plans and their coverage. With nearly 290,000 Medicare beneficiaries in New Hampshire, according to the Centers for Medicare and Medicaid Services (CMS), the demand for information is great. (Joseph Veilleux, 11/8)

The benefits of exercise are indisputable and the current perception is that a curvilinear relationship exists between the amount of physical activity and the related health benefits. Many studies have demonstrated that physical activity is associated with reduced risk of cardiovascular diseases, diabetes, cancer, and dementia in a dose-dependent fashion. However, recent studies suggest that high doses of exercise can be harmful and are associated with increased risk of cardiovascular mortality. ... These findings were interpreted to mean that exercise may harm the heart at a certain dose. The “too much exercise hypothesis” may cause confusion about the benefits of exercise and the optimal dose of physical activity to prescribe in clinical practice. (Thijs M. H. Eijsvogels and Paul D. Thompson, 11/10)

Evvery election cycle, candidates assiduously court the women’s vote—but fail to show us what they are going to do to materially improve women’s lives. Child care now costs more than in-state college tuition or housing in most states, according to a new report from the Economic Policy Institute think tank. That high cost means that it’s no surprise that child care is out of reach even for many middle-class families and downright impossible for low-wage workers. Unfortunately, that conclusion isn’t much of a surprise to any mother or father who has tried to go back to work. That might be a surprise, though, is that giving America’s working parents access to safe, high-quality child care didn’t used to be a controversial, partisan idea on the campaign trail. (Vivien Labaton, 11/9)