First Edition: February 18, 2015

Kaiser Health News: States Add Dental Coverage For Adults On Medicaid But Struggle To Meet Demand
Colorado was one of five states last year to begin offering routine dental coverage to millions of low-income adults in Medicaid — an unprecedented expansion. But like [Pavel] Poliakov, many have had trouble finding dentists willing to treat them because of Medicaid’s low reimbursements, according to providers, advocates and patients. The upshot is that many Medicaid enrollees continue to live with the pain and discomfort of tooth decay and gum disease, which can exacerbate other health problems. (Galewitz, 2/18)

Kaiser Health News: Even Insured Consumers Get Hit With Unexpectedly Large Medical Bills
Like [Pam] Durocher, many consumers who take pains to research which doctors and hospitals participate in their plans can still end up with huge bills. Sometimes, that’s because they got incorrect or incomplete information from their insurer or health-care provider. Sometimes, it’s because a physician has multiple offices, and not all are in network, as in Durocher’s case. Sometimes, it’s because a participating hospital relies on out-of-network doctors, including emergency room physicians, anesthesiologists and radiologists. Consumer advocates say the sheer scope of such problems undermine promises made by proponents of the Affordable Care Act that the law would protect against medical bankruptcy. (Appleby, 2/18)

Kaiser Health News: Advocates Want Obamacare Available To Pregnant Women Any Time
The Obama administration often touts the health benefits women have gained under the Affordable Care Act, including the option to sign up for coverage outside of open enrollment periods if they’re "having a baby." But advocates complain the special insurance enrollment period begins only after a birth. As a result, uninsured women who learn they are pregnant outside of the regular three-month open enrollment period, which this year ended Sunday, can get stuck paying thousands of dollars for prenatal care and a delivery — or worse, going without care. (Galewitz, 2/18)

The Wall Street Journal: About 11.4 Million Enrolled Under Health Law
Some 11.4 million Americans picked health plans through HealthCare.gov and state-run insurance exchanges during the official sign-up window for insurance under the federal health law, the White House said Tuesday. The announcement, made through the White House Twitter account, followed a relatively smooth enrollment period that saw few of the technological problems that hobbled the online exchanges that were launched in the fall of 2013 as part of the Affordable Care Act. (Radnofsky, 2/17)

Politico: Obamacare Enrolls 11.4 Million, Exceeds White House Goal
The Obama administration signed up about 11.4 million people for health coverage during Obamacare’s second enrollment period, exceeding its modest enrollment goal with a final-day rush. The White House trumpeted the figures Tuesday evening via a video posted on social media. In it, HHS Secretary Sylvia Mathews Burwell gives President Barack Obama the preliminary estimates of who “signed up or re-enrolled” from the start of enrollment Nov. 15 to its conclusion Sunday. (Haberkorn, 2/17)

USA Today: White House: 11.4 Million Signed Up For Health Insurance
About 11.4 million Americans are now signed up for private health coverage, thanks to the Affordable Care Act, the White House said Tuesday. "We just got great news today," President Obama said in a video posted on the White House's Facebook page. "In the final day (at the original enrollment deadline Sunday) we had more consumers sign up than we have ever had," said Department of Health and Human Services Secretary Sylvia Burwell. (O'Donnell and Ungar, 2/17)

The Washington Post: White House: 11.4 Million ‘And Counting’ Signed Up For Obamacare In 2015
About 11.4 million Americans have signed up for private health insurance coverage through Obamacare exchanges by the official end of the law's second-ever enrollment period, the White House announced in a video Tuesday night. The announcement indicates the Obama administration will beat its own 2015 enrollment goals after a much quieter sign-up season this year. But the announcement also comes just weeks before the Supreme Court will hear a case challenging the legality of premium subsidies provided through the nearly three dozen states relying on HealthCare.gov for enrollment. (Millman, 2/17)

The New York Times: Obama Cites Health Plan Tally Of 11.4 Million
The White House celebrated the latest numbers as evidence of the success of the health law, which was adopted in 2010 without any Republican votes. “The Affordable Care Act is working,” Mr. Obama said. “It’s working a little bit better than we anticipated — certainly, I think, working a lot better than many of the critics talked about early on.” More than a million people selected health plans in the last nine days of the latest open enrollment period. (Pear, 2/17)

The Associated Press: White House: Health Law Sign-Ups Top 11M
But that preliminary estimate — 11.4 million people — comes with a couple of asterisks: The final number could grow because the administration is offering a grace period for people who started applications — but couldn't finish them — before last Sunday's official deadline. They have until February 22, this coming Sunday. ... The final number could shrink if consumers who've enrolled for 2015 coverage don't follow through by paying their share of premiums. (Alonso-Zaldivar, 2/17)

Bloomberg: White House Boasts 11.4 Million Now Enrolled In Obamacare
President Obama trumpeted the success of his signature healthcare law on Tuesday, releasing a video on Facebook that boasted that 11.4 million people who have signed up or re-enrolled in Obamacare in 2015. ... While the number of people signed up for healthcare under the Affordable Care Act has given the White House reason to celebrate, the administration has reason to worry about whether the news will remain positive for Obamacare. With the April 15 tax deadline approaching, an estimated 6 million Americans are expected to to face a penalty for not enrolling in a healthcare plan. ... Even more troubling for the healthcare law, the Supreme Court will soon begin hearing arguments in the King v. Burwell case, which will decide the ultimate fate of the program's federal subsidies. (Knowles, 2/17)

Los Angeles Times: Obamacare Enrollment This Year Hits 11.4 Million, White House Says
Approximately 11.4 million people have signed up for health coverage through the Affordable Care Act this year, President Obama announced Tuesday, signaling a strong conclusion to the federal health law’s second enrollment period. ... More still may enroll if the Obama administration decides to hold a special enrollment period after April 15. The administration has been considering doing so to allow people who had to pay a penalty for not having health coverage in 2014 get insurance this year and avoid a second year of penalties. (Levey, 2/17)

Los Angeles Times: Covered California May Offer Special Obamacare Enrollment Period
California's health exchange, after notching 1.4 million in Obamacare enrollment as of Sunday's deadline, said it may give uninsured people subject to a tax penalty yet another chance to sign up. In addition, the Covered California exchange granted applicants until this Sunday to finish enrolling in case they ran into long lines or computer glitches. That matches what the federal marketplace is doing in 37 other states. California had previously offered an extension till Friday. (Terhune and Karlamangla, 2/17)

Politico: Behind The Curtain, Troubles Persist In HealthCare.Gov
Behind the scenes, HealthCare.gov is still a mess. The “back end” of the Obamacare website still isn’t properly wired to the health insurance companies. It’s slow going for health plans to make sure the 11.4 million people who have signed up end up in the right plan. Subsidy payments aren’t automated, so the insurers get payments based on estimates. And adding information like a marriage or the birth of a child is a convoluted, multi-step process. ... Instead of a swift process, health plans use clunky workarounds and manual spreadsheets. It takes time and it costs money. (Pradhan and Norman, 2/17)

The Washington Post's Fact Checker: Have Some GOP Lawmakers Flip-Flopped On Obamacare And Subsidies?
The Supreme Court on March 4 will hear the case of King v. Burwell, which threatens to unravel the Affordable Care Act, a.k.a. Obamacare, because the plaintiffs argue that the health-care law does not authorize subsidies through federally run insurance marketplaces .... In recent weeks, advocates of the law have pointed to statements made by leading Republican lawmakers that have suggested that at one point they too assumed the subsidies would be made available to all Americans. ... An upside-Pinocchio is awarded for an unacknowledged flip-flop on an issue. [Rep. Paul] Ryan, [Sen. John] Barrasso and [Sen. John] Cornyn appear to qualify. They should simply acknowledge that their understanding of the law has changed, rather than pretend that they knew all along that people living in states on the federal exchange would not qualify for premium subsidies. (Kessler, 2/18)

The Washington Post: Democrats Are Bracing For Another Obamacare Backlash
The Obamacare window technically just closed this weekend, but a new round of political headaches could just be beginning for the administration. That's because it's tax season, and many Americans could soon be getting an unwelcome surprise that they owe the government a penalty for skipping health insurance coverage. Up to 6 million Americans are expected to pay a penalty for not having coverage in 2014, according to recent Obama administration projections. (Millman, 2/17)

The Wall Street Journal: Hospital Discharges Rise At Lucrative Times
Under Medicare rules, long-term acute-care hospitals like Kindred’s typically receive smaller payments for what is considered a short stay, until a patient hits a threshold. After that threshold, payment jumps to a lump sum meant to cover the full course of long-term treatment. That leaves a narrow window of maximum profitability in caring for patients at the nation’s 435 long-term hospitals, which specialize in treating people with serious conditions who require prolonged care. General hospitals are paid under different rules. A Wall Street Journal analysis found that many long-term-hospital companies discharge a disproportionate share of patients during that window when hospitals stand to make the most, a sign that financial incentives in the Medicare system may shape patient care. (Weaver, Wilde Mathews and McGinty, 2/17)

Reuters: CVS Urges Cost Controls For New Cholesterol, Specialty Drugs
CVS Health on Monday warned that costs of a potent new class of cholesterol treatments and other specialty drugs in development could eclipse those of expensive new medicines and overwhelm the healthcare system "if rigid cost control mechanisms are not put in place." CVS, the second largest U.S. pharmacy benefit manager which negotiates drug prices for 65 million people through contracts with employers and health plans, noted that two of the new injectable cholesterol fighters - called PCSK9 inhibitors - could be approved by mid-2015 and likely each cost $7,000 to $12,000 a year. (Pierson, 2/17)

The New York Times: Doctors Strive To Do Less Harm By Inattentive Care
Suffering. The very word made doctors uncomfortable. Medical journals avoided it, instructing authors to say that patients “ ‘have’ a disease or complications or side effects rather than ‘suffer’ or ‘suffer from’ them,” said Dr. Thomas H. Lee, the chief medical officer of Press Ganey, a company that surveys hospital patients. But now, reducing patient suffering — the kind caused not by disease but by medical care itself — has become a medical goal. The effort is driven partly by competition and partly by a realization that suffering, whether from long waits, inadequate explanations or feeling lost in the shuffle, is a real and pressing issue. (Kolata, 2/17)

The New York Times: Americans May See Appeal Of Medical Tourism In Cuba
Thousands of people from other countries go to Cuba each year for what is known as medical tourism: travel abroad for surgery or other medical care, often because the treatment is less expensive there or is not available where patients live. Now, the Obama administration has relaxed restrictions on travel to Cuba. Americans can come here for a range of reasons, including family visits, academic conferences, public performances, and religious and educational activities. While tourism or traveling to receive health care are still not allowed, the administration lifted a restriction requiring many Americans to travel with authorized groups or get a license in advance to visit the island. (Neuman, 2/17)

Chicago Tribune: Medical Costs Top Retirement Concerns, Poll Finds
High medical expenses are Americans' biggest financial worry about retirement, topping concerns about running out of money, according to a new report by Bankrate.com. The report found that 28 percent of Americans said medical costs were the biggest concern and households with income of more than $75,000 were more worried than average. (Karp. 2/17)

USA Today: Incomplete Vaccination Records Leave Schools Guessing
As the measles outbreak spreads across the country, tens of thousands of children remain in a paperwork limbo — unsure whether they are fully vaccinated, a big unknown in assessing the risk at many schools. A USA TODAY analysis of school vaccination records found that at more than 2,200 public and private schools in 12 states, at least a tenth of kindergarten students had either incomplete vaccination records or had fallen behind schedule in receiving their shots. In some cases, schools dismiss that as a documentation problem, pointing out that many students have had at least one shot. Not knowing can exacerbate a crisis. (Hoyer, 2/17)

The New York Times: Facing Suits, A Nursing Home In California Seeks Bankruptcy
A California nursing home fined by the state for substandard care and facing multiple lawsuits by patients and their families has taken the extreme measure of filing for bankruptcy protection in the face of millions of dollars in potential payouts. The action, taken by North American Health Care, which operates more than 30 homes in California and other Western states, is being derided by plaintiffs’ lawyers as a legal maneuver to avoid what could be catastrophic legal verdicts, while defenders of the strategy say they are facing mounting lawsuits from overly aggressive trial lawyers. (Thomas, 2/17)

The New York Times: Sharp Rise In Occupational Therapy Cases At New York’s Schools
The number of children receiving [occuptional] therapy in New York and elsewhere has shot up in recent years, the byproduct of increasing numbers of special-needs students, a new approach toward teaching them and, to a lesser extent, greater academic demands on all young children. ... And it is widely used to give a boost to children who have trouble with their handwriting, typing or other fine motor skills. And widely used it has been. Over the last four years, New York City public schools have seen a 30 percent increase in the number of students referred to occupational therapy, to nearly 42,000 students. (Harris, 2/17)

The Associated Press: Sources: New Illinois Governor To Call For Big Budget Cuts
Illinois' new Republican governor on Wednesday will pitch a plan for fixing the state's budget mess that includes deep cuts to Medicaid and higher education and a new plan for reducing pension costs, according to three lawmakers with knowledge of the proposal. ... The three legislators, briefed on details of the plan discussed in a Tuesday meeting between Rauner and legislative leaders, told The Associated Press that the governor will recommend cutting Medicaid by $1.5 billion and reducing funding for higher education by nearly $400 million, or 31 percent. (Burnett and Lester, 2/18)