First Edition: November 14, 2014

Kaiser Health News: How The Health Law Is Using Medicare To Improve Hospital Quality
Among the tools: penalties for admitting patients too soon after they were discharged and a focus on reducing hospital-acquired infections. KHN’s Mary Agnes Carey and Jordan Rau discuss what you need to know before open enrollment in the health law’s marketplaces begins again on November 15th. (11/14)

The Wall Street Journal: Low-Key Rollout Set For Second Year Of Health Law
Facing high political stakes and re-energized opposition, the White House is tweaking its strategy for year two of the health law’s insurance enrollment after last year’s problem-plagued launch. President Barack Obama , who appeared alongside celebrities with youth appeal during the first enrollment push, won’t be in the U.S. when the insurance exchanges reopen Saturday, though he will speak about the Affordable Care Act in his weekly radio address that morning. Top administration officials plan to fan out for an appeal that relies on customer testimonial and uses a smaller marketing budget. (McCain Nelson, 11/13)

The Washington Post: Administration Doing Lower-Key Outreach On Health Insurance Sign-Ups
Three months before the debut of Healthcare.gov last year, Hollywood celebrities huddled with President Obama at the White House over their plans to urge Americans to buy health coverage under the Affordable Care Act. The president took to late-night television himself to spread the word. And on the eve of the launch, an op-ed by the nation’s top health official appeared in major newspapers across the country, proclaiming that “better options for better health are just a click . . . away.” But now, as the second sign-up time arrives this weekend for Americans to buy health coverage through the law’s insurance marketplaces, the administration’s high-wattage 2013 sales campaign has given way to a 2014 strategy that is shorter, more targeted and lower-key. (Goldstein, 11/13)

The Wall Street Journal: Consumers Still Confused Ahead Of Health Care Sign-Ups
Just a few days before the re-launch of the health-care law’s marketplaces, many consumers remain confused about key aspects of the sign-up process, including the timing of the enrollment period, presenting a challenge for insurers eager for a smooth opening. The online insurance exchanges are set to go live again Saturday, when people will be able to buy new coverage taking effect on Jan. 1. Insurance companies are required to send letters explaining changes to their customers’ plans before open enrollment starts. (McCabe and Wilde Mathews, 11/13)

The Washington Post: Affordable Care Act Enrollment Sign-Up Guide
Here’s what you need to know about the Affordable Care Act’s second enrollment period, which starts Saturday. (Millman, 11/13)

The Washington Post: Health Law’s Small-Business Enrollment Fell Far Short Of Expectations, GAO Finds
Small-business enrollment on new insurance marketplaces set up under the president’s health-care law has fallen well short of the administration’s expectations, according to government report released Thursday. The Government Accountability Office examined enrollment totals for the online small-business exchanges, commonly called SHOP exchanges, in states that built their own health insurance portals. Most states defaulted to a federally operated small-business marketplace — a complementary site to the more widely known individual exchange. Both exchanges are slated to relaunch this weekend. (Harrison, 11/13)

The Associated Press: Small Business Insurance Exchanges Seek Rebound
Early enrollment for the health overhaul's small business insurance exchanges fell far short of the 2 million workers who were expected to sign up this year. The shortfall calls into question the future of the exchanges as they begin accepting enrollment for 2015. About 76,000 people had purchased coverage on 18 exchanges through June 1, according to a report released Thursday by the U.S. Government Accountability Office. Enrollment figures from 33 state exchanges that are run through the federal government are not yet available, but researchers expect those totals to be low as well. (Murphy, 11/13)

USA Today: Insurance Agents Hope For Smoother 2nd Year For Obamacare
Where you live in many ways determines what you get from Obamacare — and some insurance agents say that may not change much in the second year of the program, which begins open enrollment Saturday. Cincinnati insurance agent Kevin Schlotman describes a neighborhood on the Ohio-Indiana border where Affordable Care Act options are vastly different depending upon which side of the street you live on. (Unger, 11/13)

The Wall Street Journal: How Health Law’s Medicaid Enrollees Strain The System
Many Americans with low incomes now have health coverage they couldn’t have gotten before this year under the act, widely called Obamacare. But their sheer numbers are straining some health-care systems that already don’t have enough doctors and staff. And the new Medicaid enrollees can challenge medical practices’ bottom lines in ways that lead them to turn some away. Almost nine million additional Americans now have coverage through Medicaid as a result of changes that took effect this year under the 2010 act. (Radnofsky, 11/13)

The Wall Street Journal: The Short Answer: Who Gets Medicaid Under The Affordable Care Act
Millions of low-income Americans are expected to join Medicaid after the second sign-up drive begins on Saturday for coverage under the Affordable Care Act, widely called Obamacare. That will further expand Medicaid–already the nation’s largest health plan–which lawmakers chose as the vehicle for covering around a third of the nation’s uninsured. (11/13)

Politico: Poll: Good Reviews For Obamacare Coverage
A majority of Americans give good reviews for insurance they recently acquired through government exchanges within the last year, a new poll shows. With the second round of Obamacare enrollment set to begin on Saturday, 71 percent said their coverage through the exchanges was good or excellent, according to a Gallup poll released Friday. Another 19 percent said the coverage was fair, while nine percent rated it poorly. (McCalmont, 11/14)

Politico: New Obamacare Furor: Was Jonathan Gruber The “Architect”?
Nobody much cared how much credit Jonathan Gruber took for Obamacare — until now. Once videos surfaced in which the MIT economist talked about the public’s “stupidity,” his claims suddenly matter a lot. (Winfield Cunningham, 11/13)

The Washington Post: Were Republicans Worried That Attacking Obamacare Would Turn Out Democrats?
It's been the comments of economist Jonathan Gruber that has vaulted talk of repealing Obamacare back into the news. Republicans have seized on Gruber's remarks as suggesting that the development of President Obama's eponymous health-care policy was tainted from the outset, reinvigorating calls to scale it back. (Bump, 11/3)

The Washington Post's Fact Checker: Did Jonathan Gruber Earn ‘Almost $400,000′ From The Obama Administration?
Republicans are demanding hearings into videos that have emerged in recent days of MIT professor Jonathan Gruber making impolitic remarks about the Affordable Care Act. Why should Gruber’s comments matter? Because Gruber is well-known in health-care circles as one of the intellectual godfathers of Obamacare and the very similar law in Massachusetts (sometimes called Romneycare), though people involved in ACA deny he was “an architect” of the ACA. (Kessler, 11/14)

The Associated Press: October Budget Deficit Rises To $121.7 Billion
But the CBO is forecasting the deficits will start rising for the rest of the decade as baby boomers retire and Social Security and Medicare costs rise. The CBO and other budget experts have warned that the current trajectory for the deficit is unsustainable and eventually could lead to a fiscal crisis. ... The improved deficit picture for 2014 reflected slower growth in spending due to lower-than-expected health care costs as well as a 2011 budget pact with Republicans that sharply curbed agencies’ operating budgets. (11/13)

The Wall Street Journal: Cancer-Care Giant Is Investigated Over Medicare Billing
The Justice Department is investigating whether a cancer-care giant improperly billed Medicare for a procedure when it administered radiation therapy to patients—the second time the company has faced federal scrutiny this year. Federal prosecutors have requested an array of documents from 21st Century Oncology Holdings Inc. “concerning allegations” that it “knowingly billed for services that were not medically necessary and for services not rendered,” the company disclosed in a regulatory filing. (Carreyrou, 11/13)

The Wall Street Journal: Will Rising Prices For Some Generic Drugs Never End?
In the frenetic U.S. health-care system, one thing has generally been constant—a generic drug is a low-cost alternative to brand-name medicines. But over the past year, this reliable view of the world has begun to change as reports emerged of consumers encountering substantial increases for some drugs. One notable example is a heart drug known as digoxin, which used to sell for pennies a pill, but a month’s supply can now fetch up to $1,200—although the average cost is closer to $50, according to GoodRx.com, a website that tracks prices. (Silverman, 11/13)

The Wall Street Journal's Pharmalot: How Lobbying For Rare Disease Research Influences Congress And NIH
For years, patient advocates and families have lobbied Congress for more funds to combat rare diseases. But to what extent does lobbying make a difference when Congress sets appropriations and the National Institutes of Health makes funding decisions? A new study suggests lobbying by private groups does, indeed, influence federal funding for rare disease research. Every dollar spent on lobbying generated congressional support in the form of soft earmarks, which are passages in an appropriations bill that urge or encourage spending but do not carry the rule of law. In this instance, the term refers to providing funding for NIH research into particular diseases. (Silverman, 11/13)

The Wall Street Journal: Biden Urges Groups To Lobby Congress For $6.2 Billion In Ebola Funds
Vice President Joe Biden urged lawmakers on Thursday to take up the administration’s request for more than $6 billion in emergency aid to deal with the worldwide Ebola outbreak. Speaking to activists and leaders from humanitarian, non-governmental and religious organizations, Mr. Biden called for members of those groups to go to Capitol Hill and make their voices heard in the forthcoming congressional debate over the funding request. (Tau, 11/13)

The New York Times: Gov.-Elect Larry Hogan, A Republican, Stands Tall In Democratic Maryland
Many of Mr. Hogan’s policy views remain largely a mystery. Since election night, he has been steadfast in refusing to articulate positions until he takes office on other major state issues — like plans for the state’s troubled infrastructure or the expansion of Medicaid. ... Further, he attacked Mr. Brown, who was in charge of the disastrous and costly rollout of the state health care exchange. Maryland’s site crashed at the start of open enrollment, delaying the ability of many residents to sign up and costing the state tens of millions of lost dollars. (Steinhauer, 11/13)

The Washington Post: In Wake Of Cantor Loss, Top Va. Republican Faces Primary Challenge Next Year
[Virginia House Speaker William J.] Howell led Republican opposition to Medicaid expansion and denied any secret effort to let it pass. But [his likely opponent Susan] Stimpson and others objected to the creation of a 10-member commission that they feared would bolster the case for expansion. They also mistrusted budget language that they believed would have given Gov. Terry McAuliffe (D) the legal power to expand Medicaid unilaterally. (Portnoy, 11/13)

The Associated Press: Panel Approves Medical Marijuana Regulations
A Maryland commission approved regulations on Thursday to implement a medical marijuana program after a drawn-out process in a state that has struggled to make marijuana available to sick patients. While the regulations still need approval from a legislative panel and the state’s health secretary, advocates say the vote marked a significant step forward. (11/13)