First Edition: November 16, 2017

California Healthline: California Fines Anthem $5 Million For Failing to Address Consumer Grievances
California’s managed-care regulator announced Wednesday it has fined insurance giant Anthem Blue Cross $5 million for repeatedly failing to resolve consumer grievances in a timely manner. The state Department of Managed Health Care criticized Anthem, the nation’s second-largest health insurer, for systemic violations and a long history of flouting the law in regard to consumer complaints. (Terhune, 11/15)

Kaiser Health News: For Millions of Insured Americans, State Health Laws Don’t Apply
Let’s say you have health insurance through your employer and live in one of 21 states with laws protecting consumers against surprise medical bills from out-of-network providers. Should one of those unwanted bills land in your mailbox, you can turn to your state law and regulators for help, right? Not necessarily. (Bazar, 11/16)

California Healthline: California Firm Running Physician Practices Is Closing Down As Scrutiny Ramps Up
SynerMed, a company that manages physician practices serving hundreds of thousands of Medicaid and Medicare patients across California, is planning to shut down amid scrutiny from state regulators and health insurers. The company’s chief executive, James Mason, notified employees in an internal email Nov. 6, obtained by Kaiser Health News, that audits by health plans found “several system and control failures within medical management and other departments.” (Terhune, 11/15)

The Associated Press: 'Obamacare' Sign-Ups 45 Percent Ahead Of Last Year's Pace
Sign-ups for Affordable Care Act health plans are running more than 45 percent ahead of last year's pace, according to government data released Wednesday. The numbers from the Centers for Medicare and Medicaid Services come as Republican senators are pushing to pay for tax cuts by repealing the "Obamacare" requirement to carry coverage. (Alonso-Zaldivar, 11/15)

Reuters: Nearly 1.5 Million People Signed Up For Obamacare Plans So Far: Officials
More than 800,000 people signed up for Obamacare individual health insurance plans in the second week of open enrollment, U.S. government health officials said on Wednesday, bringing the total number of sign-ups to nearly 1.5 million so far. (Abutaleb, 11/15)

The Washington Post: ACA Federal Enrollment Surges By At Least 47 Percent This Year, CMS Says
The portion of new consumers enrolling in ACA plans is slightly down this year, according to the latest federal report. Those Americans accounted for 23 percent of enrollees between Nov. 1 and Nov. 11, as opposed to 24 percent in the early days of 2016. (Eilperin, 11/15)

Politico: Defying Gloomy Predictions, Obamacare Enrollment Surges
In other words, there might be no such thing as bad news for Obamacare. “As P.T. Barnum would say, as long as my name is in the papers and it’s spelled correctly, it’s all good,” said Michael Marchand, chief marketing officer for Washington state’s Obamacare marketplace, which saw its website traffic increase by 24 percent during the first week of enrollment. “I think there’s some truth to that.” The conventional wisdom was that enrollment would dip significantly as a hostile administration gutted outreach and marketing. (Demko, 11/15)

The New York Times: Obamacare, Reliant On Insurance Requirement, Would Crumble Under Senate Tax Bill
Senate Republicans want to eliminate the Affordable Care Act’s requirement that most people buy health insurance as part of their overhaul of the tax code. Repealing the rule, known as the individual mandate, is a longstanding Republican goal and would allow lawmakers to save hundreds of billions of dollars to help pay for broad tax cuts. (Park, 11/15)

The Associated Press: 'Obamacare' Mandate Repeal Would Remake Market For Consumers
Millions are expected to forgo coverage if Congress repeals the unpopular requirement that Americans get health insurance, gambling that they won't get sick and boosting premiums for others. The drive by Senate Republicans to undo the coverage requirement under former President Barack Obama's health care law is a sharp break from the idea that everyone should contribute to health care. (Alonso-Zaldivar, 11/15)

The Washington Post: The GOP Plan To Kill Obamacare’s Least Popular Provision Could Backfire On Some In The Middle Class
The Republican proposal to strike the Affordable Care Act's least popular provision, the requirement that people maintain health coverage or pay a fine, could bring an immediate political victory — but would backfire on upper-middle-class people who buy individual insurance and pay full price for their plans, health policy specialists said. “The market is stable, but you need to define 'stable.' 'Stable' is the insurance companies ramming the rates to holy hell,” said Robert Laszewski, president of Health Policy and Strategy Associates. “That's a catastrophically terrible market. This is a screwed-up market, to the 16th power. But it can continue this way, indefinitely. So, therefore, it's stable." (Johnson, 11/15)

The Hill: Mandate Repeal Sparks Fears Of Premium Hikes
The move by Senate Republicans to repeal ObamaCare’s individual mandate could plunge insurance markets into uncertainty, leading to premium hikes or insurers dropping out of the market, experts say. The mandate requires most people to either have health insurance or pay a fine. It was designed to ensure that people don’t wait until they are sick to buy health insurance, since ObamaCare also bars insurers from denying coverage based on pre-existing conditions. (Sullivan, 11/16)

The Hill: GOP Senator: ObamaCare Mandate A 'Tax On The Poor And Working Class'
Sen. Tim Scott (R-S.C.) called the ObamaCare individual mandate a "tax on the poor and working class" during an interview on Wednesday, one day after Senate Republicans announced they would include a repeal of the mandate in their tax-reform legislation. "The fact of the matter is that the individual mandate is a tax on the poor and working class," Scott said on "The Hugh Hewitt Show." (Manchester, 11/15)

The Washington Post Fact Checker: Schumer’s Claim That The GOP Is ‘Kicking 13 Million People Off Health Insurance’
In a last-minute switch to the Senate version of the GOP tax plan, lawmakers added a repeal of the individual mandate embedded in the Affordable Care Act. Schumer’s comment equates the health-care move with accusations that the tax bill is tilted toward the wealthy. The requirement that Americans maintain health coverage or pay a fine is one of the least popular provisions of Obamacare. But it is a key element of the law — one of three legs of the “stool” holding up the law. The two other legs are tax subsidies that make insurance affordable and a prohibition on insurance companies from denying coverage or raising premiums based on a preexisting condition. (Kessler, 11/16)

Politico: How Cotton Brought Obamacare Repeal Back From The Dead
Sen. Tom Cotton was about to enter the White House early this month to discuss immigration policy when he got an unexpected call from President Donald Trump to talk about a different topic. For days, the Arkansas senator had been working behind the scenes to convince Republicans that reigniting a battle over repealing Obamacare in the tax fight wasn’t as crazy as it seemed. But Trump, still smarting from GOP’s failures to dismantle the law whom Cotton had first pitched on the idea four days prior, needed little persuading. (Kim and Haberkorn, 11/15)

Politico: Dems Seize On GOP’s Obamacare Attack To Awaken The Left On Taxes
Senate Republicans’ decision to strike at Obamacare in their tax legislation may be just what Democrats and progressive organizers need to rally an otherwise distracted base. The liberal activists who besieged the GOP’s health bill have yet to rise up as fiercely against the tax plan. They haven’t been helped with headlines dominated by the Roy Moore scandal and a Russia probe drawing closer to President Donald Trump. (Schor, 11/15)

The New York Times: Tax Bill Thrown Into Uncertainty As First G.O.P. Senator Comes Out Against It
Uncertainty gripped the Senate on Wednesday over efforts to pass a sweeping $1.5 trillion tax cut after a Wisconsin Republican became the first senator in his party to declare that he could not vote for the tax bill as written, and other senators expressed serious misgivings over the cost and effect on the middle class. The House is set on Thursday to pass its own version of the tax bill, which would cut taxes by more than $1.4 trillion over 10 years and broadly rewrite the business tax code. But as with the health care debate earlier this year, the Senate emerged as the inconstant ally in President Trump’s pursuit of a major legislative accomplishment in his first year. (Rappeport and Kaplan, 11/15)

The Associated Press: 1st GOP Senator Opposes Tax Bill In Early Sign Of Problems
Democrats said the measures would bestow the bulk of their benefits on higher earners and corporations. In the Senate Finance Committee, they focused their attacks on two provisions designed by Republicans to save money. One would repeal President Barack Obama's health law requirement that people buy coverage or pay a fine, a move the nonpartisan Congressional Budget Office projects would result in 13 million more uninsured people by 2027. The other would end the personal income tax cuts in 2026 while keeping the corporate reductions permanent. (11/15)

The Wall Street Journal: Bipartisan Plan Would Boost Health-Insurance Markets
Republican lawmakers looking to repeal a rule requiring most people to have health insurance said Wednesday they were now more open to a bipartisan plan to bolster the insurance markets, since they would likely face political responsibility for the health-care system. The measure, reversing President Donald Trump’s halting of payments to health insurers, is now more likely to be in a year-end spending package, Republican aides said. Repealing the Affordable Care Act’s so-called individual mandate is expected to raise insurance premiums, health experts say, adding pressure on GOP lawmakers to take offsetting measures. (Armour and Peterson, 11/15)

The Hill: Key GOP Senator: ObamaCare Payments Likely To Be Included In Funding Bill
Sen. John Cornyn (R-Texas) said Wednesday that the Senate will likely include key ObamaCare payments in an end-of-year spending bill. "I think that's likely to happen," Cornyn, the second-ranking Senate Republican, told reporters when asked if the cost-sharing reduction payments would be included in the December funding bill. (Carney, 11/15)

The Hill: Schumer: Dems Won't Back ObamaCare Deal If It Is Tied To Tax Bill
Senate Minority Leader Charles Schumer (D-N.Y.) warned on Wednesday that Democrats won't help pass a bipartisan deal on key ObamaCare payments if Republicans use their tax plan to repeal the individual mandate. "The Republicans cannot expect to pass their own separate ideological health-care provision and then turn around and ask Democrats to vote to pass Alexander-Murray," Schumer said from the Senate floor, referring to a bill by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.). (Carney, 11/15)

The Washington Post: Parents Of 4-Year-Old With Cancer Can’t Buy ACA Plan To Cover Her Hospital Care
Four-year-old Colette Briggs bounded into the dining room where her parents sat in the midst of another distressing conversation. Oblivious to their anxiety, she cheerily asked her mom to retie one of the loose pigtails atop her head. Ever since her brown locks regrew long enough for a ponytail, hair has been a big deal around here, her father, Christopher Briggs, said as Colette skipped off to rejoin her older sisters. (Itkowitz, 11/15)

The New York Times: I.R.S. Starts To Enforce Health Law’s Rule That Employers Offer Insurance
As Republicans and the Trump administration continue trying to chip away at the Affordable Care Act, the Internal Revenue Service has begun, for the first time, to enforce one of the law’s most polarizing provisions: the employer mandate. Thousands of businesses — many of them small or midsize — will soon receive a letter saying that they owe the government money because they failed to offer their workers qualifying health insurance. (Cowley, 11/16)

The New York Times: Tech Companies Get High Marks For Covering Infertility Treatments
A relatively small number of companies offer generous benefits for infertility treatment to employees, while most have minimal or no coverage, a new report found. It’s a case of “haves and have-nots,” said Jake Anderson, a founder of FertilityIQ, the start-up that wrote the report. (Carrns, 11/15)

Politico: Tax-Exempt Mayo Clinic Grows, But Rural Patients Pay A Price
The Mayo Clinic, which sprawls across this Midwestern city, is the nation's top-ranked hospital, according to U.S. News & World Report. But that might undersell its prominence: The clinic is arguably the best-regarded health care system on the entire planet. Patients from nearly 150 countries travel to Mayo Clinic sites in Minnesota, Arizona, Florida and beyond. Famed filmmaker Ken Burns is making a documentary about Mayo and the story of its founders — Will and Charlie Mayo, a pair of brothers and doctors who have assumed near-mythic status in the health care field. (Diamond, 11/16)

Stat: FDA Clears Electronic Earpiece To Block Opioid Withdrawal Symptoms
A wearable device claiming to block the pain of opioid withdrawal has been cleared by the Food and Drug Administration under an expedited review process for medical devices. However, patient safety advocates note that the device has limited evidence for its effectiveness. The NSS-2 Bridge is a device that attaches to the ear and transmits small electrical pulses through four cranial nerves. It’s marketed by Indiana-based Innovative Health Solutions, and was cleared to treat chronic and acute pain in 2014. IHS can now market the device as one that reduces symptoms of opioid withdrawal including nausea, anxiety, and aches. (Blau, 11/15)

The Associated Press: Drug Firm Founder Indicted In Opioid Conspiracy Due In Court
The founder of a pharmaceutical company charged with leading a conspiracy to bribe doctors to prescribe a powerful opioid pain medication for people who didn’t need it is due in court in Massachusetts. John Kapoor of Insys Therapeutics Inc. was arrested in Arizona last month and is expected to make his first appearance in Boston’s federal courthouse on Thursday. (11/16)

NPR: Getting Doctors To Stop Prescribing Codeine To Kids Has Taken Years
For years the Food and Drug Administration has been trying to get doctors to quit prescribing codeine, an opioid painkiller, to children after getting their tonsils or adenoids out. But it can be hard to get clinicians to change their prescribing habits, even when children have died and other less risky medications are available. (Jochem, 11/16)

The New York Times: Amish Mutation Protects Against Diabetes And May Extend Life
Amish people living in a rural part of Indiana have a rare genetic mutation that protects them from Type 2 diabetes and appears to significantly extend their life spans, according to a new study. The findings, published on Wednesday in the journal Science Advances, shed light on the processes underlying cellular aging and could lead to new therapies for chronic diseases, some experts say. The researchers are planning at least one follow-up trial that will recreate the effects of the mutation so they can study its impact on obese people with insulin resistance, a precursor to diabetes. (O'Connor, 11/15)

NPR: What If We Treated Gun Violence Like A Public Health Crisis?
When U.S. officials feared an outbreak of the Zika virus last year, the Department of Health and Human Services and state officials kicked into high gear. They tested mosquitoes neighborhood by neighborhood in Miami and other hot Gulf Coast communities where the virus was likely to flourish. They launched outreach campaigns to encourage people to use bug spray. And they pushed the development of a vaccine. (Kodjak, 11/15)

The New York Times: Heart Attack Survivors At Risk Of Later Dementia
Heart attack survivors have an increased risk for developing dementia, a new study has found. Danish researchers studied 314,911 heart attack patients and compared them with 1,573,193 controls who had not had a heart attack. They excluded anyone who had already been diagnosed with dementia or other memory disorders. The study, in Circulation, adjusted for heart failure, pulmonary disease, head trauma, kidney disease and many other variables. (Bakalar, 11/15)

The New York Times: How To Lower Your Blood Pressure
The American Heart Association and the American College of Cardiology have released new treatment guidelines that sharply lower the threshold for high blood pressure, also called hypertension. As a result, tens of millions of Americans now qualify for the diagnosis. The new guidelines have raised a number of questions for patients. Here are a few answers. (Kolata, 11/15)

The Washington Post: American Heart Association President Has Heart Attack
American Heart Association President John Warner suffered a heart attack during the organization's annual conference in Southern California, where he spoke about his family's history with heart disease. Warner, vice president and chief executive of UT Southwestern University Hospitals in Dallas, was recovering after what the American Heart Association called a “minor” episode Monday morning at the organization's Scientific Sessions, a five-day conference on cardiovascular science in Anaheim. He was in stable condition after doctors inserted a stent to open an artery, the association said in a statement. (Bever, 11/15)

NPR: A Baby Exposed To Zika Virus Is Doing Well, One Year Later
Two years ago, when the Zika virus was first identified as the cause of microcephaly in babies, women were scared. Expectant mothers who got infected had no idea what the chances were of having a healthy baby. Researchers have since learned that while Zika infection is dangerous, about 94 percent of babies born to women infected with Zika appear to be normal at birth. (Simmons-Duffin, 11/15)

NPR: Pop-Ow! 'Popeye' Deformity Can Be A Painful Armful
A 79-year-old man picked up an object with his left hand and suddenly felt a sharp pain in his shoulder. Something moved in his upper arm. And with that, he was Popeye. His right arm looked the same as it always had: lean and sagging a little with age. But his left biceps now sported a baseball-size bulge that looked like it could land a powerful punch. The brand-new muscle mound looked even bigger when the man flexed his biceps. The only thing was, it hurt. A lot. (Bichell, 11/15)

The Washington Post: New Robotic Hand Named After Luke Skywalker Helps Amputee Touch And Feel Again
Keven Walgamott wasn’t sure what to expect when scientists first hooked up what was left of his arm to a computer. Last year — 14 years after he lost his hand and part of his arm in an electrical accident — he heard about a team at the University of Utah working on an experimental robotic arm. The prosthetic hand and fingers would be controlled by an amputee’s own nerves. Even more challenging, researchers were trying to restore the sense of touch to amputees through that robotic hand. (Wan, 11/15)

Los Angeles Times: Anaheim Legionnaires' Outbreak Grows; 11 Cases Linked To Disneyland Visits
The number of people diagnosed with Legionnaires’ disease after spending time in Anaheim or Disneyland increased to 15, Orange County health officials said Wednesday. The victims were infected between late August and October, officials said. Two patients have died, though neither of them visited Disneyland. (Karlamangla, 11/15)

The Associated Press: 17 Escapes From Hawaii Hospital Since 2010
More than a dozen escapes have occurred over the past eight years at a Hawaii psychiatric hospital where a patient described as dangerous walked off the grounds and made it to California before he was captured this week. Many of the 17 escapes between 2010 and this year happened when a patient broke "curfew" and didn't return from the Hawaii State Hospital after being allowed to leave for a period of time, according to information obtained by The Associated Press from police and the state Department of Health. (11/16)

The Associated Press: Couples Sue Fertility Clinic Over Eggs With Genetic Defect
Two couples are suing a New York fertility doctor and his clinic after giving birth to children with a genetic abnormality later traced back to donated eggs. The two children, both born in 2009, have Fragile X syndrome, a genetic condition that can lead to intellectual and developmental impairments. The parents, identified by initials and last names in legal papers, argue the doctor and the clinic failed to test the women who donated the eggs to determine whether they were carriers for Fragile X. They’re seeking damages for the added expenses of raising a disabled child. (Klepper, 11/15)