First Edition: October 28, 2015

Kaiser Health News: Enrollment Guide: A Few Tips To Help You Shop For A New Marketplace Plan
Open enrollment for the health law’s 2016 marketplace plans begins Sunday, and federal officials caution consumers to check out premium prices because in many places they may be higher. But officials are planning to offer new features to make the process faster and smoother for consumers. (Carey, 10/28)

Kaiser Health News: Survey: Low-Income Elderly Reject Calif. Managed Care Experiment For Fear Of Change
A large share of low-income elderly Californians have opted out of a statewide managed care experiment because they feared losing their doctors and were reluctant to make any changes to their health care, according to survey data released Tuesday by the Field Poll. (Gorman, 10/27)

Kaiser Health News: Health Law Increases Coverage Rates For Women Not Yet Pregnant
The Affordable Care Act brought health insurance to 5.5 million women over the past two years, but many women still tell of unmet health care needs that could pose risks for them or future pregnancies, a new report finds. Researchers from the Urban Institute and the March of Dimes Foundation underscored the ACA’s long-term potential to improve health care for women in their child-bearing years, 18 to 44. The report was released Tuesday. (Gillespie, 10/27)

Kaiser Health News: Poll: Majority Of Americans Agree That The FDA Should Review Drug Ads Before They Air
There’s been a bipartisan outcry over the rising cost of prescription drugs – for instance, presidential candidates from both parties have identified high drug prices as a major concern. But there’s been far less discussion surrounding government oversight of how those medications are marketed to consumers and doctors. According to a poll released Wednesday by the Kaiser Family Foundation, almost 90 percent of people surveyed think the Food and Drug Administration should review prescription drug ads before they air – something it currently doesn’t do – to make sure they’re clear and accurate. (KHN is an editorially independent program of the foundation.) Those findings held true across political affiliations. (Luthra, 10/28)

Los Angeles Times: Obamacare Plans Could Be Forcing People To Pay Extra For Specialist Care
Many health plans sold through the Affordable Care Act in 2015 are so limited they don’t offer patients access to some medical specialists such as endocrinologists, rheumatologists and psychiatrists, a new study suggests. That may be forcing some patients to pay thousands of dollars out of their own pockets for any care provided by these specialists. (Levey, 10/27)

The Wall Street Journal: Health-Law Volunteers Face Struggle For Sign-Ups In Latest Enrollment Push
When the latest push to sign up people for insurance under the Affordable Car Act begins, the workers and volunteers charged with helping them enroll would seem to have a relatively low bar to clear, given the modest goals the Obama administration set for 2016. That doesn’t mean they have it easy. (Radnofsky, 10/27)

NPR: Some Health Plans Have No In-Network Doctors In Key Specialties
Say you bought health insurance through the federal health exchange, paid the premiums and followed the rules. And then say you start having pain in your hands. Your doctor refers you to a rheumatologist to test for arthritis. But when you search for the specialist, there isn't one there. That happens more often than you'd think. In fact, as many as 14 percent of health plans sold on the federal government's insurance exchange are missing doctors in at least one common specialty from their networks, according to a study published Tuesday in JAMA, the journal of the American Medical Association, by researchers at Harvard's T.H. Chan School of Public Health. (Kodjak, 10/27)

The New York Times: Agreement Is Seen As Short-Term Relief For Medicare And Social Security
The budget agreement reached by congressional leaders and the White House this week will prevent a sharp increase in Medicare premiums for more than 15 million older Americans and a deep cut in Social Security benefits for nine million disabled workers, but it will not alter the long-term financial outlook for either program, lawmakers and budget experts said Tuesday. (Pear, 10/27)

Los Angeles Times: No 'Grand Bargain,' But The Budget Pact Is A Big Deal For Millions Of Americans
The two-year budget deal that congressional leaders negotiated with the White House may not be the kind of sweeping accord that House Speaker John A. Boehner and President Obama once tried to hammer out, but its provisions will directly affect the lives of millions of Americans. Senior citizens will be spared a 52% increase in Medicare premiums that would otherwise have taken effect next year. ... And rather than being cut once again, spending will increase at the Pentagon and on domestic programs, including medical research and Head Start preschool programs. That last point, in particular, represents a setback for congressional Republicans, who have campaigned for a steady shrinking of most government functions. (Mascaro, 10/27)

The Wall Street Journal: Budget Deal Stirs Anger On The Right
Congressional leaders worked Tuesday to marshal support for a sweeping budget and debt deal that offered an end to fiscal fights with President Barack Obama but opened up top Republicans to criticism from conservatives, including GOP presidential hopefuls. ... For Republicans, the deal offered a path for the GOP-controlled Congress to avert blame from a potential default, instead securing at least some policy goals as a condition for raising the borrowing limit. ... The agreement incorporates measures aimed at extending the solvency of the Social Security program used to help support disabled people. The deal also would prevent an expected 52% increase in premiums for roughly 30% of the people enrolled in Medicare Part B, which covers outpatient care such as doctor visits. (Peterson and Timiraos, 10/27)

The Wall Street Journal: Budget Deal Tackles Disability, Halts Medicare Premium Increase
The budget deal hammered out between the White House and congressional leaders Monday would stave off an unprecedented increase in 2016 Medicare premiums for millions of seniors and prevent a Social Security program for the disabled from becoming insolvent next year. Both are issues that have vexed Congress in recent months. Legislators had wanted to shore up the disability fund before its expected depletion at the end of next year, given the difficulty of addressing entitlements in an election year. The White House achieved its goal of keeping the program solvent and House Republicans won sought-after reforms. (Armour, 10/27)

The Washington Post: Budget Deal Blunts, But Doesn’t Erase, Increase In Medicare Premiums
The tentative budget agreement forged by congressional leaders and the Obama administration will ward off a historic spike in Medicare premiums for the coming year, but it will nevertheless require nearly one in three older Americans to pay 17 percent more in monthly premiums for doctors’ visits and other outpatient care. (Goldstein, 10/27)

The Washington Post: House Advances Budget Bill Ahead Of Potential Wednesday Vote
The deal hit a snag Tuesday night after many Republicans raised questions about whether the $80 billion in spending increases in the legislation would be fully offset by spending cuts and other revenue. Conservatives continued to fight the bill throughout the night, including attempting to kill the bill in a late-night hearing of the House Rules Committee. But Republican leaders worked out last-minute fixes that cleared the way for a Wednesday vote. (Snell, 10/27)

The Associated Press: The House’s Big Day: Budget Deal Vote, GOP Nominating Ryan
The House is poised to vote on a bipartisan pact charting a two-year budget truce and Republicans are set to nominate Rep. Paul Ryan as the chamber’s new speaker, milestones GOP leaders hope will transform their party’s recent chaos into calm in time for next year’s presidential and congressional campaigns. (Fram, 10/28)

The New York Times' DealBook: Walgreens To Buy Rite Aid For $9.4 Billion
As companies throughout the universe of the health care industry accelerate the pace of consolidation, two of the country’s biggest drugstore chains have agreed to combine to create a new giant. Walgreens Boots Alliance said on Tuesday that it would buy Rite Aid for more than $9.4 billion in cash, significantly bolstering its influence with drug makers and pharmacy benefit managers. (de la Merced and Tabuchi, 10/27)

Los Angeles Times: Walgreens To Buy Rival Rite Aid For $9.4 Billion, Creating Drugstore Giant
The companies didn't say whether there would be store closures or layoffs after the deal closes. But they said “decisions will be made over time regarding the integration of the two companies” and that Walgreens “plans to further transform Rite Aid's stores to better meet consumer needs.” (Peltz and Masunaga, 10/27)

The Wall Street Journal: Walgreens, Rite Aid Unite To Create Drugstore Giant
The deal, which would unite two of the country’s three biggest drugstore owners, would be likely to draw scrutiny from antitrust regulators, who could demand divestitures in exchange for their approval. It also adds to a blockbuster year for health-care mergers and acquisitions, helping to put 2015 on track to be the busiest year ever for M&A. Including assumed debt, the transaction is valued at $17.2 billion. Rite Aid’s debt totaled $7.4 billion in August. (Mattioli , Siconolfi and Cimilluca, 10/27)

The Associated Press: Anthem Beats Street 3Q Forecasts
Anthem Inc. (ANTM) on Wednesday reported third-quarter profit of $654.8 million. The Indianapolis-based company said it had profit of $2.43 per share. Earnings, adjusted for non-recurring costs and amortization costs, were $2.73 per share. (10/28)

The Wall Street Journal: Novartis Profit Hurt By U.S. Settlement
Novartis AG said Tuesday that third-quarter profit fell 42% from the same period last year, as the Swiss drug company settled claims that it paid rebates to encourage specialty pharmacies to increase prescriptions. The Basel, Switzerland-based pharmaceuticals company said it has agreed to pay $390 million as part of a settlement with the U.S. Justice Department regarding claims that the company induced specialty pharmacies to boost prescriptions for Novartis drugs by paying kickbacks in the form of rebates. (Roland and Letzing, 10/27)

The Wall Street Journal: Rising Fees Pinch Some Pharmacies
A sharp rise in fees associated with a popular type of drug plan is chipping away at pharmacies’ profits across the U.S. ... These fees, known as DIR for direct and indirect remuneration, are a small piece of the tangle of contracts, rebates and reimbursements involved in the sale of prescription drugs in the U.S., which totaled $374 billion in 2014, according to the IMS Institute for Healthcare Informatics, a research group. (Ziobro, 10/28)

The Wall Street Journal: Hedge-Fund Billionaire Larry Robbins Takes ‘Punch In The Face’
Billionaire hedge-fund manager Larry Robbins once compared his bets on the success of President Barack Obama’s health-care overhaul to assembling a jigsaw puzzle. But a new slump for many large drug makers is knocking some of those pieces out of place. (Copeland and Hoffman, 10/27)

Politico: Budget Deal Will Be 'Pinata' During GOP Debate
The bipartisan congressional budget deal will be an easy target for the GOP presidential field during Wednesday’s prime-time debate. And GOP leaders are bracing for their carefully crafted work to be treated like a punching bag. ... The deal actually will be good news for the eventual GOP nominee, taking presidential year shutdown and default threats off the table. (Everett, 10/28)

The Wall Street Journal: Jeb Bush Outlines Social Security, Medicare Overhauls
Bush outlined a package of changes to limit the rising costs of Social Security and Medicare, including scaling back retirement benefits for wealthier Americans. ... On Medicare, Mr. Bush proposed a model similar to one offered by Rep. Paul Ryan, (R., Wis.), the chairman of the House Ways and Means Committee. He called for a “premium-support” plan that allows Americans to choose private insurance plans or to enroll in traditional Medicare. The government would then contribute a set amount toward the insurance premium. (Timiraos, 10/27)

The New York Times' First Draft: Jeb Bush Calls For Curtailing Costs Of Social Security And Medicare
His plan includes a call for “bipartisan Medicare premium support” — a much debated approach championed by Republicans like Representative Paul Ryan in the past — which would allow private health care plans, traditional Medicare and other entities to compete on price and other factors. Seniors’ premium support would be based on the average on those prices, Mr. Bush said, estimating a 6 percent reduction. (Flegenhaimer, 10/27)

The Associated Press: Bush Proposes Overhaul Of Social Security, Medicare
Bush outlined his proposals on the website Medium.com on Tuesday, the day before the third Republican presidential debate, in Colorado. ... Bush proposes a "Medicare premium support" program to provide seniors with a fixed amount to pay for "guaranteed coverage options" to obtain traditional Medicare or purchase a private health insurance plan. Seniors could also choose a specialized insurance plan that targets medical conditions like diabetes or Alzheimer's. (10/27)

The Wall Street Journal: For John Kasich, Medicaid Expansion Is Both Accomplishment And Liability
As John Kasich struggles to gain traction in the GOP presidential race, one of his biggest accomplishments as Ohio governor—an expansion of health insurance for the poor—is looming as one of his biggest political liabilities. The issue of expanding Medicaid was raised in the very first question to Mr. Kasich in the first Republican presidential debate in August, and it may re-emerge during Wednesday’s debate in Colorado, where Mr. Kasich is under heavy pressure to deliver a breakout performance. (Hook, 10/27)

The Washington Post: Carly Fiorina Slips Two New Words In A Rarely Told Tale: Planned Parenthood
This year, Fiorina, as a Republican candidate for president, started regularly telling another powerful, personal story that she said helped harden her antiabortion position. And two weeks ago, the story seems to have acquired two new words: Planned Parenthood. (Phillip, 10/28)

The Associated Press: Drug Prices Top Americans’ List Of Health Care Concerns
Americans from across the political spectrum are worried about the cost of prescription drugs for serious diseases, following weeks of news coverage about companies hiking prices for critical medicines. Keeping drugs for cancer, hepatitis, HIV and other conditions affordable is the top health priority for Democrats, Republicans and independents, according to a poll released Wednesday by the nonpartisan Kaiser Family Foundation. (Perrone, 10/28)

Los Angeles Times: Anthem Blue Cross To Repay $8.3 Million To California Customers
Anthem Blue Cross agreed to end midyear policy changes that raise costs for consumers and to reimburse nearly $8.3 million to about 50,000 customers in California as part of a settlement of a class-action lawsuit announced Tuesday. (Masunaga, 10/27)

The Washington Post: Virginia Health-Care Experts Review Law GOP Pans As Competition Killer
A panel of hospital CEOs, doctors and health-care executives on Tuesday considered changes to Virginia laws regulating medical facilities and services that two federal agencies said curb competition and stifle innovation in the state’s health-care industry. (Portnoy, 10/27)

The Associated Press: NY Lets Patients Tap Caregiver For Discharge Instructions
New York law now requires hospitals to let patients designate a family member or unrelated caregiver who will be advised about medical care, transfers to other facilities and medical needs upon discharge. (10/27)

Los Angeles Times: More Middle-Class Americans Visit Mexico For Low-Cost Medical Care
A new study from the Commonwealth Fund, a private foundation that aims to promote a high-performing health care system, revealed that about 23 percent of Americans with coverage are considered underinsured up from 12 percent in 2003 since the inception of Obamacare in 2012. That means roughly 31 million Americans who bought health insurance still have trouble affording treatment under their policies, according to the study. (D'Angelo, 10/27)