The New York Times: Little Growth Predicted On Health Exchanges
In a surprisingly pessimistic forecast, the Obama administration predicted on Thursday that health insurance enrollment on the Affordable Care Act’s public marketplaces will only inch up from current coverage levels by the end of 2016. After an elaborate analysis of demographic data, Sylvia Mathews Burwell, the secretary of health and human services, said that 10 million people were expected to have marketplace coverage at the end of next year, up only about 100,000 from recent levels and millions short of earlier projections. She called that “a strong and realistic goal.” (Pear, 10/15)

The Wall Street Journal: Obama Administration Projects Slim Gain For Health-Law Enrollment In 2016
This third open-enrollment season had widely been expected to make the greatest gains after the first go-round was marred by technology problems, and the second unfolded as a major challenge to the law loomed in the Supreme Court. The new season also carries a big incentive for consumers to buy insurance: to avoid the heftiest financial penalty yet on their taxes for going without coverage. (Radnofsky and Armour, 10/15)

Kaiser Health News: HHS: Remaining Uninsured Worry About Costs Of Coverage
Department of Health and Human Services officials Thursday predicted that about an additional 1 million Americans would sign up for coverage under the federal health law next year and acknowledged that prospective enrollees are worried about the cost of health insurance, even with the law’s financial help. (Carey, 10/15)

Los Angeles Times: Obama Administration Sets Low Bar For Health Law Enrollment In 2016
That is only a small increase over 2015, when 9.1 million Americans are expected to have coverage through the marketplaces, according to the Department of Health and Human Services. The 2016 target is also significantly lower than what the nonpartisan Congressional Budget Office had predicted. Earlier this year, the budget office estimated 21 million people would get coverage through the marketplaces next year. (Levey, 10/15)

The Washington Post: White House Projects Marginal ACA Enrollment Growth In 2016
The anemic projection comes as the sprawling law is entering a new phase. Having survived the disastrous 2013 rollout of HealthCare.gov, the federal exchange’s online enrollment system, and weathered two Supreme Court challenges, the ACA has moved past critics’ early hopes that the law might quickly collapse. Proponents note that the statute has been responsible for the biggest gain in insurance coverage in decades. But questions linger over whether it can reach deep into the pockets of the nation’s most intractable uninsured populations and whether people who currently have health plans through the marketplaces will decide that the coverage is worth keeping. (Goldstein, 10/15)

USA Today: 10 Million — Not 20 Million — Should Have Obamacare Plans By 2017
More than 25% of those who are uninsured and eligible to buy plans on the federal and state health insurance exchanges are expected to select plans during the open enrollment that starts Nov. 1, Health and Human Services Secretary Sylvia Matthews Burwell said Thursday. The other 75% are "a little harder to reach," said Burwell. Those who don't have health insurance in 2016 will face a penalty of $695 per person on their taxes for the year. (O'Donnell, 10/15)

Politico: White House Lowballs Obamacare Target In An Election Year
As Obamacare’s third enrollment season unfolds against the backdrop of the 2016 presidential election, the administration announced a surprisingly low enrollment goal on Thursday — a target of 10 million people covered through the health law’s exchanges by the end of 2016, or a net increase of roughly 1 million. (Pradhan, 10/15)

The Associated Press: Is Obama's Health Overhaul Losing Steam?
Burwell called the new goal “strong and realistic.” An aide said the congressional numbers are based in part on assumptions that haven’t panned out, about employers dropping job-based plans for their workers, and about people with their own private coverage switching to HealthCare.gov. (Alonso-Zaldivar, 10/15)

Reuters: U.S. Government Sees 10 Million People With Obamacare Insurance By End '16
About 17.6 million people have gained insurance coverage through the exchanges and through the expansion of Medicaid plans for the poor since early 2014. The exchange-based plans are sold by private insurers including Aetna Inc, Anthem Inc and UnitedHealth Group Inc. More than 85 percent of individuals with these plans receive a government subsidy based on their income, aimed at making them more affordable. (Humer and Lambert, 10/15)

Bloomberg: U.S. Sets 2016 Obamacare Goal At 10M Amid Challenges
The affordability of health insurance has been brought up by both Republican and Democratic presidential candidates ahead of the 2016 election, and the administration’s success or failure in signing up people for coverage next year could heighten that debate. Enrollment for 2016 coverage on the exchanges starts on Nov. 1, about three months before voters in each party begin choosing their candidates in Iowa, New Hampshire and South Carolina. (Tracer, 10/15)

The Texas Tribune: Texans Wanted In New Round of Obamacare Signups
Two weeks before a new round of signups begins for health insurance coverage under the Affordable Care Act, federal officials have dampened projections about how many people will enter the marketplace this year, but say they are making a concentrated push to get uninsured Texans in particular to enroll. (Walters, 10/16)

The New York Times: Medicaid Costs Rise, But Some States Are Spared
Spending on Medicaid rose nearly 14 percent on average in the last fiscal year, a report has found, largely because of a tide of newly eligible enrollees in the 29 states that had expanded the program by then to cover millions more low-income adults. But for most of those states, the per-member, per-month cost of the new enrollees was not higher — in a few cases, in fact, it was lower — than expected, according to the report, released Thursday by the Kaiser Family Foundation. And almost all of the additional spending was covered by federal funds, which are paying the entire cost of expanding Medicaid through 2016 and at least 90 percent thereafter. (Goodnough, 10/15)

NPR: States That Declined To Expand Medicaid Face Higher Costs
The 22 states that didn't expand Medicaid eligibility as part of Obamacare last year saw their costs to provide health care to the poor rise twice as fast as states that extended benefits to more low-income residents. It's a counterintuitive twist for those states whose governors, most Republicans who opposed the Affordable Care Act, chose not to accept federal funds to extend Medicaid to more people. (Kodjak, 10/15)

The Associated Press: Big Growth In Medicaid Enrollees In Expansion States
States that opted to expand Medicaid under the Affordable Care Act saw enrollment increase on average by 18 percent during the first full year of expansion, according to a report released Thursday. That will soon have an effect on state budgets, with expansion states to pay a portion of costs to cover the new enrollees beginning in 2017. Currently, the federal government is covering the expanded population at 100 percent. States will eventually pay 10 percent of costs by 2020. (Cassidy, 10/15)

Kaiser Health News: Medicaid Spending Soars — Mostly In Expansion States
Most of the growth in Medicaid enrollment has been from people who became eligible under the health law and therefore totally paid for by the federal government. States that expanded the program saw their share of costs increase by 3.4 percent compared to nearly 7 percent in states that did not expand. Much of the growth in the non-expansion states was from increased enrollment among previously eligible parents and children. (Galewitz, 10/15)

USA Today: Report: Medicaid Costs Hit Record High As States Look For Efficiencies
To Obamacare supporters, the report is proof the health care law is improving access to insurance coverage to those who need it most. But the report could also provide ammunition to critics who say its unwise to expand a program that is already strapping state budgets. (O'Donnell, 10/15)

Also, the government releases its latest spending numbers, which highlight the increasing cost of Medicaid.

The Associated Press: US Budget Gap For 2015 At $439 Billion, Lowest In 8 Years
he U.S. budget deficit in 2015 fell to its lowest level in eight years, spurred by gains in tax revenue that outpaced greater government spending. ... Health care programs drove some of the largest increases in spending. Medicaid, which pays for health services for the poor, reported expenses of $350 billion, 16 percent higher than in 2014. Much of that increase was attributable to greater enrollments under the Obama administration’s health care reforms. (Rugaber, 10/15)

Health News Florida: Cigna Pulls Out Of FL Marketplace, Cites Abuse
Two weeks before the federal Health Insurance Marketplace opens for enrollment, a major national company is withdrawing its Florida plans from the exchange. Cigna Inc. of Hartford, CT, told some Florida insurance brokers of the decision on Thursday through an email and said customers will be notified through regular mail starting this week. It blamed soaring costs in its Florida plans on fraud and abuse in “out-of-network substance abuse clinics and labs.” (Gentry, 10/16)

The Associated Press: Cost Of Most Individual Health Plans To Rise In Pennsylvania
Pennsylvania state regulators say the cost of health insurance premiums will rise for most Pennsylvanians next year who buy individual plans, in some cases steeply. The Department of Insurance said Thursday that it has approved rates for 18 individual health insurance plans offered in Pennsylvania. Premiums in six plans offered by Pittsburgh-based Highmark, Wilkes-Barre-based Blue Cross of Northeastern Pennsylvania and Danville-based Geisinger will rise by more than 20 percent. (10/15)

The Connecticut Mirror: Access Health CT Says Uninsured Rate Lower Than Census Figures
Connecticut’s health insurance exchange released an analysis Thursday suggesting that the state’s uninsured rate this year is 3.8 percent, significantly lower than the 6.9 percent the U.S. Census Bureau recently reported for last year. While state and exchange officials praised the results and said they showed Connecticut has one of the lowest uninsured rates in the country, the estimated uninsured rate comes with some caveats. (Levin Becker, 10/15)

Meanwhile, a Tennessee insurance co-op, Community Health Alliance, created under the health law is winding down its operations -

Tennessean: Community Health Alliance Ending Coverage For 27K Enrollees
Community Health Alliance will no longer offer insurance coverage next year, forcing about 27,000 enrollees to find new health insurance plans. The Knoxville-based health insurance cooperative, created under the Affordable Care Act, will continue to pay out existing claims but will wind down its coverage by not taking on new customers. The decision was based on the co-op’s financial condition, according to the Tennessee Department of Commerce and Insurance, and ends months of uncertainty about its future. The alliance had stopped selling its plans on the federal exchange in January after its low-cost plans attracted more enrollees than expected, and their ability to handle the high volume came into question. (McGee, 10/14)

Memphis Commercial Appeal: Knoxville-Based Co-Op Health Insurer To Shut Down In 2016
A nonprofit Tennessee health insurer founded with $73 million in loans provided by the Affordable Care Act won't offer insurance next year. Community Health Alliance, which began providing health coverage in 2014, is voluntarily winding down and won't offer coverage in 2016, the Tennessee Department of Commerce and Insurance announced Wednesday. The Knoxville-based insurer is among co-ops serving at least five other states that are also winding down service. (McKenzie, 10/14)

The Associated Press: UnitedHealth Dives Deeper Into Public Insurance Exchanges
UnitedHealth will jump into 11 more public insurance exchanges next year, as the nation's biggest health insurer grows more comfortable with one of the health care overhaul's main ways of expanding coverage to millions of people. The once-reluctant exchange participant now draws 550,000 customers from that market and predicts that business will improve next year, helped by double-digit price hikes. (10/15)

The Minneapolis Star Tribune: UnitedHealth Getting Bigger On State Exchanges
UnitedHealth Group is expanding its presence on health exchange marketplaces that were created under the federal Affordable Care Act. Currently, the insurer, based in suburban Minneapolis, has about 550,000 customers through health insurance exchanges in 23 states. Industry reports this spring suggested that many people buying exchange policies have used more care than expected, company officials said Thursday during a conference call with investors. (Snowbeck, 10/15)

Forbes: UnitedHealth Will Expand To 11 New States On Obamacare Exchanges
UnitedHealth Group (UNH) confirmed plans to expand for 2016 into 11 additional states including California with private health insurance products on government exchanges under the Affordable Care Act. The nation’s largest insurer said it would also grow its presence in the 24 states it already has insurance products operating on exchanges. UnitedHealth Group would only confirm that California will be among the 11 new states with public exchange products and the insurer will offer plans in the state’s 38 rural counties. (Japsen, 10/15)

The Wall Street Journal: UnitedHealth Has A High-Class Problem
For years, UnitedHealth Group has spoiled its investors. That came back to bite the stock Thursday. Third-quarter revenue came in at $41.5 billion and earnings per share at $1.65, both of which topped analyst estimates. Yet the shares dipped as the company’s net profit margin of 3.8% fell 1.1 percentage points from a year earlier. UnitedHealth attributed the weaker margin, in part, to greater levels of lower-paying, government-sponsored benefits business. (Grant, 10/15)

The Wall Street Journal: UnitedHealth Revenue Lifted By Recent Buy
UnitedHealth Group Inc. reported a better-than-expected 27% rise in third-quarter revenue, helped by a recent acquisition and an increase in members, but shares of the health insurer slid following cautious comments about 2016. During a conference call with analysts, UnitedHealth said it continues to expect “a further lift in the rate of earnings per share growth” in 2016. UnitedHealth’s president and chief financial officer, David S. Wichmann, suggested the company’s results would be within the “quite wide” range of analysts’ projections, but UnitedHealth guidance would likely “begin in a more conservative posture or range.” (Wilde Mathews and Dulaney, 10/15)

Reuters: UnitedHealth Profit Beats Expectations Amid Stable Costs
UnitedHealth Group Inc (UNH.N), the largest U.S. health insurer, reported a better-than-expected profit in the third quarter, helped by stable medical costs in its health plans and higher revenue from its Optum pharmacy management business. The company said medical cost trends were as expected, an indication that the use of medical services by patients was not increasing unexpectedly. The percentage of premiums paid for medical services fell 80 basis points from the second quarter. (Humer and Penumudi, 10/15)

The Wall Street Journal: Valeant Probe Reprises Federal Focus On Drug Pricing
Drug pricing, a key issue in the federal investigation of Valeant Pharmaceuticals International Inc., has been a frequent focus of federal prosecutions and whistleblower lawsuits in recent years. Pharmaceutical companies have paid more than $3 billion in fines to resolve pricing cases over the past decade, according to Patrick Burns, co-director of Taxpayers Against Fraud, a group that promotes whistleblowing. (Rockoff, 10/15)

Bloomberg: Valeant Slumps As U.S. Prosecutors Issue Subpoenas On Prices
Valeant Pharmaceuticals International Inc. shares dropped after U.S. prosecutors issued subpoenas seeking information on drug-pricing decisions, signaling fresh scrutiny just as beleaguered biotechnology investors saw signs that the cost debate may fade away. The drugmaker recently received a subpoena from the U.S. Attorney’s Office in Massachusetts and another from the Manhattan U.S. Attorney’s Office seeking information on its patient assistance programs, drug distribution and pricing decisions, Laval, Quebec-based Valeant said in a statement on Wednesday night. Valeant shares fell 4.7 percent to $168.87 at the New York close. (Cordeiro and Kitamura, 10/14)

The Associated Press: Valeant Subpoenaed Over Patient Assistance Program, Pricing
Valeant Pharmaceuticals, one of the drugmakers in the eye of the storm over rising prescription medicine prices, says two federal prosecutors have subpoenaed documents on its drug pricing and other policies. The federal subpoenas sent to the Canadian drugmaker, disclosed late Wednesday, likely won't be the last to hit the industry, according to one analyst. (Johnson, 10/15)

Politico Pro: Valeant Price Hikes Not Likely Target Of Federal Probe
Valeant Pharmaceuticals has drawn the ire of congressional Democrats and garnered negative headlines over its decision to exponentially boost the price of two old drugs earlier this year. But the prices themselves are probably not the focus of a legal probe. The price hikes may be the heart of the political controversy — but legal experts said the federal probe disclosed late Wednesday more likely is looking at possible violations of the False Claims Act, which could include anti-kickback violations or off-label promotion. (Norman and Karlin, 10/15)

The Wall Street Journal: Hot Startup Theranos Dials Back Lab Tests At FDA’s Behest
Under pressure from regulators, laboratory firm Theranos Inc. has stopped collecting tiny vials of blood drawn from finger pricks for all but one of its tests, according to a person familiar with the matter, backing away from a method the company has touted as it rose to become one of Silicon Valley’s hottest startups. (Carreyrou, (10/15)

Bloomberg: Theranos Disputes Report, Says Tests Are 'Accurate And Reliable'
Silicon Valley blood-testing startup Theranos Inc., responding to an article in the Wall Street Journal that questioned its technology, said its products and services are "accurate and reliable." The Journal article said that the company overstated the ability of its tests to accurately perform several dozen types of measurements and that Theranos relied on other companies’ equipment for many tests. While the newspaper was working on the story, Theranos removed language from its website that said, "Many of our tests require only a few drops of blood," according to the article. Theranos told the newspaper it made those changes for marketing accuracy. (Mittleman, 10/15)

USA Today: Bloodwork Darling Theranos Under Fire
Theranos, the secretive and revolutionary bloodwork analysis start-up valued at $9 billion, is under fire from a Wall Street Journal report that anonymously quotes former employees who question the efficacy and accuracy of the company's proprietary hardware. The heart of the allegations charge that of the 240 different tests Theranos offers consumers, only 15 are conducted on a machine called Edison while the rest are being outsourced to machines that are similar to those used by more traditional labs such as LabCorp and Quest Diagnostics. (della Cava, 10/15)

Bloomberg: IBM's Newest Acquisition Warned On Device By U.S. Health Agency
Merge Healthcare Inc., purchased by IBM for $1 billion in a deal completed Tuesday, received a warning letter from U.S. regulators about the potential dangers of software that monitors patients during heart procedures and a system that archives medical images. Merge failed to show that it had adequately reviewed or evaluated complaints of malfunctions in its devices and allowed its Merge Hemo cardiac monitoring system to be widely used on patients when its effectiveness hadn’t been supported, according to the Food and Drug Administration’s letter dated Sept. 30. Merge also neglected to inform the FDA when the company recalled the product because it may cause computer systems to freeze and result in a loss of patients’ vital signs while the system reboots, the agency said. The warning letter came after a June inspection of Merge’s factory in Hartland, Wisconsin. (Cao and Edney, 10/14)

Reuters: Surgical Funder Ordered To Turn Over Information On Hip Surgeries
A federal judge has ordered a surgical funding company to turn over information about payments it made to healthcare providers for surgeries performed on plaintiffs suing over artificial hips made by a unit of Johnson & Johnson . DePuy Orthopaedics in August sought to compel Texas-based MedStar Funding to hand over the information, saying it was concerned that Medstar was trying to squeeze excessive profits from liens it had placed against personal-injury settlements for 11 hip plaintiffs. (Dye, 10/15)

The Associated Press: Bristol-Myers, Five Prime Expand Work On Cancer, Other Drugs
Drugmaker Bristol-Myers Squibb Co. is expanding its collaboration with Five Prime Therapeutics Inc., which could receive more than $1.75 billion if they succeed in turning Five Prime’s antibody-based drug candidates into approved medicines for cancer and immune-system disorders. (Johnson, 10/15)

The Wall Street Journal: Kasich Tax Plan Aims To Balance U.S. Budget In 8 Years
Mr. Kasich’s proposal isn’t the largest or most radical reduction on the GOP table, but it is being offered as part of one of the most specific plans to eliminate the deficit. It is still short on many details about how the budget would be balanced but calls for drastic policy changes such as transferring responsibility for Medicaid, welfare and highway-construction funding to the states. (Hook, 10/15)

NBC News: John Kasich Outlines Broad Economic Agenda In New Hampshire
Kasich made waves across the political world when he became one of only a few Republican governors to accept the Medicaid expansion under the Affordable Care Act. In his presidential agenda outline, he proposes giving per-member per-month Medicaid allocations back to individual states. (Koenig, 10/15)

Bloomberg: Here's What Washington Could Do To Combat High Drug Prices
On the campaign trail, Hillary Clinton is proposing to force pharmaceutical companies to spend more on research. In California, the push is on for a law to contain government spending on drugs. And on the front pages of national newspapers, stories keep appearing about high medicine prices. (Cortez, Edney and Koons, 10/14)

The Arizona Republic: Inspector General Report Rips Phoenix VA Urology Care
A scathing report on urology care at the Department of Veterans Affairs hospital in Phoenix says some sick veterans died awaiting care and hundreds were medically sidetracked or neglected because of short-staffing and mismanagement. The Office of Inspector General report says 45 percent of patients with bladder, prostate and urinary-tract issues received delayed care, or no care at all, during the last two years, even after patient wait times became a national scandal. The report also says investigators cannot yet calculate the damage suffered because medical records are messed up and missing. (Wagner, 10/15)

The Associated Press: VA Cites Phoenix Facility For Poor Urology Care
Staffing shortages and a lack of access to clinical records unnecessarily endangered the health of several Phoenix patients battling prostate and bladder cancer, the U.S. Department of Veterans Affairs said Thursday. In a new report, the VA’s Office of Inspector General cited several failures of the Phoenix VA’s urology care. (10/15)

News Service Of Florida: Court Allows Challenge To Jacksonville Hospital Plan
Ruling against state health regulators, an appeals court Thursday said a Baker County hospital can challenge plans for a Jacksonville medical center that could become a competitor. The 1st District Court of Appeal, in a 16-page ruling, sided with Baker County's Ed Fraser Memorial Hospital in a dispute that centers on a state decision in 2010 to issue what is known as a "certificate of need" for West Jacksonville Medical Center. (10/15)

The San Jose Mercury News: Daughters Of Charity Deal Draws Low-Key Crowd At Public Meeting
Nine months after supporters and protesters clashed outside public hearings held to discuss the proposed sale of the Daughters of Charity Health System to a controversial Southern California firm, the mood on Thursday at O'Connor Hospital couldn't have been more different. In their first chance to comment on a New York City-based hedge fund's interest in salvaging the struggling Catholic hospital system, a few dozen O'Connor employees, local residents and others calmly addressed the pros and cons of the transaction to state regulators for two hours. (Seipel, 10/15)

Reuters: Texas Hospitals Sue U.S. For Allowing Rival's Expansion
A trio of Texas hospitals sued the U.S. Department of Health and Human Services Monday for granting a rival, physician-owned hospital an exception from federal law allowing it to double in size. The U.S. Affordable Care Act largely banned new physician-owned hospitals over concerns about conflicts of interest that may arise when doctors refer patients for services at hospitals in which they have a financial interest. (Pierson, 10/14)

And hospital shares dip after a key hospital chain missed earnings' estimates --

Bloomberg: Hospital Shares Swoon As HCA Earnings Projection Disapoints
Hospital chains’ shares dropped after industry leader HCA Holdings Inc. released preliminary third-quarter results that missed analysts’ estimates. While inpatient and emergency room admissions rose, the proportion of uninsured patients and labor costs also increased, HCA said. The company also admitted a lower rate of privately insured patients who provide its strongest revenue, said Sheryl Skolnick, an analyst with Mizuho Securities USA Inc. (Lauerman, 10/15)

Arkansas News: Hutchinson Proposes Medicaid Integrity Unit
Gov. Asa Hutchinson said Thursday the Department of Human Services’ Division of Medical Services and the Office of Medicaid Inspector General are proposing, at his request, the establishment of a new unit to focus on improving Medicaid integrity. ... The Payment Integrity Unit will use data analytics and industry best practices to identify systemic sources of waste, the governor said. DHS and OMIG will then collaborate on correcting the existing policies, providing new training for DHS and provider staff, and addressing shortcomings in the current claim processing procedures. (10/15)

Des Moines Register: Questions Persist In Child Medicaid Program
Ongoing questions about whether Iowa has acted legally in its efforts to privatize management of a health insurance program for children have prompted a state senator to ask Gov. Terry Branstad to remove the plan from what she calls his “managed care mess.” Questions were first posed in August by the chairwoman of hawk-i, citing state law saying her board is responsible for developing the criteria on which any administrative contractor would be selected. (Clayworth, 10/14)

The Wall Street Journal: Massachusetts Governor Introduces Bill Aimed At Combating Painkiller Addiction
Massachusetts Gov. Charlie Baker introduced legislation to combat the state’s growing crisis of painkiller addiction that would include allowing doctors to hold people involuntarily for treatment and limiting patients’ supply of opioid painkillers. “I’ve never seen anything with the kind of negative momentum that this particular issue has,” Mr. Baker said at a news conference Thursday. (Levitz, 10/15)

WBUR: Baker’s Proposed Limit On First-Time Opioid Prescriptions Ignites Controversy
Gov. Charlie Baker is igniting controversy with two parts of a bill he says is needed to fight the state’s growing opioid epidemic. Baker wants to reduce the chances that patients will become addicted to opioid pain pills, and then heroin, by capping all first-time opioid prescriptions at a three-day supply. (Bebinger, 10/15)

Kaiser Health News: N.Y. Attorney General Reaches Agreement With Urgent Care Clinics In First ‘Surprise Medical Bill’ Action
Four companies running urgent care centers in New York have agreed to disclose more fully which insurance plans they accept, following an inquiry by the state’s attorney general that found unclear or incomplete information on their websites that could result in larger-than-expected bills for consumers. The agreements mark the first enforcement action brought under New York’s new “surprise medical bill” law, seen as one of the broadest in the nation. The law aims to reduce the number of consumers who get such bills when they unknowingly see providers who are not part of their insurance plan networks. (Appleby, 10/16)

The Washington Post: Virginia Seeks Public Input On Substance Abuse Treatment
Virginia health officials are seeking the public’s input on how to improve Medicaid coverage for substance abuse disorder treatment services. The federal Centers for Medicare and Medicaid Services is inviting states to apply for waivers that would allow them to enhance or expand services. Virginia officials are soliciting public comment on that waiver request. (10/16)

The Associated Press: Anonymous UCare Customer Sues State Over Contract Bidding
An anonymous Minnesota resident is suing the state over its decision to drop nonprofit health insurance provider UCare from public health care programs after a competitive bid process, alleging the Department of Human Services hasn't offered the company's 370,000 enrollees adequate avenues to keep their current providers. UCare dropped its own lawsuit with the state this week, citing a desire to avoid more upheaval for low-income residents on MinnesotaCare or Medical Assistance who may need to pick new plans for next year when UCare is no longer an option. The Minneapolis company had originally argued that the Department of Human Services arbitrarily cut it out in a competitive bid process that state officials say will save $450 million in taxpayer dollars. (Potter, 10/15)

The Associated Press: Patient Attacked As Western State Hospital Faces Possible Funding Cuts
A patient attacked another patient at Washington state’s largest psychiatric hospital this week as federal regulators decide whether to cut millions of dollars to the facility over concerns about safety. Doctors at Western State Hospital say the number of violent episodes at the 800-bed facility is rising because staffing levels are inadequate, making the facility increasingly dangerous for patients and workers. The state agency in charge of mental-health services says it has asked lawmakers for more money to hire the workers needed to operate safely. (Bellisle, 10/15)

Reuters: Michigan Catholic Hospital Failed To Help Woman With Brain Tumor
The American Civil Liberties Union on Wednesday accused a Catholic hospital in Michigan of failing to provide appropriate care by refusing on religious grounds to allow a pregnant woman with a brain tumor to be sterilized. The ACLU of Michigan filed a complaint with the state department that handles health regulations against Genesys Regional Medical Center in the Detroit suburb of Grand Blanc, which is part of Ascension Health, the country's largest Catholic health organization. (Wisiewski, 10/15)

The Associated Press: Judge Orders Utah To Keep Cash Flowing To Planned Parenthood
A federal judge ordered Utah to keep sending money to the local arm of Planned Parenthood on Thursday amid a lawsuit over the governor’s decision to defund the organization -- at least for now. U.S. District Judge Clark Waddoups extended his earlier decision in the group’s favor, but he said he plans to issue a longer ruling later. (Price, 10/15)

The Philadelphia Inquirer: The Lives Of People With HIV Have Changed Dramatically. How We Treat Them Has Not
The prognosis for people with HIV has changed dramatically over the last 25 years, from almost-certain death to long life with a chronic disease. How comfortable the rest of us feel about being with the HIV-positive hasn't shifted all that much. That seeming disconnect was brought home recently when the U.S. Attorney's Office in Philadelphia announced the settlement of a discrimination case involving a bariatric surgeon who allegedly refused to meet with a patient with HIV. (Sapatkin, 10/16)

JAMA Surgery: Effect Of Hospital Safety-Net Burden On Cost And Outcomes After Surgery
[Researchers sought to] determine the effect of patient and hospital factors on surgical outcomes and cost at safety-net hospitals ... [using analysis of statistics from the] University HealthSystem Consortium database .... After adjusting for patient characteristics and center volume, [hospitals with high safety-net burden] HBHs still had higher odds of mortality for 3 procedures ..., readmission for 2 procedures ... and the highest cost of care associated with 7 of 9 procedures ....Analysis of Hospital Compare data found that HBHs had inferior performance on Surgical Care Improvement Project measures, higher rates of surgical complications .... These data suggest that intrinsic qualities of safety-net hospitals lead to inferior surgical outcomes and increased cost .... In addition, impending changes to reimbursement may have a negative effect on the surgical care at these centers. (Hoehn et al., 10/15)

Health Affairs: Uncompensated Care Burden May Mean Financial Vulnerability For Rural Hospitals In States That Did Not Expand Medicaid
We compared rural hospitals in Medicaid expansion and nonexpansion states in terms of the amount of uncompensated care they provided and their profitability and market characteristics in 2013. We found that rural hospitals in expansion states provided more dollars of uncompensated care than those in nonexpansion states and that the difference was at least partly driven by greater uncompensated costs associated with public programs such as Medicaid. We found higher dollar values of unrecoverable debt and charity care among non–critical access rural hospitals in nonexpansion states than among those in expansion states. Compared to hospitals in expansion states, those in nonexpansion states provided greater amounts of uncompensated care as a percentage of revenues and appeared to be more financially vulnerable. (Reiter, Noles and Pink, 10/5)

Health Affairs: High-Cost Patients Had Substantial Rates Of Leaving Medicare Advantage And Joining Traditional Medicare
We examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. We found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care (17 percent versus 3 percent), short-term nursing home care (9 percent versus 4 percent), and home health care (8 percent versus 3 percent). These results were magnified among people who were enrolled in both Medicare and Medicaid. Our findings raise questions about the role of Medicare Advantage plans in serving high-cost patients with complex care needs, who account for a disproportionately high amount of total health care spending. (Rahman et al., 10/5)

The Kaiser Family Foundation: New Estimates Of Eligibility For ACA Coverage Among The Uninsured
This analysis provides national and state-by-state estimates of eligibility for ACA coverage options among those who remained uninsured. It is based on Kaiser Family Foundation analysis of the 2015 Current Population Survey, combined with other data sources. ... As of the beginning of 2015, 32.3 million nonelderly people lacked health coverage in the U.S. Nationally, we estimate that nearly half (15.7 million, or 49%) of this population is eligible for financial assistance to gain coverage through either Medicaid or subsidized Marketplace coverage .... One in ten uninsured people (3.1 million) fall into the coverage gap due to their state’s decision not to expand Medicaid, and 15% of the uninsured (4.9 million) are undocumented immigrants who are ineligible for ACA coverage under federal law. (Garfield et al., 10/13)

The Kaiser Family Foundation/Health Policy Institute at Georgetown University: Medicare Part D: A First Look At Plan Offerings In 2016
This issue brief provides an overview of the 2016 [Medicare prescription drug plan] PDP marketplace .... In 2016, beneficiaries in each region will have a choice of 26 PDPs, on average, down by 4 from 2015. The average PDP premium (weighted by 2015 plan enrollment) is projected to increase by 13 percent from 2015 to 2016, from $36.68 to $41.46 per month. Even if a number of beneficiaries switch or are reassigned to lower-premium plans, the average premium increase for 2016 is likely to be the largest since 2009. More than one-third of the 11.2 million PDP enrollees who do not receive Low-Income Subsidies (LIS) would pay premiums of $60 or more per month in 2016 if they stay in the same plan. (Hoadley, Cubanski and Neumann, 10/13)

Here is a selection of news coverage of other recent research:

The New York Times: Dietary Supplements Lead to 20,000 E.R. Visits Yearly, Study Finds
A large new study by the federal government found that injuries caused by dietary supplements lead to more than 20,000 emergency room visits a year, many involving young adults with cardiovascular problems after taking supplements marketed for weight loss and energy enhancement. The study is the first to document the extent of severe injuries and hospitalizations tied to dietary supplements, a rapidly growing $32 billion a year industry that has attracted increased scrutiny in the past year and prompted calls for tougher regulation of herbal products. (O'Connor, 10/14)

The Baltimore Sun: Study Reveals Why Gowns And Gloves Can Be So Dangerous For Hospital Workers
A hospital ought to be the last place to get a life-threatening infection, but it happens. A new study helps explain why. Researchers asked real hospital workers to remove gowns and gloves smeared with fake bacteria. When they did, the fake bacteria wound up on their skin or clothes 46% of the time, according to their report published Monday in JAMA Internal Medicine. (Kaplan, 10/12)

Reuters: Women Less Likely To Be Taking Post-Heart Attack Meds
Women appear less likely than men to take all the medications needed after a heart attack to help prevent repeat episodes, a Canadian study suggests. Researchers analyzed data on more than 12,000 patients who survived for at least a year after a heart attack between 2007 and 2009. ... While the study can’t determine the exact reason for the gender gap – doctors might not have prescribed the drugs or women might not have filled the prescriptions – the findings highlight the need to offer women more aggressive treatment, said lead study author Kate Smolina. (Rapaport, 10/15)

JAMA Medical News: Transgender Care Moves Into The Mainstream
A 2011 survey by the Williams Institute, a think tank based at the University of California, Los Angeles, School of Law that conducts research on sexual orientation and gender identity law and public policy, estimated the US transgender population to be about 700 000—nearly 0.3% of the population. Many have faced difficulties ... when trying to access quality health care or, in some cases, any health care at all. According to the 2011 National Center for Transgender Equality/National Gay and Lesbian Task Force report “Injustice at Every Turn: A Report of the National Transgender Discrimination Survey,” of the 6456 transgender and gender-nonconforming people polled, 19% of respondents had been refused medical care, 28% had experienced verbal harassment in a medical setting, and 2% had been physically assaulted in a physician’s office. (Buchholz, 10/14)

JAMA Medical News: Working Late, Courting Stroke
According to a recent review and meta-analysis in The Lancet, [for people] working more than 55 hours a week, their stroke risk will climb .... The analysis included 25 prospective cohort studies involving a total of 603 838 men and women with no history of coronary heart disease who were followed up for a mean of 8.5 years and 528 908 men and women with no history of stroke who were followed up for 7.2 years. The investigators found that working 55 hours a week or more was linked with a 33% increased risk of stroke and a 13% increased risk of coronary heart disease. ... According to the US Bureau of Labor Statistics, the average full-time worker in 2014 worked 42.5 hours .... Nearly 10% of nonagricultural workers worked between 49 and 59 hours a week, and among agricultural workers, 20.7% worked more than 60 hours per week .... Hidden in those numbers are a lot of workers at risk for stroke. The question, then, is what to do about it. (Buchholz, 10/9)

Reuters: U.S. Prescription Opioid Misuse And Deaths Increase
The proportion of people reporting use of prescription opioids for reasons other than medical necessity fell between 2003 and 2013, but use disorders and overdose deaths increased, according to a new study. “The results underscore the importance of addressing the prescription opioid crisis,” said lead author Dr. Beth Han of the Substance Abuse and Mental Health Services Administration (SAMHSA) in Rockville, Maryland. (Doyle, 10/13)

Forbes: Flatlined: White House Says Obamacare Exchange Enrollment Growth To Collapse In 2016
For years, this blog has been warning about how the high cost of Obamacare-sponsored insurance would limit the law’s expansion of health coverage. Well, the chicken has come home to roost. Today, the Obama administration announced that it projected dramatically lower enrollment growth for Obamacare’s exchanges in 2016: only 1.3 million, compared to a prediction of 8 million when the law was passed five years ago. ... The problem is fairly easy to understand. Obamacare imposed thousands of pages of new federal regulations on the market for private-sector health insurance purchased by individuals. These regulations mandated that all plans had to pay for a wide range of services, even if policyholders didn’t want them. They forced young people to pay double, and sometimes triple, what they had been paying before for coverage. And plans were required to provide higher financial payouts than they previously had to. (Avik Roy, 10/15)

Bloomberg: Ask Investors Whether Obamacare Is Working
Since the Patient Protection and Affordable Care Act took effect two years ago in the rockiest of rollouts, American health-care companies outperformed every industry in the U.S. Taken together, they are the best collection of stocks among worldwide peers. The impact of Obamacare on the U.S. economy and its health-care system remains a matter of intense debate. More Americans have health insurance, but the longterm effects on the cost of medical care and on government spending are still unknown. For health-care companies, though, one thing is clear: Instead of being the economic catastrophe predicted by congressional Republicans, all of whom voted against it, Obamacare, at worst, is benign for U.S. business and, at best, is making global investors rich. (Matthew A. Winkler, 10/16)

The Washington Post: John Kasich: Washington Is Obsolete
The biggest problem with America’s economy is called Washington. The anemic growth we have today isn’t because the federal government failed to do enough but because it succeeded in doing too much. It starts with restraining spending and balancing the budget in eight years, cutting personal and corporate taxes to spark growth, and re-engineering the entitlement programs that are bankrupting us and failing those who need them. ... And nowhere has Washington’s one-size-fits-all approach done more harm to innovation and those it should be serving than with Medicaid. (Ohio Gov. John Kasich, 10/15)

The Washington Post: Obama Presidency Wallops Seniors
Two factors are making life hard for seniors. With their income flat and health care soaring, Democrats are open to attack in 2016 that they have not looked out for the elderly. ... The root of the problem for seniors is that the Obama-appointed Federal Reserve has kept interest rates at zero, and inflation therefore non-existent. That might be great for stock speculators (who move money from bonds to stocks) but for people with savings, it’s bad news. Social Security checks are frozen and the income from savings many depended on is low as well. (Jennifer Rubin, 10/15)

Los Angeles Times: Planned Parenthood Wisely Moves On
Planned Parenthood was right to stop taking reimbursement for donating fetal tissue to research programs, but not because anyone has proven that the organization did anything wrong. (10/15)

The Washington Post: Paid Family Leave Is No Pipe Dream
Tuesday’s Democratic presidential debate featured quite a few ambitious proposals: free college for all, reducing income inequality, breaking up the big banks, moving the United States to a 100 percent clean electric grid. Some of the items on this wish list would be expensive and extremely challenging to carry out. Some might be pipe dreams. Here’s one that isn’t either of those: paid family leave. (Catherine Rampell, 10/15)

The New England Journal of Medicine: Improving Value in Health Care — Against The Annual Physical
Eliminating the annual physical might appear contradictory to our health care system's increased attention to prevention. Indeed, Medicare just began reimbursing for the annual wellness exam in 2011. But it is evidence-based prevention that's key, and the annual physical is not evidence-based: research has demonstrated both its minimal benefit and potential harms. We believe it's time to act on this evidence and stop wasting precious primary care time by having a third of the adult population come in for such visits. Eliminating coverage for annual physicals, shifting our approach to preventive care delivery, and creating and reimbursing for a visit whose sole goal is to establish primary care relationships are key first steps to move us forward. (Ateev Mehrotra and Allan Prochazka, 10/15)

The New England Journal of Medicine: Toward Trusting Therapeutic Relationships — In Favor Of The Annual Physical
Continued enthusiasm among both patients and physicians for the annual physical (also known as the periodic health examination) despite the dearth of hard evidence for its benefit raises the question of what drives its persistent appeal. Educational efforts and financial incentives that encourage screening and prevention certainly contribute, but most evidence-based screening can be done without a specific annual physician visit. Perhaps the answer lies in the less commoditized aspect of primary care — people's desire or need to establish and maintain a close, trusting relationship with the doctor they consider their personal physician. (Allan H. Goroll, 10/15)