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More than 600,000 sign up for Obamacare in first four days. During the first four days of Obamacare's open enrollment, 601,462 people signed up for health insurance coverage through the federal healthcare.gov, according to data from the Centers for Medicare and Medicaid Services. Making direct comparisons to last year's open enrollment is difficult because there aren't perfectly comparable numbers, but it would appear open enrollment is off to a strong start. Last November, a little over 1 million people signed up for coverage over 12 days, meaning the current pace of signups is faster (roughly 150,000 per day on average this year vs. about 84,000 last year). That said, the open enrollment period is half as long this year at just six weeks, so there will be less time for people to sign up for coverage. Within the total signups, 464,140 customers were renewing customers who already have a plan through the exchange and 137,322 are new customers. The evaluation includes signups only on healthcare.gov, which 39 states use, and therefore does not have information about the other states that run their own exchanges. The healthcare.gov call center received 527,046 calls in the first week, according to CMS.

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  Email dailyonhealthcare@washingtonexaminer.com for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

Democrats seize on election results to urge bipartisan healthcare deal. Democrats on Wednesday pointed to gubernatorial wins in New Jersey and Virginia, as well as a ballot measure advanced in Maine to expand Medicaid under Obamacare, to press their colleagues to pass the bipartisan Alexander-Murray bill. "If Republican leaders haven't gotten the message, voters made it pretty clear last night that they reject the deeply partisan message on healthcare," said Sen. Patty Murray, D-Wash., the top-ranking Democrat on the Health, Education, Labor and Pensions Committee. She and other Democrats also pointed to reports that show 200,000 people signed up for coverage on Healthcare.gov on the first day of open enrollment. The number is double the signups at the same time last year. "Despite all the efforts to undermine the Affordable Care Act ... we are seeing a record number of people enroll in the initial days of open enrollment," said Jeanne Shaheen, D-N.H. Shaheen called the surge "remarkable" and said she was "heartened" by the results. Minnesota Sens. Amy Klobuchar and Al Franken also appeared on the floor to push for GOP leaders to bring the Alexander-Murray bill to the floor. Sen. Lamar Alexander, R-Tenn., the lead Republican co-sponsor, also urged a vote on the bipartisan deal.

Susan Collins also points to election results as evidence of need to fix Obamacare. Sen. Susan Collins, a key Republican centrist who opposed her party's efforts to repeal Obamacare this year, said Wednesday that Tuesday's election results show an urgency to work on the healthcare law's flaws. "I think it's significant that healthcare was such a prominent issue," Collins told reporters, pointing to how residents in her state of Maine voted to expand Medicaid under Obamacare. "I believe when you look at the overwhelming vote in my state for Medicaid expansion that it shows that Republicans need to put forth constructive legislation," she said. Maine Republican Gov. Paul LePage said that he will not move forward with expansion until the state finds a way to pay for it. Asked about those comments, Collins replied, "I was surprised at his comments because it was a very strong vote, but I don't know enough about how that plays out legally." Collins said she would not comment on what LePage should or should not do, adding, "I never take positions on state referendum questions." Collins cited the Alexander-Murray bill in the Senate as an example of a solution she supports on Obamacare. “Rather than trying to completely repeal the ACA we should be focused on trying to fix its flaws," Collins said.

CBO: Repealing individual mandate would save $338 billion, increase uninsured by 13 million. Repealing Obamacare's individual mandate would lead to 13 million people going without insurance and would reduce deficits by $338 billion over the next decade, according to a report from the nonpartisan Congressional Budget Office. The CBO projected on Wednesday that 4 million people would go without insurance next year if the mandate were repealed. Even though over a decade 13 million fewer people would have insurance compared to current law, CBO didn’t think that repealing the mandate would damage the individual market, which includes Obamacare’s exchanges. CBO said that average premiums on the individual market, which is used by people who don’t have insurance through their employer or the government, would increase by about 10 percent annually during most of the decade. “Those effects would occur mainly because healthier people would be less likely to obtain insurance and because, especially in the nongroup market, the resulting increases in premiums would cause more people to not purchase insurance,” CBO said.

House lawmakers seek to probe into superbugs. Bipartisan members of the House Energy and Commerce Committee asked a federal watchdog to look into what federal agencies know and don’t know about superbugs. Rep. Greg Walden, R-Ore., the committee chairman, Rep. Frank Pallone of New Jersey, the top Democrat on the committee, and Rep. Diana DeGette, D-Colo., sent the letter to the Government Accountability Office on Thursday. The lawmakers said the Department of Defense found a patient in Pennsylvania last year who had E. coli bacteria containing the resistant superbug mcr-1. It was the first appearance of the superbug in the U.S. The lawmakers asked the GAO to investigate what federal agencies know about the epidemiology of antibiotic resistant infections. They also want to know about any scientific and technical gaps that agencies have in identifying and reporting superbugs.

Trump pressures China on drugs. The president used his Thursday meetings with Chinese leaders to push for greater cooperation to stop the flow of illegal drugs from China to the U.S., which Trump said is destroying communities around the country. "We're going to work out situations to stop all these drugs," Trump said as he met with Chinese Premier Li Keqiang. Trump made the same point in a joint press conference with Chinese President Xi Jinping at the Great Hall of the People. "Every year, drug trafficking destroys millions and millions of lives," Trump said. "Today, President Xi and I discussed ways we can enhance coordination to better counter the deadly drug trade and to stop the lethal flow of poisonous drugs into our countries and into our communities. A special emphasis will be placed on the new phenomena: fentanyl — destroying lives by the millions," he said. "We're going to be focusing on it very strongly, the president and myself." Secretary of State Rex Tillerson said he believes Trump and Xi made progress on finding ways to shut off the export of the drugs. "The president committed to take new actions, including agreements to control the export of new fentanyl precursors, sharing intelligence on drug trafficking, and exchanging trafficking information packages to identify individuals and criminal networks responsible for trafficking," Tillerson said.

Jimmy Kimmel encourages viewers to sign up for 'Trumpcare' on Obamacare website. Late-night comedian Jimmy Kimmel encouraged his viewers for a second night in a row to get health coverage under what he called "Trumpcare" by enrolling for coverage on healthcare.gov. "Yesterday I was looking at the White House website, healthcare.gov specifically, and I have to admit the healthcare plan there isn't bad. It's actually pretty good," Kimmel said Wednesday on "Jimmy Kimmel Live" before describing how social media users who are typically at odds with his outlook on healthcare are praising him over his support for "Trumpcare.” His ongoing gag touting the success and support of "Trumpcare" is actually about Obamacare. Kimmel discussed reports of surging sign-ups on healthcare.gov in its first day of open enrollment and encouraged his viewers to share a video on social media that shows people praising Trump for his work on healthcare. Trump doesn't actually support Obamacare, officially known as the Affordable Care Act, and is poised to dismantle parts of it via executive order after the Republican push in Congress to repeal and replace Obamacare this year failed. Opponents had been calling that effort "Trumpcare." "Together we can make American healthcare great again," Kimmel said in a play off Trump's campaign motto.

Faith leaders urge Congress to reject House-approved rider to repeal D.C. medical aid-in-dying law. In a letter, leaders from various faiths urged Congress to reject an amendment that would repeal an aid-in-dying law passed in the District of Columbia.  “The basic premise of medical aid in dying is simple and merciful: An adult of sound mind who faces imminent death should have the option to die peacefully,” the faith leaders wrote. The House appropriations bill includes an amendment by Rep. Andy Harris, R-Md., to repeal the District of Columbia’s Death with Dignity Act, which allows terminally ill patients to end their lives with a prescription from a doctor.

RUNDOWN

The Hill Opioid treatment maker said it intends to give Kamala Harris requested information

Kaiser Health News Breathing fire: Health is a casualty of climate-fueled blazes

STAT News The White House punted to Congress on opioid funding. Congress doesn’t have a plan.

Los Angeles Times Healthcare, for years a winner for the GOP, now powers Democratic wins

Axios Why there won’t be a wave of Medicaid ballot initiatives

New York Times Ending medical expense deduction a gut punch to middle class

Wall Street Journal Democrats, GOP spar over who is to blame for rising health insurance premiums



Calendar

THURSDAY | Nov. 9

8:30 a.m. 500 5th St. NW. National Academy of Medicine Culture of Health meeting. Details.

8:30 a.m. 1801 K St. NW. Alliance for Health Policy event on “Care Delivery in the Future: The Role of the Health Care Workforce.” Details.

FRIDAY | Nov. 10

Federal government closed in observance of Veterans Day.

MONDAY | Nov. 13

Nov. 13-15. Crystal Gateway Marriott. National Alliance of Healthcare Purchaser Coalition. Details.

9 a.m. National Press Club. 529 14th St. NW. Alliance for Health Policy event on “Navigating Next Steps on Payment Reform: A Breakfast for Reporters.” Details.

TUESDAY | Nov. 14

8 a.m. Charlie Palmer Steak. 10 Constitution Ave. RealClearPolitics event on “Examining the Pharmaceutical Supply Chain: From Production to Patient .” Details.

10 a.m. 430 Dirksen. Health, Education, Labor and Pensions Committee hearing on “Gene Editing Technology: Innovation and Impact. Details.

WEDNESDAY | Nov. 15

8:30 a.m. Ritz-Carlton. 1150 22nd St NW. Friends of Cancer Research annual meeting. Details.

10 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on “Encouraging Healthy Communities: Perspective from the Surgeon General.” Details.

2 p.m. 1225 I St. NW.. Bipartisan Policy Center announces “My Healthy Weight” initiative. Details.

THURSDAY | Nov. 16

Nov. 16-17. National Academies of Sciences, Engineering and Medicine colloquium on the Science of Science Communication. Details.

8 a.m. Boston. Opioid Insights for Action Day at the OptumLabs. Details.