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Obamacare enrollment surges but faces daunting deadline. More than 823,000 people signed up for Obamacare last week through, bringing the total so far for open enrollment to 3.6 million. Last year, about 2.9 million people picked plans on as of Dec. 3, 2016, according to federal figures. But that enrollment period ended Jan. 31, and 9.2 million people picked plans on for the 2017 coverage year. That means that to match last year’s coverage number, the pace of Obamacare sign-ups would have to quicken substantially ahead of the Dec. 15 deadline to apply for coverage. In effect, more people would have to apply in the final week and a half than applied in the first month -- or more than 400,000 per day on average.

Repeal of Obamacare mandate holding strong in tax talks. Some House members who voted against Obamacare repeal in May and for tax reform last month weren't concerned about voting for a final bill that would repeal the individual mandate penalties. “I think the individual mandate question was never the burning issue for me,” said retiring Rep. Ileana Ros-Lehtinen, R-Fla., who voted against repeal. “People will choose to not be covered, which is a shame, but on the other hand, forcing them has never been a great Republican position. That one has not been my burning issue. Overall, I believe that the tax reform package is improved by the Senate.” Rep. Ryan Costello, R-Pa., another lawmaker who voted for the tax bill but against repeal, didn’t express any love for the individual mandate when asked about it by the Washington Examiner. “You mean the tax that 80 percent of it hits people making under $50,000?” he said Tuesday. The mandate requires everyone to have health insurance or pay a penalty. He added that he voted against Obamacare repeal for other reasons, but did not elaborate. Rep. Chris Collins, R-N.Y., said he isn’t “hearing outcries” over adding the repeal to the final version of the tax bill. “We all want the mandate gone,” he said. “The issue was mixing healthcare with tax reform.” The $330 billion in new revenue that repealing the mandate would raise for the treasury, according to an estimate from the nonpartisan Congressional Budget Office, has helped “put some important things back into the bill," Collins said. “There are important nuances,” Collins said. “They can easily be compromised.”

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Aetna and CVS Health set break-up fee. CVS Health would need to pay Aetna $2.1 billion if the planned merger between the two companies does not go through, according to a merger agreement that was filed on Tuesday. The fee would be owed even if the deal does not gain approval from federal regulators. Aetna paid Humana a $1 billion break-up fee this year when a federal judge blocked the merger because of antitrust concerns, following a lawsuit filed by the Department of Justice.

Some insurers on track for Obamacare profits for first time, survey finds. A survey of 31 regional Blue Cross Blue Shield plans found that major price increases last year put insurers on pace to profit for the first time in Obamacare, according to a Politico survey. However, the gains may be short-lived partly because of efforts to repeal Obamacare that threaten the viability of the market, Politico added. Last year, the average premium for the benchmark silver plan, the most popular of Obamacare’s three metal tiers, increased by about 20 percent. The individual market, which includes Obamacare’s exchanges and is used by people who don’t have insurance through a job or the government, also saw major defections from insurers worried about mounting financial losses. Blue Cross Blue Shield plans have seen stable participation in Obamacare’s exchanges.

Public comment period on birth control mandate comes to a close. Women’s and reproductive rights organizations delivered more than half a million comments opposing the birth control rule from the Trump administration that allows employers to opt out based on moral or religious exemptions. “Over half a million people have sent a clear message to the Trump administration: They will not stand for attacks on women’s healthcare that will take America backwards. Today, more women graduate, lead, and innovate than at any point in our history, and that’s true for one very important reason -- access to birth control,” said Dawn Laguens, executive vice president of Planned Parenthood Action Fund. Debra Ness, president of the National Partnership for Women and Families, said: “The Trump administration’s rules are blatantly discriminatory and would undermine this progress, allowing employers to deny women coverage for essential preventive healthcare. The rules put politics and an extremist agenda ahead of women’s health by injecting employers into decisions about basic healthcare that should be made by women and their healthcare providers.”

Murray slams decision to scale back birth control mandate as going against Congress’ wishes. Sen. Patty Murray, D-Wash., called for the Trump administration to nix its birth control rule, arguing that it defies the will of Congress. Murray blasted the reasoning that the Trump administration gave for scaling back the mandate that employers provide birth control at no cost to women. The administration decided in October to allow employers to be exempted from the mandate if they had a religious or moral objection. That dramatically ramps up the exemptions that companies can get. Previously only a religious organization could receive an exemption to providing birth control. Murray said that the administration cited other exemptions passed by Congress and a “grandfathering” provision for certain insurance plans in Obamacare. “However, the majority of statutory exemptions cited are not pertinent to insurance coverage, contraception or the [Affordable Care Act],” Murray wrote in a letter Tuesday to acting Health and Human Services Secretary Eric Hargan. She said it was Congress’ intent when drafting Obamacare to create parity among insurance coverage costs between men and women. Congress specifically included an amendment that targeted insurance companies for charging women more for healthcare. It tasked the Health Resources and Services Administration to come up with a way to narrow the gap, and the agency recommended to cover birth control.  

Lawmakers ask CDC, NIH to help investigate Cuba attacks: State Department officials should enlist help from U.S. health agencies as they assess a series of mysterious attacks on American diplomats in Cuba, according to lawmakers frustrated with the pace of the investigation. “We need to use all available resources to discover the medical cause and impact of what happened to our embassy personnel in Cuba,” House Foreign Affairs Chairman Ed Royce, R-Calif., and Democratic counterpart Eliot Engel of New York wrote in a Tuesday letter. Engel and Royce want the Center for Disease Control and Prevention and the National Institutes of Health to "take a leading role” in a review of attacks that left 24 U.S. diplomats suffering hearing loss and other “cognitive issues” over the last year.

Anti-abortion groups urge information on insurer coverage of abortion. In letters sent to HHS and to Inspector General Daniel Levinson, the Susan B. Anthony List and the Charlotte Lozier Institute accused insurers of failing to comply with Obamacare regulations to disclose abortion coverage in their plans. The letters ask HHS to look at the providers and make them comply with the abortion rule and to provide a deadline extension to people who live in states where the information hasn’t been disclosed. The organizations said that 151 plans in five states -- Colorado, Illinois, Massachusetts, New York and Texas -- hadn’t disclosed information. “Consumers deserve to know which health plans include abortion coverage before they decide on plans for themselves or their families,” SBA List President Marjorie Dannenfelser and CLI President Chuck Donovan said in a joint statement. “Shamefully, some insurance companies have made this information impossible to find or forced prospective applicants to hunt for it in an unnecessarily opaque and confusing system.”

Study: Collins Obamacare deal would lower premiums and increase enrollment if individual mandate isn't repealed.  A deal brokered by Sen. Susan Collins, R-Maine, to help win her support for the Republican tax plan would reduce premiums for Obamacare plans and increase enrollment, but only if the individual mandate in Obamacare isn't repealed, according to an analysis by the consulting firm Avalere Health. The estimate shows that the reinsurance program, which would inject $10 billion federal funds into the system distributed evenly over two years, would reduce premiums in 2019 premiums by 4 percent and increase enrollment by 180,000 people. “Together, funding for reinsurance and paying the cost-sharing reductions would significantly reduce premiums,” said Chris Sloan, senior manager at Avalere. “However, those effects only continue as long as the federal funding keeps flowing.”

California AG credits work on Obamacare as reason for his appointment. California Attorney General Xavier Becerra said Wednesday his work on Obamacare was one of the reasons he may have been appointed to become attorney general by Gov. Jerry Brown. "Perhaps he understood that when I was in Congress I was one of the people who worked hardest on the Affordable Care Act ... as a result of that, perhaps he thought that there was someone who would stand up those efforts that might occur to try to steal from people the health insurance that they had gained under the Affordable Care Act." Becerra said he was prepared to defend Obamacare in court, citing California lawsuits filed against the Trump administration on the ending of cost-sharing reduction payments as well as the final rule on birth control exempting employers with moral or religious objections. Becerra slammed the Trump administration, saying it failed to provide adequate information about why it changed certain healthcare policies. "It's difficult to explain sometimes to 40 million people that sometimes the most forceful actions I must take to defend the rule of law are against the very occupant in the White House, who is supposed to be helping us enforce the rule of law.” Becerra was appointed attorney general to replace Kamala Harris, who held the role before being elected to the U.S. Senate.


Wall Street Journal Support wavers for senate bill to shore up health insurance markets

The Hill Democrats push for more money for opioid fight

CNBC UnitedHealth Group agrees to buy DaVita dialysis clinics for $4.9 billion

New York Times The CHIP program is beloved. Why is its funding in danger?

Los Angeles Times Widespread screening for breast cancer didn’t do much to save womens’ lives: study

CNN More than a million children could lose health insurance next year

Reuters High tech, high finance and high times for the pot industry

Washington Post Skyrocketing fentanyl seizures illustrate its growing contribution to opioid crisis



10 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on the 21st Century Cures Act. Details.

Noon. Capitol Visitor Center. Congressional Meeting Room, South. Capitol Visitor Center. American Psychiatric Association briefing on “Improving the Physical Health of Patients with Serious Mental Illness:Identifying Breakthroughs in Approaches to Treatment.” RSVP to

FRIDAY | Dec. 8

Deadline for Congress to pass a spending bill before the government runs out of money.

Noon. G-50 Dirksen. Alliance for Health Policy event on “The Role of the Health Care Workforce in Delivery System Reform.” Details.

TUESDAY | Dec. 12

8:30 a.m. AARP Family Caregiving Summit. Details.

10 a.m. 430 Dirksen. Health, Education, Labor and Pensions Committee hearing on prescription drug costs. Details.

10 a.m. Dirksen 226. Senate Judiciary hearing on “Oversight of the Ensuring Patient Access and Effective Drug Enforcement Act.” Details.


10 a.m. 430 Dirksen. Health, Education, Labor and Pensions Committee hearing on the 21st Century Cures Act focusing on mental health needs. Details.