“When we see California or Massachusetts do things, we think: ‘That’s great, that’s good for them, but those lessons don’t translate back here. But seeing that everyday Utahns and Nebraskans pulled the lever for Medicaid expansion, in states not known for having robust safety-net programs, is really encouraging. We would definitely be interested in working towards this here.” —Carly Putnam, Oklahoma Policy Institute

In the first six months of 2018, 28.5 million Americans were uninsured—20.1 million fewer than 2010, the year the Affordable Care Act was signed into law by then-President Barack Obama, according to data from the federal Centers for Disease Control and Prevention. The distribution of new coverage, however, is uneven, as shown in the data for states that expanded Medicaid coverage compared to those that did not. (Alexandre Tanzi, Bloomberg News)

Fewer people are rushing to sign up for Obamacare for 2019. Nearly 1.2 million Americans selected plans in the first 10 days of open enrollment this year, compared with about 1.5 million in the first 11 days last year, according to federal data released Wednesday. The average number of sign-ups per day is about 12.5 percent lower than last year. (Tami Luhby, CNN)

Newly elected state leaders will be in a stronger position than those in Washington to steer significant shifts in health care policy over the next couple of years as a divided Congress struggles with gridlock. State Medicaid work requirements, prescription drug prices, insurance exchanges, and short-term health plans are among the areas with the potential for substantial change. (Misty Williams, Roll Call)

Rep. Frank Pallone Jr. (D-N.J.), who is set to become chairman of the House Energy and Commerce Committee in January said Wednesday that his top priorities on drugs are allowing Medicare to negotiate prices and speeding the approval of cheaper generic drugs. Pallone pointed to President Trump’s support for those two policies in expressing hope for a bipartisan deal. (Peter Sullivan, The Hill)

There was a time when America approximated other wealthy countries in drug spending. But in the late 1990s, U.S. spending took off. It tripled between 1997 and 2007, according to a study in Health Affairs. Then a slowdown lasted until about 2013, before spending shot up again. What explains these trends? Prices are a lot higher for brand-name drugs in the United States because we lack the widespread policies to limit drug prices that many other countries have.  (Austin Frakt, New York Times)

The nation’s hospitals have been merging at a rapid pace for a decade, forming powerful organizations that influence nearly every health care decision consumers make. The hospitals have argued that consolidation benefits consumers with cheaper prices from coordinated services and other savings. But an analysis conducted for The New York Times shows the opposite to be true in many cases. The mergers have essentially banished competition and raised prices for hospital admissions in most cases, according to an examination of 25 metropolitan areas with the highest rate of consolidation from 2010 through 2013, a peak period for mergers. (Reed Abelson, New York Times)

The Trump administration Tuesday allowed states to provide more inpatient treatment for people with serious mental illness by tapping Medicaid, a potentially far-reaching move to address issues from homelessness to violence. Health and Human Services Secretary Alex Azar made the announcement Tuesday in a speech to state Medicaid directors, a group that represents Republican and Democratic officials from around the country who are confronting common, deeply-rooted social problems. (Ricardo Alonso-Zaldivar, Associated Press)

U.S. Health and Human Services Secretary Alex Azar on Wednesday said Medicaid may soon allow hospitals and health systems to directly pay for housing, healthy food, or other solutions for the "whole person."  Azar said Center for Medicare and Medicaid Innovation officials are looking to move beyond existing efforts to partner with social services groups and try to manage social determinants of health as they see appropriate.  “What if we gave organizations more flexibility so they could pay a beneficiary's rent if they were in unstable housing, or make sure that a diabetic had access to, and could afford, nutritious food?" Azar said in his prepared remarks. (Paul Barr and Virgil Dickson, Modern Healthcare)

Nearly 4,000 Arkansans lost their Medicaid expansion coverage in October because they failed to comply with the state's new work requirement, joining 8,462 other low-income adults who lost benefits in the previous two months. State officials reported Thursday that 3,815 of the 69,041 people subject to the so-called community engagement requirement in October were noncompliant for three months and were dropped from Medicaid. They will lose coverage for the rest of 2018 and can only reapply in January. (Harris Meyer, Modern Healthcare)

The California union that provided major funding for successful ballot campaigns to expand Medicaid in three red states this year is already looking for where to strike next to expand Obamacare coverage in the Donald Trump era. Leaders of SEIU-United Healthcare Workers West declined to identify which states they might target in 2020. But the six remaining states where Medicaid could be expanded through the ballot are on the group's radar: Florida, Mississippi, Missouri, Oklahoma, South Dakota, and Wyoming. (Alice Miranda Ollstein, Politico)

The United States has more than double the rate of premature overdose deaths of at least 12 other countries, according to a new study. The research, published Monday in the Annals of Internal Medicine, says that there were an estimated 63,632 drug overdose deaths in 2016 in the U.S. "The U.S. has the highest death rate due to drug overdoses for both men and women (35 deaths in 100,000 men and 20 deaths in 100,000 women) in 2015, more than double those of any other country in our study," Yingxi Chen, one of the researchers and a postdoctoral fellow at the National Institutes of Health's National Cancer Institute, wrote in an email. (Naomi Thomas, CNN)

Progressive Democrats are pushing for a vote on a controversial health care bill after the party takes control of the House early next year. But the left’s push for “Medicare for all” legislation would likely divide Democrats.  (Peter Sullivan, The Hill)