• HHS Report: Obamacare Premiums Rise Significantly The Hill by Nathaniel Weixel — Premiums for Obamacare plans are rising significantly in many counties across the country according to a new government report, which experts have largely attributed to actions taken by the Trump administration. According to the report from the Department of Health and Human Services, premiums are increasing for the average "benchmark" plans by about 37 percent. But tax credit subsidies are also rising, meaning more people will be able to purchase insurance at lower rates. According to the report, nearly 80 percent of Obamacare enrollees will be able to find plans for less than $75 per month after tax credits. That's an increase from 71 percent over plan-year 2017.
  
  
• Increased Cost of Health Policies Will Be Offset by Subsidies for Many NPR by Alison Kodjak — It's time to start shopping for health insurance if you're one of the millions who buys it on an Affordable Care Act exchange. Open enrollment for 2018 starts Wednesday, and new numbers released by the Trump Administration show that the average cost of a benchmark policy will be about 27 percent higher next year. But that's just the headline. The details suggest there's good news for lots of people who are willing to shop around a bit for insurance. "In theory anyone who gets a subsidy should do better next year," says Charles Gaba, an analyst who runs the website ACASignups.net. "I have one piece of advice: Shop around." An analysis released Monday by the Department of Health and Human Services shows that while the average premium is going up, the average subsidy to help defray that cost is going up even more. The average tax credit offered to people to cut the price of their insurance will rise in 2018 to $555 — up 45 percent from this year's average credit of $382.

• ACA Enrollment Opens After GOP Fails to Kill Off Obamacare Washington Post by Amy Goldstein, Juliet Eilperin and Colby Itkowitz — From coast to coast, the fifth annual season for Americans to buy insurance under the Affordable Care Act opened on Wednesday with scattered reports of crowds, some technical difficulties, and a public confused as never before by the political turmoil surrounding the law....For his part, President Trump ignored the opening day. His only reference to the health care law was a tweet urging Congress to repeal an ACA centerpiece — the requirement that most American carry health coverage — as part of a federal tax-cut bill. In the absence of a robust federal promotion campaign, Democratic members of Congress, activists, local officials, and several celebrities launched a major push Wednesday at events across the country.
  
  
• Health Care Enrollment Counselors Facing Stiff Challenges Associated Press by Kelli Kennedy — It's not easy being an advocate for the Affordable Care Act right now. Health care advocacy groups are making an against-all-odds effort to sign people up despite confusion and hostility fostered by Republicans opposed to President Barack Obama's signature domestic policy achievement.  The Trump administration has taken numerous steps to undermine the law, and many states are doing little to promote coverage as health insurance open enrollment begins this week. Health care advocates are particularly concerned about people in Republican-led states with hundreds of thousands of uninsured residents, like Florida, Texas, and Georgia.
  
  
• Obamacare Insurance Markets Open This Week Amid Confusion and Uncertainty Los Angeles Times by Noam Levey — Health insurance marketplaces created by the Affordable Care Act begin accepting 2018 applications Wednesday amid mounting concern that the Trump administration's repeated attacks on the law will dramatically depress enrollment. The marketplaces — a centerpiece of the law commonly called Obamacare — continue to provide coverage for some 10 million people. And they remain the only option for many low- and moderate-income Americans who don't get health benefits through an employer or a government program such as Medicare or Medicaid. But across the country, the president's persistent criticism of the law and Republican congressional efforts to repeal it have fed widespread confusion among consumers.

• 200 Health, Business Groups Endorse Bipartisan Obamacare Bill The Hill by Jessie Hellmann — More than 200 health and business groups have endorsed a bipartisan bill to shore up Obamacare's insurance markets. Senate Health Committee Chairman Lamar Alexander (R-Tenn.) and ranking member Patty Murray (D-Wash.) announced the support Wednesday as part of their latest push to get the bill passed.  Those in support include influential groups such as the American Medical Association and the American Hospital Association.

• Maine Medicaid Expansion Vote Seen As Obamacare Referendum Associated Press by Marina Villeneuve — The roiling national debate over the government's proper role in health care is coming to a head in a state more commonly known for moose, lobster, and L.L. Bean. On Nov. 7, voters in Maine will decide whether to join 31 other states and expand Medicaid under former President Barack Obama's Affordable Care Act. It is the first time since the law took effect nearly four years ago that the expansion question has been put to voters. The ballot measure comes after Maine's Republican governor vetoed five attempts by the politically divided Legislature to expand the program and take advantage of the federal government picking up most of the cost.

• House Votes to Continue CHIP Funding Modern Healthcare by Virgil Dickson — The House voted 242-174 to reauthorize federal funding to maintain low-cost health insurance to 8.9 million children and 370,000 pregnant women. The vote was along party lines and reflected concerns over how Republicans in the House want to pay for continuing the Children's Health Insurance Program. There were three Republicans who voted against the bill, while only 15 Democrats supported it. 

• The More Lavish the Gifts to Doctors, the Costlier the Drugs They Prescribe New York Times by Nicholas Bakalar — When drug companies give gifts to doctors, the doctors prescribe more — and more expensive — drugs. The more lavish the gifts, the greater the effect. Researchers used data from the Center for Medicaid and Medicare Services on the prescriptions written by doctors in Washington, and information from the D.C. Department of Health on gifts from pharmaceutical and medical device companies given to providers in 2013. The study, in PLOS One, found that 39.1 percent of prescribers received gifts ranging in value from $7 to $200,000, while the rest received none. Health care providers given gifts wrote an average of 892 prescriptions compared with 389 for those who accepted none. The average cost of a prescription was $135 for gift recipients and $85 for the others. Gift recipients chose the brand-name drug a third of the time, compared with a quarter of the time for non- recipients.

• Transparency Pays as Hospitals Improve Grades on How Protect Patients USA Today by Jayne O'Donnell — Fifteen U.S. hospitals — including two in Washington, D.C. — received failing grades in a new report on 2,600 hospitals released Tuesday that includes all 50 states for the first time. Maryland, which was previously exempted from providing hospital safety reports due to a special waiver, now ranks 46th on the non-profit Leapfrog Group's  latest state rankings. Leapfrog is a watchdog organization that was started by employers and unions that wanted more public information about patient safety and quality. While the Centers for Medicare and Medicaid Services (CMS) rates about 90% of hospitals "average," Leapfrog is a much tougher grader. No other rating organization gives out anything equivalent to a D or F.
  
  
• Senators Introduce Bill to Reduce 'Colossal and Completely Preventable Waste' ProPublica by Marshall Allen — Two U.S. senators introduced legislation Tuesday requiring federal agencies to come up with solutions to the waste caused by oversized eyedrops and single-use drug vials, citing a ProPublica story published earlier this month. The bipartisan effort by Sens. Amy Klobuchar, D-Minn., and Chuck Grassley, R-Iowa, calls for the Food and Drug Administration and the Centers for Medicare and Medicaid Services to come up with a plan to reduce the waste, which is estimated to cost billions of dollars a year. "With the skyrocketing costs of prescription drugs, American taxpayers shouldn't be footing the bill for medicine going to waste," Klobuchar said in a press release announcing the bill, known as the Reducing Drug Waste Act of 2017.  Sens. Dick Durbin, D-Ill., and Jeanne Shaheen, D-N.H., are co-sponsors of the legislation. Grassley called it "common sense" legislation. "It's no secret that wasteful health care spending is a significant contributor to the rising cost of health care in the United States," he said in the release.

Editor: Peter Van Vranken