“It sends a powerful message that when members of Congress decide to get past the talking points and take just a few steps out of the partisan corner, there’s really a lot we can agree on, and a lot we can get done.” 

— Senator Patty Murray (D-WA)

• Uninsured Rate up to 12.3 Percent Amid Obamacare Turmoil Associated Press by Ricardo Alonso-Zaldivar — The number of U.S. adults without health insurance is up nearly 3.5 million this year, as rising premiums and political turmoil over "Obamacare" undermine coverage gains that drove the nation's uninsured rate to a historic low. That finding is based on the latest installment of a major survey, released Friday. The Gallup-Sharecare Well-Being Index asks a random sample of 500 people each day whether they have health insurance.  The survey found that the uninsured rate among adults was 12.3 percent during the period from July 1-Sept. 30, an increase of 1.4 percentage points since the end of last year. The increase in the number of uninsured is more striking because it comes at a time of economic growth and low unemployment.
  
  
• Study Finds More Than One-Quarter of U.S. Adults Are Underinsured Because of High Deductibles Northern Kentucky Tribune — More than one-fourth of U.S. adults with health insurance were underinsured in 2016, including 44 percent who got their coverage from the federal marketplace and almost 25 percent who got their coverage from employer plans, according to a recent study. Using data from The Commonwealth Fund’s 2016 Biennial Health Insurance Survey, a report from the fund found that of all working-age adults who had health insurance for a full year in 2016, 28 percent, or about 41 million people, were underinsured.
  
  
• ACA Enrollment Schedule May Lock Millions into Unwanted Health Plans Washington Post by Amy Goldstein — Millions of Americans with insurance through the Affordable Care Act could find themselves locked into health plans they do not want for the coming year because of the Trump administration's schedule for the enrollment season that starts in less than two weeks. The complication arises when people who already have health plans under the law are automatically reenrolled in the same plan. In the past, a few million consumers each year have been auto-enrolled and then were sent government notices encouraging them to check whether they could find better or more affordable coverage. This time, according to a federal document obtained by The Washington Post, the automatic enrollment will take place after it is too late to make any changes. Auto-enrollment will occur immediately after the last day of the ACA sign-up season, which the Trump administration has shortened, leaving the vast majority of such consumers stranded without any way to switch to a plan they might prefer.
  
  
• States Ask U.S. Court to Keep up Health Subsidies Cut by Trump Associated Press by Jonathan J. Cooper — Top government lawyers representing 19 U.S. states on Wednesday asked a federal judge in California to force the administration of President Donald Trump to make health care subsidy payments that Trump abruptly cut off last week. The monthly payments would normally be scheduled to go out Friday. The states, led by California Attorney General Xavier Becerra, asked a judge in San Francisco for an emergency court order by 4 p.m. Thursday requiring they be paid on time. Becerra said Trump is illegally trying to sabotage the Affordable Care Act, President Barack Obama's health care law, which Trump opposes and has pushed unsuccessfully to repeal.
  
  
• With Obamacare, Fewer Americans Were Uninsured When They Were Told They Had Cancer Los Angeles Times by Karen Kaplan — As President Trump and his allies in Congress keep pushing to get rid of Obamacare, new research shows that the contentious law has succeeded in expanding health insurance coverage for Americans with cancer….In the pre-Obamacare years, 5.73 percent of the patients who were newly diagnosed with cancer did not have health insurance to help them pay for their treatment, the researchers found. In 2014, that figure dropped by one-third, to 3.81 percent. The biggest differences were between the states that chose to expand their Medicaid programs (California [where it's called Medi-Cal], Connecticut, Hawaii, Iowa, Kentucky, Michigan, New Mexico, New Jersey and Washington) and those that didn't (Alaska, Georgia, Louisiana and Utah).
  
  
• Deep in Trump Country, a Big Stake in Health Care New York Times by Patricia Cohen — Medical care is the job engine in an area that strongly backed President Trump, and the cloud over the Affordable Care Act has left residents uneasy. The law has brought insurance to more than 360,000 people in Arkansas, and it now covers 61 percent of children in the state's small towns and rural areas. "That meant just a gigantic helicopter drop of federal funding," said Mark Duggan, an economist at Stanford. If that is reversed, "the hospital sector is going to get really hard hit."

• Senator McConnell Signals Willingness to Hold Vote on Health Deal If Trump Approves New York Times by Nicholas Fandos — Senator Mitch McConnell of Kentucky, the majority leader, said on Sunday that he would be willing to bring a bipartisan proposal to stabilize health insurance markets up for debate if President Trump signaled his support. "If there's a need for some kind of interim step here to stabilize the market, we need a bill the president will actually sign," Mr. McConnell said on CNN's "State of the Union."
  
  
• Bipartisan Plan to Curb Health Premiums Gets Strong Support Associated Press Erica Werner and Alan Fram — A bipartisan proposal to calm churning health insurance markets gained momentum Thursday when enough lawmakers rallied behind it to give it potentially unstoppable Senate support. But its fate remained unclear as some Republicans sought changes that could threaten Democratic backing. Republican Sen. Lamar Alexander of Tennessee and Democratic Sen. Patty Murray of Washington said their plan had 24 sponsors, divided evenly between both parties, for resuming federal subsidies to insurers. Trump has blocked the money and without it, insurers are already raising premiums for many buying individual coverage and could flee unprofitable markets.
  
  
• White House Says Rollback of Obamacare Must Be Part of Short-Term Fix Reuters by Richard Cowan and Yasmeen Abutaleb — A senior White House aide said on Thursday that U.S. President Donald Trump would demand steps toward repealing Obamacare in any health care legislation, comments that cast doubt on the prospects for a short-term bill to shore up insurance markets. Marc Short, the White House's top liaison to Congress, said on CNN that Obamacare's mandates and taxes would have to be rolled back and consumers be allowed to more heavily invest in health-savings accounts for Trump to sign off on any congressional deal.
  
  
• Top Dems Nix White House Demands to Alter Health Care Deal Associated Press by Alan Fram — Top Senate Democrats rejected White House demands Friday to add provisions weakening the Obama health care law to a bipartisan deal on steadying unsettled insurance markets. The compromise already faced an uphill path and this was the latest blow. Senate Minority Leader Chuck Schumer, D-N.Y., said the Trump administration was involved in the negotiations that produced the accord and "should support it instead of floating other ideas that would further the sabotage both parties are trying to reverse."

• States May Roll Back Children's Health Coverage Without Money From Congress Politico by Rachana Pradhan and Sarah Frostenson — Federal funds for the Children's Health Insurance Program (CHIP) expired Sept. 30, leaving states to come up with short-term fixes to keep their programs going. CHIP, now in its 20th year, primarily covers children from low-income families who earn too much to qualify for Medicaid. The program has long had bipartisan support, but lawmakers — consumed by the fight over Obamacare — blew past a key funding deadline and have been slow to extend new money. States haven't started to pare back coverage yet, but they're relying on short-term patches to keep their CHIP programs afloat. 

• CMS Approves Obama-Rejected Kansas Waiver Modern Healthcare by Virgil Dickson — The Centers for Medicare and Medicaid Services (CMS) has reversed course and approved Kansas' Medicaid waiver that was denied by the Obama administration. CMS has signed off on a one-year extension of the state's KanCare program, which allows the state to have most of its Medicaid population, including those needing long-term care services, in a managed-care plan. The program was on track to expire Dec. 31.…CMS denied the extension request during the Obama administration over concerns that managed-care organizations had inadequate state oversight. The federal agency also said the state hadn't responded to public comments on the waiver, and there wasn't sufficient information about provider networks.
  
  
• Maine's Medicaid Vote a Test of Obamacare Support Governing by Mattie Quinn — The Maine Legislature has voted to expand Medicaid five times in the last five years. But every time the bill reached GOP Gov. Paul LePage's desk, he vetoed it. So advocates of expanding Medicaid decided to go straight to voters. They collected enough signatures to put the issue to voters in November.  If passed, the state would become the 33rd to expand Medicaid and signal support for former President Obama's signature health-care law at a time when President Trump is taking major steps to reverse it.
  
  
• Report: Medicaid Enrollments, Costs Begin to Stabilize Associated Press by Christina A. Cassidy — States are seeing more stability in their Medicaid programs after experiencing a surge in enrollment and costs associated with the Affordable Care Act, suggesting that one of the major pillars of former President Barack Obama's health overhaul may be nearing its peak. At the same time, they are experiencing a high level of uncertainty as Republicans in Congress continue to advocate for a major overhaul of a program that provides health insurance to tens of millions of lower-income and disabled Americans. Thursday's report by the Kaiser Family Foundation found Medicaid enrollments in the states slowed considerably to an increase of just 2.7 percent in fiscal year 2017. By comparison, states reported a 13.9 percent increase in enrollment during fiscal year 2015 following implementation of former President Barack Obama's health care law.

• Trump Promises Action on Drug Prices The Hill by Nathaniel Weixel — President Trump on Monday attacked prescription drug companies and hinted at taking action to bring down rising drug prices. "We are going to get prescription drug prices way down because the world is taking advantage of us," Trump said during a wide-ranging press conference. He noted the same drug sold outside the U.S. sometimes costs a fraction of what it does in the U.S "The same exact pill from the same company, same box, same everything, is a tiny fraction of what it costs in the United States," Trump said. Earlier in the day, Trump told Cabinet members that drug companies were "frankly getting away with murder," a phrase he first used on the campaign trail. The administration has yet to take any substantive action on drug prices, but officials floated a draft executive order over the summer that would have lowered regulatory barriers for drug companies in order to increase competition.

Editor: Peter Van Vranken