“Insurance company executives on Wednesday told Congress that high proportions of people signing up for coverage under the Affordable Care Act paid their first month’s premium, fueling the partisan fight over the impact of the health law.”

“Top health insurance companies told members of Congress Wednesday that more than 80 percent of people who’ve signed up under the president’s new health care law have gone on to pay their premiums — a necessary step for the enrollment figures touted by the Obama administration to hold up.”

“There’s already a mountain of problems waiting for Sylvia Mathews Burwell at HHS. And that mountain will probably grow even bigger by the time she’s confirmed.”

“While health policy observers are mainly focused on the number of people enrolled in the new federal and state marketplaces, fewer are keeping a close eye on fairly big changes in the estimates and projections for enrollment in Medicare Advantage plans. The number of Medicare beneficiaries in Medicare private plans reached an all-time high this year of nearly 16 million beneficiaries, 6.3 million higher than the Congressional Budget Office (CBO) had projected in 2010 soon after the Affordable Care Act (ACA) was enacted (Figure 1). The CBO now projects Medicare Advantage enrollment will reach 22 million beneficiaries by 2020, more than double the number projected shortly after the ACA was enacted.”

“Don Berwick – who, as administrator of the Centers for Medicare and Medicaid Services, oversaw large chunks of the early implementation of the Affordable Care Act – is trying to shake up the health policy world again. He ran CMS from July 2010 to December 2011, and left because Senate Republicans blocked his confirmation to lead the agency permanently. Now, more than two years later, he is a long-shot Democratic candidate for governor of Massachusetts and the heart of his platform is a single-payer health plan.”

“Enrollees in some of the health law’s most popular plans will face high cost-sharing requirements that the pharmaceutical industry says could keep patients from getting the drugs they need.

Most silver plans in the online marketplaces, or exchanges, require patients to pay for prescription drugs as part of the plan’s deductible, while nearly all bronze plans do, according to a report from Breakaway Health prepared for the Pharmaceutical Research and Manufacturers of America (PhRMA), the drug industry’s trade group.”

“The FBI is reportedly investigating criminal fraud by the architects of Oregon’s ObamaCare program, but maybe the G-men should take a look on the East Coast too. Like Oregon two weeks ago, Massachusetts announced on Monday that it is dumping its dysfunctional insurance exchange and defaulting to the federal version—though in fairness to Governor Deval Patrick, his crimes are merely against competent government.”

“Two of the most controversial questions in health care reform are whether government-sponsored expansions of health insurance coverage like ObamaCare and RomneyCare save lives, and if so whether other policies could save more lives per dollar spent. “Changes in Mortality After Massachusetts Health Care Reform,” published today in the Annals of Internal Medicine, presents evidence suggesting RomneyCare may have saved lives, but at a very high cost.”

“As you may know if you’re a regular reader of The Apothecary, the left has systematically ignored the mountains of clinical evidence showing that the Medicaid program doesn’t actually make people healthier. Given that Obamacare is designed to achieve half of its coverage expansion via Medicaid, you can understand why: if Medicaid doesn’t make people healthier, a significant chunk of Obamacare is wasted money. But the other chunk of Obamacare—the one that expands coverage using subsidized private-sector coverage—could indeed have an impact on health outcomes. An important new study, following the health outcomes of Romneycare in Massachusetts, shows us how.”

“Over the past several years, a major debate has broken out among health policy watchers as to whether expanding insurance actually saves lives. About a year ago, I reported on a landmark study in Oregon that found no real improvement in physical health among those who had gained access to Medicaid.”