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Dylan Scott

Dylan Scott is a reporter for Talking Points Memo. He previously reported for Governing magazine in Washington, D.C., and the Las Vegas Sun. His work has been recognized with a 2013 American Society of Business Publication Editors award for Best Feature Series and a 2010 Associated Press Society of Ohio award for Best Investigative Reporting. He can be reached at dylan@talkingpointsmemo.com.

Articles by Dylan

The three years since the Affordable Care Act passed -- 2011, 2012 and 2013 -- have seen the slowest growth in health care spending since 1965, when the statistic began being consistently tracked, according to a new White House report.

That's great news, but the source of that trend is important. For the last couple years, most experts have credited the Great Recession for much of the decline. It makes sense: When times are tough, people are going to do what they can to minimize spending on everything, including health care.

But the second goal of Obamacare, beyond expanding health coverage to the uninsured, was getting health care costs under control. Health care spending had grown by an average annual rate of 3.9 percent between 2000 and 2007, before dipping to 1.8 percent between 2007 and 2010. According to the new report, the average annual rate of growth from 2011 to 2013 dropped still further, to 1.3 percent.

At some point, the White House needs to prove that the law is achieving that objective. According to the report released Wednesday, they think they have the evidence to say it's starting to. Jason Furman, chairman of President Obama's Council of Economic Advisors, explained why in a briefing with a small group of reporters.

The case is built on three parts.

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HealthCare.gov is going to get fixed. The White House has promised it. Republicans have admitted it. But that's not the end of the story for Obamacare, not by a long shot.

The Affordable Care Act is the biggest social services program to be implemented since the Great Society. It's a grand experiment in whether, with a mix of incentives and regulations, the government can expand health coverage and reduce health care costs without eliminating the free market. It's something that's never been attempted before on this scale in American government.

That experiment is, as the Obama administration has become fond of saying, much more than a website. And its success won't be guaranteed just because the website is working -- just as it wasn't doomed because the site wasn't.

So what's next on the list? What are the other markers that will tell us if the law is working as it was intended -- or if it isn't?

With some input from health policy experts, here's what to be watching for once HealthCare.gov gets fixed. Remember: It could take months, and in some cases years, until conclusions can be reached on these issues.

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Obamacare enrollment seems to be recovering from its slow start and picking up in the last few weeks, according to news reports.

The New York Times reported Monday that more than 50,000 Americans had selected a health plan through HealthCare.gov, the federal website serving 36 states, as of mid-November. That's up from about 27,000 who had picked a plan over the entire month of October.

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The Obama administration gave new life Monday to the idea of working with insurance companies to help them sign people up for health coverage outside of the troubled federal website, HealthCare.gov.

"We are working to set up direct enrollment through insurance companies so that Americans could choose to enroll directly through the insurance company," White House Press Secretary Jay Carney said during a daily press briefing after reporters asked about the possibility. "We’re interested in engaging or opening as many channels for enrollment as possible."

That makes sense on one hand because the administration wants to enroll as many people as possible -- but on the other hand, it comes through the sacrifice of the competitive nature of the online marketplace, where insurers were supposed to vie for consumers' business. That was a big part of President Obama's pitch prior to the Oct. 1 launch.

"It’s a website where you can compare and purchase affordable health insurance plans, side-by-side, the same way you shop for a plane ticket on Kayak, the same way you shop for a TV on Amazon. You just go on and you start looking, and here are all the options," he said on Sept. 26. "Now you've got new competition, because insurers want your business. And that means you will have cheaper prices."

But after HealthCare.gov's struggles since its launch, losing that feature for some people might be a price that Obamacare supporters have to accept.

"In terms of overcoming these initial glitches, I think this is fine," Jonathan Gruber, an MIT economist who helped craft the law, told TPM. "We're transforming the way health insurance is shopped. If it takes an extra few months, it's not the end of the world. We can't let the perfect be the enemy of the good here."

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House Oversight Chair Darrell Issa (R-CA) is taking his Obamacare oversight investigation on a four-state national tour in the next month.

Issa's office announced the tour Monday. It will start in Gastonia, N.C., Friday and end in Dallas, Texas, on Dec. 16. In between, there will be hearings in Gainesville, Ga., (Dec. 6) and Arizona (Dec. 6).

“While the President repeatedly said that Americans could keep their insurance under ObamaCare, even he has had to admit that just isn’t so. By holding these field hearings, the Committee will hear firsthand the stories about the initial impact of broken promises," Issa said in a statement. "These hearings will help the Oversight Committee determine how the Affordable Care Act is affecting individuals in areas hit the hardest by the ACA where costs are rising and choices are limited. HealthCare.gov continues to struggle while millions of Americans have their health plans cancelled and are left without the options the President promised.”

The Washington, D.C. insurance commissioner was fired Friday, the day after he had expressed skepticism about President Obama's plan to let people keep their current health insurance under Obamacare and indicated that it would not be implemented in Washington.

According to the Washington Post, William White was told that Mayor Vincent Gray (pictured) "wants to go in a different direction." His comments about the Obamcare 'fix' weren't explicitly referenced, but on Thursday, White had said that the plan would have damaged the law's insurance marketplaces and "make it more difficult for them to operate."

The timing was hard to ignore, White told the Post. His statement was also removed from the insurance department's website.

The city declined to comment on White's firing.

According to the Post, White had tried to apologize for the comments on Thursday night, before he was fired, in a voicemail for Gray and an email sent to the mayor's senior staff.

Beware anybody trying to help people sign up for health insurance under Obamacare.

That's the line from top Senate Republicans, who have magnified their smear campaign against the law's so-called navigators, groups that have received federal money to assist people in enrolling for coverage. Their latest shot: darkly warning that Americans could put their personal and financial safety at risk if they seek out assistance.

Republicans have a longstanding animosity toward the navigators -- state officials in a number of red states have put up roadblocks for them -- but the comments of Senate Minority Leader Mitch McConnell (R-KY), Senate Minority Whip John Cornyn (R-TX) and Sen. Marco Rubio (R-FL) are a new extreme in the party's assault on those tasked with helping Americans navigate the health reform law.

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The Obama administration has said that HealthCare.gov will be "working smoothly for the vast majority of users" by the end of November. They've brought in Jeff Zients, a former corporate executive, to save the ailing website from its disastrous launch. So how are they doing?

They're making serious progress, Zients said on a Friday conference call with reporters.

The administration is judging its improvement by two metrics, Zients said: the website's response times and its error rates. In other words, how long it takes a page to load for users and how often users encounter a crash or error page.

In both areas, Zients reported, HealthCare.gov is improving exponentially.

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"I lost my health insurance under Obamacare," Rep. Michele Bachmann lamented to CNN's Wolf Blitzer on Thursday evening.

She didn't sound happy about it. "Actually, we were just fine before," she told Democratic strategist Paul Begala after he suggested that she should be thankful for the health reform law because she and her husband, who Bachmann said had serious health issues, couldn't be discriminated against now.

Has she checked out the Washington, D.C., health insurance marketplace, where she could see what Obamacare might actually be able to offer her and her family? Yeah, right.

“Are you kidding? I’m not going to waste an hour on that thing,” she said. “I’m waiting until they fix this thing. I’m not going to sit there and frustrate myself for hours and hours.”

But as Bachmann portrayed herself another victim of Obamacare, another American kicked off her health plan, she left out one important fact: She has her fellow Republicans to thank for her so-called predicament.

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