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It’s that time of year again: doctors caring for Medicare patients once more face a steep pay cut. But this time Congress is pursuing a permanent fix to the annual drama that has undermined the medical profession’s confidence in the nation’s premier health program.

A fundamental change in the budget equation has handed lawmakers a rare opportunity to repeal Medicare’s broken physician payment policy, while also freeing them from having to waive billions of dollars in impending cuts every year. Slowing health care inflation has slashed the cost of repealing the old formula, bringing it down to $116.5 billion over 10 years, according to the latest estimates.

Democrats and Republicans on both sides of the Capitol plan to push ahead this week with a framework for a new payment policy.

Read the full report here.

If people whose health insurance was canceled under Obamacare this year don’t line up new coverage this month, the Obama administration could face a political nightmare. More people could have lost coverage than gained it when the health law benefits begin on Jan. 1.

That’s by no means a certainty; the sign-up website is doing better, some insurance carriers are extending plans instead of canceling them, and there are millions more uninsured people who stand to get covered than there are covered people facing plan cancellations. Medicaid sign-ups are also running strong.

Still, the estimated 4 million to 5 million — there are no official numbers, just industry guesstimates — getting plan cancellation notices have had a giant media megaphone, a Republican chorus and a story to tell about how President Barack Obama broke a promise that if they liked their health plans, they could keep them. And some of them need to get new coverage before the first of year.

Read more the full report here.