First Edition October 10 2013
First Edition: October 10, 2013 This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Today's headlines include a new Associated Press poll that offers the public's early reviews of the first days of the health law's online insurance marketplaces. Kaiser Health News: Health On The Hill: Health Law Fight Complicated By Shutdown, Debt Ceiling BattlesKaiser Health News’ Mary Agnes Carey and CQ Roll Call's Emily Ethridge discuss the latest developments on Capitol Hill. For instance, fights over defunding the health law remain at the center of legislative battles eight days into a federal government shutdown and just a week before the nation hits its debt ceiling (10/9). Listen to the audio or read the transcript.Kaiser Health News: Five Lessons From Massachusetts About Obamacare RolloutWBUR’s Martha Bebinger, working in partnership with Kaiser Health News and NPR, reports: "A lot of the Affordable Care Act supporters point to Massachusetts as proof that signing up the uninsured is a big, but doable task. Here, in 2013, that’s a reasonable conclusion. But back in 2007 and 2008 things were a lot messier, and some advocates for universal coverage were worried" (Bebinger, 10/10). Read the story.Kaiser Health News: Capsules: Hawaiians Still Unable To Shop On State ExchangeNow on Kaiser Health News' blog, Phil Galewitz reports: "Ten days after the Hawaii Health Connector was supposed to allow consumers and small employers to shop and enroll for coverage, officials are using paper applications and referring people to insurers’ websites to check prices. About 100,000 people are uninsured in Hawaii. It is the only one of the 14 state-run marketplaces, also called exchanges, that has no major functions online. Oregon’s marketplace does not yet allow online enrollment, but consumers can shop for health plans on its website" (Galewitz, 10/10). Check out what else is on the blog.The Associated Press/Washington Post: Poll: Health Care Exchange Rollout Gets Poor Reviews; 7 Percent Of Americans Have Tried It OutThe government’s new health insurance marketplaces are drawing lots of rotten tomatoes in early reviews, but people are at least checking them out. Seven percent of Americans report that somebody in their household has tried to sign up for insurance through the health care exchanges, according to an AP-GfK poll (10/10).The Associated Press/Washington Post: New Wrinkle: Deadline To Avoid Health Law Will Fall Around Valentine’s Day, Not March 31You’ll have to get coverage by Valentine’s Day or thereabouts to avoid penalties for being uninsured, the Obama administration confirmed Wednesday. That’s about six weeks earlier than a March 31 deadline often cited previously. The explanation: health insurance coverage typically starts on the first day of a given month, and it takes up to 15 days to process applications (10/9).The Washington Post: Some Say Health-Care Site’s Problems Highlight Flawed Federal IT PoliciesProblems with the federal government's new health-care Web site have attracted legions of armchair analysts who speak of its problems with "virtualization" and "load testing." Yet increasingly, they are saying the root cause is not simply a matter of flawed computer code but rather the government’s habit of buying outdated, costly and buggy technology (Timberg and Sun, 10/9).USA Today: Got A Health Concern? Insurance Advocates Can HelpBeginning last week, uninsured Americans could begin signing up for insurance at HealthCare.gov because of the Affordable Care Act. The law prohibits insurance companies from charging people more or denying them coverage because of pre-existing medical conditions, or setting lifetime spending limits. People who make less than 400% of the federal poverty level, or about $94,200 for a family of four, may be eligible for insurance subsidies to help pay for their insurance, or obtain free coverage through Medicaid (Kennedy, 10/9).The New York Times: Obama To Meet With Congressional Democrats And RepublicansOn Wednesday afternoon, it is the turn of the House Democratic minority, for what some Democrats characterized as a likely pep rally in the East Room for Mr. Obama’s hard-line position. Democrats are united behind the president’s stance of not negotiating with Republicans about his health care law or anything else until House Republican leaders agree to fund and reopen the government, and increase the debt limit so the Treasury can keep paying the nation’s bills. Mr. Obama has invited the Senate’s Democratic majority and its Republican minority as well as, of course, the House Republicans, a White House official said. Times and dates were being worked out (Calmes, 10/9).The Associated Press/Washington Post: Obama Seeks Opening On Shutdown With House GOP Leaders Eyeing Short-Term Debt Limit ExtensionObama had House Democrats over to the White House, while Republican conservatives heard a pitch from the House Budget Committee chairman, Rep. Paul Ryan, R-Wis., on his plan to extend the U.S. borrowing cap for four to six weeks while jump-starting talks on a broader budget deal that could replace cuts to defense and domestic agency budgets with cuts to benefit programs like Medicare and reforms to the loophole-cluttered tax code. Curbs to “Obamacare” were not mentioned. At the White House, Obama told House Democratic loyalists that he still would prefer a long-term increase in the nation’s $16.7 trillion borrowing cap but said he’s willing to sign a short-term increase to “give Boehner some time to deal with the tea party wing of his party,” said Rep. Peter Welch, D-Vt. (10/10).The Wall Street Journal: Shutdown Standoff Shows Signs Of A Thaw Solving an immediate impasse over the debt ceiling wouldn't necessarily resolve the spending fight that has closed the government. Many of the same conservatives who backed a short-term extension of the country's borrowing authority said they are willing to keep parts of the government shuttered in order to keep fighting over the health law. Mr. Obama said Tuesday—and again in a Wednesday meeting with House Democrats—that he was open to a short-term debt-limit increase. White House officials view Thursday's meeting as an opportunity for Mr. Obama to make his case directly to lawmakers who are leading the fight to try to win policy changes, among them curbs to the health law, a senior administration official said (O’Connor, Hook and Lee, 10/9).The New York Times: As Pressure Mounts, House GOP Weighs Short-Term Debt DealHouse Republicans, increasingly isolated from even some of their strongest supporters more than a week into a government shutdown, began on Wednesday to consider a path out of the fiscal impasse that would raise the debt ceiling for a few weeks as they press for a broader deficit reduction deal. That approach could possibly set aside the fight over the new health care law, which prompted the shutdown and which some Republicans will be reluctant to abandon (Weisman, 10/9).Los Angeles Times: Rep. Paul Ryan Fails To Close Republican DivideThe complaint: His plan, which centered on trimming back spending on government entitlement programs, failed to mention the demise of Obamacare as a top Republican objective. Conservatives accused him of abandoning their cause and caving in to Democrats (Mascaro and Memoli, 10/9).The Washington Post: Key Republicans Signal Willingness To Back Down On Effort To Defund Health-Care LawKey GOP figures on Wednesday sent their clearest signals that they are abandoning their bid to immediately stop the federal health-care law — the issue that forced the government to shut down — and are scrambling for a fallback strategy. Republican Party leaders, activists and donors now widely acknowledge that the effort to kill President Obama’s signature initiative by hitting the brakes on the government has been a failure. The law has largely disappeared from their calculus as they look for a way out of the impasse over the shutdown and for a way to avoid a possible default on U.S. debt (Tumulty and Hamburger, 10/9).Politico: GOP Quietly Backing Away From Obamacare A fight over Obamacare? That’s so last week. With the government shutdown firmly in its second week, and the debt limit projected to be reached next Thursday, top House and Senate Republicans are publicly moving away from gutting the health care law — a practical move that could help resolve the stalemate and appear more reasonable in the eyes of frustrated voters (Sherman and Raju, 10/10).The New York Times: House Republicans Argue For Delay In Health Law PenaltiesHouse Republicans said Wednesday that chaos in the first nine days of open enrollment under President Obama’s health care law would justify a delay in major provisions of the law, including tax penalties for people who go without insurance in 2014. The comments came at a hearing of a House committee, where a senior official of the Internal Revenue Service said that its work on the new insurance marketplaces was “going fine,’’ just as planned (Pear, 10/9).The Wall Street Journal: Medical-Device Tax Repeal Gains New LifeMedical-device makers are finally gaining traction in their three-year effort to repeal a tax on their products that helps fund the Affordable Care Act. In recent weeks, House Republicans had made repeal of the 2.3% tax a proxy for their bigger fight against the health-care law championed by President Barack Obama, and device makers stepped up their lobbying efforts (Mundy and Walker, 10/9).The New York Times: Republicans Using Shutdown To Stake Positions For Potential 2016 BidsEager to regain favor with conservatives as he considers running for president, Mr. Rubio has fully embraced Mr. Cruz’s effort to block financing for the new health care law, standing with him at news conferences and through procedural maneuvers that led to the shutdown (Martin, 10/9).The Associated Press/Washington Post: A Look At The Bruising Basics Behind The Struggle Over The Shutdown, Debt And Health CareThese are complicated times in the affairs of Washington and the nation, with death stars everywhere and all of them a struggle to comprehend. The partial government shutdown, the debt limit squeeze just around the corner, sequestration, how they fit with the health care law, how they don’t — it just goes on. So we’ve cooked up some questions about this grim galaxy and taken a stab at answers (10/9).The New York Times: Kochs Deny Pushing For Shutdown Over Health LawKoch Industries, whose co-founders, Charles and David Koch, are major donors to Tea Party-inspired conservative causes, accused Harry Reid, the Senate majority leader, on Wednesday of spreading “false information” about the brothers by suggesting they are behind the move to end financing for President Obama’s healthcare law and the partial shutdown of the federal government (Stolberg, 10/9).The Associated Press/Washington Post: Lawmakers Hear Differing Views On Health Care Law’s Effect On BusinessSome businesses say they’ll be forced to hire fewer people or cut employee hours to avoid having to offer insurance coverage to workers under the new health care law. But an economic researcher says there’s too much misinformation circulating about the law and that there’s no data to support claims that companies have already been cutting workers hours. These views were expressed Wednesday at House Small Business subcommittee hearing to look into the part of the law that requires companies with 50 workers or more to offer an affordable insurance plan to those working an average of 30 hours a week in any month (10/9).The Wall Street Journal’s Washington Wire: IRS Official: Not ‘Consorting With Devil’ On ObamacareSarah Hall Ingram, who oversees the Internal Revenue Service role in the health-care overhaul, hasn’t been “consorting with the Devil,” she testified at a hearing on Wednesday. But Republicans suggested she has been doing a few other bad things, notably discussing taxpayer information in emails with the White House, contrary to IRS rules. That’s clear from the fact that the IRS itself redacted the taxpayer identities before turning over the email conversations, citing confidentiality rules, lawmakers said (McKinnon, 10/9).Politico: IRS Obamacare Official: Rollout Smooth On Our EndA House panel finally got to question the Internal Revenue Service official running the agency’s Obamacare office today — and she calmly maintained that her part of the health law rollout is going just fine. At a House Oversight and Government Reform Committee hearing Wednesday, Sarah Hall Ingram stepped into a political hotbed and was plied with questions from Republicans about her former leadership of the IRS department that targeted tea party groups last year (Cunningham, 10/10).The Associated Press/Washington Post: Aon Hewitt Predicts That More Employers Will Offer High-Deductible Health InsuranceMore workers at big U.S. companies will likely start paying a greater share of their doctor’s bill because of a health insurance shift forecast by benefits consultant Aon Hewitt. Consumer-directed health plans, or CDHPs, could become the most common form of coverage offered by companies with 500 or more workers in the next three to five years, Aon Hewitt said Wednesday, as companies continue trying to cut health-care costs (10/9).Los Angeles Times: Gov. Jerry Brown Signs Bill To Increase Access To AbortionsGiving California women more access to abortion, Gov. Jerry Brown signed a bill Wednesday that allows nurse practitioners and certain other non-physicians to perform the procedure during the first trimester of pregnancy. The governor acted on 32 bills in all, approving measures that will cap drug costs for cancer patients, expand the number of people on CalFresh, the state's food stamp program, and promote breastfeeding (McGreevy and York, 10/9).The New York Times: California Expands Availability of AbortionsGov. Jerry Brown on Wednesday expanded access to abortion in California, signing a bill to allow nurse practitioners, midwives and physician assistants to perform a common type of the procedure, an aspiration abortion, during the first trimester. Washington, Montana, Vermont and New Hampshire allow nurse practitioners to perform such abortions, which use a tube and suction, while several other states, including California, permit nonphysicians to provide drugs to terminate pregnancy (Lovett, 10/9).Los Angeles Times: State Mental Hospitals Remain Violent, Despite Gains In SafetyIt has been nearly three years since psychiatric technician Donna Gross was strangled on the fenced grounds of Napa State Hospital — a slaying that helped expose a systemwide problem with patient violence. Although safety has improved since then, violence is still far too high, exacerbated by an increasingly prison-savvy population with predatory tendencies, an Assembly committee was told Wednesday. The committee focused its attention on the Napa facility, but will also be examining the other four state-run mental hospitals (Romney, 10/9). Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page.