KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: October 22, 2013

Today's headlines include reports about the Obama administration's plans to address the problems with 

Kaiser Health News: How Long Does Obama Have To Fix
Kaiser Health News staff writer Julie Appleby reports: "They've got a few weeks. But if federal officials can’t get the new online insurance marketplace running smoothly by mid-November, the problems plaguing the three-week-old website could become a far bigger threat to the success of the health law, hampering enrollment and fueling opponents’ calls to delay implementation, say analysts" (Appleby, 10/21). Read the story.

Kaiser Health News: Insuring Your Health: Readers Ask About HSAs, Infertility Treatment, And The Consequences Of Not Buying Insurance
Kaiser Health News consumer columnist Michelle Andrews answers various reader questions (10/22). Read the column

Kaiser Health News: New Health Policies Will Expose Many Missourians To Higher Premiums, More Risk
The St. Louis Dispatch’s Jim Doyle and Tara Kulash, working in partnership with Kaiser Health News, reports: "Thanks to government subsidies, many St. Louis-area residents will be able to afford health insurance for the first time, beginning in 2014. But the insurance they’ll be able to buy will offer a limited range of options" (Doyle and Kulash, 10/22). Read the story.

Kaiser Health News: Obama Seeks To Reassure Consumers Frustrated With (Video)
Kaiser Health News has video clips of the President Barack Obama as he discussed the rollout of the federal health law in a White House speech Monday. In the excerpt, he discusses the technical problems with the federal health insurance marketplace website and what his administration is doing to help consumers get enrolled in an insurance plan (10/21). Watch the video or read the transcript.

Kaiser Health News: Capsules: Updates: The Latest On The Health Law’s Insurance Exchanges
Now on Kaiser Health News' blog, watch video of KHN’s Jenny Gold  on C-SPAN’s Washington Journal Monday giving an update on the health law’s insurance exchanges and previewing President Obama’s comments on the exchange’s rollout (10/21). Watch the video or check out what else is on the blog.

The New York Times: Obama Admits Web Site Flaws On Health Law
President Obama offered an impassioned defense of the Affordable Care Act on Monday, acknowledging the technical failures of the Web site, but providing little new information about the problems with the online portal or the efforts by government contractors to fix it (Shear and Pear, 10/21).

Los Angeles Times: Obama Promises To Iron Out Glitches On Healthcare Website
With the shutdown and debt limit crisis past, Washington's attention has turned to persistent problems with the website, which processes enrollments for insurance under the Affordable Care Act. But the site — — has been plagued since it opened Oct. 1 by glitches that threaten to overshadow Obama's signature domestic accomplishment. The president relaunched his campaign to sell the law as Republicans announced plans for hearings on the balky website. A Gallup poll last week found that 7 out of 10 uninsured Americans were "not too familiar" or "not familiar at all" with the online marketplaces (Parsons, Levey and Terhune, 10/21).

Los Angeles Times: Obama: Fighting For A Better Perception Of Healthcare Law
President Obama held a Rose Garden event Monday morning with two goals: to convey a sense of urgency about fixing the problems that have confounded those trying to sign up for insurance using the program’s online insurance site, and to split the divergent group of Americans who oppose Obamacare right now. Two polls released Monday showed how, at this point, opponents of the healthcare law have benefited from opposites attracting (Deckler, 10/21).

Politico: The Obamacare Bunker Mentality
President Barack Obama likes to say his team is the most transparent administration in history — but on the Obamacare website debacle, it’s been more like they’ve been holed up in the bunker. That’s why there’s growing pressure for the administration to come out from underneath the covers, and start releasing more details on what, exactly, is wrong with the site and how soon it might be fixed (Nather, 10/22).

The Wall Street Journal: Obama Admits Health Website Flaws
Mr. Obama promised that the website crucial to the success of the health law is "going to get fixed." His comments came as Republican lawmakers began trying to assign blame to the Obama administration. In a letter released Monday, a House committee chairman said the top contractor developing the website cited a Department of Health and Human Services agency as making 11th-hour decisions that led to some of its biggest problems (Radnofsky, Schatz and Weaver, 10/21).

The Washington Post: White House Won’t Say Whether Web Site Glitches Will Delay Mandate
White House press secretary Jay Carney was bombarded with questions Monday about whether the glitches  will lead the Obama administration to withdraw penalties for people who don't comply with the requirement that they carry insurance. "Americans who have access to affordable insurance would need to have insurance by March 31," Carney said. "People who do not have access to affordable care due to a state not expanding Medicaid, for example, or due to other factors will not be penalized." Reporters pressed Carney on whether having trouble with the Affordable Care Act Web site also qualified as another exemption (Blake, 10/21).

NPR: How Politics Set The Stage For The Obamacare Website Meltdown
Since the Affordable Care Act's health care exchanges launched to a long series of error messages Oct. 1, most of the 'what went wrong' fingers have been pointing at software developers. But some say there's more to it than that – that politics has played a role as well (Rovner, 10/21).

The Washington Post: Health Insurance Exchange Launched Despite Signs Of Serious Problems
Days before the launch of President Obama’s online health ¬insurance marketplace, government officials and contractors tested a key part of the Web site to see whether it could handle tens of thousands of consumers at the same time. It crashed after a simulation in which just a few hundred people tried to log on simultaneously. Despite the failed test, federal health officials plowed ahead (Sun and Wilson, 10/21).

The Associated Press/Washington Post: Insiders Who Worked On US Health Website Describe High Stress, Complaints About Major Problems
Crammed into conference rooms with pizza for dinner, some programmers building the Obama administration’s showcase health insurance website were growing increasingly stressed. Some worked past 10 p.m., energy drinks in hand. Others rewrote computer code over and over to meet what they considered last-minute requests for changes from the government or other contractors (10/22).

USA Today: Geographic Issues Plague Federal Health Site
The federal government's new Web portal for health insurance lags the rest of the health care industry in performance, and the problems could have been prevented with adequate pre-testing, according to a new analysis by Compuware APM, which monitors and manages the performance of websites and other Internet-based assets (O’Donnell, 10/21).

NPR: The 'Tech Surge' Is Racing Against The Clock
A "tech surge" is underway to help clean up the code of the error-plagued site. The Obama administration says this surge is made up of engineers from inside and outside government, but beyond saying that Presidential Innovation Fellows are involved, officials haven't specified who's making up those teams and what exactly they're doing to fix the systemic issues with the site. Either way, tech industry leaders say the tech system — responsible for helping people in 36 states get health coverage — may have such deep flaws that it could take several months to fix them (Hu, 10/21).

The New York Times: Awareness Grows Of Online Insurance Exchanges, And Their Problems, Survey Finds
Public awareness of the new health insurance exchanges has risen substantially in the weeks since they opened, but only a small percentage of consumers have visited the sites. Most of those already have insurance and are simply trying to learn more about the program, according to a survey released on Monday by the Pew Research Center (Bornemeier, 10/21).

Politico: Kathleen Sebelius Offers To Testify On Obamacare
HHS Secretary Kathleen Sebelius is expected to testify before Congress about the rocky Obamacare rollout a week from Wednesday, House Republicans announced late Monday, just hours after House Speaker John Boehner slammed the White House for skipping an earlier hearing scheduled for this Thursday. A few hours after Sebelius signaled she was willing to testify before the House Energy and Commerce Committee at a “mutually agreeable date,” the committee announced she was “expected” on Wednesday, Oct. 30. Her testimony would come a few days after the lead contractors working on the balky Obamacare enrollment system — CGI and QSSI — testify before the same committee (Cheney, 10/21).

The Washington Post: Sebelius Negotiating With House Republicans, But Won’t Testify Thursday
Health and Human Services Kathleen Sebelius is negotiating with House Republicans over when she will appear before the House Energy and Commerce Committee to answer questions about the troubled rollout of enrollment for the new federal health-insurance exchange, according to agency spokeswoman Joanne Peters, but has not agreed to appear at a hearing scheduled on Thursday (Eilperin, 10/21).

The Wall Street Journal’s Washington Wire: Sebelius To Testify On Rocky Health Care Rollout
The Department of Health and Human Services said Monday that Secretary Kathleen Sebelius will testify before Congress on the law’s rocky rollout “as early as next week.” Ms. Sebelius’s staff had declined a request for her to testify at a House Energy and Commerce Committee hearing this Thursday, citing a schedule conflict. That decision was criticized last week by lawmakers who then called on the department to send other officials “voluntarily” (Radnofsky, 10/21).

Politico: 5 Obamacare Questions Kathleen Sebelius Won’t Answer
The reality is that no matter how long Sebelius sits and takes the heat, there are some questions she can’t or won’t answer (Norman and Millman, 10/22).

Politico: Even Obamacare Successes Have Hit Some Roadblocks
Most of the people representing Obamacare success stories who flanked President Barack Obama during his Monday Rose Garden speech haven’t gotten past the glitches. They’re still exploring their options (Haberkorn, 10/22).

The New York Times: Medicaid Expansion Is Set for Ohioans
As a Republican chairman of the House Budget Committee in the 1990s, John R. Kasich wielded a ferocious budget ax. On Monday, as Ohio’s governor, Mr. Kasich defied his party’s majorities in the state legislature to push through a multibillion dollar expansion of Medicaid under President Obama’s health care law (Gabriel, 10/21).

The Washington Post: Ohio Will Expand Medicaid After Months-Long Battle Between Governor And Legislature
Ohio agreed Monday to offer Medicaid to about 300,000 more low-income people, a major victory for Gov. John Kasich over fellow Republicans who control the state legislature and oppose the expansion. After nine months of battling with the state GOP’s conservative wing, Kasich resorted to an uncommon maneuver in which he turned to a relatively obscure state board with power over certain budget decisions. The board voted to accept $2.55 billion in federal money to cover the cost of expanding Medicaid in Ohio through July 2015 (Goldstein, 10/21).

The Washington Post: Ohio Just Became The Fourth GOP-Controlled State To Approve Medicaid Expansion Under Obamacare
As of the start of the month, 24 states had opted to forge ahead with the expansion and 26 had not, according to the Kaiser Family Foundation, a health policy news and analysis nonprofit. Ohio was among those that were not expanding health care to more low-income adults, though Republican Gov. John Kasich wanted it (Chokshi, 10/21).

The Wall Street Journal: Ohio's Governor Pushes Through Medicaid Expansion
Mr. Kasich this year proposed adding an estimated 275,000 residents to the Medicaid rolls under the provision, in which the federal government would pay 100% of coverage costs through 2016. But the proposal didn't win support from Republican leaders in the legislature, where the party controls both chambers. Those Republicans have said they are concerned about the rising costs of the government health-care program (Peters and Radnofsky, 10/21).

Politico: Ohio OKs Obamacare Medicaid Expansion
An obscure Ohio board has approved Obamacare’s Medicaid expansion, but a likely legal fight by furious conservatives is looming. The decision, 5-2, by the state Controlling Board to back expansion at the urging of Republican Gov. John Kasich would accept billions of federal dollars to extend coverage to an estimated 300,000 poor Ohioans. Kasich pursued a vote of the board after efforts to win over his Republican-led Legislature failed to gain traction (Cheney, 10/21).

The New York Times’ Economix Blog: Medicaid And The Incentive To Work
The Affordable Care Act is — to state the obvious — aimed at bolstering insurance coverage in the United States. But the law is so big that it will necessarily have widespread economic ramifications, economists think, including an effect on the labor market. For instance, the Congressional Budget Office has surmised that the law may lead more workers to choose early retirement, since they would not fear losing their insurance coverage if they did so. It might also lead certain employers to hire more part-time workers, to avoid the so-called “employer mandate” (Lowry, 10/21).

Politico: Judge To Rule On Lawsuit Challenging Obamacare Subsidies
A District of Columbia federal judge says he’ll rule Tuesday on a lawsuit over whether Americans enrolling in federally run exchanges as part of the health care law can collect insurance subsidies after he directed pointed questions to the Obama administration in a three-hour hearing Monday. The case is one of two prominent attempts to stop premium subsidies from being awarded in states where the federal government is running the new health exchange. The seven businesses and self-employed individuals bringing the case say the Affordable Care Act allows insurance subsidies in the state-run exchanges, but not the federal ones (Cunningham, 10/22).

The Washington Post’s The Fact Checker: Jim DeMint’s Claims About Medicare Cost Estimates From 1965
Jim DeMint, president of the Heritage Foundation, wrote an opinion article in which he declared that the organization would continue to fight the Affordable Care Act, a.k.a. Obamacare, despite the failure of the government-shutdown strategy that the organization had advocated earlier this year. In making the case that the cost of the health-care law was sure to grow, DeMint cited some figures about Medicare that struck us as a bit fishy. So we decided to investigate (Kessler, 10/22).

The Washington Post’s The Fact Checker: President Obama’s Claim That 6 Of 10 Uninsured Will Pay Less Than $100 A Month In Premiums
Whether health insurance premiums go up or go down is a central part of the debate over the Affordable Care Act, a.k.a. Obamacare. The research and policy arm of the Department of Health and Human Services released a report last month asserting premiums before tax credits were 16 percent lower than projected — a claim immediately challenged by skeptics of the law as a “load of spin.” So what about the study referenced by the president? The study, titled “Fifty-Six Percent of the Uninsured could pay $100 or less per month for Coverage in 2014,” turns out to also be an in-house study produced by HHS — a fact that the president failed to mention. Moreover, it really is not based on an examination of premiums at all, but household composition and income data (Kessler, 10/22).

Los Angeles Times: Laptop Thefts Compromise 729,000 Hospital Patient Files
The health information of 729,000 patients was compromised when thieves stole two laptops from an administration building of a San Gabriel Valley-based hospital group, officials said Monday. The laptops were stolen Oct. 12 and contain data from patients treated at AHMC hospitals: Garfield Medical Center in Monterey Park, Monterey Park Hospital, Greater El Monte Community Hospital in South El Monte, Whittier Hospital Medical Center, San Gabriel Valley Medical Center and Anaheim Regional Medical Center (Winton, 10/21).

Los Angeles Times: Kaiser To Join L.A. County Transfer Network For Heart Attack Care
Amid concern among some experts that the healthcare giant had been slow to act, Kaiser Permanente has announced it will join a Los Angeles County patient transfer network that quickly gets victims of severe heart attacks to specially equipped hospitals to reduce chances of serious complications or death (Brown, 10/21).  

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