KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: September 25, 2013

Today's headlines include reports about projected health insurance premium costs on the health law's new online marketplaces, as well as news from Capitol Hill and a joint appearance by President Barack Obama and former President Bill Clinton to talk about the overhaul.

Kaiser Health News: Average Obamacare Premiums Will Be Lower Than Projected
Kaiser Health News staff writers Julie Appleby and Phil Galewitz report: "Just days before new online health insurance markets are set to open, the Obama administration Wednesday released a look at average premiums, saying rates in most states are lower than earlier projected -- and that 95 percent of consumers will have at least two insurers to choose from. The report – released the same day that President Barack Obama and former President Bill Clinton touted the law’s benefits -- comes as part of a stepped-up administration effort to explain and defend the health law as congressional Republicans target it for defunding" (Appleby and Galewitz, 9/25). Read the story.

Kaiser Health News: Some Say Obamacare's 'Affordable' Coverage Isn't Affordable For Them
Kaiser Health News’ staff writer Julie Appleby, working in collaboration with NBC News, reports: "Michelle La Voie wants health insurance, but as a single mom making $38,000 a year and supporting two teenagers, she's not sure she can afford it -- even with a subsidy through the federal health law known as Obamacare" (Appleby, 9/24). Read the story.

Kaiser Health News: 8 Ways Young Women Benefit From Obamacare
Kaiser Health News staff writer Phil Galewitz, working in partnership with Cosmopolitan, reports: "You've heard people arguing about Obamacare (officially known as The Affordable Care Act or ACA) for months ... but you may have tuned it all out, because it's all so confusing and you don’t even know how -- or if -- it affects you. But starting in 2014, the law will require people who can afford insurance to carry it or risk paying a fine, so now's the time to pay attention. And the fact is, you may discover that there are lots of benefits you'll be able to take advantage of. Here's a quick list of what's great about the ACA, especially for young women" (Galewitz, 9/24) Read the story.

Kaiser Health News: Capsules: 3 States, 3 Different Obamacare Outreach Plans; Questions And Answers About Obamacare Marketplaces
Now on Kaiser Health News' blog, Jenny Gold reports on the enrollment outreach plans being followed by three states: "How many ads will it take to get the uninsured signed up for the new coverage options launching Oct. 1? States do not know yet. But those running their own marketplaces are rolling out some creative new outreach techniques to get there as quickly as possible" (Gold, 9/24).

Also on the blog, Mary Agnes Carey and Julie Appleby were hosted once again by the Washington Post’s Charity Brown  for a live discussion with Post readers about how the new online marketplaces will work under the health law. Read a transcript of the discussion or check out what else is on the blog.

The New York Times: Officials Detail Premium Costs Of Health Plan
Administration officials released the information, central to their campaign to persuade millions of uninsured Americans to sign up for coverage, even as Senator Ted Cruz, Republican of Texas, waged a fierce fight on the Senate floor, risking a government shutdown if necessary to eliminate financing for the expansion of coverage under President Obama’s health care law (Pear, 9/25).

The Wall Street Journal: Prices Set For New Health-Care Exchanges
The plans, offered under the health-care overhaul to people who don't get insurance through an employer or government program, in many cases provide broader coverage than current policies. Costs will vary widely from state to state and for different types of consumers. Government subsidies will cut costs for some lower-income consumers (Radnofsky 9/25).

NPR: Administration Touts Lower-Than-Expected Obamacare Premiums
Premiums in the health insurance exchanges set to open next week will be lower than anticipated, the Obama administration announced Wednesday. According to a report released by the Department of Health and Human Services, "premiums nationwide will ... be around 16 percent lower than originally expected," and 95 percent of uninsured people live in a state with average premiums that are lower than expected (Rovner, 9/25).

Los Angeles Times: Online Obamacare Marketplaces Offer Ample Options, Report Says
Most Americans who shop for health insurance on new online marketplaces set up under President Obama's health law will have a wide variety of choices, a new report from the Department of Health and Human Services indicates. And many young consumers will be able to select health plans that cost $100 a month or less, according to the report, which is based on a preliminary analysis of premiums that insurers will charge when the insurance becomes available Jan. 1 in 36 states (Levey, 9/24).

The Washington Post's Wonk Blog: How Much Will Obamacare Premiums Cost? Depends On Where You Live.
A 27-year-old in Austin who earns $25,000 could pay $85 per month for health insurance next year, and a family of four in St. Louis with income of $50,000 might face a $32 monthly premium, according to new federal data on health insurance rates under the Affordable Care Act. The report, released Wednesday by the Department of Health and Human Services, showed significant variation in the insurance premiums that Americans shopping on the individual market could pay under the president’s health-care overhaul. Across the 48 states for which data were available, the unsubsidized monthly premiums could be as low as $70 for an individual and as high as $1,200 for a moderate plan for a family of four (Somashekhar and Kliff, 9/25).

The Associated Press/Washington Post: Obama Administration Unveils Premiums And Choices In 36 States As Health Overhaul Debut Nears
The overview of premiums and plan choices, released Wednesday by Health and Human Services Secretary Kathleen Sebelius, comes as the White House swings into full campaign mode to promote the benefits of the Affordable Care Act to a skeptical public. Congressional Republicans, meanwhile, refuse to abandon their quest to derail "Obamacare" and flirt with a government shutdown to force the issue (9/25).

USA Today: How The Insurance Exchanges Stack Up
Wednesday's report is the latest review of exchanges' rates and policies from HHS and various states. Most have shown lower rates than anticipated, as more insurers have entered the markets and pegged their prices to capture more customers. The Obama administration estimates that 7 million uninsured Americans will use the exchanges to buy insurance in the six-month enrollment period that starts next week and ends March 1 (Kennedy, 9/25).

Politico: HHS Reveals Obamacare Coverage Prices For Federal Exchanges
The administration put the best face on the health insurance premiums, emphasizing that the rates have come in lower than expected in the 36 states where the feds will run part or all of the exchanges. That part of the report gives them a snappy answer to the widespread predictions of "rate shock" by critics of Obamacare (Norman and Millman, 9/25). 

NPR: Commander In Chief, Explainer-In-Chief Tout Health Care Law
President Obama's health care law has so far survived challenges in Congress and the courts. But its biggest test could begin next week. That's when the online marketplaces offering health care coverage to the uninsured are set to start signing people up. The question is, will they come? (Horsley, 9/25).

The New York Times: Obama And Clintons Share Stage For Health Care Talk
After delivering a much-anticipated speech to the United Nations General Assembly in the morning and meeting with world leaders in the afternoon, President Obama turned to health care on Tuesday evening, sharing center stage with the Clinton family at an event to highlight the rollout of the Affordable Care Act (Shear, 9/24).

Los Angeles Times: With Bill Clinton At His Side, Obama Sells Healthcare Law
President Obama accused foes of his healthcare law of trying to sabotage it for political gain, saying opposition has become a “litmus test” for Republicans. The result, Obama said Tuesday evening, is that the law is mired in partisan politics in state legislatures and Congress. … As he spoke, Sen. Ted Cruz, a tea party Republican from Texas, was staging a filibuster at the Capitol to try to strip funding for the nearly 4-year-old law, an effort that threatened to shut down the federal government. It also divided the GOP over tactics (Hennessey, 9/24).

The Associated Press/Washington Post: Obama, Bill Clinton Reunite To Discuss Health Care Law A Week Before Key Enrollment Date
Joining forces under dimmed lights in a hotel ballroom in New York, Obama and Clinton laid out the law’s benefits and its connection to the economy while dispelling what they called disinformation about its downsides. Clinton, acting as host, lobbed the questions; Obama answered with the eagerness of a guest on a daytime TV talk show (9/24).

The Washington Post: President Obama Enlists Bill Clinton To Help Pitch New Health Insurance Exchanges
The two men who stand as bookends for the modern Democratic Party made a united sales pitch to millions of uninsured Americans to enroll when new insurance marketplaces open Oct. 1. … Obama has enlisted Clinton again as his "secretary of explaining stuff," a nickname he earned after his well-received speech at the 2012 Democratic National Convention. The aim is for Clinton to help sell the health-care law to skeptics across the country while combating Republican attempts to undermine it (Rucker, 9/24).

NPR: Would A Federal Shutdown Delay Health Care Exchanges?
Well, it's almost Oct. 1, the day of a threatened government shutdown and the day state health insurance exchanges are scheduled to begin operations. Those are the online marketplaces created by the Affordable Care Act where people can compare health plans and sign up for coverage (Rovner, 9/24).

The Wall Street Journal: Shutdown Unlikely To Hit Health Law's Rollout
Getting a passport or seeing pandas at the National Zoo would be more difficult if the government shuts down, but consumers should still be able to shop for health insurance on new online marketplaces. The marketplaces, the centerpiece of President Barack Obama's health law, are set to open Oct. 1. On the same day, parts of the government would shut down if Congress doesn't pass a bill extending federal agencies' discretionary spending (Schatz, 9/24).

The Wall Street Journal: Medicaid Applications Face Delay In Health Exchanges
The federal government's insurance exchanges won't be able to transfer Medicaid applications to states when the exchanges open Oct. 1, another sign of the technical hurdles the Obama administration is facing in preparing for the health-overhaul law (Radnofsky, 9/24).

The Washington Post: Democrats See GOP Shutdown Threat As Opening For 2014 Election Gains
The key to the Democratic strategy is a belief that a showdown is likely to play out similarly to the government shutdowns of 1995 and 1996, which turned public opinion sharply against the Republican majority. … As a result, many Democrats welcomed Tuesday’s filibuster-style floor speech by conservative Sen. Ted Cruz (R-Tex.), who pledged to talk for as long as he could in an attempt to slow Democratic plans to advance a bill that would keep the government open while also funding President Obama’s signature health-care law. House Republicans voted to strip funding from Obamacare last week in exchange for keeping the government running (Goldfarb, 9/24).

Los Angeles Times: Republican Leaders Considering Plan B To Stop Healthcare Law
With their effort to block money to run the government until President Obama guts the new healthcare law starting to fizzle, Republican leaders are considering Plan B. Senate Republicans are pushing renegade Sen. Ted Cruz (R-Texas) to wrap up his filibuster-like obstruction of the government funding bill sooner rather than later. Top Republicans want to get the legislation back to the House in time to give Speaker John A. Boehner (R-Ohio) an opportunity to attach new healthcare repeal amendments that might have a better chance at achieving GOP policy goals (Mascaro, 9/25).

Politico: House GOP May Attach Obamacare Delay To CR
The House Republican leadership is seriously considering attaching a one-year delay of Obamacare’s individual mandate to the Senate bill to avert a government shutdown, according to senior GOP aides. If House Republicans decide to go this route, it would all but provoke a government shutdown, since Senate Democrats might not even schedule a vote on a bill that includes that provision, Senate leadership staffers say. Even if the Senate schedules a vote, there might not be time to move the legislation through the slow-moving chamber (Sherman and Bresnahan, 9/25).

The Associated Press/Washington Post: Analysis: Republicans In A Risky Fight With Obama On Health Care, Budget, Government Shutdown
Under relentless pressure from their right wing, Republicans are in the midst of a risky fight with President Barack Obama they know they will lose, little more than a year before an election that history says they should win. To minimize the damage, the party must redefine victory as something less than a full defunding of Obama’s 3-year-old health care law, yet convince the most conservative GOP supporters that Republican lawmakers succumbed after a principled fight. All without triggering a government shutdown or a default by the Treasury, or otherwise offending independents whose ballots will settle the 2014 elections (9/25).

The Washington Post: Sen. Cruz Continues Night-Long Attack On Obamacare
Speaking with little assistance from his Republican colleagues, Cruz assured that debate on the spending measure will stretch well into the weekend. With Senate passage all but certain on a bill that will include funding for the health-care law, Cruz’s strategy will give House Speaker John A. Boehner (R-Ohio) and his colleagues only a few hours to respond with a different version of the legislation (O’Keefe and Kante, 9/25).

The New York Times: Senator Persists Battling Health Law, Irking Even Many In His Own Party
Facing an increasingly likely defeat in his tangled procedural fight over funding the government, Senator Ted Cruz took to the Senate floor on Tuesday and declared he would speak “until I cannot stand” to rally voters against the health care law (Weisman, 9/24).

Los Angeles Times: Sen. Ted Cruz Digs In As Shutdown Looms
Three hours into his Senate speech-a-thon, Sen. Ted Cruz recalled that Sen. Rand Paul's filibuster criticizing U.S. drone policy was seen at first as "curious if not quixotic," but ultimately "transformed the debate." Cruz, a Texas Republican, took control of the Senate floor Tuesday to herald his campaign to eliminate the money needed to implement President Obama's healthcare law. He hoped for a galvanizing moment similar to the one sparked by his Kentucky colleague in March (Memoli, 9/24).

The Wall Street Journal: Cruz's Defiant Stand Is Also A Lonely One
Wearing black tennis shoes in lieu of his customary boots, the Republican took to the Senate floor Tuesday afternoon in front of a handful of lawmakers and vowed to speak until he was "no longer able to stand" in resistance to President Barack Obama's health-care law. It technically was just a long speech that stretched late into the night—not a filibuster—and couldn't significantly delay a Senate vote expected Wednesday. But Mr. Cruz's defiant stand exemplified his unyielding brand of conservatism that, less than a year into his Senate career, has fueled speculation that he might run for president (Peterson and Hook, 9/24).

The New York Times: About New York: A Republican Calls Another a 'Fraud'
Jumping ahead to that third minute, Mr. King said precisely what he thought of the Cruz tactic: "It is just a form of governmental terrorism." Strong coffee, which Mr. King began pouring last week, a near-solitary voice against what he saw as a cynical maneuver to delude ordinary Republican voters into thinking that President Obama’s health care law could be effectively repealed without winning elections or court cases. Now, other Republicans are beginning to speak against Mr. Cruz and what he has wrought (Dwyer, 9/24).

The New York Times: In Corner Of Arkansas, Frustration But No Panic Over Possible Shutdown
People do have strong feelings about some of the issues, most significantly an almost universal suspicion of the Affordable Care Act. But in a conservative district that has sent Republicans to Congress every year since 1967, people seem to see the current turmoil as the new normal of Washington rather than a seminal political moment likely to affect their own lives. And if Republican legislators could be overplaying their hand by pushing their case against Obamacare to the outer limits, there is not much sign of that in the reactions here. Their second-term congressman, Steve Womack, voted with House Republicans to defund Obamacare, and no one can imagine anything so dire that voters could elect a Democrat here. Still, that does not mean people are happy about what they see (Fernandez, 9/24).

The Washington Post’s The Fact Checker: How Unpopular Or Popular Is Obamacare? 
In the fight over President Obama’s health care law, politicians love to toss around statistics that show either how popular it is — or is not. But this pair of statements is truly head-spinning. How can the most unpopular law ever passed in the history of this country be supported by 59 percent of the American people? And can a government shutdown really be "the worst idea that came along"? Let’s take a look (Kessler, 9/25).

The New York Times: Rules Sought for Workplace Wellness Questionnaires
A federal lawmaker is asking the Equal Employment Opportunity Commission to investigate employer wellness programs that seek intimate health information from employees, and to issue guidelines preventing employers from using such programs to discriminate against workers (Singer, 9/24).

The Wall Street Journal: Getting Mental-Health Care At The Doctor's Office
Seattle psychiatrist Anna Ratzliff oversees mental-health care for nearly 500 patients—most of whom she will never meet. As the consulting psychiatrist for four primary-care practices, Dr. Ratzliff confers weekly with 10 care managers who follow the patients closely, provide counseling and chart their progress in electronic registries. She helps devise treatment plans and suggests changes for those who aren't improving (Beck, 9/24).

The Associated Press/Washington Post: Judges Weight Whether Businesses Can Be Exempt From Health Care Law’s Contraception Mandate
A federal appeals court is considering whether for-profit businesses can be exempted from a contraceptive mandate in the health care law because of the owners’ religious views. The law already exempts houses of worship from the requirement, but two brothers who own businesses in Ohio argue they shouldn’t have to comply. The brothers, Francis and Philip M. Gilardi, say the requirement would force them to violate their Roman Catholic religious beliefs and moral values by providing contraceptives such as the Plan B pill for their employees (9/24).

The Wall Street Journal's Washington Wire: Nuns Challenge Obamacare's Contraception Rule
A public-interest law firm challenging the federal health law’s requirement that employers cover contraception in workers’ insurance plans has a new plaintiff: nuns. The Becket Fund for Religious Liberty filed a lawsuit Tuesday in federal district court in Denver on behalf of the Little Sisters of the Poor, a Catholic religious order that operates homes with 13,000 poor elderly people (Radnofsky, 9/24).

The Washington Post: Federal Worker Health Program To Remain Largely Stable
Premiums in the Federal Employees Health Benefits Program will rise an average of about 4 percent for 2014, the third straight year of increases in that range, the Office of Personnel Management announced Tuesday (Yoder, 9/24).

The Washington Post: Inova's Contract With Kaiser Permanente To Expire
Two of the largest players in Northern Virginia’s health industry are parting ways. Inova Health System said Tuesday that its contract with Kaiser Permanente will not be renewed when it expires Oct. 1, a break that could be a sign of what is to come as pressure to contain medical costs forces companies to rethink their relationships (Halzack, 9/24). 

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