Turning three: Progress reports on health overhaul abound

As the law approaches its third birthday, news outlets examine a variety of issues surrounding its implementation.

National Journal: Obamacare At Age 3: Still Too Young For Prognosis
The Affordable Care Act, the Obama administration's signature attempt to broadly transform the health care system, marks its third anniversary this weekend. And it is still very much a toddler. Advocates and opponents have been seizing on the anniversary to offer their assessments of the law. On Monday, the Health and Human Services Department took credit for the more than 100 million Americans who have received at least one free preventive health service because of the law (Sanger-Katz, 3/19).

Kaiser Health News: Capsules: Some States Balk At Enforcing Health Law's Insurance Protections
Florida regulators won't penalize insurance companies that violate new health law consumer protections that take effect in January but will report them to the federal government, according to an agreement between the state and federal officials. Citing lack of money and legal authority, Pennsylvania's top insurance regulator hasn't decided whether his agency can enforce the provisions, … such as requiring insurers to provide coverage to all applicants regardless of their health status, prohibiting insurers from charging more based on gender or health, and greatly limiting what insurers can charge for premiums based on age. At least three others-; Missouri, Oklahoma and Wyoming -; have informed the Obama administration that they can't or won't enforce the law. … While federal officials say they will step in if necessary, policy experts note they have little experience enforcing health insurance laws and few resources in states to do it (Galewitz, 3/19).

Modern Healthcare: Proposal Limits Waiting Period For Health Insurance
Employers who offer health insurance coverage to their employees must offer that benefit no more than 90 days after those employees start working, according to a proposed rule that implements part of the healthcare reform law. Before the Patient Protection and Affordable Act, employers could have waited longer to provide health insurance coverage to employees, said Michael Rosenbaum, a partner with Drinker, Biddle & Reath in Chicago. The reform law changed that, and the new regulation this week from HHS, the Labor department and the Internal Revenue Service makes clear that starting in 2014, the waiting period for employees and their dependents to receive coverage should not last beyond 90 days (Zigmond, 3/19).

Los Angeles Times: Richer Health Benefits Cost 47% More, Industry Report Warns
This latest report examined the cost of about 30,000 individual plans that included eight health benefits and were purchased across 32 states through eHealth Insurance. The federal law requires coverage for a similar group of 10 "essential health benefits," such as maternity care, mental health services and prescription drugs (Terhune, 3/19).

Politico: Under New Health Law, Battles Over Who'll Do What
State legislatures are wrestling with all kinds of "scope-of-practice" issues -; turf battles over who can provide what kind of health care, under whose supervision and for what kind of payment. And with the health law coverage expansion going into effect in earnest in 2014, the battles are sharp and numerous, particularly regarding primary care. Everyone agrees there's a primary care shortage, at least in underserved areas. There's less agreement on the role of other practitioners -; notably physicians' assistants and nurse practitioners with advanced degrees -; in preventing the already-strained primary-care system from buckling (Smith and Cheney, 3/20).

Politico: Experts: Obamacare Insurance Gains Could Stress Primary Care System
The health system is girding for millions of new patients under Obamacare, and experts are worried that an already-strained primary care system could buckle unless other health care professionals are marshaled to perform primary care. "We need to get away from the old system of fragmented care and really work on team-based care," said Wanda Filer, director of the American Academy of Family Physicians, at a POLITICO Pro Breakfast Briefing on Tuesday morning (Cheney, 3/19).

Kaiser Health News: Health Law Covers Breast Pumps, But Not All Moms Get The Best
Under the Affordable Care Act, insurance plans are required to give new mothers equipment and services to enable them to breast feed. What that means in practical terms for most moms is that insurers have to cover the cost of a breast pump – either a rental or a new one (Foden-Vencil, 3/20).