Implementation news: Co-Ops face historic test, White House makes hire for health law PR push

Politico notes the support and challenges of nonprofit CO-OPs as alternatives to commercial insurance plans, while HealthyCal examines parts of the health law that may be giving pause to small businesses. Meanwhile, California Healthline examines whether the higher-than-expected costs and lower-than-expected enrollment in high-risk pools might foreshadow the future of new insurance exchanges.

Politico: CO-OP 'Movement' Offers An Insurance Alternative
The public option is dead. Long live CO-OPs! That's the chant from mostly grass-roots health reformers in 24 states, backed by billions of dollars in government loans, who are gearing up to offer alternatives to commercial insurance plans on the exchanges next fall. ... [But] to succeed, CO-OPs will have to compete with large established insurers that are also hungry for the new exchange business under the health law (Norman, 4/25).

HealthyCal: Benefits In Federal Health Reform May Not Entice Small Businesses
The federal Affordable Care Act kept the nation's employer-based health insurance system intact – and that decision may leave small business struggling to provide health care to their employees…But critics say provisions in the Affordable Care Act aren't enough to ensure that small businesses can provide coverage to their employees. Some provisions may actually discourage employers from providing insurance (Shanafelt, 4/25).

California Healthline: Are High-Risk Pools A Preview Of Obamacare's Failure?
Following the Obama administration's announcement about the suspension of enrollment in a high-risk health insurance program known as the Pre-Existing Condition Insurance Plan, a flurry of commentary began on what the move means for the Affordable Care Act. Some observers said that the program's underwhelming enrollment numbers and high costs foreshadow inevitable problems with the ACA's health insurance exchanges, while others drew a clear division between a program intended to insure only those with pre-existing health conditions and state marketplaces designed to spread risk by insuring both those who are sick and those in good health. Two months after the halted enrollment, the debate continues (Wayt, 4/24).

In other news -

Politico: WH Taps CAP's McGuinness For Obamacare Push
Tara McGuinness, a well-regarded strategic communications expert currently serving as a senior vice-president at the Center for American Progress and executive director of the think-tank's advocacy arm, and will be reunited with former CAP-er Jen Palmieri as a senior White House communications advisor. She'll be focusing on communications and outreach around Affordable Care Act implementation. The move signals a new focus in the White House communications operation on the ACA, an administration official tells POLITICO (Thrush, 4/24).

NPR: Family Doctors Consider Dropping Birth Control Training Rule
One of the more popular provisions of the federal health law requires that women be given much freer access to prescription methods of birth control. That includes not only the pill, but implants and IUDs as well. But what happens if there are not enough doctors to prescribe those contraceptives? That's exactly what worries some reproductive health advocates, as efforts are underway to rewrite rules governing the training of the nation's family doctors (Rovner, 4/25).