First Edition: September 30, 2013

Today's headlines include reports about the readiness of the health law's online marketplaces and other key provisions the day before their Oct. 1 launch date even as the looming government shutdown becomes more of a reality.

Kaiser Health News: In Kentucky, Confusion And Misinformation Abound On Eve Of Obamacare Rollout
Kaiser Health News staff writer Phil Galewitz, working in collaboration with The Washington Post, reports: "On a late September night – just days before the Oct. 1launch of the state's online health insurance marketplace called Kynect -- most passersby are unaware of their new health insurance options under the law, confused by the political sniping and doubtful the law will help them. … Politically divided,  Kentucky is the only southern state running its own Obamacare marketplace and one of just two committed to expanding Medicaid, making it a unique bellwether of public receptivity to the law.  While Gov. Steve Beshear is a Democrat, its two senators, Senate Minority Leader Mitch McConnell and Rand Paul, are Republicans and ardent foes of Obamacare" (Galewitz, 9/29). Read the story and a related Q & A with Kentucky Gov. Steve Beshear (9/29).

Kaiser Health News: Three Critical Measures Of Marketplaces' Impact Could Take Several Years To Assess
Kaiser Health News staff writer Jordan Rau reports: "Rev your engines: On Oct. 1 people can start shopping for insurance on the new on-line marketplaces created by the health law. The first weeks and months will be closely watched, but many policy experts say don't speed to judgment on how well they are working. While people can enroll for insurance until the end of March, real assessments of these marketplaces will take months if not years" (Rau, 9/29). Read the story.

Kaiser Health News: Where You Live Determines How Much You Pay For Health Insurance
Kaiser Health News staff writers Julie Appleby and Jordan Rau, working in collaboration with The Philadelphia Inquirer, report: "When buying health insurance, where you live matters. In Pennsylvania and more than a half dozen states, consumers in some cities will pay at least 50 percent more for the same type of coverage than their friends and relatives in other parts of the state" (Appleby and Rau, 9/29). Read the story and check out a related chart, Monthly Premiums For A 'Benchmark' Silver Plan In Federally Run Insurance Marketplaces.

Kaiser Health News: Capsules: Poll Finds Most Unaware of Tuesday Opening of Health Insurance Marketplaces
Now on Kaiser Health News' blog, Jordan Rau reports: "A new poll finds a majority of the public -; especially those lacking health coverage -; is unaware that new insurance marketplaces created by the health law are slated to open next week. The poll also found deep skepticism of media coverage of the law, with more than half the public saying they don't trust any media source to provide credible information" (Rau, 9/29). Check out what else is on the blog.

Kaiser Health News also tracked weekend health policy headlines about the House vote to delay the health law and repeal the medical device tax (9/29). 

The New York Times: Senate Action On Health Law Moves To Brink Of Shutdown
The Senate is expected to reject decisively a House bill that would delay the full effect of President Obama's health care law as a condition for keeping the government running past Monday, as Senator Harry Reid, the Democratic majority leader, expressed confidence that he had public opinion on his side. Angering Republicans who lead the House, Mr. Reid kept the Senate shuttered on Sunday, in a calculated move to stall action on the House measure until Monday afternoon, just hours before the government's spending authority runs out at midnight (Peters and Weisman, 9/29).

The Wall Street Journal: Government Heads Toward Shutdown
The nation braced for a partial shutdown of the federal government, as time for Congress to pass a budget before a Monday midnight deadline grew perilously short and lawmakers gave no signs Sunday they were moving toward a resolution. ... House Speaker John Boehner (R., Ohio) urged Senate leaders to pass legislation that the Republican-controlled House had approved early Sunday morning, which would fund the government through mid-December. But that prospect was remote, as the House legislation included a one-year delay of the new federal health law that Democrats have vowed to reject, as well as a repeal of the new law's tax on medical devices (Hook and Peterson, 9/29).

The Associated Press: With Less Than 48 Hours To Avert A Government Shutdown, Democrats, Republicans Trade Blame
With the government teetering on the brink of partial shutdown, congressional Republicans vowed Sunday to keep using an otherwise routine federal funding bill to try to attack the president's health care law. ... Since the last government shutdown 17 years ago, temporary funding bills known as continuing resolutions have been noncontroversial, with neither party willing to chance a shutdown to achieve legislative goals it couldn't otherwise win. But with health insurance exchanges set to open on Tuesday, tea-party Republicans are willing to take the risk in their drive to kill the health care law (Taylor, 9/29).

Politico: Obamacare Medical Device Tax Assumes Big Role In Spending Battle
Along with a one-year delay in the president's health law, House Republicans have included provisions repealing the 2.3 percent tax on medical devices in their bill to fund federal agencies into the next fiscal year. And some have suggested the move to wipe out that tax might -; at some point-; become a path to compromise with the Senate. But Senate Democratic leaders have so far opposed the device tax as part of a short-term spending bill (Faler and Norman, 9/29).

The New York Times: Federal Agencies Lay Out Contingency Plans For Possible Shutdown
As Congress continued to spar on Saturday over a stopgap spending measure to keep the government running, federal agencies made contingency plans for a potential shutdown. ... Although more than half of the Department of Health and Human Services would be furloughed, Medicare and Medicaid beneficiaries would continue to receive services. Retirees would continue to get checks from the Social Security Administration. The rollout of President Obama's health care law, with the first insurance marketplaces to go online starting on Tuesday, would continue because most of the money for that program was provided by the Affordable Care Act and other laws (Schmidt, Shanker and Siddons, 9/28).

Politico: As Government Shutdown Looms, Obamacare Exchanges Still Set For Launch
It's looking more and more like Tuesday will be a split-screen day: The government will shut down, and Obamacare will open for business. That's going to annoy a lot of Republicans -;because the ones who are pushing the shutdown are doing so precisely because they want to halt Obamacare (Cunningham and Nather, 9/29).

Los Angeles Times: As Key Parts Of Obamacare Kick in, Stakes Are High For Both Parties
The debate over President Obama's signature healthcare law enters a crucial phase this week as the real effect on consumers starts to come into focus after more than 3 1/2 years of partisan claims and counter-claims. For both sides in the protracted battle over what has come to be called Obamacare, it is a moment of political peril (Levey, 9/29).

The New York Times: U.S. Plans To Unveil New Insurance Options
The Obama administration plans on Monday to announce scores of new health insurance options to be offered to consumers around the country by the Blue Cross and Blue Shield Association and the United States Office of Personnel Management, the agency that arranges health benefits for federal employees, according to administration officials. The options are part of a multistate insurance program that Congress authorized in 2010 to increase options for consumers shopping in the online insurance markets scheduled to open on Tuesday (Pear, 2/29).

The New York Times: On The Threshold Of Obamacare, Warily
The insurance marketplaces that form the centerpiece of President Obama's health care law are scheduled to open on Tuesday, a watershed moment for the Obama administration, but also a crucial turning point for millions of Americans who will finally get the chance to square the law's lofty ambitions with their own personal needs. While some people desperate for coverage will need no persuading to sign up, for others the decision will amount to a series of complicated calculations that would challenge an accounting whiz, let alone an ordinary human (Thomas and Abelson, 9/28).

NPR: Insurance Exchange 101: Here's What You Need To Know
The Affordable Care Act has been through two years of legislative wrangling, a presidential election and a Supreme Court test that took it to the brink. Now, after yet another round of debate and argument, major pieces of the federal health law are expected to kick in Tuesday. If all goes as planned, people who don't have insurance or who buy it on their own will be able to shop online or at various locations in their communities for coverage that will take effect Jan. 1 (Rovner, 9/30).

USA Today: Exchanges Open Tuesday: Here's What To Do
Don't wait. But don't hurry either. That's the best approach to the new health insurance exchanges that are scheduled to open for business Tuesday. Buying insurance is supposed to be easier than ever once several provisions of the Affordable Care Act take effect this fall. That doesn't mean the process is easy or should be done speedily, however, experts say. That's especially true if insurance shopping is new to you (O'Donnell and McGinnis, 9/29).

The Wall Street Journal: What Does New Health Law Mean For Me?
The rollout of the Affordable Care Act-;also known as "Obamacare"-;is approaching, and starting in October people will be able to sign up for new insurance policies that begin Jan. 1, when the law's major provisions are set to go into effect. Here's what you need to know about whether and how the law affects you (Radnofsky, 9/29).

Los Angeles Times: Selling Obamacare: White House Touts Health Law In Women's Magazines
The current Cosmopolitan magazine explains the Affordable Care Act with the "Top Eight Ways Young Women Benefit from Obamacare." Glamour lays out the "Five Things You Need to Know" about the marketplaces kicking into gear Tuesday. The other night, late-night TV host Conan O'Brien put his own spin on the meme with "Ten Pre-existing Conditions to Drive Your Man Crazy" (Parsons, 9/30).

The New York Times: As Opening Day Nears, Insurance Exchanges Scramble To Prepare
Tuesday is the long-awaited kickoff for President Obama's signature health care law, when millions of Americans can start signing up for new insurance options. Yet across the country, officials are issuing warnings that despite fevered efforts, their new insurance exchanges -; online markets where people can shop for health plans and see if they qualify for federal subsidies -; will not be fully operational for weeks or even months (Goodnough, 9/29).

The Wall Street Journal: 'Lego' Model For Exchange Software
Pradeep Goel arrived from India 23 years ago to study in America. On Tuesday, Mr. Goel, now chief executive of a fast-growing technology company, faces his toughest examination yet: Making sure the software behind two new health-insurance exchanges doesn't crash. ... For the state exchanges to work, normally separate computer systems have to talk to each other and it is EngagePoint Inc.'s job to build software bridges between those systems (Corbett Dooren, 9/29).

NPR: One Key Thing No One Knows About Obamacare
Tuesday is a big day for Obamacare. The online marketplaces where people can shop for health insurance are supposed to open for business. No one really knows who is going to sign up -; not the Obama administration, not the insurance industry, not the president's critics. Yet the success of the law hangs on this question: Will the right mix of people sign up? In particular, will healthy people buy health insurance? (Kestenbaum, 9/30).

The Wall Street Journal: Health Law Hits Late Snags As Rollout Approaches
Obama administration officials scrambling to get the health law's insurance marketplaces ready to open on Tuesday keep hitting technical problems, while government-funded field workers across the country say they aren't fully prepared to help Americans enroll in the program (Weaver, Martin and Radnofsky, 9/29).

Politico: How Obamacare Affects Businesses – Large And Small
It's one of the biggest political ironies of the health care law: Some of the loudest gripes are coming from the employers who were meant to benefit from it. But the reality is, from the smallest startups to the largest corporations, employers have a lot of new rules and reporting requirements to keep track of. And in some cases, there are new costs, too. It's the only way to make the law work -; but it's also a headache for many employers (Nather, 9/30).

The Wall Street Journal: Key Groups Have Love-Hate Relationship With Health Law
Health-insurance companies spent more than $80 million trying to defeat President Barack Obama's health-care plan. Having failed, they have spent the years since trying to kill a string of provisions they don't like. And yet, it is those same insurance companies that are working harder than just about anyone to try to make the law succeed. It is one of the paradoxes of the sweeping health-care law: Fierce critics can also act as supporters who are key to whether the law will work. With Mr. Obama's struggles in selling the law, their efforts have become even more critical to its success (Meckler and Radnofsky, 9/28).

Politico: Can The Media Avoid Rush Judgment On Obamacare?
When Obamacare enrollment begins on Tuesday, reporters in the Twitter age will be tempted to declare the health law a success or a failure in the first few days -; a judgment that will certainly be stoked by advocates on both sides of the issue. And any rush judgments could have a big impact on public opinion of the law (Gold and Cheney, 9/28).

The New York Times: Survey Shows Confusion Over Health Care Law But Support For Medicaid Expansion
A day before the new health care exchanges open across the country, a new report shows that the more people understand it, the more they're inclined to participate. But while most people are aware of the law's requirement to buy insurance or face a penalty, a much smaller number have any understanding of the insurance exchanges opening on Tuesday or of the financial aid available to help people buy insurance (Bornemeier, 9/30).

Politico: Poll: Most Will Get Health Insurance
Asked whether they plan to get insurance when the requirement takes effect or pay the fine for not doing so, 65 percent of uninsured Americans said they would get health insurance, according to a Gallup poll out Monday. Twenty-five percent said they would pay the fine. Gallup also asked about the whether those individuals planned to use the exchange markets that launch Tuesday to buy their insurance. Almost half, 48 percent, said they planned to use the exchanges, 36 said they did not and 17 percent weren't sure (Kopan, 9/30).

The Associated Press: FACT CHECK: Slippery Salesmanship From Obama On Health Care, Dubious Counterclaims From GOP
President Barack Obama is the insurance industry's most powerful pitchman these days as he drums up interest in the health insurance markets opening for business Tuesday. Whatever the merits of his product, there are reasons for the buyer to beware of his rhetoric. The president is being a bit slippery on the costs of coverage, in particular. His opponents are taking their own liberties as they talk up the ills of what they deride as "Obamacare" and defend their approach to the budget impasse that threatens to close parts of the government come Tuesday. On these points, caveat emptor (Woodward, 9/29).

The New York Times: One State's Way To Bolster Health Coverage For Poor
Federal officials said Friday that they had approved a novel proposal from Arkansas to expand Medicaid by buying private coverage for poor people through the insurance marketplace being set up under the new federal health care law. The Arkansas program, expected to cover more than 200,000 people, sets a precedent of national significance. It offers a hybrid coverage plan calculated to appeal to Republicans, taking federal money for the expansion of Medicaid and using it to purchase commercial insurance (Pear, 9/27).

Los Angeles Times: California Insurance Exchange Chief Has Health Reform 'In His Bones'
Republicans in Congress are railing against the healthcare law as a government takeover of medicine. The massive program will harm patients and cost far too much, critics say. ... It mirrors the scene 50 years ago during the contentious debate over Medicare. Two brothers, Peter and Philip Lee, fought on the front lines back then, bucking the medical establishment to guarantee healthcare for seniors. Now another Peter Lee -; Peter's son and Philip's nephew -; is carrying on the family tradition. He's in charge of enrolling millions of Californians in Obamacare (Terhune, 9/28).

The Associated Press: States Resist, Build Nascent Insurance Markets
With new online health insurance exchanges set to launch Tuesday, consumers in many Southern and Plains states will have to look harder for information on how the marketplaces work than their counterparts elsewhere (Dalesio, 9/29).

The New York Times: Trends To Watch For In Employer Health Plans
A lot of attention has been given to the health insurance exchanges opening next month. But if you're like most Americans, you'll still get your insurance through an employer. And that means the annual open enrollment season, when you choose your benefits for the coming year, will soon be upon you. ... Here are some questions to consider this year (Carrns, 9/27).

The New York Times: Lacking Rules, Insurers Balk at Paying For Intensive Psychiatric Care
Patients often find themselves at odds with health insurers, but the battles are perhaps nowhere so heated as with the treatment of serious mental illness. It was not supposed to be this way. A federal law, the Mental Health Parity and Addiction Equity Act of 2008, was aimed at avoiding fights like this over coverage by making sure insurers would cover mental illnesses just as they cover treatment for diseases like cancer or multiple sclerosis. ... But five years after President George W. Bush signed the law, there is widespread agreement that it has fallen short of its goal of creating parity for mental health coverage. As enrollment in coverage under the Affordable Care Act becomes available on Tuesday, the rules underlying mental health coverage in general -; for both private insurers and the new health care exchanges -; are still unclear, mental-health patient advocates say, leaving patients and families to grind through the process as best they can (Abelson, 9/28).

Los Angeles Times: Gov. Brown Signs 2 Of 3 Bills Fighting Prescription Drug Abuse
Gov. Jerry Brown signed two bills Friday aimed at curbing prescription drug abuse but vetoed a third that could have helped the state's medical board identify reckless doctors whose patients died on pills they prescribed (Glover and Girion, 9/27).

The New York Times: Rights Groups And Clinics Sue Texas Over Provisions In Its New Abortion Law
National women's rights groups and Texas abortion clinics filed suit on Friday in federal court in Texas, seeking to block provisions of a new state law that they said would have "dramatic and draconian effects" on women's access to the procedure (Eckholm, 9/27).