First Edition: October 2, 2013

Today's headlines include news reports about how the health law's new online insurance marketplaces -- glitches and all -- went live at both the federal and state levels.  

Kaiser Health News: Obamacare Marketplaces Open, Despite Technical Glitches And Government Shutdown
Kaiser Health News staff writers Jay Hancock, Phil Galewitz and Ankita Rao report: "Online marketplaces at the heart of the health law opened for business Tuesday, often haltingly, as a government shutdown loomed over a milestone in President Barack Obama's signature domestic accomplishment" (Hancock, Galewitz and Rao, 10/1). Read the story.

Kaiser Health News: Obamacare Day One: A Tale Of Two States
Kaiser Health News staff writers Jenny Gold and Sarah Varney report: "'Keep calm and go live.' Those were the words on the backs of the t-shirts worn by workers at a bustling state health insurance call center in Rancho Cordova, California yesterday. But if the t-shirts urged calm, the mood was ecstatic and emotional among the architects and key backers who gathered to flip the switch on the Golden State's new insurance marketplace" (Gold and Varney, 10/2). Read the story.

Kaiser Health News: Language, Knowledge Are Barriers For Immigrants Seeking Insurance In California
Kaiser Health News staff writer Anna Gorman reports: "Carrying Spanish-language brochures, outreach worker Sandra Pena walked around a crowded health clinic here early Tuesday morning. 'Have you heard of the program Obamacare?' Pena asked a group of patients. A few nodded. Others stared blankly. As enrollment began around the nation, the scene at this Wesley Health Center underscored one of the major challenges facing officials – overcoming the lack of awareness" (Gorman, 10/1). Read the story.

Kaiser Health News: Three Things To Know Before Buying A Health Plan -- And Where To Find Them
Kaiser Health News staff writer Julie Appleby reports: "Consumers shopping for coverage in new online markets for health insurance will be able to see what plans are offered in their area, how much they will cost per month, what their annual deductibles  are and whether their families might qualify for federal subsidies or Medicaid. But they should consider at least three other factors before making their decisions, which may take a little effort to ferret out" (Appleby, 10/1). Read the story.

Kaiser Health News: Seven Things To Know About Signing Up For Obamacare
Kaiser Health News staff writer Phil Galewitz, working in collaboration with Cosmopolitan, reports: "If you've been unable to get insurance either because of a pre-existing illness or high costs, the Affordable Care Act opens up new options. Here are seven things you need to know" (Galewitz, 10/1). Read the story.

Kaiser Health News: Capsules: HHS Releases List Of Premium Rates For 36 States; Live Blog: Exchanges Launch, Government Shuts Down
Now on Kaiser Health News' blog, Jordan Rau posts the list from the Department of Health and Human Services of premium rates in 36 states: "The Department of Health and Human Services has posted premiums for more than 78,000 plans on its website. The data lists each plan by insurer and the plan name and the monthly premium rate for a child, a 27-year-old,a family with 30-year-old parents and two kids, a single-parent family with two 30-year-olds, and a 40-year-old couple without children" (Rau, 10/1).

Also on Capsules, yesterday was Oct. 1, which means that the online insurance marketplaces created by the Affordable Care Act launched. But it also means that the start of the new federal fiscal year was marked by a government shutdown. Kaiser Health News helped make sense of the day's developments on this live blog (Stapleton, 10/1). Check out what else is on Capsules.

Kaiser Health News also tracked news headlines related to the launch of the health law's online insurance marketplaces, including coverage of President Barack Obama's comments regarding the public response to the exchanges and his thoughts on the technical glitches as well as his remarks urging GOP lawmakers to abandon their push to derail the overhaul (10/1). 

The New York Times: Opening Rush to Insurance Markets Runs Into Snags
Millions of Americans visited new online health insurance exchanges as enrollment opened on Tuesday, suggesting a broad national appetite for the affordable coverage that President Obama has promised with his health care law. But many people quickly encountered technological problems that prevented them from getting rates, comparing health plans or signing up (Goodnough, Pear and Perez-Pena, 10/1).

The Washington Post: Obamacare Site Goes Live, With Some Glitches
Millions of Americans flooded government Web sites Tuesday to get a long-awaited look at insurance options available under the health law, but the high traffic contributed to widespread computer problems on what President Obama hailed as a historic day. HealthCare.gov, the federal Web marketplace serving more than 30 states, was jammed for most of the day, with people encountering error messages that froze their applications. In the states operating their own marketplaces, the experience was spotty. Maryland's site, Maryland Health Connection, was down for the morning and sluggish into the evening. Lesser problems were reported in Colorado, Washington, Hawaii and elsewhere (Somashekhar, Kliff and Svrluga, 10/1).

Los Angeles Times: Glitches, Delays Mar Rollout Of Online Health Insurance Marketplaces
New online insurance marketplaces created by President Obama's healthcare law got off to a bumpy start Tuesday, as a rush of consumers and a host of technical glitches slowed enrollment on the first day uninsured Americans could sign up for coverage. Several states running their own marketplaces -; including Hawaii, Maryland, Minnesota and Washington -; were forced to delay the rollout of their websites, even as other states reported that shoppers were signing up (Levey, 10/1).

Politico: Obamacare: Hurry Up And Wait
By mid-afternoon, the Department of Health and Human Services reported that 2.8 million unique visitors had been to the Website, though there were no statistics available for how many were actually able to enroll. Some users experienced long waiting periods, and others ran into impediments that likely had little to do with the volume of traffic. For example, the drop-down boxes on the federal Website weren't working for much of the day, preventing users from answering security questions and establishing accounts. But HHS, which cited figures of 81,000 consumers calling the department's toll-free number to sign up and another 60,000 requesting help through online chats, celebrated the fact that the health insurance marketplaces at the heart of Obamacare were in fact open for business Tuesday (Allen, 10/1).

The Associated Press/Washington Post: First Day For Online Insurance Markets Brings Surge Of Consumer Interest, Technical Glitches
For millions of Americans trying to log in, the online insurance marketplaces created by the new health care law began with a stalled website, an error message or a menu that didn't work. But the debut of the new insurance marketplaces might have been a victim of the law's own success. The initial sign-up day appeared to draw heavy interest that suggested pent-up demand for just the kind of coverage now being offered (10/2).

The Wall Street Journal: Health Exchanges Open, With Glitches
The health-insurance marketplaces at the center of President Barack Obama's health law saw a surge of consumer interest Tuesday that surprised even many of the law's backers. But the debut proved patchy, with few applicants actually able to buy coverage on clogged websites that were bedeviled with technological problems (Weaver, Martin and Radnofsky, 10/1).

The New York Times: As Insurance Marketplaces Make Debut, Questions Remain
Most predictions have been for a trickle of new customers at first, with polls showing that many Americans remain uncertain about the purpose of the exchanges and unconvinced that the law will help them. The exchanges are online markets where people can shop for health plans and see if they qualify for federal subsidies. Despite months of feverish preparation, few officials are sure the exchanges have overcome a range of problems that have plagued the system in many states, including with Spanish-language versions, subsidy calculators and programs to enroll small businesses (Perez-Pena, 10/1).

The Wall Street Journal: Health-Law Glitches Lead To Frustration, Resolve To Keep Trying
Americans who flocked Tuesday to shop for health insurance on the online marketplaces created under the federal health law were largely frustrated in their attempts. But many were undeterred and said they would be back. Kevin Burke, a 44-year-old New Jersey entrepreneur, logged onto an exchange website eager to find a plan for himself, his wife and two children that would be less expensive than the one they have now with Aetna Inc. … But high traffic and glitches on the website made it impossible to find what he needed, said Mr. Burke, who is starting an online business. "It's a total mess. I can't get any information. I'm no more knowledgeable now than I was yesterday," he said. Still, he said, "I'm going to keep trying" (Needleman and McWhirter, 10/1).

Politico: Glitches And Recoveries: State Exchanges Run The Gamut
Despite the early troubles, a few states were quick to report the number of enrollment and consumer interaction throughout the day, showing consumers had been waiting for the rollout. Kentucky's state-run exchange, known as Kynect, reported processing more than 1,000 applications by morning. Connecticut's exchange, Access Health CT, said 18,000 people logged into its site, and dozens signed up on the first day. But right up to launch day, some insurers continued to report problems with the federal computer system's ability to accurately produce plan premiums and to match those premiums with the subsidy a consumer might be eligible for. That's essential. It's what determines the price someone would pay for a particular plan (Millman and Norman, 10/2).

Politico: Obamacare's Day 2 Message: Forget Washington
If there's one message coming out of the White House about the Obamacare sign-up period, it's this: Forget Washington. While the nation's capital remains in shutdown mode, lost in a seemingly hopeless partisan clash over whether the rest of the government's operations and its creditworthiness should be held captive to the health care law, the administration's six-month window to "enroll America" enters Day Two on Wednesday (Allen, 10/2).

The Associated Press/Washington Post: Leaders In Republican States Sit Idly As Residents Start Using New Health Insurance Exchanges
After three years of bashing President Barack Obama's health care overhaul, Republican governors were surprisingly mute on the first day consumers could shop for insurance policies through online marketplaces. But in the 36 mostly Republican states that left the operation of their exchanges to the federal government, consumer interest Tuesday was high, while Democrats and advocacy groups took the lead in promoting the latest provision of the law (10/2).

NPR: Tech Problems Plague First Day Of Health Exchange Rollout
Many Americans got "please wait" messages Tuesday when they tried to start shopping for health coverage on the federal government's new health insurance website, healthcare.gov. A series of technological glitches, delays and crashes kept people from getting to several of the 16 state exchanges, too (Hu, 10/2).

The New York Times: For Many, Personal Service Is More Helpful Than Web Site
By 10:30 a.m. Eastern time, Mr. Flynn said he had tried to enter preliminary login information on the site but was unable to submit it, apparently because of the volume of requests that the site was receiving from around the country. But working with Kyle Rouse, a "navigator" with the Health Federation of Philadelphia who was tasked with helping consumers, Mr. Flynn discovered that he would face maximum out-of-pocket expenses of $6,250 if he enrolled in a "bronze" level plan in the new marketplace. That would be significantly lower than the $10,000 he currently faces, in the first sign that the marketplace could offer him a better deal than the old system (Hudle, 10/1).

Los Angeles Times: Demand Is Strong As Obamacare Enrollment Starts In California
Kicking off a historic healthcare expansion, California's new insurance market stumbled out of the gate with computer glitches, long hold times and an online enrollment delay for small businesses. Still, many consumers rushed to get coverage Tuesday when enrollment opened nationwide as part of President Obama's Affordable Care Act. It was a rocky start for many government-run insurance exchanges across the country as computers froze and online enrollment was postponed for several hours. In California, officials nonetheless took heart at the stronger-than-expected response: about 5 million online hits and more than 17,000 calls (Terhune, Mason and Reston, 10/1).

NPR: In Florida, Insurer And Nonprofits Work On Enrollment
Florida Gov. Rick Scott and other Republican leaders have worked to block the Affordable Care Act since it was first proposed. As Tuesday's opening of enrollment approached, Florida's Health Department said it wouldn't allow navigators and others to use its offices to educate and counsel people on the new law (Allen, 10/1).

The Washington Post: Computer Glitches Prevent Health-Insurance Enrollment For D.C. Family
After going six months without health insurance, Mohammad Goni walked into Mary's Center in Petworth ready to enroll his family for benefits on the opening day of health insurance exchanges under Obamacare. Goni took the day off from his work as a pizza cook, prepared to fill out applications and navigate bureaucracy at the federally funded health center with his wife, Razia, and their 10-month-old and 21-month-old children in tow (Bui, 10/1).

The Washington Post: As Obamacare Starts, Patients In Maryland Community Clinics Are Eager To Sign Up
The day Maryland's health insurance exchange opened for business was Rebecca Wener's first day of work. She sat down next to Maria Martinez on Tuesday in the waiting room of a Silver Spring clinic and started gently asking questions in Spanish. Do you have health insurance? Wener asked. No, replied Martinez, 44, of Rockville. She works two part-time jobs -; in customer service at Balducci's, a gourmet food store, and cleaning houses. Do you know that many new options are available to you under health reform? No, Martinez said. She knew that a law had been passed and that everyone had to have insurance, but not much more than that (Sun, 10/1).

The New York Times: Health Care Coverage Business Is Bustling At New York City Hospital
Ms. Munoz, a community relations manager, was helping to staff an informational booth outside the hospital on Tuesday as part of Montefiore's extensive efforts at helping patients and other community members enroll in insurance under the new health care law (Thomas, 10/1).

The New York Times: In Ohio, Little Help For Consumers In Navigating Enrollment
The federally run health insurance exchange opened in Ohio on Tuesday, but the state had no certified "navigators" to help consumers find insurance plans on the first day of the Affordable Care Act marketplace. In addition to federal authorization and training, navigators here must also get approved by the Ohio Department of Insurance, the state regulatory agency that is monitoring the exchange. Chris Brock, a spokesman for the state insurance agency, confirmed Tuesday morning that none of the state's navigator grant recipients, which received a total of more than $3 million to implement outreach programs and assist people through the sign up process, had been authorized by the state to fully begin their work (Yaccino, 10/1).

Los Angeles Time: Team Takes Healthcare Plan To Ethnic Areas
As political forces collide in the nation's capital over the Affordable Health Care Act, a small army of workers fans across Southern California, going door-to-door and store-to-store in communities where some residents are so isolated that they know little about the healthcare reform or even how to plan for its arrival (Do, 10/1).

The New York Times: New York State Health Dept. Has Heavy Traffic On First Day
Like those in several other states, the Web site for New York State's health exchange – nystateofhealth.ny.gov – was having difficulty Tuesday, the first day of enrollment, because of a crush of traffic. Visitors were walked through the familiar first steps of any online enrollment: Provide your name, your e-mail and a password, and retype some scrambled characters from the image provided (Hartocollis and Kaminer, 10/1).

The Wall Street Journal: New York Health Insurance Exchange Launches
Thousands of New Yorkers struggled Tuesday as they sought to use a balky new website that hosts the state's new health-insurance exchange, but officials pledged to fix the bugs and took heart that the site received unexpectedly high traffic on its first day. … The state's online marketplace, which opened for business as enrollment for insurance under the federal Affordable Care Act began around the U.S., was receiving upgrades to handle more traffic late Tuesday, Ms. Frescatore said. The website recorded more than 10 million hits, while about 9,000 people were able to shop. The site counts every hit, regardless of whether someone was able to get onto the site, a spokesman said (Dawsey, 10/1).

The Wall Street Journal: Massachusetts Officials Try To Keep New Rules From Curbing Enrollment
As open enrollment for the U.S. health law kicks off nationwide, the state that helped inspire the law is trying to avoid a potential pitfall: watching its own coverage numbers slip. Massachusetts, where a 2006 law created a marketplace where uninsured people could shop for coverage, sometimes with state subsidies, estimates 97% of its 6.6 million residents have insurance. But because of different federal rules, roughly 150,000 people who got coverage through the state's exchange marketplace will have to re-enroll to avoid losing coverage next year, state officials said. Until now, their coverage automatically carried over (Kamp, 10/1).

The New York Times: Health Insurers Report High Volume Of Queries On Health Care Coverage
"We are up and running," said one health insurance company official on Tuesday, even as the Web sites for many of the state marketplaces, and for www.healthcare.gov, the source of information about the health plans being run by the federal government, seemed plagued by technical problems. Blue Cross Blue Shield of North Carolina reported that it was experiencing higher volumes of calls and online queries regarding coverage than usual, as well as more visits to its retail stores (Abelson, 10/1).

Los Angeles Times: Health Providers Fielding Few Questions On First Day For Obamacare
For all the fuss over Obamacare -- the president's plan to extend health coverage to about 30 million Americans -- Southern California health providers were fielding only a smattering of questions on Tuesday, the first day of enrollment. Officials at Covered California, the agency overseeing the state's health insurance exchange, have a goal of signing up more than 2 million people through next year, the most of any state (White, 10/1).

Los Angeles Times: In California, Some With Big Needs Have High Hopes For Obamacare
Healthcare coverage is an issue that weighs heavily on Alfred Luevano's family. Luevano, 35, of Boyle Heights came to the Healthcare Partners Medical Clinic on Atlantic Boulevard in Monterey Park for a medical checkup, but also wanted answers about Obamacare. The federal healthcare overhaul, after years of debate, officially opened enrollment on Tuesday in state health insurance exchanges, with California looking to play a lead role (White, 10/1).

The New York Times: Employees Without Health Care Coverage Looking To Exchanges
Ms. Graham was among a group of curious people at the Aurora Public Library, outside Denver, who stopped by a table set up by the Aurora Mental Health Center. It had stationed experts -; known as "navigators" -; there to tell people about the new health care coverage options available under the law. Ms. Graham said she had never heard anything about the exchange before walking into the library on Tuesday and she planned on checking with her employer to see if she was eligible (Frosch, 10/1).

The New York Times: Closer Look At Polls Finds Views Of Health Law A Bit Less Negative
On opening day of the new federal and state health insurance exchanges, a deeper look at how Americans view the Affordable Care Act shows that public opinion is not as negative as has been reported. Although much polling has shown that more Americans disapprove of the 2010 health care law than approve, recent polling has shown that a slice of those who disapprove are critical of the law because it does not go far enough in changing the nation's health care system (Kopicki, 10/1).

The New York Times: Obama Urges Republicans To Drop Health Law Fight
Flanked by new beneficiaries of his health law, President Obama on Tuesday publicly admonished Republicans in the House to "reopen the government" rather than continue to block federal spending to battle the three-year-old Affordable Care Act (Calmes, 10/1).

The Associated Press/Washington Post: Obama Blames Shutdown On House GOP's 'Ideological Crusade' Against Health Care Law
President Barack Obama says House Republicans have shut down the federal government over an "ideological crusade" against his health care law. Obama is speaking in the Rose Garden on the first day of the government shutdown. He says the longer the shutdown continues, the worse the impact will be (10/1).

Los Angeles Times: Obama: Amid Shutdown, Obamacare Is 'Open For Business'
President Obama on Tuesday blamed Republicans for the government shutdown, noting the "irony" that the healthcare program they were trying to kill is "open for business." "This shutdown isn't about spending or deficit or budgets," Obama said. "This shutdown is about rolling back our efforts to provide health insurance to folks who don't have it. This, more than anything else, seems to be what the Republican Party stands for these days." The president's remarks came shortly after noon EDT in the Rose Garden, as the White House went into a partial shutdown along with the rest of the federal government (Parsons and Hennessey, 10/1).

The Wall Street Journal: Capital Digs In For Long Haul
President Barack Obama pointed the finger at House Republicans for their efforts to scale back or dismantle the 2010 health law, the Affordable Care Act. "They've shut down the government over an ideological crusade to deny affordable health insurance to millions of Americans," Mr. Obama said from the White House Rose Garden. House Speaker John Boehner (R., Ohio) pinned the blame on his adversaries, saying, "Senate Democrats today slammed the door on reopening the federal government by refusing to talk." House Republicans launched a new strategy aimed at increasing pressure on Senate Democrats to negotiate with them, only to see it fail in their own chamber Tuesday night. GOP leaders brought forward a series of short-term bills to finance small parts of the government, including veterans services and national parks, through Dec. 15 (Hook, Peterson and Lee, 10/1).

The Washington Post: Washington Braces For Prolonged Government Shutdown
Washington began bracing for a prolonged government shutdown on Tuesday, with House Republicans continuing to demand that the nation's new health-care law be delayed or repealed and President Obama and the Democrats refusing to give in. There were signs on Capitol Hill that Republicans -; knowing that blame almost certainly will fall most heavily on them -; are beginning to look for ways to lift some of the pressure (Tumulty and Montgomery, 10/1).

Los Angeles Times: Republican Moderates Hold Key To Ending Government Shutdown
In the current battle, conservative Republicans have forced votes on issues they hoped would cause Democratic senators from Republican-majority states to break with Senate Majority Leader Harry Reid (D-Nevada). Democrats have hoped to divide suburban moderates such as Meehan from hard-line conservatives, who have repeatedly tried to tie money for government agencies to measures aimed at delaying or dismantling President Obama's healthcare law (Memoli and Mascaro, 10/1).

The New York Times: Conservatives Choose Between Budget And Health Law
Congressional Republicans have insisted on defunding, delaying or repealing the Affordable Care Act as a condition of keeping the government running. Congressional Democrats have refused to negotiate over the health care law, and much of the federal government has shut down (Lowery, 10/1).

Politico: GOP Goes Off-Message On Obamacare
The Obamacare train wreck happened Tuesday -; and Republicans were chasing a different train. By walking into a government shutdown that's dominating the news coverage, some Republicans are realizing they blew their chance to shine a spotlight on all the website crashes and breakdowns that plagued the first day of Obamacare signup. There was plenty of material for the Republicans to work with. The federal health insurance exchange website gave users error messages, drop-down menus failed, and the system went down for a while on Tuesday morning. State exchange websites got snarled by heavy traffic and spat out error messages, too (Nather, 10/1).

Politico: House Conservatives Still Fighting On Obamacare
They've tried to defund, delay and eliminate portions of the president's health care law, and they're still not wavering. Instead, they are demanding that Senate Democrats and Majority Leader Harry Reid (D-Nev.) come to the negotiating table. But at the first post-shutdown meeting of House Republicans on Tuesday, conservatives ignored questions about a realistic way out of the current standoff (Gibson, 10/2).

The Wall Street Journal: Deep Divide Over Health Law Persists
Lurking behind the first government shutdown in 17 years are two starkly different views of how Americans see the health-care law championed by President Barack Obama. In making the budget fight all about the law, popularly known as Obamacare, Republicans point to a program they say is broadly and consistently unpopular. Democrats see a program that Americans aren't quite sold on yet but believe should be given time to work-;and they note the health law is actually less unpopular now than the Medicare prescription-drug benefit was before it went into effect. Complicating the debate, recent polls provide ammunition to both sides. Surveys reveal an American people clearly ill at ease over the law, but also uncertain over its provisions and ambivalent about its eventual impact (King, 10/1).

The Associated Press/Washington Post: Conservative Group Airing Ads Urging Democrats To Defund Obama's Health Care Law
A conservative group is airing television and radio ads urging Democrats to eliminate funding for President Barack Obama's health care law to resolve a government shutdown. The Senate Conservatives Fund accuses Senate Majority Leader Harry Reid of Nevada and fellow Democrats of "forcing a government shutdown" in order to allow the so-called Obamacare system to move forward. The ad buy is expected to be about $500,000 per week (10/1).

Politico: NRCC Targets Democrats On Obamacare
Under withering assault from the White House and congressional Democrats for their role in the government shutdown, House Republicans are hitting back. The National Republican Congressional Committee on Wednesday will begin airing 60-second radio ads hammering vulnerable House Democrats for refusing to defund Obamacare. It represents an effort to frame the shutdown narrative around the health care law, which polling shows remains unpopular among vast swaths of the public. Individual health care marketplaces began opening on Tuesday (Isenstadt, 10/1).