First Edition: November 19, 2013

Today's headlines include news that Obama administration officials were warned about the possibility of website difficulties months ago by an outside consulting firm.

Kaiser Health News: Insuring Your Health: Readers Ask If They Can Buy A Policy After March 31 And If An Employer Can Cancel A Spouse's Coverage
Kaiser Health News consumer columnist Michelle Andrews writes: "The news has been focused on the troubles of people trying to use the health care law's insurance exchanges and new options for people whose individual policies are being canceled. But open enrollment continues, and people who are shopping for individual or job-based coverage have many questions. Here are some answers" (Andrews, 11/19). Read the column.

Kaiser Health News: Scott Walker's Medicaid Maneuver
WUWM's Erin Toner, working in partnership with Kaiser Health News and NPR, reports: "Wisconsin Gov. Scott Walker, who appears to be laying the groundwork for a 2016 presidential run, is getting attention for his entitlement reform. He is one of 25 Republican governors who are rejecting the health law's expansion of Medicaid. But Wisconsin's own Medicaid program, known as BadgerCare, was more generous than many states, and now Walker wants to transfer many of those people to the insurance marketplace created by the law. It's a plan that allows Walker to reject Obamacare, turn down federal money on the table, but still provide health coverage to many of Wisconsin's poor and working poor residents" (Toner, 11/19). Read the story.

Kaiser Health News: In Pa., A Big Gap In Health Insurance Coverage
The Philadelphia Inquirer's Robert Calandra, working in partnership with Kaiser Health News, reports: "As many as 400,000 Pennsylvanians will plunge into the hole between traditional Medicaid and the new marketplace come Jan. 1, according to the Pennsylvania Health Access Network. … That gap was supposed to be filled with federal money states could use to cover more people. Gov. Corbett first chose to turn down the so-called Medicaid expansion. Officials have since presented a 12-page plan called Healthy Pennsylvania to the federal government. The aim is to reform Medicaid, increase access, and stabilize financing. The feds have yet to render a decision on the plan" (Calandra, 11/19). Read the story.

Kaiser Health News: Capsules: 3 State Exchange Leaders Try To Get Good News Out
Now on Kaiser Health News' blog, Jenny Gold writes: "Democrats in states running their own exchanges are seeking to put a more positive spin on the rollout of the Affordable Care Act, despite the mostly negative news coming out of Washington. 'What we're seeing is incredible momentum,' Peter Lee, executive director of Covered California, said during a conference call for reporters held by Families USA on Monday. 'We need to remind everyone that one-third of Americans are enrolling in state exchanges,' he added. 'We're showing that [the ACA] can and is working for Americans'" (Gold, 11/18). Check out what else is on the blog.

The Washington Post: Obama's Ratings Tumble After Health-Care Flaws
The flawed rollout of the Affordable Care Act has pushed President Obama to the lowest point of his presidency, with dwindling faith in his competence and in many of the personal attributes that have buoyed him in the past, according to a new Washington Post-ABC News poll. Opposition to the new health-care law also hit a record high in the survey, with 57 percent saying they oppose the president's most significant domestic initiative. Forty-six percent say they are strongly against it. Just a month ago, as the enrollment period was beginning, the public was almost evenly divided in its assessments of the law (Balz and Craighill, 11/19).

Politico: Obamacare Vs. ACA: What's In A Name?
President Barack Obama and loyal Democrats once embraced the term Obamacare to sell the American people on health care reform. Not anymore. With the president's approval ratings at record lows, a broken website and Obama under fire for his pledge that people could keep their plans, the "Affordable Care Act" has returned (Epstein, 11/19).

The New York Times: Officials Were Warned About Health Site Woes
Senior Obama administration officials, including several in the White House, were warned by an outside management consultant early this year that the effort to build the HealthCare.gov site was falling behind and at risk of failure unless immediate steps were taken to correct the problems, according to documents released by House investigators. The report, by McKinsey & Company, which was prepared in late March at the request of the Department of Health and Human Services, said that management indecision and a "lack of transparency and alignment on critical issues" were threatening progress, despite the tight deadline (LaFraniere and Lipton, 11/18).

The Washington Post: Private Consultants Warned Of Risks Before Healthcare.gov's Oct. 1 Launch
The Obama administration brought in a private consulting team to independently assess how the federal online health insurance enrollment system was developing, according to a newly disclosed document, and in late March received a clear warning that its Oct. 1 launch was fraught with risks. The analysis by McKinsey & Co. foreshadowed many of the problems that have dogged HealthCare.gov since its rollout, including the facts that the call-in centers would not work properly if the online system was malfunctioning and that insufficient testing would make it difficult to fix problems after the launch (Eilperin and Somashekhar, 11/18).

Politico: Report Warned Of Healthcare.gov Flaws Last Spring
The administration was warned last spring that its website didn't meet key requirements for a successful rollout, including relying too heavily on outside contractors, according to a copy of a "Red Team" report prepared for the Centers for Medicare and Medicaid Services and obtained by POLITICO. The report, which was delivered at the end of March, identified six tests that the developing healthcare.gov website didn't meet: Its needs were evolving, rather than clearly articulated; there was no clear definition of success; the program relied too heavily contractors and other outside parties; the design, build and test phases were stacked on top of each other rather than sequential, there wasn't enough time allotted or a side enough scope for valid end-to-end testing of the system; and the site was expected to launch at full volume rather than phasing in over time (Allen, 11/19).

The Associated Press/Washington Post: White House: 1 In 5 People Won't Make It Through Health Exchange Website Despite Fixes
The White House says 20 percent of Americans won't make it through the website to buy health insurance through new exchanges. The Obama administration is scrambling to fix the malfunctioning website by Nov. 30. But White House spokesman Jay Carney says there will still be 1 in 5 who will start the process online but won't be able to purchase insurance (11/18).

USA Today: Fix Speeds Health Site's Insurance Account Choices
Technicians working to repair the HealthCare.gov website have fixed most of the problems that stymied health insurance customers from creating personal accounts, the spokeswoman for the Centers for Medicare and Medicaid Services said Monday. Those fixes mean the system can "easily" handle 20,000 to 25,000 people in the area of the site where they choose their insurance plans, said Julie Bataille, the CMS spokeswoman. Bataille did not comment on the site's total capacity, although last week, the total capacity for all areas of the site was 20,000 to 25,000 people (Kennedy, 11/18).

Los Angeles Times: Healthcare Plan Enrollment Surges  In Some States After Rocky Rollout
Despite the disastrous rollout of the federal government's healthcare website, enrollment is surging in many states as tens of thousands of consumers sign up for insurance plans made available by President Obama's health law. A number of states that use their own systems, including California, are on track to hit enrollment targets for 2014 because of a sharp increase in November, according to state officials (Levey, 11/18).

The Associated Press/Washington Post: Once Considered A Leader, Oregon's Insurance Exchange Still Hasn't Enrolled Anyone
With all the problems facing the rollout of President Barack Obama's health care overhaul, nowhere is the situation worse or more surprising than in Oregon, a progressive state that has enthusiastically embraced the federal law but has so far failed to enroll a single person in coverage through the state's insurance exchange. Despite grand ambitions, an early start, millions of dollars from the federal government and a tech-savvy population, Oregon's online enrollment system still isn't ready more than a month after it was supposed to go live. The state has resorted to hiring or reassigning 400 people to process insurance applications by hand (11/18).

Los Angeles Times: California Health Exchange Is Hesitant To Extend Canceled Policies
California's health insurance exchange remained hesitant to embrace a controversial request from President Obama to extend canceled insurance policies for another year. The state exchange, called Covered California, said Monday that it won't decide until later this week whether 1 million policyholders with expiring policies can keep their coverage for 2014 (Terhune, 11/18).

Los Angeles Times: Obamacare's Backers And Foes View To Recruit Young People
The raucous scene at a University of Miami tailgate party on a recent weekend might have seemed an unlikely spot for a debate over Obamacare. But with six dozen pizzas in hand, the youthful staffers from Generation Opportunity rolled up in Hummers and Ford F-150s to claim their spot (Reston, 11/18).

The Washington Post: Obama's Message To OFA Supporters On Obamacare
President Obama sought to reassure supporters on Friday evening that the fight to stand up his health-care law would succeed, while also trying to enlist their help in spreading word about the importance of signing up Americans for the Affordable Care Act. In a conference call with thousands of supporters hosted by Organizing for Action, Obama said the problems with Healthcare.gov have led to "misinformation" about the health-care law, although he did not offer specific examples (Goldfarb, 11/18).

The Associated Press/Washington Post: Not Just The Website: Obama Asks For Health Enrolling By Mail, On Phone, In Person
President Barack Obama urged his supporters Monday to help Americans enroll for health insurance by mail, in person and over the phone, seeking to tamp down expectations that the error-riddled HealthCare.gov website will ever be a panacea for the uninsured -; even once it's fixed (11/18).

The Wall Street Journal's Washington Wire: Obama Seeks Help From Supporters For Health Law
President Barack Obama on Monday sought help from his former campaign supporters in implementing the troubled health law, urging them to get people enrolled in insurance plans and telling them that doing so will save lives. "My main message is, I'm going to need your help," Mr. Obama said in a call with Organizing for Action, previously named Obama for America, the campaign group that helped him win re-election. "As a consequence of that work, you're going to save somebody's life" (Favole, 11/18).

Los Angeles Times: Obama, Admitting Problems, Asks Backers To Rally For Healthcare Law
President Obama told supporters to tune out the "noise" and the "setbacks" to his floundering healthcare law on Monday as he tried to motivate his network of activists to join a campaign to boost enrollment. During an online call hosted by Organizing for Action, Obama acknowledged problems with the federal health insurance website, saying he believed the bugs and errors on healthcare.gov had "created and fed" a lot of misinformation about the law. Obama asked his backers to fight against criticism and spread the word about the benefits of the law (Hennessey, 11/18).

USA Today: Obama To Backers: Don't Depend On Healthcare.gov Alone
President Obama said Monday that his backers will play a crucial role in whether implementation of his signature health care law is a success. Obama again acknowledged problems with the glitch-plagued HealthCare.gov website, but framed the battle for his troubled health care law as one he'll fight with his supporters. Obama's comments came in a call organized by Organizing for Action, a political group founded by alumni of his two presidential campaigns (Madhani, 11/18).

The New York Times' The Caucus: Another Website, Another Problem For Obama
Some supporters who tried to log in to hear President Obama defend his embattled health care law on Monday night were unable to hear him because the website of the group behind the call, Organizing for Action, failed to work for them. The website problems were an inconvenient moment for a president who has spent the last six weeks trying to explain the failure of HealthCare.gov, the online marketplace for Mr. Obama's Affordable Care Act (Shear, 11/18).

The Washington Post's The Fact Checker: How Much Did Healthcare.gov Cost? (Part 2)
At the hearing, held by the House Oversight and Government Reform Committee, Powner repeated the $600 million figure several times. He made clear he was speaking about all IT funding for the health care exchanges, including what was spent at the Internal Revenue Service. One lawmaker lauded him as the "$600 million man" and several other lawmakers, including Chairman Darrell Issa (R-Calif.), cited the number as well. The Fact Checker contacted Powner and asked how he came up with this figure, and he shipped us a document that he said appears on the federal government's IT Dashboard for the health-insurance exchanges. He also made it clear that he believes any cost-figure for the Web site should include back-end and front-end expenses necessary for it to run, such as creating the data hub (Kessler, 11/19).

Politico: President Obama To Insurers: No Bailout
President Barack Obama had some bad news for the insurance company CEOs who met him at the White House: His "fix" might cost them. Obama asked the CEOs to reinstate millions of Americans' health insurance plans that were cancelled because they fell short of coverage requirements under the law, according to two executives who attended the session Friday (Cheney and Haberkorn, 11/19).

Politico: Brokers Feel Pain Of Obamacare
Add insurance brokers to the list of people stymied by HealthCare.gov. And it's not just a headache. It's their income. Some brokers are waiting for the site to be fixed before they deal with clients using it. But those that are sticking with the arduous online enrollment journey are facing a new question: Will I get paid for this? (Villacorta, 11/19).

The Washington Post: Alaska Says No To Medicaid Expansion
Alaska Gov. Sean Parnell (R) said Friday his state will not expand Medicaid under President Obama's signature health-care law after a report estimated it would cost the state about $200 million over seven years. "I believe a costly Medicaid expansion, especially on top of the broken Obamacare system, is a hot mess," Parnell said at a news conference on Friday. "The bottom line is: Obamacare failed to launch, is failing to deliver on its promises, and remains in disarray. We simply cannot bail out this failed experiment by expanding Medicaid" (Wison, 11/18).

The Associated Press/Washington Post: Christie Predicts Health Care Overhaul Will Not Succeed
New Jersey Gov. Chris Christie says President Barack Obama's health care overhaul is a "failure" and predicts it "will not succeed -; it just won't." The potential 2016 presidential candidate says the leaders of both political parties, including Obama, are to blame for a 16-day partial federal government shutdown in October. He says the effort by some Republicans to defund the so-called Obamacare law by shutting down the government failed and "absolutists" from both parties hurt the process (11/18).

The New York Times: Bill On Drug Compounding Clears Congress A Year After A Meningitis Outbreak
A bill that would give the Food and Drug Administration more power to police compounding pharmacies passed its final hurdle in Congress on Monday, in what experts said was an important step to a safer drug supply in the United States (Tavernise, 11/18).

Los Angeles Times: State Says 3 Health Insurers Denied Medically Necessary Therapy
California officials said three of the state's largest health insurers illegally denied speech and occupational therapy to patients, and regulators fined one of the companies, Health Net Inc., $300,000 for repeated violations. The state Department of Managed Health Care said Monday that it ordered Health Net, Anthem Blue Cross and Blue Shield of California to stop denying medically necessary therapy in cases of developmental disabilities, autism and other medical conditions. The state said the three insurers will be required to reimburse patients who paid out of pocket for these improperly denied treatments (Terhune, 11/18).

Los Angeles Times: O.C. Ambulance Company Pays $3 Million To Settle Fraud Suit
An Orange County ambulance company has paid $3.05 million to settle a lawsuit alleging that it billed Medicare and other federal healthcare programs to transport patients who didn't need an ambulance, federal prosecutors said. The suit was filed on behalf of the United States by two former employees of Lynch Ambulance, which is based in Anaheim, under whistle-blower provisions of the federal False Claims Act, according to a written statement by the U.S. attorney's Central District of California office (Esquivel, 11/18).