First Edition: December 6, 2103

Today's headlines include news about how both the federal and state-based health insurance websites are doing.

Kaiser Health News: What Happens If My Income Changes After I Receive An Insurance Subsidy?
Kaiser Health News consumer columnist Michelle Andrews answers a reader's question about subsidies and buying insurance on the health law's new exchanges (12/6). Read her response.

Politico: Next Up: Obamacare Worst-Case Scenario?
Enrollment surge or no enrollment surge, the next Obamacare challenge is a big one: How will the White House make sure all those people with canceled policies get new coverage by Jan. 1? At the rate the signups are going -; even with the speedier, newly functioning Obamacare website -; the administration has a vast distance to travel before the estimated 4 to 5 million people with canceled policies get new health coverage (Nather, 12/6).

The Associated Press/Washington Post: Obama's Fixer-Upper Website Races To Catch Up
It looks like President Barack Obama's fickle health insurance website is finally starting to put up some respectable sign-up numbers, but its job only seems to have gotten harder. Two months in and out of the repair shop have left significantly less time to fulfill the White House goal of enrolling 7 million people by the end of open enrollment on March 31 (12/6).

Politico: State Exchanges Hitting Data Snags, Too
Even in states where Obamacare enrollment is booming, insurance companies are running into significant behind-the-scenes technical glitches that could threaten Jan. 1 health coverage. Many of these 14 states and the District of Columbia have been eager to tout the success of their own exchanges compared with the bungled federal portal, but they now appear to be worrying about back-end problems similar to those afflicting HealthCare.gov (Cheney and Millman, 12/6).

Los Angeles Times: State Health Exchange Swamped With Enrollees
California's health exchange is struggling to keep pace with a surge of applicants who are encountering long waits and website problems as they try to meet a Dec. 23 deadline. In response to higher-than-expected demand, the Covered California exchange said it is adding staff and expanding its capacity to answer consumer calls. It received 17,000 calls in less than an hour Wednesday, more than it received in an entire day in recent weeks. The exchange is also trying to dig through a backlog of 25,000 paper applications filed in October and November (Terhune, 12/5).

The Associated Press/Washington Post: Santa's Big Surprise – A Health Insurance E-Card?
California's health insurance exchange Thursday urged holiday shoppers to think about giving young people "the gift of health." Some suggestions from Covered California: Help a young adult pay for coverage, or send an e-card with a personal message and information about the federal health care overhaul. There's also a website where family members can pledge to help get relatives coverage (12/5).

Los Angeles Times: Kentucky Governor Sees Promise For Democrats In Healthcare Law
Beshear spoke to House Democrats in a closed-door meeting about his state's experience with implementation of the Affordable Care Act. The commonwealth has become "the gold standard" for implementation thus far, Beshear said, with heavy interest from residents and 69,000 enrollments so far (Memoli, 12/5).

Politico: Kentucky Gov. Steve Beshear Hits Mitch McConnell On Obamacare
Democratic Kentucky Gov. Steve Beshear took a jab at Senate Minority Leader Mitch McConnell over his continued opposition to the Affordable Care Act. Speaking on Capitol Hill on Thursday, Beshear called on McConnell and other Republicans in his state's congressional delegation to come see the exchange and the state residents who want to take advantage of the law. Kentucky's state-run insurance exchange is operating more efficiently than most other exchanges in the country, including the federal system (Gibson and Haberkorn, 12/5).

The Washington Post: Gansler Campaign Accuses Brown Of Ducking Responsibility For Md.'s Health-Exchange Flaws
After spending the early months of his campaign on the defensive, Maryland gubernatorial candidate Douglas F. Gansler has pounced on an issue on which he believes his leading rival is vulnerable: the botched rollout of the state's online health-insurance exchange. On Thursday, the Gansler campaign issued its latest attack on Lt. Gov. Anthony G. Brown, accusing the fellow Democrat of dodging the news media and ducking responsibility for a task assigned to him by his boss, Gov. Martin O'Malley (Wagner, 12/5).

Los Angeles Times: A Health Care Navigator In Unfriendly Waters
Rascoe is one of thousands of foot soldiers hired nationwide to sign Americans up for coverage under President Obama's Affordable Care Act. Her task is made all the more challenging because she works in one of the Republican-led states openly hostile to the act. The GOP-controlled Legislature ordered state health officials not to cooperate with the federal program. Many of the people in this rural swath of North Carolina -; despite being among the neediest potential beneficiaries of Obamacare -; remain skeptical and uninformed (Bennett, 12/6).

The Associated Press/Washington Post: Feds' Site Gives States Incomplete Medicaid Data
People shopping for insurance on the federal marketplace may be informed they're eligible for Medicaid and that their information is being sent to state officials to sign them up. However, states say they aren't able to enroll them because they're receiving incomplete data from the Obama administration (12/5).

The Washington Post: Study: Refusing Medicaid Expansion Will Cost States Billions Of Dollars
When the Supreme Court ruled in 2012 that the federal government could not compel states to expand their Medicaid programs under the Affordable Care Act, it gave Republican opponents of the measure the opportunity to decline to participate in one of the law's central tenets. But a new study estimates the decision not to participate will cost those states billions of dollars over the next decade -; costs that will be passed on to taxpayers. The Affordable Care Act requires the federal government to pay 100 percent of the costs of expanding Medicaid for three years. After that period, the law mandates the federal government pay 90 percent of the costs of expansion (Wilson, 12/5).

The Washington Post: Obama Administration Awards $55 Million To Boost Health-Care Workforce
The Department of Health and Human Services has awarded $55.5 million in grants to help bolster a health-care workforce that is stretched thin and possibly due for more strain under the Affordable Care Act. The health legislation, known as Obamacare, requires the uninsured to obtain medical coverage, potentially placing more stress on the nation's health-care network (Hicks, 12/6).

The Washington Post: House Extends Current Health Plans For Lawmakers, Staffers, If Needed
Acknowledging widespread issues with the process of enrolling for new health-care coverage, House officials reiterated Thursday that lawmakers and their staffs whose current health insurance is set to be terminated at the end of the year will automatically have that coverage extended until the end of January unless they have already enrolled in new coverage. The reminder from House administrative officials is standard operating procedure for anyone set to lose coverage under the health-care program for federal employees. But the reminder also came as the congressional opening enrollment period is scheduled to end on Monday and amid reports of serious trouble with the Web site of the District's health-care exchange, D.C. Health Link (O'Keefe, 12/5).

Politico: House Official Presses OPM On Obamacare
The House's chief administrative officer is urging the Office of Personnel Management to take "immediate steps" to ensure lawmakers and aides can get enrolled under Obamacare despite the myriad glitches they've endured as they've tried to sign up. Dan Strodel wrote in a message sent Thursday evening that he is well aware of the struggles that people have faced with the D.C. exchange, where members of Congress and qualifying aides will enroll for their coverage (Kim, 12/5).

The Washington Post's The Fact Checker: Obama's Claims On Death Rates And Poverty Due To A Lack Of Health Insurance
Let's first concentrate on the claim that millions of citizens are driven into "poverty" by out-of-pocket costs. The White House said this fact came from the Census Bureau's Supplemental Poverty Measure, which is a long-term effort to update the current official poverty statistic. Critics have said the current measure is out of date because it does not reflect either the effect of government policies, such as food stamps, that alleviate poverty or the impact of expenses, such as medical costs or transportation costs to work, that reduce income (Kessler, 12/6).

Politico: Poll: Obamacare Opposition Ticks Up
As the White House claims to have significantly improved the Obamacare exchange website after a bungled rollout, more than half of all Americans still want to see the Affordable Care Act slimmed down or gone entirely. Fifty-two percent of those polled in a new Gallup survey said they want the law scaled back or repealed, compared with 50 percent in October (Kopan, 12/6).

The New York Times: Congress Nears Modest Accord On The Budget
The deal would increase revenue by raising some fees and would shift some cuts away from domestic and defense programs, partly alleviating the squeeze of across-the-board spending cuts imposed last year, which are set to worsen in 2014. Spending on defense and domestic programs would rise to about $1 trillion for the current fiscal year from $986 billion, the fiscal 2013 level that remains in effect under the continuing resolution passed in October. Absent a deal, further cuts would go into effect in January, and discretionary spending would be cut to $967 billion for fiscal 2014. But the agreement would leave to future negotiations the big issues of curbing future spending increases in the fast-growing entitlement programs and the proper level of tax revenues. It also would not extend unemployment benefits set to expire Dec. 28, or deal with impending cuts to Medicare health care providers (Weisman, 12/5).

The Wall Street Journal: Budget Pact Comes Into View
Officials familiar with the talks say negotiators are stitching together a package of offsets to the planned sequester cuts that would include none of the major cuts in Medicare or other entitlement programs that Mr. Ryan has wanted, nor eliminate any of the tax increases that Ms. Murray sought. Instead, it would include more targeted and arcane measures, such as increased fees for airport-security and federal guarantees of private pensions (Hook, 12/5).

The New York Times: U.S. Says Diplomats Defrauded Medicaid
The contours of the alleged insurance fraud seemed unusual enough: The participants, men and women, were accused of improperly seeking Medicaid benefits for pregnancies, births and postnatal care. That the defendants were Russian was, perhaps, not altogether unusual, given the number of recent prosecutions for similar insurance schemes perpetrated in New York by immigrants from the former Soviet Union (Weisner, 12/5).

Los Angeles Times: Russian Diplomats Accused Of Medicaid Fraud In New York
Current and former Russian diplomats in New York claimed poverty to fraudulently collect Medicaid for their pregnant wives and children while shopping at Prada and Tiffany's and taking cruise vacations, the U.S. government charged Thursday. The Justice Department said 49 Russians or their spouses currently or formerly attached to the Russian Consulate, United Nations or trade missions illegally collected $1.5 million in benefits over about a decade in New York City (Phelps, 12/5).

The Wall Street Journal: U.S. Accuses Russian Diplomats, Spouses of Medicaid Fraud
Federal prosecutors have accused current and former Russian diplomats and their spouses of participating in an alleged scheme that garnered nearly $1.5 million dollars in fraudulent Medicaid benefits. The criminal complaint against 49 current or former Russian diplomats and their spouses, announced on Thursday, is likely to further pressure already sour relations between Moscow and Washington (Matthews, 12/5).