First Edition: December 12, 2013

Today's headlines include ongoing coverage of the health law's implementation -- from details of Health and Human Services Secretary Kathleen Sebelius' Wednesday Capitol Hill appearance and more information about the most recent enrollment numbers to analysis of policy issues related to the overhaul.

Kaiser Health News: New York Data Show Hospital Charges All Over The Map
WNYC's Fred Mogul, working in partnership with Kaiser Health News and NPR, reports: "New York State has pulled back the curtain on hospital charges. A new database shows what each hospital across the state charges for 1,400 different procedures. The differences can be dramatic: At Bellevue Hospital, the median charge for an uncomplicated birth is $6,330, and at NYU Langone Medical Center next door, the median charge is $12,222. Lutheran Medical Center in Sunset Park, Brooklyn, typically charges $5,686 and Maimonides Medical Center, a dozen miles away, $14,763" (Mogul, 12/12). Read the story.

Kaiser Health News: Health On The Hill: Sebelius Asks Inspector General To Probe Website Problems
Kaiser Health News' Mary Agnes Carey and CQ Roll Call's Emily Ethridge discuss HHS Secretary Kathleen Sebelius' testimony on Capitol Hill Wednesday, which included updates on steps officials are taking to repair the health law's online insurance exchange (12/11). Read the transcript or listen to the conversation.

Kaiser Health News: Capsules: Obesity Rate Flat For First Time In Decades, Health Rankings Find
Now on Kaiser Health News' blog, Eric Whitney reports: "An annual state-by-state survey says the country is making good progress in improving its overall health -; including a flat obesity rate and a lower rate of smoking. But individual states, especially in the South, continue to lag. The 2013 edition of 'America's Health Rankings' by United Health Foundation, the American Public Health Association and Partnership for Prevention says that, 'for the first time in decades,' the nation's obesity rate did not rise between 2012 and 2013. Americans are also becoming more physically active, the report says" (Whitney, 12/11). Check out what else is on the blog.

The New York Times: U.S. Cites Rise In Health Plan Signups As Sebelius Testifies
The number of people selecting health insurance plans in the federal and state marketplaces increased last month at a brisk pace, bringing the overall figure to nearly 365,000, the Obama administration said on Wednesday. The November number was more than double the one for October, but still well below the administration's goal (Pear, 12/11).

The Washington Post: Sebelius: Enrollment Up With Improving Healthcare.gov; Review Of Problems Launched
Health and Human Services Secretary Kathleen Sebelius said Wednesday that the ailing health insurance Web site was improving thanks to "relentless" efforts to work out the bugs, and she cited an uptick in enrollment as evidence that the program is back on track after a false start. But she told a congressional panel she has launched an investigation into what policies and management failures may have contributed to the initial failures of HealthCare.gov, the main portal for people in 36 states to buy private insurance plans under the health-care law (Somashekhar and Goldstein, 12/11).

Politico: Kathleen Sebelius Takeaways: 1 Cranky Hearing
What's the one thing worse than taking fire from Congress in a crowded hearing room? Taking fire from really cranky members of Congress in a half-empty hearing room. That's what Kathleen Sebelius went through on Wednesday, as she parried Obamacare questions from a House subcommittee while much of Washington had moved on to other things. But in the hearing room, the Obamacare tensions were as high as ever, with Republicans and Democrats snapping at each other and one GOP lawmaker griping that trying to get answers out of the Health and Human Services secretary was like talking to North Korea (Nather, 12/11).

The Wall Street Journal: Sebelius Calls For Review Of HealthCare.gov Contracting Practices
Health and Human Services Secretary Kathleen Sebelius, responding to the botched launch of the HealthCare.gov health-insurance website, said Wednesday she has called for a review of contracting practices and a new official to oversee risk. Mrs. Sebelius testified again on Capitol Hill Wednesday and faced questions from House Republicans about issues that have plagued the rollout of President Barack Obama's health law. Lawmakers raised concerns about the security of consumer data, the cancellation of millions of health policies, limited networks of doctors and hospitals and higher-than-expected premiums (Schatz, 12/11).

Los Angeles Times: Obamacare Sign-Ups Continue To Increase
Growing numbers of Americans are signing up for insurance through President Obama's health law, with more than 250,000 selecting a plan in November, according to a new government report. That is more than double the number in October, when problems with the new HealthCare.gov website made enrollment virtually impossible in most states for long stretches of time (Levey, 12/11).

The Associated Press/Washington Post: Health Care Sign-Ups Pick Up But May Not Close Gap
With time running short, the nation's health care rolls still aren't filling up fast enough. New sign-up numbers Wednesday showed progress for President Barack Obama's health care law, but not enough to guarantee that Americans who want and need coverage by Jan. 1 will be able to get it. Crunch time is now, as people face a Dec. 23 deadline to sign up if they are to have coverage by New Year's (12/11).

USA Today: Analysts Predict Surge In Health Care Enrollment
The surge in health insurance enrollment in November lifted the spirits of federal officials Wednesday, but industry experts say the potential for higher enrollments comes from a huge pool of customers who are eligible for subsidies to buy insurance but who have not used the exchanges. The government quadrupled its enrollment numbers from October to November, with 364,682 people signed up for health insurance through either the federal or state exchanges, officials announced Wednesday (Kennedy, 12/11).

The Wall Street Journal: White House Works To Attract Younger Health-Plan Users
New enrollment figures show health-insurance exchanges nationwide are attracting more customers, but the Obama administration said that it has more work to do to get enough younger, healthy people into the system. The administration said Wednesday that as of Nov. 30, nearly 365,000 people nationwide had selected private health plans in the exchanges created by the Affordable Care Act-;sharply up from October, but still far from the seven million level officials are hoping to achieve by March 31. Health and Human Services Secretary Kathleen Sebelius faced renewed criticism of the health-care law's rollout at a House hearing Wednesday. Republicans suggested the plans on offer are a bad deal for many Americans, pointing to problems such as limited networks of doctors and hospitals, and higher-than-expected premiums (Schatz, 12/11).

Los Angeles Times: California Enrolls 107,000 In Obamacare Policies Through November
California's health exchange has signed up 107,087 people in Obamacare policies through the end of November, federal data show, accounting for nearly a third of enrollment nationwide. The federal figures released Wednesday also show that 181,817 Californians have qualified for an expansion of Medi-Cal, the state's Medicaid program for the poor (Terhune, 12/11).

USA Today: Affordability Under ACA Becomes An Issue
Many small businesses remain in the dark about how the ACA affects them, however. When asked this year if their insurers had changed their small business' benefit package because of the law, 22% of 604 companies queried said they hadn't, and 34% said they didn't know, according to a report from the independent research organization NORC at the University of Chicago. They aren't likely to miss the big changes coming next year for ACA-compliant plans. What will be different next month: Insurers will be prohibited from refusing to cover people with pre-existing conditions, charging them more or delaying their coverage. Plans will also be required to cover certain "essential health benefits" and fully cover preventive care (O'Donnell, 12/12).

The New York Times: Dropping Health Plans, To Pick Better Coverage
For nearly 20 years, Keith Perkins offered health insurance to employees of his small electrical contracting company in Greencastle, Pa., and footed most of the bill. This year, with the arrival of the Affordable Care Act's insurance marketplace, he decided to stop. Mr. Perkins, who is 54, did the math and calculated that most of his employees, who are spread across Maryland, West Virginia and Pennsylvania, would come out ahead if he dropped his group policy and let them buy insurance individually through the new federal and state exchanges (Cowley, 12/11). 

The Associated Press/Washington Post: O'Malley, Back From A Trade Million, Plans To Provide Update On Health Insurance Rollout
Maryland Gov. Martin O'Malley (D), who recently returned from a trade mission to Brazil and El Salvador, plans to brief the media on Thursday regarding the status of the state's online health insurance exchange, an aide said. O'Malley's expected appearance comes just two days after Lt. Gov. Anthony Brown (D) addressed reporters on the same subject and declined to say whether the state would meet a mid-December target set by O'Malley to fix the major glitches that have hindered enrollments in private insurance plans (Wagner, 12/12). 

The Associated Press/Washington Post: Federal Data Show Health Disparities Among States
Newly released federal figures show more people are picking private insurance plans or being routed to Medicaid programs in states with Democratic leaders who have fully embraced the federal health care law than in states where Republican elected officials have derisively rejected what they call "Obamacare" (12/12). 

The Washington Post: Cuomo Spars With Obama Administration Over Medicaid Expansion
A plan to help struggling hospitals that cater to minority and low-income patients in New York City that has been under consideration for more than a year is causing friction between the state's Congressional delegation and the Obama administration, and leading to heated words between Albany and Washington. In a tense phone call late last month, New York Gov. Andrew Cuomo (D) pushed Health and Human Services Secretary Kathleen Sebelius to act promptly on his state's request to spend billions of dollars on Medicaid reforms, including hundreds of millions to shore up public hospitals on the brink of financial collapse(Wilson, 12/12). 

The Associated Press/Washington Post: Michigan Puts Restrictions On Abortion Insurance
Michigan will join more conservative states in requiring residents who want health insurance coverage for abortions to buy an extra policy, after Republican legislators passed the law Wednesday over the objections of Democrats who pleaded for them to take the issue to voters instead. The citizens' initiative approved 62-47 by the House and 27-11 in the Senate -; almost entirely along party lines -; will become law in March without the signature of Republican Gov. Rick Snyder, who vetoed similar legislation a year ago. The anti-abortion group Right to Life collected more than 300,000 signatures to put the legislation before lawmakers, who also had the option of letting it go to a statewide vote next November (12/11).

The Washington Post: House Republicans Appear To Be Rallying Behind $85 Billion Budget Deal
The moment seemed to mark a potentially significant shift by House Republicans away from the uncompromising confrontation of recent years and toward a determined era of more functional governance. After multiple standoffs and threatened defaults and one actual shutdown, polls show that the Republican brand has been badly damaged among voters, and even some of the most conservative Republicans said they were ready for a breather (Montgomery, 12/11). 

The Wall Street Journal: Budget Deal Picks Up Steam
Few lawmakers expressed enthusiasm for the narrowly focused agreement reached by House Budget Chairman Paul Ryan (R., Wis.) and his Senate counterpart, Budget Chairman Patty Murray (D., Wash.), to ease the effect of across-the-board spending cuts known as the sequester. But lawmakers from both parties predicted that bipartisan desire to call a cease-fire in Congress's budget wars would carry the bill through the House and into the Senate next week. "If you are for more deficit reduction, you are for this agreement," said House Speaker John Boehner (Hook and Peterson, 12/11). 

The New York Times: Fewer Psychiatrists Seen Taking Health Insurance
Psychiatrists are significantly less likely than doctors in other specialties to accept insurance, researchers say in a new study, complicating the push to increase access to mental health care (Pear, 12/11). 

The Washington Post: 'Stuck In The Safety Net,' Elderly District Veteran Hopes Crowdfunding Will Help
Eighty-year-old Ralph Bolen sat in front of the care facility where he lives, pulled on a cigarette and contemplated the four blocks separating him from his first-floor studio in a co-op near Dupont Circle. "It's one big room and it's very comfortable, with a picture window," he said, adding that he likes to lounge on his couch there and watch TV, or sit on the steps and chat with neighbors (Bahrampour, 12/11). 

The Associated Press/Washington Post: Trial On Assisted Suicide Law Begins In New Mexico
Two doctors and a Santa Fe woman with advanced uterine cancer want physicians in New Mexico to be able to prescribe -; without the fear of prosecution-; the needed medications for terminally ill patients who want to end their lives on their own terms. Standing in their way is a decades-old New Mexico law that makes it a fourth-degree felony to assist someone in suicide (12/12).