The early morning highlights from the major news organizations, including reports about what to expect of the health law in 2014.
Kaiser Health News: The Health Law Takes Effect: A Consumer's Guide
Kaiser Health News staff writer Mary Agnes Carey reports: "Starting Jan. 1, central provisions of the Affordable Care Act kick in, allowing many uninsured Americans to afford health insurance. But the landmark law still faces heavy opposition from Republicans and from a public that remains skeptical the law can improve health care coverage while lowering its cost. The law has already altered the health care industry and established a number of consumer benefits. It will have sweeping ramifications for consumers, state officials, employers and health care providers, including hospitals and doctors. … Here's a primer on where the law stands now and how it might change" (Carey, 1/1). Read the story.
Kaiser Health News: Insuring Your Health: Despite Health Law's Protections, Many Consumers May Be 'Underinsured'
Kaiser Health News consumer columnist Michelle Andrews writes: "People with chronic conditions will be better protected from crippling medical bills starting in January as the health law's coverage requirements and spending limits take effect. But a recent analysis by Avalere Health found that many may still find themselves 'underinsured,' spending more than 10 percent of their income on medical care, not including premiums, even if they qualify for cost-sharing subsidies on the health insurance marketplaces" (Andrews, 12/31/13). Read the column.
Iowa's version of Medicaid expansion: "When the federal Affordable Care Act called for states to expand Medicaid programs to cover people like Gross, Iowa Republican Gov. Terry Branstad refused. He said he feared the federal government wouldn't come through on its promise to fund the expansion to include childless adults. Iowa was one of many states that initially refused all or part of the federal funds offered. … Eventually Branstad said 'yes,' but only if Iowa could take the money on its own terms. The state legislature, which is evenly split between Republicans and Democrats, came up with an alternative: Federal expansion dollars would pay for managed care policies that poor people would select on the HealthCare.gov site" (Masters, 1/1).
Also on the blog, Mississippi Public Broadcasting's Jeffrey Hess reports on how the federal health exchange is working for his state's residents: "If you're looking for evidence that healthcare.gov, the federal health insurance marketplace, is working much better these days, you might want to ask Arlene Wilson. The 56 year old is a chef with a popular pizza shop in Jackson, Mississippi. Wilson says that "most jobs don't offer" health insurance. Because "most of us live paycheck to paycheck," she says she's been unable to afford insurance for the past eight years. But the health law was designed to help people like Wilson and her co-workers (Hess, 1/2). Check out what else is on the blog.
The New York Times: Consumers Start Using Coverage Under Health Law
Consumers around the country began using coverage provided by the new health care law on Wednesday, the same day that Medicaid expanded to hundreds of thousands of people in about half the states. Many provisions of the 2010 health care law offering new benefits and protections to consumers, including those with pre-existing conditions, also took effect. Hospitals said they were getting ready for an influx of newly insured patients, but many health care providers said the pace was slower than usual because of the New Year's holiday. In a typical report, Clay Holtzman, a spokesman for Swedish Medical Center in Seattle, said the system's hospitals were not seeing an immediate surge (Pear and Goodnough, 1/2).
Politico: For Obamacare, It's Finally Showtime
Obamacare just got real. Sure, there were some new rules and benefits over the last few years, but that was just a warmup. Starting today, all of the big pieces of the Affordable Care Act -; the biggest domestic achievement of Barack Obama's presidency and one of the most far-reaching changes in American social policy in decades -; go into effect. And Americans will start to see, for better or worse, how the law really works. ... Obamacare supporters and the president and his team can bask for just a moment in the glow of their long-sought goal finally becoming law -; but only for a moment. The ACA's Perils of Pauline debut is going to continue. Here are the obstacles ahead this year (Nather, 1/1).
The Wall Street Journal: Health Law's Uneasy Launch
Nearly four years after President Barack Obama signed his health initiative into law, the Affordable Care Act is officially reshaping America's $2.75 trillion health-care system. A survivor of bare-knuckle political fights, a U.S. Supreme Court challenge and a technologically disastrous rollout, the law now faces a fundamental test: Can its mix of government subsidies and market-based competition extend health insurance to millions of people whose medical conditions, income level or personal choice left them without it? (Weaver, 1/1).
Politico: White House Expects Day 1 Obamacare Snags
The health coverage under Obamacare finally begins New Year's Day and the Obama administration knows that it may not all go smoothly. More than 2.1 million people have signed up through the state and federal exchanges, and Obama administration officials acknowledged that some of them may not actually have their new health plan finalized Jan. 1, because of all the tech problems that plagued HealthCare.gov during the last three months (Norman, 1/2).
Los Angeles Times: White House Issues New Tip Sheet For Obamacare Consumers
The Obama administration is releasing a new tip sheet for Americans who have signed up for coverage under the president's healthcare law and is urging consumers to be careful before they start using their new insurance Wednesday. … Since Oct. 1, approximately 2.1 million people have enrolled in a private health plan through new marketplaces created by the Affordable Care Act, the administration announced Tuesday. About an additional 4 million low-income Americans have qualified for Medicaid or the Children's Health Insurance Program (Levey, 12/29/31).
Politico: Key Obamacare Changes Come With The New Year
Coverage begins on Jan. 1 for people who selected plans through new federal and state exchanges before the Dec. 24 deadline. Others have until March 31 to sign up. Many Americans can receive federal subsidies to help pay for insurance. Several million low-income people also qualified for Medicaid, which 26 states are expanding under the health law that President Barack Obama signed nearly four years ago. But there's a ton of fine print taking effect, too, nitty-gritty details that are critical to making the health law work as intended. Here's a look at some of the other Obamacare elements taking effect Jan. 1 (Cheney, 12/31/13).
USA Today: Health Care Changes To Watch For 2014
Beyond the law's new requirements, analysts and industry officials say they anticipate a series of related changes to affect health care in 2014, including: Private exchanges. ... Employer mandate. ... Pricing transparency. ... New rules and higher enrollments. ... Electronic records. ... Shrinking networks. ... States will drive change. Medicaid, which is run by the states, will have the most impact on local price structures (Kennedy, 1/1).
The Washington Post: Beneath Health Law's Botched Rollout Is Basic Benefit For Millions Of Americans
Adam Peterson's life is about to change. For the first time in years, he is planning to do things he could not have imagined. He intends to have surgery to remove his gallbladder, an operation he needs to avoid another trip to the emergency room. ... Peterson is among the millions of uninsured Americans who are benefiting from the Affordable Care Act ... These beneficiaries have not been oblivious to the problems of the new insurance exchanges, ... [Yet] as New Year's Day approaches, and with it, health insurance, their frustration is trumped by gratitude (Sun and Goldstein, 12/28/13).
The New York Times: Millions Gaining Health Coverage Under Law
The decisively new moment in the effort to overhaul the country's health care system will test the law's central premise: that extending coverage to far more Americans will improve the nation's health and help many avoid crippling medical bills. Starting Wednesday, health insurance companies can no longer deny coverage to people with pre-existing conditions and cannot charge higher premiums to women than to men for the same coverage. In most cases, insurers must provide a standard set of benefits prescribed by federal law and regulations (Pear and Goodnough, 12/31/13).
The Washington Post: Obamacare's 2013 Tally: Six Million Signed Up For Coverage
Health and Human Services Secretary Kathleen Sebelius told reporters that 2.1 million have signed up for coverage through Dec. 28. That includes the 1.1 million that the White House had announced this past Sunday, who had enrolled through Dec. 24 on HealthCare.gov. There are also 3.9 million people who have been found eligible for Medicaid (Kliff, 12/31/13).
The Wall Street Journal: Health-Plan Enrollment Surpasses 2.1 Million
Nationwide enrollment in private health plans under the Affordable Care Act has topped 2.1 million, the Obama administration said Tuesday as it prepared to tackle potential new problems when coverage takes effect New Year's Day. The enrollment figure as of Dec. 28, announced by Health and Human Services Secretary Kathleen Sebelius, encompasses the federal health-insurance exchange serving 36 states and those who enrolled through exchanges in the 14 states that are running their own marketplaces. ... Uninsured people have until March 31 to sign up for coverage or run the risk of being required to pay a 2014 penalty (Schatz, 12/31/13).
The Washington Post: With New Year, Medicaid Takes On A Broader Health-Care Role Medicaid embarks on a massive transformation Wednesday -; from a safety-net program for the most vulnerable to a broad-based one that finds itself at the front lines of the continuing political and ideological battle over the Affordable Care Act. Already the nation's largest health-care program, Medicaid is being expanded and reshaped by the law to cover a wider array of people. Among them will be many who consider themselves middle class (Somashekhar and Tumulty,, 12/31/13).
USA Today: Health Law May Hit Midsize Businesses Hardest
The new year will bring tough new health care decisions for many businesses, especially those that are too small to easily absorb new costs and too big to think about dropping coverage, experts say. These midsize businesses, particularly those with 50 to 200 workers, are having the toughest time affording escalating health care costs, says Nancy Taylor, a health care lawyer with Greenberg Traurig (O'Donnell, 12/31/13).
Politico: W.H. Stands By Birth-Control Rule
The Obama administration Wednesday said the Affordable Care Act contraceptive coverage regulations are fair – and they don't really hurt the Denver-based religious organization that got a temporary New Year's Eve reprieve from Supreme Court Justice Sonia Sotomayor. "We defer to the Department of Justice on litigation matters, but remain confident that our final rules strike the balance of providing women with free contraceptive coverage while preventing non-profit religious employers with religious objections to contraceptive coverage from having to contract, arrange, pay, or refer for such coverage," a White House official said (Allen, 1/2).