First Edition: February 11, 2014

Today's headlines include detailed coverage of the Obama administration's announcement that it will delay a health law requirement that mid-sized employers provide health insurance to workers while also allowing larger employers more flexibility.

Kaiser Health News: Pharmacists Increasingly Take On Clinical Roles
Kaiser Health News staff writer Anna Gorman, working in collaboration with USA Today, reports: "Once limited to filling and dispensing drugs, pharmacists are increasingly providing direct care to patients. Across the country, they are working with doctors to give immunizations and help patients safely manage medications. In some places, they can even write prescriptions after a physician's diagnosis. California is among the states to give pharmacists the greatest flexibility, thanks in part to a law that took effect this year. Other states, including New Mexico and North Carolina, have also allowed pharmacists to take on more clinical responsibilities" (Gorman, 2/11). Read the story.

Kaiser Health News: States Accelerate Shift Of Nursing Home Residents Into Medicaid Managed Care
Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today, reports: "Muenz' visit is part of a transformation of how Medicaid, the state-federal health insurance program for the poor, is providing long-term care to hundreds of thousands of people in Florida and a growing number of states. After two decades of shifting millions of Medicaid enrollees into managed care, most of them women and children, Florida is mandating that approach for 45,000 nursing home residents and another 40,000 who get long-term care services at home or assisted living facilities. The job of a case worker like Muenz is to make sure her clients get what they need to stay healthy – and that they live in the least-restrictive and least costly setting possible" (Galewitz, 2/11). Read the story.

Kaiser Health News: Insuring Your Health: Some Same-Sex Couples Denied Family Policies On Insurance Marketplaces
Kaiser Health News consumer columnist Michelle Andrews writes: "Carl Bechdel and Dan Miller started looking for a family plan on the Pennsylvania health insurance marketplace last fall. After submitting their application for a bronze-level plan to Highmark Blue Shield in early December, they became concerned when the end of the month approached and they hadn't heard from the insurer. Bechdel called customer service and finally learned the reason: The company doesn't offer family coverage to same-sex couples" (Andrews, 2/11). Read the column.

The New York Times: Further Delays for Employers In Health Law
The Obama administration announced on Monday that it would postpone enforcement of a federal requirement for medium-size employers to provide health insurance to employees and allow larger employers more flexibility in how they provide coverage (Pear, 2/10).

The Washington Post: White House Delays Health Insurance Mandate For Medium-Sized Employers Until 2016
For the second time in a year, the Obama administration is giving certain employers extra time before they must offer health insurance to almost all their full-time workers. Under new rules announced Monday by Treasury Department officials, employers with 50 to 99 workers will be given until 2016 -; two years longer than originally envisioned under the Affordable Care Act -; before they risk a federal penalty for not complying. Companies with 100 workers or more are getting a different kind of one-year grace period. Instead of being required in 2015 to offer coverage to 95 percent of full-time workers, these bigger employers can avoid a fine by offering insurance to 70 percent of them next year (Eilperin and Goldstein, 2/10).

Politico: Obamacare Delay Sparks New Mandate Fight
Once again, it's employers who are getting a break from their Obamacare mandate – and that's sure to increase the pressure on the Obama administration to delay the mandate for individuals, too. Regulations announced by the Obama administration Monday give two levels of delay to employers who would have had to cover their workers next year. Some businesses will get an extra year – until 2016. And the bigger businesses that do have to worry about the mandate will have it phased in over two years (Norman and Nather, 2/10).

Los Angeles Times: U.S. To Further Delay Obamacare Employer Mandate
Now, under Monday's action, the employer mandate will be phased in and won't fully take effect until 2016. The additional delay is likely to have little effect on employees because the vast majority of large employers already offer health benefits. The phase-in plan drew praise from several leading business groups that have worried about complying with the complicated documentation required by the law (Levey, 2/10).

The Wall Street Journal: Health-Law Mandate Put Off Again
Most employers won't face a fine next year if they fail to offer workers health insurance, the Obama administration said Monday, in the latest big delay of the health-law rollout. The Treasury Department, in regulations outlining the Affordable Care Act, said employers with 50 to 99 full-time workers won't have to comply with the law's requirement to provide insurance or pay a fee until 2016. Companies with more workers could avoid some penalties in 2015 if they showed they were offering coverage to at least 70% of full-time workers. The move came after employers pressured the Obama administration to peel back the law's insurance requirements. Some firms had trimmed workers' hours to below 30 hours a week to avoid paying a penalty if they didn't offer insurance (Radnofsky and Francis, 2/10).

NPR: Health Law's Employer Mandate Hits Another Speed Bump
For most businesses affected by the law (firms with fewer than 50 workers are exempt), the employer provisions will go into effect, as scheduled, on Jan. 1, 2015. The companies will, however, get a small bit of relief. For the first year they will only have to offer coverage to 70 percent of their full-time employees, rather than 95 percent, as was originally written. Under the "final rules" issued by the Treasury Department, the 95 percent requirement won't kick in until 2016 (Rovner, 2/10).

The Washington Post: Obama Administration Pushes Back Deadline For Some Businesses To Provide Health Care
One of the most controversial parts of the legislation within the business community, the rules in question require businesses with at least 50 employees to offer health plans that meet new minimum coverage and affordability standards in the law. If not, the company will be required to pay a potentially steep fine -; or, as the administration refers to it, an "employer responsibility payment" (Harrison, 2/10).

The Associated Press/Washington Post: Employers Scrutinize Latest Health Care Concession
It may take weeks to render a verdict on the Obama administration's latest health care concession to employers. But that could make a difference for Democrats battling to keep control of the Senate in the fall congressional elections (2/11).

Politico: The Web's Cacophony Of Anti-ACA Sentiment
The ire at #brokenpromises is beating the push to #getcovered. Anger is contagious on social media, and it has been easier to use Twitter and Facebook to stoke opposition to Obamacare than to implore people to sign up. Social media experts say supporters of the president's health law just haven't been as effective as the seething anti-Obamacare forces in getting out sharp, clear messages (Cunningham, 2/11).

The New York Times: In Arkansas, 'Private Option' Medicaid Plan Could Be Derailed
Last year, the Republicans who control this state's Legislature devised a politically palatable way to expand Medicaid under President Obama's health care law. They won permission to use federal expansion funds to buy private insurance for as many as 250,000 poor people instead of adding them to traditional Medicaid, which conservatives disparage as a broken entitlement program (Goodnough, 2/10).

The Associated Press/Washington Post: Weekend Tech Maintenance To Affect Healthcare.gov
This time, they're giving you notice. Some consumers won't be able to finish their online health insurance applications this weekend because Social Security's computer system will be undergoing heavy maintenance. It will not be able to verify Social Security numbers and certain other personal details needed for coverage under President Barack Obama's health care law (2/10).

The Associated Press/Washington Post: Official: Md. Looking At Health Exchange Options
Maryland's online health care exchange has some significant problems that are not on track to be corrected by the March 31 deadline for open enrollment, and officials are exploring other options for the second enrollment period starting in November, state officials told a legislative oversight panel on Monday (2/10).

The New York Times: California's Physician Directories Removed Because Of Errors
The California health care exchange has taken down its physician directories, amid continuing complaints from doctors and patients alike that the lists of doctors and hospitals included in each insurance plan were error-riddled and unreliable. Since the October rollout of Covered California, inaccuracies have posed countless problems: The lists described doctors as fluent in languages they did not speak; obstetricians were labeled as ophthalmologists; and physicians were falsely listed under insurance plans that did not cover care at their offices (Lovett, 2/10).

Los Angeles Times: Covered California Is Hiring More Workers To Fix Service Problems
California's health insurance exchange is racing to fix persistent service problems before it faces another surge of Obamacare applicants eager to beat a March enrollment deadline. The Covered California exchange said 250 new call-center workers began training Monday, and as many as 150 more employees will come on board in the coming weeks to ease phone wait times that stretch nearly an hour. Those additions would bring the total number of call-center staff to 900 people from about 500 now (Karlmangla, 2/10).

The Associated Press/Wall Street Journal: NY Health Exchange Insures Thousands More 
The state's new health exchange reports nearly 697,000 New Yorkers have completed applications for insurance while more than 412,000 of them have now enrolled for specific coverage (2/11).

The Associated Press/Washington Post: Illinois Using The Onion To Reach Young Uninsured
Trying to sell young adults on the idea of health insurance before an upcoming deadline, Illinois officials announced Monday they are launching an ad campaign with the satirical online newspaper The Onion (2/10).

The Associated Press/Washington Post: GOP Mulls Raising Debt Limit, Undoing Pension Cut
The GOP bill would extend Treasury's borrowing authority for at least another year, repeal the curb passed in December on pension inflation adjustments for military retirees under the age of 62, and extend automatic cuts to Medicare and other programs to 2024 (2/11).

The Washington Post: House GOP Homes In On Debt-Ceiling Plan Tied To Military Pension Benefits
Despite the uncertain fate, Boehner's team moved ahead with the option linking a restoration of recently cut military pension benefits to a one-year extension of the Treasury's borrowing authority. The cost of restoring that cut to military pensions, about $7 billion, would be offset by an extension, by one year, of planned automatic spending cuts to entitlement programs. … Other GOP ideas, floated during the past week, were jettisoned by Monday, including the perennial fix to the way Medicare reimbursements are calculated. That legislation is now moving on its own separate track amid bipartisan talks (Costa and Kane, 2/10).

The New York Times: House Republicans Seek To Trade Debt Deal For Repeal On Military Pensions
"As a senator from the most military-friendly state in the nation, I'm pleased that we have voted to advance this legislation that will affect so many brave men and women who have served our country," Senator Hagan declared after Monday's vote, adding that the cut would siphon an average of $80,000 over a military retiree's life. "We can never balance the budget on the backs of those who have answered the call of duty." House Republican leaders argued that the measure they were championing would not add to the deficit. That is because it would extend to 2024 a 2 percent cut to Medicare health care providers that already is in effect until 2023 (Weisman, 2/10). 

The Associated Press/Washington Post: AMA Supports Overhaul Of Medicare Doctors' Pay
The American Medical Association says it strongly supports legislation that would change the way Medicare pays doctors, to emphasize quality care and not just sheer volume of services (2/10). 

NPR: Fifty Years After Major Report, Surgeons General Work To End Smoking
The first Surgeon General's report on the dangers of smoking came out just over 50 years ago. Now a group of former Surgeon Generals are finding new ways to prevent smoking. Host Michel Martin speaks with two of them: Dr. Regina Benjamin and Dr. Antonia Novello (2/10). 

The New York Times: Drug Shortages Continue To Vex Doctors
Despite efforts by the Obama administration to ease shortages of critical drugs, shortfalls have persisted, forcing doctors to resort to rationing in some cases or to scramble for alternatives, a government watchdog agency said on Monday. The number of annual drug shortages -; both new and continuing ones -; nearly tripled from 2007 to 2012. In recent years, drug shortages have become an all but permanent part of the American medical landscape. The most common ones are for generic versions of sterile injectable drugs, partly because factories that make them are aging and prone to quality problems, causing temporary closings of production lines or even entire factories (Tavernise, 2/10).

Los Angeles Times: L.A. Care Health Plan CEO Howard Kahn To Step Down In January 2015
Howard A. Kahn, the chief executive of L.A. Care Health Plan, said he plans to leave in January after leading the large Medicaid managed-care provider for 13 years. The organization announced the move late Friday. Kahn said it was time to do something different (Terhune, 2/10).

The Washington Post: Ethics, Mental Health Bills Advance In Virginia General Assembly
Virginia lawmakers moved forward Monday on an ethics law overhaul and mental health legislation, two causes given urgency by recent events. The Senate passed the ethics package with only one dissenting vote, despite grumbling by some lawmakers that the legislation is poorly designed. A similar bill was approved on a preliminary vote in the House. The mental health bill passed the Senate with no opposition and was backed by the House on a preliminary vote (Weiner, 2/10). 

The Wall Street Journal: Regulators Seen Taking Notice Of WellPoint Deal In New York
An agreement by WellPoint Inc. to grant some New York health-law marketplace consumers a three-week break on premiums could draw attention from regulators in other states where insurers have struggled with service issues. The New York governor's office said the agreement came after an investigation by state regulators into consumer complaints about service issues. The insurer has agreed to provide payments equivalent to three weeks of premiums for people who enrolled through the state's exchange, paid a premium for January and didn't receive care during that month, the state said. WellPoint sells plans in New York under the Empire BlueCross BlueShield brand (Mathews, 2/10).