First Edition: March 13, 2014

Today's headlines include details of Wednesday's Capitol Hill testimony by Health and Human Services Secretary Kathleen Sebelius.

Kaiser Health News: What Went Wrong With Minnesota's Insurance Exchange
MPR News' Elizabeth Stawicki and Catherine Richert, working in partnership with Kaiser Health News and NPR, report: "Behind MNsure's upbeat façade was a swamp of management failures and technical glitches that crippled the more-than $100 million website. MNsure leaders blamed tight deadlines and evolving federal requirements for the website's malfunctions. However, internal MNsure documents and interviews with insurance company officials, county workers and other stakeholders reveal a more complicated story" (Stawicki and Richert, 3/12). Read the story.

Kaiser Health News: Capsules: Ryan Quizzes Sebelius On Savings Estimate From IPAB; Injured Who Lived Near Closed Trauma Centers More Likely To Die; Employers See Negligible Increase In Workers Participating In Job-Based Coverage
Now on Kaiser Health News' blog, Mary Agnes Carey reports on a Capitol Hill appearance by Health and Human Services Secretary Kathleen Sebelius: "On Wednesday, Rep. Paul Ryan, R-Wis., asked Department of Health and Human Services Secretary Kathleen Sebelius how the agency determined that IPAB savings would be $12.9 billion over the next decade and why it was so much higher than the fiscal 2014 budget estimate, which was $4 billion. 'The question is, where does it come from?' Ryan asked'" (Carey, 3/13). 

In addition, Roni Caryn Rabin reports on a new California study of trauma centers: "Injured patients who had to travel an average 13 minutes longer to reach a hospital trauma center because a facility nearer to home had closed were more likely to die of their injuries in the hospital, according to a new California study" (Rabin, 3/13). 

Also on Capsules, Julie Appleby reports on a new survey of employers regarding workers and job-based coverage: "Employers saw only a tiny increase in enrollment in their health insurance plans this year, even as key provisions of the health law -; including a requirement that nearly all Americans carry coverage or face a fine -; went into effect, a survey by benefit firm Mercer finds" (Appleby, 3/12). Check out what else is on the blog.

Politico: So How Many Have Paid ACA Premiums? 
The White House insists it doesn't know how many people are fully enrolled in Obamacare, but insurers say they've handed over enough data to show that the sign-up numbers are not as rosy as federal officials say. The latest administration figures show that 4.2 million people have selected health plans in the new insurance markets. Insurance industry officials at four of the big national health plans tell POLITICO that about 15 to 20 percent of people who have signed up have not yet paid their first monthly premium -; the final step to get coverage (Cheney, 3/13).

The New York Times: Health Mandate Won't Be Delayed, Sebelius Says
Kathleen Sebelius, the secretary of health and human services, said Wednesday that the Obama administration would not extend the deadline for people to sign up for health insurance or delay the requirement for most Americans to have coverage. And she declined to say whether the administration was still committed to its original goal of enrolling seven million people in private coverage through federal and state exchanges by March 31 (Pear, 3/12).

The Wall Street Journal: Health Insurance Rates Likely To Rise In 2015
Health and Human Services Secretary Kathleen Sebelius said health-insurance premiums are "likely to go up" in 2015, an acknowledgment that the Obama administration doesn't believe the sweeping changes to the health-insurance marketplace will end premium increases in the near term. Testifying Wednesday before the House Committee on Ways and Means about the White House's 2015 budget proposal, Mrs. Sebelius was peppered with questions about the impact of the Affordable Care Act, including one from Rep. Erik Paulsen (R., Minn.) about its effect on insurance rates (Corbett Dooren and Radnofsky, 3/12).

Politico: Kathleen Sebelius: No More Obamacare Delays
HHS Secretary Kathleen Sebelius said Wednesday that there would be no delay of Obamacare's individual mandate, the penalty for violating it or the March 31 closing date of the enrollment period, the strongest statement yet that the administration has no plans for more major changes to the law in the final weeks of the first sign-up period. Asked by Rep. Kevin Brady (R-Texas) at a House hearing whether the administration would change its policy for enforcing the individual mandate after all the other delays, extensions and adjustments it has made to different provisions in the law, Sebelius bluntly replied, "No, sir" (Norman, 3/12).

The New York Times: In Alabama, College Students Take On Challenge Of Health Insurance Sign-Up
Students at the University of Alabama Honors College here are encouraged to do volunteer work in the community and on campus. For Marlan Golden, a senior, that has included being a Big Brother; running an education project for local Latinos; serving as president of the Alpha Tau Omega fraternity; and, most recently, signing up people for health insurance under the Affordable Care Act (Winerip, 3/12).

The Washington Post's Wonkblog: HHS Will Push Back Against State Restrictions On Obamacare Ground Troops
After a number of states have passed laws limiting the reach of Obamacare "navigators," the Obama administration is getting ready to push back. HHS has signaled it will soon take on restrictions that states have placed on the federally funded program meant to educate consumers about health insurance. There are different designations of Obamacare-related in-person help: navigators, in-person assisters and certified application counselors. Each designation has varying responsibilities, but the general idea is that they're supposed to help people understand their insurance options under the health care law, though they can't actually enroll anyone in coverage (Millman, 3/12).

The Washington Post: Virginia's Fight Over Medicaid Expansion Shifts From Capitol To Cities, Towns, Rural Enclaves
Legislators left dug-in Richmond on Saturday after an impasse on Medicaid expansion prevented the passage of a state budget. They return March 24 to try again in a special session. That gives them two weeks to beat the drum for or against Medicaid expansion and to line up support from mayors, business leaders and ordinary Virginians (Vozzella, 3/12).

The Associated Press/Washington Post: Republicans Confident On Va. Medicaid Fight
Virginia House Republican leaders said Wednesday the momentum is in their favor in the battle with Gov. Terry McAuliffe and Democratic lawmakers over whether to expand Medicaid eligibility. House Majority Leader Kirk Cox said growing public opinion agrees with the Republican position that lawmakers should pass a budget before debating Medicaid (3/12).

The Washington Post: Mizeur: Maryland Is Not Doing Enough To Boost Medicaid Enrollment
Amid all of the shortcomings and embarrassments of the Maryland health insurance exchange, Gov. Martin O'Malley (D) and other leaders have pointed to one bright spot: The number of people signing up for Medicaid has exceeded their expectations. But Del. Heather R. Mizeur (D-Montgomery), who is running for governor, says Maryland is still not doing enough to get as many low-income families and individuals as possible signed up for Medicaid. Given that the federal government is picking up the cost of these new enrollees for the next few years, she said that not maximizing enrollment will only continue to cost the state in uncompensated care. State health officials argue their own strategies are working just fine (Johnson, 3/12).

The Associated Press/Washington Post: Catholic Groups Mounts Challenge To Health Care Law
A group of nearly 200 Catholic employers filed a new lawsuit in Oklahoma against the federal government Wednesday, hoping to stop parts of the federal health care law that force them to provide insurance that covers contraceptives. The recently formed Catholic Benefits Association, which includes archdioceses, an insurance company and a nursing home, takes issue with a compromise in the Affordable Health Care Act offered by the Obama administration that attempted to create a buffer for religiously affiliated hospitals, universities and social service groups that oppose birth control. The law requires insurers or the health plan's outside administrator to pay for birth control coverage and creates a way to reimburse them (3/12).

The Associated Press/Washington Post: House Backs Bill To Sue President Over Laws
The vote was 233-181 in the Republican-led House as GOP lawmakers excoriated Obama for multiple changes to his 4-year-old health care law, steps he's taken to allow young immigrants to remain in the United States and the administration's resistance to defend the federal law banning gay marriage (3/12).

Los Angeles Times: Low Turnout, Not Obamacare, Poses Chief Threat, Democrats Say
Following their loss in Tuesday's special congressional election in Florida, Democratic strategists increasingly are willing to say publicly that the party faces a problem in this year's midterm election – but it's not necessarily the one you'd think of. Not Obamacare, Democrats argue. Republicans may point to the president's healthcare law as the centerpiece of their election strategy, the subject which the vast majority of their television ads in the Florida race talked about, but Democrats deny that's the key (Lauter, 3/12).

The Associated Press/Washington Post: Analysis: Dispute On Obamacare Role In House Race
Republicans have a new calling card for the midterm elections, same as the old one. It's Obamacare all the way to Nov. 4 after the party's triumph Tuesday in the race for a House seat in Florida. Soon it will be time for rank-and-file Democrats in both houses of Congress to decide how closely to stick to the controversial health care program as their own races develop (3/13).

The Washington Post: Democrats Pinning Fla. Special Election Loss On Dismal Turnout Effort
Democrats spent Wednesday trying to explain away a disappointing loss in a Florida special congressional election that they had been expected to win. "The takeaway from the special in Florida is that Democrats will need to invest heavily in a national field program in order to win in November. Nearly 50,000 fewer people voted in the special than in the 2010 general election, a 21% drop off," officials at the Democratic Senatorial Campaign Committee (DSCC) wrote in their daily morning memo (Kane and Sullivan, 3/12).

Politico: $700K Ad Buy Hits Mark Pryor On Obamacare
Americans for Prosperity is launching a major ad buy hitting Sen. Mark Pryor (D-Ark.) on Thursday, pushing the group's advertising investments in the race to more than $1.4 million so far this year. Pryor, who is facing off with Rep. Tom Cotton (R-Ark.) in one of the most hotly contested races of the year, was the subject of a six-figure negative ad buy last month from the outside conservative group. The second batch of ads, shared first with POLITICO, totals about $700,000 and links Pryor to cancelled insurance plans tied to Obamacare (Glueck, 3/13).

The New York Times: Medicare Changes Prompt Enrollees To Reconsider Plans
When Don and Elizabeth Dersch, of Chester, Va., both 68, became eligible for Medicare a few years ago, they carefully weighed the costs of traditional Medicare and Medicare Advantage, the coverage provided by private insurers. They chose Medicare Advantage. Their plan from Anthem covered the doctor visits, treatment, testing and hospital coverage that traditional Medicare covers, and it offered low co-payments, Medicare D prescription drug coverage and a Y.M.C.A. membership (Konrad, 3/12).

The Associated Press/Washington Post: Arizona Gov. Jan Brewer Won't Seek Third Term
She signed the immigration crackdown law known as Senate Bill 1070 in 2010 and sparred with the Obama administration over health care, joining states that sued to overturn his health care law. But she then surprised last year when she embraced a signature part of that law, the expansion of Medicaid (3/12).

The Wall Street Journal: Arizona Gov. Brewer Will Not Seek Third Term
Ms. Brewer's backers also note she battled her own party at times-;pushing for a one-cent sales-tax increase against the wishes of Republicans, and expanding the state's Medicaid rolls. But Ms. Brewer also cut state medical coverage for patients in need of lifesaving organ transplants (Lazo and Audi, 3/12).

Los Angeles Times: Arizona Gov. Jan Brewer Declines To Seek Reelection
She signed into law some of the nation's most restrictive immigration laws, including one that allowed police to check the legal papers of anyone stopped for any reason, and she later engaged in a finger-wagging airport tarmac dispute with President Obama that drew national attention. But Brewer was never a knee-jerk conservative. She angered many in her party by proposing an expansion … under the president's healthcare program -; a move made by few Republican governors but driven, in Brewer's case, by a desire to restore cuts to medical and mental health programs in the state (Decker and Carcamo, 3/12).

Los Angeles Times: Health Clinic Operator To Raise Workers' Pay To $15 An Hour
A nonprofit that operates 10 health centers downtown, in South Los Angeles and in Compton will increase its employees' pay to a minimum of $15 an hour in what it deemed an anti-poverty measure intended to jump-start "living wage" efforts around the region. The wage hike by St. John's Well Child and Family Center, to be announced Thursday, will increase the pay of 137 workers, many of whom now make $11 to $12 an hour (Rainey, 3/12).