First Edition: April 2, 2014

Today's headlines include news and analysis about the 7 million insurance enrollment tally.  

Kaiser Health News: Co-op Health Insurance Plans See Early Success
Reporting for Kaiser Health News, in partnership with NPR, Eric Whitney writes: "The names of the big health insurance companies are familiar – Blue Cross, Aetna, United Healthcare. But what about CoOportunity Health, or Health Republic Insurance of New York? These are among 23 new health insurance companies that started under the Affordable Care Act. They're all nonprofit, member-owned cooperatives, and the aim is to create more competition and drive prices down" (Whitney, 4/2). Read the story.

Kaiser Health News: Obama: 'The Affordable Care Act Is Here To Stay' (Video)
Kaiser Health News posted excerpts from a Tuesday White House Rose Garden by President Barack Obama in which he touted over 7 million sign-ups for health insurance on the health law's marketplaces (4/1). Watch the video. 

Kaiser Health News: Capsules: As Insurance Enrollment Exceeds 7M, Obama Says Health Law 'Here To Stay'
Now on Kaiser Health News' blog, Mary Agnes Carey writes: "The Obama administration took a victory lap Tuesday as enrollment through the health law's exchanges topped 7 million, a goal previously thought untouchable when the website healthcare.gov sputtered and crashed as sign-ups began last fall" (Carey, 4/1). Check out what else is on the blog.

The New York Times: Obama Claims Victory In Push For Insurance
President Obama declared victory Tuesday in the government's aggressive push to enroll seven million people in private health insurance plans under the Affordable Care Act, even as his senior aides braced for an escalated political battle over the law ahead of the fall's crucial midterm elections (Shear and Pear, 4/1).

The Washington Post: More Than 7 Million Have Enrolled Under Affordable Care Act, White House Says
Even after the official cutoff, more than 100,000 people at a time were on HealthCare.gov, the online federal insurance marketplace, into the early morning hours, according to a person familiar with the details of the last-minute surge. People who have started to enroll on the federal exchange, as well as on some state exchanges, have a grace period to finish their applications (Goldstein and Eilperin, 4/1).

The Wall Street Journal: More Than Seven Million Sign Up For Health Coverage, Obama Says
Speaking in the White House Rose Garden, the president offered one of his most forceful defenses of the law in months after a surge in sign-ups Monday pushed enrollment past the seven million mark. That figure generally was viewed as unattainable after technical problems with HealthCare.gov impeded sign-ups for weeks after the Oct. 1 launch (McCain Nelson and Radnofsky, 4/1).

NPR: Debate Over Repealing Health Care Law Is Over, Obama Says
Six months after a disastrous rollout, more than 7 million people had signed up for health insurance on the federal and state exchanges when the deadline passed on Monday (Keith, 4/2).

Los Angeles Times: Obamacare Passes First Big Test
The Affordable Care Act has passed its first big test, but the law's distribution of winners and losers all but guarantees the achievement will not quiet its political opposition. White House officials, who had a near-death experience with the law's rollout six months ago, were nearly giddy Tuesday as they celebrated an open-enrollment season that ended on a high note (Lauter and Parsons, 4/1).

The Washington Post's The Fact Checker: Obamacare Enrollment Numbers: What We Know And What We Don't Know
With the enrollment period ended on March 31, it's time to do the numbers. What do we actually know about Obamacare enrollment numbers -; and what is missing? (Kessler, 4/2).

The Wall Street Journal: 5 Questions About Obamacare's 7 Million Enrollees
What does the 7 million mark mean for the health law? It tells us the final days of enrollment attracted a surge of consumers and that the sometimes-panicked rush by the Obama administration to fix HealthCare.gov after a disastrous launch largely paid off. What the politically crucial milestone doesn't reveal, however, is much about whether the law will work. For instance, we still don't know whether the new marketplaces will make much of a dent in the number of uninsured people, or if the business will prove sustainable for insurers (Weaver, 4/1).

Politico: Enrollment Caveats Will Keep ACA Counting
For Obamacare enrollment, it's not over even when it's over.
With special enrollment, extra special enrollment, slightly extended state enrollment and very extended state enrollment, the sign-up tally will keep climbing beyond the 7.1 million people President Barack Obama announced Tuesday (Kenen, 4/1).

Politico: Behind The Obamacare Surprise
The administration overcame a disastrous start to actually hit 7 million enrollees. They lost two months -; and all the political capital they won from the government shutdown -; to a broken website that seemed to prove every one of their critics' complaints, and fed the most negative coverage and worst polls President Barack Obama's ever gotten. They've done nothing to settle the political objections, and know May 1 is going to be a whole new kind of trouble trying to educate the newly insured on how to use the plans they've now got. But Tuesday, in private meetings in the Oval Office and his triumphant speech in the Rose Garden, there was no missing the bounce in the president's step (Dovere and Budoff Brown, 4/2). 

NPR: Beyond The Fog Of Spin And Doubt: What Has ACA Achieved?
The Affordable Care Act has made it possible for millions of Americans to obtain health insurance -; but how successful has the law been in reforming the health care system? (Ydstie, 4/1).

Politico: Obamacare Critics: Hubida, Hubida, Hubida
On Tuesday, Obamacare sign-ups passed 7 million, six months after the launch of a federal website that could barely sign up anybody. There are still a lot of questions about how solid that figure is, but the idea that the law could even come close to the original goal after such a disastrous start would have been laughable even a few weeks ago. It was also a wake-up call for Republicans and conservatives, and even the occasional liberal, who pushed the argument that the failed website challenges the idea at the heart of Obama's agenda -; that government can still solve big social problems (Nather, 4/2). 

Politico Vulnerable Dems Still Wary Of Obamacare
After 7 million people signed up for Obamacare, an unexpectedly sunny end to a dreary enrollment process, Democrats outlined plans Tuesday to step up attacks on Republicans for wanting to repeal the health care law. But while Obama administration officials popped champagne to celebrate the enrollment figure, Democrats on the ballot this year continue to tread cautiously (Hohmann, 4/1).

The New York Times: Newly Enrolled, But Not Counted By Insurance Exchange
Millions of newly insured people are hiding in plain sight. They are the people who have bought new health insurance since the start of this year but have chosen for one reason or another to bypass the state and federal exchanges that opened last year under the Affordable Care Act. While the exact number is unknown, some health care experts estimate that it may be in the millions (Thomas, 4/1).

Los Angeles Times: For Faulty State Exchanges, Big Decisions Loom About Healthcare Law
Although the Obama administration appears to have surpassed its goal of enrolling more than 7 million people in the new healthcare program this year, some of the states that have struggled with technology problems are headed into an intensive new phase of fixes as they try to shepherd final enrollees through the process (Reston, 4/1).

Los Angeles Times: Maryland To Overhaul Healthcare Exchange With Help From Connecticut
The board of the Maryland Health Benefit Exchange voted Tuesday night to overhaul its troubled healthcare website by adopting the smooth-running technology platform developed by Connecticut. Maryland has spent about $125.5 million operating and building its exchange, but in late February the state severed its $193-million contract with prime technology contractor Noridian Healthcare Solutions after struggling with technical problems that led to thousands of lost and stuck applications, as well as long wait times for frustrated consumers (Reston, 4/1).

The Washington Post: Board Of Md. Health-Insurance Exchange Votes to Hire Deloitte To Overhaul It
The board of Maryland's health-insurance exchange voted Tuesday to hire Deloitte Consulting to replace most of the state's troubled online marketplace with technology that has successfully worked in Connecticut. The change is expected to cost between $40 million and $50 million to implement, plus some hardware and software costs, according to Isabel FitzGerald, Maryland's secretary of information technology. Fitzgerald told board members that Maryland would adopt Connecticut's system, which has run as smoothly as any in the country, largely as is, with little retrofitting (Johnson and Wagner, 4/1).

The Wall Street Journal: Maryland To Scrap Health Insurance Website
The state, under Gov. Martin O'Malley, a Democrat who quickly moved to implement the Affordable Care Act, was expected to be a leader among the 14 states running their own health insurance exchanges. Instead, Maryland's health connection website crashed soon after it launched Oct. 1 and was plagued with problems for months, crippling the ability of people to sign up for coverage (Corbett Dooren, 4/1).

The Associated Press: Md. Moves To Revamp Flawed Health Exchange
Maryland has had one of the worst exchange websites of the 14 states that developed their own: The state's health exchange website crashed shortly after it opened Oct. 1 (4/1).

The Associated Press: It's Not Too Late To Get Health Coverage
It's not too late to get covered. A few routes remain open for those who missed the health care law's big enrollment deadline. Millions may be eligible for a second chance to sign up for subsidized insurance this year. And people who get coverage after the deadline can still avoid, or at least reduce, the fine for going uninsured (4/2).

The Washington Post: Hundreds Cram Into Va. Senate Hearing ON Medicaid Expansion Through State Budget
Virginia's on-again, off-again special session got rolling again Tuesday, as hundreds of lobbyists and activists on opposite sides of the state's Medicaid battle crammed into a Senate hearing on whether to expand the program through the state budget. The hearing was the first sign of life from the Senate since last week, when the chamber went home one day into the special budget session, leaving the House and its two-year, $96 billion spending plan hanging (Vozzella, 4/1).

The Washington Post: Bobby Jindal, With An Eye On 2016, To Unveil Plan To Replace Obama Health-Care Law
Louisiana Gov. Bobby Jindal will announce Wednesday a plan to repeal and replace President Obama's health-care law, an effort by the Republican to insert himself into the increasingly competitive early maneuvering for his party's presidential nomination. Jindal, a former state and federal health official, said his plan is one of many policy proposals he will release in coming months, making clear that he wants to be seen as a policy-driven problem solver (Costa and Goldstein, 4/2).

The New York Times: Ryan's Budget Would Cut $5 Trillion In Spending Over A Decade
Mr. Ryan, the House Budget Committee chairman and a possible White House contender in 2016, laid out a budget plan that cuts $5 trillion in spending over the next decade. He said it would bring federal spending and taxes into balance by 2024, through steep cuts to Medicaid and food stamps, and the total repeal of the Affordable Care Act just as millions are reaping the benefits of the law (Weisman, 4/1). 

Los Angeles Times: House GOP Revives Paul Ryan's Austere Budget, Medicare Cuts
The blueprint from Ryan, the party's former vice presidential nominee, is expected to be met with stiff opposition not only from Democrats, but also from hard-line Republicans who want deeper austerity cuts to more quickly balance the budget (Mascaro, 4/1).

The Washington Post: Paul Ryan's Final Budget Plan Would Slash $5 Trillion In Next Decade
The 99-page plan is Ryan's last manifesto on government austerity as head of the Budget Committee. He has emerged as the GOP's leading light on fiscal policy in recent years, but he is term-limited as head of the budget panel and vying to become chairman of the tax-writing Ways and Means Committee next year while considering a 2016 presidential bid (O'Keefe, 4/1).

Politico: Paul Ryan's Budget Makes Big Medicare Changes
It's Paul Ryan's wish list. The House GOP 2015 budget, penned by the Wisconsin Republican, will seek to shave federal spending by $5 trillion by offering changes to social welfare programs, ending government ownership of Fannie Mae and Freddie Mac and repealing Obamacare (French, 4/2).

The Wall Street Journal: Ryan Sees Budget Balancing 
House Budget Committee Chairman Paul Ryan released an election-year budget blueprint Tuesday designed to unify Republicans behind an effort to balance the federal budget in 10 years, exposing the party to Democratic attacks over its proposed cuts to Medicare and other safety-net programs (Peterson and Paletta, 4/1).

Los Angeles Times: Paul Ryan Budget Cuts Deeply – But Will It Balance As Promised? 
Ryan, the House Budget Committee chairman, relies on a combination of previously approved Obamacare savings and tax hikes, along with a new way of measuring economic growth, to reach the 10-year goal of ridding the budget of red ink. That approach does not sit well with hard-line budget hawks, and could make Ryan's job even more difficult as the House prepares to vote on the budget next week (Parsons, 4/1).

The Associated Press: House GOP Plan Seeks Health Cuts To Balance Budget
Ryan promises to balance the government's books with wide-ranging cuts to programs such as food stamps and government-paid health care for the poor and working class. It's a nonstarter with Obama but polishes the GOP's supply-side brand heading into midterm elections likely to be determined by the core voters of either party (4/2).

The Associated Press: Obama Signs Bill Temporarily Fixing Medicare Fees
The $21 billion bill would stave off a 24 percent cut in Medicare reimbursements to doctors for a year and extend dozens of other expiring health care provisions, such as higher payment rates for rural hospitals. The legislation is paid for by cuts to health care providers, but fully half of the cuts won't kick in for 10 years (4/1).

Los Angeles Times: Healthcare Advocates Push For Medical Services For Uninsured
Healthcare advocates Tuesday urged the Los Angeles County Board of Supervisors to set aside at least $11 million in additional funding for free medical services for low-income residents -; including immigrants lacking legal status -; who remain uninsured under Obamacare (Brown, 4/1). 

Los Angeles Times: Abortion Restrictions Take Effect In Arizona After Judge's Ruling
Restrictions on some types of abortions in Arizona went into effect Tuesday morning after a federal judge upheld state changes limiting a woman's access to an abortion-inducing drug. U.S. District Judge David Bury issued an order Monday afternoon rejecting a bid to block the new abortion restrictions while the state's 2012 law is litigated. The law allowed the state to issue new rules banning the use of the most common abortion–inducing drug, RU-486, after the seventh week of pregnancy, compared with the current restriction of nine weeks (Muskal, 4/1).

The Associated Press: Court: Hawaii Not Required To Pay For Migrant Care
Hawaii isn't required to fund Medicaid for migrants from three Pacific Island nations in Micronesia to make up for a reduction in federal funding, a federal appeals court ruled Tuesday. The 9th U.S. Circuit Court of Appeals said in a ruling filed Tuesday that Hawaii has no constitutional obligation to fill a gap left in 1996 when Congress cut health care funding for migrants under the Compact of Free Association (4/2).