First Edition: April 4, 2014

Today's headlines include reports about a Capitol Hill hearing in which state exchange officials discussed the difficulties they faced with the operation of their online insurance marketplaces.   

Kaiser Health News: Health On The Hill: State Exchange Executives Face Tough Questions From House Subcommittee
Kaiser Health News staff writer Mary Agnes Carey and CQ Roll Call's Emily Ethridge discuss what we've learned about why some states did better than others with their health exchange rollouts (4/3). Listen to the audio or read the transcript.

Kaiser Health News: A Reader Asks: Does My Swedish Health Plan Meet ACA Requirements?
Kaiser Health News consumer columnist Michelle Andrews answers this reader's question (4/4). Read her response.

The Associated Press: Health Insurance Isn't A Year-Round Thing Anymore
Here's more fallout from the health care law: Until now, customers could walk into an insurance office or go online to buy standard health care coverage any time of year. Not anymore. Many people who didn't sign up during the government's open enrollment period that ended Monday will soon find it difficult or impossible to get insured this year, even if they go directly to a private company and money is no object. For some it's already too late (4/4).

Politico: April 15 Mixes Tax, Obamacare Deadlines
April 15 will be the last day for most people to enroll in Obamacare exchanges for health coverage during 2014. Although the official deadline was midnight Monday, the Obama administration had offered anyone who started an application by then the chance to continue enrolling -; but not until Thursday did it give a hard deadline for this grace period (Cheney, 4/3).

The New York Times: State Officials Cite Technology Problems On Health Insurance Sites
Officials from five states, on the defensive at a congressional hearing, said Thursday that their health insurance exchanges had been hobbled by technology problems like those that bedeviled the federal marketplace. But they said their states were recovering. The states -; Hawaii, Maryland, Massachusetts, Minnesota and Oregon -; all have Democratic governors who support the Affordable Care Act. They built their own exchanges with millions of dollars of federal money, but many residents in all five states were frustrated as they tried to enroll online last fall (Pear, 4/3).

Los Angeles Times: Leaders Of Troubled State Exchanges Say They Won't Need U.S. Bailouts
Pressed by Republican House members, directors of troubled state insurance exchanges said Thursday that they could fix continuing Obamacare glitches with grant money they have already received and would not ask for federal bailouts. Members of the House Government & Oversight Reform committee sought to turn their attention to the technical glitches after a week of celebration for the White House, which surpassed its goal of signing up more than 7 million under the new healthcare law. Witnesses called to Capitol Hill included the current and interim heads of the exchanges in Hawaii, Maryland, Massachusetts, Minnesota and Oregon -; which have all had varying degrees of problems (Reston, 4/3).

The Wall Street Journal: States Grapple With Fixing Problem-Plagued Health Exchanges
Deep problems with state-run health-insurance exchanges are prompting a handful of states to rethink their systems for next year's enrollment period. Lawmakers are concerned that the most troubled state marketplaces are burning through money faster than expected and could struggle after federal funds are cut off in 2015. Fourteen states and Washington, D.C., are running their own insurance exchanges, largely using federal funds tied to the Affordable Care Act (Corbett Dooren, 4/3).

Los Angeles Times: Latino Healthcare Sign-Ups Soar In California
Enrollment by Latinos in California's healthcare insurance exchange surged in the final month of sign-ups after an intensive push to reach that key population. "Our enrollment became more diverse in this last month, particularly among California's Latino population; our enrollment became younger," Covered California Executive Director Peter Lee said during a conference call with reporters Thursday after testifying with the heads of other state exchanges on Capitol Hill (Reston, 4/3).

The Washington Post: Md. Health Official: Exchange Debacle Included 'Decisions We Wish We Could Make Again'
As Maryland's top health official testified before a congressional committee and addressed a panel of state lawmakers on Thursday, he kept facing questions about how much the state spent on its troubled health insurance marketplace -; and how much more it will have to spend to replace that system. Joshua M. Sharfstein, Maryland's secretary of health and mental hygiene, did not always have firm answers to those questions (Johnson, 4/3).

The Associated Press: Md. Audit Released On Health Exchange Problems
Maryland auditors who examined the state's badly flawed health exchange website were given redacted documents to review and produced a report that is limited and provides an incomplete understanding of the development of the site, the state's legislative auditor wrote. Thomas Barnickel, the state's legislative auditor, wrote that about 26 percent of the documents were redacted. Procurement documents were "heavily redacted," he wrote in a letter accompanying the report (4/3).

The Washington Post's Wonkblog: Why Would A Person Sign Up For Obamacare But Not Pay The Premium?
By now, you've probably heard that 7.1 million people have signed up for coverage in Obamacare's health insurance marketplaces. That doesn't tell us the actual enrollment number, though, because people need to pay their premium to officially get coverage. There are a few numbers out there about how many have actually paid their premium. It's generally either 80 percent, 85 percent or 90 percent of those signing up (Millman, 4/3).

The Washington Post's The Fact Checker: CBO's Obamacare Estimate: It's More Complicated Than You Think
With all of the hoopla this week about the administration achieving 7 million sign-ups for the Affordable Care Act insurance exchanges, we wanted to offer a technical note about the source of that goal -; the estimate by the nonpartisan Congressional Budget Office that 7 million people would be enrolled in the exchanges. After healthcare.gov's troubled start, CBO then reduced the estimate to 6 million (Kessler, 4/4).

The Wall Street Journal's Washington Wire: Carney Dismisses Gibbs's Prediction Employer Mandate Will Die
President Barack Obama's former chief spokesman predicted that the employer mandate of the Affordable Care Act won't go into effect. The president's current chief spokesman, Jay Carney, said it will. The employer mandate, Mr. Carney said in his daily briefing with reporters, "will be phased in starting next year" (Favole, 4/3).

The Associated Press: House GOP Moves Against Health Care Law
House Republicans renewed their election-year assault on President Barack Obama's health care law Thursday, their opposition undimmed just days after Obama celebrated news that more than 7 million Americans had signed up for coverage under the law. The GOP-led chamber voted 248-179 to change the law's definition of full-time work from 30 hours a week to 40 hours a week. The result would be that fewer workers would get employer-sponsored health coverage and hundreds of thousands more people would be uninsured, according to the Congressional Budget Office (4/3).

The Washington Post: House Votes To Change Health-Care Law's Definition Of Full-Time Work
Eighteen House Democrats voted with Republicans Thursday to change the definition of full-time work as it relates to the Affordable Care Act, signaling that for some members of President Obama's party the law remains a difficult political issue. The bill approved Thursday would change the law's definition of full-time work from 30 hours a week back to 40 hours, a move that Republicans say is necessary as employers continue limiting the hours of part-time workers in anticipation of the law's employer insurance requirement (O'Keefe, 4/3).

The Wall Street Journal: Health-Law Tweak Redefining Full-Time Worker Gains Bipartisan Traction
An effort to change the 2010 health-care law's definition of a full-time worker to ease its requirements on businesses has gained bipartisan support on Capitol Hill, as the Republican House on Thursday passed a bill to make the change with the help of 18 Democrats. The idea has popped up in several places in recent days. In the Senate, a similar measure has attracted two Democratic co-sponsors and has been floated as part of a potentially bipartisan package to raise the minimum wage. Republicans are pushing the issue hard, and sought to attach it as an amendment to unemployment-insurance legislation on Thursday (Peterson, 4/3).

The Washington Post's The Fact Checker: 'Billions' Spent On Attacking Obamacare
A reader asked us about this comment during the president's victory lap on the Affordable Care Act. Were there really "billions" of dollars' worth of commercials opposing the law? Our initial reaction was that this was just a bit of presidential hyperbole. On the other hand, the president did make this assertion in a major speech. So let's see what the data say (Kessler, 4/4).

The Wall Street Journal: Young Workers Fail To Flock To Employer Health Plans
Young workers in the U.S. signed up for employer-sponsored health plans at a lower rate than last year, a surprising result that helped keep overall workplace enrollment rates flat. Companies had been bracing for a big bump in the number of workers signing up for workplace plans because of the new government mandate that most American adults buy health insurance or pay a penalty. But new data on worker behavior for the 2014 coverage year from payroll-services company Automatic Data Processing Inc. suggest that surge of enrollment never happened, at least broadly across large companies (Francis and Banjo, 4/3).