First Edition: September 27, 2013

Today's headlines include the latest updates on the congressional brinksmanship related to current budget battles and efforts to defund the health law, as well as reports about President Barack Obama's campaign-style speech about the law and details on another implementation delay.

Kaiser Health News: Lessons From The Obamacare Data Dump
Kaiser Health News staff writer Jay Hancock reports: "This week the Department of Health and Human Services released a ton of information about how insurance sold in 36 states under the Affordable Care Act will work. Most of it came in the form of data showing the number of carriers and their premium prices in hundreds of regions. Until now we've seen information on subsidized policies to be sold through online marketplaces released in trickles by states that are creating their own online portals" (Hancock, 9/27). Read the story.

Kaiser Health News: Obamacare In Middle Of Countdown To Possible Shutdown On Capitol Hill
Kaiser Health News staff writer Mary Agnes Carey and Politico Pro's Jennifer Haberkorn discuss how the standoff is likely to be resolved. The Affordable Care Act lies at the center of a last minute push to fund the government past Sept. 30 (9/26) Listen to the audio or read the transcript.

Kaiser Health News: Houston Embraces Obamacare Outreach, Despite Cruz And Perry
KUHF's Carrie Feibel, working in partnership with Kaiser Health News and NPR, reports: "Two high-profile Texans are fighting the Affordable Care Act. Governor Rick Perry has loudly dismissed the law, and Republican Sen. Ted Cruz took to the Senate floor this week to rail against it at length-;21 hours and 19 minutes to be exact. On the other side you have Rosy Mota and her clipboard, standing at the door of a CVS pharmacy in one of Houston's Latino neighborhoods, stopping shoppers. … Mota works for Enroll America, a national organization that has borrowed its tactics from the Obama re-election campaign. Using data-mining and digital maps, the group is figuring out where the uninsured in Houston live, down to the block and house level" (Feibel, 9/27). Read the story.

Kaiser Health News: A Reader Asks: What Happens To My Coverage If I Move?
Kaiser Health News consumer columnist Michelle Andrews answers the reader's question about coverage through the health exchanges after a move (Andrews, 9/27). Read the answer.

Kaiser Health News: South Florida Insurance Rates Will Be Among Lowest In State, Report Says
The Miami Herald's Evan S. Benn and Patricia Borns, working in partnership with Kaiser Health News, reports: "Miami-Dade and Broward County residents who buy health insurance through federally run online marketplaces opening Tuesday will be paying some of the cheapest rates available in Florida, according to federal data released Wednesday" (9/26). Read the story.

Kaiser Health News: Capsules: Online Obamacare Enrollment In Spanish Delayed
Now on Kaiser Health News' blog, Jenny Gold writes: "The Spanish-language version of healthcare.gov will not be equipped to handle online enrollments on Oct 1., according to an Obama administration official. Instead, Spanish speakers will have to wait until Oct. 21 to sign up online" (Gold, 9/26). Check out what else is new on the blog.

The New York Times: Obama Scorns G.O.P. 'Blackmail' On Health Law
President Obama mounted a passionate, campaign-style defense of his health care program on Thursday, just days before its main elements take effect, mocking opponents for "crazy" arguments and accusing them of trying to "blackmail a president" to stop the law (Baker, 9/26).

The Washington Post: Obama's Line In The Sand Is On The Debt Ceiling
On Thursday, Obama categorically rejected the Republican demand that he roll back the Affordable Care Act in order to keep the government open and also refused to entertain negotiations on raising the debt ceiling. Both positions, a centerpiece of his strategy this fall, are striking for a president who has made his willingness to meet the opposition "more than halfway" a defining characteristic of his political persona. Obama gave in on a key feature of his health-care plan in 2010 -; a public insurance option -; and engaged in a lengthy negotiation over the debt ceiling in 2011. But in his remarks Thursday, Obama said Republicans were trying "to blackmail" him over the health-care law and pledged that he would have none of it (Goldfarb, 9/26).

Los Angeles Times: Obama: Healthcare As Easy As Online Shopping
President Obama says his Affordable Care Act is about to make health insurance cheaper than the average cellphone bill and as easy to get as "a plane ticket on Kayak." In a pitch to community college students in suburban Maryland on Thursday morning, Obama compared the soon-to-launch healthcare "marketplaces" to Internet travel websites that let users compare prices and details with a few keystrokes (Parsons and Hennessey, 9/26).

The Washington Post: Obama Defends Health-Care Law, Calling Health Insurance 'A Right'
President Obama offered a ringing defense of his signature health-care law Thursday amid what he called increasingly "irresponsible" Republican tactics to undermine it, ruling out changes as long as he is in office. Traveling to Prince George's Community College just outside the Capital Beltway, Obama made a moral argument, as well as an economic one, for legislation that will help define his domestic record for history. He said health insurance is now a "right" in the United States, not a benefit available only to those who can afford it (Wilson and Wiggins, 9/26).

The Associated Press/Washington Post: Obama Ridicules 'Crazy' Republican Doomsday Predictions Of Health Care Law, Pitches Enrollment
With just five days to go before Americans can begin signing up for health care under his signature law, President Barack Obama on Thursday ridiculed Republican opponents for "crazy" doomsday predictions of the impact and forecast that even those who didn't vote for him are going to enroll. With polls showing many Americans still skeptical of the law known as "Obamacare," the president went back to the basics of explaining how nearly 50 million uninsured Americans will be able to buy coverage in new government-run exchanges while mocking Republicans for trying to block its implementation. "The closer we get, the more desperate they get," Obama argued (9/26).

Los Angeles Times: Healthcare Law: White House Shifts From Selling To Explaining
In the years since the Affordable Care Act became law, the measure known as Obamacare has been debated, excoriated, legally challenged, upheld and then debated some more. Now, with its centerpiece element opening for business in five days, the White House is focusing on a task that many critics of the administration say is long overdue: explaining it. Explaining was Priority No. 1 for the Obama administration during much of the week, with everyone from the commander in chief to the rank-and-file press staff setting out details for reporters (Parsons and Hennessey, 9/26).

The Wall Street Journal: Health Law Puts Obama Legacy On The Line
With the enrollment date approaching and support for the health law lagging in the polls, the administration is starting a sustained effort to make the case for its benefits, deploying the president, first lady, vice president, cabinet officials and an array of celebrities. On Thursday, Mr. Obama delivered an emphatic defense of the law, delving into the details of insurance exchanges and accusing Republicans in Congress of trying to "blackmail" him with threats of default or shutting down the government (McCain Nelson, 9/26).

The New York Times: Uninsured Americans Divided On Impact Of Health Care Law
Less than a week before the health insurance marketplaces established by the 2010 health care law begin accepting customers, a New York Times/CBS News poll has found that there is some support among uninsured Americans for President Obama and his law, but also a wariness and a lack of understanding about what the law will mean for them (Kopicki, 9/26).

USA Today: Colorado: Microcosm Of Confusion On Health Law
In Colorado and across the country, the insurance marketplaces known as exchanges are scheduled to open Tuesday, and the success or failure of Obama's signature legislative achievement is at stake. Passing the health care overhaul defined much of his first term in the White House, and defending it from Republican assault has defined much of his second -; including in the current budget showdown (Page, 9/27).

The New York Times: Senate Is Expected To Approve Budget Bill
The Senate will conclude one of its more unpredictable -; and stranger -; weeks on Friday when it is expected to approve a bill to finance the federal government, including the health care law that Republicans have been trying to kill (Peters, 9/27).

Politico: Dems: No Obamacare Concessions
There will be no concessions from the Senate on Obamacare to avoid a government shutdown, Democratic leaders said Thursday afternoon. The Democratic leadership team said time and again Thursday that they will only accept a clean continuing resolution, which is precisely what the Senate is set to send back to the House by Saturday. Senate Majority Leader Harry Reid (D-Nev.) will strip out Obamacare defunding language passed by the House last week and send the bill back to the House no later than Saturday, though senators are seeking to move even more quickly but have yet to break through on an expedited time agreement (Everett, 9/26).

The New York Times: Republicans Facing A Test Of Unity
As the Congressional showdown over President Obama's health care law threatens to shut down the government, conservative advocacy groups have emerged as central players -; exerting outsize influence, investing tremendous time and resources, and turning the long-shot budget fight into a do-or-die battle that has pitted Republicans against one another (Parker, 9/26).

Los Angeles Times: As GOP Infighting Persists, Threat Of Government Shutdown Heightens
Options for keeping the federal government open narrowed Thursday as some of the most conservative Republicans in the House rebuffed proposals from Speaker John A. Boehner, who had aimed to break a stalemate over the federal budget. The opposition from conservatives to any measures that fall short of their goals of cutting federal spending or dismantling President Obama's healthcare law left the Ohio Republican with little room to maneuver as a Monday night deadline approached for providing money to keep federal agencies running (Mascaro and Memoli, 9/26).

The Washington Post: Republican Hard-Liners Block Strategy To Avoid Federal Government Shutdown
Boehner (R-Ohio) and his leadership team revealed the first step of that plan to rank-and-file lawmakers early Thursday, urging conservatives to shift their ¬assault on President Obama's health-care law to the coming fight over the federal debt limit. That would allow lawmakers in the meantime to try to reach an agreement on a plan to fund federal agencies into the new fiscal year, which begins Tuesday, and avoid a shutdown. But about two dozen hard-liners rejected that approach, saying they will not talk about the debt limit until the battle over government funding is resolved (Montgomery and Kane, 9/26).

The Washington Post: Shutdown Grows More Likely As House Digs In
Using Senate rules permitting him to change the wording of a spending measure approved by the House last week, Majority Leader Harry M. Reid (D-Nev.) is expected to strip out language that would defund the law, change the expiration date on the funding bill to Nov. 15, and pass the measure with a simple majority achieved entirely with Democratic votes. Once the bill returns to the House, any move to change it would by necessity mean that the fight over funding the government would almost certainly continue at least until the final minutes of the fiscal year late on Monday night since the Senate's arcane, time-sensitive rules would make swift consideration unlikely (O'Keefe, Helderman and Montgomery, 9/26).

The Wall Street Journal: No Clear Path To Avoid Shutdown As House GOP Stands Firm
The Senate is expected to pass a bill Friday that would fund the government for the first 1½ months of the new fiscal year. But Senate Democrats plan to restore money for the Affordable Care Act that House Republicans had stripped out, leaving the two chambers in conflict (Hook and Peterson, 9/26).

The New York Times: House G.O.P. Raises Stakes In Debt-Ceiling Fight
Trying to round up votes from a reluctant rank and file, House Republicans said they would agree to increase the debt limit to avert a mid-October default only if Democrats accepted a list of Republican priorities, including a one-year delay of the health care law, a tax overhaul and a broad rollback of environmental regulations (Weisman, 9/26).

The Wall Street Journal: Tweaks To Health Law Attract Some Democrats
Sen. Mary Landrieu, facing the prospect of a tough race next year, is squarely behind the Affordable Care Act-;up to a point. "It needs to be fixed, not repealed," she said. Democrats overwhelmingly oppose Republican efforts to defund or delay the law, which the GOP wants to attach to must-pass fiscal measures. At the same time, many are eager to find ways to improve it, opening a small chink in a unified Democratic position that will be tested in coming days (O'Connor and Peterson, 9/26).

Politico: Manchin OK With Obamacare Individual Mandate Delay
West Virginia Democratic Sen. Joe Manchin said Thursday he would vote for a government funding bill that delays Obamacare's individual mandate for a year if it came up in the Senate, later backtracking and clarifying he doesn't believe Obamacare should be part of the government funding showdown (Kopan, 9/26).

Politico: House GOP Banking On Plan C
At this point, it's difficult to conclusively determine where all the House GOP's maneuvering and false starts will end. In one sense, the developments might help Congress avoid a government shutdown. Most House Republicans now seem to recognize that they will likely have to swallow a funding resolution that leaves Obamacare intact. Yet, the ups-and-downs also dramatically increase the stakes in the debt-ceiling fight. The borrowing cap must be raised by Oct. 17, or the nation will default on its debts (Sherman and Bresnahan, 9/26).

The New York Times: Enrollment To Be Delayed For Small-Business Marketplaces
The Obama administration on Thursday announced another minor delay in the implementation of the Affordable Care Act, saying that the insurance marketplaces for small businesses would be fully open for enrollment a month later than it had planned. White House officials played down the development, putting it at the end of a news release announcing that the Department of Health and Human Services was "launching the Small Business Health Option Program Marketplace" (Shear, 9/26).

Los Angeles Times: Glitch Delays Online Tools For U.S. Health Insurance Marketplaces
California is unaffected by the delay. But small businesses in some states that want to sign up their employees for health coverage on new federally run marketplaces created by the Affordable Care Act will have to use paper forms until November, according to administration officials (Levey, 9/26).

The Associated Press/Washington Post: Deadline Glitches: Health Overhaul Online Sign-Up Delayed For Small Firms And Spanish Speakers
Administration officials are quietly telling key interest groups to expect initial glitches signing up online for coverage under President Barack Obama's health care overhaul. Two sources tell The Associated Press that small businesses will not be able to enroll online starting Oct. 1 when new health insurance markets go live. Instead, one of the sources, a person who was briefed on the situation, said business owners will initially have to mail or fax their information so that they can enroll (9/26).

The Washington Post: Obamacare Suffers Another Delay, Pushing Back Exchange Enrollment For Small Firms
On the federal exchange, which is scheduled to launch on Tuesday, small business owners will not be able to purchase coverage online until Nov. 1. Instead, for the first month, they will have to mail or fax their information to government officials to enroll on the federal exchange, which will serve individuals and business owners in the 34 states that elected not to set up their own exchanges. Plans purchased through the small-business exchange will still take effect Jan. 1, as planned, HHS spokeswoman Joanne Peters told The Washington Post (Harrison, 9/26).

The Wall Street Journal: Online Health Exchanges For Small Businesses Hit Snag
The Obama administration acknowledged for the first time Thursday that a technological problem is forcing it to delay part of the rollout of the new health-care law, saying insurance exchanges won't be ready to accept online applications from small businesses when the program launches Tuesday. With less than five days left to debug the sprawling new computer system, there are other signs of trouble: People close to the situation are also skeptical the online marketplaces for individual customers will be fully ready. The administration said it was confident they would open on time (Radnofsky, Weaver and Needleman, 9/26).

Politico: Another Obamacare Delay
The one-month delay is not a major blow to the health care law -; the exchanges for individuals are still expected to open on time. But it's yet another PR headache for the White House as it ramps up a major Obamacare sales pitch just five days before open enrollment is scheduled to begin (Millman and Haberkorn, 9/26).

The New York Times: As Some Companies Turn To Health Exchanges, G.E. Seeks A New Path
Although the new federal health care law is designed to help people buying individual policies, even people with employer-provided policies are beginning to see changes in their coverage as companies rethink health care for their workers, discontinuing it in a few cases and redesigning it in many others (Abelson, 9/26).

The Wall Street Journal: Hospitals Give Health Law Real-World Test
In an ACO, hospitals or groups of doctors contract with insurers to provide care for an assigned patient population. The aim: better care at lower cost. ACOs have incentives to keep patients healthy and incurring lower costs because they get to share the savings. Commercial insurers have created more than 200 ACOs with health-care systems in recent years. Now, the Affordable Care Act is giving the concept a government-funded test by authorizing Medicare to set up pilot ACOs. More than 250 health systems have signed on since 2011, creating ACOs covering more than four million Medicare beneficiaries (Beck, 9/26).

The Washington Post: Ken Cuccinelli Launches First Campaign Ad To Focus On Obama Health-Reform Law
With portions of the Affordable Care Act set to kick in next week, Attorney General Ken Cuccinelli II's campaign for Virginia governor is airing its first ad explicitly aimed at the health-reform measure. The ad, titled "Obamacare," focuses on Cuccinelli's (R) long-standing opposition to President Obama's signature legislation while blaming foe Terry McAuliffe (D) for the measure's perceived faults  (Pershing, 9/26).

The Wall Street Journal's Washington Wire: Michigan GOP Governor To Washington: Work It Out
Michigan Gov. Rick Snyder may be a Republican, but he blames both sides for the bitter partisan fight underway in Washington over federal spending and borrowing, and the shape of the president's health-care overhaul. "I hold all sides equally accountable. I see no value in 'Who did what to whom?" he said in an interview after a speech at the conservative American Enterprise Institute (King, 9/26).

The Associated Press/Wall Street Journal: NY Officials Say Insurers To Repay Seniors $2.2 M
New York regulators say four insurers will pay $2.2 million in restitution to 3,475 seniors across the state because of overcharges on their policies. The Department of Financial Services says the refunds are for Medicare supplemental insurance and average $624 per policyholder. Distribution will begin on Sept. 30 (9/27).