First Edition: November 6, 2013

Today's headlines include reports detailing the contents of the health law's "war room" notes as well as scene-setters for today's Senate hearing testimony about healthcare.gov by Health and Human Services Secretary Kathleen Sebelius. 

Kaiser Health News: Labor Unions May Get Health Law Tax Relief
Kaiser Health News staff writer Jay Hancock reports: "Weeks after denying labor's request to give union members access to health-law subsidies, the Obama administration is signaling it intends to exempt some union plans from one of the law's substantial taxes. Buried in rules issued last week is the disclosure that the administration will propose exempting 'certain self-insured, self-administered plans' from the law's temporary reinsurance fee in 2015 and 2016" (Hancock, 11/6). Read the story.

Kaiser Health News: Capsules: Obama Administration Hoping 800K Enroll By End Of November
Now on Kaiser Health News' blog, Phil Galewitz reports: "About 800,000 people are expected to enroll in the new online health insurance marketplaces by the end of November, Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner said Tuesday at a congressional hearing. A CMS official said later that estimate includes people signing up for Medicaid as well as private insurance" (Galewitz, 11/5). Check out what else is on the blog.

The Wall Street Journal: Obama Recalibrates 'Keep Your Insurance' Pledge
President Barack Obama has continued to recalibrate his promise that "you'll be able to keep your health-care plan" under the Affordable Care Act, adding new language to those oft-repeated words and arguing that those who are losing their insurance will end up with better coverage. The altered phrasing comes amid criticism that Mr. Obama didn't properly characterize the law since thousands of Americans are receiving notices that their health insurance has been canceled. The administration has worked to explain how events on the ground match Mr. Obama's assurances that the new federal law wouldn't force people out of their health plans (Nelson and Nicholas, 11/5).

Los Angeles Times: Obama Adjusts Pitch For Healthcare Law
While a team of techies tries to reboot the broken federal insurance website, President Obama is trying to retool efforts to promote the flailing healthcare law. The flawed launch of the new online marketplaces has forced Obama to spend time defending the insurance exchanges rather than selling them to a skeptical public, as he had planned. More than a month into the rollout, he has few bright spots to highlight and one big gaping hole to avoid: The website he planned to sell with the zeal of a late-night infomercial pitchman does not work properly (Hennessey and Mascaro, 11/6).

The Associated Press/Washington Post: Obama To Pitch Health Care Law In Texas, Drawing Attention To High Rate Of Uninsured
Beset by hard-to-keep promises and a massive website failure, President Barack Obama is promoting his embattled health care law in the state with the highest rate of uninsured Americans in the nation, but also the state that has been among the most politically hostile to the signature initiative of his presidency (11/6).

USA Today: Obama Heads To Dallas For Health Care PR Blitz
President Obama heads to Dallas on Wednesday to make his case for uninsured Americans to enroll for coverage under the Affordable Care Act -; heading to a city in a "red state" that the administration believes is prime to hear the president's pitch. Obama will be visiting an area that has one of the highest concentrations of uninsured people in the USA -; with more than 670,000, or 28% of Dallas County's population, uninsured (Madhani, 11/5).

Politico: Obama To Pressure Perry On Health Care During Texas Visit
President Barack Obama plans to call on Texas Gov. Rick Perry – one of the most prominent Obamacare foes in the country - to follow the lead of a handful of other Republican governors and agree to the expansion of Medicaid in the state as he visits Dallas on Wednesday. "This isn't a political issue. This is about making sure people where they live have access to good quality, affordable health care," White House deputy senior adviser for communications and strategy David Simas said Tuesday as he previewed the president's trip (Epstein, 11/5).

The Associated Press/Washington Post: Obama's Chief Of Staff Asks Largest Health Insurers To Help Explain Cancellations To Americans
The White House is asking insurance companies to explain to Americans the cancellation letters they're receiving in the mail. President Barack Obama's chief of staff, Denis McDonough, met Tuesday with CEOs from some of the largest health insurers. The White House says McDonough updated the CEOs on fixes to healthcare.gov and problems with enrollment data sent electronically to insurers. McDonough also solicited input on whether the system is getting better (11/5).

The Wall Street Journal: Health Insurers Urged To Extend Policies Beyond Year-End
Federal lawmakers and state officials are stepping up pressure on insurers to allow consumers whose coverage has been canceled in response to the health overhaul to keep their policies beyond the end of the year. On Tuesday, one of the largest regional health plans in the nation, Blue Shield of California, said it would relax its stance on terminated policies for about 115,000 people after state regulators demanded it do so. Customers now will have until March to decide which plan to choose for 2014, a three-month extension. Because the newer plans generally cost more, the extension could save residents as much as $28.6 million on premiums, said Dave Jones, California's insurance commissioner  (Martin and Radnofsky, 11/5).

The New York Times: Notes Reveal Chaotic White House Talks On Health Care Site
More than 100 pages of "war room notes" released by congressional investigators on Tuesday offer a window into the chaos that overwhelmed the Obama administration as the federal health insurance marketplace started up last month and officials realized that its problems could not be fixed quickly (Pear, 11/5).

Politico: Darrell Issa Releases 175 Pages Of Obamacare 'War Room' Notes
A slew of newly released notes documenting Obamacare's first month fill in more of the blanks of how the troubled launch unfolded but don't reveal any enrollment numbers. During the first few days following the federal exchange site's Oct. 1 launch, the Obama administration publicly blamed the HealthCare.gov glitches on high website traffic. But the 175 pages of notes from the Obamacare "war room" -; released Tuesday by the House Oversight and Government Reform Committee -; contain little to no mention of higher-than-expected volume (Cunningham, 11/5).

The Associated Press/Washington Post: Questions Mount Over Incomplete Testing Of Healthcare.gov Website
Obama administration officials are facing mounting questions about whether they cut corners on security testing while rushing to meet a self-imposed deadline to launch online health insurance markets. Documents show that the part of HealthCare.gov that consumers interact with directly received only a temporary six-month security certification because it had not been fully tested before Oct. 1, when the website went live. It's also the part of the system that stores personal information (11/6).

The Wall Street Journal: Health-Site Security Concerns Raised
The Obama administration official overseeing the troubled federal health-insurance website acknowledged Tuesday that a North Carolina man accidentally received another applicant's personal information, raising concerns among lawmakers about the site's security (Schatz, 11/5).

Politico: Security Experts Fear ACA Vulnerabilities
Early stumbles on the hobbled Obamacare website -; password glitches, incomplete testing and fractured development -; underscore considerable safety risks and hint at deeper vulnerabilities, data security experts warn. Lawmakers seized on those concerns Tuesday and will most likely do so again Wednesday, reverting attention to a process that has astounded IT specialists (Meyers, 11/5).

Politico: Obamacare Could Increase Food Stamp Rolls
Republicans have another reason to hate Obamacare: It could grow the number of people on food stamps. The Obama administration has ordered a study to determine whether the Affordable Care Act, by increasing the number of people eligible for Medicaid, will also increase the number of people enrolled in the Supplemental Nutrition Assistance Program based on how states enroll people (Parti, 11/5).

Los Angeles Times: State Insurance Chief Faults Health Exchange For Cancellations
Stepping into the national backlash over health policy cancellations, California Insurance Commissioner Dave Jones faulted the state's health exchange for requiring insurers to terminate coverage Dec. 31, but acknowledged that he has little power to stop it. Jones reiterated his support for President Obama's healthcare law Tuesday, but he said these cancellation notices and the resulting avalanche of consumer complaints were an unnecessary blunder (Terhune, 11/5).

NPR: In Colorado, A Couple Finds Relief In Obamacare
There's plenty of criticism of the Affordable Care Act and how it's being implemented. But let's introduce you to someone who is quite pleased with her Obamacare experience: Lela Petersen of Flagler, Colo. She's a small business owner with a very big health insurance bill (Brady, 11/6).

The Associated Press/Washington Post: Sebelius Back To Capitol Hill For Fresh Grilling On Health Care As lawmakers' Worries Grow
Health and Human Services Secretary Kathleen Sebelius is returning to Capitol Hill for a fresh interrogation on the health care law, this time from senators with growing concerns about President Barack Obama's crowning legislative achievement. Sebelius was due to face questions Wednesday from the Senate Finance Committee, whose chairman, Sen. Max Baucus, D-Mont., was a chief author of the 2010 law and remains a vocal defender. Yet in a measure of its troubled rollout, even he has concerns about the problem-plagued HealthCare.gov website and the potential security risks it poses for consumers' private information (11/6).

Los Angeles Times: Senators Grill Obamacare Administrator Over Healthcare.gov
The top Obamacare administrator told a Senate committee that setbacks will not hamper overall enrollment in the Affordable Care Act, which she said was expected to start slowly and then grow before the 2014 deadline to carry insurance coverage. Democrats joined Republicans on Tuesday grilling Marilyn Tavenner, the chief of the Centers for Medicare & Medicaid Services, which is overseeing the website for the Health and Human Services Department (Mascaro, 11/5).

The Washington Post: Medicare Chief Marilyn Tavenner Testifies Before Senate On Healthcare.gov Troubles
An administration official overseeing the federal online health insurance marketplace encouraged Americans to log on to the Web site despite its well-publicized technical problems and try to shop for coverage. Testifying Tuesday on Capitol Hill, Marilyn Tavenner said her agency, the Centers for Medicare and Medicaid Services (CMS), plans to release information next week about who enrolled through the state and federal exchanges. She said the target for the end of November is 800,000 enrollments (Somashekhar and Goldstein, 11/5).

The Wall Street Journal: HCA 3rd-Quarter Profit Up 1.4% Amid Modest Growth in Admissions, Revenue
The company said it now expects adjusted earnings before interest, taxes, depreciation and amortization for the year near the upper end of its previously guidance for $6.25 billion to $6.5 billion (Stynes, 11/5).

The Associated Press/Washington Post: McAuliffe Elected Governor, Defeats Cuccinelli After Pledging To Expand State's Medicaid Rolls
In his emotional concession speech, Cuccinelli also noted the lopsided spending and vowed he would not give up on his fight against Democrats' national health care law. … From the outset, the campaign shaped up as a barometer of voters' moods and a test of whether a swing-voting state like Virginia would elect a tea party-style governor. Republicans bet a deeply conservative candidate would be their best shot at holding onto the governor's office, passing over a lieutenant governor for Cuccinelli, a crusader against the federal health care law (11/6).