First Edition: October 24, 2013

Today's headlines include reports that the Obama administration plans to tweak the tax-penalty deadline for signing up for health insurance as well as previews of what might happen when the contractors who built the health law's online insurance marketplace testify today on Capitol Hill.

Kaiser Health News: Obama Administration Plans To Delay Penalties For Consumers Who Sign Up For Insurance By March 31
Kaiser Health News staff writer Mary Agnes Carey reports: "The Obama administration said Wednesday that it would delay imposing penalties for six weeks on some consumers who might have been caught in a sticky timing problem for enrolling in coverage through the health law's new insurance marketplaces. Those marketplaces, also known as exchanges, have come under intense scrutiny since opening on Oct. 1 because the technology has malfunctioned. But the White House is not linking this change of policy to website problems" (Carey, 10/23). Read the story.

Kaiser Health News: Are Federal Call Centers Up To The Task Of Enrolling Millions In Health Plans?
Kaiser Health News staff writer Phil Galewitz reports: "An elderly man calls to ask if the land he owns will count as income to qualify for health coverage through Medicaid. A legal immigrant asks if she can sign up for a health plan through the state's online insurance marketplace. A broker wants help to become certified to start selling coverage. It's 10 a.m. Monday inside the call center of Connecticut's new insurance exchange established under the federal health law. On the 21st floor of the downtown Prudential Building, about 25 operators in blue shaded cubicles are talking on telephone headsets while a dozen more callers wait on hold" (Galewitz, 10/24). Read the story.

Kaiser Health News: Health Law Brings Changes In How Therapists Do Business
Kaiser Health News staff writer Sarah Varney, working in collaboration with NPR, reports: "In the corporate world of American health care, with its consolidating hospital chains and doctors' groups, psychologists and other mental health therapists are still mostly Mom-and-Pop shops; they've built solo practices, hanging their own shingles, not unlike Lucy in the Peanuts gang: 'Psychiatric Help 5¢, The Doctor Is In.' But that business model is shifting from solo practices toward large medical groups, say mental health experts" (Varney, 10/24). Read the story.

Kaiser Health News: Capsules: Study: Low-Income Californians Want Better Information; Navigators Tread Water As Website Problems Continue; A View From The States: Health Care Continues Stumbling Startup
Now on Kaiser Health News' blog, Ankita Rao reports on the quality of health care information that low-income Californians seek: "For many low-income Californians, enrolling in health insurance is just one hurdle to overcome in getting the care they want. A new report says better communication with doctors and obtaining clearer information is also high on their wish lists" (Rao, 10/23).

Also on Capsules, Jenny Gold writes about how "navigators" are handling health care website problems: "Navigators in states relying on the flawed federal exchange healthcare.gov are focusing on bolstering excitement and education about the law as they wait for fixes to the website" (Gold, 10/24).

Also on the blog, an update of how states are dealing with the early troubles of their health exchanges: "States are making some progress getting customers signed up for health insurance. But it isn't pretty. Here is a roundup of dispatches from KHN's radio partners at NPR member stations" (10/24). Check out what else is on the blog.

The New York Times: White House To Tweak Tax-Penalty Deadline
The Obama administration said Wednesday that people who obtained health insurance by March 31 would not face any tax penalties for being uninsured in the first three months of 2014. Under President Obama's health care law, most Americans will be required to have insurance next year, and they may be subject to tax penalties if they go without coverage (Pear, 10/23).

The Washington Post: Americans Will Have An Extra Six Weeks To Buy Health Coverage Before Facing Penalty
The Obama administration said Wednesday night that it will give Americans who buy health insurance through the new online marketplaces an extra six weeks to obtain coverage before they incur a penalty. The announcement means that those who buy coverage through the exchange will have until March 31 to sign up for a plan, according to an official with the Department of Health and Human Services (Somashekhar, Goldstein and Eilperin, 10/23).

The Wall Street Journal's Washington Wire: Officials Affirm March 31 Is Deadline for Health Enrollment
Americans won't face a health-insurance penalty so long as they sign up for coverage by March 31, 2014, the Obama administration said late Wednesday, offering what amounted to a six-week extension on the deadline. The Affordable Care Act's most prominent feature is the "individual mandate," the requirement that most Americans carry coverage or pay a tax penalty, starting on Jan. 1, 2014 (Radnofksy, 10/23).

Politico: White House May 'Align' Obamacare Signup Dates
The Obama administration is working to push back a deadline to prevent people who buy insurance during Obamacare's open enrollment from being hit by the law's individual mandate penalty, a Health and Human Services official said Wednesday. Right now people must to sign up by Feb. 15 if they want to avoid paying the penalty -; even though there are six weeks left in the enrollment season (Chaney, 10/24).

NPR: Why Postponing Insurance Mandate Is No Easy Fix For Obamacare
The Obama administration has entered full damage-control mode over the balky website intended to enroll people in new health plans under the Affordable Care Act. Senior officials met Wednesday morning with Democrats on Capitol Hill, and in the afternoon insurance CEOs got an audience at the White House. Tomorrow some of the private contractors responsible for building the website, HealthCare.gov, will testify at a House committee hearing (Rovner, 10/23).

Politico: Obamacare Hearings: Oversight Or Heckling?
There's congressional oversight that answers everyone's most urgent questions - and then there's just heckling from the partisan peanut gallery. Over the next few weeks, Republicans are going to have to decide which path they're going to take as they open hearings into the broken Obamacare website (Nather, 10/24).

The New York Times: Contractors Assign Blame, But Admit No Faults Of Their Own, In Health Site
Contractors that built President Obama's health insurance marketplace point fingers at one another and at the government, but each insists that it is not responsible for the problems that infuriated millions of Americans trying to buy insurance on the Web site, according to testimony prepared for a Congressional hearing on Thursday (Pear, 10/23).

The Wall Street Journal: Executive To Defend Firm's Role In Health Site
An executive from the top contractor involved in designing the federal website consumers can use to sign up for health insurance is set to testify Thursday in Congress about the problems that have stymied the site. Cheryl Campbell, senior vice president of CGI Federal Inc., the U.S. unit of Canadian company CGI Group Inc., is expected to be asked about the firm's role in an enrollment process riddled with glitches that risk jeopardizing President Barack Obama's signature law (Nagesh, 10/23).

USA Today: Hot Seat For Health Care Exchange Website Builders
High demand for health insurance coupled with confusion between contractors led to many of the problems that have plagued the HealthCare.gov website meant to allow uninsured Americans to buy insurance through the Affordable Care Act, an official with the top contractor will say in prepared testimony to a House panel Thursday. Cheryl Campbell, senior vice president of CGI Federal, said in advance testimony for her scheduled Thursday appearance before the House Energy and Commerce Committee that another contractor was responsible for the technology that allowed users to create new accounts and which caused the initial bottleneck issues on the site (Kennedy, 10/24).

The Wall Street Journal: Contractors Point Fingers Over Health-Law Website
A new round of finger-pointing will kick off Thursday morning when a House committee grills four contractors involved in the development of HealthCare.gov, the troubled site where uninsured consumers are supposed to sign up for health insurance. CGI Federal, the lead contractor for HealthCare.gov, said the federal agency in charge of the project was "the ultimate responsible party for the end-to-end performance of the overall" health exchange, according to testimony released Wednesday by the House Energy and Commerce Committee (Schatz, 10/24).

Politico: Contractors To Explain Rough Rollout
Key Obamacare contractors testify before Congress on Thursday to explain the disastrous rollout of HealthCare.gov. It will be a much different scene from their previous trip to the Hill a little more than a month ago. Just three weeks before the health care law's troubled launch, four contractors assured a House panel that everything was on track for the Oct. 1 launch. According to written testimony posted Wednesday night, none of them are taking the blame for the website mess ahead of an expected grilling from the House Energy and Commerce Committee (Millman, 10/24).

Los Angeles Times: WellPoint CEO Upbeat On Exchanges, Talks Obamacare At White House
Insurance giant WellPoint Inc., a key player in the rollout of the Affordable Care Act, said it remains optimistic about the healthcare expansion despite the rocky start of a federal insurance exchange. WellPoint's chief executive, Joseph Swedish, and other industry executives are meeting Wednesday with White House officials about continuing problems with the 36-state federal insurance marketplace and its troubled healthcare.gov website (Terhune, 10/23).

Politico: White House, Insurance Industry Tackle Obamacare Tech Problems
Top White House and HHS officials met with CEOs of about a dozen major insurance companies Wednesday to address the flawed Obamacare enrollment system, particularly the problems in generating accurate enrollment files that are sent to the insurers selling health plans through the new exchanges. They also discussed the problems arising as people try to bypass the federal website and enroll directly with the insurers (Kenen, 10/23).

The Wall Street Journal: WellPoint's Profit Falls On Higher Total Expenses
WellPoint Inc. beat third-quarter earnings expectations and boosted its full-year forecast on Wednesday but remained cautious about next year, saying it is still too early to gauge the impact of the new health law. While the Indianapolis-based insurer raised its 2013 earnings forecast, to $8.40 a share, Chief Financial Officer Wayne DeVeydt cautioned against expecting that "this improvement [will continue] into 2014, given the number of changes to our business" due to the federal health overhaul. However, Mr. DeVeydt affirmed a target of per-share earnings of "above $8" for next year (Martin, 10/23).

NPR: It's Easy To Blame The Canadians For HealthCare.gov Problems
President Obama is putting former CEO Jeff Zients in charge of the "tech surge" -; the administration's emergency effort to fix the Web portal at the heart of the federal government's new health care market. But what about the contractors that built the system? What's their responsibility? (Kaste, 10/23).

The New York Times: Republicans, Sensing Weakness In Health Law Rollout, Switch Tactics
Emboldened by the intense public criticism surrounding the rollout of the online insurance exchange, Republicans in Congress are refocusing their efforts from denying funds for the health care law to investigating it (Steinhauer and Pear, 10/23).

Politico: GOP Reconsiders Obamacare Tactics
The stiffest test facing congressional GOP leaders is how to avoid another Obamacare-induced fiscal crisis, which top Republicans say would put their House majority in jeopardy and further deplete the party's uphill chances of capturing control of the Senate. Two different tactics are on display: In the House, the approach is to be meek; in the Senate, it's to be muscular (Sherman and Raju, 10/23).

The Wall Street Journal's Washington Wire: Boehner Goes Back on Offense Over Health Care
House Speaker John Boehner (R., Ohio), seeking to move past a failed political strategy that shuttered large parts of the government and sank the party's approval ratings, on Wednesday went back on offense, targeting budget deficits and the new health-care law as problems Republicans could address (Hughes, 10/23).

Los Angeles Times: Obama Allies Join In Criticism Of Healthcare Website
The rocky rollout of the Affordable Care Act again came under sharp criticism Wednesday, three weeks into the launch, but this time some of the loudest voices were among top Democrats, including President Obama's closest allies. Democrats on Capitol Hill said they were unhappy with the performance of the Obamacare website, which has been plagued with problems since its debut Oct. 1. Even the president's longtime campaign guru, David Axelrod, was critical of the administration's handling of the issue (Mascaro and Parsons, 10/23).

The Associated Press/Washington Post: Frustrated Dems Lament Damage Glitchy 'Obamacare' Website Has Inflicted On Broader Law
Frustrated Democrats lamented Wednesday that persistent problems with new health care exchanges have inflicted damage on the public's perception of the already unpopular "Obamacare" -; with some lawmakers insisting President Barack Obama should ensure those responsible lose their jobs. Emerging from a closed-door briefing with health officials from the Obama administration, House Democrats appeared to have at least as many questions as answers about how and when the beleaguered website will be fixed. Although they resolved not to let setbacks with one aspect of the health law outshine the parts that are working, they griped that the shoddy website had given Republicans an opening to do just that (10/23).

Politico: Hill Democrats Frustrated By Obamacare Rollout
House Democrats voiced growing frustration and anger with the broken Obamacare enrollment site on Wednesday as administration officials tried to reassure them that HealthCare.gov will be repaired. Democrats, who labored to get the Affordable Care Act through Congress in the first year of the Obama presidency, said they wanted the administration to share details of what's wrong and when it will be fixed (Haberkorn and Allen, 10/23).

The Associated Press/Washington Post: Some Dems Say Obama Should Fire those Responsible For Problems With HealthCare.gov Website
The principal contractors responsible for the federal government's trouble-plagued health insurance website say the Obama administration shares responsibility for the snags that have crippled the system. Executives of CGI Federal, which built the federal HealthCare.gov website serving 36 states, and QSSI, which designed the part that verifies applicants' income and other personal details, are testifying Thursday before the House Energy and Commerce Committee (10/24).

The Wall Street Journal: Democratic Unease Grows On Health Law
The hard line Democrats have drawn against delaying a core element of the federal health law has begun to crack, as problems with the new federal insurance website prompted calls for President Barack Obama to delay penalties on people who don't carry health coverage (Hughes and Nelson, 10/23).

Politico: Red State Democrats Propose Changes To Obamacare
The Obama administration's day ended much as it began, with Democrats frustrated over Obamacare's rollout. After the administration briefed House Democrats on the myriad remaining issues with HealthCare.gov, red and swing-state Democratic senators began to call for further changes to Obamacare (Everett and Kim, 10/24).

The Associated Press/Washington Post: Obama Administration Spells Out Those Health Care Site Problems – And Its Efforts To Fix Them
On the defensive, the Obama administration acknowledged Wednesday its problem-plagued health insurance website didn't get enough testing before going live. It said technicians were deep into the job of fixing major computer snags but provided no timetable. Democratic unhappiness with the situation began growing louder -; including one call for President Barack Obama to "man up" and fire someone -; as the president's allies began to fret about the political fallout. Democrats had hoped to run for re-election touting the benefits of the health care law for millions of uninsured Americans, but the computer problems are keeping many people from signing up (10/23).

The Washington Post's Post Politics: Democrats Rally Around Health-Care Law After Shutdown
Despite a series of problems with the Web site for President Obama's new health care exchanges, support for the law is up slightly.
A new Gallup poll shows support has increased four points since August, thanks to a rise in support from Democrats (Blake, 10/23).

The Wall Street Journal: Medicaid Applications Face Delay In Health Exchanges
The federal government's insurance exchanges won't be able to transfer Medicaid applications to states when the exchanges open Oct. 1, another sign of the technical hurdles the Obama administration is facing in preparing for the health-overhaul law (Radnofsky, 10/24).

Politico: Medicaid Could Be The Next Headache For Obamacare
A new phase of the Obamacare launch is coming, this one involving Medicaid. And it could be déjà vu all over again. On Nov. 1, the health law's malfunctioning enrollment system is supposed to send reams of data to states so they can begin placing thousands of people into Medicaid. But state officials say that transfer system has barely been tested and could be vulnerable to technical failures like those that have crippled the broader Obamacare sign-up process (Cheney, 10/24).

Los Angeles Times: In Ohio, Obamacare Fight Renewed As GOP Governor And Activists Tussle
It is the center of the political universe in presidential contests. And now the war over the nation's new healthcare program has come to Ohio as well, with potential repercussions for the short- and long-term future of the state's governor, John Kasich (Decker, 10/23).

The New York Times: Tea Party Group Begins Anti-Health Care Law Blitz In Four House Districts
Americans for Prosperity, the Tea Party group that has made rolling back the health care law one of its priorities, is starting a $2 million campaign of television, radio and Internet advertisements aimed at lawmakers facing tough re-election battles in four House swing districts (Stolberg, 10/23).

Los Angeles Times: Next Wave Of Obamacare War: Ads To Hold Lawmakers 'Accountable'
As it wages a state-by-state battle to limit the reach of the nation's healthcare law, the conservative group Americans for Prosperity is launching a $2-million ad buy to hold congressional lawmakers "accountable" for their votes on Obamacare. AFP is launching the first round of the new television ads Wednesday in Arizona, Colorado, Florida and California, where they are targeting Rep. Scott Peters of San Diego, a freshman Democrat (Reston, 10/23).

The Wall Street Journal's Washington Wire: Troubled Health Site Cost At Least $400 Million
How much did it cost to put together the problem-plagued HealthCare.gov website? The House Committee on Oversight and Government Reform said Wednesday that by its latest tally, the Department of Health and Human Services had awarded between $400 and $600 million in contracts to develop the federal health-insurance exchange and related data services (Radnofsky, 10/23).

The Washington Post's The Fact Checker: How Much Did Healthcare.gov Cost?
How much did the troubled HealthCare.gov actually cost? It may be much less than you've heard. Given the vagaries of the federal contracting system, this is not an easy question to answer. But that has not stopped some people from speculating that the total is $500 million or more. That may be a reasonable figure, but the more we looked into this, the more it seemed a bit high (Kessler, 10/24).

Los Angeles Times: Sebelius: Obama Not Told Of Healthcare.gov Problems Before Launch
Health and Human Services Secretary Kathleen Sebelius says President Obama did not know about the problems with the health insurance law website before its launch, and she is dodging questions about whether she will resign over the troubled rollout of the federal health insurance marketplace (Hennessey, 10/23).

The New York Times: Sebelius Finds A Friendly Crowd in Boston
For Kathleen Sebelius, the Obama administration official who has become the focus of bipartisan anger over the bungled rollout of the online health insurance exchanges, a night out in Boston appeared to be a much-needed respite from scrutiny and criticism (Bidgood, 10/23).

The New York Times: Health Law Fails To Keep Prices Low In Rural Areas
As technical failures bedevil the rollout of President Obama's health care law, evidence is emerging that one of the program's loftiest goals -; to encourage competition among insurers in an effort to keep costs low -; is falling short for many rural Americans (Abelson, Thomas and McGinty, 10/23).

The Washington Post: Virginia's Mental Health System Needs More Money; Candidates Differ On How To Provide It
When people talk about improving Virginia's mental health system, they inevitably return to one word: money. Money for treatment centers and hospital beds, money for staff, money for youth programs, money for housing. Money that has been cut significantly in recent years. The major-party candidates for governor of Virginia agree that mental health systems need more resources. But their approaches differ greatly, based in part on how they view the Medicaid expansion of the new health-care law in Virginia (Jackman, 10/23).