Health law challenges leave some Democrats complaining -- in public, even

Some challenges associated with implementing the health law have some Democrats complaining about the law in public -- something once unthinkable. In the meantime, California runs into problems using the law to enroll the uninsured, and physicians who treat Medicaid patients have yet to see a raise the health law promised.

Politico: With Obamacare Entrenched, Democrats Feel Free To Gripe
A funny thing happened once Democrats grew confident that Obamacare is truly the "law of the land." They started complaining about pieces of it in public. Democrats aren't walking away from the overall law and its sweeping goals; they still see it as a historic achievement they had sought for generations (Haberkorn, 3/11).

Roll Call: Signing Up Uninsured For Health Care A Big Challenge
When a California county wanted to encourage residents to buy health insurance earlier this year, officials employed a time-tested tactic for generating interest: nudity. The Alameda County Social Services Agency's ad campaign featured bare-skinned people who held up signs in strategic spots that read, "Cover your family." The use of naked people in ads about health care underscores the desperation felt by organizations and government entities that want to encourage enrollment as the launch of new coverage under the 2010 health care law approaches. On Oct. 1, people all over the nation can start signing up for coverage, which kicks in on Jan. 1, 2014 (Adams, 3/11).

Medscape: Check Is Not in the Mail for Medicaid Primary Care Raise
A Medicaid raise for primary care physicians in 2013 is a "slow train coming," in the words of a Bob Dylan song. As in months and months behind schedule. The Affordable Care Act (ACA) boosted Medicaid rates for evaluation and management (E/M) services and vaccine administration to far more generous Medicare levels for primary care physicians effective January 1. By all accounts, however, eligible physicians have yet to see the pay hike, thanks to the grinding wheels of state and federal bureaucracy. The extra money may not materialize until spring or summer, depending on the state (Lowes, 3/11).

The Washington Post fact-checks a claim on the health law's tax hikes --

The Washington Post's The Fact Checker: Does 'Obamacare' Have $1 Trillion In Tax Hikes, Aimed At The Middle Class?
The argument over President Obama's health-care law, aka Obamacare, never seems to end, as witnessed by the fact that House Republicans on Tuesday will unveil a budget that yet again seeks to eliminate it. This exchange on one of the Sunday shows caught our attention, as the battling lawmakers appear to be completely at odds. Are there $1 trillion in taxes in the law, which Wasserman Schultz denies? And are these "middle-income" tax increases, as Johnson asserts? (Kessler, 3/12).

In other health law news --

The Associated Press: Health Care Law To Create Gap For 21K In Hawaii
Roughly 21,000 people in Hawaii who were previously covered under Medicaid will need to buy their own health insurance once President Barack Obama's sweeping federal health care overhaul takes effect next year, the chief executive of the Hawaii Primary Care Association told a state Senate committee Monday. Robert Hirokawa, of the Hawaii Primary Care Association, said during an informational briefing of the Senate Health Committee that the group represents a so-called "gray" zone that lawmakers should consider as they approach implementing the law (Garcia, 3/11).

CQ HealthBeat: Health Law Provisions To Spur Shared Decision-Making Neglected, Some Analysts Say
A strategy designed to give patients a deeper understanding of their treatment options for certain serious medical conditions isn't getting the boost it was intended to under the health law, some analysts say. Shared decision-making, which the chairman of the Medicare Payment Advisory Commission late last week described as an ethical imperative, is an approach designed to better incorporate patient preferences when it comes to treating such diseases as prostate and breast cancer and other serious medical conditions where the medical evidence is unclear about which of several treatment options is best (Reichard, 3/12).