First Edition: September 12, 2013

Today's headlines include a range of stories related to the politics and policies in play as Oct. 1 -- the health law's big day -- quickly approaches.

Kaiser Health News: Obamacare Insurance Co-ops At The Starting Gate
Kaiser Health News staff writer Jay Hancock reports: "They have rented offices and zero customers. All their capital is borrowed. They're trying to sign the kind of expensive, chronically ill individuals  that insurers have avoided for decades. In three weeks they face mighty competitors with a hundred times the resources. But the 24 insurance-company startups created by the Affordable Care Act say they're ready to battle the establishment, stay in business and change health care" (Hancock, 9/12). Read the story.

Kaiser Health News: Consumer, State Officials Warn Buyers To Be On The Lookout For Fake, Look-Alike Exchange
Reporting for Kaiser Health News in collaboration with Government Computer News, Kelsey Miller writes: "As states are setting up their online health insurance marketplaces, officials are watching for look-alike websites that can lead consumers to be the victims of fraud or simply, confusion" (Miller, 9/12). Read the story.

Kaiser Health News: Two Types of Subsidies To Help Cover Costs Will Be Available (Video)
Two Types of Subsidies To Help Cover Costs Will Be Available
Kaiser Health News columnist Michelle Andrews helps you navigate the new insurance marketplaces that are scheduled to launch on Oct. 1. Today she answers a question about the subsidies that will be available to help obtain health insurance through the new online exchanges (9/12). Watch today's video or the others in this series.

Kaiser Health News: A Road To Health? Rural Alaska Town Argues For Access
APRN's Annie Feidt, working in partnership with Kaiser Health News and NPR, reports: "The town of King Cove, Alaska is crowded onto a narrow spit of land, surrounded by ocean and volcanic mountains.  It's an Aleut Native community of about 1,000 people, and for roughly a third of the year, weather closes its gravel air strip. When that happens, the only way residents can get to the nearest town, Cold Bay, is by boat -- two hours on choppy seas. So when an emergency call wakes up Bonita Babcock in the middle of the night, she first wants to know how bad the wind is blowing.  Babcock is a community health aide and a lifelong resident of King Cove. Her job is to stabilize patients and get them to Cold Bay, where there is a year-round air strip and patients can get to the nearest hospital -- in Anchorage, 600 miles away" Feidt, 9/11). Read the story.

Kaiser Health News: Pennsylvania Governor Weighing Medicaid Expansion If Tied To Changes
The Philadelphia Inquirer's Don Sapatkin, working in partnership with Kaiser Health News, reports: "Pennsylvania Gov. Tom Corbett is considering an expansion of Medicaid to cover hundreds of thousands of uninsured residents if he can also win significant changes to the existing part of the entitlement program, which otherwise would continue in its current form" (Sapatkin, 9/11). Read the story. 

The New York Times' The Caucus: House G.O.P. Delays Vote On Stopgap Budget Measure
Facing another revolt by the House's most ardent conservatives, Republican leaders scrapped a vote this week on legislation that would keep the federal government financed through mid-December while ending financing for President Obama's health care law. The leaders say they will bring the measure up next week, but with just a handful of legislative days left until a government shutdown, Republicans are in a squeeze (Weisman, 9/11).

The Washington Post: House Republican Leaders Delay Vote On Budget Bill Until Next Week
With a government shutdown looming in less than three weeks, Republican House leaders conceded Wednesday that they have yet to muster enough votes to approve a plan to keep federal agencies open. A vote on the measure, set for Thursday, was postponed until at least next week after conservatives balked, demanding that any deal to fund the government include a provision to cut off funding for President Obama's signature health-care initiative (Kane, 9/11).

Los Angeles Times: GOP Split Over Healthcare Law Boosts Threat Of Government Shutdown
In the midst of an international crisis, the prospect of a government shutdown intensified Wednesday as House conservatives balked at Republican leaders' efforts to pass a spending bill that did not explicitly eliminate funds for President Obama's healthcare law (Mascaro, 9/11).

The Wall Street Journal: House Delays Vote On Funding Measure
A brewing rebellion among conservatives caused House Republican leaders to delay plans to vote this week on legislation that would fund government operations through mid-December but stop funding of the federal health-care overhaul. The decision comes as conservatives who want to undo the Affordable Care Act ramped up their opposition just before a major component of the law was set to go live, casting doubt on congressional efforts to keep the government open this fall without a big political fight (Boles, 9/11).

Politico: GOP Weighs Obamacare Vs. Shutdown
Senate Republicans still haven't figured out how to defund Obamacare and keep funding the government. Competing factions of the party are arguing over just how aggressive they should be in seeking to dismantle the health care law (Everett, 9/12).

USA Today: Health Insurance Sales Hit The Mall – And Web
Call it the retailization of health insurance. Shopping center owners may not be courting them as they would Apple or trendy fashion brands, but health insurers are increasingly opening stores alongside far sexier retail tenants. With few people buying health insurance on their own, insurers have long focused on retaining and attracting the companies that offer it to their employees. Now, however, the new health law known as the Affordable Care Act means most uninsured Americans are required to have insurance beginning March 31 or pay a penalty at tax time in 2015 (O'Donnell, 9/12).

Politico: Reluctant States Face Medicaid: Yes? No? Punt?
Obamacare sign-up starts less than a month but a few states are still answering a basic question: Are they in, or are they out of the law's massive expansion of Medicaid? Legislatures in pivotal swing states like Ohio and Pennsylvania are dusting off their gavels from summer recess and diving back into the high-stakes Medicaid debate over whether to extend health coverage to hundreds of thousands of low-income Americans. Others are looking at ballot measures to spur action because lawmakers won't convene again until next year (Cheney and Millman, 9/12).

The Associated Press/Washington Post: Less Help For Uninsured In Many States As Obama Health Care Markets Open In A Divided Nation
Entrenched political divisions over "Obamacare," have driven most Republican-led states to turn their backs on the biggest expansion of the social safety net in a half century. If you're uninsured in a state that's opposed, you may not get much help picking the right private health plan for your budget and your family's needs. The differences will be more glaring if you're poor and your state rejected the law's Medicaid expansion (9/12).

The Associated Press/Washington Post: Enrollment In State Exchanges Under Health Overhaul Confuses Medicare Beneficiaries
Dear seniors, your Medicare benefits aren't changing under the Affordable Care Act. That's the message federal health officials are trying to get out to elderly consumers confused by overlapping enrollment periods for Medicare and so-called "Obamacare." Medicare beneficiaries don't have to do anything differently and will continue to go to Medicare.gov to sign up for plans. But advocates say many have been confused by a massive media blitz directing consumers to new online insurance exchanges set up as part of the federal health law. Many of the same insurance companies are offering coverage for Medicare and the exchanges (9/12).

The Associated Press/Washington Post: Consumers Will Need Personal Financial Info, Basic Insurance Knowledge To Get Covered
Getting covered through President Barack Obama's health care law might feel like a combination of doing your taxes and making a big purchase that requires research. You'll need accurate income information for your household, plus some understanding of how health insurance works, so you can get the financial assistance you qualify for and pick a health plan that's right for your needs (9/12).

The Associated Press/Washington Post: In Colorado, Medicaid Expansion Provides A Welcome Surprise For Counselor Just Starting Career
Colorado is one of at least 24 states expanding Medicaid access for adults under the Affordable Care Act. In Colorado, that means single adults who earned less than $15,400 last year will have access to Medicaid. Childless adults in the state currently qualify for Medicaid only if they make less than $95 a month. Colorado estimates about 160,000 people will be added to state Medicaid rolls under the new guidelines. … Kinney said he feels incredibly fortunate to live in a state where he will receive basic coverage through the government program. He has seen firsthand just how expense medical expenses can be (9/12).

The Associated Press/Washington Post: Lack Of Medicaid Expansion Creates Unease About Health Insurance For Low-Wage Pizza Employee
His home state, Oklahoma, opted against accepting the expansion of Medicaid under the Affordable Care Act. The result is that thousands of Oklahomans who would have qualified under the expanded program are left in limbo about their health insurance. At the same time, a Medicaid-linked program called Insure Oklahoma that provides Gatliff with his current coverage was due to expire Dec. 31. That left him facing the prospect of having no insurance at the end of the year, so the part-time pizza shop employee began planning to stockpile his medications (9/12).

The Associated Press/Washington Post: Michigan Smoker May Face Penalty, Go Without Health Insurance Unless He Quits Long-Time Habit
The law requires insurers to accept all applicants regardless of pre-existing medical problems. But it also allows them to charge smokers premiums that are up to 50 percent higher than those offered non-smokers -; a way for insurers to ward off bad risks (9/12).

The Associated Press/Washington Post: Health Care Reforms Likely To Raise Insurance Costs For The Self-Employed With Higher Incomes
President Obama's health care reforms will be a huge boost to the working poor but are likely to make life more expensive for Aaron Brethorst and others like him. The Seattle software developer and consultant doesn't have a problem with that because he figures he'll be able to afford quality insurance. He says his annual income is in the low six-figures, and he expects to receive better coverage once the Affordable Care Act kicks in (9/12).

The Associated Press/Washington Post: Hard Time Understanding Health Reform Law? Try Figuring It Out In Tagalog, Hmong Or Vietnamese
Understanding the law is a challenge even for governors, state lawmakers and agency officials, but delivering its message to non-English speakers who can benefit from it is shaping up as a special complication. That is especially true in states with large and diverse immigrant populations (9/12).

The Associated Press/Washington Post: Key Milestones – And Potholes – In President Barack Obama's Health Care Overhaul Law
Medicare was signed into law on July 30, 1965, and within a year seniors were receiving coverage. President Barack Obama signed the Affordable Care Act on March 23, 2010, and the uninsured start getting coverage more than three years later on Jan. 1, 2014. Some key dates in the saga of Obama's signature legislation (9/12).

The New York Times: Unions' Misgivings On Health Law Burst Into View
When President Obama phoned the president of the A.F.L.-C.I.O. last month, he shared some news that the labor leader had long wanted to hear -; the administration would propose measures to reduce workplace exposure to disease-causing silica dust. But their conversation soon moved to what has become a contentious topic this summer: labor's renewed anger over Mr. Obama's health care law and decisions surrounding it, especially the postponement of an employer mandate to ensure coverage for workers and the potential effects of the coming health insurance exchanges on existing plans (Greenhouse and Martin, 9/11).

Politico: Obamacare Enrollment Rules For Hill Staff May Be Delayed
The Office of Personnel Management may not issue final rules about how members of Congress and their staff can get insurance coverage through exchanges until after enrollment opens on Oct. 1, Chief Administrative Officer of the House Dan Strodel wrote in a memo to staff Wednesday. Without the final rule, Hill staff won't be able to view their plan options, costs, benefits or final details on who must enter the exchange, he wrote (Cunningham, 9/11).

The Associated Press/Washington Post: Despite White House Pressure, AFL-CIO Steps Up Criticism Of Obama's Health Law
The strongly worded resolution says the Affordable Care Act will drive up the costs of union-sponsored health plans to the point that workers and employers are forced to abandon them. Labor unions still support the law's overall goals of reducing health costs and bringing coverage to all Americans, the resolution says, but adds that the law is being implemented in a way that is "highly disruptive" to union health care plans (9/11).

Politico: Poll: Obamacare Opposition Climbs
More than half of Americans oppose most or all of the proposals in Obamacare, a sharp increase in opposition to the healthcare law from earlier this year, according to a new poll Wednesday. Fifty-seven percent of those surveyed said they opposed most or all of the proposals in the law, while just 39 percent favored most or all of the law, according to a CNN/ORC International poll. The opposition rose from 44 percent in similar survey in January, while the support for President Obama's signature healthcare law dropped from 51 percent (Arkin, 9/11).

The Wall Street Journal's Washington Wire: Heritage Unveils Anti-Obamacare Billboard In Big Apple
Brightly lit Times Square displays singing the praises of "Mamma Mia!" and "Wicked" find themselves with an unusual new companion this week, as the Heritage Foundation unveiled a billboard blasting Obamacare on 42nd Street. The 90-foot-high, 67-foot-long billboard reads, "WARNING: Obamacare may be hazardous to your health," and encourages viewers to support defunding the health-care law. The sign displays a number viewers can text to get more information (Ballhaus, 9/11).

Politico: DC United To Help Publicize District's Obamacare Exchange
Obamacare is about to get a big assist from D.C.'s professional soccer team. The District's health exchange is teaming up with D.C. United to spread the word about coverage options in the new insurance marketplace set to open in just three weeks. The District's exchange, known as DC Health Link, disclosed the plans in a Wednesday night board meeting. A more formal announcement is still to come (Millman, 9/11).

The Washington Post's The Fact Checker: Has Mitch McConnell Done 'Nothing' In The Fight Against Obamacare?
This might come as news to the Obama administration-;Mitch McConnell apparently has done nothing in the Senate to thwart the Affordable Care Act, aka Obamacare. At least that's the charge leveled by Matt Bevin, a tea party-backed candidate who claims the Republican leader is not conservative enough. We've previously written about this bruising battle taking place in Kentucky. How valid is Bevin's claim? (Kessler, 9/12).

Politico: Mitch McConnell Files Obamacare Amendment To Energy Bill
Senate leaders agreed to keep the debate over Syria out of an energy bill on the floor but there will be no such luck for Democrats on Obamacare. Senate Minority Leader Mitch McConnell (R-Ky.) submitted an amendment Wednesday evening to the energy efficiency bill under consideration that would delay the health care law's individual mandate for a year. It would also codify the White House's one-year delay of the employer mandate, which Republicans believe may be legally murky (Everett, 9/11).

The Washington Post: The Northeast Is Getting Older, And It's Going To Cost Them
Most of the nation's oldest population is now clustered in the Northeast and growing rapidly, according to Census data, straining medical, housing and transportation budgets and forcing lawmakers to look for new approaches. And legislators and governors are reaching the conclusion that the way to pay for the elderly is to cater to the young (Wilson, 9/12).

NPR: For Native Americans, Mental Health Budget Cuts Hit Hard
Native American tribes gave up millions of acres to the federal government in the 19th century in exchange for promises of funded health care, education and housing. But time and again, those funds have been cut. The recent across-the-board federal budget cuts, known as the sequestration, are no exception. They came with a 5 percent reduction in funding for mental health services, including suicide prevention. That's especially troubling for Native Americans, whose suicide rate are four times the national average (Morales, 9/12).

Los Angeles Times: VA Finally Making Progress On Benefits Claims Backlog
The new computer system is the centerpiece of a major overhaul that department officials promise will clear the backlog of claims that has had severely wounded veterans waiting months -; if not years -; to find out whether they will receive financial help. With pressure mounting from lawmakers, veterans groups and the media, the VA has been reorganizing its work flow, hiring more claims processors, revamping their training and requiring them to work 20 hours of overtime a month to clear the backlog (Zavis, 9/11).