First Edition: September 24, 2013

Today's headlines include reports about Senate action on the effort to defund the health law as well as a scheduled appearance by former President Bill Clinton and President Barack Obama to kick off the roll out of a key part of the overhaul. 

Kaiser Health News: Swapping COBRA For Obamacare Likely To Be Windfall For Big Business
Kaiser Health News staff writer Jay Hancock reports: "Health-law provisions taking effect next year could save U.S. employers billions of dollars in expenses now paid for workers who continue medical coverage after they leave the company, benefits experts say" (Hancock, 9/23). Read the story.

Kaiser Health News: Readers Ask: What Options Do Parents Have To Get Coverage For Their Kids?
Kaiser Health News consumer columnist Michelle Andrews answers questions from parents who have many questions about covering their children as the October launch of the state health insurance marketplaces approaches (9/24). Read the column.

Kaiser Health News: Missouri, Illinois Health Insurance Exchanges Gear Up Quietly
The St. Louis Post-Dispatch's Virginia Young, working in partnership with Kaiser Health News, reports: "Across the country, states are featuring celebrities, quirky songs and football game-day ads to promote the Oct. 1 debut of the online health insurance exchanges. Minnesota's multimillion-dollar campaign, for example, stars Paul Bunyan and Babe the Blue Ox in zany situations in which the lumberjack unexpectedly needs medical attention -; and health insurance" (Young, 9/23). Read the story.

Kaiser Health News: What Consumers Really Want From An Obamacare Plan
The Philadelphia Inquirer's Robert Calandra, working in partnership with Kaiser Health News, reports: "It doesn't have the inherent drama of a space launch countdown, but in T-minus nine days, America will embark on a voyage into the vast, unexplored regions of the health-insurance marketplace. Actually, those regions aren't that unexplored. Insurers have been running consumers through simulated exchanges for the last several years. While insurers may not be completely comfortable with how things unfold after Oct. 1, they do have a pretty good idea about what coverage consumers want and what they will pay for it" (Calandra, 9/23). Read the story.

Kaiser Health News: Fight Over Obamacare Is Anything But Over In Florida
The Miami Herald's Marc Caputo, working in partnership with Kaiser Health News, reports: "Florida isn't just a battleground state for presidential elections; it's ground zero in the nation's Obamacare wars. It's all about demographics. And geography. Retiree-heavy Florida has a surplus of voting seniors nervous about Obamacare's changes. But Hispanics -; the state's least-insured but fastest-growing population -; tend to support the Affordable Care Act" (Caputo, 9/24). Read the story.

Kaiser Health News: Colorado Floods Isolate Hospital At Foot Of Rockies
Reporting for Kaiser Health News, in partnership with NPR, Eric Whitney writes: "As snow begins falling in Rocky Mountain National Park, Estes Park, the town at its doorstep, finds itself newly isolated.  The only year-round road into or out of town now is the Peak to Peak Highway.  It traverses a jumble of mountains all the way - not the kind of road an ambulance can scream along at 60 miles an hour" (Whitney, 9/24). Read the story.

Kaiser Health News: Capsules: How Will Obamacare Affect Workers' Health Coverage?; Federal Judge Throws Out Lawsuit Over Hospital Observation Care
Now on Kaiser Health News' blog, watch KHN staff writer Jay Hancock on C-SPAN's Washington Journal Monday morning taking questions about how the health law will affect the health insurance coverage workers get from their employers and what they need to know (9/23).

Also on the blog, Susan Jaffe reports on action related to Medicare's observation care status: "A federal court judge in Hartford, Conn., dismissed a lawsuit Monday which was filed against the government by 14 Medicare beneficiaries who were denied nursing home coverage" (Jaffe, 9/23). Check out what else is on the blog.

The Associated Press/Washington Post: Senate Sets Test Votes On Defunding Health Care And Preventing Partial Government Shutdown
In a break with tea party-aligned Senate conservatives, Republican leader Mitch McConnell announced Monday he will not vote to block legislation aimed at preventing a partial government shutdown, even though Democrats intend to rewrite it to restore funds needed to keep the nation's three-year-old health care law in existence. Referring to a bill the House passed last week, McConnell's spokesman said the Kentucky lawmaker supports the measure "and will not vote to block it, since it defunds Obamacare and funds the government without increasing spending by a penny" (9/23).

The New York Times: Senate Democratic Leader Sets Stage For Budget Showdown
The Senate's Democratic majority leader, Harry Reid, delivered a broadside this week to advocates of the House plan to tie future government financing to the gutting of President Obama's health care law, starting the clock on a showdown that could be decided on the eve of the potential government shutdown next Tuesday (Weisman, 9/24).

Los Angeles Times: Much Theater, Little Action As Congress Ponders Government Shutdown
This latest round of brinkmanship, led by tea party Republicans trying to block President Obama's Affordable Care Act, appears to be on that same track. By Monday afternoon, the tea party effort appeared to be losing ground among Senate Republicans, but the schedule showed no sign of speeding up. The tea party conservatives have vowed to block any effort to provide money for federal agencies after the end of the current budget year unless Obama agrees to a measure that would stop his signature healthcare law from going into effect. Obama has rejected that idea (Mascaro, 9/23).

The New York Times: McConnell's Deal-Making Yields To Politicking
Democrats and, increasingly, Republicans are complaining that the minority leader's absence from many of this year's most intense and consequential negotiations -; from the immigration overhaul to the budget to a fight over internal rule changes that almost paralyzed the Senate -; has created a power vacuum and left Democrats without a bargaining partner. They worry that Mr. McConnell is too hamstrung by political concerns in the Capitol and back home in Kentucky. In Washington, a rebellious crop of new Republican senators, led by Ted Cruz of Texas, has rejected his compromising brand of politics. Mr. Cruz has led the charge to tie any further government financing to gutting President Obama's health care law, a movement that has angered many veteran Republicans and brought the federal government to the brink of a shutdown (Weisman and Peters, 9/23).

The Wall Street Journal: McConnell Won't Back Cruz On Health-Law Strategy
A push by Senate conservatives to eliminate funding for the new federal health-care law suffered a setback Monday, when Senate Minority Leader Mitch McConnell said he wouldn't support their strategy when legislation comes before the chamber this week. The announcement by Mr. McConnell (R., Ky.) put him at odds with Sen. Ted Cruz (R., Texas) and other conservatives allied with the tea-party movement. They have promised to use parliamentary tactics to support legislation that links funding for federal agencies with the conservative rallying cry of "Defund Obamacare" (Hook, 9/23). 

The Washington Post: Sen. Ted Cruz Happy To Be Outlier In Shutdown Showdown
Ted Cruz began a frantic effort Monday to bend the Senate to his will by employing tactics that have earned him mostly enemies in his less than nine months in the chamber. A master of fiery conservative oratory, the freshman senator is trying to block funding for President Obama's health-care law with a strategy that, if successful, will almost certainly lead to a partial government shutdown next week. The Texan has become the face of an effort variously described as the "dumbest idea," leading Republicans to a "box canyon" and ending with their political "suicide note" (Kane, 9/23).

Los Angeles Times: Karl Rove Calls Out Fellow Republican Sen. Ted Cruz On Healthcare
When Karl Rove starts truth-squadding fellow Texas Republicans over the Affordable Care Act, aka Obamacare, you know there are some tall tales floating around. On Sunday, U.S. Sen. Ted Cruz (R-Texas) told Chris Wallace of Fox News: "You know what's interesting? Last week, the Wall Street Journal, for the first time in years, found Republicans are leading on healthcare. Americans trust Republicans more than Democrats on healthcare" (Abcarian, 9/23).

Politico: Rand Paul On Obamacare Compromise: 'Maybe'
Sen. Rand Paul acknowledged Monday the uphill battle for Republicans looking to fully defund Obamcare and said "there could be a compromise in the middle." "The president wants 100 percent of Obamacare, we want zero. Maybe we make it less bad through a compromise. So if the Republicans in the House pass defund, Democrats in the Senate continue to fund, maybe there could be a compromise in the middle where we get some rid of the taxes, and get rid of some of the bad parts of Obamacare," Paul (R-Ky.) said on Fox News's "Fox and Friends" (McCalmont, 9/23).

The Washington Post: Health-Care Push Brings Bill Clinton, Obama Together, With Political Benefits For Both
In one of his first acts as President Obama's new health-care adviser, Chris Jennings traveled to Harlem last month to pay a visit to his old boss, Bill Clinton. Armed with a PowerPoint presentation detailing how the new health-care law will go into effect, Jennings made his pitch: Obama needs your help, both to persuade millions of uninsured Americans to sign up for coverage and to combat Republican attempts to undermine the law (Rucker, 9/23).

The Associated Press/Washington Post: Obama, Bill Clinton Reunite To Discuss Health Care Law A Week Before Key Enrollment Date
Health care is reuniting President Barack Obama and former President Bill Clinton. The two are set to appear together Tuesday to discuss Obama's health care law at a session sponsored by the Clinton Global Initiative, the former president's foundation (9/24).

Politico: President Obama, Bill Clinton Begin Health Care Rollout
President Barack Obama will kick off his administration's six-month rollout of Obamacare during a "conversation" Tuesday with former President Bill Clinton. With the Obamacare insurance exchanges set to open Oct. 1, the White House is deploying the president, first lady Michelle Obama, Vice President Joe Biden and Cabinet secretaries to encourage consumers to sign up for coverage before enrollment closes March 31, 2014 (Budoff Brown, 9/23).

The Wall Street Journal's Washington Wire: Poll: Americans Lean Against Defunding Obamacare
According to a new CNBC poll, 59% of Americans are opposed to defunding Obamacare if it means defaulting and shutting down the government and 19% are in favor of it. Eighteen percent of people polled were unsure. In regards to solely defunding Obamacare, 44% of Americans were against it and 38% were in favor, according to the poll, done by Hart-McInturff, the same pollsters that do the Wall Street Journal-NBC News polls. Broken down by gender, 47% of women are against defunding Obamacare and 33% are in favor (Prang, 9/23).

Politico: Obamacare: One Blow After Another
The Obamacare that consumers will finally be able to sign up for next week is a long way from the health plan President Barack Obama first pitched to the nation. Millions of low-income Americans won't receive coverage. Many workers at small businesses won't get a choice of insurance plans right away. Large employers won't need to provide insurance for another year. Far more states than expected won't run their own insurance marketplaces. And a growing number of workers won't get to keep their employer-provided coverage (Haberkorn and Budoff Brown, 9/23).

The Wall Street Journal: Health Insurers Scramble to Keep Healthy Customers
Health insurers are making a big push to hang onto their policyholders ahead of new government-run exchanges expected to roll out next week, but state regulators have accused some of misleading those customers in the process (Martin, 9/23).

USA Today: HHS Starts Features To Help Consumers Learn Insurance
The government launched a new webpage, training videos and infographics Monday to help Americans better understand the health insurance exchanges that will launch Oct. 1 (Kennedy, 9/23).

Kaiser Health News/The Washington Post: Medicare Penalizes Hospitals In Effort To Reduce The Number Of Patients Readmitted
Every hospital in the District and five in the Virginia suburbs will be penalized in the second round of Medicare's campaign to reduce the number of patients readmitted to hospitals within a month, according to federal records. Nationwide, Medicare identified 2,225 hospitals that will have their reimbursements for patient care reduced starting Oct. 1 because readmissions at each occurred more frequently than Medicare believes they should have. Hospitals that treated large proportions of low-income patients were more likely to be penalized than those treating the fewest low-income patients (Rau, 9/23).

The New York Times: F.D.A. To Regulate Some Health Apps
The Food and Drug Administration said Monday that it would regulate only a small portion of the rapidly expanding universe of mobile health applications, software programs that run on smartphones and tablets and perform the same functions as medical devices (Tavernise, 9/23).

Politico: Lobbyists Roll Up Sleeves For Compounding Battle
If you want to know how nervous the pharmaceutical industry is about the prospect of new federal regulation of compounding pharmacies -; like the one involved in last year's lethal fungal meningitis outbreak -; look to K Street. As lawmakers have introduced bills in the House and Senate to regulate these drug-making practices, pharmacies, pharmaceutical companies and trade groups are ramping up their lobbying support for the battle to come (Drusch, 9/24).

Politico: Sleep Apnea Bill Crosses The Aisle
The tale of a sleep apnea bill shows what just might be the most efficient Congress has been in years. In a few short weeks, two House members went from writing a simple two-page bill to seeing the Federal Motor Carrier Safety Administration committing to a formal rule making on sleep apnea testing and treatment for truckers and other professional drivers (Snider, 9/24).

The New York Times: Global Spending To Fight AIDS Has Grown Slowly, Report Finds
Global financing to fight AIDS has remained essentially flat since the 2008 financial crisis, according to a report by the Kaiser Family Foundation and the United Nations AIDS-fighting agency. About $7.9 billion from donors went to poor and middle-income countries last year (McNeil, 9/23).

The Associated Press/Washington Post: Company Objects Over Being Disqualified From Bidding For Arkansas Medicaid Contract
The head of a Maryland company disqualified from bidding on a Medicaid contract in Arkansas complained Monday that the state relied too much on the knowledge that Louisiana had terminated a similar contract and didn't take into account the firm's performance in other states (9/23).

The Wall Street Journal: Amid Push for Clinics, Some Patients Prefer Hospitals
Health-care officials are searching for funds to open smaller clinics as hospitals close. But another obstacle might prove equally hard to overcome: New Yorkers like their local hospitals. Clinics are typically open during business hours, not evenings and weekends. It often takes weeks to get an appointment. Health-care experts say clinics are sometimes perceived as less trustworthy than imposing brick hospitals that have been in the neighborhood for decades. Smaller clinics staffed by local residents create privacy fears in tightly knit cultural communities (Kusisto and Fox, 9/23).

The Wall Street Journal: Brooklyn Grapples With Struggling Hospitals And Demand For Health Care
A new vision for Brooklyn health care was unveiled two years ago with much fanfare: Several struggling hospitals would merge with others, a state panel proposed, and less-expensive outpatients clinics would spring up in their place (Kusisto, 9/23).