First Edition: October 11, 2013

Today's headlines include news about what experts are diagnosing as the trouble spots in the federal online health insurance exchange and how to fix them. 

Kaiser Health News: Looking For Washington's Best Hospital? Here's A Little Advice
Kaiser Health News staff writer Jordan Rau, working in collaboration with Washingtonian, reports: "What is the best hospital in Washington, D.C.? It's not as easy to figure out as you might think. Over the past two decades, a cottage industry of nonprofits and companies has sprung up that offers grades and rankings on the quality of hospitals. Because of the proliferation in ratings, two-thirds of the hospitals in the Washington area have won at least one distinction from a major rating group or company" (Rau, 10/11). Read the story.

Kaiser Health News: A Reader Asks: My Coverage Is Intermittent. Can I Do Better On The Marketplace?
Kaiser Health News consumer columnist Michelle Andrews answers a question from a contract worker looking for more consistent coverage (Andrews, 10/11). Read the column.

Kaiser Health News: Mississippi Consumers Try And Try Again To Use Healthcare.gov
Mississippi Public Broadcasting's Jeffrey Hess, working in partnership with Kaiser Health News and NPR, reports: "In Mississippi, one of 34 states letting the federal government operate the online health insurance marketplace created by the health law, consumers continue to face long delays and other technical difficulties as they try to log on and shop for affordable coverage" (Hess, 10/11). Read the story.

Kaiser Health News: Capsules: Healthcare.gov Offers New Shopping Feature -; Sort Of; Good News About Saving For Retirement Health Costs
Now on Kaiser Health News' blog, Phil Galewitz reports on the new shopping feature available on the federal government's health care website: "With consumers in 36 states struggling to access a federal exchange website to compare health plans, the Obama administration launched a new online tool Thursday that lets users see premium estimates by state, health plan and two age categories" (Galewitz, 10/11).

Also on the blog, Ankita Rao reports on a new study regarding planning for retirement health care costs: "A new report from the Employee Benefit Research Institute found that Medicare beneficiaries, who are 65 years or older, would need to save six to 11 percent less in 2013 than they did in 2012" (Rao, 10/10). Check out what else is on the blog.

Politico: Democrats – So Far – Confident That Obamacare Web Site Can Be Fixed
Democrats are cutting President Barack Obama some slack on the clunky Obamacare website -; for now. Problems with the HealthCare.gov signup site have been so massive that most people who try to sign up can't get to step one. The troubled rollout is about the last thing Democrats need while they're trying to fend off the Republican efforts to defund or delay the president's signature health law (Nather, 10/11).

Politico: GOP To Obamacare Contractors: What Happened?
Republican lawmakers are demanding answers from the White House about the technical flaws that have crippled Obamacare's online enrollment system in its opening week. Top House watchdog Rep. Darrell Issa and others say the troubled reality doesn't jibe with the rosy predictions administration officials and contractors were making ahead of the Oct. 1 launch of HealthCare.gov, the online portal most of the country will use to enroll new Obamacare coverage programs (Cheney, 10/10).

The Wall Street Journal: Healthcare.Gov's Flaws Found, Fixes Eyed
Government officials are considering rebuilding some parts of the federally run health-insurance marketplace that have been identified as the key flaws that blocked many consumers from getting coverage. Much of the problem stems from a design element that requires users of the federal site, which serves 36 states, to create accounts before shopping for insurance, according to policy and technology experts. The site, healthcare.gov, was initially going to include an option to browse before registering, but that tool was delayed, people familiar with the situation said (Weaver and Radnofsky, 10/10).

The Wall Street Journal: New State Health Exchanges Have Largely Fixed Glitches
New state-run health-insurance exchanges have largely fixed their technical problems, marking a sharp contrast with the federal government more than a week after the centerpiece of the Affordable Care Act opened for business (Schatz, Dawsey, Dooren, 10/10).

The New York Times: Blue Cross Plans Jump To An Early Lead
On the first day that people could buy coverage under the federal health care law last week, the chief executive of Independence Blue Cross in Philadelphia had just learned that his company's plans were the area's least expensive available through the new state exchanges. "We were thrilled," said Daniel J. Hilferty, the nonprofit insurer's chief executive (Abelson, 10/10).

The New York Times: In Florida, Opposition By The State And Snags In Signing Up On The Web
Be it gold, silver or bronze level, there are two ironclad requirements for buying health insurance in Florida on the federal online exchange: patience and persistence. … First the State Legislature roundly rejected the law, refusing to create a state insurance exchange and punting it to the federal government to run the new insurance market. It also rejected $51 billion in federal funds that was available over 10 years to expand Medicaid coverage for the state's poor. As the day neared for consumers to enroll in insurance plans, state officials announced that so-called navigators -; a group assigned to help people sign up -; would be barred from state health offices just like all other outside groups. But blame this week shifted to the federal government (Alvarez, 10/10).

The New York Times: Health Act Embraced  In California
There are radio and television commercials galore, along with Twitter and Facebook posts and scores of highway billboards. There are armies of outreach workers who speak Spanish, Tagalog, Cambodian, Mandarin and Cantonese, all flocking to county fairs, farmers markets, street festivals and back-to-school nights across the state. There are even dinner parties in Latino neighborhoods designed to reach one family at a time (Medina, 10/10).

Los Angeles Times: Obamacare Q & A: Will My Plan Skyrocket? How Will The Unemployed Pay?
Millions of Americans have been checking out new health insurance exchanges since enrollment in Obamacare launched Oct. 1. During its first week, California's insurance exchange received nearly 60,000 calls from consumers and about 1 million Web visitors. Despite numerous technical glitches, federal officials say 8 million people logged on last week to their online exchange for 36 states not running their own marketplace. This rollout has prompted many questions from people about what President Obama's Affordable Care Act will mean for them (Terhune, 10/10).

The New York Times: Kochs And Other Conservatives Split Over Strategy On Health Law
Under attack for the government shutdown, some of the most vocal elements of the conservative wing of the Republican Party are publicly splintering, a sign of growing concerns among even hard-core conservatives that the defeat-health-care-at-any-cost strategy may have backfired (Lipton and Confessore, 10/10).

The New York Times: No Quick Deal, But Offer By G.O.P. On Debt Shifts The Tone
Many House Republicans, leaving a closed-door party caucus earlier Thursday that at times grew contentious, said they would support their leadership's short-term debt limit proposal. But they said they would do so only if Mr. Obama agreed to negotiate a broader deficit reduction deal, with big savings from entitlement programs. The president has insisted he will not agree to significant reductions in projected Medicare and Medicaid spending -; even his own tentative proposals -; unless Republicans agree to raise revenues by curbing tax breaks for corporations and wealthy individuals. And Mr. Boehner in recent days reaffirmed the party's anti-tax stance, which suggests that future talks could founder (Calmes and Parker, 10/10).

Los Angeles Times: GOP Plan To Extend Debt Limit Raises Hope Of End To Impasse
The president's healthcare law, which Republicans spent weeks trying to block or delay as a condition of approving any funding bills this fall, was "not discussed," Rogers said. The House could vote as early as Friday, but both houses planned weekend sessions. The Treasury Department says the debt ceiling needs to be raised by Oct. 17 (Mascaro and Memoli, 10/10).

The Associated Press/Washington Post: No Deal Yet, But House GOP, White House Seek End To Debt Limit, Government Shutdown Battles
Boehner's offer represented give on the part of Republicans, who had been insisting on cuts to Obama's 2010 health care law and other programs as the price for reopening government and extending the debt limit. But they claimed victory on one front, noting that they were in negotiations with a president who had said repeatedly there would be none until the government was open and default prevented. The speaker's plan -; and positive though unenthusiastic words about it from White House spokesman Jay Carney -; seemed to spark a good day in the financial world (10/11).

The Washington Post: Competing Plan Emerges In Senate To End Shutdown, Raise Debt Limit For 3 Months
The package was being assembled by Sen. Susan Collins (R-Me.) and has attracted the interest of Senate Democrats, sparking the first bipartisan negotiations since the stand-off began in early September. … Senate Democrats were intrigued by Collins' proposal, but unhappy with its demand for Democratic concessions. Those include repeal of a tax on medical devices needed to fund the new health care initiative and new income verification procedures for people who receive tax subsidies to buy health insurance on the law's new exchanges (Montgomery, 10/10).

The Wall Street Journal: Obama, GOP Open Talks Over Temporary Debt Fix
A new poll shows that Republicans are bearing the brunt of public outrage over the budget impasse. The Wall Street Journal/NBC News poll found 53% of Americans blamed the GOP for the shutdown, compared with 31% who blamed Mr. Obama. The Republican Party's image has slumped to its lowest level in Journal/NBC polling, which dates to 1989, with more than twice as many people holding a negative image of the GOP as a positive one. Until now, Mr. Obama had refused to negotiate until the government was reopened and the debt ceiling raised. Republicans, in turn, said those steps must be paired with a deficit-reduction plan and changes to the 2010 health care law that they knew Mr. Obama wouldn't accept. While Republicans on Thursday initially proposed moving only to raise the debt limit, discussions broadened to include efforts to reopen the federal government (Hook and O'Connor, 10/10).

The New York Times: Ryan Is Again In The Forefront For The G.O.P.
Mr. Ryan, 43, has immense credibility with conservatives for his "Path to Prosperity" budget, which proposed politically risky Medicare changes and deep tax cuts. Moderates see Mr. Ryan, who has broken with some conservatives over immigration, as a lawmaker with some flexibility. In many respects, his standing exceeds that of the party's titular leader, Speaker John A. Boehner. Perhaps most important, Democrats believe that when Mr. Ryan drafts a plan, he can actually deliver the votes. They hold no such confidence in Mr. Boehner (Weisman, 10/10).

NPR: Shutdown Imperils Costly Lab Mice, Years Of Research
The government shutdown is likely to mean an early death for thousands of mice used in research on diseases such as diabetes, cancer and Alzheimer's. Federal research centers including the National Institutes of Health will have to kill some mice to avoid overcrowding, researchers say. Others will die because it is impossible to maintain certain lines of genetically altered mice without constant monitoring by scientists. And most federal scientists have been banned from their own labs since Oct. 1 (Hamilton, 10/10).

Los Angeles Times: Gov. Brown Extends Insurance Coverage For Autism Treatment
Gov. Jerry Brown has approved a 2 1/2-year extension of a program that requires insurance coverage for early autism treatment. Since its creation in 2011, the program has helped more than 12,500 Californians, according to Senate leader Darrell Steinberg (D-Sacramento), the author of the bills creating and extending the program (McGreevy, 10/10).

Los Angeles Times: Santa Clara University Drops Insurance For Elective Abortions
Santa Clara University, a Catholic institution in the Silicon Valley area, is dropping coverage for elective abortions under health insurance for its faculty and staff members, officials said. The move is part of what seems to be a trend among Catholic campuses seeking to uphold their religious beliefs against abortion while employing and enrolling many non-Catholics. Loyola Marymount University in Los Angeles took a similar step this week but, in a compromise, is allowing employees to buy coverage for elective abortions through an insurance plan not administered or subsidized by the school (Gordon, 10/10).

Los Angeles Times: Gov. Brown Orders Swift Response To Mental Hospital Crimes
Gov. Jerry Brown on Thursday signed legislation aimed at protecting victims of sex crimes in state hospitals and developmental centers. SB 651 by Senator Fran Pavley (D-Agoura Hills) mandates that victims of suspected abuse in the hospitals and centers for the developmentally disabled receive immediate examinations by trained investigators at independent facilities to collect evidence (McGreevy, 10/10).