First Edition: October 31, 2013

Today's headlines include reports about the Obama administration's efforts to recover from health law implementation hiccups and challenges. 

Kaiser Health News: Key Senate, House Committee Chairs Offer Plan To Fix Medicare Doctor Payments
Kaiser Health News staff writer Mary Agnes Carey reports: "The Democratic And Republican leaders of two key congressional committees have agreed on a framework to scrap the problematic Medicare payment formula for physicians and replace it with one that would link physician reimbursement to the quality of care provided, a step that could put an end to the annual 'doc fix' debate" (Carey, 10/31). Read the story.

Kaiser Health News: Why Insurers Cancel Policies, And What You Can Do When It Happens
Kaiser Health News staff writer Julie Appleby reports: "News that health insurers are ending the policies of what could be millions of Americans has rattled consumers and added to the debate over the health care law.  If you or a family member has been notified that your individual policy is being cancelled at year's end, you may be stunned and upset. Here is a guide to help you understand the bigger picture, including why your premiums and benefits are likely to change next year and what you should consider as you shop for a new policy (Appleby, 10/30). Read the story.

Kaiser Health News: Health On The Hill: Sebelius Says Healthcare.gov Problems Are Her Responsibility
Kaiser Health News staff writer Mary Agnes Carey and CQ Roll Call's Emily Ethridge discuss the days events on Capitol Hill, including Health and Human Services Secretary Kathleen's Sebelius' testimony in which she said she couldn't give firm numbers on how many people have enrolled for health insurance using the website because the data are not yet trustworthy (10/30). Read the transcript or listen to the audio.

Kaiser Health News: Help Flies In For Troubled Hospital In Estes Park, Colo.
Reporting for Kaiser Health News, in partnership with NPR, Eric Whitney writes: "Estes Park, Colorado, is weathering a tough season. Seven weeks ago floods wiped out all but one road into the small, tourism-dependent community adjacent to Rocky Mountain National Park. Hotels and businesses were just getting cleaned up and the town was hoping to salvage some kind of fall color season, when the government shutdown hit, closing the park for ten days" (Whitney, 10/30). Read the story.

Kaiser Health News: Capsules: Rep. Ryan And CMS Chief Tavenner's Exchange Muddles Subsidies For Young Adults
Now on Kaiser Health News' blog, Michelle Andrews reports: "In a contentious House Ways and Means Committee hearing Tuesday about the problem-plagued launch of the federal health insurance exchange, Rep. Paul Ryan, R-Wis., and Marilyn Tavenner, the administrator of the Centers for Medicare & Medicaid Services, managed to agree about one thing: Young adults who have access to their parents' health insurance can't get subsidies if they choose instead to buy a plan on a health insurance exchange. Unfortunately, they're both wrong, say health policy experts" (Andrews, 10/30). Checkout what else is on the blog.

The New York Times: Contrite White House Spurns Health Law's Critics
The White House on Wednesday blended expressions of contrition for the troubled rollout of its health care law with an aggressive rejection of Republican criticism of it, as the administration sought a political strategy to blunt the fallout from weeks of technical failures and negative coverage. While Kathleen Sebelius, the secretary of health and human services, apologized profusely during a politically charged hearing on Capitol Hill, President Obama traveled to Massachusetts to argue forcefully that the Affordable Care Act will eventually be just as successful as the similar plan pioneered by Mitt Romney, his onetime rival and a former governor of the state (Shear and Pear, 10/30).

Politico: Obamacare's Split-Screen Day
President Barack Obama's prescription for health care law critics: Take a deep breath -; and move on. Never mind that House Republicans have beaten up on two of his top health officials on consecutive days; that one of them, Health and Human Services Secretary Kathleen Sebelius, faces new calls to resign seemingly every day; or that the Obamacare website crashed while Sebelius was testifying on the Hill Wednesday (Allen and Budoff Brown, 10/31).

Los Angeles Times: Obama: GOP Critics Of Obamacare Should Follow Romney Example
President Obama said the buck stops with him on the failures of healthcare.gov but accused Republican governors of working against the success of the Affordable Care Act. Speaking to a crowd in Boston, at the historic hall where onetime Republican Gov. Mitt Romney signed that state's 2006 healthcare reform into law, Obama pointed to his former rival as an example of bipartisan cooperation (Parsons, 10/30).

Politico: Obama Can't Quite Mitt
President Barack Obama just can't leave Mitt Romney alone. The former Massachusetts governor and 2012 GOP presidential nominee serves as a perpetual foil for the White House – and he's one who can't effectively fight back, has no base of support among Republicans and just happened to be the only other American politician to sign a universal health care law (Epstein, 10/30).

The Washington Post: Obama On Health Care Law: 'We Are Going To See It Through'
President Obama delivered a spirited defense of his health-care law Wednesday in the face of problems with the launch of its online insurance marketplace, vowing that "we are going to see it through." In a speech in Boston, Obama took responsibility for making sure that problems with the Web site, HealthCare.gov, are fixed as soon as possible (Rucker and Branigin, 10/30).

The Associated Press/Washington Post: Obama Claims 'Full Responsibility' For Health Care Website Fixes As Security Concerns Surface
Obama underscored the administration's unhappiness with the problems so far: "There's no excuse for it," he said during a Boston speech to promote his signature domestic policy achievement. "And I take full responsibility for making sure it gets fixed ASAP." The website HealthCare.gov was still experiencing outages as Sebelius faced a new range of questions at the House Energy and Commerce Committee about a security memo from her department. It revealed that the troubled website was granted a temporary security certificate on Sept. 27, just four days before it went live on Oct. 1 (10/30).

The Wall Street Journal: Obama Tempers Insurance Pledge As Health Fight Rages
President Barack Obama on Wednesday said Americans who are losing insurance under the health law would find better coverage, rebutting a rising chorus of complaints that he had oversold the law's benefits. With Republican criticism in Congress intensifying over canceled policies and the new online insurance marketplaces malfunctioning, Mr. Obama used a speech in Boston to tell Americans that they could obtain improved insurance if they shopped around. This comes after the president has long said that people who like their health plans would be able to keep them after the new law takes effect next year (Nelson and Nicholas, 10/30).

The Washington Post: Sebelius On Health-Care Law Rollout: 'Hold Me Accountable For The Debacle. I'm Responsible."
The battle over the government's problem-plagued health-care Web site escalated on Wednesday as Republicans attacked the Obama administration over an array of emerging issues involving the health law, including potential security vulnerabilities on the site and complaints from Americans facing cancellations of existing policies (Kliff, Rucker and Somashekhar, 10/30).

NPR: Congressmen Berate Sebelius For Cancellations, Website Woes
Health and Human Services Secretary Kathleen Sebelius headed to Capitol Hill Wednesday for a date with lawmakers frustrated by the rocky rollout of the HealthCare.gov website. What she got at the House Energy and Commerce Committee was four hours of venting from Democrats and Republicans alike (Rovner, 10/31).

The New York Times: Sebelius Apologizes For Health Site's Malfunctions
In three and a half grueling hours of testimony before a House committee, Ms. Sebelius apologized for the missteps and problems in efforts to carry out the president's most important domestic initiative (Pear, 10/30).

Los Angeles Times: Sebelius Apologizes For Obamacare 'Debacle'
Sebelius acknowledged that enrolling in insurance plans through the federal government's online marketplace was a "miserably frustrating experience for way too many Americans" -; an observation Republicans repeatedly underscored by pointing to a screen that showed in real time that the website, healthcare.gov, was displaying an error message (Memoli, 10/31).

The Wall Street Journal: Sebelius Apologizes For Health Site's Woes
Despite calls from some Republicans for her resignation, Mrs. Sebelius gave no indication that she had plans to do so, saying she was "committed to earning your confidence back" by fixing the site (Schatz and Radnofsky, 10/30).

The Associated Press/Washington Post: Fact Check: Sebelius Offers A Flawed Defense When Pressed To Enroll In Health Exchange
But her response to Republicans who pressed her Wednesday to sign up under a health insurance exchange was problematic. She said that because she's part of the federal employee health plan, she's not eligible to switch to the exchanges. In fact, Americans who have workplace health insurance, as most with coverage do, can drop it in favor of individual policies offered by the exchanges. But doing so would not make financial sense for most (10/30).

Politico: GOP Rides Wave Of Insurance Cancellation Notices
Since the Affordable Healthcare Act was introduced in 2009, Republicans have dismissed President Barack Obama's oft-repeated promise that anyone who liked their insurance plan would be able to keep it. But was anyone paying attention? (Byers, Gold and Samuelsohn, 10/31).

NPR: Notices Canceling Health Insurance Leave Many On Edge
President Obama repeated this line or a variation of it many times during the campaign to pass his landmark health care bill: "If you like your health care plan, you'll be able to keep your health care plan, period." But while that might be true for people who get health insurance through their employer, it's not true for many people who buy their policies in the individual market -; about 5 percent of the nation's policyholders (Ydstie, 10/30).

The Washington Post: Obama's Health-Care Promise That People Can Keep their Insurance Comes Back To Haunt Him
It is a catchy sound bite that has turned around to bite the hand that fed it to the country: If you like the health insurance you have, you can keep it. President Obama's credibility has taken a hit over that line, which he tossed off in various versions during countless campaign stops and policy speeches (Tumulty, 10/30).

The Associated Press/Washington Post: Promises, Promises: A Big Obama Health Insurance Promise That Never Stood A Chance
President Barack Obama's soothing promise that Americans happy with their health insurance could simply keep it was doomed from the start, and everyone familiar with the market seemed to recognize that except the president. Even his aides said four years ago, early in the huge push for his health care law, that he wasn't to be taken literally on that point. But he kept making the promise, literally and forcefully, through the long debate about the overhaul, after it became law and directly to voters in the campaign for the 2012 election. The words sometimes varied but the message didn't: Not only was a better day coming for people with no insurance or bad insurance -; but everyone else could just relax (10/31).

Los Angeles Times: Insurers, White House Argue Against Delaying Healthcare Deadline
Even with its health insurance marketplace floundering for the fourth week, the Obama administration is resisting what some Democratic allies contend is the most logical response to the problem: giving consumers more time to sign up. According to insurers and the White house, delaying the deadline could undermine efforts to lure a broad, young and healthy mix of consumers to the market. That would end up costing insurers, and possibly taxpayers, money (Hennessey and Parsons, 10/30).

Los Angeles Times: Lack Of Enrollment Workers Hampers Insurance Exchange Sign-Ups
A month into enrollment under the Affordable Care Act, hundreds of healthcare workers and insurance agents are still unable to sign up consumers for health coverage through California's new exchange. Despite promises of an army of workers blanketing the state to help, many aren't in place -; or they're hitting one state roadblock or another (Terhune and Brown, 10/30).

Los Angeles Times: EHealth CEO To Obama: Let Us Take Over Healthcare.gov
EHealth Inc., the nation's largest online seller of health insurance, is offering to run Obamacare enrollment for the federal government while the balky healthcare.gov website is being fixed. Gary Lauer, chief executive of EHealth, said in a letter this week to President Obama that his Mountain View, Calif., company was willing to operate the federal exchange through its website as a temporary stopgap to give officials more time to repair the troubled online marketplace (Terhune, 10/30).

The Wall Street Journal: Doctors Fault Provider Lists Exchanges Get From Insurers
Many new health exchanges don't yet let shoppers see which doctors accept which insurance plans. Where exchanges do post the so-called provider lists, they often contain inaccurate or misleading information, some doctors say, including wrong specialties, addresses and language skills, and no indication whether providers are accepting new patients (Beck, 10/30).

The Wall Street Journal: Some Factories Stick With Old Health Plans
Some small manufacturers facing soaring costs for employee health insurance say they are likely to continue coverage for their workers, even though they won't be required to under the Affordable Care Act. They are wary of discontinuing coverage and sending their employees to new insurance exchanges to obtain their own insurance. They say the problem-filled rollout of the federal government's online insurance market has raised further doubts about whether their employees would have access to sufficient coverage at lower costs (Tita, 10/30).

The Associated Press/Washington Post: Conservative Group Files Lawsuit Seeking To Have New Health Care Law Declared Unconstitutional
The Association of American Physicians and Surgeons is seeking to have the health care law overturned. The group is seizing on a provision that was supposed to go into effect next year but ultimately was postponed for 12 months. That provision requires employers with 50 or more workers to offer affordable coverage or face fines, but it's been put off until 2015 (10/30).

The Washington Post: Beneath Conference Committee's Sweet Words Lurks Old Sticking Point: Taxes
Chastened by three years of budget showdowns and economic near-calamities, the 22 senators and seven House members on a new budget conference committee expressed fresh eagerness to end the era of government by crisis. Democrats, for instance, said they are ready to swap sharp but temporary cuts to federal agencies, known as the sequester, for permanent "structural changes" to federal health programs long sought by Republicans (Montgomery, 10/30).

Los Angeles Times: Budget Talks To Ward Off Another Shutdown Begin
The panel, created from this month's budget agreement, has until Dec. 13 to negotiate a budget framework. Funding to keep the federal government open runs out by Jan. 15. Republicans resisted new taxes, saying they would rather reduce spending on Medicare and other safety-net programs. Democrats want wealthy individuals and corporations to contribute more tax revenue to help solve the nation's fiscal problems (Mascaro, 10/30).

Los Angeles Times: Federal Appeals Court Could Rule Soon On Texas Abortion Law
A federal appeals court in New Orleans had yet to rule Wednesday on Texas officials' request for an emergency order allowing a set of new abortion restrictions to take effect in their state as scheduled. On Monday, a federal judge in Texas issued a ruling that blocked some of the restrictions that he found unconstitutional, including a provision requiring doctors at abortion clinics to have admitting privileges at nearby hospitals and limits on medication-induced abortions (Hennessy-Fiske, 10/30).

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