First Edition: November 4, 2013

Today's headlines include the latest on the efforts to address the problems with healthcare.gov, as well as the continuing controversy surrounding President Barack Obama's promise that Americans could keep their health coverage if they liked it juxtaposed with the news of recent policy cancellations.

Kaiser Health News: In Alabama, Lack Of Competition May Be Behind Insurance Premium Costs
Kaiser Health News staff writer Jay Hancock, working in collaboration with USA Today, reports: "The letters landed in early October, cancelling health plans for thousands of BlueCross BlueShield of Alabama members and offering to enroll them in new coverage at often substantially higher cost. 'I thought my plan might go up like $30. I didn't know it was going to [nearly] double' to $478 a month, said Merry Hardy, who is self-employed and lives in Alexander City, in the middle of the state. 'I'm thinking, please God, let Obamacare fail'" (Hancock, 11/4). Read the story.

Kaiser Health News: Doctors Treat New Condition: Questions About Health Law
Kaiser Health News staff writer Anna Gorman, working in collaboration with McClatchy, reports: "Carolyn Senger, a preventive medicine doctor, regularly treats uninsured patients, coaching them how to stay healthy. Now she is teaching them one more thing -- how to sign up for insurance under the nation's Affordable Care Act. 'Not only can I help you with your health, but I can also help you get some coverage,' Senger says to her patients. Despite the ongoing controversy over the website and the rocky rollout of the law, the Obama administration still hopes that millions will sign up for new insurance options before the March 31 deadline. To make that happen, health officials are counting on physicians to shift the conversation from the online problems to the benefits of coverage. They are motivated by a longstanding principle: People trust their doctors" (Gorman, 11/4). Read the story.

Kaiser Health News: So You Found An Exchange Plan. But Can You Find A Provider?
WNYC's Fred Mogul, working in partnership with Kaiser Health News and NPR, reports: "Consumers shopping for coverage on the new health insurance exchanges have been focused on the lowest-cost options. But some shoppers are trying to determine which plans offer the widest array of doctors and hospitals -; and are finding that can be trickier than it sounds" (Mogul, 11/4). Read the story.

Kaiser Health News: Adding To Health Insurance Confusion, Other Groups Try To Cash In
WFSU's Lynn Hatter, working in partnership with Kaiser Health News and NPR, reports: "The 30 or so attendees at St. Mary Primitive Baptist Church on a recent evening believed they were about to hear an official presentation by the 'Obamacare Enrollment Team' on all of their options to get insurance because of the Affordable Care Act. They were told: 'If anybody is interested in getting enrolled we can get you enrolled tonight.' Signs outside the church even looked official:  A familiar large 'O' with a blue outline, white center and three red stripes" (Hatter, 11/4). Read the story.

Kaiser Health News also tracked weekend health policy headlines, including news about the appearance of Mitt Romney, former Massachusetts governor and failed GOP presidential nominee, on a Sunday talk show (11/3) as well as an appeals court ruling on the health law's contraception rule (11/1).

The New York Times: Under Health Care Act, Millions Eligible for Free Policies
Millions of people could qualify for federal subsidies that will pay the entire monthly cost of some health care plans being offered in the online marketplaces set up under President Obama's health care law, a surprising figure that has not garnered much attention, in part because the zero-premium plans come with serious trade-offs (Abelson and Thomas, 11/3).

The Associated Press/Washington Post: Americans See Potential For Winners And Losers Under Health Law, Causing Anxiety And Confusion
Now is when Americans start figuring out that President Barack Obama's health care law goes beyond political talk, and really does affect them and people they know. With a cranky federal website complicating access to new coverage and some consumers being notified their existing plans are going away, the potential for winners and losers is creating anxiety and confusion (11/3).

The Wall Street Journal: Critical Weeks Begin For Health Law Rollout
A potentially decisive month for the Affordable Care Act is beginning, with the Obama administration racing to meet its target of getting its health-insurance website functioning normally by the end of November. As a notice on the HealthCare.gov website suggests, normalcy is still a ways off.  The site's core function–allowing people to sign up for health insurance–"isn't available from approximately 1 a.m. to 5 a.m. EST daily while we make improvements," says the notice (Paletta, 11/3).

The Wall Street Journal: Officials Rebuff Call To Suspend Health Site
The Obama administration said Sunday it had rejected a call from a senior Democratic senator to shut down HealthCare.gov until it is fully fixed, saying that wouldn't help the government team racing to have the website up to scratch by the end of the month. November is developing into a challenging month for the administration, which is likely to face calls for more far-reaching changes to the Affordable Care Act if it can't get HealthCare.gov in shape by Nov. 30. Some Democrats have said that if the site isn't fixed soon, they would act to delay the law's requirement that most Americans carry health insurance in 2014 or pay a tax penalty (Radnofsky and Paletta, 11/3).

The Associated Press/Washington Post: Health Insurance Website's Application Page Down For Repairs Overnight
The application page of the troubled health insurance website is offline until Sunday morning. The Health and Human Services Department says a technology team will be working onHealthCare.gov, so people won't be able to apply or enroll through the site (11/2).

Politico: Max Baucus: Delay Obamacare Penalties If Website Still Lags
Senate Finance Committee Chairman Max Baucus says Congress would need to consider delaying Obamacare's penalties if the website is not repaired, but he said such conversations are "premature" at this point. "If it looks like Humpty Dumpty isn't getting good, back together, maybe we should start thinking about delaying the penalties," Baucus (D-Mont.) told News Talk 730 radio in Billings, Mont (Haberkorn, 11/4).

The Wall Street Journal: Outspoken Group Bears Brunt Of Canceled Health-Insurance Policies
Somebody has to pay more to enable America's uninsured to take part in the Obama administration's health-insurance marketplace-;somebody like Dave Hamilton, for example. Unfortunately for the Obama administration, Mr. Hamilton and others in his situation tend to be politically savvy and very vocal. Mr. Hamilton runs MacObserver.com, a website for fans of Apple equipment based in Durham, N.H. He is one of the 10 million or so who buy insurance on the individual market, don't qualify for subsidies under the Affordable Care Act and recently received notice that their current plans don't comply with the law's standards and will be canceled. Mr. Hamilton, 42, said he expected to pay more. But his rates are expected to rise by far more than the 20% he had calculated (Williamson, 11/1).

The Washington Post: For Consumers Whose Health Premiums Will Go Up Under New Law, Sticker Shock Leads To Anger
Americans who face higher ¬insurance costs under President Obama's health-care law are angrily complaining about "sticker shock," threatening to become a new political force opposing the law even as the White House struggles to convince other consumers that they will benefit from it. The growing backlash involves people whose plans are being discontinued because the policies don't meet the law's more-stringent standards. They're finding that many alternative policies come with higher premiums and deductibles (Cha and Sun, 11/3).

Politico: Obamacare Losers Could Pack Political Punch
Meet the new Soccer Mom: Obamacare losers. Millions of married, older, white, college-educated, GOP-leaning Americans have quickly seen their political profile rise after their health insurance companies sent them cancellation letters with the launch of the giant new health care law. It's not a huge segment of the population -; estimates show between 10 million to 19 million people bought health insurance from what Health and Human Services Secretary Kathleen Sebelius dubbed the "Wild West" individual marketplace (Samuelsohn and Millman, 11/1).

The Associated Press: Sticker Shock Often Follows Insurance Cancellation
The Griffins are among millions of people nationwide who buy individual insurance policies and are receiving notices that those policies are being discontinued because they don't meet the higher benefit requirements of the new law. They can buy different policies directly from insurers for 2014 or sign up for plans on state insurance exchanges. While lower-income people could see lower costs because of government subsidies, many in the middle class may get rude awakenings when they access the websites and realize they'll have to pay significantly more. Those not eligible for subsidies generally receive more comprehensive coverage than they had under their soon-to-be-canceled policies, but they'll have to pay a lot more (Kennedy, 11/2).

The Associated Press: Health Law Leads To Cancellation Of N.D. Policies
About 42,500 North Dakota residents, or roughly 6 percent of the state, were covered by individual plans at the end of 2013, according to state insurance records. In North Dakota, the health care changes will wipe out virtually all the 2,500 individual plans carried by Medica and Sanford Health (11/3).

The Associated Press/The Wall Street Journal: NY Expects 100,000 To Change Insurance
New York health officials say that about 100,000 individuals will have to change their health insurance under the federal health care overhaul. According to the state Health Department, those changes are required where current insurance plans don't comply with the terms of the Affordable Care Act (11/2).

The Washington Post: HealthCare.gov: How Political Fear Was Pitted Against Technical Needs
In May 2010, two months after the Affordable Care Act squeaked through Congress, President Obama's top economic aides were getting worried. Larry Summers, director of the White House's National Economic Council, and Peter Orzag, head of the Office of Management and Budget, had just received a pointed four-page memo from a trusted outside health adviser. It warned that no one in the administration was "up to the task" of overseeing the construction of an insurance exchange and other intricacies of translating the 2,000-page statute into reality. ... For weeks that spring, a tug of war played out inside the White House, according to five people familiar with the episode (Goldstein and Eilperin, 11/2).

USA Today: Small Businesses Race To Renew Health Plans Early
Thousands of small businesses around the U.S. are racing to renew their health insurance policies Dec. 1 to beat large premium increases their brokers say will hit them Jan. 1 when the Affordable Care Act takes full effect. Some health insurance brokers also say 2014 may be the last year many of the companies even offer health insurance (Jayne O'Donnell, 11/3).

Los Angeles Times: President Was Told Healthcare Website Would Work, Official Says
President Obama was assured that the healthcare insurance website was ready to launch on Oct. 1, even as private contractors and some administration officials knew the site had failed in early testing, a senior White House advisor said Sunday (Hennessey, 11/3).

The Wall Street Journal: Aides Debated Obama Health-Care Coverage Promise
As President Barack Obama pushed for a new federal health law in 2009, he made a simple pledge: If you like your insurance plan, you can keep your plan. But behind the scenes, White House officials discussed whether that was a promise they could keep. ... At one point, aides discussed whether Mr. Obama might use more in-depth discussions, such as media interviews, to explain the nuances of the succinct line in his stump speeches, a former aide said. Officials worried, though, that delving into details such as the small number of people who might lose insurance could be confusing and would clutter the president's message (Nelson, Nicholas and Lee, 11/2).

The Washington Post: Rep. Matt Cartwright, Loyal Democrat, Stand By Health-Care Law, Takes Stage To Defend It
Rep. Matthew Cartwright (D-Pa.) is in Congress today because of the Affordable Care Act. He did not vote for it, but he won because the veteran moderate Democrat he challenged in a primary voted against it. That's the kind of deep-blue district he now represents. Cartwright spent his first year in office preparing constituents for "the ACA" -; he never calls it "Obamacare" -; and reminding them to sign up for benefits at HealthCare.gov (O'Keefe, 11/3).

USA Today: Obama's Day: Health Care And Hockey
President Obama will spend part of his Monday rallying supporters to help his administration's push to get uninsured Americans signed up for coverage under the Affordable Care Act. Obama is set to deliver remarks on Monday evening at the Organizing for Action health care summit. He'll also hold a question-and-answer session at a working dinner with a smaller group at the summit, which is being hosted by OFA, a group run by the alumni of the president's two campaigns (Madhani, 11/4).

Politico: Obama To Talk Health Care In Dallas
President Obama will try to turn the tide from explanations of problems with the individual health care marketplace to a discussion of successful enrollment efforts as he travels to Dallas on Wednesday. Obama will use the visit to highlight work that's being done in communities across the country to explain and help Americans prepare for the full implementation of the Affordable Care Act as he meets with local volunteers, a White House official said (Epstein, 11/3).

The Wall Street Journal: Branded Drugs Chalk Up A Win Under Health Law
Drug makers scored a significant win last week in their effort to increase sales from the rollout of the health-care overhaul, when the Obama administration cleared a path for the companies to help pay patients' out-of-pocket costs of prescriptions. At issue was whether drug makers could help cover the cost of copayments on brand-name drugs for patients who get insurance through the overhaul's new insurance exchanges. The pharmaceutical industry spent about $4 billion on copayment assistance to patients in private health plans in 2011, according to an estimate by Amundsen Group, a consulting firm (Rockoff and Loftus, 11/3).

The Wall Street Journal: Kickbacks From Drug Makers Given All-Clear On Health Exchanges
The federal Department of Health and Human Services said it won't hold the new insurance offerings available on state and federally run exchanges to the same anti-kickback standards maintained for federal health programs such as Medicare. The decision was closely watched by the drug industry and patient advocacy groups, which worried long-standing-;but controversial-;programs in which drug makers help patients pay copays for costly medicines would be barred in the new health plans (Weaver, 11/1).

Texas Tribune/The New York Times: G.O.P. Pursues Hispanic Votes With Abortion Stance
Following this summer's divisive abortion debate in the State Legislature, Texas Republicans see an opening for the 2014 election as they work to reach out to Hispanic voters who could be spurred to the polls by the party's anti-abortion stance. But Democrats see the plan as a losing proposition for Republicans, arguing that the reputation of most Hispanics as socially conservative is inaccurate and that Hispanics tend to side with Democrats on the issues that matter most to them (Ura, 11/2).

Los Angeles Times: Health Insurer Alameda Alliance Dropped From Covered California
California's health insurance exchange lost one of its 12 insurers because a nonprofit health plan failed to get a necessary state license, reducing the number of choices for some consumers (Terhune, 11/1).

Politico: Graham Calls 20-Week Abortion Ban A Debate 'Worthy Of A Great Democracy'
As he moves to introduce a bill in the Senate banning abortions after 20 weeks of pregnancy, Sen. Lindsey Graham said Sunday the issue is a conversation a "humane" society needs to have. "This is a debate worthy of a great democracy. When do you become you? At 20 weeks of a pregnancy, what is the proper role of the government in protecting that child?" Graham said on "Fox News Sunday." Despite concerns about the constitutionality of such a ban, the South Carolina Republican who is up for re-election, said he and other advocates would make the case to the Supreme Court that it's a legitimate government interest to ban such abortions, making an exception for the health of the mother and cases of rape or incest (Kopan, 11/3).

The New York Times: Long-Term Care Agency To Repay Millions To Medicaid For Enrolling Ineligible Patients
The largest managed long-term care agency in New York has agreed in principle to repay $33.6 million to the state's Medicaid program for improper billings linked to the use of social adult day care centers, the attorney general, Eric T. Schneiderman, announced on Friday. As part of the settlement with the attorney general's Medicaid fraud control unit, the state will allow the agency, VNSNY Choice, to resume enrolling patients in its long-term care plan (Bernstein, 11/1).

The New York Times: Both Sides Invoke Obama in Climax of Virginia Governor's Race
At the same time, Mr. Cuccinelli, Virginia's attorney general, sought to turn the race into a referendum on the disastrous rollout of the federal health care exchange, mockingly welcoming Mr. Obama to Virginia. "Come on in, Mr. President, we're happy to see you," Mr. Cuccinelli told supporters on Saturday. "You just bring everybody's focus to Obamacare." Outside of a high school here where Mr. Obama spoke, a sizable band of protesters waved signs reading "You Lie!" referring to the hundreds of thousands of people whose health insurance is being canceled under the overhaul law, despite Mr. Obama's pledge that people who liked their plans could keep them (Gabriel, 11/3).