First Edition: November 5, 2013

Today's headlines include continuing coverage of the implementation issues that are plaguing the health law, as well as President Barack Obama's pledge to campaign for the overhaul's success.  

Kaiser Health News: Insuring Your Health: For Many Workers, It's Time To Consider Insurance Options
Kaiser Health News consumer columnist Michelle Andrews writes: "It's annual enrollment time, the autumn period when many people with job-based health insurance ante up for another year. Although news reports have fixated on the problems with the online health marketplaces that launched Oct. 1, for the vast majority of people that's a nonissue. If they get insurance through a job at a company that has at least 50 employees, they probably won't be using the marketplaces, also called exchanges" (Andrews, 11/4). Read the story.

Kaiser Health News: Call Centers Got Big Contracts From Health Law, But How Big Is Unclear
WNPR's Jeff Cohen, working in partnership with Kaiser Health News and NPR, reports: "Before the Affordable Care Act was even open for enrollment, Viviana Alvarado was already taking calls from people who wanted to know more. She and about 40 of her colleagues are answering the phones for Maximus, the company Connecticut contracted to run its call center. The contractors running the troubled federal healthcare.gov website have been under intense scrutiny in the past month, but those businesses aren't the only ones being paid to roll out Obamacare" (Cohen, 11/5). Read the story.

Kaiser Health News: Oregon's State Exchange May Be Worse Than Healthcare.gov
Oregon Public Broadcasting's Kristian Foden-Vencil, working in partnership with Kaiser Health News and NPR, reports: "As the federal government consumes humble pie over failures in the health insurance exchanges, some states that have set up their own exchanges are also struggling. Oregon has yet to enroll one single person, and it's been reduced to pawing through paper applications to figure out eligibility. When Cover Oregon opened Oct. 1, executive director Rocky King was excited. He'd been preparing for years. 'Day one, we are accepting applications. And staff at the Oregon Health Authority and Cover Oregon are ready to process those applications,' he said on opening day" (Foden-Vencil, 11/4). Read the story.

Kaiser Health News: Capsules: 17 Million People Eligible For Premium Subsidies, Study Finds; Study Points To "Imbalance" In Spending On Doctor Training
Now on Kaiser Health News' blog, Mary Agnes Carey reports on a new study regarding eligibility for health law subsidies: "Seventeen million people who are now uninsured or who buy their own health insurance will be eligible for tax credits next year to help purchase coverage on the health law's online marketplaces or exchanges, according to an analysis released Tuesday" (Carey, 11/5).

Also on the blog, Phil Galewitz reports on findings about a spending "imbalance" related to doctor training: "Florida and New York have roughly the same population, but New York has five times as many Medicare-sponsored residency training positions and seven times the Medicare funding graduate medical education. The numbers give a glimpse into the 'imbalance' in how Medicare distributes its $10 billion a year for graduate medical education (GME), according to a study by George Washington University researchers published Monday in Health Affairs" (Galewitz, 11/4). Check out what else is on the blog.

The Wall Street Journal: Young Avoid New Health Plans
Insurers say the early buyers of health coverage on the nation's troubled new websites are older than expected so far, raising early concerns about the economics of the insurance marketplaces. If the trend continues, an older, more expensive set of customers could drive up prices for everyone, the insurers say, by forcing them to spread their costs around. "We need a broad range of people to make this work, and we're not seeing that right now," said Heather Thiltgen of Medical Mutual of Ohio, the state's largest insurer by individual customers. "We're seeing the population skewing older" (Weaver and Martin, 11/4).

The Associated Press/Washington Post: Obama's Promises On Health Care Return To Haunt As Simple Sales Pitch Meets Complex Reality
It sounded so simple. Too simple, it turns out. President Barack Obama's early efforts to boil down an intricate health care law so Americans could understand it are coming back to haunt him, leaving a trail of caveats and provisos in place of the pithy claims he once used to sell the law (11/5).

The Wall Street Journal's Washington Wire: Obamacare Notes Show Worries About Pushing Paper Applications
Top health officials worried that encouraging people to fill out paper applications for insurance after they couldn't sign up through the troubled HealthCare.gov website wouldn't get them coverage any faster, but they gave in as the site's troubles persisted, internal meeting notes released Monday show (Radnofsky, 11/4).

Politico: State Health Exchanges Are Showing Mixed Results
On the Obamacare racetrack, Washington, Kentucky and New York are leading the pack. Relatively free of the technical problems that have plagued the federally run insurance exchanges -; but still encumbered by some glitches of their own -; the 15 state-run exchanges tell a varied story. Some states are charging ahead on enrollment while others have run up against roadblocks (Cunningham, 11/5).

The New York Times: Strategic Move Exempts Health Law From Broader U.S. Statute
The Affordable Care Act is the biggest new health care program in decades, but the Obama administration has ruled that neither the federal insurance exchange nor the federal subsidies paid to insurance companies on behalf of low-income people are "federal health care programs." The surprise decision, disclosed last week, exempts subsidized health insurance from a law that bans rebates, kickbacks, bribes and certain other financial arrangements in federal health programs, stripping law enforcement of a powerful tool used to fight fraud in other health care programs, like Medicare (Pear, 11/4).

The New York Times: Obama To Campaign To Ensure Health Law's Success
On the fifth anniversary of his election, President Obama told a rally of grass-roots supporters on Monday evening that "I've got one more campaign in me" -; to make sure his signature health care law works. The president, who has faced four years of Republican attacks against the law in Congress, state capitals and the Supreme Court, sought to reassure about 200 leaders of his Organizing for Action network at its health care summit meeting. His comments followed a month of controversy since the law's health insurance exchanges opened, including the program's malfunctioning website and complaints about canceled policies (Calmes, 11/4).

The Washington Post: Obama On Health Care: 'I've Got One More Campaign In Me … To Make Sure This Law Works.'
Obama has come under heavy criticism for his promises before the law was passed in 2010 that Americans who were happy with the plans they purchased on the open market could keep them. Since then, millions of people have received notices from their insurers that their plans have been canceled because of the new federal requirements. But at a health-care summit of supporters, Obama said the change was necessary because many of those insurance plans would not cover the costs of medical care (Nakamura, 11/4).

Los Angeles Times: Obama Says He's Got One More Campaign In Him: The Fight For Obamacare
President Obama put a new shine on his Obamacare pitch Monday night and asked his most loyal supporters to help him sell it to the American people. Obama urged Organizing for Action volunteers to help him spread "far and wide" the good news of the Affordable Care Act, which he said had always been about "making the insurance market better for everybody" (Reston and Parsons, 11/4).

USA Today: Obama Asks Supporters To Hang Tough On Health Care
Speaking to more than 200 organizers and activists gathered by Organizing for Action, the political group founded by high-ranking alumni of his two political campaigns, Obama began an effort to reframe the public conversation over the Affordable Care Act that has been overshadowed by the problems with the roll-out (Madhani, 11/4).

Politico: Obama's ACA Message Evolves Again
Obama on Monday sought to push back against the most recent tide of inconvenient Obamacare headlines -; tales of insurance companies ending inexpensive individual market plans that provide insufficient coverage under the ACA. Allowing those plans to be changed or sold to new customers, Obama told supporters of his Organizing for Action political arm who gathered in Washington to celebrate and strategize for the implementation of his signature law, would be "breaking an even more important promise" of extending "quality, affordable" health coverage to all (Epstein, 11/4).

The Wall Street Journal's Washington Wire: Obama Says People Losing Plans Will Get Better Ones
President Barack Obama tried to beat back criticism of the Affordable Care Act Monday, assuring supporters that those who want coverage will get it and that people who are losing their insurance will end up with better health-care plans. After facing a month's worth of complaints about the botched rollout of HealthCare.gov, Mr. Obama found a friendlier crowd in Washington as he appeared at an "Obamacare summit," held by Organizing for Action, the advocacy group that supports the White House's agenda (Nelson, 11/4).

The New York Times: For Uninsured, Clearing A Way To Enrollment
Known as "navigators" or "assisters," people like Ms. Cauley are going to work across the country, searching for the uninsured and walking them through the enrollment process. Under the Affordable Care Act, these trained, paid counselors typically work for community groups or government agencies, with a mandate to provide impartial guidance. Given the problems plaguing the federal online insurance exchange used by 36 states, the workers have become even more important in helping people understand their insurance options. But in Kentucky and some of the 13 other states that have their own exchanges, which in general are running more smoothly than the federal site, watching navigators on the job also provides the clearest view yet of how enrollment could work once the technical problems of HealthCare.gov are resolved (Goodnough, 11/4).

The Washington Post: A Self-Employed Woman Decides She's Not Ready To Buy Yet On The Health Exchanges
Like many self-employed people, I'm waiting to purchase a health plan on the new online exchanges, and it's not just because of the problems with the Web sites. I need a new policy Jan. 1 -; the date my insurer will drop my plan because it doesn't comply with the Affordable Care Act. (Among other things, the deductible is too high and it doesn't offer maternity benefits.) I have until Dec. 15 to enroll. Since the first premium is due upon purchase, I see no reason to sign up yet (Aschwanden, 11/4).

Los Angeles Times: Anthem Blue Cross Is Sued Over Policy Cancellations
In a new line of attack on canceled health policies, two California residents are suing insurance giant Anthem Blue Cross, alleging they were misled into giving up their previous coverage. About 900,000 Californians and many more nationwide have received cancellation notices on their individual health insurance policies, triggering a public uproar against the rollout of President Obama's healthcare law (Terhune, 11/4).

The Associated Press/Washington Post: Hollywood Targeted To Give Affordable Care Act A Boost With TV Story Lines About The New Law
The health care overhaul might get a Hollywood rewrite. The California Endowment, a private foundation that is spending millions to promote President Barack Obama's signature law, recently provided a $500,000 grant to ensure TV writers and producers have information about the Affordable Care Act that can be stitched into plot lines watched by millions (11/4).

The New York Times: CNN Ratings Fall As Health Care Coverage Rises
Did that mean people didn't want to hear wall-to-wall coverage of the failure of the site? Maybe not, if they were viewers already committed to the one of the partisan corners: Both Fox News and MSNBC did far better last week, with heavy coverage of issues related to the health care law. But CNN, which led most of its news hours last week with reporting related to the site's inadequacies, drew little interest from viewers, even on the day that Kathleen Sebelius, the secretary of Health and Human Services, testified in Congress and took many hostile questions from Republican representatives (Carter, 11/4).

The Associated Press/Washington Post: Lawmakers Push To Keep Obama's Health Care Pledge To Allow People To Keep Their Policies
Little more than a week after millions of consumers received health care cancellation notices, lawmakers in both parties are pushing legislation to redeem President Barack Obama's long-ago pledge that anyone liking their coverage will be allowed to keep it under the nation's controversial new law. The result is a stern new challenge for the White House as it struggles to fix website woes for the signup portal for those seeking to enroll under the law, and simultaneously copes with angry consumers who rightly or wrongly blame "Obamacare" for cancellation letters mailed by insurers (11/4).

The Washington Post: GOP Lawmaker Proposes 'Keep Your Health Plan' Bill
A top House Republican has proposed legislation that would allow the continued use of health plans that existed before January 2013, regardless of whether the coverage meets Affordable Care Act standards. The move comes as a growing number of Americans are complaining about losing their insurance or facing higher premiums because of the law, in addition to ongoing troubles with the online health exchange where individuals can purchase new coverage (Hicks, 11/4).

The Associated Press/Washington Post: Medicare Chief Tavenner Faces Questions From Senate Panel That Helped Write Health Law
A month into the rollout of President Barack Obama's health care overhaul and no end to problems, the senior administration official closest to the law's implementation will answer questions Tuesday from a Senate panel that wrote much of it. Medicare chief Marilyn Tavenner will go before the Health, Education, Labor and Pensions, or HELP, committee as the balky HealthCare.gov website continues to experience service problems. Adding to website woes is the political fallout from a wave of cancellation notices reaching millions of consumers who currently buy individual policies. Those plans don't meet requirements of the law taking effect next year (11/5).

Politico: CMS Head Cites Website Improvements
CMS Administrator Marilyn Tavenner in prepared testimony for the Senate HELP committee says the troubled HealthCare.gov website is slowly improving. "We are seeing improvements each week and by the end of November, the experience on the site will be smooth for the vast majority of users," her statement prepared for Tuesday's hearing said. She also said the Centers for Medicare and Medicaid Services has added capacity by doubling the number of servers (Kenen, 11/4).

Politico: Touting Ken Cuccinelli, Ron Paul Urges 'Nullification'
Headlining the final rally of Ken Cuccinelli's underdog campaign for Virginia governor, Ron Paul suggested the "nullification" of Obamacare on Monday night. "Jefferson obviously was a clear leader on the principle of nullification," the former Texas congressman said of the third president. "I've been working on the assumption that nullification is going to come. It's going to be a de facto nullification. It's ugly, but pretty soon things are going to get so bad that we're just going to ignore the feds and live our own lives in our own states" (Hohmann, 11/5).

Politico: Democrats Offer David Vitter A Vote On Obamacare Amendment
Senate Democrats have made an offer for Sen. David Vitter: You can have a vote on your health care amendment, but you have to live with the outcome. The idea is to get the issue out of the way once and for all, so Vitter doesn't continuously push for a vote on virtually every bill that comes to the floor, according to several people familiar with the matter. The Vitter plan -; which would kill federal dollars to help pay for lawmakers' and their aides' Obamacare coverage -; has become a major sticking point as the Louisiana Republican has demanded a vote (Raju and Kim, 11/4).

Los Angeles Times: Johnson & Johnson To Pay $2.2 Billion To Settle Federal Cases
The world's eighth-largest drug maker, Johnson & Johnson, has agreed to pay the U.S. government $2.2 billion to settle cases in which the government has alleged that the company and its subsidiaries promoted powerful psychiatric medications for uses not approved by the Food and Drug Administration and offered financial kickbacks for physicians who prescribed those medications frequently (Healy, 11/4).

The Wall Street Journal: Rural/Metro Strikes Deal To Settle Whistleblower Suit
Rural/MetroCorp. is seeking bankruptcy-court approval to settle a whistleblower lawsuit over the alleged submission of false Medicare claims. The ambulance company would pay $8 million to the U.S. Department of Justice under the settlement, which would resolve a whistleblower lawsuit against two Rural/Metro subsidiaries, according to court papers filed Fri (Palank, 11/4).

Los Angeles Times: Hospital Chain Sutter Health Settles Suit Over Anesthesia Billing
A major California hospital chain, Sutter Health, agreed to pay $46 million and disclose more pricing information to consumers to resolve a whistle-blower complaint alleging false and misleading charges for anesthesia. Sutter Health, which runs 24 acute-care hospitals in Northern California, said it reached the settlement Monday just prior to a trial starting this month over the allegations that it added thousands of dollars for "Code 37x" anesthesia charges that were already covered by other billing for the hospital operating room (Terhune, 11/4).

Los Angeles Times: High Court's Refusal To Hear Oklahoma Appeal Is Blow to Abortion Forces
The legal push in some Republican-controlled states to restrict abortion rights suffered a setback Monday when the U.S. Supreme Court declined to hear Oklahoma's appeal seeking to reinstate a law that effectively banned the use of abortion-inducing drugs. The court's decision delivered a surprise victory for abortion rights groups and was seen as a sign that while conservative justices may be open to giving states new powers to restrict abortion, they are not ready to impose sweeping new limits that would significantly interfere with women's constitutionally protected rights (Savage and Hennessy-Fiske, 11/4).

Los Angeles Times: Opponents Of New Texas Abortion Law Appeal To Supreme Court
Planned Parenthood and others opponents of new Texas abortion restrictions have appealed to the U.S. Supreme Court to reinstate an injunction blocking portions of the law concerning doctors' admitting privileges. The appeal was filed with U.S. Supreme Court Justice Antonin Scalia, who gave state officials until next Tuesday to file a response before he rules. Scalia could rule on the injunction himself or refer the issue to the full court (Hennessy-Fiske, 11/4).

The Associated Press/Wall Street Journal: Study Shows NY Medical Residents Get Most Support
Researchers at the George Washington University School of Public Health and Health Services say New York doesn't lack physicians. But it received $2 billion out of $10 billion available in 2010 federal funding to support residencies. Lead author Dr. Fitzhugh Mullan faults "the rigid formula" governing the system that sends "a disproportionate share" of the federal investment in the physician work force to certain states, including Massachusetts and Rhode Island (11/4).