First Edition: November 13, 2013

Today's headlines include not-so-positive predictions about whether healthcare.gov will be fully functional by the end of November.   

Kaiser Health News: Medicaid Questions Delay Some Health Insurance Purchases In Colorado
Reporting for Kaiser Health News and NPR, Eric Whitney writes: "If you want to find somebody who's really happy with the Affordable Care Act, meet Colorado's Medicaid director, Sue Birch. Colorado has been enrolling just under a thousand people a week in new private health insurance since its Obamacare marketplace opened. But the number enrolling in Medicaid is ten times that" (Whitney, 11/13). Read the story.

Kaiser Health News: Capsules: Medicaid Chief Thanks State Leaders, Even As They Skip Expansion Option; Emails Ask Those Who Failed To Try Healthcare.gov Again
Now on Kaiser Health News' blog, Phil Galewitz offers this report from a meeting of state Medicaid directors: "It wasn't all hugs and kisses,  but the nation's top Medicaid official on Tuesday told Medicaid directors from around the country that she was proud of the job they were all doing -; even though half of their states opted against expanding the state-federal health insurance program for the poor under the health law. 'Hats off to you,' Cindy Mann, director of the federal Center for Medicaid and CHIP, told a meeting of the National Association of Medicaid Directors. 'I am enormously encouraged by the commonality of purpose'" (Galewitz, 11/13).

Also on the blog, Marissa Evans reports on an effort by the Centers for Medicare & Medicaid Services to connect with people who started the healthcare.gov enrollment process, but couldn't finish: "Roughly 275,000 'come back, we miss you' emails will be sent in waves this week encouraging consumers who couldn't create an account or log-in to the  malfunctioning Healthcare.gov website to try again, officials at the Centers for Medicare & Medicaid Services said Tuesday" (Evans, 11/12). Check out what else is on the blog.

The New York Times: Obama In Bind Trying To Keep Health Law Vow
Under intense bipartisan pressure to answer mounting consumer complaints about the botched health care rollout, White House officials are struggling to make good on President Obama's promise that Americans can keep their insurance coverage without undermining the new health law or adding unaffordable costs (Shear and Pear, 11/12).

NPR: With Pressure From All Sides, Obamacare Vise Tightens On Dems
Democrats at the White House and in Congress find themselves in an ever-tightening vise over all those canceled health insurance policies. House Republicans plan a vote as soon as Friday on a bill that would allow people to keep health plans they like, just as President Obama said they'd be able to (until it became clear they couldn't) under the Affordable Care Act (James, 11/12).

Los Angeles Times: Bill Clinton Says Americans Should Be Able To Keep Their Health Plans
In an interview released Tuesday, former President Bill Clinton said President Obama should make sure Americans can retain their current health insurance plans, even if it means revamping the Affordable Care Act. "I personally believe, even if it takes a change to the law, the president should honor the commitment the federal government made to those people and let them keep what they've got," Clinton told OZY, a news website (Little, 11/12).

The Associated Press/Washington Post: Bill Clinton Says Obama Should Follow Through On Pledge To Let Americans Keep Health Coverage
The former president, a Democrat who has helped Obama promote the 3-year-old health law, becomes the latest in Obama's party to urge the president to live up to a promise he made repeatedly, declaring that the if Americans liked their health care coverage, they would be able to keep it under the new law. Instead, millions of Americans have started receiving insurance cancellation letters. That, coupled with the troubled launch of the health care law's enrollment website, has prompted Republican critics and frustrated Democrats to seek corrections in the law (11/12).

The Wall Street Journal: Bill Clinton Says Health Law May Need To Be Changed
Mr. Clinton's remarks come amid growing unease among Democrats about a balky website performance, low enrollment levels and mounting cancellations of existing policies by health insurers. Democratic lawmakers, who successfully beat back efforts to repeal the law, now worry that they will be blamed for its problems at the ballot box. Insurers, who have sent thousands of cancellation notices to people, say the policies aren't compliant with new requirements for coverage and have changed too much since 2010 to be eligible for a "grandfathering" exemption that allows some people to keep plans that existed before the law was passed (Schatz, 11/12).

Politico: Obama's Critic-In-Chief Strikes Again
President Bill Clinton -; the man President Barack Obama once dubbed his "Secretary of Explaining Stuff" -; once again has some explaining of his own to do with the Obama White House. In an interview released Tuesday, Clinton called for a fix to the Affordable Care Act that would put an end to the wave of insurance cancellations that have been a public relations disaster for the White House and prompted Obama to apologize last week for having repeatedly assured Americans that they could keep their insurance if they liked it (Gerstein, 11/12).

Politico: White House Fires Up Its Obamacare Spin Machine
But after the website debacle, the bad press of people losing their health plans and President Barack Obama's defense and then walk-back of his "if you like your plan, you can keep it" slogan, the White House has a tougher job on its hands. There's essentially no avoiding a bad news cycle, but there are ways to mitigate the damage (Epstein, 11/13).

The Washington Post: Troubled Healthcare.gov Unlikely To Work Fully By End Of November
Software problems with the federal online health insurance marketplace, especially in handling high volumes, are proving so stubborn that the system is unlikely to work fully by the end of the month as the White House has promised, according to an official with knowledge of the project. The insurance exchange is balking when more than 20,000 to 30,000 people attempt to use it at the same time -; about half its intended capacity, said the official, who spoke on the condition of anonymity to disclose internal information. And CGI Federal, the main contractor that built the site, has succeeded in repairing only about six of every 10 of the defects it has addressed so far (Goldstein, Eilperin and Sun, 11/12).

Politico: The Making Of An Obamacare Management Failure
In the days after HealthCare.gov went live, White House chief of staff Denis McDonough quietly dispatched Jeff Zients, a favorite West Wing fixer, to assess the operation and report back. When Zients did, President Barack Obama learned the project was in worse shape than suspected -; riddled with coding problems, management issues and communication gaps, according to a senior administration official. It was only then that Obama and his top aides realized the extent of what they didn't know (Budoff Brown, 11/12).

NPR: Administration Invites HealthCare.gov Users To Try Again
If at first you don't succeed, try again. That's the message from the White House on Tuesday, with the Centers for Medicare & Medicaid Services (CMS) asking more than 275,000 people who tried and failed to sign up for health plans on the stalled HealthCare.gov website to give it another shot (Neuman, 11/12).

Politico: HHS To Obamacare Website Shoppers: Please Come Back
The Obama administration is asking people frustrated by early application problems with HealthCare.gov to give the website a second chance. So they're reaching back out to the earliest HealthCare.gov shoppers who may have given up on the broken website after the awful Oct. 1 launch, hoping they'll try again (Millman, 11/12).

The New York Times' Political Memo: Fighting To Stop An Entitlement Before It Takes Hold, And Expands
Underlying fierce Republican efforts to stop President Obama's health care law and the White House drive to save it is a simple historical reality: Once major entitlement programs get underway, they quickly become embedded in American life. And then they grow (Harwood, 11/12).

The New York Times: Some State Insurance Exchanges Continue To Battle Technical Problems
Six weeks into the rollout of President Obama's new health care law, some of the online insurance exchanges run by states are continuing to have serious technological problems, often mirroring the issues plaguing the much larger federal exchange (Goodnough and Abelson, 11/12).

Politico: Obamacare Glitches Shadowing Medicaid
Another under-the-radar Obamacare malfunction could stymie January health coverage for some of the nation's poorest people, state Medicaid officials say. And that's casting a shadow on one of the parts of the Affordable Care Act that's actually working quite well-; sign-ups for Medicaid, which is being expanded under the health law (Cheney, 11/13).

USA Today: For Some Areas, Insurance Plan Choices Are Paltry
Some counties in the U.S. have almost 30 times more choices of health insurance plans than others do, a stark example of the lack of competition in many parts of the country as consumers try to shop for affordable coverage on the new federally run exchanges. USA TODAY analyzed data from HealthCare.gov, the federal health insurance exchange selling plans for 34 of the states that didn't set up their own exchanges. The analysis clearly shows the impact of insurers' hesitancy to move into states where they aren't already doing business (O'Donnell and Overberg, 11/12).

Los Angeles Times: Washington State Is Making Health Exchange Work
More than 55,000 people in Washington state enrolled in health coverage in October -; most in Medicaid -; and about 40,000 more applied for coverage, making the Evergreen State one of the brightest success stories in the rocky national rollout of the federal health law. Here in the home of online shopping giant Amazon.com, officials credit the exchange's success in part to the Pacific Northwest's high-tech bent (La Ganga, 11/12).

The Associated Press/Wall Street Journal: NY Says 197,000 Have Applied In Health Marketplace
New York's new online health exchange reports 197,011 New Yorkers have completed applications to get insured, while 48,162 have subsequently enrolled in plans, nearly half in the government-funded Medicaid program for low-income New Yorkers. The exchange, which opened Oct. 1 as the state's response to the federal Affordable Care Act, includes low-cost plans for individuals and small businesses with coverage starting Jan. 1 (11/12).

The Wall Street Journal's Washington Wire: OMG: Sequels to 'Brosurance' Ad Target Women
While many of the new spots feature messages on the benefits of insurance for children, expectant moms and others, some of the ads are more provocative. One ad has the title "Let's Get Physical," with the text: "OMG, he's hot! Let's hope he's as easy to get as this birth control. My health insurance covers the pill, which means all I have to worry about is getting him between the covers." Another ad, playing on a Ryan Gosling meme, starts, "Hey girl, you're excited about easy access to birth control and I'm excited about getting to know you." Colorado runs its own health exchange under the new federal health law. The spots from the Colorado Consumer Health Initiative and ProgressNow Colorado Education target 20-somethings – the young, healthy demographic needed to keep rates down – and are designed to be shared on social media such as Twitter and Pinterest (Hanrahan, 11/12).

The Wall Street Journal's Washington Wire: With Healthcare.gov's Woes, Enroll America Adjusts Its Pitch
Enroll America, a group whose sole focus is help people sign up for insurance programs through Obamacare, is readjusting its outreach campaign as HealthCare.gov works out its technological problems. The group, which has been running a "Get Covered America" grassroots campaign, plans to launch a "Coverage is Coming" campaign in December, when the Obama administration has said the website's biggest problems will be fixed (Dooren, 11/12).

The New York Times: Health Law Rollout Provides Rich Target For Oversight Chief
Representative Darrell Issa has long been known on Capitol Hill as one of the most aggressive -; some would say overzealous -; thorns in the side of Obama administration, using his seat as chairman of the House oversight committee to trumpet any missteps that can be traced to the White House (Lipton and Stolberg, 11/12).

Los Angeles Times: Obama's Top Tech On House Panel Hot Seat
Todd Park, the nation's chief technology officer, is the top tech expert in the U.S. government and the face of President Barack Obama's effort to bring the federal bureaucracy into the iPad era. The onetime entrepreneur, a 40-year-old wunderkind with two startups in his rearview mirror, is a Silicon Valley success story. But House Republicans are seeking to add a new chapter by forcing him to answer for one of the nation's highest-profile technology debacles: the flawed federal health insurance website (Parsons and Hennessey, 11/12).

The Wall Street Journal: White House Tech Team Missed Health-Site Alert
Even before he took office in 2009, President Barack Obama knew the government had problems with technology. So he introduced the concept of a White House "SWAT team," designed to swoop in and rescue big projects before they became disasters. … Members of Congress are zeroing in on White House Chief Technology Officer Todd Park, whose position was created by Mr. Obama. Rep. Darrell Issa (R., Calif.), the House oversight committee chairman, subpoenaed Mr. Park to testify at a Wednesday hearing, and the White House said late Tuesday that Mr. Park would comply (Nagesh, 11/12).

The Associated Press/Washington Post: House Panel Investigates Whether White House Played A Role In 'Obamacare' Technology Debacle
Probing whether the White House shares blame for health-care website woes, the House's chief investigator is delving into technical issues behind the dysfunctional rollout of HealthCare.gov. Rep. Darrell Issa, R-Calif., the chairman of the House Oversight and Government Reform Committee, will explore concerns about online security in the sixth major congressional hearing since President Barack Obama's computerized insurance markets went live Oct. 1 and millions of consumers encountered frozen screens (11/13).

Politico: Darrell Issa Panel To Grill Tech Officials On Obamacare
Obama administration tech gurus will get a rare time in the spotlight when they testify about the failed Obamacare rollout at a House hearing Wednesday. Congress has heard from the lead contractors on the HealthCare.gov project and top health officials. But the House Oversight and Government Reform hearing Wednesday will be the first time that five administration officials who were directly engaged with the technology behind the dysfunctional site will face questions in public about what went wrong (Norman and Villacorta, 11/13).

Los Angeles Times: Supreme Court Decision Disappoints Abortion Foes
For the second week in a row, the Supreme Court let stand a ruling that strikes down a major abortion regulation from Oklahoma, disappointing abortion foes who had hoped conservative justices would impose new limits on a woman's right to terminate a pregnancy. The justices Tuesday turned down Oklahoma's appeal seeking to revive a law that would have required pregnant women to undergo an ultrasound and hear about the fetus' size and possible heartbeat (Savage, 11/12).

The Washington Post's The Fact Checker: Sebelius's Claim That Insurance Premiums Are 16 Percent Lower Than CBO Projected
Estimates from the nonpartisan Congressional Budget Office are considered the gold standard in Washington. The budget impact of every bill voted on by Congress is calculated by CBO analysts -; and their findings often make a difference in whether legislation passes or not. That's why politicians often tout CBO's estimates. So we were curious last week when Secretary Sebelius cited a CBO projection of insurance rates -; and how actual premiums turned out to be lower than expected. What's the source of this factoid? (Kessler, 11/13).