First Edition: November 15, 2013

Today's headlines include range of stories examining the policy, marketplace and political dynamics in play as a result of President Barack Obama's move to stop the cancellation of insurance plans. 

Kaiser Health News: Nearly 1,500 Hospitals Penalized Under Medicare Program Rating Quality
Kaiser Health News staff writer Jordan Rau reports: "More hospitals are receiving penalties than bonuses in the second year of Medicare's quality incentive program, and the average penalty is steeper than it was last year, government records show. Medicare has raised payment rates to 1,231 hospitals based on two-dozen quality measurements, including surveys of patient satisfaction and-;for the first time-;death rates. Another 1,451 hospitals are being paid less for each Medicare patient they treat" (Rau, 11/14). Read the story and take a look at the interactive chart and a chart detailing bonuses and penalties by state.

Kaiser Health News: What Consumers Need To Know About The Obama Plan For Canceled Health Policies
Kaiser Health News staff writers Jay Hancock, Julie Appleby, Phil Galewitz and Anna Gorman report: "President Barack Obama's pledge to Americans that they could keep their health plans if they liked them began to backfire last month. Insurers sent cancellation letters to hundreds of thousands of customers holding individual and family policies, saying the plans didn't comply with health law provisions effective Jan. 1. Obama eventually apologized. On Thursday he offered what he called 'an idea that will help' fix the problem, allowing insurers to renew existing plans even if they don't include the full menu of health-law benefits" (Hancock, Appleby, Galewitz and Gorman, 11/15). Read the story.

Kaiser Health News: California Considers Its Options On Canceled Insurance Plans
Kaiser Health News staff writers Anna Gorman and Sarah Varney report: "President Barack Obama's announcement Thursday that insurers can extend cancelled policies that don't comply with the health law has prompted conflicting reactions from California insurance regulators and the companies they oversee. State Insurance Commissioner Dave Jones said he will urge companies to let more than a million consumers keep their plans for an additional year, fulfilling the president's promise that people didn't have to switch policies if they didn't want to. 'The federal government told people in California and throughout the United States that they could stay in their plans,' he said at a press conference Thursday" (Gorman and Varney, 11/15). Read the story.

Kaiser Health News: Oregon Shines On Medicaid, As Texas Stalls On Sign-Ups
Oregon Public Broadcasting's Kristian Foden-Vencil and KUHF's Carrie Feibel, working in partnership with Kaiser Health News and NPR, report: "The work-around is necessary because Cover Oregon's website isn't functioning. But the reason Oregon's website is having more problems than most states is because it included many different kinds of insurance: private policies (with or without subsidies); children qualifying for the Oregon Health Kids Plan; as well as the Oregon Health Plan (Medicaid). … Meanwhile, in Texas, the get-out-to-the-people approach hasn't gotten much momentum. Only about 3,000 Texans have signed up for private insurance and the state isn't expanding its Medicaid program" (Foden-Vencil and Feibel, 11/14). Read the story. 

The New York Times: Obama Moves To Avert Cancellation Of Insurance
President Obama, trying to quell a growing furor over the rollout of his health care law, bowed to bipartisan pressure on Thursday and announced a policy reversal that would allow insurance companies to temporarily keep people on health plans that were to be canceled under the new law because they did not meet minimum standards (Parker and Pear, 11/14).

The Washington Post: Obama Announces Change To Address Health Insurance Cancellations
President Obama relented to pressure from the public and his own party Thursday and changed one of the bedrock requirements of the new health-care law to fulfill his promise to allow people to keep their insurance plans if they want. While the move was aimed at solving a problem that was threatening the president's credibility and public faith in the law, it raised a slew of new questions, including whether insurers would adjust, whether millions of customers would pay higher premiums and whether states would make the fix available (Eilperin, Goldstein and Sun, 11/14).

The Wall Street Journal: White House To Allow Insurers To Continue Canceled Health Plans
The president's support for allowing the insurance plans to continue for existing policyholders essentially shifted responsibility for the cancellations to the insurers. Millions of people have received cancellation notices from their insurers, who said the policies aren't compliant with new requirements for coverage and have changed too much since 2010 to be eligible for a "grandfathering" exemption. It remained unclear how many insurers would restore policies they had ended, and some industry officials called Mr. Obama's reversal unworkable (Lee and Radnofsky, 11/14).

Los Angeles Times: Obama Acts To Ease Health Insurance Plan Cancellations
President Obama's plan to help millions of consumers facing health insurance cancellations calmed Democrats on Capitol Hill on Thursday even as its practical effect appeared unclear. The decision could give some consumers who like their health plans the chance to keep them into 2015, allowing the president to say he honored his pledge that his health law would not force Americans to give up their coverage (Levey, Hennessey and Memoli, 11/14).

The Wall Street Journal: Officials Leave Door Open to Further Extension of Older Health Plans
The Obama administration signaled it might consider a further extension beyond 2014 of insurance plans that were initially set to be canceled at the end of this year. President Barack Obama outlined a plan earlier Thursday that aims to allow current policy holders to keep their insurance policies in 2014. Millions of Americans who have individual coverage have received notices from insurance companies canceling policies that don't meet requirements under the 2010 Affordable Care Act, but Mr. Obama's move paves the way for some of those policies to be revived (Dooren, 11/14).

The Washington Post: Health-Care Law's Problems Test Loyalty Of Democrats In Congress
The political fallout from the botched launch of the health-care law is presenting congressional Democrats with one of their toughest tests of party loyalty in the five years of the Obama administration. House Republicans are expected to pass a bill Friday that could dramatically undermine the law. And after years of trying to impale the initiative, GOP leaders are hopeful that the political turmoil over the rollout will provide them the support of a sizable bloc of Democrats (Kane and Kucinich, 11/14).

USA Today: Obama's Health Care Fix Doesn't Allay Dems' Jitters
But his proposed fix, which is intended to assist Americans in the individual insurance market who saw their policies canceled because they didn't meet minimum benefit requirements set under the ACA, failed to stanch Republican outrage and only temporarily alleviated Democratic unease over the problems arising from the law's rollout (Madhani and Davis, 11/14).

Politico: Trust Frays Between Obama, Democrats
When Denis McDonough stepped onto House Democrats' turf on Thursday, he was armed only with a PowerPoint presentation on fixing Obamacare's website and talking points about the president's proposal allowing people to keep their health care plans. The White House chief of staff might have been better off revealing a U.S. map with the president's plan for saving congressional Democrats' seats -; or just apologizing for letting so many Democrats walk out in public and repeat wildly inaccurate White House claims about the health of the enrollment website and Americans' ability to keep their insurance plans if they liked them (Allen and Sherman, 11/14).

The Wall Street Journal's Washington Wire: Boehner: Health Law Needs Legislative Fix
House Speaker John Boehner (R., Ohio) said he would press ahead with a House vote Friday on a bill designed to help people whose health insurance policies have recently been cancelled, even though President Barack Obama announced a plan Thursday to accomplish a similar goal without legislation (Hook, 11/14).

The Wall Street Journal's Washington Wire: Landrieu Welcomes Obama Action On Health Law, Remains Open To Pushing Legislation
Sen. Mary Landrieu (D., La.), principal author of legislation to address the problem of individual health insurance policies being cancelled, said she welcomed President Barack Obama's Thursday announcement on the issue but that further legislative action may still be needed. "The president's announcement was a great first step," said Ms. Landrieu. "We will probably need legislation to make it stick." Still, Ms. Landrieu did not promise a major push to force action on her bill. And she suggested that the president's action could have broad ramifications (Hook, 11/14).

Politico: Senate Democrats Not Fully Satisfied With Obamacare Fix
Senate Democrats are still considering legislation to repair President Barack Obama's broken Obamacare promise, despite the White House plans for an administrative fix. Sens. Mary Landrieu (D-La.) and Mark Udall (D-Colo.) still want to see votes on their separate, alternative proposals aimed at helping Americans who lost insurance plans. Several of the other Democrats who are up for reelection in 2014 want to vote on a legislative fix, too (Everett, Kim and Haberkorn, 11/14).

Politico: Democrats Not Likely To Back House GOP Obamacare Bill
House Democrats say that President Barack Obama's move to address a broken promise of Obamacare should prevent large numbers of defections on a GOP bill coming to a vote Friday that addresses the wave of health insurance cancellations. House Minority Whip Steny Hoyer (D-Md.), the chief vote-counter for House Democrats, said a "large part" of the Democratic Caucus would vote against the GOP bill called the "Keep Your Health Plan Act." Democratic leaders had earlier feared up to 100 members might vote for the bill sponsored by House Energy and Commerce Chairman Fred Upton (Haberkorn and Kim, 11/14).

Politico: Nancy Pelosi: House Democrats Have Own Obamacare Plan
House Minority Leader Nancy Pelosi said Thursday that Congressional Democrats are hoping to vote on their own plan to address the mass health insurance cancellations associated with Obamacare. She called it a "belt and suspenders" approach that would reinforce, but is not intended to compete with the administrative fix announced by President Barack Obama on Thursday (Haberkorn and Delreal, 11/14).

The Wall Street Journal: Obama Contrite Over Health-Law Problems
In an effort to revive his standing with Americans and suppress a growing rebellion within his own party, President Barack Obama on Thursday displayed a level of self-criticism he has seldom shown publicly in his five years in office as he acknowledged he "fumbled" the rollout of his signature legislative achievement. Throughout an hourlong news conference at the White House, Mr. Obama showed rare contrition about the political fallout from his self-described missteps-;from his failed promise that, under his 2010 health-care law, people who liked their coverage could keep it, to a problem-plagued website that has yielded embarrassingly low enrollment numbers and weeks of intense criticism of a divisive overhaul that has been a political flash point for years (Lee and Nicholas, 11/14).

The Wall Street Journal: Health Insurers Express Worries Over Obama Shift On Policy Cancellations
The president's move to placate millions of Americans on Thursday rattled health insurers, who said they were unsure how to revive canceled policies in short order. While companies had expected the White House to address the white-hot issue of policy cancellations, President Barack Obama's decision to let people keep their old policies undercuts years of preparations for the overhaul of the health-insurance market and introduces new uncertainties. Two senior insurance executives said they had not yet received any formal direction on how to carry out the change, and had only learned the outlines of the plan Thursday morning (Martin, Weaver and Kamp, 11/14).

Politico: Barack Obama's Messy Breakup With Insurers
President Barack Obama is breaking up with the health insurance industry again. He's had a love-hate relationship with the insurers ever since the early days of the health care reform debate. He yelled at them in public for giving people skimpy coverage, then slipped them a gift-wrapped box of chocolates -; the individual mandate they wanted to gain millions of new customers (Nather, 11/15).

NPR: Insurers Aren't Keen On Obama's Pledge To Extend Coverage
Remember when President Obama said, "If you like your health plan you can keep it?" Now it's more like, "If you like your health plan you can keep it -; for another year, and only if your insurance company says it's OK." It's not clear whether the administration's proposal to let insurers extend the policies they've been canceling for the past couple of months will solve the president's political problem. But it's sure not going over very well with the insurance industry (Rovner, 11/14).

The New York Times: Obama Proposal Worries Insurers And Regulators
President Obama's effort to quiet a political uproar by suggesting on Thursday that consumers should be allowed to keep their current health plans met significant resistance from many insurers and state regulators, who said they had not been consulted in advance about the proposal, doubted it could work and feared it might seriously damage the new insurance marketplace (Abelson and Goodnough, 11/14).

USA Today: Chaos Ensues After Insurance Cancellation Reversal
President Obama's announcement Thursday that consumers can keep insurance plans that don't meet the Affordable Care Act for a year will only create chaos, insurance brokers, regulators and carriers say (O'Donnell, 11/14).

Los Angeles Times: Healthcare Q & A: What Do Obama's New Plans Mean?
Millions of Americans have been notified in recent weeks by their health insurance companies that their coverage will soon be canceled because of President Obama's healthcare law. To address the outrage over these cancellations, the Obama administration on Thursday outlined a new policy to allow insurers to extend current health plans into 2015 (Levey, 11/14).

Los Angeles Times: Obama's Call For Insurers To Extend Canceled Health Plans Splits State
With 1 million Californians facing cancellation of their health insurance, state officials and the insurance industry were sharply divided over President Obama's call to let consumers extend their policies. And the state agency on the spot, California's health insurance exchange, was noncommittal on what exactly it will do for affected policyholders. Health insurers in the state warned that abruptly reversing course -; and doing what Obama wants -; could undermine California's new insurance marketplace and trigger more rate increases (Terhune, 11/14).

The New York Times: California Shuts Down Sites Mimicking State Insurance Marketplace
The California attorney general's office has shut down 10 websites that mimicked state's official health insurance marketplace, the attorney general, Kamala Harris, announced Wednesday. "These websites fraudulently imitated Covered California in order to lure consumers away from plans that provide the benefits of the Affordable Care Act," Ms. Harris said in a prepared statement. "My office will continue to investigate and shut down these kinds of sites" (Lovett, 11/14).

The Wall Street Journal: California Shuts Down Sites Imitating State Health Exchange
California officials have shut down 10 websites they say were designed to imitate the state's official health-insurance marketplace created under the nation's new health law. California Attorney General Kamala D. Harris said Thursday her office ordered the sites to either shut down or redirect consumers to the state's official site, www.coveredca.com. All 10 sites have complied, she said (Lazlo, 11/14).

Los Angeles Times: California Orders Closure Of 10 Sites Imitating Its Health Exchange
California Atty. Gen. Kamala Harris said she has ordered 10 websites to shut down because they violated state law by imitating the official site of the state's health insurance exchange. Harris said she began investigating these misleading websites in September and multiple operators were sent cease and desist letters telling them they were in violation of state law (Terhune, 11/14).

USA Today: Medicaid Enrollment Is Health Law's Bright Spot
Amid the low enrollment numbers for health insurance via the HealthCare.gov website, the Obama administration found one bright spot: Medicaid. Almost 400,000 people have learned they are eligible to enroll in the states' Medicaid programs, and the numbers are high even in Republican-dominated states that have chosen not to expand the program (Kennedy, 11/14).

The New York Times: Wisconsin Governor Seeks To Extend Medicaid
Blaming an "abysmal" rollout of the new federal insurance market, Gov. Scott Walker of Wisconsin said on Thursday that he would ask the Legislature to allow thousands of low-income residents to remain in the state's Medicaid program until April 1 -; a three-month extension. In a news conference, Mr. Walker, a Republican, said he would ask the Legislature, which is Republican-controlled, to return in early December to vote on his proposal. Under current state law, about 77,000 Wisconsin residents would be removed from the state's Medicaid rolls on Jan. 1 and required to obtain insurance in the subsidized online federal marketplace created by President Obama's Affordable Care Act (Yaccino, 11/14).

The New York Times: Health Law Rollout's Stumbles Draw Parallels To Bush's Hurricane Response
Barack Obama won the presidency by exploiting a political environment that devoured George W. Bush in a second term plagued by sinking credibility, failed legislative battles, fractured world relations and revolts inside his own party. President Obama is now threatened by a similar toxic mix. The disastrous rollout of his health care law not only threatens the rest of his agenda but also raises questions about his competence in the same way that the Bush administration's botched response to Hurricane Katrina undermined any semblance of Republican efficiency (Shear, 11/14).

Politico: The Obamacare Fumble
It's the cardinal rule of marketing management: Under-promise and over-deliver. If the sign at "Pirates of the Caribbean" says the wait is 45 minutes, and your kids are floating along on the ride in half that time, Disneyland really is the Happiest Place on Earth. So it's little wonder that the glaring contrast between the White House's perpetually optimistic talk about its health care plan -; "Try it! You'll like it!" -; and the messy realities of its rollout has sent President Barack Obama's job approval ratings to all-time lows, and for the first time left the public with a negative view of his honesty in some surveys (Purdum, 11/15).

The New York Times: Obama Selects Health Policy Advocate As Surgeon General
President Obama nominated Dr. Vivek H. Murthy, an early supporter and grass-roots advocate for the Affordable Care Act, as surgeon general on Thursday. Dr. Murthy, 36, is a founder and the president of Doctors for America, a group that campaigned for the health care law before Congress passed it in 2010 and that was an outgrowth of Doctors for Obama, which worked to help elect the president in 2008 (Kenny, 11/14).

Politico: President Obama Nominates Vivek Hallegere Murthy For Surgeon General
He is the co-founder and president of Doctors for America, which began as Doctors for Obama in 2008. He is a hospitalist attending physician and instructor in medicine at Brigham and Women's Hospital at Harvard Medical School (Haberkorn, 11/14).