States lead in health law insurance sign-up race

States operating their own insurance websites are leading the federal government in signing up people for health coverage. Though healthcare.gov, the federal website which serves the residents of 36 states, is working better for some, complicated cases still bewilder "navigators" -- and Texas has proposed new rules and background checks for the workers.

CBS News: How Some States Are Pulling Off Stealth Obamacare Sign-Ups
Despite the failings of the buggy federal healthcare.gov site, there's a stealth march on enrolling people in Obamacare.  That's coming from the 14 states and the District of Columbia that have created their own websites to sign people up for private health insurance. In October, these sites signed up almost 80,000 people for health-care plans, compared with fewer than 27,000 enrollees for the federal site that serves 36 states, Bloomberg notes (Picchi, 12/3).

The Associated Press: Health Care Website OK, Cases Can Be Complicated
The federal health care website worked just fine Tuesday for Texans seeking insurance coverage, but trained helpers are finding some individual cases are not so simple and those delays have nothing to do with technology. On the same day President Barack Obama vigorously defended his program to make sure the vast majority of Americans have health insurance, counselors across Texas dealt with an influx of applicants hoping to get insured after months of delays due of shoddy technology (12/4).

The Texas Tribune: TDI Proposes New Rules For Health Navigators
To address privacy concerns raised by state leaders, the Texas Department of Insurance on Tuesday proposed additional rules for the so-called navigators directed to help Texans find health insurance under the federal Affordable Care Act (Aaronson, 12/3).

The Dallas Morning News: Texas Insurance Chief Says Obamacare 'Navigators' Need Background Checks, Training 
The Texas Department of Insurance on Tuesday proposed background checks and 40 hours of additional training for the federally paid "navigators" who help consumers sign up for coverage under the federal health law. The department called for state testing and registration of navigators. The tentative rules would make organizations that hire navigators post sureties or carry malpractice insurance to pay out tens of thousands of dollars for their potential "wrongful acts" (Garrett, 12/3).

NPR: Nonprofits Challenge Missouri Licensing Law For Insurance Guides
In the first lawsuit of its kind, several nonprofit groups that received federal grants to help people sign up for insurance under the Affordable Care Act are suing the state of Missouri. The Missouri law requires health insurance helpers called navigators to be licensed by the state, which involves passing an exam and paying a fee (Rovner, 12/3).

In the meantime, there are updates from how exchanges are doing in Washington state, Colorado, California and Maryland --

The Seattle Times: Healthplanfinder Enrollment Tops 175,000 -- Mostly In Medicaid
More than 175,000 Washington residents have signed up for health insurance through Washington Healthplanfinder, the state's online insurance marketplace, according to the latest enrollment figures released Tuesday by the Washington Health Benefit Exchange. The vast majority of enrollees qualified for the state's Medicaid program, Apple Health, which is expanding eligibility in 2014 to include adults with incomes up to 138 percent of the federal poverty level, which is about $16,000 for an individual (Landa, 12/3).

The Denver Post: Enrollments At Colorado Health Insurance Exchange Rise To 9,980
Enrollment in the state health exchange and expanded Medicaid programs ramped up steeply in the last half of November, with private policies climbing by two-thirds in two weeks. Colorado's state-run exchange now has 9,980 members buying private policies, many subsidized by federal credits, since the Oct. 1 rollout of new Affordable Care Act reforms. That was up from 6,001 when the exchange last reported on Nov. 18 (Booth, 12/2).

The Denver Post: Colorado's Congressional Delegation Still Shopping For Health Care
The very people casting the votes and doing the most thinking and talking about the virtues and vices of the Affordable Care Act face a personal decision with a looming deadline: What to do for their own health care next year (Sherry, 12/3).

California Healthline: California Small Business Exchange Up & Running, Unlike Delayed Federal Exchange
Covered California officials yesterday said the state's small business exchange has 1,500 applications in progress and is successfully online, as well -- unlike the recently delayed federal small-business exchange site. "We are up and running and open for business," Covered California executive director Peter Lee said. About 1,500 employers have set up accounts with the Small-Business Health Options Program -- or SHOP -- since enrollment opened Oct. 1, Lee said (Gorn, 12/3).

California Health Report: Knocking On Doors For Obamacare 
Hundreds of paid canvassers and volunteers fanned out across the state over the last two weeks to tell residents such as Ordaz about the new health-care law and encourage the uninsured to sign up for coverage. The canvassing, which stretched across 12 counties from San Diego to the Bay Area, was organized by California Calls, a nonprofit that aims to change the state's voting electorate. In a twist on health-care advocacy, the group is using the new law as leverage for its activism. After telling registered voters about Obamacare, the community organizers asked residents for their contact information and whether they'd like to participate in community forums (Guzik, 12/4).

The Baltimore Sun: Despite Troubles, State Keeps Goal For Health Exchange
Despite continuing technical glitches, the director of Maryland's troubled health exchange said Tuesday that she believes the state can reach its goal of enrolling roughly a fifth of its uninsured residents by the end of March. Rebecca Pearce, executive director of the Maryland Health Benefit Exchange, acknowledged that only about 3,000 people have signed up for private health plans so far (Cox, 12/3).

Some are having better luck enrolling at healthcare.gov --

The Associated Press: Federal Health Care Website Working Better In Utah
When she first tried several weeks ago to sign up for health insurance on the federal government's online marketplace, Pam Sheridan was repeatedly kicked off by the glitch-plagued website. Her second attempt Friday went much smoother: she was able to enroll without any hitches in less than an hour (McCombs, 12/3).

The Associated Press: Pa. Residents See Some Upgrades On Health Website
The federal government's beleaguered health insurance website is better than it was, but still far from flawless, according to Pennsylvanians who are trying to help other residents use it to obtain health coverage. In Harrisburg, Roberta Vann, a certified application counselor at the Hamilton Health Center, reported a noticeable improvement in the operation of Healthcare.gov Monday morning (Jackson, 12/3).

ProPublica: For Uninsured Missouri Reporter, Obamacare Is A Real-Life Story
For Missouri public radio reporter Harum Helmy, the Affordable Care Act is more than just a story she covers. It is also a story she's living (Ornstein, 12/3).

In other state news related to the health law's implementation -

Reuters: Wisconsin Lawmakers Consider Delay In State Medicaid Changes
Wisconsin lawmakers on Wednesday are expected to consider delaying by three months a plan to shift thousands of people from a state Medicaid program onto the federal health insurance marketplace that has been plagued by technical problems. Under the proposal backed by Republican Governor Scott Walker, about 72,000 people now due to be shifted from Wisconsin's BadgerCare Medicaid program on January 1 would be allowed to stay on until the end of March (O'Brien, 12/4).

The Wall Street Journal: States Divided On Letting Insurers Extend Old Plans
Insurance commissioners in most Republican-led states have agreed to a request from President Barack Obama to allow carriers to extend many insurance plans slated for cancellation, while regulators in Democratic states remain divided, The Wall Street Journal has found. At least 21 of 30 states with GOP governors have said they are willing to let insurers extend policies through 2014 that otherwise would be canceled because they don't comply with the new federal health law. Many of the Republican-led states are allowing renewals that would extend coverage well into 2015 (Scism and Radnofsky, 12/3).