First Edition: December 17, 2013

Today's headlines include reports about how the health law is viewed by immigrant populations.   

Kaiser Health News: Medicare Identifies 97 Best And 95 Worst Hospitals For Hip And Knee Replacements
Kaiser Health News staff writer Jordan Rau reports: "Medicare has begun tracking the outcomes of hip and knee replacement surgeries, identifying 95 hospitals where elderly patients were more likely to suffer significant setbacks. The government also named 97 hospitals where patients tended to have the smoothest recoveries. The analysis, which was released last week, is the latest part of the government's push to improve quality at the nation's hospitals instead of simply paying Medicare patients' bills" (Rau, 12/17). Read the story and check out the accompanying table.

Kaiser Health News: How Palliative Care Helps: One Iowa Family's Journey
Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: "Ihrig met the Avelleyras family last year at UnityPoint hospital in Fort Dodge, where Phyllis was given a diagnosis of congestive heart failure, which is often fatal. As all of the other physicians at the hospital were running tests and drawing blood, Ihrig had another kind of inquiry: what did Phyllis want from the rest of her life?" (Gold, 12/16). Read the story.

Kaiser Health News: In California, It's Not A Done Deal Until You Get The Insurance Card
Kaiser Health News staff writer Anna Gorman reports: "For all the attention paid to the troubles at the front end of the enrollment process in the nation's new insurance marketplaces, the back end can be just as fraught. The path to receiving an insurance card, the key to receiving non-emergency medical care, can be tortuous. Once someone signs up, the insurance exchange still has to give the information to the insurer, which must send a confirmation packet and, even more important, a bill" (Gorman, 12/16). Read the story.

Kaiser Health News: Insuring Your Health: Readers Ask: Will Health Law Help Cover My Braces; Should A Couple File Separate Tax Returns To Avoid Penalties?
Kaiser Health News consumer columnist Michelle Andrews answers questions from readers of all ages -- teenagers to seniors – who have inquiries about the health law (Andrews, 12/17). Read the column.

Kaiser Health News: Capsules: Latest Federal Rules, Requests Put New Pressure On Insurers, Says Moody's
Now on Kaiser Health News' blog, Jay Hancock reports: "Insurers responded softly if not sweetly to the Obama administration's latest requests and rule changes for individuals trying to buy coverage in online marketplaces by Jan. 1. Moody's Investor Service, which is watching Obamacare from the outside, isn't so tactful" (Hancock, 12/16). Check out what else is on the blog.

The Washington Post: Obama Suffers Most From Year Of Turmoil, Poll Finds
President Obama is ending his fifth year in office matching the worst public approval ratings of his presidency, with record numbers of Americans saying they disapprove of his job performance and his once-hefty advantages over Republicans in Congress eroded in many areas, according to a new Washington Post-ABC News poll. His position is all the more striking when compared with his standing a year ago, as he was preparing for his second inauguration after a solid reelection victory. That high note proved fleeting as the president faced a series of setbacks, culminating in the botched rollout of his Affordable Care Act two months ago (Balz and Clement, 12/17).

The New York Times: One White House Shift Is Delayed For A Month
President Obama will soon name a new overseer to complete repairs of the government's health insurance website, but the current manager, Jeffrey D. Zients, is delaying his move to become chief White House economic adviser for about a month, administration officials said Monday (Calmes, 12/16).

Reuters/The New York Times: Obama To Seek Advice On Portal At Tech Meeting
President Obama will meet executives from leading technology companies like Google and Apple on Tuesday to discuss ways to improve the federal health care exchange website, the White House said. An Obama administration official said the meeting would cover capacity issues with the site, HealthCare.gov, which has not worked well since its Oct. 1 rollout. Many people face a Dec. 23 deadline to sign up in order to have insurance on Jan. 1 (12/16).

Politico: Obama Calls In Tech To Talk Healthcare.gov, NSA
Now that the Obamacare website is functional, the administration has called the tech honchos to Washington. The White House paints President Barack Obama's huddle with tech company leaders on Tuesday as a chat headlining HealthCare.gov progress and ways the government can fix federal IT. But the Silicon Valley heavyweights, which include Google, Microsoft, Apple, Facebook and Twitter, appear more likely to highlight another issue on the administration's agenda -; federal surveillance efforts and the impact on their companies (Meyers, 12/17).

The Wall Street Journal: Insurers Fight Hospitals' Paying Premiums
A charity's plan to help people pay for coverage through new health-care exchanges has put it at the center of a high-stakes fight between the insurance and hospital industries that could pose a challenge to the economic underpinnings of President Barack Obama's health law. A Better LA, a decade-old Los Angeles nonprofit, said last week it was signing up 50 low-income people for health plans in California's health-insurance marketplace. The charity, which said it has the blessing of the state agency overseeing the marketplace, will pay $50 to $100 a month to cover the share of the people's premiums not already financed by federal subsidies (Radnofsky and Weaver, 12/16).

USA Today: HHS Vows It Will Be Ready For Dec. 23 Insurance Deadline
The ability of the HealthCare.gov website to keep operating despite a high number of visitors has heightened health officials' belief that the site will be ready to help customers meet the Dec. 23 deadline to enroll in insurance in order to be covered by Jan. 1. By noon Monday, 165,000 people visited the site, where people can shop for and buy health insurance, while another 500,000 went to the site over the weekend, said Julie Bataille, communications director for the Centers for Medicare and Medicaid Services (Kennedy, 12/16).

The Washington Post: Maryland Health Exchange Users Hit Snags, But O'Malley Reasserts 'Major Fixes' Are Done
Maryland's online health-insurance exchange got mixed marks from some users Monday who said the Web site continued to have serious difficulties despite Gov. Martin O'Malley's announcement this weekend that the major problems hindering enrollment had been fixed (Wagner, 12/16).

The Associated Press/Washington Post: O'Malley: Most Problems Resolved On Health Website
The governor announced that Optum/QSSI, a Columbia-based company, has been brought in to help improve the overall performance of the website. O'Malley also said CareFirst has agreed to extend the enrollment deadline from Dec. 23 to Dec. 27 to help more people get coverage that begins Jan. 1. Hours will be extended at call centers to help people enroll, O'Malley said. The administration also said health exchange officials will reach out to consumers who have started but not finished the application process through emails, regular mail and robocalls (12/16).

The Washington Post: In Nevada, The Republican Governor Who Doesn't Completely Hate Obamacare
The biggest threat to Senate Majority Leader Harry Reid's future in the Senate isn't the success or failure of the Affordable Care Act. Instead, it's the Republican governor of Reid's home state who has embraced Obamacare -; or at least worked to implement it effectively. Only eight states run by Republican governors moved to expand Medicaid to cover residents making less than 138 percent of the federal poverty level. Only three states with Republican governors set up state-based health-care exchanges. Just two states led by Republicans -; Nevada and New Mexico -; did both. And Nevada is the only Republican-led state with an exchange that's actually signing people up for insurance (Wilson, 12/16).

The Associated Press/Washington Post: Many Immigrants Hesitate To Seek Health Insurance
Day after day, Adonias Arevalo tried to calm his parents' nerves, attempting to convince them it was safe for him to apply for government-subsidized health insurance through the nation's new coverage system. Like many other immigrants, Arevalo's parents worried that personal information on their son's application could somehow draw immigration authorities' attention to the couple, who emigrated here illegally from El Salvador seven years ago (12/16).

Politico: Immigration's Next Hurdle: Obamacare
The flawed rollout of the Affordable Care Act has endangered another of President Barack Obama's top agenda items: Immigration reform. It's forcing the White House and its allies to confront a basic, but politically potent, criticism. If the government can't build a website, how can it be trusted to correctly process millions of undocumented immigrants and require every employer to verify the status of their workers? (Allen and Budoff Brown, 12/17).

Politico: Next Obamacare Crisis: Small-Business Costs?
Think the canceled health policies hurt the Obamacare cause? There's another political time bomb lurking that could explode not too long before next year's elections: rate hikes for small businesses. Like the canceled individual health plans, it's another example of a tradeoff that health care experts have long known about, as the new rules for health insurance prices create winners and losers. But most Americans won't become aware of it until some small business employees learn that their premiums are going up because of a law called -; oops -; the Affordable Care Act (Nather, 12/17).

The New York Times: A Gap In The Affordable Care Act
The Affordable Care Act mandated that insurers cover dental care for children. Indeed, it was one of the 10 essential health benefits meant to set the bar for adequate health insurance. But pediatric dental care is handled differently from coverage of other essential benefits on federal and state exchanges. These plans are often sold separately from medical insurance, and dental coverage for children is optional. People shopping on the exchanges are not required to buy it and do not receive financial support for buying it (Saint Louis, 12/16).

The Washington Post: On Health Care, White House And Others Reach Out To LGBT Americans
A disproportionate number of LGBT Americans are uninsured and qualify for federal premium subsidies to help buy coverage, and the administration is intensifying its efforts to get them enrolled before the end of the year. There are several reasons for this disparity, among them that same-sex partners often don't qualify as family members for employer-based insurance plans and that individuals sometimes lose coverage when they are fired because of their sexual orientation or gender identity. The White House on Tuesday will release an infographic on the Affordable Care Act's benefits for the LGBT community (Eilperin, 12/16).

The Washington Post: Bipartisan Senate Budget Deal Appears Likely To Pass
The deal, struck by Senate Budget Committee Chairman Patty Murray (D-Wash.) and House Budget Committee Chairman Paul Ryan (R-Wis.), is intended to end nearly three years of acrimony over the budget in Washington. It would cancel half the sequester cuts for the current fiscal year, replace them with other savings and allow Congress to avert another government shutdown in January (Montgomery and O'Keefe, 12/16).

The Associated Press/Washington Post: Several GOP Senators To Back A Vote On Budget 
Nobody is claiming the pact worked out between the high-profile Ryan, the Republican Party's vice presidential nominee last year, and Washington state Sen. Patty Murray, a Democratic loyalist over her 21-year Senate career, is perfect. It eases $63 billion in scheduled spending cuts over the next two years and replaces them with longer-term savings measured over 10 years, many of which don't accumulate until 2022-23. Deficits would increase by $23.2 billion in 2014 and by $18.2 billion the year after that. But the deal would put a dysfunctional Washington on track to prevent unappealingly tough cuts to military readiness and weapons, as well as continued cuts to programs cherished by Democrats and Republicans alike, including health research, school aid, FBI salaries and border security (12/17).

The New York Times: Benefits Questioned In Tax Breaks For Nonprofit Hospitals
The billions of dollars in tax breaks granted to the nation's nonprofit hospitals are being challenged by regulators and politicians as cities still reeling from the recession watch cash-rich medical centers expand (Rosenthal, 12/16).

The New York Times: Glaxo Says It Will Stop Paying Doctors to Promote Drugs
The British drug maker GlaxoSmithKline will no longer pay doctors to promote its products and will stop tying compensation of sales representatives to the number of prescriptions doctors write, its chief executive said Monday, effectively ending two common industry practices that critics have long assailed as troublesome conflicts of interest (Thomas, 12/16).

The Wall Street Journal: GlaxoSmithKline To End Payments To Doctors For Drug Promotion
GSK said it wouldn't pay doctors to speak about its drugs, or diseases treated by its drugs, to doctors and other health-care professionals who write prescriptions or influence prescriptions, a practice that has been a linchpin sales and marketing across the pharmaceutical industry. It said it would also stop payments for attendance at medical conferences (Plumridge and Rockoff, 12/17).

The Washington Post: Options DC Charter School's Medicaid Billing Is At Center Of Investigation
Federal investigators are looking into whether former leaders of the District's Options Public Charter School committed Medicaid fraud by, among other things, exaggerating the needs of its disabled students and paying students with gift cards to ride school buses, according to several people familiar with the criminal investigation (Brown and Marimow, 12/16).

The Washington Post: Gov. Robert McDonnell Unveils Two-Year Spending Plan For Virginia That Tops $96 Billion
Outgoing Gov. Robert F. McDonnell trumpeted hefty cash reserves and investments in education and mental health Monday as he unveiled a two-year, $96 billion proposed budget that also makes some cuts to schools and hospitals. The budget is $10 billion larger than the current budget, with much of the added spending directed to Medicaid, K-12 education and state employee retirement and insurance programs. The state's contingency fund also gets a boost, reflecting tepid economic growth and cuts to military spending that have defense-heavy Virginia bracing for a downturn (Vozzella, 12/16).