First Edition: February 3, 2014

Today's headlines include a range of stories about how the health law is working in different locations across the country. 

Kaiser Health News: In Southwest Georgia, The Affordable Care Act Is Having Trouble Living Up To Its Name
Kaiser Health News staff writer Jordan Rau, working in collaboration with The Washington Post, reports: "All the dynamics that drive up health costs have coalesced here in Southwest Georgia, pushing up premiums. Expensive chronic conditions such as obesity and cancer are common among the quarter million people in this region. One hospital system dominates the area, leaving little competition. Only one insurer is offering policies in the online marketplace, and many physicians are not participating, limiting consumer choice"(Rau, 2/3). Read the story or the related sidebar detailing the 10 most expensive insurance markets in the country.

Kaiser Health News: When Your Parent Is the State, It's Tough For Young Adults To Stay Insured
Kaiser Health News staff writer Anna Gorman, working in collaboration with the Los Angeles Daily News, reports: "A little-known provision of federal health law now extends Medicaid coverage to former foster youths until they turn 26, regardless of where they live or how much they earn. The only requirements: They must have been in foster care when they turned 18 and have previously received Medicaid, the state-run insurance plan for the poor known as Medi-Cal in California" (Gorman, 2/3). Read the story and watch the video. 

Kaiser Health News: Joining GOP Trend, U.S. Chamber Of Commerce Urges Fix, Not Repeal, Of Obamacare
Reporting for Kaiser Health News, in partnership with NPR, Eric Whitney writes: "Some influential conservatives are now saying the health care law is too entrenched to repeal. Take the U.S. Chamber of Commerce, the powerful business lobbying group. When the Affordable Care Act Passed in 2010, the Chamber got behind a major business lawsuit to fight it at the U.S. Supreme Court. And in January, 2011 during his annual State of American Business address, Chamber President Tom Donohue said, 'It's time, in my opinion, to go back to the drawing board...and thus we support legislation in the House to repeal it'" (Whitney, 1/31). Read the story. 

The Washington Post: Life After Jan. 1: Kentucky Clinic Offers Early Glimpse At Realities Of Health-Care Law
This is the world that many critics of the new health-care law have worried about, one in which the sick and the poor expand the ranks of Medicaid while other Americans see premiums rise, policies canceled or favorite doctors booted out of networks. Supporters of the new law argue that another scenario will unfold in places such as eastern Kentucky, in which the sick and the poor get insurance, seek treatment for long-neglected illnesses and prevent other health problems down the line, ultimately saving the health-care system billions in emergency-room visits and other costs. A week at the Breathitt County Family Health Center provides an early glimpse into how those theories are beginning to play out in a place where people have long worried about having no insurance at all (McCrummen, 2/1).

The Wall Street Journal: Administration Weighs Extending A Change To Health Law 
The Obama administration said Friday that it is considering ways to extend into 2015 efforts to prevent consumers whose health coverage changes from suddenly losing access to particular doctors. President Barack Obama was told by a Kentucky woman in a Google Hangout on Friday afternoon that she was worried her 10-year-old son would not be able to continue to see his specialist ... Mr. Obama replied: "If you have a particular specialist and you haven't found that specialist in the network of the exchange that's offered in Kentucky, then we are looking at rules to make sure that somebody who's actively being treated, for example, can remain with their specialist for the duration of their treatment" (Radnofsky, Favole and Corbett Dooren, 1/31).

The Washington Post: Healthcare.gov Can't Handle Appeals Of Enrollment Errors
Tens of thousands of people who discovered that HealthCare.gov made mistakes as they were signing up for a health plan are confronting a new roadblock: The government cannot yet fix the errors. Roughly 22,000 Americans have filed appeals with the government to try to get mistakes corrected, according to internal government data obtained by The Washington Post. They contend that the computer system for the new federal online marketplace charged them too much for health insurance, steered them into the wrong insurance program or denied them coverage entirely (Goldstein, 2/2). 

The Washington Post: Labor Union Officials Say Obama Betrayed Them In Health-Care Rollout
Labor leaders who have spent months lobbying unsuccessfully for special protections under the Affordable Care Act warned this week that the White House's continued refusal to help is dampening union support for Democratic candidates in this year's midterm elections. ... Their complaints reflect a broad sense of disappointment among many labor leaders, who say the Affordable Care Act has subjected union health plans to new taxes and mandates while not allowing them to share in the subsidies that have gone to private insurance companies competing on the newly created exchanges (Mufson and Hamburger, 1/31).

The New York Times: Glitches In State Exchanges Give G.O.P. A Cudgel
Republicans have seized on the failures of homegrown exchanges in states like Maryland, Minnesota and Oregon -; all plagued by technological problems that have kept customers unhappy and enrollment goals unmet -; and promise to use the issue against Democratic candidates for governor and legislative seats this fall (Goodnaugh, 2/1).

The Washington Post: Maryland Leaders Accused Of Political Motives Over Long Review Of Health Exchange Problems
For nearly two months, top Maryland leaders have promised to investigate what went wrong with the launch of the state's online health insurance marketplace. But they have been vague on when or how that would happen. Last week, legislative leaders said that instead of continuing to question health officials and request documents, they are likely to defer to a previously scheduled state audit of the exchange that is expected to begin this summer and could take a year to complete. That angered many Republicans and some Democrats who want a full accounting now (Johnson and Flaherty, 2/2). 

The Washington Post: O'Malley Says Jail Scandal, Health Exchange Glitches Are Part Of Much Broader Record
Maryland Gov. Martin O'Malley (D) acknowledged in an interview that two episodes that emerged last year -; the Baltimore jail scandal and the state's botched rollout of its online health insurance exchange -; run counter to his reputation as an effective manager. But O'Malley, who is preparing for a possible 2016 White House bid, said those events should not be considered "in isolation." ... While Maryland's online health insurance exchange has been riddled with technical glitches since its Oct. 1 debut, O'Malley said the state remains committed to getting it right. And he noted that several other of his initiatives had taken more than one try before they were successful (Wagner, 2/2).

Los Angeles Times: Medi-Cal Seen As Relief For Some, Confusing Burden For Others
Supporters of national healthcare reform tout the expansion of Medicaid -; called Medi-Cal in California -; as one of the great successes of the Affordable Care Act. For many needy people, learning they're eligible for the usually free program has been a tremendous relief -; assurance that, after decades of forgoing care or worrying about medical expenses, they'll now be able to afford medications, see a doctor or seek emergency care without worrying about ending up broke. But the news isn't wholly welcome for others, who find the complexities of signing up with Medi-Cal bewildering and onerous (Brown, 2/1).

The Washington Post: Court To Review Religious Law Once Hailed By Democrats But Now Used To Battle Obamacare
A law championed by Senate Democrats (including one named Joe Biden) to undermine a Supreme Court ruling written by Justice Antonin Scalia has become the latest obstacle to the Affordable Care Act. Who says Washington's not bipartisan? Of course, no one knew back in 1993 that the Religious Freedom Restoration Act (RFRA) would one day be invoked by business owners who say their religious beliefs forbid offering employees health insurance plans that cover some types of contraceptives (Barnes, 2/2). 

The Washington Post's The Fact Checker: The Most Popular Fact Checks Of January (It's Still Almost All About Obamacare)
Fact checks about the Affordable Care Act continue to dominate our monthly roundup of the most widely read fact checks. In fact, the only non-Obamacare fact check to make it in our top five list (on the Keystone XL pipeline) just narrowly beat out yet another health-care fact check. In compiling this list, we focused on full fact checks of specific claims. Otherwise, The Fact Checker's round-up of claims made by President Obama in the State of the Union address would have easily topped the list (Kessler, 2/3). 

Politico: Cantor: 'Obamacare Is On Borrowed Time'
The end of the Affordable Care Act is within sight, House Majority Leader Eric Cantor says, outlining Republican plans to propose health care legislation later this year. "In my opinion, Obamacare is on borrowed time," the Virginia Republican said in an interview for Sunday on CBS's "Face the Nation." "As we begin to see the further growth in terms of implementation of this law, you will see, I believe, more and more people negatively affected. And there's going to be a real problem, a real need for an alternative" (Epstein, 2/2).

The Wall Street Journal: Cantor: Expect 2014 Vote On A GOP Health Law 
After spending much of last year bashing President Barack Obama over the stumbles of his health-care overhaul, House Majority Leader Eric Cantor (R., Va.) told House Republicans Thursday to expect a vote this year on a GOP alternative to the 2010 Affordable Care Act. The gambit is politically risky, exposing Republicans to scrutiny leading up to the 2014 midterm elections. But it gives them a chance to sound a more positive tone after last year's intraparty warring led to a partial government shutdown  (Peterson and Meckler, 1/31).

Politico: Pre-Super Bowl, Obama Sparks With Bill O'Reilly
President Barack Obama faced questions Sunday on Obamacare, Benghazi and the IRS's targeting of conservative groups during a pre-Super Bowl interview with Fox News host Bill O'Reilly and dismissed much of the criticism of him as ginned up by the cable news channel. ... Asked if the "biggest mistake" of his presidency was his claim that Americans who liked their health insurance plans would be able to keep that coverage, Obama nudged his interviewer. "Oh, Bill, you've got a long list of problems of my presidency," he said (Epstein, 2/2).

The Associated Press: Obama Defends Himself From Array Of GOP Criticism
Obama would not say why he didn't fire Health and Human Services Secretary Kathleen Sebelius after the failed launch of the government's online marketplace. He also declined to say that the biggest mistake of his presidency was telling Americans if they liked their health care they could keep it and argued the website is now working the way it's supposed to (2/2).

The New York Times: Obama Is Tackled By O'Reilly Before Game
Some of the hardest hits of Super Bowl Sunday came a couple of hours before kickoff. ... His answers shed little if any new light on some of the most controversial moments of Mr. Obama's presidency, but it was a feisty 10-minute encounter that exposed the different world views of Mr. Obama and some of his sharpest critics. For Mr. Obama it may have been an unpleasant duty that was more or less unavoidable but for some conservative fans of Fox, it was an opportunity to watch the president challenged in a way they believe he has not been by the rest of the news media (Baker, 2/2).

The Wall Street Journal: Obama Defends Handling Of Controversies On O'Reilly Show 
Mr. O'Reilly began the Fox News interview by saying he wanted to "get some things on the record" and questioned the president about the Affordable Care Act. While Mr. Obama rarely gets unsettled during interviews, at several points he criticized Mr. O'Reilly and Fox News for spreading what he said was misinformation (Favole, 2/2).

The New York Times: Method of Study Is Criticized In Group's Health Policy Tests
But now that the center has gotten started, many researchers and economists are disturbed that it is not using randomized clinical trials, the rigorous method that is widely considered the gold standard in medical and social science research. Such trials have long been required to prove the efficacy of medicines, and similarly designed studies have guided efforts to reform welfare-to-work, education and criminal justice programs. But they have rarely been used to guide health care policy -; and experts say the center is now squandering a crucial opportunity to develop the evidence needed to retool the nation's troubled health care system in a period of rapid and fundamental change (Kolata, 2/2). 

The Washington Post: Walgreens To Use Software To Help Clinicians Assess Patients
The next time a patient walks into a Walgreens clinic, the clinician may not be the only one assessing patients. Soon, hundreds of Walgreens clinics will be equipped with new software that guides health-care providers through checkups -; requiring them to ask certain questions or request particular lab tests depending on the patient's history. The software, called ePASS, was developed by Inovalon, a Bowie-based health IT firm with about 3,000 employees worldwide (Ravindranath, 2/2). 

NPR: Abortions Reportedly Drop To Lowest Rate Since 1970s
Abortions in the U.S. resumed their downward trend between 2008 and 2011, according to a new study. But its authors say the recent surge of state laws intended to restrict the procedure is likely not the reason (Rovner, 2/2). 

Los Angeles Times: U.S. Abortion Rate In 2011 Lowest Since 1973, Study Says
The U.S. abortion rate fell in 2011 to its lowest level since the 1973 Supreme Court decision legalizing the procedure, Roe vs. Wade, according to a new study. Research by the Guttmacher Institute, a nonprofit organization that supports abortion rights, found that in 2011 there were 16.9 abortions for every 1,000 women ages 15-44. In 1973, the rate was 16.3 abortions per 1,000 women (Hamedy, 2/2).

The Washington Post: Study: Abortion Rate At Lowest Point Since 1973
The study did not examine the reasons for the drop. But the authors suggested that one factor was greater reliance on new kinds of birth control, including intra-uterine devices such as Mirena, which can last for years and are not susceptible to user error like daily pills or condoms (Somashekhar, 2/2). 

The Washington Post: Health Care Spending Still Rising For States And Cities
The Affordable Care Act, President Obama pledged, would stem the rapidly rising cost of health care. Early indications suggest it has: The growth of total U.S. health-care spending ebbed in 2012 to just 4 percent. But for state and local governments, bending the cost curve hasn't happened. In fact, a new report from the Pew Charitable Trusts shows health-care spending is consuming a greater percentage of state and local government budgets than at any time since the Centers for Medicare and Medicaid Services began collecting data. State and local governments spent 31.5 percent of their budgets on health-care costs in 2012, according to CMS and the Bureau of Economic Analysis (Wilson, 1/31).

The Associated Press/Wall Street Journal: Detroit, Retirees Reach Agreement On Health Insurance
The city of Detroit and its retirees have reached an agreement in a health insurance dispute that may end a lawsuit against the city. Retirees filed suit in November to stop the city from shifting them to Medicare and giving those under age 65 a $125 monthly stipend to buy their own insurance. The parties reached an agreement in principle Thursday night covering benefits through the end of 2014, mediators in Detroit's bankruptcy said Friday in a statement. Some features of the deal include the increase to $300 in the monthly stipend for retirees over age 65 who aren't eligible for Medicare. The stipend for retirees under age 65 will be increased to $175 if the household income is less than $75,000 and the retiree acquires insurance under a health care exchange (1/31).