First Edition: March 31, 2014

Today's early morning highlights from the major news organizations offer assessments of the administration's campaign to get people signed up for health care and a look at the issues going forward after today's deadline for most enrollments.

Kaiser Health News: What Happens Next On The Health Law?
Kaiser Health News staff writers Julie Appleby, Mary Agnes Carey and Phil Galewitz, in collaboration with USA Today, report: "Just because open enrollment for people who buy their own health insurance formally closes March 31 doesn't mean debate over the health law will take a hiatus. After more than four years of strident rhetoric, evidence about how the law is actually working is starting to trickle in. Here are seven things to watch before the next enrollment period begins in November" (Appleby, Carey, and Galewitz, 3/31).

Kaiser Health News: Capsules: Former Young Invincible Becomes Less So
Now on Kaiser Health News' blog, Sarah Varney, working in collaboration with NPR, reports: "When we last left Brad Stevens, he was living in Lakeport, Calif., a struggling massage therapist in a struggling town on the southern tip of Clear Lake. Brad has been uninsured his entire adult life .... After a bike accident which injured his shoulder and a battle with advanced thyroid cancer, Brad was anxious to enroll in some form of insurance – any kind of insurance – under the Affordable Care Act. ... The insurance broker had warned Brad about long wait times, but when he called the toll-free line for Covered California, the state's insurance marketplace, Brad said, "I waited four minutes. It was a piece of cake." The operator didn't offer to help him apply for Medi-Cal, and instead told Brad to call the social services office in Lake County. 'It wasn't a one-stop shop' " (Varney, 3/31).

Kaiser Health News: Insurance Agents Enroll More Than 4,000 Haitian-Americans In South Florida
The Miami Herald's Patricia Borns, working in collaboration with Kaiser Health News, reports: "While the White House has focused on enrolling the country's Hispanic population in health plans, a group of Haitian-American insurance agents in South Florida have seized the opportunity to bring health coverage to their own communities, where they estimated seven out of 10 people are uninsured" (Borns, 3/28).

Los Angeles Times: Obamacare Has Led To Health Coverage For Millions More People
President Obama's healthcare law, despite a rocky rollout and determined opposition from critics, already has spurred the largest expansion in health coverage in America in half a century, national surveys and enrollment data show. As the law's initial enrollment period closes, at least 9.5 million previously uninsured people have gained coverage. Some have done so through marketplaces created by the law, some through other private insurance and others through Medicaid, which has expanded under the law in about half the states. The tally draws from a review of state and federal enrollment reports, surveys and interviews with insurance executives and government officials nationwide (Levey, 3/30).

The Wall Street Journal: Long Waits as Health Insurance Deadline Nears
Last-minute applicants for health insurance strained enrollment offices over the weekend, triggering long lines, extra security and hours of waiting across the country ahead of Monday's federal deadline. HealthCare.gov, the federal website, blocked some applicants late Friday but didn't show major technological problems as consumers rushed before the end of the 2014 open-enrollment period for obtaining insurance under the Affordable Care Act. But the system's human capacity maxed out, with too few "navigators" and other enrollment workers to steer consumers through the complex application process (Radnofsky and Corbett Dooren, 3/30).

USA Today: Interest In Health Care Surges As Enrollment Deadline Nears
Sunday evening, Health and Human Services announced 2 million visits over the weekend to HealthCare.gov, the federal government's enrollment site. ... Over the weekend, HHS Secretary Kathleen Sebelius appeared at a Baptist church in Miami to urge Floridians to sign up before the deadline. She plans a fresh round of television interviews with local stations Monday to boost enrollment numbers. ... "The traffic and energy and interest this weekend shows many more are interested in the coverage," White House spokeswoman Tara McGuinness said (Schouten and Kennedy, 3/30). 

The Wall Street Journal: Health Insurers Make Late Push To Sign Up Young Customers
Insurers are pressing ahead with a final marketing push to bring as many young, healthy customers as possible onto their rolls and buttress a recent surge in health-law enrollments. The flood of late sign-ups that helped boost the marketplace total to six million enrollees, a key milestone for the Obama administration, has also brought some insurers an uptick among younger people. But it isn't clear if the trend is broad enough to balance out an earlier skew toward older enrollees, who are more likely to have costly ailments (Wilde Mathews and Weaver, 3/28).

Los Angeles Times: Fighting For Obamacare Through Stage IV Cancer
Michael Robertson put the bag of chemicals in an inside pocket of his sport coat, the pump in the other. He snaked the tubes between the buttons of his shirt to the port in his chest. He adjusted his tie to cover them. Then he sat down in a cavernous room in the White House complex and pulled his chair close to the table, hiding the bulges. Robertson, an aide to President Obama, was meeting with top officials from federal agencies working to implement the Affordable Care Act. He was also in treatment for stage IV colorectal cancer. A soft "bzzt" every 90 seconds alerted him to another dose and another wave of nausea. He timed the cadence of his questions and comments to the ebb and flow of the chemo. No one seemed to notice, and that's how he wanted it (Parsons, 3/29).

The Hill: GOP Senator: Administration 'Cooking The Books' On ObamaCare Enrollment
Sen. John Barrasso (R-Wyo.) said Sunday that the Obama administration was "cooking the books" on enrollment figures for ObamaCare. Appearing on "Fox News Sunday," Barrasso said he wasn't persuaded by statistics that said that more than six million people had signed up for insurance under the healthcare law. ... Sen. Angus King (I-Maine), who has offered legislation to make fixes to ObamaCare, said that it was a great victory for so many people to have signed up for insurance, and said he wasn't concerned about the number of young people or uninsured signing up (Becker, 3/30).

NPR: Latinos Wary Of All-Out Push To Sign Up For ACA
All throughout the country, supporters of the Affordable Care Act have worked to reach the uninsured, holding health fairs and putting ads on TV and radio. The push continues to get as many enrolled as possible, especially Latinos -; the most uninsured group in the country. ... Undocumented immigrants aren't eligible for insurance under the Affordable Care Act, but Obama's deportation of nearly 2 million of them during his presidency may have soured many Latinos' opinion of him (Corley, 3/29).

Politico: Procrastinators: Obamacare Wants You
Leading up to the deadline, President Barack Obama, Vice President Joe Biden, cabinet secretaries and other surrogates have done more than 300 radio interviews, attended 45 enrollment events and appeared in videos that have collectively gotten 33 million hits over the last six weeks, according to figures released to POLITICO by a White House official (Haberkorn, 3/30).

Reuters: Obamacare Hits Milestone, But Detours Ahead For Health Law
[A]s the White House and its allies declare victory, major hurdles remain. And it will take years to determine whether the law will accomplish its mission of creating stable insurance markets that can help a significant number of America's nearly 50 million uninsured gain health coverage, experts say. Republicans are counting on that uncertainty to play into their strategy for the midterm congressional elections in November  (Morgan, 3/30).

The New York Times: In New Health Care Era, Blessings And Hurdles
In a plain brown health clinic on a busy boulevard [in Louisville, Ky.], the growing pains of the Affordable Care Act are already being felt -; almost too sharply for the harried staff trying to keep up with the flow of patients. ... The law still faces steep challenges in Kentucky and nationwide, not only from energized political opponents who plan to attack it until Election Day, but also from skeptical consumers who think the cost of many new plans is too high, and the choice of doctors, hospitals and prescription drugs too limited. ... Yet beneath the loud debate, the law is quietly starting to change the health care landscape (Goodnough, 3/30).

Politico: The Obamacare Report Card
It's pretty obvious that the Obama administration wasn't ready for the launch, despite three and a half years to prepare. The political messaging hasn't impressed anyone; Democrats are scampering away from what was supposed to be a legacy achievement. No one's going to forget that notion that everyone could keep their plans. But the critics will have to round out their picture of the law, too. The signups have now hit 6 million -; a feat that seemed impossible in the worst days of the website failures -; and the administration's outreach efforts are better than they used to be. And although there are lots of complaints about the prices, some low-income customers seem to be genuinely happy with the rates and subsidies they're getting (Nather, 3/30).

Politico: The Obamacare Enthusiasm Gap
Irony alert: The Democrats' biggest challenge this fall is to get their voters excited about a law that they asked for. Obamacare will be a huge voting issue for Republicans -; that's already clear. They'll turn out in droves because they hate the law. What's less clear is how Democrats will get their supporters to the polls to say, "hey, thanks for health reform" (Nather, 3/31).

Politico: Dems Try To Keep Hope Alive With ACA Mantra
According to administration officials, Democrats on Capitol Hill and other strategists who've been in touch with the White House, President Barack Obama's team is sure the health care law's problems will fade in people's minds by November, months after the website rollout. They believe the intense attacks Republicans are using to stoke their own base won't completely depress Democratic turnout. And they're confident that independents will see the GOP's 50 votes to repeal all or parts of Obamacare as a sign of Washington dysfunction (Dovere, 3/31).

The Washington Post: Democrats, Republicans Prepare For New Round Of Battles Over Health-Care Law
Supporters face an array of political, financial and legal challenges in the coming months. Democrats and insurance industry officials are already seeking ways to blunt what may be the next big controversy: an expected increase in monthly insurance premiums next year for the health plans sold through the federal and state marketplaces. Republicans, meanwhile, continue to use the law to attack vulnerable Democratic incumbents in the midterm elections, which will decide whether the GOP wins control of the Senate. ... In the months and years ahead, other questions will loom: How will Americans react when they get fined next year for not having insurance? Will more states expand Medicaid under the law? And will the federal courts make future changes to the law, including barring the use of government subsidies to help pay for coverage in the federal marketplace? (Eilperin, Goldstein and Somashekhar, 3/30).

Los Angeles Times: Insurers Already Calculating 2015 Premiums As Obamacare Kicks In
Even before enrollment closes Monday, California has far exceeded its initial goals for signing up people under the Affordable Care Act. Although the sheer volume of 1.1 million policyholders is impressive for a brand new government program, the number of sicker patients is what's likely to draw the most attention. How sick they are and the size of their medical bills will be front and center in the weeks to come as insurers begin drawing up next year's insurance rates, which will become public this summer (Terhune, 3/30).

The Associated Press: Poll: Obama Health Law Fails To Gain Support
Despite a late surge in sign-ups, support for President Barack Obama's health care law is languishing at its lowest level since passage of the landmark legislation four years ago, according to a new poll. The Associated Press-GfK survey finds that 26 percent of Americans support the Affordable Care Act. Yet even fewer -; 13 percent -; think it will be completely repealed. A narrow majority expects the law to be further implemented with minor changes, or as passed (Alonso-Zaldivar and Junius , 3/30).

Christian Science Monitor: Obamacare Launch: What Americans Like About The Law, And What They Don't 
A narrow majority of US adults say they oppose the law, which is designed to reduce the number of people who lack health insurance, according to a new Christian Science Monitor/TIPP poll conducted this week. ... The results, when viewed alongside other polls about "Obamacare," show the broad political challenge that the president and Democrats face regarding the law. Even though particular elements of the Affordable Care Act are popular – as is its broad goal of expanding access to health care – the financial math is a sticking point (Trumbull, 3/28).

Politico: Self-Employed Artists, Actors Benefit From ACA
[Karin] Abromaitis is among the hundreds of thousands of artists, musicians, dancers, actors and filmmakers around the country who especially stand to gain under Obamacare, either through the plans and premium subsidies available on its new insurance exchanges or from the plans employers must start offering. Typically a well-educated but lower-earning demographic -; whose members are self-employed more often than not -; these Americans have frequently struggled to buy insurance on their own  (Winfield Cunningham, 3/31).

The New York Times: Repercussions And Reprieves At Health Insurance Enrollment Deadline
America's health insurance marketplace closes on Monday night, the deadline for most people to obtain coverage or face a penalty. The confusion and uncertainty of the last six months appear likely to continue as consumers, including some who have never had insurance, begin using new policies for the first time. Here are answers to some frequently asked questions (Pear, 3/29).

The Wall Street Journal: 5 Things To Know About The Health Law's March 31 Deadline
Six months after the disastrous launch of the Affordable Care Act's online insurance marketplaces, Monday is slated to be the final day to sign up for coverage under President Obama's signature domestic program-;sort of. Here's what you need to know about the health law's impending deadline, and the last-minute changes that will push the date back for many consumers (Weaver, 3/30).

The Washington Post: Maryland Gears Up For Health Exchange Redo
On Monday, the first enrollment period for health insurance plans made possible by the Affordable Care Act will end, so call centers in Maryland plan to stay open until midnight in a last-minute effort to boost enrollment numbers. Then on Tuesday, Maryland will begin the process of replacing its troubled exchange, which has had so many problems since its launch on Oct. 1 that officials have decided it would be better to start anew. ... The exchange's board plans to vote Tuesday to use technology from Connecticut, which has had one of the most successful exchanges in the country, and hire the contractor that built that system, Deloitte, according to two people familiar with the decision (Johnson and Flaherty, 3/30).

NPR: Obamacare Rolls Into N.H. Like A Political Campaign -; And Wins
Monday is the deadline to sign up for health insurance under the Affordable Care Act, or at least to begin the process. We already know that nationwide more than six million people have enrolled. But each state has its own insurance market and its own experience with the law. In New Hampshire, polls show the law is quite unpopular. ... And yet, enrollments in the state have greatly exceeded expectations (Keith, 3/31).

Los Angeles Times: States That Have Struggled With Healthcare Sites Consider Lawsuits
Enrollments in the nation's healthcare program have nearly concluded, but for states whose insurance exchanges have been crippled by technical problems, a difficult phase is just beginning: potential legal battles and a race to overhaul their systems before federal grant money dries up. Officials in Oregon, Massachusetts and Maryland are exploring legal options as they sever contracts with those who created their sites (Reston, 3/29).

Los Angeles Times: L.A. County Grapples With Healthcare For Remaining Uninsured
One long period of Obamacare hand-wringing in Los Angeles County will end Monday, as the window for residents to enroll in mandatory healthcare coverage comes to a close. But less than 24 hours later, county elected officials will be confronted with another politically sensitive facet of the nation's healthcare overhaul: how to manage roughly a million people, many of them poor or undocumented, who will remain uninsured either because they aren't eligible or failed to enroll (Brown, 3/30).

Politico: Washington State Obamacare: 'No Frills' Success
In contrast to the other Washington's HealthCare.gov, this Washington's Healthplanfinder has run fairly smoothly almost from the start. While programs elsewhere sputtered and the federal portal didn't work at all, the state signed up more than one in every five Americans who enrolled in an Affordable Care Act plan during the first month. ... This land of a thousand baristas, high-tech giants and evergreen-scented landscapes designed a straightforward exchange, chose a contractor that delivered, and kept lawmakers, policymakers and advocates from getting in the way with their own priorities, no matter how attractive or well-meaning (Haberkorn, 3/31).

Politico: Obamacare In Oregon: A Failed Exchange
Oregon had all the right ingredients for a sparkling Obamacare success story: A Democratic doctor as governor, an eager legislature and a history of health care innovation. It ended up with Obamacare's biggest technological disaster. CoverOregon.com, the state's equivalent of HealthCare.gov, is the only insurance exchange in the country where people still cannot buy coverage entirely online. ... the exchange board is hunting for its third leader since December (Haberkorn, 3/31).

The New York Times: New York Curbs Medical Bills Containing Surprises
Every year, thousands of New Yorkers find themselves responsible for a surprise medical bill from a doctor, like an anesthesiologist, who becomes involved in their care but, unbeknown to the patient, is not covered by their insurance. Now a provision in the state budget agreement announced Saturday is intended to protect consumers by requiring that they be given a reasonable amount of notice when an out-of-network doctor will be treating them (Hartocollis, 3/30).

The Wall Street Journal: Bid To Raise Malpractice Cap Gets A Rider
A California law on medical malpractice awards, in place since 1975, puts a $250,000 ceiling on the amount of money that can be given for noneconomic damages. Now, lawyers and some consumer groups are mounting an effort to substantially raise the cap through California's referendum system, but they are coupling it with a popular idea that hospital doctors should undergo routine drug and alcohol testing (Lazo, 3/28).

The Washington Post: A Legacy Of Pain And Pride
More than half of the 2.6 million Americans dispatched to fight the wars in Iraq and Afghanistan struggle with physical or mental health problems stemming from their service, feel disconnected from civilian life and believe the government is failing to meet the needs of this generation's veterans, according to a poll conducted by The Washington Post and the Kaiser Family Foundation. The long conflicts, which have required many troops to deploy multiple times and operate under an almost constant threat of attack, have exacted a far more widespread emotional toll than previously recognized by most government studies and independent assessments: One in two say they know a fellow service member who has attempted or committed suicide, and more than 1 million suffer from relationship problems and experience outbursts of anger -; two key indicators of post-traumatic stress (Chandrasekaran, 3/29).

USA Today: Health Care Spending Growth Hits 10-Year High
Health care spending rose at the fastest pace in 10 years last quarter, a development that could foreshadow higher costs for consumers this year. Expenses for health care rose at a 5.6% annual rate in the fourth quarter, the Bureau of Economic Analysis said  last week. The jump triggered a sharp upward revision in the government's estimate of consumer spending overall and accounted for nearly a quarter of the economy's 2.6% annualized growth in the last three months of 2013 (Davidson, 3/30).

The Wall Street Journal: AARP Faces Competition From Conservative-Leaning Groups
But now, a handful of conservative-leaning groups are seeking to provide an alternative voice to AARP, which they say leans too far to the left despite its stated "nonpartisan" nature. These competitors include nonprofit advocacy groups and for-profit firms hoping to gain a slice of the lucrative market selling supplemental Medicare insurance. They generally describe themselves as supportive of free enterprise and family values. While alternatives to AARP have existed for at least two decades, several groups say they have gotten a boost in recent years because of AARP's support of the politically divisive Affordable Care Act, signed into law in 2010 (Johannes, 3/30).