KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Where’s Obama’s ‘Mission Accomplished’ Banner?; Health Law Critics Overlooking Those Denied Affordable Care In The Past

The Wall Street Journal: Obamacare Mission Accomplished
Great news: The White House says that Healthcare.gov and the 36 federally run insurance exchanges are finally good to go. The only thing missing from Sunday's relentlessly upbeat progress report was President Obama in front of a "Mission Accomplished" banner. Sunday's eight-page report was intended to meet Mr. Obama's deadline for fixing the site after its October 1 debut was a calamity. But the more important goal was political -- namely, claiming enough progress to prevent Democrats on Capitol Hill from joining the GOP demand for delaying the individual mandate to buy insurance or even the entire program (12/1).

The New York Times: Rooting For Failure
Yes, it is a big and legitimate news story, for a presidency built on technical expertise, that the federal exchange is not working as promised. Ditto Obama's vow that people could keep their bottom-feeder health care policies. But where were the news conferences, the Fox News alerts, the parading of people who couldn’t get their lifesaving cancer treatments under the old system? Where was the media attention when thousands of people were routinely dumped once they got sick? When did Republicans in Congress hold an oversight hearing on the leading cause of personal bankruptcy -- medical debt? (Timothy Egan, 11/28). 

USA Today: Kathleen Sebelius: Improvement Dramatic Over Oct. 1
The new Marketplace is an opportunity for individuals without employer insurance to obtain coverage -- with choice and competition that was previously unavailable. Many Americans and their families are eligible for financial assistance to make insurance even more affordable. Yet, far too many of those who have visited HealthCare.gov have experienced problems. These problems are unacceptable (Secretary of Health and Human Services Kathleen Sebelius, 12/1).

USA Today: Healthcare.gov Better But Not Yet Well: Our View
A couple of weeks after the disastrous debut of its health insurance website Oct. 1, the Obama administration woke up and finally began doing what it should have done all along, bringing in a competent troubleshooter, consolidating fix-it efforts under a central coordinator and setting a real deadline -- Nov. 30 -- to repair the site. That seems to have worked, at least to some degree. The White House announced Sunday that it had hit its target of having the website function smoothly for "the vast majority" of people who want to sign up, which it defines as about 80 percent (12/1).

Los Angeles Times: As Obamacare Website Relaunches, There Is Reason To Hope
The opportunity to be reborn is a rare gift indeed, granted to few beyond the mythical phoenix and some adherents of the Baptist faith. Them -- and the Affordable Care Act, which this week will undergo what its supporters hope will be a second launch much different from its first. Reports are flowing in that HealthCare.gov, the federal enrollment website serving residents of 36 states that didn't bother to set up their own sites, is working much better than at any time since its calamitous launch on Oct. 1 (Michael Hiltzik, 12/1). 

The Washington Post: Obamacare – A Question Of Morality
There was a lot of bloviating about the Affordable Care Act on the talk shows last weekend. The Obamacare critics' chief focus was the open-enrollment fiasco, the un-kept presidential promise and the millions of cancellation notices. Overlaying the palaver was the unrestrained glee of health-reform opponents. The same weekend, in a section of our nation's capital where pompous politicians and self-important opinion-makers seldom venture, the Affordable Care Act was the subject of thanks and praise at the First Baptist Church at Randolph Street and New Hampshire Avenue NW (Colbert I. King, 11/29). 

The Wall Street Journal: In the Trenches With the Obamacare Army
Even when the Obama administration was under the impression that the launch of the Affordable Care Act was going to work splendidly, with a first-rate website, the plan still called for "navigators" to help people sign up. Now, with the ACA website Healthcare.gov hobbled, and even many of the president's supporters grumbling that the law may need a radical rethinking, the work of the tens of thousands of these helpers is more vital than ever. How's it going? Not well, to judge from a visit with navigators in North Carolina, one of 34 states that decided not to open their own health-insurance exchanges (Eliana Johnson, 11/29).

The Wall Street Journal: Obamacare's Plans Are Worse
The reason this furor will continue even if the website is fixed is that the public is learning that Obamacare's insurance costs more in return for worse coverage. Mr. Obama and his liberal allies call the old plans "substandard," but he doesn't mean from the perspective of the consumers who bought them (11/29).

Bloomberg: Obamacare: The Result Of All Politics, All The Time
Why were so many stupid, avoidable mistakes made during the preparations for the debut of HealthCare.gov? Why did they go undetected until it was too late? Why did Obama even dare to make his promise that all who wanted to keep their insurance would be able to? Why did it come as such a shock when that promise turned out to be false -- as a moment's thought at any point would have told you it was bound to be? Political dysfunction is part of the answer -- though only part (Clive Crook, 11/27).

Bloomberg: War On Contraception? No, An Attack On Religion
From reading the New York Times, you might think that religious conservatives had started a culture war over whether company health-insurance plans should cover contraception. … That way of looking at the issue will be persuasive if your memory does not extend back two years (Ramesh Ponnuru, 12/1).

The Oregonian: Obamacare Contraception Challenge Has Oregon Implications
Say this for Oregon health care policy: It doesn’t think that private employers should get to make decisions about their workers' contraception choices. Bedrooms are crowded enough these days. But a possible U.S. Supreme Court decision on the subject, concluding that because corporations are people they can hold religious beliefs, could topple not only federal law on the subject but also Oregon law. We could find ourselves with a burst of Uncover Oregon, in more ways than one (David Sarasohn, 11/30).

Dallas Morning News: As GOP States Flip, Where's The Texas Answer On Medicaid?
There's a silver lining in the fumbled rollout of Obamacare, even in Texas. Unfortunately, state leaders want nothing to do with it. While HealthCare.gov was freezing up after its Oct. 1 launch, Medicaid enrollment took off. Texas added almost 12,000 people in the first month. That's four times more than signed up on the federal exchange. And Texas isn't even expanding Medicaid (Mitchell Schnurman, 11/30).

The New York Times: Obamacare's Secret Success
The law establishing Obamacare was officially titled the Patient Protection and Affordable Care Act. And the "affordable" bit wasn't just about subsidizing premiums. It was also supposed to be about "bending the curve" -- slowing the seemingly inexorable rise in health costs. ...  So, how's it going? The health exchanges are off to a famously rocky start, but many, though by no means all, of the cost-control measures have already kicked in. Has the curve been bent? The answer, amazingly, is yes. In fact, the slowdown in health costs has been dramatic (Paul Krugman, 11/28). 

The Wall Street Journal: Obamacare's Next Legal Challenge
As millions of Americans see their health-insurance premiums increase, have their coverage dropped as a result of the Affordable Care Act, and are unable to use the federal exchange, Oklahoma has sued the Obama administration. The Sooner State and several others are trying to stop the government from imposing tax penalties on certain states, businesses and individuals in defiance of the law. If these legal challenges are successful, the deficit spending associated with the new health-care law could be reduced by approximately $700 billion over the next decade (Scott Pruitt, 12/1).

CNN: Better Health Not About Obamacare, It's About You
The website may be working better now, but to me that's not the most important issue. In my mind, the real suspense comes from whether Obamacare will really make us a healthier America, even if it succeeds in its ambitions to dramatically expand coverage. A healthier America: That is the goal we should share as Americans, but access alone won't get us anywhere close. This past spring, the New England Journal of Medicine followed up on an important experiment in Oregon (Dr. Sanjay Gupta, 12/2). 

The Oregonian: Tips To Qualify For Tax Credits On Health Exchanges Like Cover Oregon
She's 61, an on-call receptionist making less than $15,860 a year and not yet eligible for Social Security benefits. She's four years away from qualifying for Medicare, so she needs to buy health insurance to comply with the new federal law requiring coverage. But under the Patient Protection and Affordable Care Act, she earns too little to qualify for a subsidized private health plan on Cover Oregon or any other state or federal exchange. Instead, she qualifies for the Oregon Health Plan, the state's form of Medicaid. "I've never qualified for entitlements and I don't want to use them," Christine said. "I don't feel I should. And I don't want to be on Medicaid either" (Brent Hunsberger, 11/30).

On other subjects --

Los Angeles Times: AIDS Fatigue: A Dangerous Diagnosis
I saw my first AIDS case in 1981, the year the disease was identified. And for most of the time since then, I've conducted laboratory research to better understand the precise mechanisms by which the virus HIV causes AIDS. Lately, however, I've been equally worried about a related condition that is prevalent, persistent and threatens to bankrupt us. People in my world call it AIDS fatigue (Dr. Warner C. Greene, 12/1).

Bloomberg: Why It's OK To Pay Bone-Marrow Donors
Locating a marrow donor is often a needle-in-a-haystack affair. The odds that two random individuals will have the same tissue type are less than 1 in 10,000, and the chances are much lower for blacks. Among the precious few potential donors who are matched, nearly half don’t follow through with the actual donation. Too often, patients don’t survive the time it takes to hunt for another donor. Allowing compensation for donations could enlarge the pool of potential donors and increase the likelihood that compatible donors will follow through (Sally Satel, 12/1).

The New England Journal of Medicine: New Insights into the Dementia Epidemic
The combined effects of longer lives and the dramatic bulge of baby boomers reaching old age will magnify the [dementia] epidemic in future decades. ... Research on preventing late-life dementias should explore ways of reducing risk factors at both the societal and the personal levels. We don't know the extent to which better risk-factor control can reduce dementia rates. However, a potentially ominous trend that could lead to a reversal of the decrease in risk is the growing prevalence of obesity and diabetes among middle-aged and younger people. Other factors to consider in the United States and other countries with increasingly racially and ethnically diverse older populations are changes seen in some groups of second- and third-generation Americans that might drive increased risk for vascular disease (Drs. Eric B. Larson, Kristine Yaffe and Kenneth M. Langa, 11/27).

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