KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Coburn, USA Today, WSJ, New Yorker On Obamacare Deadline

USA Today: Obamacare Deadline Comes With Humble Pie (Our View)
As Obamacare's first enrollment period ends Monday (except for those who got an extension), the president's signature initiative is behind schedule, increasingly unpopular in polls and coming up short of the numbers the administration originally targeted. So should it be junked, as Republicans have been trying to do ever since it was passed? Hardly. Thanks to both administration incompetence and Republican intransigence, the Affordable Care Act is far from the runaway success its supporters imagined when President Obama signed the law four years ago. But neither is it the unmitigated disaster that opponents contend (3/30).

USA Today: Obamacare Cuts Choices, Not Costs
Obamacare supporters are touting reports that 6 million Americans bought insurance on exchanges as evidence the plan is moving in the right direction. But these numbers are misleading. If anything, they show that Obamacare's greatest challenges are yet to come. Of these enrollees, as many as 89% were previously insured. Helping 5 million Americans re-enroll in insurance is no great achievement, particularly when many of those customers were forced to give up plans they liked. For everyone else, costs continue to skyrocket (Sen. Tom Colburn, R-Okla., 3/30). 

The Washington Post: The Insiders: Is Obamacare Working?
From an insurer standpoint, an enrollment mix where only 25 percent are in the golden 18-34 age bracket is not the definition of “success.” And if the enrollees lean toward older, sicker people, premiums are going to go up dramatically for everyone. The premiums will be higher, and the only way insurers can lower prices is to make their networks more and more restricted, limiting access and choice for millions of Americans. That’s not what success looks like (Ed Rogers, 3/28).

The New Yorker: Obamacare: Where Are We Now? 
Lots of Americans who previously couldn’t obtain insurance ... now have health coverage. ... despite all the carve-outs and delayed deadlines imposed by an anxious White House, Obamacare is up and running. Contrary to the predictions of doom, it hasn’t collapsed under the weight of its own complications. Why, then, does the over-all reform remain so unpopular? ... The Republicans, with the enthusiastic help of conservative media outlets, have done a fiendishly effective job of stigmatizing what is essentially a private-sector solution as a big-government intrusion, and a handout to the unworthy (John Cassidy, 3/28).

The New Yorker: Health Caring
As the first deadline for coverage in 2014 drew near, the Administration announced that the number of people who signed up had passed six million. ... Those gains have been achieved amid a political controversy that has at times seemed almost unprecedented but which in many ways replicates the example of two of the law’s forerunners, Medicare and Medicaid. Those programs were born together in the summer of 1965, but their paths quickly diverged. ... the core of the law is the guarantee of health care to the people who need it most. As the story of Medicaid illustrates, the hardest thing about programs to aid the poor is getting them started in the first place. Obamacare has now passed that hurdle (Jeffrey Toobin, 4/7). 

The Wall Street Journal: Is ObamaCare A Law?
Liberals keep dismissing challenges to ObamaCare, political and legal, so it's no surprise they mostly ignored last week's oral argument at the D.C. Circuit Court of Appeals that could send another case to the Supreme Court. Coming in the week the White House wheeled out its 38th rewrite of the law, Halbig v. Sebelius is even more important for the contours of executive power and the rule of law. The case asks whether the Affordable Care Act, which limits insurance subsidies to "an Exchange established by the State," also authorizes subsidies for the 36 exchanges established by the federal government. ... here the Administration is asking the court to declare that the statute unambiguously means the opposite of what the plain language says (3/30).

Chicago Tribune: Monday Is The Obamacare Deadline. Sort Of. 
Another reason the law's supposed enforcement mechanisms are so wobbly: Consumers can claim one of many "hardship exemptions," some of which require little or no proof, to sidestep the mandate and penalty. Many Americans, heads spinning from all the Obamacare changes so far, may suspect that there's another reprieve — from penalties or deadlines — in store. Who knows? Thirty-eight Obamacare asterisks are a lot of asterisks. We'd bet there are more on the way (3/31).

Los Angeles Times: How A Koch Brothers Operative Played The Sexism Card Against MSNBC 
I suggest you take a look at the masterful performance of one Jennifer Stefano, a regional director of the Obamacare-hating, Koch brothers-funded Americans for Prosperity. She appeared as a guest on Chris Hayes’ MSNBC program "All In" Wednesday night to talk, ostensibly, about AFP’s objection to the two-week Obamacare deadline extension. The conversation quickly devolved into a one-sided screaming match, with Stefano working herself into the kind of tizzy any parent of a teenager would recognize as phony. Let’s put it this way: Any interview about health policy that ends with the guest demanding “How dare you?” has the ring of a set-up (Robin Abcarian, 3/28).

Bloomberg: Republican Senate Could Work Around Obama's Veto 
If Republicans take control of the U.S. Senate in this year's elections, it will be, as Vice President Joe Biden might put it more graphically, a big deal. ... President Barack Obama has the veto pen for the last two years of his term. That glosses over the profound policy implications of a change that would affect many areas. The Affordable Care Act: The president can stop repeal of Obamacare, but a determined congressional majority can wreak havoc by using the initial budget process, known as reconciliation, which allows major changes to be made with only a majority Senate vote that isn't subject to veto (Albert R. Hunt, 3/30).

On other health issues -

NPR: Why Paper Prescriptions Are Going The Way Of Snail Mail
Charlie is like a lot of my patients. He's in his late 50s, weighs a little too much and his cholesterol and blood pressure are both too high. To lower his risk of a heart attack or stroke, he takes daily pills to control his blood pressure and lower his cholesterol. A couple of times a year, Charlie visits me to make sure the drugs are working and aren't causing problems. Caring for patients like Charlie has become easier in the last few years because of something that you might take for granted in 2014: electronic prescribing (John Henning Schumann, 3/30). 

The Hill: Yet Another Short-Term 'Doc Fix', But With Glimmers Of Hope
House leaders approved a 12-month short-term patch to prevent looming physician payment cuts that would threaten access to needed care for millions of Americans. ... While imperfect and not the permanent fix that we hoped for, the authors of the bill included a number of provisions not typically included in SGR legislation ... A number of these policies were recommended in March 2013 by the National Commission for Physician Payment Reform and hit on important areas within healthcare. Furthermore, their inclusion illustrates that the SGR patch is one of the few legislative vehicles that has bicameral and bipartisan viability (Dr. Kavita Patel and Jeffrey Nadel, 3/29).

The Washington Post: Having 'The Other Talk' With Your Kids — Not Storks, But Aging
As parents, we care for our children until they can fend for themselves. Then one day, the roles are reversed. ... Perhaps you won’t need assistance in your senior years. You would be one of the lucky ones. The fact is that about 70 percent of people 65 or older will need long-term care services at some point, according to Genworth Financial. But long before a health crisis forces the issue, you need to talk with your adult children about your later years. The problem is, many people can’t bring themselves to have that talk (Michelle Singletary, 3/28).

The New York Times: Antibiotic Use, And Abuse, On The Farms
The Food and Drug Administration’s efforts to get the voluntary cooperation of drug companies to curb the overuse of antibiotics in animal feed is off to a rousing good start. The agency announced on Wednesday that 25 of the 26 manufacturers of the antibiotics of greatest concern had agreed to modify their labels to block such usage. They account for almost all sales of these drugs (3/28).

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