KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Despite Website Woes, Administration Should Be Given More Time; Health Law Credibility ‘Going Up In Smoke’

The Washington Post's Plum Line: What The Obamacare Enrollment Numbers Really Tell Us
The enrollment numbers are in, and as expected, they are well short of projections. Around 106,000 enrolled in new plans during October — with approximately 27,000 coming from states where the federal government is running the exchange (with its extensive problems), and another 79,000 coming through the state exchanges. Republicans are gleefully pointing to the numbers as proof Obamacare needs to be scrapped entirely. That confirms two things we’ve long known to be true: the website is a disaster, and short term enrollment figures are a serious political problem for the White House and Democrats (Greg Sargent, 11/13).

Los Angeles Times: Obamacare's Dismal Stats
The Obama administration made it official Wednesday: The number of people who signed up for health coverage through new state and federal insurance exchanges last month was dwarfed by the number whose policies have been canceled as a result of the 2010 Affordable Care Act. The figures were disappointing but not surprising, considering how badly the federally run exchanges' website, HealthCare.gov, has malfunctioned. Yet as tempting as it may be for lawmakers to delay or reverse some of the changes set in motion by the law, they should give the administration more time to get HealthCare.gov back on track and consumers more time to learn about their options (11/14). 

The Wall Street Journal: The Affordable Care Act 26,794
The White House briefly lifted its Affordable Care Act information embargo on Wednesday, sort of, and now we know why the political pros imposed the blackout. The millions of Americans who are losing their private health insurance greatly exceed the handful who signed up for an ObamaCare plan. ... But don't make too much of the numbers because they're deliberately inflated through junk accounting. A technical footnote in the HHS release explains that the agency is only reporting people who "selected a plan." That means they may or not have paid for it as required (11/13).

USA Today: Obamacare Credibility Going Up In Smoke: Our View
Administration troubleshooter Jeffrey Zients promised the website would be working smoothly for most users by the end of this month. Even if the exchanges begin to work well by then -- a big if -- that will leave people whose insurance policies run out at the end of the year little time to sign up for insurance that kicks in on New Year's Day. ... That's frightening for two reasons. One is that the White House has next to no credibility left when it comes to promises about its website. The other is that the administration's disastrous incompetence is panicking Democrats, emboldening Republicans and threatening to unravel health reform. That would be a sickening outcome, but with each passing day, there is more to do and less time to do it (11/13).

The Washington Post: Obamacare Is In Much More Trouble Than It Was One Week Ago
The Affordable Care Act's political position has deteriorated dramatically over the last week. President Bill Clinton's statement that the law should be reopened to ensure everyone who likes their health plans can keep them was a signal event. It gives congressional Democrats cover to begin breaking with the Obama administration. The most serious manifestation of that break is Sen. Mary Landrieu's "Keeping the Affordable Care Act Promise Act." It's co-sponsored not just by the usual moderate Democrats ... but also by Oregon liberal Jeff Merkley. It's worth noting that Merkley is up for reelection in 2014 (Ezra Klein, 11/13).

The New York Times: Obamacare And Character
The president's job approval numbers have hit new lows. That's actually not the worst news in a new round of polling. The worst news — or what the White House should find most worrisome — is that the president's character has taken a hit (Charles M. Blow, 11/13). 

The Washington Post: Obama Needs His Friends Back
In situations of this sort, there is always a search for an instant repair. "Fix the Web site" is the most obvious, and it's certainly necessary. But a tech problem has been compounded by the reality of health-care reform itself. The small but highly visible individual-insurance market was volatile before Obamacare. It's hardly surprising that some who are in it are angry when plans are canceled and premiums rise. The very purpose of insurance reform is to create a broad market in which the less healthy will be able to get coverage at affordable prices (E.J. Dionne Jr., 11/13).

Bloomberg: Congress Shouldn't Repeat Obama's Mistake
The idea is deceptively simple: Because President Barack Obama promised Americans they could keep their existing insurance under his new health-care-reform law, Congress should pass a law guaranteeing that they can. In reality, though, Obama was wrong to have made that promise -- and Congress would be compounding his foolishness by forcing insurance companies to keep it. The primary goal of the Patient Protection and Affordable Care Act is to make the health-care system more efficient and comprehensive. It has never been to preserve individual insurance plans (11/13).

The New York Times' Evaluations: Does Individual Insurance Work?
Amid this week's hints that the federal exchange still won't be anywhere close to functional on December 1st, Matt Yglesias offers the latest noble attempt to explain to Americans losing their individual-market coverage why they're actually better off paying higher premiums for new, Obamacare-era plans. Instead of focusing on the more comprehensive benefits that the new plans offer, he takes a different tack — suggesting that most people with cheapish individual-market coverage didn't really have insurance at all (Ross Douthat, 11/13).

The Wall Street Journal: Escape From ObamaCare
The Affordable Care Act appears to be misfiring in every imaginable way, and Democrats are having second thoughts about serving as human shields for White House ineptitude. If they really want to make amends, they'll join Republicans in trying to repair some of the damage they caused. The first act of penance is modest legislation the House will vote on Friday that would try to honor President Obama's promise that people who liked their insurance could keep it (11/13).

The Wall Street Journal: Voters May Cancel Democratic Coverage in 2014
The mounting cancellations of people's health plans is not a result of faulty implementation. The Affordable Care Act was designed to make unavailable health-insurance policies that didn't include its extensive, expensive and often unnecessary provisions (Karl Rove, 11/13). 

The Wall Street Journal: A Conservative Alternative To ObamaCare
As ObamaCare's failures and victims mount by the day, Republicans have so far mostly been watching in amazement. ... What Republicans can and should do is offer the public something better. Now is the time to advance a conservative reform that can solve the serious, discrete problems of the health-care system in place before ObamaCare, but without needlessly upending people's arrangements or threatening what works in American medicine (Ramesh Ponnuru and Yuval Levin, 11/13).

The Washington Post: Darrell Issa’s Obamacare Kangaroo Court
No human makes leaps quite like Darrell Issa. He leaps to conclusions. He makes huge leaps of logic. He leaps before he looks. And he invariably leaps right into the White House, alleging high-level political misbehavior and administration corruption for just about everything that goes wrong. On Wednesday, the topic was Obamacare, but the California Republican followed the script he used when investigating "Fast and Furious" gun-running, the Benghazi attack, and IRS targeting: make inflammatory allegations of high-level skullduggery, release selective information that appears to support the case while withholding exculpatory details, then use his chairman’s privileges to turn hearings into episodes of "The Darrell Issa Show" (Dana Milbank, 11/13).

Politico: The Obamacare Lie That Can't Be Fixed
Who knew that the day would come when Bill Clinton would be in a position to lecture President Barack Obama about honoring his word? In an interview with Ozy.com, the former president addressed those millions of Americans getting cancellation notices from their insurance companies, even though Obama had infamously promised that they could keep their plans. "I personally believe," Clinton said, "even if it takes a change in the law, the president should honor the commitment the federal government made to these people and let them keep what they got." Clinton has a black belt in verbal escape hatches and has never been one to let a strict adherence to truthfulness become an obstacle, so his statement hit with extra force (Rich Lowry, 11/14).

Health Policy Solutions (a Colo. news service): Protecting Patients Central To Physical, Behavioral Health Reforms
All this hostility obscures the fact that at the core of these reforms are the health and health care of all Americans — almost half of whom will experience a mental health condition in their lifetime. … More to the point, given recent announcements by insurance companies that they are canceling policies held by hundreds of thousands in Colorado alone, it is vital to understand how this landmark legislation protects all of us by extending and strengthening parity for mental health and substance use disorder services (Michael Lott-Manier, 11/13).

The Fiscal Times: Beyond Healthcare.Gov: Testing The Private Market
One of the numerous "proof's in the pudding" tests for the Affordable Care Act (ACA) will be if the plans offered on state and federal online exchanges are competitive with similar plans on the private market. To test this idea on a practical basis – I'm looking for a plan for my family of four – I sampled some policy quotes on ehealthinsurance.com, a privately run site I've used many times in the past. It's a practical model for how online exchanges can work. It's fast, efficient and easy to contact a live person. The site claims to offer 13,000 plans from more than 150 carriers (John F. Wasik, 11/14).

In other health issues -

The American Prospect: The Supply-Side Economics Of Abortion
Last June, Ohio Republicans quietly slipped a handful of abortion restrictions into the state’s budget, alongside provisions to invest in Ohio’s highway system and a new funding model for the state’s colleges and universities. Eight states, including Ohio, already require clinics that perform or induce abortion to have a “transfer agreement” with a local hospital so that patients can be transported quickly to a more sophisticated medical center in case of an emergency. The budget, which Republican Governor John Kasich signed into law with the abortion provisions intact, included an innovative new rule, making Ohio the first state to prohibit abortion clinics from entering into transfer agreements with public hospitals (Thomson-Deveaux, 11/13).

The New York Times: Don't Give Patients More Statins
On Tuesday, the American Heart Association and the American College of Cardiology issued new cholesterol guidelines that essentially declared, in one fell swoop, that millions of healthy Americans should immediately start taking pills — namely statins — for undefined health "benefits." This announcement is not a result of a sudden epidemic of heart disease, nor is it based on new data showing the benefits of lower cholesterol. Instead, it is a consequence of simply expanding the definition of who should take the drugs — a decision that will benefit the pharmaceutical industry more than anyone else (John D. Abramson and Rita F. Redberg, 11/13). 

Health Policy Solutions (a Colo. news service): Providers Who Address Social Determinants Maximize Patient Outcomes
These social determinants of health, such as income, education, access to quality food and housing, and race or ethnicity, exert powerful influences in our patient’s lives before they ever set foot into our office. It is our responsibility as providers to appreciate each patient’s unique situation and ability to follow through on a treatment plan or access necessary resources (Dr. Paul Melinkovich, 11/13).

The Star Tribune: Rosenblum: Program Sheds Light On Mental Illness Issues
While most individual and small-group policies remain exempt, our state’s new online health insurance exchange, called MNsure, will follow parity in coverage of mental health and substance-abuse issues. “Even more people will get covered,” said a buoyed Sue Abderholden, executive director of NAMI, the National Alliance on Mental Illness Minnesota. But mental health parity is only part of the healing (Gail Rosenblum, 11/13).

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