KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Commentary On Health Law Rollout: Coverage Is ‘More Expensive, More Subsidized And More Comprehensive;’ Politics Kept Congress From Setting Up Simpler Medicare-Style Insurance

The New York Times: But What if Obamacare Works?
One way to understand what is being offered is to think in terms of three "mores." Insurance à la Obamacare will be more expensive, more subsidized and more comprehensive than what was previously available on the individual market. This may not be obvious if you're struggling to log on to HealthCare.gov. But some of the state-level exchange Web sites are working well enough to enable illuminating window shopping (Ross Douthat, 10/26).

The New York Times: The Big Kludge
Why did this thing have to be so complicated in the first place? ... Imagine, now, a much simpler system in which the government just pays your major medical expenses. In this hypothetical system you wouldn’t have to shop for insurance, nor would you have to provide lots of personal details. The government would be your insurer, and you’d be covered automatically by virtue of being an American. Of course, we don’t have to imagine such a system, because it already exists. It’s called Medicare, it covers all Americans 65 and older, and it’s enormously popular. So why didn’t we just extend that system to cover everyone? The proximate answer was politics (Paul Krugman, 10/27). 

The New York Times: Roll Out The Health Care
The Democrats are depressed. The Republicans enjoy pointing out that the Obamacare rollout has been a mess. But they obviously can't pretend to be upset that people are finding it hard to sign up for a program their party wanted to kill, eviscerate and stomp into tiny pieces, which would then be fed to a tank of ravenous eels. Well, actually, they can (Gail Collins, 10/26).

Politico: Obamacare Vital Signs Not Just Numbers
Obviously, the website must be fixed soon, or the ACA will be in deep trouble. If it is not fixed, the political fallout will worsen, and one of the ACA’s gateways to coverage, the federal exchange, will remain dysfunctional. But assuming the website is repaired fairly soon, the public’s judgment about Year One will be based much more on whether people believe the coverage they get is a good deal than on early website numbers or projections made in Washington for first-year enrollment (Drew Altman, 10/27).

Bloomberg: Obamacare’s Excellent Prognosis
Obamacare is in trouble. The federal website for buying insurance is a disaster, half the states have refused to expand Medicaid, and whether the whole thing will actually save money is still uncertain. Big as these problems are, however, the project’s potential value is as great as ever, and its odds of success remain high. Bet against it at your peril (10/25).

The Washington Post: Sebelius On National Damage-Control Tour Over Obamacare Web Site
Her many friends note that it isn't as though [Health Secretary Kathleen] Sebelius herself wrote the code for HealthCare.gov or even ran the tests. But given the stakes, the unhappy history of previous government tech launches and the disconnect between her promises that everything was on track and the reality that it wasn't? Those do add up to a communications disaster with her name on it (Melinda Henneberger, 10/25).

Los Angeles Times: Trying To Knock Out Obamacare On A Technicality
The Pacific Legal Foundation, a Sacramento-based advocacy group for limited government, is seeking a do-over of sorts on the legality of the individual mandate: the law's requirement that virtually all adult Americans carry comprehensive health insurance starting in 2014. The Supreme Court tackled that question head-on in 2012, ruling that the mandate amounted to a tax that Congress had the authority to impose. On the surface, that ruling appeared to negate all the lawsuits that Obamacare opponents had filed against the mandate, including the one that the Pacific Legal Foundation had filed on behalf of Matt Sissel, an artist in Washington state who did not want to have to buy health insurance. But the foundation amended Sissel's complaint with a new angle: Instead of arguing that Congress had exceeded its authority, it contended that the law violated the constitutional requirement that revenue measures start in the House of Representatives (Jon Healey, 10/25).

Los Angeles Times: Obamacare's Next Hurdle
One of these weeks, now that the Obama administration has recruited a SWAT team of computer whizzes, Healthcare.gov will recover from its shambolic debut and turn into, well, just another website. After all, it's only a website, and websites can be fixed. But that's when a far more interesting chapter in the life of Obamacare will begin. We're about to witness a massive experiment in federalism to see whether the Affordable Care Act can succeed in two very different kinds of states: those where governments are actively working to help the law succeed, and those where they're working to make it fail (Doyle McManus, 10/27).

The Wall Street Journal: 'Cover Oregon' Doesn't Have Me Covered
Despite official statements in recent days, the problems at the federal and state health insurance exchanges are far from merely "technical." Based on my experience trying to navigate the utter confusion at the "Cover Oregon" health exchange over something as simple as determining one's income and eligibility for tax credits, I wonder if they'll ever get ObamaCare working. And I'm someone who would love to sign up for one of the plans (David Kline, 10/25). 

The Wall Street Journal: Running Away From ObamaCare
What do Sens. Mary Landrieu of Louisiana, Mark Begich of Alaska, Kay Hagan of North Carolina and Mark Pryor of Arkansas have in common, besides being Democrats up for re-election next year in states that President Obama lost in 2012? Each has come out in favor of extending ObamaCare's enrollment period or delaying the individual mandate requirement to purchase health insurance or pay a penalty. West Virginia's Joe Manchin, who is not facing re-election next year, was the first Democrat to break ranks, but others clearly see the issue as a way to distance themselves from the unpopular law (Jason L. Riley, 10/25).

The Wall Street Journal: Comparison Shopping For Knee Surgery
Here we go again. The Affordable Care Act intends to transform the health-care system, extend coverage, reduce costs and increase quality—all without asking anything of the patients. Consumers will pay with higher taxes, of course, but otherwise will face no incentives to make wise choices, compare price with performance or shop for value. Doctors, hospitals, insurers and, most of all, the government will do that for them, which is hardly reassuring. This reflects what I call the "impossibility theorem" in health care (James C. Robinson, 10/27). 

The Seattle Times: After Affordable Care Act Launch, Competence Is The New Sexy
Let us now praise competence. … While we're at it, let us demand an explanation for incompetence — and some accountability to go along with it. It is unconscionable and unbelievable that the nation where Amazon.com was born, the nation that pioneered online retailing, cannot cobble together a website to sell health-care insurance (Leonard Pitts Jr., 10/27).

The Star Tribune: Obamacare: The Good, The Bad And The GOP
I sincerely hope the exchanges are successful. But it won’t be easy. In the 1990s, the Minnesota Employees Insurance Program attempted to offer health insurance to employers with as few as two employees. MEIP lasted for four years before going broke because the pool increasingly was made up of high-cost enrollees. The current exchanges have safeguards to defend against that sort of death spiral, but they still need healthy people to sign up (Bryan Dowd, 10/27). 

The Star Tribune: Companies Hope To Cash In On Health Insurance
“You’ve probably heard of this new act where everybody needs to have health insurance by 2014 or pay a penalty and you’re wondering how, where or what, and you’re probably wondering how much is this going to cost me?” he said. I thought it was an ad for MNsure, but then Steve-O said, “your first step to finding out is caretaxcredit.com. Find out in seconds if you can get financial help with purchasing insurance.” It turns out that the pitch was another example of how companies are looking to take advantage of the confusion swirling around the debut of the Affordable Care Act (Ale Matos, 10/26).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.