KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

First Edition: April 1, 2014

Today's early morning highlights from the major news organizations, including an array of stories as the health law's enrollment period comes to a close:

Kaiser Health News: Burnt Out Primary Care Docs Are Voting With Their Feet
Reporting for Kaiser Health News in collaboration with The Washington Post, Roni Caryn Rabin writes: “Physician stress has always been a fact of life. But anecdotal reports and studies suggest a significant increase in the level of discontent-especially among primary care doctors who serve at the frontlines of medicine and play a critical role in coordinating patient care” (Rabin, 4/1). Read the story.

Kaiser Health News: Insuring Your Health: Community Health Centers May Provide Services For Those Who Remain Uninsured
Kaiser Health News consumer columnist Michelle Andrews writes: “If you're uninsured, you may have run out of time. Yesterday was the formal deadline to sign up for health insurance on the marketplaces or face a penalty, unless you were already “in-line” for enrollment. Still, people who missed the cutoff or couldn’t buy insurance have options to get the health care services they need. But doing so may not be simple or assured” (Andrews, 4/1). Read the column.

Kaiser Health News: Capsules: Healthcare.gov Woes Frustrate In-Person Helpers Around The Country; For California’s Uninsured, A Rush To The Finish
Now on the blog, Kaiser Health News provides a collection of updates on enrollment developments from a variety of states: "Last minute health insurance shoppers nationwide turned up in record numbers online Monday, and they also showed up in person at clinics, county health departments and libraries to sign up for Obamacare on the last official day of open enrollment. Here are dispatches from public radio reporters in Ohio, Pennsylvania and Houston — three of the 36 states that are using healthcare.gov — and Minnesota, which has one of the most troubled state-run marketplaces" (4/1).

In addition, Anna Gorman reports on enrollment information from California: “Uninsured Californians flocked to shopping malls, beauty salons, clinics and libraries Monday to meet the deadline for enrolling in health coverage. The website of the state-run insurance exchange, coveredca.com, was so inundated that officials directed some consumers who began online applications to return later to complete them. The state was seeing a ‘huge surge’ in last-minute applications, with more than 150,000 people signing up in the last week, Peter Lee, executive director of the exchange said Monday. More applications were started on Sunday than any other day since Oct. 1, when open enrollment began on the nation’s insurance exchanges” (Gorman, 4/1). Check out what else is on the blog.

Kaiser Health News: For A Family With Job-Based Insurance, Premium Subsidies Fall Far Short Of Promises
Writing for Kaiser Health News, Kathie Platt explains her family’s first-hand experience with health insurance: “On Monday, the first open enrollment period for the new Affordable Care Act will close, and the opportunity to sign up for health insurance will not reopen again until November. For our family, President Barack Obama’s promise to make health insurance "affordable and available to every single American" has not come true” (Platt, 3/31). Read the story.

The Associated Press/Washington Post: Deadline Brings High Interest For Health Insurance
The last-minute rush was expected to significantly boost the number of Americans gaining coverage under the new law, and government officials told The Associated Press late Monday that they were on track to sign up more than 7 million Americans for health insurance by the deadline. But the months ahead will show whether the Affordable Care Act will meet its mandate to provide affordable health care coverage or whether high deductibles, paperwork snags and narrow physician networks make it a bust (4/1).

The Wall Street Journal’s Washington Wire: Obama Sees Health-Care Sign-Ups Nearing 7 Million
Last Thursday, the White House announced that more than six million people had signed up for private health coverage through state and federal insurance exchanges. That figure surpassed the nonpartisan Congressional Budget Office’s revised estimate that six million people would enroll, down from its initial forecast of seven million. Monday is the final day of enrollment under the Affordable Care Act. If an insufficient number of people sign up, or not the right mix, the law won’t work effectively because insurers may end up with too few healthier members to offset the costs of less-healthy enrollees (Favole, 3/31).

Politico: Obamacare Enrollment Period Ends With Massive Surge
The first open enrollment season of Obamacare ended at midnight Monday, a day that saw millions of Americans click onto Obamacare sign-up portals, dial into call centers and stand in long lines at assistance sites nationwide. The huge surge made it increasingly likely that enrollment would hit 7 million, the finish line that seemed out of reach during much of the often rocky six-month period. Shortly after 10 p.m., the Associated Press cited two sources that said sign-ups were “on track” to hit 7 million. Administration officials wouldn’t confirm the number but said that signs were pointing in that direction (Kenen and Cheney, 4/1).

The Wall Street Journal: New Technical Woes Hobble Health-Insurance Sign-Ups At Zero Hour
New problems in the federal health-insurance website stymied some of the hundreds of thousands of Americans trying to sign up at the last minute, prompting health plans and officials to brace for the complex task of enrolling people after Monday's official deadline. The HealthCare.gov site for 36 states that have about 33 million uninsured people went down shortly after midnight Sunday and remained unusable until about 7:45 a.m. EDT Monday, a person familiar with the matter said. It was hit by a second problem around noon EDT that prevented new users from creating accounts, while some people who already had accounts were unable to log in, this person said (Ante and Radnofsky, 3/31).

The New York Times: Health Website Failures Impede Signup Surge As Deadline Nears
A frenzied last-minute scramble to sign up for health insurance overloaded phone lines and temporarily overwhelmed the website of the federal marketplace on Monday, as hundreds of thousands of people around the country raced to beat the deadline to obtain coverage under the Affordable Care Act (Pear, 3/31).

The Washington Post: Healthcare.gov Stumbles On Deadline Day As Consumers Race To Sign Up For Insurance
The first six-month window for Americans to gain health insurance under the Affordable Care Act closed on Monday with large numbers of consumers speeding to get coverage at the last minute. Some of them encountered obstacles as HealthCare.gov, the main enrollment Web site, faltered on and off throughout the day (Goldstein and Sun, 3/31).

NPR: Cause For Hope And Frustration In the Shadow Of ACA Deadline
As the Affordable Care Act's midnight deadline draws near, there has been a surge in last-minute signups. The heavy traffic has caused both glitches in the website and optimism from some forecasters (Horsley, 3/31).

The New York Times: Last-Day Rush Causes Another Malfunction Of HealthCare.gov
For a second time on Monday, the federal website where consumers can sign up for medical coverage under President Obama’s health care law unexpectedly stopped taking applications. It is the last day of open enrollment for the year (Joachim, 3/31).

Los Angeles Times: California Gives Further Reprieve For Obamacare Sign-Ups
Overrun by last-minute demand for Obamacare coverage, California gave many consumers until April 15 to enroll as thousands of people across the nation endured long lines and website troubles. Despite the problems, the late surge in sign-ups was a substantial boost to President Obama's signature law, particularly after such a disastrous launch in October (Terhune, Levey and Karlamangla, 3/31).

Los Angeles Times: Celebrities Assist White House In Final Obamacare Push
With hours before the deadline to sign up for coverage under the Affordable Care Act, the White House pulled out all the stops – fueling its final drive with celebrity tweets, an appearance by Vice President Joe Biden on the Rachael Ray show, and a push in key states by allied groups such as Organizing for Action and Planned Parenthood (Reston, 3/31).

The Associated Press/Washington Post: Q&A: Status Update As Health Law Marks A Milestone
Like so much about the government’s health care overhaul, Monday’s deadline to sign up for coverage in 2014 didn’t turn out quite as planned: Many people still are eligible for extensions that will let them enroll. The change of plans shouldn’t come as much of a surprise, given the disastrous HealthCare.gov rollout last fall, the mass policy cancellation notices that shocked even the president, and other set-in-law deadlines that turned out not to be not so firm (4/1).

The Wall Street Journal’s Washington Wire: Fights Over The Health Law Aren’t Over
The rollout of the government website for signing up for insurance was a disaster. The president was embarrassed and angry over what many in the West Wing lamented as a self-inflicted wound. Republicans were lobbing attacks that even the White House conceded were legit. But now that the website has seemingly delivered close to – if not more than – the seven million enrollees needed by the deadline, the White House can breathe a little easier. Not for long, however (Lee, 4/1).

The Washington Post’s Wonkblog: How The Administration Could Miss A CBO Obamacare Target
The large media focus in the first Obamacare enrollment period has been on whether the administration would hit CBO targets for exchange enrollment. The CBO has said it expects 6 million people to enroll through exchanges in 2014 - more than 6 million have signed up, so that target looks in reach if enough people pay their premiums. But about one-third of those exchange signups were previously uninsured people, according to the report findings. It also found about 4.5 million adults had newly enrolled in Medicaid; 9 million people, most who were previously insured, have signed up for individual plans off the exchanges; and fewer than 1 million people who had their coverage cancelled remain uninsured (Millman, 3/31).

The Washington Post: Gansler Renews Attack On Brown’s Handling Of Maryland Health Insurance Exchange
The latest development in Maryland’s race for governor was something you don’t see every day: A candidate handing out his rival’s campaign literature. But Attorney General Douglas F. Gansler (D) wanted to make sure reporters got a good look at the brochure of Lt. Gov. Anthony G. Brown (D) on Monday so that he could properly attack it. In the glossy piece, Brown says that under his leadership, Maryland is “leading the nation in implementing President Obama’s health reform law” (Wagner, 3/31).

The Associated Press/Washington Post: Md. Board To Discuss Future Of Health Exchange
A Maryland board is scheduled to discuss what the state will do about its badly flawed health exchange website. The Maryland Health Benefit Exchange Board of Trustees has a 5 p.m. meeting in Baltimore on Tuesday, when it could officially decide to use technology from another state that has had a more successful exchange rollout. Maryland is one of 14 states with its own exchange (4/1).

The Wall Street Journal: GOP Budget Expected To Expand Medicare Proposal
House Republicans are expected to unveil a budget Tuesday that seeks to make their proposed revamp of Medicare more politically palatable, while at the same time moving to expand its reach. House Budget Committee Chairman Paul Ryan (R., Wis.) is expected to unveil a budget that would give people age 55 and younger a choice between keeping traditional government-run Medicare or receiving a subsidy to buy private health insurance, lawmakers said (Peterson, 3/31).

The Washington Post: For 17th Time In 11 Years, Congress Delays Medicare Reimbursement Cuts As Senate Passes ‘Doc Fix’
The Senate voted Monday evening to pass a so-called "doc fix" bill approved last week by the House, the 17th time that Congress has acted since 2003 to temporarily delay cuts to doctor reimbursements under Medicare due to a structural problem in the formula used to determine funding levels. Senators voted 64 to 35 to pass the bill, which delays the cuts for one year in a vote that came after House Republicans used a rare voice-vote to get the measure through the lower chamber due to uncertainty over whether the bill had sufficient support to pass (Lowery, 3/31).

The Wall Street Journal: Senate Passes 'Doc Fix' Legislation
The Senate on Monday passed a bill preventing Medicare-payment cuts to physicians for 12 months, sending the measure to the White House for President Barack Obama's expected signature. The "doc fix" legislation, already passed by the House last week, cleared the Senate on a 64-35 vote, with 46 Democrats, 16 Republicans and two Independents supporting the plan (Peterson, 3/31).

The Associated Press/Washington Post: Obama Gets Bill Giving Docs Temporary Medicare Fix
Congress once again has given doctors temporary relief from a flawed Medicare payment formula that threatened them with a 24 percent cut in their fees. A 64-35 Senate vote Monday cleared the measure for President Barack Obama’s signature, which was expected as early as Tuesday (4/1).

Politico: Senate Backs One-Year ‘Doc Fix’ Patch
The latest “doc fix” prevents a 24 percent cut in physician pay and comes after a battle on Capitol Hill over whether to permanently repeal the formula — and the politically dicey question of how to pay for that — or patch it for another year. The bill also delays for a year the ICD-10 implementation of new medical codes (Haberkorn, 3/31).

The Washington Post: Dave Camp To Retire After His Current Term
Camp said in a statement that his decision "was reached after much consideration and discussion with my family. Serving in Congress is the great honor of my professional life. I am deeply grateful to the people of the 4th Congressional District for placing their trust in me. Over the years, their unwavering support has been a source of strength, purpose and inspiration. During the next nine months, I will redouble my efforts to grow our economy and expand opportunity for every American by fixing our broken tax code, permanently solving physician payments for seniors, strengthening the social safety net and finding new markets for U.S. goods and services" (O’Keefe and Kane, 3/31).

The Wall Street Journal: Michigan Rep. Dave Camp Won't Seek Re-election In 2014
House Ways and Means Committee Chairman Dave Camp (R., Mich.) announced Monday that he won't seek re-election in 2014, ending a 12-term congressional career that made him a leading proponent of tax reform and a powerful voice in federal health, welfare and trade policy. The announcement turns the spotlight on what was already an expected change of leadership at the powerful tax-writing committee. Rep. Paul Ryan (R., Wis.) has already been seen as his likely successor as the panel's chairman after this year, when Mr. Camp's chairmanship expires under the GOP's term-limit rules. … Even if the plan dies this year, it could help frame future debates over the issue. But while Mr. Ryan has expressed enthusiasm for the Camp plan, he is considered more likely as chairman to give priority to overhauling entitlement programs such as Medicare and Medicaid (Hook and McKinnon, 3/31).

Politico: Dave Camp Won’t Seek Reelection
He is the 23rd House lawmaker to announce he or she will leave this Congress. Other prominent Republicans calling it quits include Natural Resources Chairman Doc Hastings of Washington state, Armed Services Chairman Buck McKeon of California and Intelligence Chairman Mike Rogers of Michigan. Senior Democrats forgoing reelection include Reps. Henry Waxman and George Miller of California and John Dingell of Michigan (Sherman and Bresnahan, 3/31).

The Washington Post: Democrats’ Support For Obamacare Surges
Democrats are rallying back behind the 2010 health-care law and boosting President Obama's ratings for handling the law's rollout, according to a new Washington Post-ABC News poll (Clement and Craighill, 3/31).

The New York Times: ‘Imperial Presidency’ Becomes A Rallying Cry For Republicans
The phrase is part of an effort by Republicans to nationalize a series of concerns about the Obama White House, and the role of government, into a pithy, compelling expression. The “imperial presidency” mantra not only captures existing voter frustration over the Affordable Care Act and turns it, Republicans believe, into a broader referendum on the president’s entire administration, but also reflects an underlying conservative philosophy about the appropriate role of government (Parker, 3/31).

Los Angeles Times: Democratic Turnout Seen As Key To Party’s Retaining Senate Control
Because of the states up for grabs this year, "we're playing defense, they're playing offense," said Joel Benenson, Obama's chief pollster. Moreover, anger at the party in power has proved a powerful motivating force to get people to the polls. With Obama in the White House and his signature healthcare law a rallying point for conservatives, Republicans can count on their core voters showing up. A recent NBC/Wall St. Journal poll found Republicans significantly more likely than Democrats to express high interest in the fall election (Memoli and Lauter, 3/31).

The Wall Street Journal: Humana Names Brian Kane Finance Chief
Brian Kane, 41 years old, will join Humana after spending nearly 17 years at Goldman Sachs, where he was responsible for leading financing transactions for a number of companies across multiple industries. Mr. Kane's health- insurance work has included coverage of the national and government-focused managed care organizations (Kell, 3/31).

The Wall Street Journal: Sales Soar For Pricey Hepatitis Drug Sovaldi
A hepatitis C pill from Gilead Sciences Inc. GILD +3.37% that costs $1,000 a day is on track to notch among the biggest sales ever for the first year of a newly approved drug, showing just how hard it is for insurers to curb the use of pricey life-saving medicines (Rockoff, 3/31).

The New York Times: Judge Won’t Block Rules On Abortion Drug In Arizona
A federal judge in Tucson has refused to block some of the strictest rules in the nation on the use of abortion drugs. The rules, which were approved by the Arizona Legislature in 2012 and will take effect on Tuesday, restrict the use of a medication to induce abortions during the early stages of pregnancy to the first seven weeks (Schwartz, 3/31).

The Associated Press/Washington Post: Judge Won’t Block New Arizona Abortion Drug Rules
The most stringent restrictions in the nation on the use of abortion drugs were allowed to take effect Tuesday by a federal judge’s ruling in the latest in a series of court fights over Arizona abortion laws. U.S. District Judge David C. Bury on Monday refused to stop the new rules just hours before they were to take effect. Opponents of the rules said they would continue to challenge the restrictions in court (4/1).

The Washington Post: Creigh Deeds Vows To Keep Working On Virginia’s Mental Health System
Referring to newly passed reforms as “modest,” state Sen. Creigh Deeds said Monday that he plans to keep the pressure on his colleagues to fix Virginia’s long-troubled mental health system. “My scars aren’t going away,” Deeds (D-Bath) told an audience at the National Press Club on Monday. “Believe me, I’m not done” (Shin, 3/31).

The Associated Press/Washington Post Senator: ‘Real Work Lies Ahead’ On Mental Health
During this year’s legislative session, Deeds, who was the Virginia Democratic nominee during the 2009 gubernatorial campaign, helped push through several changes to the state’s current mental health system. Most notably, the General Assembly approved legislation that extends the time allotted for finding a bed for those under an emergency custody order to 12 hours. If no private beds can be found after eight hours, a state hospital will now be required to admit (3/31).

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