KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

First Edition: December 4, 2013

Today's headlines spotlight the White House's push to defend the health law and advance positive messages about its benefits.   

Kaiser Health News: Medicaid Expansion Expected To Offer Coverage To Many Former Prisoners
Kaiser Health News staff writer Guy Gugliotta, working in collaboration with The Washington Post, reports: "When Medicaid expands next year under the federal health law to include all adults living close to the poverty line, one group of eligible beneficiaries will be several million men and women who have spent time in state and federal prisons and jails. The Department of Justice estimates former inmates and detainees will comprise about 35 percent of the people who will qualify for Medicaid coverage in the states expanding their programs to anyone earning less than 138 percent of the federal poverty level, or about $15,000 for an individual in 2013. The Congressional Budget Office estimated earlier this year  that 9 million people will get that new coverage next year" (Gugliotta, 12/4). Read the story.

Kaiser Health News: Capsules: Video: Problems Remain With Healthcare.gov Website; 1.46 Million Determined To Be Eligible for Medicaid And CHIP In October
Now on Kaiser Health News’ blog, Marissa Evans reports on Medicaid and CHIP eligibility numbers: "After two months of media shellacking, healthcare.gov website woes and a series of skeptical congressional grillings, the Centers for Medicare & Medicaid Services (CMS) was accentuating the positive, noting the jump in the number of people eligible for Medicaid under the Affordable Care Act" (Evans, 12/4). 

Also on the Capsules, you can watch the video of KHN's  Mary Agnes Carey on PBS NewsHour Monday to discuss the bug fixes to the federal health insurance marketplace and the problems that remain to be addressed (12/3). Check out what else is on the blog.

The Washington Post: Obama Embarks On New Health-Care Push After Web Site Fixes, Urges Americans To Sign Up
President Obama on Tuesday embarked on the difficult task of persuading Americans to reconsider his landmark health-care law after its botched launch, imploring people to sign up as part of a major push to publicize the benefits of the Affordable Care Act. Republicans immediately lampooned the effort — coming more than three years after passage of the law and two months after its disastrous rollout — and conservative activists vowed to wage a counterassault publicizing the law’s downsides (Goldfarb and Eilperin, 12/3).

Politico: W.H. Kicks Off Turnaround Campaign On Obamacare
President Barack Obama, confident that HealthCare.gov is finally working, attempted Tuesday to shift the nation’s attention toward Affordable Care Act benefits that he says were overshadowed by website problems at a critical time for the law. The president’s brief speech marked the start of the White House’s latest messaging push, a three-week campaign that aims to boost anemic enrollment figures and put Republicans on the defensive after Obamacare’s embarrassing rollout (Millman and Epstein, 12/4).

Politico: White House Turns To Bully Pulpit For ACA Turnaround
The White House launched three weeks of Affordable Care Act promotion in what it promises will be one of Obama’s most extensive, consistent messaging efforts in office. The first event was low-key — a short, quiet, decidedly non-rally-like appearance in a White House complex auditorium (Dovere and Allen, 12/3).

The New York Times: Obama To Defend Health Law As Economic Benefit
President Obama leaves the White House on Wednesday for one of the capital’s most struggling neighborhoods to talk about the economy, not simply to divert attention from his troubled Affordable Care Act but to explain how that law, for all of its flaws, fits into his vision for Americans’ economic security and upward mobility (Calmes, 12/4).

Los Angeles Times: Obama To Urge 'Young Invincibles' To Buy Health Insurance
President Obama will urge young people to sign up for health insurance at a White House forum aimed at mobilizing a demographic that is crucial to the success of his signature healthcare law. Wednesday's youth summit at the White House — and the evening Google chat with White House advisors David Simas and Kal Penn to reach a wider audience — will offer Obama a chance to reengage young people, a White House official said, and the president will make brief remarks (Reston, 12/3).

Politico: Poll: 28% Would Rather Pay Fine
More than a quarter of uninsured Americans say they are more likely to pay the fine than sign up for Obamacare before the deadline, a new poll shows. Twenty-eight percent of those surveyed say they will likely pay the fine, according to a Gallup poll released Tuesday’s number that has remained consistent despite the approaching enrollment deadline in March (McCalmont, 12/4).

The New York Times: Obama Urges Focus On Health Care Law's Benefits
In brief remarks at the White House, the president began what aides described as a weekslong effort to move on from the negative stories of the botched HealthCare.gov rollout. Mr. Obama again conceded the problems but said critics who contended that the law had failed were wrong (Shear, 12/3).

The Associated Press/Washington Post: Obama Declares Health Care Law Is Working
Seeking to regroup from his health care law’s disastrous rollout, President Barack Obama on Tuesday insisted that the sweeping overhaul is working and warned Republican critics that he would fight any efforts to strip away its protections. “We’re not repealing it as long as I’m president,” Obama said during a health care event at the White House. “If I have to fight another three years to make sure this law works, then that’s what I’ll do” (12/3).

Los Angeles Times: Obama Acts To Defend Obamacare And Democrats From GOP Attacks
Two turbulent months into the launch of the Affordable Care Act's insurance marketplace, President Obama moved to defend the law against Republican attacks Tuesday as the administration tried to deflect attention from the federal website's botched rollout. The White House's renewed effort to tout the law has two aims: to encourage Americans to sign up for coverage and to reassure nervous Democratic lawmakers and other allies who have watched Obama's so-far unsuccessful efforts to contain the political damage (Hennessey and Parsons, 12/3).

The Wall Street Journal: Health-Law Fight Pivots Toward Midterms
The fight between the political parties to shape public opinion of the 2010 health-care law is entering a new phase that looks beyond the problems of the enrollment website, amid signs that the law's rocky rollout has damaged Democratic prospects for the next election. President Barack Obama, who spent weeks shouldering the blame for the troubled rollout, said Tuesday the HealthCare.gov website "is working well for the vast majority of users'' and used the moment to try to hit the reset button on the administration's effort to persuade people to sign up for insurance (Nelson, O’Connor and Hughes, 12/3).

The Washington Post: For Obama, Enrolling Under The Health-Care Law Was Inevitable
Unlike members of Congress, President Obama is not obligated to sign up for a plan under his signature health-care law. But from a political perspective, the president has little choice but to opt for either the federal or state health insurance exchange by the end of the year. The White House had announced in March 2010 that the president would enroll in an exchange in response to a political gambit by Republican Sen. Charles Grassley (Iowa), who proposed an amendment to the law that would have required Obama to buy a plan through the exchanges (Eilperin, 12/3).

Politico: Obamacare Fix Wins Applause, But Troubles Remain
For House Democratic Caucus Chairman Xavier Becerra, the new, improved Obamacare website is better than it was — but the law won’t be a success “until every American who has a chance to qualify for these health insurance policies gets it.” For Jeremy Milarsky, who works for one of the “navigator” groups in Missouri that’s helping people sign up, the website is improved enough to make the job easier, mainly because of a new health plan browser feature that actually works (Nather, 12/4).

The New York Times: Even With Website Fixes, Troubles Persist In Applying For Insurance
While Obama administration officials were heralding the improvements with the website, saying that 750,000 users logged on Monday, hundreds of people took to the website’s Facebook page and other social media platforms to report mixed results (Preston, 12/3).

USA Today: 1 Million People Visited Health Care Website Monday
One million people accessed HealthCare.gov on Monday, its first weekday of operation since a team of technology experts finished a series of fixes aimed at stabilizing the troubled website, the Centers for Medicare and Medicaid Services said Tuesday (Kennedy, 12/3).

The New York Times: Considering Which Head Or Heads May Roll For A Troubled Website Rollout
White House officials, asserting that the HealthCare.gov website is largely fixed, are under mounting pressure from Democrats and close allies to hold senior-level people accountable for the botched rollout of President Obama’s signature domestic achievement and to determine who should be fired. For weeks, the president and his aides have said they are not interested in conducting a witch hunt in the middle of the effort to rescue the website. But in the West Wing, the desire for an explanation about how an administration that prides itself on competence bungled so badly remains an urgent mission (Shear, 12/3).

The Wall Street Journal: States Divided On Letting Insurers Extend Old Plans
Insurance commissioners in most Republican-led states have agreed to a request from President Barack Obama to allow carriers to extend many insurance plans slated for cancellation, while regulators in Democratic states remain divided, The Wall Street Journal has found. At least 21 of 30 states with GOP governors have said they are willing to let insurers extend policies through 2014 that otherwise would be canceled because they don't comply with the new federal health law. Many of the Republican-led states are allowing renewals that would extend coverage well into 2015 (Scism and Radnofsky, 12/3).

The Associated Press/Washington Post: Audit: Health Care Subsidies Vulnerable To Fraud
Government subsidies to help Americans buy insurance under the health care overhaul may be vulnerable to fraud, a Treasury Department watchdog warned on Tuesday in the latest indication that troubles are far from over for President Barack Obama’s signature legislation. The rollout of the law has been hurt by canceled policies and problems with the federal website used by people to enroll in health plans, causing political headaches for the White House and for Democrats in Congress. The new problems concern subsidies that are available to low- and medium-income people who buy insurance through state-based exchanges that opened in October (12/3).

The Wall Street Journal’s Washington Wire: IG Report: IRS Must Be Vigilant on Health-Care Fraud
The Internal Revenue Service has developed accurate systems for calculating health-care tax credits under the Affordable Care Act, but it needs to strengthen fraud detection and other systems, the inspector general for the IRS said in a report. Starting in January, eligible taxpayers who buy insurance through government-run exchanges can qualify for the credits under the health law to help them pay their premiums (McKinnon, 12/3).

Politico: Report: IRS Ready ON ACA Tax Credits But Not For Fraud
The Internal Revenue Service has successfully finished testing systems to accurately calculate tax credits under Obamacare but needs to improve its controls to avoid problems with fraud as the agency begins doling out the credits in 2014, an inspector general report said Tuesday. The Treasury inspector general for tax administration said in a report that IRS software has a system to verify tax credit calculations before it issues them to health insurers, but it said the agency may not yet have a system in place to stop tax cheats seeking to underestimate their incomes and fraudulently cash in on health subsidies (Bade and French, 12/4).

NPR: Nonprofits Challenge Missouri Licensing Law For Insurance Guides
In the first lawsuit of its kind, several nonprofit groups that received federal grants to help people sign up for insurance under the Affordable Care Act are suing the state of Missouri. The Missouri law requires health insurance helpers called navigators to be licensed by the state, which involves passing an exam and paying a fee (Rovner, 12/3).

The Washington Post: South Dakota Governor Daugaard Won’t Rule Out Future Medicaid Expansion
South Dakota Gov. Dennis Daugaard (R) doesn’t favor expanding Medicaid coverage to include more low-income residents, but it appears he won’t rule out the possibility of expanding the program in the future. Daugaard, who plans to address the state’s budget in a speech to the legislature Tuesday, is expected to tell legislators he will pursue coverage for tens of thousands of uninsured South Dakota residents through other means (Wilson, 12/3).

The New York Times: October Medicaid Applications Far Outpace Enrollment Through Exchanges
The Obama administration said Tuesday that 1.46 million people had applied and been found eligible for Medicaid or the Children’s Health Insurance Program in October, far more than had selected a private health plan in the new insurance marketplaces (Pear, 12/3).

The Washington Post: Health-Care Law's Critics See Court Case Over Subsidies As Their Last Shot
Opponents of the health-care law took their latest legal challenge to a federal courtroom in the District on Tuesday in a case that many critics of the law view as their last and best chance to gut it before key provisions kick in Jan. 1. Though some legal scholars view the case as a long shot, it could have significant consequences if it is successful. Millions of people in 34 states could be denied the government subsidies established by the law to help low- and middle-income people pay their health-insurance premiums starting next year. Even those who think the case has no merit are closely watching it unfold (Somashekhar, 12/3).

The Wall Street Journal: Federal Judge Hears Arguments On Health-Law Subsidies
A federal judge in Washington offered few hints Tuesday of how he plans to rule during arguments in a case challenging the legality of federal subsidies available to some consumers who purchase health insurance through federally run online exchanges. At issue is the implementation of a key part of the 2010 Affordable Care Act, which requires most Americans to carry health insurance or pay a tax penalty. To make coverage more affordable, the law calls for the government to subsidize coverage for qualifying low- and middle-income individuals (Kendall, 12/3).

The Associated Press/Washington Post: Notre Dame Sues Over Birth Control Mandate
The University of Notre Dame on Tuesday filed another lawsuit opposing portions of the federal health care overhaul that forces it to provide health insurance for students and employees that includes birth control, saying it contravenes the teachings of the Roman Catholic Church. The lawsuit filed in U.S. District Court in South Bend claims the Affordable Health Care Act violates Notre Dame’s freedom to practice religion without government interference. Under the law, employers must provide insurance that covers a range of preventive care, free of charge, including contraception. The Catholic Church prohibits the use of contraceptives (12/3).

The Wall Street Journal: Notre Dame Suit Says Compromise On Birth-Control Rule Is Inadequate
Notre Dame says in its complaint, filed Tuesday in U.S. District Court for the Northern District of Indiana, that the compromise offered by the administration still leaves the school complicit in something it considers immoral. The university says the health-care law has created a situation in which its sponsorship of an insurance plan is tantamount to condoning birth control and its acquisition. Notre Dame cited a recent advertising campaign aimed at young people that described contraception access as one of the key benefits to getting coverage (Radnofsky, 12/3).

The Associated Press/Washington Post: UnitedHealth Details Expected 2014 Overhaul Hits
UnitedHealth Group is the latest company to detail the hit its business will absorb from the health care overhaul. The nation’s largest health insurer said Tuesday that it expects to pay as much as $1.9 billion in taxes and fees imposed by the law next year and absorb a funding cut for a key product, Medicare Advantage plans, which are privately run versions of the government’s Medicare program for the elderly and disabled people. All told, it expects the overhaul to take a $1.1 billion bite out of its after-tax operating earnings in 2014 (12/3).  

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