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Monthly Archives: March 2014

For A Family With Job-Based Insurance, Premium Subsidies Fall Far Short Of Promises

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. 

In 2008, during the recession, my husband, Mike, accepted a buyout during the downsizing of his company and began a new career as a Texas public high school English teacher. Despite more than 30 years of experience in the publishing industry and five years now teaching, he earns just $37,000 a year. Combined with my small freelance income, that puts our family of three at 200 percent of the federal poverty level, an income level that qualifies other uninsured families for hefty premium and cost-sharing subsidies for policies sold on the health law’s online marketplace.   

Laura Platt, Michael Platt, Kathie Platt, and Emily Platt, who lives independently and is not on the family’s health policy. (Photo Courtesy of Kathie Platt).

Good insurance coverage is important to us, especially because our daughter has a rare autoimmune disease. So we have opted for the PPO insurance plan offered through Mike’s school district, instead of the lower-cost HMO option. We pay more than $1,000 a month for the coverage, and that doesn’t include dental and vision insurance, which easily adds another $1,000 a year.  

To try to save money, I got off his policy and purchased an individual plan that saves us about $100 a month. 

When the ACA offered premium subsidies for the low-to-middle-wage worker, we began to have some hope of relief. We could not have been more wrong. Here’s why: Under Obamacare, people who get insurance through their employer are not qualified for subsidies if their work-place coverage is considered affordable—it cannot cost more than 9.5 percent their income—and it meets the minimum value standard—it must provide at least 60 percent of allowed medical expenses.  

We’re paying nearly a third of our income for insurance, but the affordability standard is based on cost of coverage offered to the individual worker, no matter how much he pays in addition to that for spousal or family coverage. Mike’s insurance is considered very affordable, because the HMO offered to him alone costs just $420 a year, about 1 percent of his salary and well belowʼn.5 percent. 

So I continue to look for full-time employment with benefits and keep my independent insurance. 

Congress apparently built this exclusion into the health care law to prevent a mass exodus of workers from their employer-sponsored health plans. And the administration decided to interpret the law as referring to the cost of an individual’s coverage, despite lobbying from consumer groups and some Democratic lawmakers. However, offering some low-to-middle wage earners health insurance subsidies through tax credits, and not make it available to others like us, smacks of legalized disparity.

I wrote to the president and one of my senators, John Cornyn, a Republican, about the disparity.  The president responded with a form letter extolling the virtues of his new health care marketplace, and  Sen. Cornyn wrote back  condemning the atrocities inherent in the health law. I’m just guessing that neither of them ever read my letter or honestly considered my questions. Certainly, neither was prepared or willing to answer them.

While Sen. Cornyn boasted profusely for five paragraphs about his all-out-effort to repeal Obamacare (without ever addressing unsustainable health premium costs born by Texans before and after Obamacare), the president offered an equally profuse boast in the opposite direction. “The bottom line is that nobody is losing their right to healthcare coverage,” Obama wrote. 

Right or left, red or blue, both sides of the power divide are conspicuously silent about the inequitable distribution of subsidies. 

The operative question is: What exactly is a health care marketplace subsidy? It is essentially up-front tax relief and tax credit based on income, but only offered preferentially to those without employee health insurance that the government considers “affordable.” It does not matter that these subsidy-receiving workers are making just as much as, or more than, those who are ineligible for a subsidy by virtue of a bogus affordability formula.

One of the abiding principles of our great American democratic experiment is: No taxation without representation. A corollary of this principle would also seem to be: No tax relief without representation implying the attempt, at least, to safeguard the equal application of tax law.

I am reminded of the popular fairy tale, “The Emperor’s New Clothes.” The ACA has promised every American who doesn’t have health insurance a beautiful new suit of clothes. Some Americans may actually receive this new attire. The rest of America will help pay for it. While marketplace enthusiasts celebrate the ACA as a great success, low-to-middle income workers who already receive employee health insurance will see the ACA as it really is: window dressing, or successful enchantment, but a failed attempt to address some real disparities.

Kathie Platt is a freelance writer living in Beaumont, Texas.

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Marketplace Website Has A Rocky Day As Thousands Try To Beat Enrollment Deadline

Federal officials took the healthcare.gov marketplace offline twice to deal with problems that surfaced under the heavy use.

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. Aaron Albright, a spokesman for the Department of Health and Human Services, indicated that the second failure occurred shortly after noon, and that it seemed to be caused by a flood of traffic on the site, HealthCare.gov. Earlier, he had said that the first failure, for about three hours in the morning, was caused by a software error unrelated to traffic volume. By 1:40 p.m., Mr. Albright said the site was functioning normally again (Joachim, 3/31).

Politico: HealthCare.gov Experiences Double Trouble On Deadline Day
Health and Human Services spokeswoman Joanne Peters said early Monday afternoon that the issue preventing new users from signing up had been resolved as of about 1:30. “There was an issue earlier this pm with users creating new accounts — it has now been resolved and all functionality is back up,” she tweeted shortly before 2 p.m. (Kenen and Cheney, 3/31).

USA Today: Glitches In Race To Meet Health Deadline
Consumers who waited until the last day to enroll for insurance on the federal HealthCare.gov were out of luck on Monday morning, and the problem still may not be fixed: The tools to set up new accounts and enroll are functioning erratically and some people can’t even get onto the site to try to set up an account. Department of Health and Human Services spokeswoman Joanne Peters said the tech team monitoring HealthCare.gov identified an issue with users creating new accounts, a problem agents were reporting earlier in the day and USA TODAY found when reporters tried to create accounts (O’Donnell, 3/31). 

The Wall Street Journal: HealthCare.gov Glitch Prevents Users From Creating New Accounts
A second software glitch took HealthCare.gov offline on Monday as the site struggled to stay open during this year’s final day of enrollment under the Affordable Care Act. The new problem hit around 12 p.m. EDT and was preventing users from creating new accounts and logging in with new accounts, said a person familiar with the matter. The glitch is related to the part of the system that processes peoples’ identities, the person said. A user who visits the site now and tries to log in is told “HeatlhCare.gov has a lot of visitors right now” and is put into a queue. A software bug took down the site earlier on Monday for a number of hours. Despite the two problems, the site has been very busy and was handling more than 100,000 simultaneous users at one point, the person said (Ante, 3/31).

NBCNews: Obamacare Website Freezes For A Second Time
“There is a technical problem that the tech team is on,” White House spokesman Jay Carney told reporters. “There are currently 100,000 people on the system who are enrolling and there is no problem for them to enroll.” A spokeswoman said 1.2 million people had visited the site as of noon (Fox, 3/31).

The Hill: HealthCare.gov Struggles Under Surge Of Last-Minute Demand
While the administration said the problem was resolved quickly on Monday afternoon, it shows how the website is having trouble keeping up with the last minute rush of people seeking coverage before the March 31 deadline. … “The tech team is working to resolve the issue as quickly as possible,” an official said as the problem persisted. “The Data Services Hub is still fully operational. Users already in system remain able to complete enrollment” (Easley, 3/31). 

Several news outlets reported on the heavy use of the website over the weekend.

The Wall Street Journal: Long Waits As Health Insurance Deadline Nears
Last-minute applicants for health insurance strained enrollment offices over the weekend, triggering long lines, extra security and hours of waiting across the country ahead of Monday’s federal deadline. HealthCare.gov, the federal website, blocked some applicants late Friday but didn’t show major technological problems as consumers rushed before the end of the 2014 open-enrollment period for obtaining insurance under the Affordable Care Act. But the system’s human capacity maxed out, with too few “navigators” and other enrollment workers to steer consumers through the complex application process (Radnofsky and Corbett Dooren, 3/30).

The Hill: Record Volume For O-Care Exchanges
The federal health insurance marketplace saw record volume for a Saturday, and operators at the federal call centers struggled to keep up with the volume of calls as consumers flooded the ObamaCare exchanges ahead of Monday’s enrollment deadline. According to the Obama administration, HealthCare.Gov saw two million visits this weekend, while the call centers received 380,000 phone calls (Sink, 3ቺ).

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Looking Ahead At Health Law Milestones

With open enrollment for 2014 set to formally close today, analysts note that it will take years to assess whether the health law succeeds at creating stable markets for those without employer-sponsored insurance. Several look at likely victories and hurdles.

Kaiser Health News: What Happens Next On The Health Law?
Just because open enrollment for people who buy their own health insurance formally closes March 31 doesn’t mean debate over the health law will take a hiatus. After more than four years of strident rhetoric, evidence about how the law is actually working is starting to trickle in. Here are seven things to watch before the next enrollment period begins in November (Appleby, Carey, and Galewitz, 3/31).

Reuters: Obamacare Hits Milestone, But Detours Ahead For Health Law
[A]s the White House and its allies declare victory, major hurdles remain. And it will take years to determine whether the law will accomplish its mission of creating stable insurance markets that can help a significant number of America’s nearly 50 million uninsured gain health coverage, experts say. Republicans are counting on that uncertainty to play into their strategy for the midterm congressional elections in November  (Morgan, 3/30).

The New York Times: In New Health Care Era, Blessings And Hurdles
In a plain brown health clinic on a busy boulevard [in Louisville, Ky.], the growing pains of the Affordable Care Act are already being felt — almost too sharply for the harried staff trying to keep up with the flow of patients. … The law still faces steep challenges in Kentucky and nationwide, not only from energized political opponents who plan to attack it until Election Day, but also from skeptical consumers who think the cost of many new plans is too high, and the choice of doctors, hospitals and prescription drugs too limited. … Yet beneath the loud debate, the law is quietly starting to change the health care landscape (Goodnough, 3/30).

Los Angeles Times: Insurers Already Calculating 2015 Premiums As Obamacare Kicks In
Even before enrollment closes Monday, California has far exceeded its initial goals for signing up people under the Affordable Care Act. Although the sheer volume ofŁ.1 million policyholders is impressive for a brand new government program, the number of sicker patients is what’s likely to draw the most attention. How sick they are and the size of their medical bills will be front and center in the weeks to come as insurers begin drawing up next year’s insurance rates, which will become public this summer (Terhune, 3/30).

Politico Pro: Off-Exchange Enrollment Could Shore Up Risk Pools
The Obama administration’s tally of sign-ups for the federal health care law doesn’t include a key group that is likely to boost the total number of people — and the share of younger and healthier people — with Obamacare coverage. These are the people who are getting covered in new plans that live up to the new Affordable Care Act rules, but aren’t sold on the exchanges. The people buying them don’t qualify for the premium subsidies in the exchange, so they go directly to insurance companies or online brokers. … federal health officials, insurers and health policy experts say that it’s likely to be a sizable group that tends to be more affluent and younger than the people in the exchanges (Norman, 3/29).

The Hill: ObamaCare’s 4-Year Checkup 
The deadline for ObamaCare’s first-year enrollment has arrived, four years after one of the most far-reaching and divisive pieces of domestic legislation became law. It’s a historic moment and a time to take stock of a measure proponents said would provide health insurance to people who lacked it, drive down costs, take a bite out of the deficit, boost the economy and lower the amount ordinary people had to pay (Viebeck and Easley, 3/31).

The Milwaukee Journal Sentinel: Despite Concerns About Obamacare, Big Employers Not Abandoning Health Benefits
Patrick Hansen, the chief financial officer of Strattec Security Corp., has no pretensions of knowing how the Affordable Care Act will affect employers years from now. But for now, Strattec, based in Glendale, has no plans to stop offering health benefits to its employees. “We’d have a hard time recruiting,” Hansen said. Opponents of the Affordable Care Act — among them Wisconsin Republicans Rep. Paul Ryan and Sen. Ron Johnson — have contended that the law will result in employers no longer offering health benefits. Now Ezekiel Emanuel, a physician and former adviser in the Obama administration when the law was making its tortuous way through Congress, is contending the same … Most supporters of the law — and some policy analysts and economists ambivalent about it — don’t see that happening (Boulton, 3/29).

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Veterans Struggle With Mental Health Problems

More than half of the 2.6 million Iraq and Afghanistan veterans say they struggle with physical or mental health problems as a result of their service and feel detached from civilian life, according to a poll conducted by The Washington Post and the Kaiser Family Foundation.

The Washington Post: A Legacy Of Pain And Pride
More than half of the 2.6 million Americans dispatched to fight the wars in Iraq and Afghanistan struggle with physical or mental health problems stemming from their service, feel disconnected from civilian life and believe the government is failing to meet the needs of this generation’s veterans, according to a poll conducted by The Washington Post and the Kaiser Family Foundation. The long conflicts, which have required many troops to deploy multiple times and operate under an almost constant threat of attack, have exacted a far more widespread emotional toll than previously recognized by most government studies and independent assessments: One in two say they know a fellow service member who has attempted or committed suicide, and more than 1 million suffer from relationship problems and experience outbursts of anger — two key indicators of post-traumatic stress (Chandrasekaran, 3/29).

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LA Times: More Than 9 Million Uninsured Gain Coverage Under Law

The newspaper’s tally draws on state and federal enrollment reports, surveys by consultants and interviews with insurance and government officials. Meanwhile, insurers and others intensify efforts to sign up young customers.

Los Angeles Times: Obamacare Has Led To Health Coverage For Millions More People
President Obama’s healthcare law, despite a rocky rollout and determined opposition from critics, already has spurred the largest expansion in health coverage in America in half a century, national surveys and enrollment data show. As the law’s initial enrollment period closes, at least 9.5 million previously uninsured people have gained coverage. Some have done so through marketplaces created by the law, some through other private insurance and others through Medicaid, which has expanded under the law in about half the states. The tally draws from a review of state and federal enrollment reports, surveys and interviews with insurance executives and government officials nationwide (Levey, 3/30).

The Wall Street Journal: Health Insurers Make Late Push To Sign Up Young Customers
Insurers are pressing ahead with a final marketing push to bring as many young, healthy customers as possible onto their rolls and buttress a recent surge in health-law enrollments. The flood of late sign-ups that helped boost the marketplace total to six million enrollees, a key milestone for the Obama administration, has also brought some insurers an uptick among younger people. But it isn’t clear if the trend is broad enough to balance out an earlier skew toward older enrollees, who are more likely to have costly ailments (Wilde Mathews and Weaver, 3/28).

Los Angeles Times: Fighting For Obamacare Through Stage IV Cancer
Michael Robertson put the bag of chemicals in an inside pocket of his sport coat, the pump in the other. He snaked the tubes between the buttons of his shirt to the port in his chest. He adjusted his tie to cover them. Then he sat down in a cavernous room in the White House complex and pulled his chair close to the table, hiding the bulges. Robertson, an aide to President Obama, was meeting with top officials from federal agencies working to implement the Affordable Care Act. He was also in treatment for stage IV colorectal cancer. A soft “bzzt” every 90 seconds alerted him to another dose and another wave of nausea. He timed the cadence of his questions and comments to the ebb and flow of the chemo. No one seemed to notice, and that’s how he wanted it (Parsons, 3/29).

The Hill: GOP Senator: Administration ‘Cooking The Books’ On ObamaCare Enrollment
Sen. John Barrasso (R-Wyo.) said Sunday that the Obama administration was “cooking the books” on enrollment figures for ObamaCare. Appearing on “Fox News Sunday,” Barrasso said he wasn’t persuaded by statistics that said that more than six million people had signed up for insurance under the healthcare law. … Sen. Angus King (I-Maine), who has offered legislation to make fixes to ObamaCare, said that it was a great victory for so many people to have signed up for insurance, and said he wasn’t concerned about the number of young people or uninsured signing up (Becker, 3/30).

NPR: Latinos Wary Of All-Out Push To Sign Up For ACA
All throughout the country, supporters of the Affordable Care Act have worked to reach the uninsured, holding health fairs and putting ads on TV and radio. The push continues to get as many enrolled as possible, especially Latinos — the most uninsured group in the country. … Undocumented immigrants aren’t eligible for insurance under the Affordable Care Act, but Obama’s deportation of nearly 2 million of them during his presidency may have soured many Latinos’ opinion of him (Corley, 3/29).

Politico: Procrastinators: Obamacare Wants You
Leading up to the deadline, President Barack Obama, Vice President Joe Biden, cabinet secretaries and other surrogates have done more than 300 radio interviews, attended 45 enrollment events and appeared in videos that have collectively gotten 33 million hits over the last six weeks, according to figures released to POLITICO by a White House official (Haberkorn, 3/30).

ABC News: Obamacare Enrollment Deadline Will Test High-Profile Sales Pitch
LeBron James wants you to sign up for health coverage under Obamacare. So do Magic Johnson and Jonah Hill’s mom. Monday is (sort of) the deadline for Americans without employer-provided health coverage to sign up for insurance under the Affordable Care Act — the White House extended it so that anyone who’s begun to sign up by Monday can still complete the process by April 7 — and the final enrollment numbers will be an important test for a law intended to expand access for the uninsured. It’ll also be a test for the White House’s high-octane sales pitch, one that’s involved celebrities, YouTube videos, and paid media (Good,Ń/30). 

The Fiscal Times: The Growing Puzzle Over Obamacare Enrollment
Probably the only thing harder than predicting the final enrollment figures for the Affordable Care Act is guessing the winners in the NCAA Tournament Brackets.  President Obama announced last week that more than six million people would have enrolled for insurance during the six-month enrollment period that officially ends on Monday — despite the troubled rollout of Obamacare. Surpassing that six-million mark brings enrollment in line with a revised estimate by the nonpartisan Congressional Budget Office – albeit well below the seven-million target that was initially set by the administration (Pianin, 3/31).

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Utah's Effort To Modify Medicaid Expansion May Pave Route For Other Red States

Gov. Gary Herbert and aides have been meeting with federal officials to find a different option. Meanwhile, news outlets look at the Medicaid expansion battles in Virginia and Florida and Republican concerns in Illinois.

The Washington Post: Why Utah Is The State To Watch On Medicaid Expansion
Utah Gov. Gary Herbert is looking for a way to join the Medicaid expansion, and that could have national implications. Herbert, whose aides have been meeting with federal officials at the Centers for Medicare and Medicaid Services since last week, told local media yesterday that he hopes to have a deal in place with the Obama administration by the summer. “There’s clearly a growing understanding in the Obama administration in the need for states to have more flexibility,” the Republican governor told reporters (Millman, 3/29). 

PolitiFact: McAuliffe Says Medicaid Expansion Will Save Virginia $1 Billion
Gov. Terry McAuliffe says expanding the state’s Medicaid program would allow Virginia to save money by offering health coverage to 400,000 poor and disabled citizens. … The potential savings is a key issue as the General Assembly struggles this spring to decide whether to expand Medicaid eligibility … the analysis he cites says the state will save $420 million of that sum, regardless of whether it broadens Medicare, from other provisions in Obamacare. The research concludes that $601 million in savings over the next eight years are riding on the legislature’s decision. So McAuliffe is right that there’s a lot of expansion money on the table, but he exaggerates how much. We rate his claim Half True (Madsen, 3/30).

The Richmond Times-Dispatch: Backlog Of Medicaid Applications Muddies Debate
A backlog of applications for Medicaid in Virginia has become fodder for political debate over the wisdom of expanding the program in some fashion under the Affordable Care Act. Virginia officials expect more than 40,000 applications to arrive from the new federal marketplace and strain local services offices that will review them for eligibility under the state’s health care program for the poor, elderly and disabled. The state already is coping with a 60 percent surge in applications through the state system since Oct. 1, when the launch of enrollment in the new marketplace prompted more people to seek eligibility for publicly subsidized health insurance (Martz, 3/30). 

The Associated Press: Medicaid Ads Target Virginia House Speaker
New ads funded by groups on both sides of the debate over expanding Medicaid appear to be narrowly aimed at one person: House Speaker William J. Howell. The focus on Howell underscores what is likely a pivotal role that he will play in deciding the outcome. The Democrat-controlled Senate and Democratic Gov. Terry McAuliffe supporting expanding the Medicaid rolls. But the Republican Howell, and his colleagues in the GOP-controlled house, have remained resolutely opposed (3/28).

The Richmond Times-Dispatch: Flawed Obamacare Rollout Colors Virginia Debate
House Appropriations Chairman S. Chris Jones, R-Suffolk, drew applause and laughter during the debate over the state budget in the House of Delegates last week when he announced “the Obama administration has announced another extension to Obamacare.” Jones referred to the announcement that the federal government would process people who are “still in line” to buy health insurance on the new federal marketplace after the deadline for enrollment expires tomorrow night. … What the government calls flexibility, critics call reason to doubt the federal promise under the Affordable Care Act to pay for the long-term costs of a proposed expansion of health insurance to the uninsured (Martz, 3/31).

Chicago Tribune: Kirk, Rauner Question Illinois’ Medicaid Expansion
Republican U.S. Sen. Mark Kirk on Sunday sharply criticized a feature of President Barack Obama’s signature health care law, contending Illinois’ expansion of Medicaid coverage deceives people into believing they have health insurance. The state’s junior senator was joined by Republican governor nominee Bruce Rauner, who warned of the potential for a “massive” budget hole down the road due to Democratic Gov. Pat Quinn’s Medicaid expansion. Still, Rauner stopped short of saying Illinois should roll back the expanded Medicaid program (Pearson, 3/30).

Health News Florida: Public Keeps Pushing For Expansion 
A campaign — that some would call a doomed campaign — to expand Medicaid for Florida’s uninsured poor continued in Tallahassee on Thursday with a mass lobby conducted by doctors and nurses from Miami’s Jackson Hospital. They went from office to office in the state capitol seeking legislative support …but got basically nowhere. Along with the 100 or so doctors and nurses who took the trip, were consumers such as Orlando resident Kathleen Voss Woolrich, who spent some of the time on her computer (Stone, 3/28).  

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Marketplace Website Goes Offline Briefly This Morning After Weekend Enrollment Crush

The site was down for maintenance after federal officials said that it had 2 million visits over the weekend.

Politico: HealthCare.gov Offline For Nearly Six Hours On Deadline Morning
Obamacare sign-up closes at midnight and enrollment is surging, but a technical flare-up on HealthCare.gov Monday morning marred the administration’s momentum. The online portal, which had been handling millions of visitors over the past few days as enrollment pushed past 6 million, was “down for maintenance” starting at around 3:20 a.m. Officials said it returned to functionality atʼn a.m. (Kenen and Cheney, 3/31).

USA Today: Healthcare Site Goes Down Briefly As Deadline Nears
The federal government’s healthcare enrollment website — HealthCare.gov — went down briefly early Monday for extended maintenance as heavy traffic was building on the last day of open enrollment for 2014. At one point, the site told visitors that it was “down for maintenance” and asked people to “please try again later.” At other points, visitors were told there was heavy traffic on the system and were asked to remain online in a “virtual waiting room” until they could be connected. Administration spokesman Aaron Albright said the website undergoes “regular nightly maintenance” during off-peak hours and that period was extended Monday because of a “technical problem.” … Administration officials said interest was surging as the deadline neared. Sunday evening, Health and Human Services announced 2 million visits over the weekend to HealthCare.gov, the federal government’s enrollment site. (Schouten and Kennedy, 3/30).

NBC News: Obamacare Website Down As Deadline Arrives
People trying to apply and enroll for private health insurance through Obamacare before Monday’s midnight deadline discovered the website was “currently unavailable.” Healthcare.gov, the online marketplace bedeviled by bugs since its launch last fall, went down for several hours Monday morning, a statement from the Department of Health and Human Services said. The “tech team is working now to bring the system online as soon as possible,” HHS said in a statement. The site later appeared to be operating, but it was putting customers in a “queue”, meaning they’d be notified by email when they could proceed with enrollment (Fox, 3/31).

The New York Times: HealthCare.gov Malfunctions on Last Enrollment Day
The federal website where consumers can sign up for medical coverage under President Obama’s health care law unexpectedly stopped taking applications for several hours early Monday, the last day of open enrollment, because of a software problem, the administration said. The enrollment system on the site, HealthCare.gov, was taken offline for scheduled maintenance between 1 a.m. and 5 a.m., but then remained down for several more hours because of a software bug discovered by technology personnel during maintenance, said Aaron Albright, a spokesman for the Department of Health and Human Services (Joachim, 3/31).

The Wall Street Journal: Long Waits As Health Insurance Deadline Nears
Last-minute applicants for health insurance strained enrollment offices over the weekend, triggering long lines, extra security and hours of waiting across the country ahead of Monday’s federal deadline. HealthCare.gov, the federal website, blocked some applicants late Friday but didn’t show major technological problems as consumers rushed before the end of the 2014 open-enrollment period for obtaining insurance under the Affordable Care Act. But the system’s human capacity maxed out, with too few “navigators” and other enrollment workers to steer consumers through the complex application process (Radnofsky and Corbett Dooren, 3/30).

The Hill: Record Volume For O-Care Exchanges
The federal health insurance marketplace saw record volume for a Saturday, and operators at the federal call centers struggled to keep up with the volume of calls as consumers flooded the ObamaCare exchanges ahead of Monday’s enrollment deadline. According to the Obama administration, HealthCare.Gov saw two million visits this weekend, while the call centers received 380,000 phone calls (Sink, 3/30).

The Chicago Sun-Times: Monday Is Last Day To Enroll In Obamacare Health Plan For 2014
Last-minute shoppers for health insurance were greeted by lines and lengthy wait times Sunday as they attempted to obtain coverage under the Affordable Care Act before Monday’s registration deadline. After several enrollment deadlines for President Barack Obama’s signature health insurance law were rolled back, Monday is when nearly everyone is required to have coverage. Those who don’t risk paying a penalty — one that will increase each year, starting at $95 or 1 percent of your yearly household income, if that is higher. “We got here at 10 a.m.,” Dayanara Valladares, 20, said roughly five hours after her family arrived at Norwegian American Hospital in Humboldt Park to sign up. Seated on a park bench outside the hospital, Valladares, who lives in Albany Park, said the wait time was “ridiculous” (3/30).

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Health Care Spending Growth Hits Decade High

In other news, health care stocks have emerged as robust gainers in a resilient U.S. stock market.

USA Today: Health Care Spending Growth Hits 10-Year High
Health care spending rose at the fastest pace in 10 years last quarter, a development that could foreshadow higher costs for consumers this year. Expenses for health care rose at a 5.6% annual rate in the fourth quarter, the Bureau of Economic Analysis said  last week. The jump triggered a sharp upward revision in the government’s estimate of consumer spending overall and accounted for nearly a quarter of the economy’s 2.6% annualized growth in the last three months of 2013 (Davidson, 3/30).

The Wall Street Journal: Health-Care Stocks Lead From The Front 
This isn’t your father’s health-care sector. Long embraced by investors seeking to weather market downturns and recessions, the group — comprising drug companies, hospitals and health insurers, among others — has emerged as one of the healthiest gainers in a resilient U.S. stock market (Russolillo, 3/30).

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Looking Ahead To Impact Of Obamacare On Nov. Elections

A variety of news organizations analyzed what might happen in the fall, because of political campaigns built around the health law.  

Politico: The Obamacare Enthusiasm Gap
Irony alert: The Democrats’ biggest challenge this fall is to get their voters excited about a law that they asked for. Obamacare will be a huge voting issue for Republicans — that’s already clear. They’ll turn out in droves because they hate the law. What’s less clear is how Democrats will get their supporters to the polls to say, “hey, thanks for health reform” (Nather, 3/31).

Politico: Dems Try To Keep Hope Alive With ACA Mantra
According to administration officials, Democrats on Capitol Hill and other strategists who’ve been in touch with the White House, President Barack Obama’s team is sure the health care law’s problems will fade in people’s minds by November, months after the website rollout. They believe the intense attacks Republicans are using to stoke their own base won’t completely depress Democratic turnout. And they’re confident that independents will see the GOP’s 50 votes to repeal all or parts of Obamacare as a sign of Washington dysfunction (Dovere, 3/31).

The Washington Post: Democrats, Republicans Prepare For New Round Of Battles Over Health-Care Law
Supporters face an array of political, financial and legal challenges in the coming months. … In the months and years ahead, other questions will loom: How will Americans react when they get fined next year for not having insurance? Will more states expand Medicaid under the law? And will the federal courts make future changes to the law, including barring the use of government subsidies to help pay for coverage in the federal marketplace? (Eilperin, Goldstein and Somashekhar, 3/30).

The Associated Press: Health Law Legacy Eludes Obama As Changes Sink In
As a roller-coaster sign-up season winds down, President Barack Obama’s health care law has indeed managed to change the country. Americans are unlikely to go back to a time when people with medical problems could be denied coverage. But Obama’s overhaul needs major work of its own if it is to go down in history as a legacy achievement like Medicare or Social Security (Alonso-Zaldivar, 3/29).

The Associated Press: GOP Challenger Is The Focus In Colo. Senate Race
The Senate race in Colorado has shot toward the top of the nation’s most competitive contests this midterm election year, giving the Democratic incumbent a tougher battle than he expected and Republicans a new pickup opportunity in their drive to win the chamber’s majority. Sen. Mark Udall responded to Rep. Cory Gardner’s surprise challenge by quickly trying to define his opponent as an extremist. … As Gardner scrambles to raise money and assemble a campaign staff, his allies have hammered Udall’s support for President Barack Obama’s health care law (Riccardi,Ń/29).

The Washington Post: Senate Democrats Struggle To Define A Message That Can Save Their Majority
Democrats are going into the 2014 midterm elections with their control of the Senate greatly imperiled and with the prospect of an Obama presidency completely hobbled in its final two years. In response, the president and his party are struggling to come up with a broad economic message that can rebut, or at least deflect, the continued GOP assaults on the president and his new health-care law (Tumulty and Kane, 3/29).

CBS News: Clock Winds Down On Enrollment But Not On Obamacare’s Political Fight
March 31 has finally arrived, and with it comes the last official day for people to sign up for health insurance on the federal exchange websites.  The deadline, of course, isn’t a hard one: the administration announced last week that people who started to apply for health insurance by the deadline but didn’t finish the process will still be able to get coverage. Just as enrollment doesn’t close for good on Monday, the fight over Obamacare will hardly be settled by the coming and going of the end of the month (Kaplan, 3/31).

Fox News: Debate Over ObamaCare Far From Over As Signup Deadline Arrives
The deadline to sign up for ObamaCare technically is Monday, but the roiling, years-long debate about enrollment numbers and practically every other aspect of President Obama’s signature health care law appears far from over in this politically charged election year. … On Sunday, ObamaCare supporters were on television championing the law’s recent successes, particularly the late-enrollment surges, including 1.2 million visitors Saturday to the federal site. Some who have trouble signing up by Monday will also be given extra time (3/31).

Bloomberg: Obamacare Changes Illegal, McMorris Rodgers Says 
President Barack Obama is “picking and choosing” how the 2010 health-care law will be implemented and “doesn’t have the flexibility” legally to do so, U.S. Representative Cathy McMorris Rodgers said. Asked if she was saying such changes to the law are illegal, McMorris Rodgers, a Republican from Washington state, replied, “Yes, I am” (Wallbank, 3/29).

Miami Herald: PolitiFact: Rick Scott’s Political Committee Says Obamacare Has Led To 3Ǡ,000 Health Plans Canceled
A new TV attack ad against former Gov. Charlie Crist zeroes in on Crist’s support for Obamacare.
Republican Gov. Rick Scott’s political committee, Let’s Get to Work, unveiled the ad March 24. Scott’s campaign said it will spend $2 million on the statewide ad, which started running on Thursday. The ad repeats snippets of Crist’s March 9 interview on CNN when he called Obamacare “great.” … Scott’s TV ad says, “300,000 health plans canceled,” attributing the number to news reports. … The statement has an element of truth but leaves out important details, so we rate this claim Mostly False (Sherman, 3/30).

Meanwhile, several polls give a glimpse of what voters are thinking.

The Associated Press: Poll: Obama Health Law Fails To Gain Support
Despite a late surge in sign-ups, support for President Barack Obama’s health care law is languishing at its lowest level since passage of the landmark legislation four years ago, according to a new poll. The Associated Press-GfK survey finds that 26 percent of Americans support the Affordable Care Act. Yet even fewer — 13 percent — think it will be completely repealed. A narrow majority expects the law to be further implemented with minor changes, or as passed (Alonso-Zaldivar and Junius, 3/30).

Christian Science Monitor: Obamacare Launch: What Americans Like About The Law, And What They Don’t 
A narrow majority of US adults say they oppose the law, which is designed to reduce the number of people who lack health insurance, according to a new Christian Science Monitor/TIPP poll conducted this week. … The results, when viewed alongside other polls about “Obamacare,” show the broad political challenge that the president and Democrats face regarding the law. Even though particular elements of the Affordable Care Act are popular – as is its broad goal of expanding access to health care – the financial math is a sticking point (Trumbull, 3/28).

 

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State Roundup: W.Va. Governor Tomblin Vetoes Abortion Ban; New York Curbs Medical Bills With Surprises; California Bill Aims To Raise Malpractice Cap

A selection of health policy stories from California, Illinois, New York, West Virginia and Wisconsin.

Charlestown (W.Va.) Gazette: Tomblin Vetoes 20-Week Abortion Ban 
Gov. Earl Ray Tomblin vetoed a bill late Friday that would have banned abortions of fetuses after 20 weeks gestation. The governor called the bill unconstitutional and a “detriment” to women’s health (White, 3/28).

The New York Times: New York Curbs Medical Bills Containing Surprises
Every year, thousands of New Yorkers find themselves responsible for a surprise medical bill from a doctor, like an anesthesiologist, who becomes involved in their care but, unbeknown to the patient, is not covered by their insurance. Now a provision in the state budget agreement announced Saturday is intended to protect consumers by requiring that they be given a reasonable amount of notice when an out-of-network doctor will be treating them (Hartocollis, 3/30).

The Wall Street Journal: Bid To Raise Malpractice Cap Gets A Rider
A California law on medical malpractice awards, in place since 1975, puts a $250,000 ceiling on the amount of money that can be given for noneconomic damages. Now, lawyers and some consumer groups are mounting an effort to substantially raise the cap through California’s referendum system, but they are coupling it with a popular idea that hospital doctors should undergo routine drug and alcohol testing (Lazo, 3/28).

Chicago Tribune: Cook County Health System Inks $1.8 Billion Contract 
The board running Cook County’s public health system on Friday approved a contract worth up to $1.8 billion over five years to manage health care for an estimated 115,000 low-income residents as the county adapts to the federal Affordable Care Act. IlliniCare Health Plan Inc., a division of St. Louis-based Centene Corp. that already manages health care programs for the state of Illinois, was chosen to operate the CountyCare program. Through CountyCare, people receive either Medicaid or insurance subsidies via the Affordable Care Act, which has come to be known as Obamacare (Dardick, 3/29).

The Milwaukee Journal Sentinel: Health Tied To Wealth: Ozaukee Ranks First, Milwaukee Near Bottom
While overall life expectancy in the nation has increased during roughly the past two decades, the increase has been concentrated almost entirely among the one-third of society with the most wealth and the most education. For those with just a high school diploma or less, life expectancy has stayed the same or fallen, according to a report from the Council on Health Care Economics and Policy’s annual conference. So not surprisingly, a new study shows that the overall healthiest county in Wisconsin also is one of the richest: Ozaukee. At the same time, the county with the worst health — Menominee — is one of the poorest in the state. And Milwaukee County, with large pockets of poverty, is right behind it (Boulton, 3/30).

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