Daily Health Policy Report

Wednesday, January 8, 2014

Last updated: Wed, Jan 8

KHN Original Reporting & Guest Opinion

Health Reform

Health Care Marketplace

Health Information Technology

State Watch

Editorials and Opinions


KHN Original Reporting & Guest Opinion

Former HHS Head Offers His Insight Into The Health Law's Problems

Kaiser Health News staff writer Julie Appleby talked with Michael O. Leavitt, secretary of Health and Human Services during the George W. Bush administration, who oversaw another troubled rollout — that of the Medicare prescription drug benefit in 2006. It also was criticized for computer glitches, long waits for telephone assistance and consumers incorrectly enrolled in coverage. Leavitt, a former Utah governor who opposed the Affordable Care Act, now runs Leavitt Partners, a consulting firm that works with health care organizations and state governments on implementing the law (Appleby, 1/8). Read an edited transcript of the conversation.

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Capsules: Survey Finds Wealthier Patients In California More Satisfied With Their Health Care

Now on Kaiser Health News' blog, Daniela Hernandez reports: "Money may not buy happiness, but patients with more money to spend tend to be happier with their health care providers, a statewide survey sponsored by the Blue Shield of California Foundation found" (Hernandez, 1/8). Check out what else is on the blog.

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Political Cartoon: 'DiagNOsis?'

Kaiser Health News provides a fresh take on health policy developments with "DiagNOsis?" by Ron Morgan.

Here's today's health policy haiku:  


For Republicans --
It's Obamacare, stupid...
They'll stay on message.


If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story. 

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Health Reform

The Challenge Of Spreading Positive Obamacare News

Politico reports on the uphill climb faced by the White House to publicize stories about satisfied customers as one White House official says the health law is making a comeback from a tough start.

Politico: The High Bar For Obamacare Success Stories
Here’s the challenge the White House faces in telling Obamacare success stories: Try to picture a headline that says, "Obamacare does what it’s supposed to do." Somehow, the Obama administration and its allies will have to convince news outlets to run those kinds of stories — and to give the happy newly insured the same kind of attention as the outraged complainers whose health plans were canceled because of the law (Nather, 1/8).

USA Today: Obama Adviser: Health Care Rollout Like A Football Game
The Obama administration's new point person on the health care rollout compares the effort to a football game, and cites one specific example. Just as the Indianapolis Colts rallied from a 28-point deficit to beat the Kansas City Chiefs this past weekend, the health care law is coming back from its rough start and will prevail, senior adviser Phil Schiliro said (Jackson, 1/7).

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Feds Develop 'Workarounds' To Make Sure People Who Are Eligible Get Covered By Medicaid Expansion

Medicaid officials have developed methods to get around healthcare.gov's limitations in transmitting applications to state agencies, Modern Healthcare reports. But as election-year politics begin to heat up, some states continue to wrestle with the concept of expanding the low-income health insurance program.

Modern Healthcare: CMS Creates Workarounds To Ensure Medicaid Coverage
Faced with the reality that HealthCare.gov still has limited ability to transmit completed Medicaid applications to state agencies, the CMS has come up with two new workarounds to ensure people get covered. As many as 100,000 Americans who were told they were eligible for new Medicaid or Children's Health Insurance Program coverage have not been enrolled because of the technology problems, according to a report in the Washington Post attributing the figure to federal and state officials. However, states remain split on whether to use the workarounds or wait until fully automated transfers can take place (Dickson, 1/7).

Stateline: Obamacare Decisions Roil States
Election-year politics will further complicate the health care debate, as 36 governors and a majority of state lawmakers will be up for re-election in November. In debating expansion, some Republican-led states are tilting toward a so-called "private option." Instead of expanding Medicaid, they would use federal Medicaid dollars to help people purchase private insurance on the exchanges. Last year the federal government allowed Arkansas and Iowa to pursue the strategy, while warning that it would not grant permission to every state. "I'd be really surprised if we see any more straight Medicaid expansions," said Judith Solomon of the Center on Budget and Policy Priorities. "Every one of the remaining states wants to put its own stamp on it" (Vestal, 1/8).

Also in the news, the president of the Kansas Senate thinks the expansion is unlikely to win approval this year, and Oregon's Medicaid enrollment tally is beating early projections -

Kansas Health Institute: KS Senate President Says Medicaid Expansion Unlikely To Gain Approval This Session
Kansas Senate President Susan Wagle said she thinks Medicaid expansion is unlikely to win approval from lawmakers this year given the shaky rollout of the Obamacare insurance marketplace (Shields, 1/7).

The Oregonian: Oregon's Medicaid Enrollment Beats Projections While Private Insurance Lags
Enrollment by Oregonians in the state's Medicaid program is beating projections while those signing up for private insurance is lagging due to difficulties with the state's health insurance exchange, new statistics show. About 150,000 people have enrolled in the low-income Oregon Health Plan, while about 20,000 enrolled in private insurance, according to numbers released Tuesday. The latter group used paper applications to substitute for the non-functional health insurance exchange website, Cover Oregon (Budnick, 1/7).

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170,000 Oregon Residents Enrolled In Coverage

Cover Oregon officials reported that 170,000 residents signed up for new health coverage effective Jan. 1 despite problems with that state's site. Meanwhile, Anthem Blue Cross extended the payment deadline for Connecticut applicants until Jan. 15, and MNsure officials are under pressure to get their site working smoothly.

The Oregonian: About 170,000 Oregonians Enroll In Health Insurance Despite Exchange Problems
About 170,000 Oregonians used the state or Oregon's health insurance exchange to enroll in health insurance effective Jan. 1, according to statistics released Tuesday. A joint release from the Oregon Health Authority and Cover Oregon stressed that enrollment proceeded despite problems with the health exchange website that forced consumers to submit paper applications to be processed by an army of temporary hires (Budnick, 1/7).

The CT Mirror: Anthem Extends Payment Deadline For Obamacare Customers
With some customers still waiting to receive bills or have their payments processed, Anthem Blue Cross and Blue Shield is extending the deadline for customers to pay their first month’s premium to Jan. 15. The five-day extension means that people who signed up for coverage through the state’s health insurance exchange, Access Health CT, by Dec. 23 will receive coverage retroactive to Jan. 1 as long as they pay their premium by next Wednesday. Anthem is the state’s largest health insurer and also dominates the market on plans sold through the Connecticut’s health insurance exchange (Becker, 1/7).

The Star Tribune: Pressure Building For MNsure Officials
As MNsure officials scramble to eliminate the problems bedeviling the state’s health care exchange, they are facing a growing swirl of constituencies demanding accountability. Gov. Mark Dayton has strongly criticized one major vendor and publicly demanded improvement since the bumpy rollout of the website in October. The state legislative auditor launched a review Tuesday to determine to what degree vendors and state officials are responsible for the problems. And a committee of state legislators will convene Thursday demanding answers for a program envisioned as a gateway to health insurance for more than 800,000 Minnesotans this year (Crosby, 1/7).

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Health Industry Insiders Analyze, Predict And Prescribe

Kaiser Health News checks in with former HHS chief Michael Leavitt while CQ HealthBeat details insights from another insider, Robert Laszewski.  

Kaiser Health News: Former HHS Head Offers His Insight Into The Health Law's Problems
Kaiser Health News staff writer Julie Appleby talked with Michael O. Leavitt, secretary of Health and Human Services during the George W. Bush administration,... Leavitt: "The administration needs to come up with the 60 percent workaround. That is, they’ve got to find a simple way to solve a complex problem, which will have imperfections for everyone. We did the [Medicare] prescription drug plan in 2006 and had lesser problems, but of a similar nature, where people were walking up to the pharmacy counter to get their drugs and their name wasn’t in the computer" (Appleby, 1/8).

CQ HealthBeat: No ‘Obamacare Death Spiral’ In 2015, Insurance Insider Says
The man who, more than any other person, has kept the press informed about the foul-ups bedeviling insurers since the launch of the health law’s online marketplaces says plans won’t jack up their premiums next year. That’s unexpected, given the series of blogs posted by industry consultant Robert Laszewski in recent weeks detailing how those problems are likely to swamp the exchanges with too many high risks (Reichard, 1/7).

Meanwhile, Bloomberg examines the latest health spending figures through the lens of the health law -

Bloomberg: Obamacare Tested By Recession’s Effect On Health Care
The U.S. recession remained a drag on health-care spending three years after it ended as a net of 9.4 million people lost private insurance coverage before key provisions of Obamacare had begun, a government report showed. ... The 2010 Patient Protection and Affordable Care Act’s largest health-care expansions didn’t begin until this year, including private insurance for about 2.1 million new people and expanded Medicaid coverage for others (Wayne, 1/7).

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Health Care Marketplace

A New Health Insurer Raises Funds After Rapid Growth

A new health insurer is betting that it can enter a crowded, but lucrative market. In the meantime, health care stocks helped markets surge Tuesday.

The New York Times' Dealbook: Oscar, A New Health Insurer, Raises $30 Million 
Most of the darlings of the last few years have been consumer-focused start-ups, like Instagram and Warby Parker. But a group of investors, including the venture capitalist Joshua Kushner, are doubling down on a bet on health insurance. Oscar, a health insurer co-founded by Mr. Kushner, has raised $30 million in new capital from existing investors, the firm plans to disclose this week. The financing was led by the Founders Fund, the venture capital firm co-founded by Peter Thiel. It also includes Mr. Kushner’s firm, Thrive Capital, Khosla Ventures and General Catalyst Partners (De La Merced, 1/7).

The Associated Press: Health Care Stocks Lead Wall Street Uptick
Stocks rallied Tuesday, ending a slump that had ushered in the new year. The Standard and Poor's 500 index climbed the most in three weeks, led by gains for health care stocks. United­Health Group, the nation's largest health insurer, and Johnson & Johnson climbed on recommendations for brokerage firms (1/7).

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Health Information Technology

Federal Report Finds Electronic Health Records Push Lacks Key Safeguards

The New York Times: Report Finds More Flaws In Digitizing Patient Files
Although the federal government is spending more than $22 billion to encourage hospitals and doctors to adopt electronic health records, it has failed to put safeguards in place to prevent the technology from being used for inflating costs and overbilling, according to a new report by a federal oversight agency (Abelson and Creswell, 1/8).

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State Watch

State Highlights: Blue Shield Of Calif. Rate Hike Called 'Excessive'; Fla. Medicaid Contract Problems

A selection of health policy stories from California, Florida and Minnesota.

Los Angeles Times: Blue Shield Of California Rate Hike Is Excessive, Regulator Says
California Insurance Commissioner Dave Jones criticized Blue Shield of California for an "unreasonable" rate hike affecting about 81,000 individual policyholders. ... But he and other state officials don't have the authority to reject changes in premiums. Jones said the latest rate hike amounted to an average increase of 32 percent over a two-year period (Terhune, 1/7).

Los Angeles Times: Blue Shield Of California To Buy Gem Care Health Plan In Bakersfiled
Blue Shield of California said it has agreed to acquire GemCare Health Plan, expanding its presence in Kern County and the Central Coast area. Blue Shield, one of the state's largest health insurers, said Tuesday that GemCare customers should see minimal changes at first (Terhune, 1/7).

Kaiser Health News: Capsules: Survey Finds Wealthier Patients In California More Satisfied With Their Health Care
Money may not buy happiness, but patients with more money to spend tend to be happier with their health care providers, a statewide survey sponsored by the Blue Shield of California Foundation found (Hernandez, 1/8).

Health News Florida: Medicaid Contract In Turmoil
Miami-Dade County, the juiciest plum in Florida Medicaid's switch to mandatory managed care, could still be in play following a ruling against the Agency for Health Care Administration in its contracting decisions. Hundreds of millions of dollars could ride on the outcome (Gentry, 1/7).

The Star Tribune: A Medical-Testing Lesson From Minnesota: Less Can Be More
A novel strategy that has saved Minnesota millions of dollars in unnecessary medical-imaging scans -- and probably prevented dozens of patient deaths -- might soon go national. ... Minnesota's "decision support" strategy, enacted in 2006, created a single set of standards for doctors to follow in deciding when patients need the costly scans. It also created a green-yellow-red coding system to show patients when scans were recommended and when they weren't (Olson, 1/7).

California Healthline: Returning Health Bills On Capitol Agenda
As attention turns to legislative issues, lawmakers will have some familiar ground to cover with 104 bills carrying over on the Assembly side and 108 bills in the Senate, including many health care issues in both chambers. The health care issues that may be in play this session include: ... AB 880 by Assembly member Jimmy Gomez (D-Los Angeles) was put on the inactive file, and can be returned. It would require large employers to pay a share of health care costs when employees go onto Medi-Cal coverage. It was prompted, in part, by Walmart's decision to eliminate health benefits for those working less than 24 hours a week (Gorn, 1/7).

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Editorials and Opinions

Viewpoints: Health Law Debate On Contraceptive Coverage; Cuccinelli: No Investigators For Medicaid Fraud; 50 Years After The Famed Report On Smoking

Los Angeles Times: The Little Sisters Of The Poor Vs. Obamacare
The Little Sisters of the Poor, an organization of Roman Catholic nuns that runs nursing homes around the country, is testing the contraceptive coverage mandate of the Affordable Care Act. Last week, we're sorry to say, the nuns won a temporary reprieve from Supreme Court Justice Sonia Sotomayor. Under the law, most employers are required to provide their employees with health insurance that covers birth control. But the Obama administration agreed to a compromise for nonprofit religious groups that object to contraception, exempting them from paying for such coverage. Instead, insurers agreed to absorb the cost. All the religious organization has to do is fill out a simple form attesting to its situation. Unfortunately, even that was too much for the Little Sisters of the Poor (1/7). 

The Washington Post: Hooey And Hype Over The Birth-Control Mandate
You'll be hearing a lot in coming months about the Obamacare requirement that health-care plans offer no-cost contraceptive coverage. Much of what you hear will be wrong, either (from opponents of the mandate) overstating the infringement on religious freedom or (from supporters) exaggerating the impact of excluding coverage for birth control. Herewith, my guide for the soon-to-be-perplexed (Ruth Marcus, 1/7).

The Washington Post: Should You Be Scared To Use Healthcare.gov?
The House Republicans' bill would require the government to notify victims of any illegal security breach in the [Affordable Care Act's] systems within two business days. If that makes sense for HealthCare.gov, though, why not require the same of other sensitive federal systems, too? If Republicans want to pass useful policy, rather than simply throw another bomb at the ACA, they should detach their proposal from anti-Obamacare politics and vote on a broader federal transparency requirement, or even renew their push for more ambitious federal cybersecurity reforms. ... It would be unfortunate, though, if Republicans succeeded in scaring Americans away from enrolling in health insurance plans, undoubtedly a goal for some (1/7). 

The Washington Post: It's Obamacare All The Time For Republicans
A reporter from the Cedar Rapids (Iowa) Gazette asked [Republican National Committee Chairman Reince] Priebus if "Obamacare is going to be the Johnny-one-note campaign for Republicans" in which "every issue that comes up, you're going to respond with Obamacare." Or, he inquired, "is there more to what Republicans want in 2014?" "The answer is Obamacare," Priebus said, before adding a "just kidding." But he wasn't really kidding (Dana Milbank, 1/7).

The Wall Street Journal: Fast Times At Obamacare High
The worst must be over for the Affordable Care Act because its boosters are taking credit for trends that began long before the law passed. Maybe ObamaCare should also get retroactive political credit for the germ theory of disease. All the back-slapping is over Monday's report by federal actuaries that U.S. public and private health spending rose only modestly in 2012, growing 3.7% to $2.8 trillion. Because the economy grew somewhat faster, health spending as a share of GDP fell to 17.2% from 17.3% in 2011. The real lesson in these numbers is that faster economic growth solves most fiscal ills (1/7). 

Richmond Times-Dispatch: Medicaid Expansion Is Wrong For Virginia
One fact that has been missing from the public discussion about whether or not to expand Medicaid is that there will be an explosion of fraud with any such expansion, and unfortunately, as a practical matter, there will be no one to investigate or prosecute that fraud within Virginia state government, and only nine people in the federal government. Those nine are already tasked with pursuing Medicare fraud in Virginia, thus they have no meaningful ability to police the new wave of fraud that would come with the proposed expansion of Medicaid (Virginia Attorney General Ken Cuccinelli, 1/8).

The Fiscal Times: When Will We Finally Know What Our Health Care Really Costs?
The government announced this week that health care spending rose only modestly in 2012, the fourth year in a row of low growth. The numbers released by the Centers for Medicare & Medicaid Services offer a broad overview of the $2.8 trillion spent on everything from hospitals and clinics to drugs and dentists. They don’t, however, fully address a lingering enigma for American consumers: How much does our care really cost? (John F. Wasik, 1/8).

On other issues --

The New York Times: The Missing Piece In The War On AIDS
Most people living with or at risk of HIV still do not have access to prevention, care and treatment. The epidemic continues to ravage families, communities and entire nations. This is particularly true in sub-Saharan Africa, which bears the burden of disease in disproportionate measure, and where HIV/AIDS is the leading cause of death in adults. We must acknowledge that medicines and technology alone are not enough. ... Our strategy, if it is to be successful, must recognize that achieving universal access to care and treatment necessarily means addressing human rights barriers to health services (Ellie Feinglass, 1/7).

Journal of the American Medical Association: Tobacco Control 50 Years After The 1964 Surgeon General's Report
The 50th anniversary of the landmark 1964 surgeon general's report on Smoking and Health marks a time for national recognition, resolve, and reaffirmation. It is important to recognize the persons who courageously completed the report under intense scrutiny while guarding against potential industry interference. It is also important to honor the extraordinary scientific advances in tobacco control in the years since the release of the report—advances that have led to countless lives saved. Ultimately, however, this anniversary must reaffirm the fundamental resolve to end the tobacco epidemic once and for all, and doing so should not take another 50 years (Dr. Steven A. Schroeder and Dr. Howard K. Koh, 1/8).

Journal of the American Medical Association: The War Against Tobacco: 50 Years And Counting
While the overall prevalence of adult smoking in the United States has declined markedly, from about 42% in 1965 to an estimated 18% in 2012 with comparable declines in per capita cigarette consumption, higher smoking rates persist among the poor; the least educated; individuals with mental health, substance abuse, and alcohol diagnoses; the lesbian, gay, bisexual, and transgender community; and Native Americans. Moreover, on any given day, an estimated 3800 US adolescents smoke their first cigarette, 1000 of whom will join the ranks of daily (lifetime) cigarette smokers (Dr. Helene M. Cole and Dr. Michael C. Fiore, 1/8).

Journal of the American Medical Association: Tobacco Control Progress And Potential
However, there are 2 important and concerning surprises in tobacco control. First, even 50 years later, studies are continuing to elucidate new ways tobacco causes death and disability among both smokers and people exposed to secondhand smoke—new diseases it causes or complicates. ... Second, despite progress both in the United States and globally, proven strategies have not been fully implemented to protect children, support smokers who want to quit, and prevent myocardial infarctions, strokes, cancers, and other tragic and expensive health consequences of smoking (Dr. Thomas R. Frieden, 1/8).

Journal of the American Medical Association: Accommodating Bigotry
Despite the United States' inexorable march toward racial, ethnic, and gender equality, it is clear that prejudice persists. What I find difficult to reconcile is how to deal with patient prejudices in a health care system with a growing emphasis on patient-centered care. Does a patient have the right to request or to deny a clinician of a certain race, ethnicity, gender, religion, or sexual orientation? Physician-patient race concordance has emerged in the disparities literature as a factor in differential health outcomes. When patients and physicians share race, visits tend to be longer and patient satisfaction is higher, bolstering the argument that patient preferences (assuming they prefer concordance) should be respected (Meghan Lane-Fall, 1/8).

JAMA Internal Medicine: Moving Toward Evidence-Based Complementary Care
Therapies that lie outside the spectrum of traditional, science-based clinical medicine and surgery are often labeled as complementary or alternative. ... Among complementary measures, meditation has occupied a special position, revered in religious circles and Eastern societies for centuries and rediscovered in the West in the mid-20th century ... studies overall failed to show much benefit from meditation with regard to relief of suffering or improvement in overall health, with the important exception that mindfulness meditation provided a small but possibly meaningful degree of relief from psychological distress .... the phenomenon is causing a collision of opinion in examining rooms and offices as physicians and other health care professionals committed to evidence-based practice encounter patients who are enthusiastically and uncritically incorporating unvalidated measures into their daily lives and into the treatment of their illnesses (Allan H. Goroll, 1/7).

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Jobless Benefits For Health Law Suspension? Dems Say No.

Republicans are pushing proposals involving suspending parts of the health law in return for extending unemployment aid. Lawmakers also are making progress on a $1 trillion spending bill, again with health law negotiations at the center.

Los Angeles Times: Jobless Benefits Bill Takes Small Steps In An Uphill Climb
The Republican leader in the Senate, Mitch McConnell of Kentucky, offered an amendment Tuesday that would have extended unemployment insurance in return for a one-year suspension of the health care law's requirement that all individuals carry health insurance. It was rejected by Democrats (Mascaro and Parsons, 1/7).

Fox News: GOP Senator: Give Companies That Hire Long-Term Jobless A Break From ObamaCare
A Republican senator is pushing a curious alternative to extending aid for the long-term unemployed -- entice companies to hire them by letting those businesses off the hook on Obamacare.  Sen. John Thune, R-S.D., is one of several Republicans offering up amendments to a Senate bill that would extend long-term jobless benefits for three months, at a cost of more than $6 billion. The bill narrowly advanced Tuesday, teeing up a debate over possible changes. The central plank of Thune's amendment would create an incentive program for businesses to hire those who have been unemployed 27 weeks or more (1/7).

Los Angeles Times: Analysis: Senate Action A Preview Of 2014 Election Fight: Who’s On Your Side? 
The frantic image-making by Democrats and Republicans as the 2014 elections loom rippled through the Senate debate Tuesday over whether to extend jobless benefits that expired late last year. For Democrats, who unanimously supported a procedural vote on the benefit extension, the issue offered an opportunity to come to the defense of a middle class still. … For Republicans, only six of whom crossed party lines to further the benefit extension, the day brought a renewed effort to tie jobless relief to Obamacare. … The merging of the two issues came in a proposal by Senate Republican leader Mitch McConnell of Kentucky to pay for the extension with a one-year delay of Obamacare's requirement that all Americans carry health insurance. Though that was defeated, along with an attempt by Republicans to block the benefits extension from being considered, final approval of the legislation is iffy in the Senate and, at this point, exceedingly iffy in the Republican-controlled House (Decker, 1/7).

The Hill: Negotiators Make Progress On $1T Spending Bill
Prospects for completing a giant spending bill and avoiding another government shutdown appeared to improve Tuesday, as a top negotiator said a repeat of October’s Obamacare-driven shutdown could be avoided. Sen. Tom Harkin (D-Iowa), who chairs a subcommittee overseeing health, labor and education spending, told reporters that the $1 trillion omnibus is nearing completion, and both sides should be able to agree on an Obamacare compromise (Wasson, 1/7).

And one prominent lawmaker pushes Medicare reforms --

CQ HealthBeat: Wyden Pushes Bipartisan Medicare Overhaul Focused On Chronic Disease, Transparency
Ron Wyden, heir apparent to the Senate Finance Committee chairmanship, plans to push for bipartisan bills that he says will transform Medicare by focusing on chronic disease and increasing price transparency (Ethridge, 1/7).

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RNC Launches 'Obamacare' Attack Ads

The advertisements, which will run in 12 states this week, target Democratic senators and representatives who supported the health law by attempting to link them to President Barack Obama's failed promise that people who like their coverage could keep it. The administration, meanwhile, will run ads during the Winter Olympics, urging people to sign up for coverage.

CNN: RNC Targets Democrats Over Obama Insurance Pledge
There's no let-up in the new year in the GOP push to attack Democrats over Obamacare during the midterm elections. Case in point: New radio ads announced Tuesday morning by the Republican National Committee that attack 12 Democratic senators and representatives, many of whom are in competitive races this November. The ads focus on President Barack Obama's broken pledge that people who liked their health insurance plans could keep them under the Affordable Care Act (Steinhauser, 1/7).

McClatchy: Republicans Launch 'Obamacare' Ads
The Republican National Committee is launching ads in a dozen states this week, mostly incumbents who supported President Barack Obama's health care law. The radio ads, which will run Tuesday and Wednesday, will attempt to tie Democrats across the country to Obama's failed promise that Americans could keep their existing insurance plans. "Obamacare is going to be the issue in 2014," RNC chairman Reince Priebus told reporters (1/7).

CBS News: GOP Leader: Impossible To Take Focus Off Obamacare In 2014
Democrats intend on putting a special emphasis on income inequality issues this year, with efforts to raise the minimum raise and help the unemployed, but the Republican Party is betting that voters in November will still make their concerns about Obamacare their priority. “When you’re talking about something that takes up a sixth of the United States economy and that has been dramatically misrepresented to the American people and that's affecting everybody... it’s impossible for this not to be the number one issue,” Republican National Committee (RNC) Chairman Reince Priebus told reporters Tuesday. The RNC on Tuesday is launching radio ads targeting 12 red state or potentially vulnerable congressional Democrats for repeating the now-infamous Obamacare pledge, "if you like your health care, you can keep it" (Condon, 1/7).

Politico: Obamacare Ads To Hit The Olympic Slopes
The Obama administration is planning an Olympic-size ad blitz to push health coverage during the winter games next month. HHS confirmed Tuesday that it has bought advertising time in markets with high rates of uninsured people to air during the Winter Olympics, which run Feb. 7-23 (Cheney and Hohmann, 1/7).

The Washington Post examines how attack ads seek to render the law itself unsuccessful --

The Washington Post's The Fix: The Hidden Effect Of Anti-Obamacare Ads
But, there's another potential impact -- beyond the political one -- of these early ads, according to Elizabeth Wilner, senior VP at Kantar Media Ad Intelligence. "This isn’t just about using the issue to defeat Democrats, though that’s emerging as the primary goal for 2014; it’s also about rendering the law unsuccessful," explained Wilner. "It’s a quirk of geography, and of political demography that has been decades in the making, that vulnerable Democratic incumbents represent a lot of areas where there are a lot of Americans who need health coverage." In other words, the most vulnerable Democratic senators up for reelection in 2014 represent a remarkably large number of people who are uninsured. That means that ad spending on anti-Obamacare messaging in those states is -- and will continue to be -- higher than the national average despite the fact that, in theory, more people in those states might benefit from the law (Cillizza, 1/7).

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Stephanie Stapleton

Andrew Villegas

Lisa Gillespie
Shefali Luthra

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.