First Edition: October 25, 2013

Today's headlines include reports and analyses of yesterday's Capitol Hill hearing, which featured website contractors talking about the troubled rollout of healthcare.gov. 

Kaiser Health News: Health On The Hill: Lawmakers Challenge Healthcare.gov Contractors On Website Problems
Kaiser Health News staff writer Mary Agnes Carey and Politico Pro's Jennifer Haberkorn discuss recent events on Capitol Hill. For more than four hours in a hearing Thursday, House Energy and Commerce Committee members grilled contractors who helped build the health law's problem-plagued online insurance marketplace (10/24). Read the transcript or listen to the conversation.

Kaiser Health News: A Reader Asks: I Don’t Have Children, So Why Do I Have To Buy Pediatric Dental Insurance?
Kaiser Health News consumer columnist Michelle Andrews answers a question about pediatric dental insurance (10/25). Read the exchange.

Kaiser Health News: Capsules: Administration Says 700,000 Have Applied For Coverage; Medical Schools See Record Numbers Of Enrollees
Now on Kaiser Health News’ blog, Phil Galewitz reports on administration estimates about how many people have sought insurance coverage: "The Obama administration said Thursday that 700,000 people have completed applications for coverage in the health law’s new marketplaces — a key step before people can begin shopping for insurance plans" (Galewitz, 10/24).

Also on Capsules, Ankita Rao reports that medical schools are experiencing a record level of enrollees: "About 20,000 students enrolled in medical school in 2013, around 2.8 percent more than the year before, according to the data distributed by the Association of American Medical Colleges on Thursday. First-time applications were also up by almost 6 percent" (Rao, 10/24). Check out what else is on the blog.

The Washington Post: Full Testing Of Healthcare.gov Began Too Late, Contractors Say
Private contractors in charge of building the federal online health insurance marketplace testified Thursday that the administration went ahead with the Oct. 1 launch of HealthCare.gov despite insufficient testing. In their first public remarks since the debut of the problem-ridden insurance exchange, executives of the main IT companies told members of the House Energy and Commerce Committee that full tests of the Web site that should have been carried out months in advance, but began just two weeks before its rollout (Somashekhar and Goldstein, 10/24).

The New York Times: Contractors Describe Limited Testing of Insurance Web Site
Federal officials did not fully test the online health insurance marketplace until two weeks before it opened to the public on Oct. 1, contractors told Congress on Thursday. While individual components of the system were tested earlier, they said, the government did not conduct "end-to-end-testing" of the system until late September (Pear, 10/24).

Los Angeles Times: Health Website Contractors Acknowledge Late Changes, Limited Tests
Developers of the troubled Obamacare website confirmed Thursday that a last-minute decision requiring users to sign up before shopping for insurance caused the system to bottleneck and acknowledged they did not conduct an "end to end" test until just before this month's botched rollout. The federal contractors sought to shift responsibility for the more than $400-million project to the Obama administration, providing fuel for Republicans who want to kill the Affordable Care Act (Mascaro and Hennessey, 10/24).

The Wall Street Journal: Botched Launch Of Health Site Blamed On Poor Coordination
No one in the government made sure the many complex parts of the federal health-insurance website worked together properly, and testing of the complete site didn't take place until two weeks before its Oct. 1 launch, contractors said at the first congressional hearings into the matter. The website's botched launch has become the biggest threat to the success of President Barack Obama's health law, just days after Democrats beat back a Republican bid to defund it. More Democrats said Thursday that penalties on those who lack health insurance—a linchpin of the law—should be delayed because of the difficulties many people have had in navigating the site (Schatz, 10/25).

Politico: Contractors Grilled On The Hill
Top Obamacare contractors said Thursday they never recommended that the Obama administration delay the Oct. 1 launch of HealthCare.gov — even though some of them harbored doubts about a website that would crash shortly after it went live. Republicans pressed four contractors appearing before the House Energy and Commerce Committee on why they had told Congress in September that Obamacare’s online enrollment system was on track, only to go off the rails in October (Haberkorn and Millman, 10/24).

The Associated Press/Washington Post: Contractors: Obama Admin. Left Little Time For Testing Health Care Site And Made Late Changes
Who’s to blame? The first congressional hearing into what went wrong dug into issues of website architecture and testing protocols — but also re-stoked the partisan battle over President Barack Obama’s signature expansion of health coverage for millions of uninsured Americans. Republicans who’ve been trying to kill the program the past three years sounded outraged that it is being poorly carried out, while Democrats jeered them as political hypocrites (10/24).

Politico: Obamacare Website Hearing Takeaways: Missing Word Was 'Sorry'
So now we know the contractors’ side of the Obamacare website debacle: They did a great job, the bad decisions weren’t their fault, and they’re fixing it. Thursday’s standing-room-only hearing on the snakebit federal Obamacare enrollment website, HealthCare.gov, saw a parade of witnesses who weren’t about to take responsibility for the disaster. We just do what the client asks, they said — and in this case, the client was the Obama administration (Nather, 10/24).

The Washington Post's Post Politics: Pallone: House Health-Care Hearing A 'Monkey Court'
Rep. Frank Pallone (D-N.J.) derided today's House Energy and Commerce Committee hearing as a "monkey court," accusing Republicans of exhibiting false concern during testimony and chastising them for raising security concerns that he said were specious. “You are trying to scare people so they won’t apply,” he said, adding that he believes the Republicans’ true purpose is to undermine people’s trust in the new health-care law so that it has to be delayed or repealed. His outburst came after two Republicans alleged that the federal marketplace does not adequately protect people’s medical privacy (Somashekhar and Eilperin, 10/24).

USA Today/The Arizona Republic: Sebelius Promises Fixes To Health Care Site
As a congressional panel probed her agency's oversight of the federal health care website, Health and Human Services Secretary Kathleen Sebelius said Thursday during a visit to Arizona that a team of government and private-sector technology experts are working around the clock to fix the problem-filled website. Following a tour of a Phoenix call center that handles enrollment and a community health center, Sebelius acknowledged that the website, Healthcare.gov, has not operated as seamlessly as she had hoped when it launched Oct. 1 (Alltucker, 10/25).

Politico: Kathleen Sebelius Hits Back At Critics
Health and Human Services Secretary Kathleen Sebelius took a swipe at those calling for her resignation over the troubled launch of the Obamacare enrollment site, saying she doesn’t work for them. “The majority of people calling for me to resign, I would say, are people who I don’t work for and do not want this program to work in the first place,” Sebelius said Thursday during a press availability, according to the Associated Press (McCalmont, 10/25).

Politico: CMS Obamacare Briefing Day One: It's Getting Better
The Obama administration’s tech “surge” to repair the Obamacare enrollment system may be more of a slow crawl — but a senior official said Thursday she’s confident the system will be running smoothly for consumers by mid-December. The agency quarterbacking the repair process told reporters Thursday that any fixes to HealthCare.gov would be “incremental.” Consumers may not even detect them (Cheney, 10/24).

Los Angeles Times: Nearly 700,000 Applications Completed At Heatlhcare.Gov, Officials Say
Nearly 700,000 applications for health insurance coverage under the Affordable Care Act have been completed, administration officials said Thursday, although they would not release data on how many people successfully enrolled in insurance plans despite problems with the online marketplace. The updated figure comes as administration officials tried to respond to complaints and finger-pointing from the contractors who built the troubled website, www.healthcare.gov (Hennessey, 10/24).

The Wall Street Journal's Washington Wire: Health-Insurance Applications Near 700,000
Nearly 700,000 Americans have completed applications for health insurance using federal and state insurance marketplaces, an Obama administration spokeswoman said Thursday, trying to parry characterizations of the health-law rollout as a failure and a disaster. Thursday was the first of what the administration says will be daily briefings by the Centers for Medicare and Medicaid Services, or CMS, the agency in charge of the problem-plagued HealthCare.gov website (Dooren, 10/24).

The Washington Post: State Insurance Boards Frustrated With Obamacare Technical Glitches
Commissioners responsible for overseeing insurance industries in states relying on the federal government to run health-care exchanges are hearing from consumers who can’t log into Web sites, and some aren’t hearing back when they call Washington for answers. At the same time, the Department of Health and Human Services says its Web site, HealthCare.gov, is working better every day. More than 700,000 applications have been completed, many through the Web site, according to a department spokeswoman (Wilson, 10/25).

The New York Times: In White House Pitches, Rosy View Of Health Care Site
Just days before HealthCare.gov went live with disastrous results, top White House officials were excitedly briefing lawmakers, reporters, Capitol Hill staff members and Washington pundits on their expectations for the government’s new health care Web site. … In fact, the rosy presentations set President Obama up for even more criticism when the portal was swamped by millions of people who quickly found out they could not log on. The technical problems that emerged have raised questions — still not entirely answered — about how much the president’s aides knew, or should have known, about the site’s troubles (Shear and Stolberg, 10/24).

The Washington Post: Maryland Shelves Educational Workshops For Small-Business Health Insurance Exchange
It isn’t just the federal health insurance exchange that is running into problems. Some of the state-run exchanges are facing their own setbacks — including the one in Maryland. State health officials, who already missed the federal government’s deadline to launch an insurance exchange for small businesses, have quietly nixed plans to hold informational sessions this month to educate employers about their soon-to-open insurance marketplace (Harrison, 10/24).

Politico: Democrats' United Front Cracks
The great Democratic unity of 2013 held for five-and-a-half days. For weeks leading up to the shutdown — and over the 16 days it dragged on — President Barack Obama did the unthinkable: he held every Democrat in the House and Senate together. There weren’t any defectors. There wasn’t even anyone running to reporters to question his strategy. The man who’d disappointed them so many times was suddenly exciting them, with his newly apparent backbone and successful resistance to Republicans. They were rushing to do whatever they could to stand by him, next to him, with him (Dovere, 10/25).

The Wall Street Journal's Washington Wire: More Democrats Seek Delay In Health-Law Penalty
More Democrats called for a delay in a core element of the federal health law, with two senators blasting the Obama administration’s rollout of a health-insurance website and its response to public criticism. Sen. Kay Hagan (D., N.C.), who is up for re-election in 2014, said in a Thursday statement that the $95 penalty on individuals who fail to enroll in a health insurance plan should be waived for two months. That penalty starts at $95 for 2014 tax returns. A few hours earlier, Sen. Richard Blumenthal (D., Conn.) said in a television interview that the U.S. needs to consider delaying the penalty, which as at the heart of the 2010 law designed to prod Americans without health insurance into buying coverage (Hughes, 10/24).

 

Politico: Senate Leaders Consider Health Exchanges
Senate leaders are beginning to make the tough choice about whether to put their staffers on Obamacare’s health insurance exchanges. Three members of Senate leadership all plan to place their aides on the health exchanges, they confirmed to POLITICO. They are: Sen. John Thune (R-S.D.), the No. 3 in GOP leadership; Sen. John Barrasso (R-Wyo.), the No. 4 among Senate Republicans; and Sen. Patty Murray (D-Wash.), No. 4 in Senate Democratic leadership and the Senate Budget Committee chairwoman (Everett, 10/24).

The Associated Press/Washington Post: Both Sides Agree: No ‘Grand Bargain’ Budget Agreement In Upcoming Congressional Negotiations
Long-standing, entrenched differences over taxes make a large-scale budget pact virtually impossible, according to lawmakers, their aides and observers who will be monitoring the talks. Republicans say they simply won’t agree to any further taxes atop the 10-year, $600 billion-plus tax increase on upper-income earners that President Barack Obama and Democrats muscled through Congress in January. Without higher taxes, Democrats say they won’t yield to cuts in benefit programs like Medicare (10/25).

The Washington Post: Lawmakers Now Focusing On Replacing Sequester Spending Cuts
But the two parties remain far apart on the question of how to replace the sequester cuts, which are scheduled to slice about $100 billion a year out of agency budgets through 2021. Democrats are insisting that even a partial replacement of the cuts — which are set to hit the Pentagon particularly hard next year — must include new revenue raised by closing tax loopholes for corporations and the wealthy. Republicans want to replace the agency cuts by trimming spending on Medicare and other long-term expenses, such as pensions for federal workers. House Speaker John A. Boehner (R-Ohio), Senate Minority Leader Mitch McConnell (R-Ky.) and on Thursday, Ryan, have ruled out new taxes, saying they would rather stick with the sequester (Montgomery, 10/24).

The Associated Press/Washington Post: CBO: Raising Medicare Eligibility Age Produces Smaller Savings Than Previously Thought
Raising the eligibility age for enrolling in Medicare won’t produce nearly the cost savings that had been assumed previously, said a new report issued Thursday. The Congressional Budget Office analysis says that phasing in an increase in the eligibility age from 65 to 67 years old would lower the budget deficit by just $19 billion over the coming decade. Savings would rise more in future years, however (10/24).

NPR: Clinics Close As Texas Abortion Fight Continues
The fight over abortion in Texas is being played out in federal court, where abortion rights activists are challenging a new state law. The measure bans abortions at 20 weeks, adds building requirements for clinics and places more rules on doctors who perform abortions. Some clinics have shut down, saying they can't comply with the law set to go into effect Oct. 29 (Lohr, 10/25).

The New York Times: Visiting Nurse Service Cuts 500 Workers
The move is new evidence of the turbulence in the home-care industry under Gov. Andrew M. Cuomo’s sweeping redesign of Medicaid, which has transferred tens of thousands of people receiving long-term help from a fee-for-service system to managed care, in an effort to save money and reduce nursing home use (Bernstein, 10/24).

The Wall Street Journal: Fight Against HIV Hits A Roadblock, New Study Shows
New research has dealt a setback to scientists' quest for a cure for HIV, finding that the virus might be harder to eliminate from the human body than previously thought. The study, published Thursday, found that the amount of potentially active HIV that lurks in infected immune-system cells could be up to 60 times as large as previously observed. That poses a major hurdle for a promising strategy researchers have hoped might one day eradicate the virus and enable HIV patients to go off therapy (Winslow and McKay, 10/24).

The Wall Street Journal: FDA Recommends New Limits On Pain Drugs
The Food and Drug Administration Thursday recommended imposing far more severe restrictions on the prescribing of the most commonly used narcotic painkilling drugs in the U.S., an effort to combat their widespread abuse. The move will fundamentally change the use of medicines taken by millions of Americans to alleviate acute pain, such as broken bones or following dental surgery (Burton and Martin, 10/24). 

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