First Edition: September 10, 2013

Today's headlines include reports from Capitol Hill about the GOP strategy to link debate of a stopgap spending bill to keep the government operating to efforts to defund the health law.

Kaiser Health News: Insuring Your Health: Consumers With Serious Medical Problems Need To Carefully Assess Total Plan Costs
Kaiser Health News consumer columnist Michelle Andrews reports: "One of the health care overhaul's most far-reaching provisions prohibits health plans from refusing to cover people who are sick or charging them higher premiums. Still, for people with serious medical conditions, the online health insurance marketplaces present new wrinkles that could have significant financial impact" (Andrews, 9/10). Read the column.

Kaiser Health News: Health Marketplaces Open For Shopping Oct. 1 (Video)
As part of a Kaiser Health News video series, consumer columnist Michelle Andrews answers a question about when a consumer must enroll in an exchange in order to start getting insurance benefits in January, 2014? (9/10). Watch the video and others from this series.

Kaiser Health News: Checking The Facts Behind Obamacare Claims
The Philadelphia Inquirer’s Robert Calandra, working in partnership with Kaiser Health News, reports: "Lori Robertson has been covering the Affordable Care Act from the earliest debates on it in 2009. A journalist for FactCheck.org, the nonpartisan nonprofit that monitors the accuracy of e-mails, viral claims, and statements by politicians, Robertson researches and writes about many statements involving the ACA. 'We fact-check all sides,' she said. Now is a hectic time for her group, part of the Annenberg Public Policy Center of the University of Pennsylvania, because the law is reaching its climactic phase. Here's a sample of statements and claims FactCheck.org has checked on Obamacare"(Calandra, 9/9). Read the story.

Kaiser Health News: Texas Outbreaks Make A Case For Vaccinations
The Texas Tribunes' Becca Aaronson, working in partnership with Kaiser Health News, reports: "A measles outbreak in a vaccination-wary North Texas megachurch and soaring rates of whooping cough across the state are drawing renewed calls for immunization legislation, which some lawmakers and medical professionals argue would help the state prevent public health crises" (Aaronson, 9/10). Read the story.

Kaiser Health News: Capsules: Law Will Shift Demographics For Medicaid, Study Finds; How Will Obamacare Affect Your Medicare Benefits?
Now on Kaiser Health News' blog, Ankita Rao reports on the changing demographics of Medicaid: "As part of the federal overhaul, some states have opted to expand in January this state-federal health insurance program for low income people to include Americans who earn as much as 138 percent of the federal poverty line (just under $16,000 for an individual in 2013). As a result, the new enrollees will include more white, male and healthy individuals than those eligible before the Affordable Care Act expansion, according to a study in the Annals of Family Medicine" (Rao, 9/9).

Also on Capsules, watch a video clip of KHN's Mary Agnes Carey on C-SPAN's Washington Journal Monday morning taking questions about how the health law will affect Medicare’s benefits (9/9). Check out what else is on the blog.

Los Angeles Times: Covered California Says Healthcare-Law Enrollment On Track For Oct. 1
California's new health insurance marketplace says online enrollment should launch Oct. 1, dismissing earlier concerns about a delay. Covered California, the state agency implementing the federal Affordable Care Act, said recent computer tests indicate that its website will be ready to take online sign-ups on schedule (Terhune, 9/9).

Los Angeles Times: Consumers Could Be Surprised At Tax Time Due To Federal Health Law
Some families may end up owing Uncle Sam a sizable refund if they accept government help on buying health insurance next year under President Obama's Affordable Care Act. A study published Monday in Health Affairs estimates that 38% of families that qualify for federal premium subsidies might have to repay some portion if changes in their household income aren't reported to the government (Terhune, 9/9).

The Washington Post’s Wonk Blog: Two Groups Quite Obamacare Outreach Program
In the face of mounting Republican opposition, two organizations have dropped out of a key Obamacare program meant to enroll millions of the uninsured in coverage. Republican legislators in Washington began investigating "navigators," the thousands of outreach workers funded by the health law, who are fanning out across the country to give Americans face-to-face help with signing up for Obamacare's new programs (Kliff, 9/9).

The Associated Press/Washington Post: Cancer Patient Stuck With Higher Bills As Obamacare Pre-Existing Condition Plan Runs Low On Cash
Coping with advanced cancer, Bev Veals was in the hospital for chemo this summer when she got a call that her health plan was shutting down. Then, the substitute insurance she was offered wanted her to pay up to $3,125, on top of premiums. It sounds like one of those insurance horror stories President Barack Obama told to sell his health overhaul to Congress, but Veals wasn’t in the clutches of a profit-driven company. Instead, she's covered by Obama's law — one of about 100,000 people with serious medical issues in a financially troubled government program (9/9).

The New York Times: In New Health Law, A Bridge To Medicare
The sweeping federal health care law making its major public debut next month was meant for people like Juanita Stonebraker, 63, from Oakland, Md., who retired from her job in a hospital billing office a year and a half ago. She was able to continue her health insurance coverage from the hospital for a time, but when she tried to find an individual policy on her own, none of the insurers she contacted would cover her because she was diabetic (Abelson, 9/9).

NPR: How Expansion Will Change The Look Of Medicaid
Starting in January, it will get a lot easier for millions of people across to the country to qualify for Medicaid. Adults making up to 138 percent of the federal poverty level ($15,856 in 2013) will be able to sign up for Medicaid, under an expansion paid for entirely by the federal government between 2014 and 2017 (Hensley, 9/9).

The Wall Street Journal: The Health-Care Overhaul: What You Need To Know
Whatever its larger merits or shortcomings, the federal health-care overhaul seems likely to benefit one demographic group in particular: the 50-plus crowd. Starting Oct. 1, state-based health-insurance exchanges created by the 2010 Patient Protection and Affordable Care Act will open for business. For those without access to insurance through work, or for the self-employed who have been buying coverage as sole proprietors, the exchanges will serve as clearinghouses for evaluating and buying health plans (Tergesen, 9/8).

Los Angeles Times: Conservative Group Pushes Its Plan To Cripple Healthcare Overhaul
With funding for government operations set to run out at the end of this month, Heritage Action, part of a coalition of conservative lawmakers and outside groups, wants Republicans to refuse to vote for a law that would authorize spending unless it also eliminates money for the healthcare law, a move that would hobble the Obama administration's efforts to launch Web-based insurance marketplaces Oct. 1 (Memoli, 9/9).

The Associated Press/Washington Post: House GOP May Link Debate Of Stopgap Spending Bill With Measure To Defund 'Obamacare'
House Republicans plan to condition a short-term spending bill for averting a government shutdown next month on making Senate Democrats vote on — but not necessarily pass — a tea party-backed plan to dismantle President Barack Obama’s health care overhaul. The move would be a partial victory for conservatives demanding a House vote to "defund 'Obamacare'" as part of any must-pass stopgap funding bill. But GOP leaders are employing an unusual procedural trick to make sure that the tea party measure doesn’t get in the way of smooth passage of a straightforward stopgap funding bill before the Oct. 1 start of the new budget year (9/9).

Politico: Obamacare Defunding Pushed Aside By Syria
Congress’s curtain came down for summer break with Obamacare defunding center stage. But as the curtain goes back up as lawmakers return, it's Syria — not defunding — in the spotlight. At noon Tuesday, some of Obamacare’s most ardent foes — Sens. Rand Paul of Kentucky, Ted Cruz of Texas and Mike Lee of Utah among them — will hold a Tea Party Patriots-sponsored rally outside the Capitol to try to reignite the defunding enthusiasm. Time is short: Obamacare enrollment starts Oct. 1 (Cunningham, 9/10).

The Wall Street Journal: House Republicans Craft Proposal To Avoid Shutdown
House Republicans on Monday prepared a plan to avoid a government shutdown this fall, while giving conservatives a fresh chance to attack President Barack Obama's signature health-care law. The proposal, to be presented to rank-and-file lawmakers as early as Tuesday, is an attempt by GOP leaders to fund government operations until mid-December and meet a key demand of conservative House Republicans, who have wanted to use a must-pass spending bill to take aim at the health-care law they continue to oppose (Boles, 9/9).

Politico: House GOP May Reuse Legislative Gambit On Obamacare
House Republicans are dusting off an old legislative gambit from April 2011 as one way to move ahead this week with a stopgap spending bill for the first months of the new fiscal year beginning Oct. 1. The goal is to give conservatives a vote on defunding health care reform without resulting in a government shutdown. It has worked before, but “before” is the operative word. And until Tuesday’s Republican Conference, Speaker John Boehner (R-Ohio) and Majority Leader Eric Cantor (R-Va.) won’t really know whether this flash from the past can flash again (Rogers, 9/10).

Politico: Mitch McConnell's Close Ties With Humana Founder
In 2005, David A. Jones Sr., founder of health insurance giant Humana Inc., needed help raising money for a Louisville, Ky., parks project he was personally overseeing. So Jones and then-Louisville Mayor Jerry Abramson — a Democrat — turned to the most powerful person in Kentucky politics: GOP Sen. Mitch McConnell. They asked McConnell for $10 million in federal funds for the project. Instead, the then-Senate majority whip came through with $38 million in a spending earmark, breaking the good news himself to Jones in a late-night phone call. Jones has also been quite helpful to McConnell; the veteran senator’s earmark came several months after it was disclosed that Jones and the charitable foundations he and his family control had donated $1.6 million to the McConnell Center at the University of Louisville, which both men attended (Bresnahan and Raju, 9/10).

The New York Times: Choices Give New Meaning to 'Home, Sweet Home'
Amy Goyer, the home and family expert at AARP, recommends that a geriatric case manager, social worker or other professional analyze the older person's needs to find the best option. AARP and the National Association of Home Builders in 2002 developed "aging in place" certification for home modifications, to teach contractors how to adapt homes. Among typical improvements are widened doorways for wheelchair access and safety features like grab bars in bathrooms (Hawthorne, 9/9).

Politico: Rite Aid Joins Promotion Effort For Obamacare
Rite Aid is joining the nationwide Obamacare education effort, announcing on Monday plans to host insurance agents in its stores in a few weeks. The pharmacy chain will invite independent, insurance agents into more than 2,000 of its stores to offer free help starting Oct. 1, the first day millions of Americans can enroll in coverage on Obamacare health insurance exchanges. All Rite Aid stores — more than 4,600 across 31 states and Washington, D.C. — will offer informational brochures about the Affordable Care Act, and the company has set up a website to educate customers (Millman, 9/10).

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