First Edition: September 20, 2013

Today's headlines include the latest on the Capitol Hill hijinx surrounding efforts to defund the health law and avert a government shutdown. 

Kaiser Health News: Health On The Hill: Health Law Caught In The Middle Of Budget Fight
Kaiser Health News staff writer Mary Agnes Carey talks with Politico Pro's Jennifer Haberkorn about recent Capitol Hill happenings. Specifically, with implementation of major provisions of the law looming, Republicans see this fall's budget showdown as their last chance to slow or stop the president's signature legislation from taking effect (9/19). Listen to the interview or read the transcript.

Kaiser Health News: FAQ: Obamacare And Coverage For Immigrants
Kaiser Health News staff writer Julie Appleby reports: "The U.S. is home to more than 21 million immigrants who are not citizens, and for many of them, health coverage is a concern. That is partly because so many of them--both those who came here legally and those who do not have permission to live in the United States--work in low wage jobs that don't include health coverage" (Appleby, 9/19). Read the story.

Kaiser Health News: In Most States, Policies Will be Sold Outside The Health Law Marketplace (Video)
Kaiser Health News consumer columnist Michelle Andrews helps you navigate the new insurance marketplaces that are scheduled to launch on Oct. 1. Today she answers a question about where consumers can buy health coverage (9/20). Watch this video or others in the series.

Kaiser Health News: Capsules: Census: More Than 850,000 Texas Kids Lack Health Coverage
Now on Kaiser Health News' blog, The Texas Tribune's Becca Aaronson, working in partnership with KHN, reports: "Texas continued to have the highest rate of people without health insurance in 2012 at 24.6 percent, or more than 6 million residents, according to the Current Population Survey estimates released by the U.S. Census Bureau this week. Texas also has the largest number of children without health insurance and the highest rate of poor adults without health insurance, according to 2012 American Community Survey estimates" (Aaronson, 9/20). Check out what else is on the blog.

The Associated Press/Washington Post: Showdown: House To Vote On Stopgap Funding Bill That Seeks To Derail Obama's Health Care Law
Congressional Republicans struggled to tamp down a family feud Thursday as they approached a politically charged showdown with the White House that combines the threat of a government shutdown, a possible first-ever federal default and the GOP's bid to repeal the nation's three-year-old health care law (9/19).

Los Angeles Times: GOP Steps Up Its Vow To Kill Obama's Healthcare Law
House Speaker John A. Boehner on Thursday promised a "big victory" when the chamber votes to defund President Obama's healthcare law as part of a must-pass bill to keep the government running. But it may be short-lived: The White House has promised a veto. Republicans in Congress believe the American people are on their side as they head toward Friday's vote, using the threat of a government shutdown on Oct. 1 to force the president to undo his signature healthcare law. They insist opposition to the Affordable Care Act will force Obama to change course (Mascaro, 9/19).

Politico: House Might Nix Obamacare Subsidies In CR
House GOP leaders are warning they may not simply just take up a continuing resolution funding government operations if Senate Democrats strip out language defunding Obamacare. Instead, House Republicans could either sit on the bill -; which is unlikely, as that would lead to a government shutdown -; or insert other, more onerous provisions into the $986 billion continuing resolution or CR, and then send that revised package back to the Senate (Bresnahan, 9/19).

The Wall Street Journal's Washington Wire: Obama Issues Veto Threat On GOP Budget Bill
The White House on Thursday said President Barack Obama would veto a bill from House Republicans that would fund federal agencies into the new fiscal year but also strip all money from his signature health care law. The White House budget office said the administration strongly opposes the Republican bill's effort to hamper the health law, saying the bill "advances a narrow ideological agenda that threatens our economy and the interests of the middle class" (Favole, 9/19).

Los Angeles Times: Government Shutdown Is No Idle Threat
The opening round of the fight comes Friday with a vote in the House. … Moreover, the fight has morphed from a straightforward battle between Republicans and Democrats into a three-way brawl in which the GOP congressional leadership must contend not only with the White House, but with conservative insurgents in their own ranks. House Speaker John A. Boehner (R-Ohio) presides over an uneasy coalition of Republican regulars and tea-party-backed conservatives. The conservatives, rallying to the demand to "defund Obamacare," have insisted that the GOP refuse to keep the government financed unless the White House and the Democratic majority in the Senate agree to block President Obama's healthcare law. The administration plans to roll out new online health insurance marketplaces -; a key part of the new law -; on Oct. 1 (Lauter and Mascaro, 9/19).

The New York Times: Conservatives Take Turns Standing Up To The Speaker
Those in the circle of fiery House conservatives who are spearheading a fiscal showdown that threatens to shut down the government see themselves in vaunted company. "It only takes one with passion -; look at Rosa Parks, Lech Walesa, Martin Luther King," said Representative Ted Yoho of Florida, one of the rank-and-file House Republicans who have risen up to challenge their party's leadership over whether to confront the Senate and President Obama with their demands to cut off funding for the president's health care law. "People with passion that speak up, they'll have people follow them because they believe the same way, and smart leadership listens to that" (Parker and Weisman, 9/19).

The Wall Street Journal: Spending Battle Set For The Senate
The Senate began girding for a contentious fight over a bill to fund the government after conservatives on Thursday threatened to use delaying tactics in an effort to eliminate money for the new federal health-care law. The vow from Sen. Ted Cruz (R., Texas), a leading foe of the health law, pointed to a protracted and uncertain Senate battle that could drag Congress close to the Oct. 1 deadline for avoiding a partial government shutdown (Hook and Peterson, 9/19).

Los Angeles Times: Cruz Vows To Do 'Everything Necessary' To Defund Health Law
Sen. Ted Cruz (R-Texas) vowed to do "everything necessary and anything possible" to ensure passage of legislation that would strip the new healthcare law of some of its funding, assuring House Republicans of his full support for a strategy that could risk a government shutdown. At a news conference Thursday, Cruz locked arms with House Republicans who have championed the "defund Obamacare" strategy, one day after conservative lawmakers bristled at a statement Cruz issued that acknowledged Republicans had little chance of succeeding in the Senate (Memoli, 9/19).

Politico: Ted Cruz In Middle Of GOP Civil War
Ted Cruz is in the middle of an escalating GOP civil war on Obamacare, a risk that could turn into a major public relations debacle for the prospective presidential hopeful. For the past few months, Cruz has been riling up the right, urging Republicans to use a government funding bill as leverage to defund Obamacare. But given Democratic control of the Senate and White House -; and growing Republican reticence about shutting down the government -; even Cruz's GOP supporters acknowledge there's virtually no chance his tactics will succeed (Raju, Everett and Sherman, 9/19).

The Washington Post: Rand Paul: Filibuster May Not Stop Obamacare Funding
Sen. Rand Paul (R-Ky.) on Thursday defended "Defund Obamacare" supporters in the Senate, who have come under criticism from House Republicans for suggesting they may not be able to stop a budget that includes funding for Obamacare. Paul noted that even his 13-hour filibuster against the Obama administration's drone policies wasn't able to stop the Senate from approving the nomination of CIA director John Brennan (Blake, 9/19).

Politico: John McCain: Defund Effort 'Not Rational'
Sen. John McCain said Thursday that it is "not rational" to think the Senate will vote to defund Obamacare. "In the United States Senate, we will not repeal, or defund, Obamacare. We will not. And to think we can is not rational," McCain said on CNN's "The Lead with Jake Tapper" (Arkin, 9/19).

The Washington Post: Scott Walker Opposes Government Shutdown Over Obamacare
Wisconsin Gov. Scott Walker (R) has been an outspoken opponent of Obamacare, challenging its constitutionality in court and rejecting federal funds to expand Medicaid under the program. But that doesn't mean he backs the current House GOP strategy to risk shutting down the government over the issue (Eilperin, 9/19).

The Washington Post: Obama, Bill Clinton To Tout Health Care Law  In New York
For the second time this month, President Obama will enlist the previous Democratic occupant of the White House in his push to publicize the benefits of his landmark health care law. On Tuesday in New York, Obama will attend the Clinton Global Initiative hosted by former president Bill Clinton, where the two will engage in "a conversation about the benefits and future of health care reform in America and access to quality health care around the globe," White House press secretary Jay Carney said (Nakamura, 9/19).

The Wall Street Journal: Pricing Glitch Afflicts Rollout Of Online Health Exchanges
Less than two weeks before the launch of insurance marketplaces created by the federal health overhaul, the government's software can't reliably determine how much people need to pay for coverage, according to insurance executives and people familiar with the program (Weaver, Martin and Dooren, 9/19).

The Associated Press/Washington Post: Small Businesses Rush To Renew Health Policies In 2013, Avoid Higher Prices Under ACA
Many small businesses have found a way to temporarily sidestep some of the headaches brought on by the new health care law. One of them is Huber Capital Management. The asset management firm is renewing its health insurance policy early, in 2013 instead of 2014. By renewing its policy this year, the company doesn't have to buy insurance that conforms to the requirements of the new health care law. And it won't have the surge in premium rates expected under the Affordable Care Act (9/19).

The Wall Street Journal's Washington Wire: Senators' Plea To OMB: No Carve Out For Union Health Plans
Adding insult to injury? A group of 21 Republican senators urged the Office of Management and Budget not to approve any regulations that would provide a special "carve out" to union-sponsored health plans under the Affordable Care Act. In a blow for unions, the White House already said late Friday that it can't legally make the primary change unions want to the new health-care law. For months, unions have been warning that the law could cause millions of their members who get health insurance under multiemployer plans  to  lose their coverage (Trottman, 9/19).

The New York Times' The Caucus: 'Creepy Uncle Sam' Is Anti-Health Care Law Mascot
A group seeking to persuade young people to "opt out" of President Obama's health care law posted videos on YouTube Thursday that show young patients on exam tables recoiling in fear as a character the group is calling "Creepy Uncle Sam" appears out of nowhere and looms over them. The group, Generation Opportunity, said in a news release that the videos were part of a new, six-figure campaign to educate people between the ages of 18 and 29 about "alternatives to expensive and creepy Obamacare exchanges" (Goodnough, 9/19).

The Wall Street Journal's Washington Wire: Blowback Swift For Creepy 'Uncle Sam' Anti-Obamacare Ad
A controversial new online anti-health law ad depicting a cartoonish "Uncle Sam" as a malevolent gynecologist is -; predictably -; becoming the focus of the latest dust-up between supporters and opponents of the Obama administration. The video, by a group called Generation Opportunity that describes itself as a "national, non-partisan youth advocacy organization," encourages young people to "opt out" of a health law rather than letting "government play doctor" on a woman in stirrups (Radnofsky and Schatz, 9/19).

USA Today: Koch-Based Group Launches New Attack On Health Care Law
A conservative group backed by billionaire brothers Charles and David Koch will launch a new round of advertising Thursday to attack President Obama's health care law, less than two weeks before enrollment opens for new health care exchanges (Schouten, 9/19).

Los Angeles Times: High Court May Take Up Religious Challenge To Birth Control Coverage
The Obama administration set the stage Thursday for another Supreme Court showdown on the president's healthcare law, this time to decide whether for-profit companies can be forced to provide full contraceptive coverage for their employees despite religious objections from their owners. The administration's lawyers asked the justices to take up the issue this fall to decide whether these corporations can claim a religious exemption to this part of the healthcare law (Savage, 9/19).

The Wall Street Journal's Risk & Compliance Journal: Supreme Court Asked To Hear Health-Law Challenge
Lawyers for one of the businesses challenging the federal health law's contraception coverage requirements asked Supreme Court to hear their case Thursday, in the first of dozens of religious lawsuits against the provision to reach the top court (Radnofsky, 9/19).

Politico: DOJ To SCOTUS: Settle The Contraception Fight, Already
The Obama administration on Thursday asked the Supreme Court to revisit Obamacare -; this time to decide whether it can require employers to provide access to contraceptives. The move increases the odds that the high court will step in to settle the explosive issue once and for all -; because the justices don't like to say no to the White House (Haberkorn, 9/20).

The Wall Street Journal: Home Depot Alters Insurance For Part-Timers
Home Depot Inc. plans to end health-care coverage for almost 20,000 part-time employees, instead directing them to government-sponsored insurance exchanges. The Affordable Care Act-;President Barack Obama's health-care overhaul -;precludes the company from offering the limited-liability plans that part-time workers currently receive, said spokesman Stephen Holmes. The change will affect nearly 20,000 people, which is about 5% of the company's work force, Mr. Holmes said (Beckerman, 9/19).

NPR: Report: Cases Of Elderly Dementia To Nearly Triple By 2050
By the middle of the century, the number of older people suffering from Alzheimer's and other forms of dementia will nearly triple, severely straining caregiving resources, the charity Alzheimer's Disease International says in a new study released Thursday (Neuman, 9/19).

The Associated Press/Wall Street Journal: 25 NJ, NY, Pa. Hospitals To Share Some Resources
Twenty-five hospitals in three states have agreed to research and share ideas about what works in a new health care alliance. AllSpire Health Partners announced its plans Wednesday night, saying the idea is designed in reaction to President Barack Obama's health insurance overhaul. The group says it can improve care and lower costs (9/19).