First Edition: October 8, 2013

Today's headlines include the latest on how the health law's online insurance marketplaces are operating and what caused the initial systemic problems.

Kaiser Health News: Insuring Your Health: Consumers Shopping For Health Policies Outside The Marketplaces May Be Confused By Mix Of Plans Offered
Kaiser Health News consumer columnist Michelle Andrews writes: "The state health insurance marketplaces that opened Oct. 1 give consumers who are looking for coverage on the individual market a whole new way to shop for health plans. At the same time, health insurance brokers and insurers will also continue to sell plans directly to customers. Sorting out who's selling what can be confusing" (Andrews, 10/8). Read the column.

Kaiser Health News: Costliest 1 Percent Of Patients Account For 21 Percent Of U.S. Health Spending
Reporting for Kaiser Health News, in collaboration with The Washington Post, Sandra G. Boodman writes: "A 58-year-old Maryland woman breaks her ankle, develops a blood clot and, unable to find a doctor to monitor her blood-thinning drug, winds up in an emergency room 30 times in six months. A 55-year-old Mississippi man with severe hypertension and kidney disease is repeatedly hospitalized for worsening heart and kidney failure; doctors don't know that his utilities have been disconnected, leaving him without air conditioning or a refrigerator in the sweltering summer heat. A 42-year-old morbidly obese woman with severe cardiovascular problems and bipolar disorder spends more than 300 days in a Michigan hospital and nursing home because she can't afford a special bed or arrange services that would enable her to live at home" (Boodman, 10/7). Read the story.

Kaiser Health News: Capsules: Report: Even States Not Expanding Medicaid Will See Surge In Spending, Enrollment; Addressing A Dangerous Epidemic: Abuse Of Painkillers And Other Prescription Drugs; Why Some Veterinarians Have a Bone To Pick With Obamacare
Now on Kaiser Health News' blog, Phil Galewitz reports on a new 50-state Medicaid budget survey: "Enrollment is expected to surge by nearly 12 percent next year in states expanding the program under the health law, but even states that will not expand eligibility project a 5 percent jump in the number of people enrolled in the state-federal health insurance program for the poor, according to a new report issued Monday" (Galewitz, 10/7).

Also on the blog, Ankita Rao reports on state efforts to curb abuse of painkillers and other prescription drugs: "About 50 Americans die every day from a prescription drug overdose -; a tally that, in most states, turns out to be more than deaths from car accidents. In a new report, 'Prescription Drug Abuse: Strategies to Stop the Epidemic,' researchers at the Trust for America's Health found that rates of overdose and addiction doubled since 1999 in most states. In West Virginia -; the state with the highest number of drug overdose deaths -; the rate was six times higher than fourteen years ago" (Rao, 10/7).

In addition, Galewitz also reports on an emerging issue between veterinarians and the health law: "The law's 2.3 percent medical device tax, which started this year, was meant to have device manufacturers and their buyers contribute to the cost of expanding health coverage because they would benefit from having more business from insured patients. But some devices used on humans are also used for animals, including ultrasound machines, laboratory and X-ray equipment. So as a result, veterinarians have to pay the extra tax as well" (Galewitz, 10/8). Check out what else is on the blog.

The New York Times: Health Exchange Delays Tied To Software Crash In Early Rush
The technical problems that have hampered enrollment in the online health insurance exchanges resulted from the failure of a major software component, designed by private contractors, that crashed under the weight of millions of users last week, federal officials said Monday (Shear and Pear, 10/7).

The Associated Press/Washington Post: Insurers, Others Say There's Still Time To Fix Online Glitches In 'Obamacare'
The federal government's biggest foray into online commerce has left millions of tech-savvy Americans thoroughly bewildered. But the insurance industry and others experienced with rolling out new programs say there's still enough time to fix the glitches with President Barack Obama's health care law before uninsured people start getting coverage on Jan. 1 (10/8).

Politico: Obamacare Exchange Websites Still Full Of Glitches And Errors
The second week of Obamacare enrollment started a lot like the first: with error messages. Glitches continued crippling online enrollment in new Obamacare exchanges on Monday, despite assurances by the White House that the consumer experience would markedly improve this week (Cheney and Millman, 10/7).

USA Today: Health Care Exchanges Working Out Kinks A Week Later
A week after the launch of the health insurance exchanges that are the centerpiece of the health care law, the federal and state-run sites are working out the bugs. Technical difficulties are keeping many people from enrolling or even from setting up accounts. Though consumers, including Busch, are frustrated, administration officials and state spokespeople say the sites were overwhelmed by demand, problems are being addressed, and there will be plenty of time for people to sign up once the bugs are worked out (O'Donnell and Kennedy, 10/8).

Los Angeles Times: California Health Exchange Looks To Speed Up Enrollment In Week 2
After a weekend tune-up, California's health insurance exchange will try to overcome first-week glitches that frustrated many consumers trying to sign up under Obamacare. The state marketplace, called Covered California, shut down its online enrollment system Saturday night through early Monday morning for what it described as "regular maintenance" (Terhune, 10/7).

The Associated Press/Washington Post: Online Health Marketplace Improving In Md., But Some Technical Issues Still Being Dealt With
Officials say more than 13,000 residents have created accounts on Maryland's online marketplace for health insurance. But technical issues remain in using Maryland Health Connection, the state-based health insurance marketplace, officials said Monday (10/7).

The Wall Street Journal's Washington Wire: Maryland Says It Has 326 Enrollees In Health Exchange
That number is one of the few trickling out about enrollment in the new health-insurance exchanges created by the 2010 Affordable Care Act, or Obamacare. The federal government, which is operating exchanges on behalf of 36 states, hasn't given enrollment numbers yet for its HealthCare.gov exchange, which, as The Wall Street Journal reported today, has been plagued by design and software problems (Landers, 10/7).

The Wall Street Journal's Washington Wire: Minnesota Health Exchange Reports ID Problems
A Minnesota official said the state's insurance website, MNsure, is being hampered by new troubles with the federal government's identify verification system that's needed to create an account to buy health insurance. April Todd-Malmlov, MNsure's executive director, didn't elaborate on what the exact problem was but said late Monday that it "appears to be a different issue" than one prevented many consumers from setting up an account late last week. She said MNsure staff is currently trying to figure out the details of the new problem with the federal government but said it appears related to a system update installed over the weekend meant to fix the original glitches (Dooren, 10/7).

The Washington Post: California Aggressively Pushes Health-Care Law
Fliers and tablet computers in hand, a small team of outreach workers from a local nonprofit health clinic blanketed a shopping strip east of Los Angeles, spreading the word about the state's expanding health insurance landscape under Obamacare. Stopping passersby on the sidewalk as they ducked in and out of the row of discount stores and easy-credit furniture shops at the Valley Mall, the workers assured them that the changes would put health insurance within the reach of more Californians. The mostly Latino shoppers seemed intrigued, but they also were skeptical. They worried about the penalties imposed on those without insurance. They worried about the cost of policies. And they did not know where and how to sign up (Fletcher, 10/7).

The New York Times: Senate Leaders Mull Raising Debt Ceiling In Challenge To House
Senate Democratic leaders will move forward this week on a measure to raise the government's legal borrowing limit without any policy strings attached, answering House Republicans' taunts that Democrats would not force their politically vulnerable senators to cast that difficult vote. … Mr. Boehner told the ABC News program "This Week" that the House could not pass federal financing for the fiscal year that began last Tuesday without measures limiting Mr. Obama's health insurance law, the Affordable Care Act. House Democrats and some moderate Republicans say that a bipartisan majority does exist, but that Mr. Boehner refuses to defy Tea Party conservatives and hold a vote on the Senate-passed measure (Weisman and Calmes, 10/7).

Politico: Is Obamacare Still The Point?
Suddenly, even as everyone in Washington focuses on the government shutdown and debt ceiling standoff, fewer than ever want to talk about the issue that launched those fights in the first place: Obamacare. President Barack Obama and his aides are painting GOP leaders as hostage takers and suicide bombers over their shutdown and debt ceiling strategy. House Republicans are pushing the idea that Obama and Democrats are intransigents who refuse to engage in civil discourse on a solution. Senate Democrats are hammering Speaker Boehner with the president's call for a House vote on a clean funding bill. And everyone wants to talk about how shutdown pain is hitting home for ordinary Americans (Epstein, 10/7).

NPR: Delaying Aging May Have A Bigger Payoff Than Fighting Disease
Curing cancer and eliminating heart disease has been the holy grail of medical research. But there could be even greater benefits if aging itself could be delayed, a study finds. This is not quite as farfetched as it sounds. While the anti-aging "cures" being marketed these days are largely snake oil, in the laboratory scientists have managed to extend the lives of laboratory animals. And they have a better understanding of the mechanisms of biological aging (Jaffe, 10/7).

The New York  Times: Jesuit Campus To End Coverage For Elective Abortions
The trustees of Loyola Marymount University, a Jesuit university in Los Angeles, voted Monday to eliminate coverage for elective abortions from the health care plans offered to faculty and staff members in 2014 (Lovett, 10/7).

Politico: Cal State System Pushes Obamacare For Students
If California -; with its huge, diverse population of uninsured residents -; is a test for Obamacare in the United States, then the California State University system is a test for Obamacare in California. The university's 437,000 students hit a demographic sweet spot for the health care law. The system serves a large number of young adult students, too old for their parents' insurance but still young enough to be the healthy, uncomplicated clients insurance companies need. Nonwhite students make up about two-thirds of the student body, and a third are Hispanic or Latino -; another group the administration is counting on to get coverage through the Affordable Care Act (Nelson, 10/8).