First Edition: March 24, 2013

Today's early morning highlights from the major news organizations examine the final week for health law enrollment, the Supreme Court case this week about the law's contraceptive mandate and the fourth anniversary of the enactment of the controversial overhaul.

Kaiser Health News: FAQ: What Are The Penalties For Not Getting Insurance?
Michelle Andrews, writing for Kaiser Health News, reports: "If you're uninsured, now's the time to buy a plan. March 31 is the end of the annual open enrollment period when people who don't have coverage through their employers can sign up on or off their state's marketplace. With limited exceptions, people who miss this enrollment window will be unable to sign up for health insurance until next fall for coverage that starts in January 2015. In addition to being uninsured, they'll face a penalty for not having coverage. The fine may be bigger than they expect. Here are the details" (Andrews, 3/24).

Kaiser Health News: Draft Rules Would Help Protect Seniors When Medicare Advantage Plans Drop Doctors
Susan Jaffe, writing for Kaiser Health News in collaboration with The Washington Post, reports: "Federal officials are considering new Medicare Advantage rules to help protect seniors when insurers make significant reductions to their networks of doctors and other health care providers. The proposals follow UnitedHealthcare's decision to drop thousands of doctors from its Medicare Advantage plans in at least 10 states last fall" (Jaffe, 3/24).

Kaiser Health News: Connecticut Customers Rush To Retail Store To Buy Insurance
WNPR's Jeff Cohen, working in partnership with Kaiser Health News and NPR, reports: "Mike Dunn stands inside a store in downtown New Haven, Conn., looking through the big glass windows at his future customers outside. He's not selling phones or food or clothes. He's selling Obamacare. There's one week left to get health insurance through the Affordable Care Act marketplaces, and states have gone to great lengths to enroll as many people up as possible. In Connecticut, the exchange has opened two retail storefronts where people can walk in and sign up" (Cohen, 3/24).

Kaiser Health News: Capsules: AHIP President Calls For New Level Of Insurance Under Health Law
Now on Kaiser Health News' blog, Mary Agnes Carey reports: "A new tier of coverage should be added to the health law's online marketplaces, or exchanges, that would be less comprehensive than what plans are now required to offer, the head of the health insurance industry's trade group said Sunday" (Carey, 3/24).

The Wall Street Journal: Are Firms Entitled To Religious Protections?
Tuesday's Supreme Court hearing will be the second time the health law will be scrutinized by the justices. At issue is whether for-profit companies such as Hobby Lobby are entitled to the same religious protections as people or churches. Hobby Lobby covers most forms of contraception in its health plan, including the pill and sterilization. It objects to a requirement that it include certain emergency contraceptives and intrauterine devices, which Hobby Lobby's owners consider a form of abortion. The case is distinct in a couple of ways from legal challenges to the law brought by some Catholic schools and charities, now winding their way through lower courts (Adamy, 3/21).

The Washington Post: High Court With Vocally Devout Justices Set To Hear Religious Objections To Health-Care Law
There's something that makes the current Supreme Court different from some of its recent predecessors. The justices got religion. Or at least they seem more open about their faith, appearing before devout audiences and talking more about how religion shaped their lives or guides them now. As the court this week weighs religious conviction vs. legal obligation in the latest challenge to the Affordable Care Act, those who study the court say the change is hard to quantify but easy to notice (Barnes, 3/23).

The Washington Post: Even While Overseas, The Obamas Urge Americans To Get Covered
While Barack and Michelle Obama will be overseas this week, the White House is ensuring they will have a virtual presence in targeted media markets across the country before the Affordable Care Act's initial enrollment period ends March 31. ... The Obama administration has devoted most of its outreach efforts for the past several months on a handful of constituencies: young people, women and Hispanics, often in the two dozen U.S. cities that have a disproportionately high numbered of uninsured residents. In many ways, the approach mirrors what Obama's staff did during his two presidential campaigns, where they used local and niche media outlets to reach targeted voting blocs (Eilperin, 3/23). 

The Wall Street Journal: Worries Over Fines Aid Health-Insurance Sign-Ups
In launching the Affordable Care Act, the Obama administration has emphasized the appeal of inexpensive insurance policies and financial subsidies to lure people to new online marketplaces. But what seems to be motivating many as the final deadline for signing up looms is more the fear of financial penalties (Radnofsky, 3/23).

The Associated Press: Millions On The Sidelines For Big Health Care Push
Millions of people in the United States will remain uninsured despite this week's final, frenzied push to sign them up under the health law. Their reasons are all over the map. Across the country, many of the uninsured just don't know much about the health overhaul and its March 31 deadline for enrolling in plans that can yield big discounts, researchers say. ... But the complexities of the Affordable Care Act can stymie even the well-informed (Cass, 3/23).

The New York Times: Names Of Health Plans Sow Customer Confusion
As Americans race to sign up for health insurance in the final days of open enrollment, many consumers and consumer advocates say the names of plans are unhelpful, confusing and in some cases misleading. A number of insurers sell their plans under names like Select, Preferred, Premier, Exclusive, Enhanced, Essential, Essential Plus, Prime, Ultimate and Deluxe. Multiple offerings from one company may have the same benefits and cover the same share of a consumer's costs, but go by different names (Pear, 3/22).

Politico: Obamacare Enrollment Rides A Bus Into The Mississippi Delta
In the poorest state in the nation, where supper is fried, bars allow smoking, chronic disease is rampant and doctors are hard to come by, Obamacare rolls into town in a lime green bus. It took some real convincing by the Obama administration and a leap of faith by one state Republican official to get one of the nation's largest insurance companies -; Humana -; to set up shop across Mississippi. Virtually no other insurer was willing to do so, discouraged by the acute health needs here and most elected officials' outright hostility to the law. Four months and more than 200 bus stops later, enrollment numbers here remain dismal. Only 9 percent of the state's Obamacare-eligible population have signed up, putting it near the bottom of yet another national statistic (Haberkorn, 3/22).

USA Today: Voices: Afraid To Apply For Health Care For Their Kids
For Esperanza Cuevas, the phone call has become disturbingly common. Undocumented immigrants balk at registering their U.S.-born children under the Affordable Care Act, because they fear furnishing the information will lead to their deportation (Gomez, 3/23).

The Hill: Dems Ramp Up Offense On ObamaCare
The White House and congressional Democrats are ramping up a coordinated effort to celebrate ObamaCare's fourth anniversary this weekend, looking to go "on offense" ahead of the final week of open enrollment. The effort includes a social media campaign by members of Congress and administration officials, enrollment events featuring lawmakers and Senate floor speeches marking the four-year anniversary. The tightly coordinated final push was the result of work between the White House and House and Senate "healthcare strike teams," which were created in the aftermath of the botched ObamaCare rollout to push back against a flood of bad headlines. The White House has provided members of Congress with packets that detail state-by-state benefits of the law, and what the cost of repeal would mean for constituents within their districts (Sink and Viebeck, 3/22).

NPR: Health Law's 4th Birthday Divides Democrats, Unites GOP On Message
With the fourth anniversary of President Obama's signing of the Affordable Care Act this weekend, if you were a Democrat boasting about the health law, you were more than likely a party official or lawmaker with a seat so safe you could publicly celebrate the occasion. ... Meanwhile, Republican lawmakers, and even GOP candidates not in Congress but hoping to get there, are observing the anniversary with events that underscore the long-running Republican message: The health law is causing more harm than good (James, 3/21).

Los Angeles Times: After Setbacks, Tea Party Members Vow To Reinvent Movement
Five years after it emerged as the most potent force in conservative American politics since the Reagan revolution, the tea party is at a crossroads -; and some critics have declared the movement all but dead. Insisting that they've learned from the setbacks, however, stalwarts are vowing to reinvent their defiant brand of politics to ensure they stay part of the debate in Washington and particularly in the Republican Party. ... And they plan to take the fight to repeal Obamacare to the state level, pushing legislatures to enter into interstate health compacts that they say would allow states to ignore federal regulations and enact their own reforms. Though dismissed as a long shot by some, proponents hope the strategy will render the Affordable Care Act inoperable in those states and give compact members control over federal healthcare dollars (Memoli, 3/23).

The Washington Post: Virginia Lawmakers Return To Richmond To Try To Break Impasse Over Medicaid Expansion
Virginia's pitched battle over Medicaid expansion returns to the Capitol on Monday with no indication that Gov. Terry McAuliffe is any closer to a deal on his top priority. Two weeks after an impasse over Medicaid prevented passage of a two-year, $96 billion budget, the legislature is coming back to Richmond to try again in a special session (Vozzella, 3/22).

The New York Times: Virginia Governor Finds Jollity Is No Guarantee Against Gridlock
The sticking point forcing the special session is Mr. McAuliffe's desire to expand Medicaid to up to 400,000 of Virginia's poor and disabled under the Affordable Care Act. The proposal was a centerpiece of his campaign last year and his top priority in office, and on Thursday at a clinic in the Washington suburbs that serves the uninsured, he was unequivocal. "I promise you in this room we will get this done this year," he told patients, doctors and administrators at Alexandria Neighborhood Health Services. His opponents are just as dug in, noting that in the three weeks since Republicans defeated expansion in a test vote in the House, 67 to 32, there have been no defections on their side (Gabriel, 3/23).

The Washington Post: Biden: GOP Governors Will Eventually Take Medicaid Expansion
Vice President Biden predicted Friday that Republican governors who have declined the federal Medicaid expansion will eventually be forced to reverse course and take the expansion because of political pressure. Speaking to the National Association of Community Health Centers in Washington, Biden criticized the GOP governors who have declined the extra funding but said he expects them to come around. "I'm convinced, as a practitioner of the so-called art of politics, that they ... will not be able to sustain the heat," Biden said. (Blake, 3/21).

The Associated Press: Obamacare Plans Bring Hefty Fees For Certain Drugs
Breast cancer survivor Ginny Mason was thrilled to get health coverage under the Affordable Care Act despite her pre-existing condition. But when she realized her arthritis medication fell under a particularly costly tier of her plan, she was forced to switch to another brand. Under the plan, her Celebrex would have cost $648 a month until she met her $1,500 prescription deductible, followed by an $85 monthly co-pay. Mason is one of the many Americans with serious illnesses -; including cancer, multiple sclerosis and rheumatoid arthritis -; who are indeed finding relatively low monthly premiums under President Barack Obama's law. But some have been shocked at how much their prescriptions are costing as insurers are sorting drug prices into a complex tier system and in some cases charging co-insurance rates as high as 50 percent. That can leave patients on the hook for thousands (Kennedy, 3/22).

The Wall Street Journal: Expect Health-Insurance Premiums To Rise
You could continue to see prices increasing this year for your health-care coverage. Several recent studies point to provisions in the Affordable Care Act-;such as the requirement that insurers cover sick individuals as well as preventive care, like mammograms-;that could lead to higher prices, at least in the short term. The underlying cost of care itself, meanwhile, continues to rise at a steady clip (Johnson, 3/22).

NPR: Insurance Chief Suggests Adding A New, Lower Level Of Health Plan
Rather than letting people keep their old health plans that don't comply with the new requirements of the Affordable Care Act, the head of the group that represents the nation's health insurance companies is floating an alternative: weakening the requirements. "If you take 10 categories of coverage," said Karen Ignagni, president and CEO of America's Health Insurance Plans, in an interview taped for C-SPAN's Newsmakers, "no matter how meritorious each and every one of those benefits may be ... you have a giant step up" from what many people had before, and wanted to pay for (Rovner, 3/21).

The Washington Post: For Some Who Are Married But Filing Taxes Separately, Another Healthcare.Gov Hurdle
In May 2012, when the Internal Revenue Service proposed its rules for Americans to get government subsidies for health insurance, officials acknowledged that a legal quirk needed to be fixed: The Affordable Care Act was written in a way that inadvertently denied such help to some people who live apart from spouses who abuse them, are in prison or are on the cusp of a divorce. The problem is that the law's authors, in creating tax credits to help pay for health plans bought through the new insurance marketplaces, had overlooked the fact that some married people file their tax returns separately (Goldstein, 3/23).

The New York Times: Lawmakers Attack Cost of New Hepatitis Drug
A new drug to treat hepatitis C that costs $1,000 a pill has caused rising concern among insurers and state Medicaid programs. It has now also spurred interest from Democratic congressmen whose queries about the drug prompted a sell-off in biotechnology stocks on Friday. Three Democratic members of the House Energy and Commerce Committee have demanded that Gilead Sciences, the developer, justify the price of its drug, which is called Sovaldi (Pollack, 3/21).

Los Angeles Times: Gilead Sciences' $84,000 Price For Hepatitis Drug Is Scrutinized
U.S. lawmakers have asked Gilead Sciences Inc. to justify the price of its new $84,000 drug for hepatitis C patients amid growing concern about the high cost to taxpayers and consumers. In a letter to the Foster City, Calif., company, Rep. Henry A. Waxman (D-Beverly Hills) and two other Democratic lawmakers asked Gilead Chief Executive John C. Martin to explain the rationale for selling Sovaldi for $1,000 per pill (Terhune, 3/21).