First Edition: November 14, 2013

Today's headlines detail the online health insurance enrollment numbers released yesterday by the Obama administration and examine what might happen next. 

Kaiser Health News: Will Low Online Enrollments In The Fall Hobble The Health Law?
Kaiser Health News staff writers Jay Hancock and Phil Galewitz report: "Hope that the health law's online insurance marketplaces will work well enough to enroll millions this fall had already faded before the administration disclosed results Wednesday. News that only 27,000 had signed up for private coverage on the federally run marketplaces through October amplified the doubts" (Hancock and Galewitz, 11/14). Read the story.

Kaiser Health News: Capsules: Strange Pricing Details Can Bedevil Medicare Beneficiaries;
California Bright Spot In Obamacare, Makes Up One-Third Of All Marketplace Enrollees
Now on Kaiser Health News' blog, Susan Jaffe reports on this Medicare pricing issue: "Pharmacist Gina Upchurch knows all the ins and outs of the Medicare prescription drug benefit and was sure she discovered something very wrong:  using the government’s online plan finder tool to help seniors compare dozens of 2014 drug policies, she noticed that some insurers charge higher prices for a prescription filled every two or three months compared to the same drug bought every month" (Jaffe, 11/13).

Also on the blog, Anna Gorman reports on California’s enrollment numbers: "Nearly 60,000 Californians have enrolled in insurance plans under the nation’s health law since its launch on Oct. 1, officials from the state’s marketplace announced Wednesday" (Gorman, 11/14). Check out what else is on the blog.

The Washington Post: For Obama, Loss Of Trust Over Health-Care Law Poses Major Problems for His Agenda, Legacy
Essential elements of Brand Obama in 2008 were trustworthiness and competence, virtues the candidate used to contrast himself with his predecessor, George W. Bush. Obama promised honesty in foreign policy — no unfounded claims of weapons of mass destruction to justify a military invasion. He pledged precision in governing — no Hurricane Katrinas. … But his likability among the general public has fallen sharply in recent weeks amid the self-inflicted problems with implementation of his health-care law (Wilson, 11/13).

The New York Times: Only 106,000 Pick Health Insurance Plans In First Month
Only about a fourth of the new enrollees — 26,794 — signed up through HealthCare.gov, the problem-plagued federal exchange, according to figures released by the Centers for Medicare and Medicaid Services. A much larger number, 76,319, signed up through the 14 state-run marketplaces (Stolberg and Craig, 11/13).

Los Angeles Times: Obamacare Enrollments Far Below Targets
Newly released figures show enrollments for coverage under President Obama's healthcare plan fell far below official projections, underscoring the damage inflicted by the botched rollout and further endangering the administration's support among restive Democrats on Capitol Hill. Just 106,185 Americans successfully enrolled in health coverage in October. The administration had hoped to get half a million people signed up in Obamacare's first month. About a third of the enrollments — 35,364 — came from California (Mascaro, Levey and Memoli, 11/13).

The Washington Post: Administration: 106,000 Enrolled In Health Insurance In First Month Of Healthcare.gov
Slightly more than 106,000 Americans signed up for health plans in the first month of new state and federal insurance marketplaces, the Obama administration reported Wednesday. The figure, which was far lower than the administration predicted, points to the steep challenge ahead as the White House tries to overcome public and congressional frustration with the program’s problem-plagued rollout. The tally showed that just a quarter of the enrollments were in the federally run marketplace, while the rest were in the state exchanges (Goldstein and Kane, 11/13).

NPR: The Health Care Numbers Are Out, And They're Disappointing
The Obama administration released its much anticipated enrollment numbers for the first month of the troubled HealthCare.gov website Wednesday. And as predicted, the numbers were disappointing. Just over 100,000 people managed to navigate the process and choose a health plan between Oct. 1 and Nov. 2 — 106,185 people, to be precise (Rovner, 11/13).

The Associated Press/Washington Post: Fewer Than 27,000 Health Care Sign-Ups Through Federal Website, 79,000 More In State Sites
Planting a paltry number on a national disappointment, the Obama administration revealed Wednesday that just 26,794 people enrolled for health insurance during the first, flawed month of operations for the federal "Obamacare" website. Adding in enrollment of more than 79,000 in the 14 states with their own websites, the nationwide number of 106,000 October sign-ups was barely one-fifth of what officials had projected — and a small fraction of the millions who have received widely publicized private coverage cancellations as a result of the federal law (11/13).

The Wall Street Journal: Obama Administration Gives First Month Health-Site Tallies
The news that only 106,185 people nationwide were able to get through the sites in a month comes as a significant blow to the administration. In one memo, it had projected some 500,000 people would obtain private-insurance coverage nationwide. The Congressional Budget Office projected in May 2013 that seven million people nationwide would sign up for private plans by the end of March 2014 (Radnofsky and Ante, 11/13).

Politico: Takeaways: Obamacare By The Numbers
The Obama administration did everything possible to dress up the ugliness of the first month of Obamacare enrollment numbers — adding in people who haven’t even paid and throwing in figures that have nothing to do with actual signups. The one true bright spot is there seems to be interest, so enrollment could pick up in the coming months, just like the White House always said it would (Nather, 11/13).

The New York Times: California Health Exchange Beats All Others in Enrollment, Officials Say
In its first month of business, California’s insurance exchange enrolled more people than any other state-run exchange and more than the federal exchange serving 36 states, which has been paralyzed by technological failures. About 2,000 people are enrolling in private health plans daily through California’s exchange, officials there said, a rate that has picked up considerably over the last few weeks (Goodnough, 11/13).

Los Angeles Times: State Is On Track With Its Health Sign-Ups
In contrast to lackluster results so far in the troubled federal exchange, California said it remains on track to reach its enrollment goals by having signed up 131,000 people in private health insurance or Medicaid through the state's marketplace. California's first enrollment figures, released Wednesday, marked a rare bright spot for the Obama administration as it faces intense criticism over its error-prone enrollment website and millions of consumers getting insurance cancellation notices because their coverage doesn't meet requirements of the Affordable Care Act (Terhune and Brown, 11/13).

NPR: 6 Ideas Being Floated To 'Fix' Obamacare Sign-Up Woes
As technical problems with the government's new health insurance marketplace slow the pace of sign-up, a variety of "fixes" have been proposed. But some of these would create their own challenges. In rough order from least to most disruptive, here are some of the ideas (Horsley, 11/14).

Politico: Fateful Dates Ahead On Obamacare Calendar
Over the next five months, the calendar is loaded with dates and deadlines that will shape the fate of Obamacare. The October enrollment figures released Wednesday underscored the damage done by the health law’s technical problems since it launched on Oct. 1; 106,000 signing up in the first 32 days was a poor showing, even by the White House’s own admission. The Obama administration insists that the poor numbers can be reversed, momentum restored. Here are some key dates on that road to redemption — or further dysfunction (Cheney and Millman, 11/13).

Los Angeles Times: New Obamacare Numbers Give Incomplete Picture, Advocates Say
Some figures released Wednesday on the enrollment of Californians in insurance programs under President Obama's healthcare overhaul exclude many low-income applicants and fail to present a complete picture of those receiving coverage, experts said. Many Californians who qualify for newly expanded government insurance for the poor have been enrolling directly with county health systems. Those enrollees are not included in the preliminary Obamacare participation numbers released Wednesday, officials said (Brown, 11/13).

Los Angeles Times: Obamacare: Critics Seize On Low Enrollment Numbers
Immediately after the numbers were released, House Speaker John A. Boehner (R-Ohio) renewed his call for legislation that would change the law to prevent Americans from losing access to the healthcare plans they currently have. Obama has been looking for ways to make such changes without involving Congress, where Republicans are looking for any opportunity to repeal the entire law (Levey, 11/13).

The Washington Post’s The Fact Checker: The White House’s Happy Tweet About ‘Obamacare’ Enrollment
This tweet from the White House is a great example of trying to make lemonade out of lemons. Let’s explain what these numbers mean — and how the administration has shifted its goals (Kessler, 11/14).

Politico: Obamacare Decision Time For Democrats: Fight Or Flight
A White House under siege. A signature policy initiative turning into an embarrassing public spectacle. Dissent within the president’s own party that threatens to turn into a full-blown revolt. For Republicans, such a moment came in 2005, as the party faced a daunting midterm election under the shadow of the disastrous Iraq War and a presidency in the dumps. For Democrats, the fear now is that the Affordable Care Act’s clumsy rollout — complete with a botched enrollment website and a debunked presidential pledge that Americans could keep their existing insurance plans — could produce a similar rout at the ballot box, with candidates dragged down by President Barack Obama’s dropping job approval and dimming public perceptions of the law known as Obamacare (Burns and Glueck, 11/13).

The Associated Press/Washington Post: Low ’Obamacare’ Enrollment Causing  Heartburn For Democrats Looking To Next Year’s Elections
The White House also is taking a more open approach to changes in the law itself. “We welcome sincere efforts,” presidential press secretary Jay Carney said Wednesday at the White House as Democratic impatience grew over a program likely to be at the center of next year’s midterm elections for control of Congress (11/14).

The Associated Press/Washington Post: White House Sends Aides To Meet With House Democrats On Health Law Problems
The White House is dispatching top aides and other administration officials to Capitol Hill to mollify Democratic lawmakers anxious about deep problems with the rollout of President Barack Obama’s health care law. White House spokesman Jay Carney says top Obama aide David Simas and Health and Human Services official Mike Hash met with House Democrats on Wednesday. He says Democrats want the law to succeed and have the same concerns as Obama (11/13).

The Wall Street Journal: Obama Open To Health-Law Change
The government released numbers Wednesday showing that far fewer Americans had enrolled in private insurance plans under the new health law than expected and, in a marked shift, the Obama administration signaled it was open to legislation to fix the troubled rollout. The move came as the administration faced mounting dissatisfaction from Democrats over the law's implementation (Hughes, Hook and Nelson, 11/13).

The New York Times: With Enrollment Slow, Some Democrats Back Change in Health Law
Anxious congressional Democrats are threatening to abandon President Obama on a central element of his signature health care law, voicing increasing support for proposals that would allow Americans who are losing their health insurance coverage because of the Affordable Care Act to retain it.  The dissent comes as the Obama administration released enrollment figures on Wednesday that fell far short of expectations, and as House Republicans continued their sharp criticism of administration officials at congressional hearings examining the performance of the health care website and possible security risks of the online insurance exchanges (Parker and Shear, 11/13).

Politico: Senate Democrats Seek Obamacare Balance
Senate Democrats are trying to find a precarious balance on Obamacare by distancing themselves from the law’s troubled rollout without running away from it. In dribs and drabs, moderates and liberals, endangered incumbents and lawmakers with safe seats alike are working to get on the right side of increasingly sour public opinion on President Barack Obama’s landmark domestic achievement (Everett and Kim, 11/13).

The New York Times: Senator Manchin Takes On Democratic Party Leaders In Pursuit Of A Middle Ground
It has been that way all year for Mr. Manchin, a centrist Democrat from an increasingly Republican state who has shown an impulsive, almost reflexive, willingness to reject the position of his leaders and try to entice fellow senators to a middle ground. Now he is trying to delay parts of the new health care law, the latest effort by Mr. Manchin, a former governor and the grandson of an Italian immigrant, to engage on virtually every issue flaring up on Capitol Hill, just as he did in West Virginia (Weisman, 11/13).

The Wall Street Journal’s Washington Wire: Poll: Health-Care Woes Wipe Out Democrats’ Lead
The controversy surrounding the rollout of the health-care law has wiped out the ratings boost Democrats received from last month’s government shutdown, with a new poll showing voters are now split on whether they would vote for a Democrat or a Republican in midterm elections. A Quinnipiac University poll has voters divided 39%-39% on which party they would vote for in a generic matchup. That’s a significant shift from last month, when an Oct. 1 poll showed 43% of voters would choose a Democrat, versus 30% who would choose a Republican (Ballhaus, 11/13).

Politico: Obama’s Trust Gap
Six weeks of website follies and anger that the president either misspoke or made a bungled oversimplification of his claims that people could keep health care plans they like appear to have damaged the core of the Obama brand more than Hillary Clinton, John McCain, Mitt Romney or five years of sustained attacks on his presidency ever did (Dovere and Epstein, 11/13).

The New York Times: Health Website Official Tells Of White House Briefings
The chief digital architect for the federal health insurance marketplace said Wednesday that he met periodically with White House aides to discuss the status of the website over the last three years, but he said the meetings focused narrowly on specific technical issues and therefore gave the president no clear warning of the disaster that ensued on Oct. 1 (Pear and Lipton, 11/13).

The Wall Street Journal’s Washington Wire: Official: HealthCare.Gov Shopping Feature Failed ‘Miserably’
A feature of HealthCare.gov that would allow consumers to comparison shop for insurance plans without identifying themselves was blocked when the insurance exchange opened on Oct. 1 because it wasn’t working well, an Obama administration official said, denying allegations from Republican lawmakers that it was disabled to prevent “sticker shock” (Dooren, 11/13).

Los Angeles Times: Officials Won’t Commit To Meeting Deadline For Health Website Fix
A top administration official Wednesday stopped short of guaranteeing that technical issues with the new healthcare website would be largely resolved by the president’s Nov. 30 deadline, heightening Democrats’ concerns about the political fallout of ongoing problems with the implementation of the new law. Asked whether the government’s HealthCare.gov site would be working properly by the end of the month as expected, Chief Technology Officer Todd Park sounded less confident than the recent assurances coming from the White House (Memoli, 11/13).

The Wall Street Journal: White House Aides Grilled On Website Woes
A top White House technology official told a House committee Wednesday that HealthCare.gov can currently handle up to 25,000 website users at the same time. White House chief technology officer Todd Park said technology teams were working aggressively to fix the website and get it working "for the vast majority" of Americans by the Nov. 30 deadline set by the administration.  The federal agency running HealthCare.gov, the Centers for Medicare and Medicaid Services, originally envisioned a site with capacity to handle up to 60,000 concurrent users, Mr. Park said. Heavy usage of the site is expected near the Dec. 15 deadline for people to sign up for coverage effective Jan. 1 (Dooren and Radnofsky, 11/13).

Politico: Darrel Issa Hearing Shows Obamacare Deadline Slipping
For the few dribbles of information that came out about the Obamacare website at the latest congressional hearing Wednesday, there sure were a lot of fireworks. Members of the House Oversight and Government Reform Committee spent four and half hours at each other’s throats. Chairman Darrell Issa snarked his way through several rounds of questions, Democrats complained that Republicans were pointing fingers at the White House without any proof, and Issa accused Democrats of trying to “rehabilitate” Obama administration witnesses (Nather, 11/13).

NPR: Can Young People Get Obamacare For $50 A Month? Sometimes
For Obamacare to succeed, it's crucial for young people to sign up. Healthy young Americans need to pay into the insurance system to help cover the costs for older, sicker people. So the White House is reaching out. Its website sent emails to subscribers with a big, orange graphic that says half of young people can get coverage for $50 a month or less (Arnold, 11/13).

The Associated Press/Washington Post: Feds Investigating Settlement Between DC And Contractor, Say City Is Withholding Documents
Federal prosecutors are looking into a $7.5 million settlement between the District of Columbia government and its former Medicaid contractor, businessman Jeffrey Thompson, and the investigation has led to an unusual public spat between the U.S. Attorney and the city’s attorney general (11/13). 

Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page.