October 1, 2013

Legislation and Policy

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Obama Defends ACA, Criticizes “Crazy” Predictions Of Negative Impact.

President Obama’s speech on the Affordable Care Act in Largo, Maryland Thursday receives generally sympathetic coverage, calling the President’s remarks “passionate” and “a ringing defense” of the law, though some also note Democratic criticism that the presidential effort to explain and promote the law is coming very late, and only after the ACA’s opponents have defined it negatively in many minds. The speech’s message is also said to have been undercut somewhat by reports of new difficulties in the implementation of the law.

The CBS Evening News reported, “Five days before the new state health insurance exchanges open for business, President Obama was out encouraging folks to sign up for Obamacare. But while he was doing that, his Administration revealed a couple of new glitches. A Spanish language enrollment website won’t be up and running for a few more weeks and there will be a one-month delay for small businesses to sign up.” NBC Nightly News reported the President “acknowledged today there will be some ‘glitches,’ in his words, as the healthcare law is rolled out and people have to sign up.” NBC also noted the problems with the enrollment website, before segueing into a backgrounder on the Affordable Care Act as a whole.

The AP  (9/27, Superville) reports the President, speaking in Prince George’s County, Maryland, “ridiculed Republican opponents for ‘crazy’ doomsday predictions of the impact and forecast that even those who didn’t vote for him are going to enroll.” With polls “showing many Americans still skeptical” of the ACA, the President “went back to the basics” of explaining the law “while mocking Republicans for trying to block its implementation.” Obama said, “The Republican Party has just spun itself up around this issue. And the fact is the Republicans’ biggest fear at this point is not that Affordable Care Act will fail. What they’re worried about is it’s going to succeed.” On the Senate floor, Minority Leader McConnell responded, “This law is a mess. It needs to go. It’s way past time to start over.”

The New York Times  (9/26, Baker, Subscription Publication) says the President “mounted a passionate, campaign-style defense” of the law before “a friendly audience” at Prince George’s Community College in Largo. Before the “largely black crowd,” the President “noted that one Republican,” a New Hampshire state legislator, “recently said the health care program was as destructive to liberty as the Fugitive Slave Act of 1850.” He said, “Think about that. Affordable healthcare is worse than a law that lets slave owners get their runaway slaves back. I mean these are quotes. I’m not making this stuff up.”

The Washington Post  (9/27, Wilson, Wiggins) says the President “offered a ringing defense” of the ACA and derided “what he called increasingly ‘irresponsible’ Republican tactics to undermine it.” The President “reviewed the history of legislation…and offered a preview of the benefits to come.” He said, “In the wealthiest nation on Earth, no one should go broke just because they get sick. In the United States, healthcare is not a privilege for the fortunate few, it is a right.”

The Baltimore Sun  (9/27, Fritze) says the President and other Democrats “have been working feverishly” to explain the healthcare marketplaces that open next Tuesday. The President said “signing up for coverage would be as easy as shopping for ‘a TV on Amazon.’” The Los Angeles Times  (9/27, Parsons, Hennessey) says with the marketplaces “days from opening for business, the White House is focused on a task that many of the law’s supporters complain is overdue: explaining it.”

The Wall Street Journal  (9/27, Nelson, Subscription Publication) says the success of the ACA will be central to the President’s legacy, hence the successful, White House’s sustained effort to promote the law.

Sebelius Stops In Texas To Discuss ACA.

HHS Secretary Kathleen Sebelius traveled to Dallas, Texas, Thursday as part of her tour across the country to tout the Affordable Care Act. In addition to print, the visit and its message received significant television coverage, including two interviews on national cable networks. First, the AP  (9/27, Merchant) reports that her stop in Texas was the “fifth time in two months.” While highlighting the benefits of the ACA, Sebelius “acknowledged that many poor, uninsured Texans will get no help without the cooperation of state Republicans who unyieldingly oppose the law.” She said, “The money starts to flow on January 1, 2014. That’s when this federal deal would kick in. And every day, Texas would leave a portion of that money on the side of the road.”

Other print coverage is offered by the Washington Times  (9/27, McLaughlin) “Inside Politics” blog, the Washington Examiner  (9/27, Mali), the Dallas Morning News  (9/27, Tsiaperas) “The Scoop” blog, and the Fort Worth (TX) Star-Telegram  (9/27, Fuquay).

In television coverage, CNN’s New Day welcomed HHS Secretary Sebelius Thursday morning, asking her to explain the Affordable Care Act and respond to all the “negative” messaging surrounding it. She said, “I think what we’ve seen, for three and a half years, is a relentless battle driving misinformation both from opponents of the law itself and a lot of media and now paid advertising, continuing to give the American public information that just isn’t correct.” She continued, “So what we’re trying to do is remind people what’s already happened…and the final piece of the puzzle is going to start on October 1.”

Later on, MSNBC Now With Alex Wagner featured Sebelius, discussing the “latest delay” in the Affordable Care Act, to the SHOP exchanges. She said the exchanges would be available “as promised,” but online enrollment was pushed back until November 1. Sebelius reminded host Alex Wagner that the plans don’t start until January 1, so that “well before any insurance benefits will be available,” enrollment will be open.

ACA Could Lead To Expansion In Accountable Care Organizations.

The Wall Street Journal  (9/27, A1, Beck, Subscription Publication) reports on the role of accountable care organizations, in which healthcare providers and hospitals make agreements with insurers to provide care for a certain group of patients in order to offer quality care at lower costs. The ACOs share in cost savings, giving them an incentive to keep costs down. The Affordable Care Act is testing the concept, authorizing the creation of pilot ACO programs through Medicare.

CMS Tells Auditors To Delay “Two-Midnight” Rule Scrutiny.

In continuing coverage, Modern Healthcare  (9/27, Carlson, Subscription Publication) reports that yesterday, officials with the Centers for Medicare & Medicaid Services, in an effort to address “widespread anger among hospitals and doctors about the new ‘two-midnights’ rule for outpatient observation,” announced that “government recovery auditors will delay scrutiny of short inpatient stays for 90 days while providers get acclimated to the new policy.” In a document  (pdf) published yesterday, the CMS said that “Medicare’s aggressive recovery audit contractors…have been told they will not be allowed to question the medical necessity of any inpatient stay lasting a day or less between Oct. 1 (when the rule goes into effect) and Dec. 31.”


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