CHICAGO (AP) - The Illinois Department of Insurance and the state's major health insurer say they are reviewing changes to the health law announced Thursday by President Barack Obama that address policy cancellations.
Obama said insurers can continue to sell policies canceled under the Affordable Care Act for at least one more year to existing customers. But insurers aren't required to continue the canceled plans.
Blue Cross Blue Shield of Illinois officials say the company is "determining next steps" and will reach out to consumers who may have new options as a result of Obama's announcement.
A spokesman says Illinois Insurance Director Andrew Boron has been in contact with federal authorities and is evaluating options, keeping in mind what's best for the state's consumers.
At least 4 million Americans have received cancellation notices.
A clinic that serves mostly the uninsured and under-insured in St. Louis is closing its doors. St. Louis ConnectCare has announced it will close the Smiley Urgent Care Center November 15th.
The non-profit had announced in August it would shut down its specialty services, but now says it must also close the clinic at the old Regional Hospital on Delmar.
St. Louis Regional Health Commission Chief Robert Fruend believes other health care providers will follow suit because of state budget cuts. Fruend told the St. Louis Post-Dispatch that 1,000 healthcare jobs have been lost in the region in the last six months.
The paper reports a Missouri Hospital Association estimate that the state will lose $4 billion in health care funding over the next six years, mainly from budget cuts to Medicare and Medicaid. They say the decision by Missouri lawmakers not to expand Medicaid through the Affordable Care Act will further limit the amount of health care funds coming into the state.
WASHINGTON (AP) — Now is when Americans start figuring out that President Barack Obama's health care law goes beyond political talk, and really does affect them and people they know.
With a cranky federal website complicating access to new coverage and some consumers being notified their existing plans are going away, the potential for winners and losers is creating anxiety and confusion.
"I've had questions like, 'Are they going to put me in jail if I don't buy insurance? Because nobody will sell it to me,'" said Bonnie Burns, a longtime community-level insurance counselor from California. "We have family members who are violently opposed to 'Obamacare' and they are on Medicaid — they don't understand that they're already covered by taxpayer benefits.
"And then there is a young man with lupus who would have never been insurable," Burns continued. "He is on his parents' plan, and he'll be able to buy his own coverage. They are very relieved."
A poll just out from the nonpartisan Kaiser Family Foundation documents shifts in the country in the month since insurance sign-ups began.
Fifty-five percent now say they have enough information to understand the law's impact on their family, up 8 percentage points in just one month. Part of the reason is that advertising about how to get coverage is beginning to register.
"The law is getting more and more real for people," said Drew Altman, the foundation's president. "A lot of this will turn on whether there's a perception that there have been more winners than losers. ... It's not whether an expert thinks something is a better insurance policy, it's whether people perceive it that way."
The administration is continuing its efforts to influence those perceptions. On Wednesday, Obama will meet with volunteers in Dallas who are helping people enroll in health insurance plans. Cabinet officials are also expected to make stops around the country in the coming weeks to encourage people to sign up for insurance even as the website problems persist.
A look at three groups impacted by the law's rollout:
LOSING CURRENT PLAN
The Obama administration insists nobody will lose coverage as a result of cancellation notices going out to millions of people. At least 3.5 million Americans have been issued cancellations, but the exact number is unclear. Associated Press checks find that data is unavailable in a half the states.
Mainly they are people who buy directly from an insurer, instead of having workplace coverage. Officials say these consumers aren't getting "canceled" but "transitioned" or "migrated" to better plans because their current coverage doesn't meet minimum standards. They won't have to go uninsured, and some could save a lot if they qualify for the law's tax credits.
Speaking in Boston's historic Faneuil Hall this past week, Obama said the problem is limited to fewer than 5 percent of Americans "who've got cut-rate plans that don't offer real financial protection in the event of a serious illness or an accident."
But in a nation of more than 300 million, 5 percent is a big number — about 15 million people. Among them are Ian and Sara Hodge of Lancaster, Pa., in their early 60s and paying $1,041 a month for a policy.
After insurer Highmark Inc., sent the Hodges a cancellation notice, the cheapest rate they say they've been able to find is $1,400 for a comparable plan. Ian is worried they may not qualify for tax credits and doesn't trust that the federal website is secure enough to enter personal financial information in order to find out.
"We feel like we're being punished for doing the right thing," he said.
Their policy may not have met the government's standards, "but it certainly met our minimum standards," Hodge added.
"The main thing that upsets us is the president ... said over and over and over again: If you like your health plan, you will be able to keep your health plan, guaranteed."
There's a chance the number of people getting unwanted terminations may grow. In 2015, the law's requirement that larger companies provide health insurance will take effect. It's expected that a small share of firms will drop coverage, deciding that it's cheaper to pay fines imposed under the law.
Before the law's online health care markets launched Oct. 1, the administration estimated nearly 500,000 people would enroll for subsidized private insurance within the first month. Despite high consumer interest, a computer system beset by gremlins has kept most from doing so.
The administration refuses to release enrollment numbers until mid-November, when a crash program of computer fixes may be showing results. The numbers are expected to be disappointingly low; officials acknowledge as much.
A different prong of Obama's coverage expansion seems to be doing fairly well. It's an expanded version of Medicaid, embraced so far by 25 states and the District of Columbia. An informal survey of 14 of those states by The Associated Press shows that at least 240,000 people had enrolled in or applied for the expanded safety-net program as of the third week of October.
Private coverage is what interests Cecilia Fontenot of Houston, a part-time accountant in her early 60s. She has diabetes, high blood pressure and high cholesterol. Though she manages well, she has been unable to find affordable insurance. Under Obama's law, insurers will not be able to turn away people with medical problems or charge them more.
Fontenot gave up on HealthCare.gov and instead applied through a call center on Oct. 19.
"They said it may take a while because so many people had called in," Fontenot explained. "I'm a very patient person, and I'm looking forward to getting that insurance."
She wants a plan that covers a better diabetes drug than the one she can afford now by paying out of pocket. Her doctor has also recommended a high-tech imaging test for a breast lump.
WONDERING WHETHER COVERAGE WILL CHANGE
Americans are still divided over the Affordable Care Act, with negative views outweighing positives. But they also lean against repealing it. The final judgment may be in the hands of people who now have employer-provided health insurance. They're about half the population, and they've noted Obama's assurances that their coverage won't be disrupted.
Up to now, the changes for employer plans have been incremental. They tend to expand benefits, not take things away.
For example, young adults can stay on a parent's coverage until they turn 26. Employers cover women's birth control as a preventive service, free of charge. Screening tests such as colonoscopies are also free.
But cost control provisions, mainly a tax on expensive insurance plans that starts in 2018, are converging with the long-standing push by employers to tame health costs. Some companies have raised deductibles and copayments for employees, saying they need to scale back to avoid tangling with the coming tax. Others are giving employees a fixed amount of money to shop in private health insurance markets that resemble those created by the law.
Expect cutbacks to be blamed on the law. Sorting out whether that's warranted may be difficult.
"What the Affordable Care Act did was give companies a very convenient excuse to say 'Oh, gosh, we really have to get serious about insurance costs,'" said Paul Keckley, an independent health benefits consultant. "I think there's a bit of a bob and weave. The ACA was a convenient excuse for doing what (corporate) human resources departments have been calculating to do for years."
WASHINGTON (AP) — Republicans said Sunday they intend to press Health and Human Services Secretary Kathleen Sebelius on the Obama administration's troubled launch of healthcare.gov, the online portal to buy insurance — even as the website suffered yet another setback.
A component of the online system that has been working relatively well experienced an outage Sunday. The federal data services hub, a conduit for verifying the personal information of people applying for benefits under the law, went down in a failure that was blamed on an outside contractor, Terremark.
"Today, Terremark had a network failure that is impacting a number of their clients, including healthcare.gov," HHS spokeswoman Joanne Peters said. "Secretary Sebelius spoke with the CEO of Verizon this afternoon to discuss the situation and they committed to fixing the problem as soon as possible."
Jeffrey Nelson, a spokesman for Verizon Enterprise Solutions, of which Terremark is a part, said: "Our engineers have been working with HHS and other technology companies to identify and address the root cause of the issue. It will fixed as quickly as possible."
The Obama administration will face intense pressure this week to be more forthcoming about how many people have actually succeeded in enrolling for coverage in the new insurance markets. Medicare chief Marilyn Tavenner is to testify during a House hearing Tuesday, followed Wednesday by Sebelius before the House Energy and Commerce Committee. The officials will also be grilled on how such crippling technical problems could have gone undetected prior to the website's Oct. 1 launch.
"The incompetence in building this website is staggering," said Rep. Marsha Blackburn, R-Tenn., the second ranking Republican on the panel and an opponent of the law.
Democrats said the new system needed time to get up and running, and it could be fixed to provide millions of people with affordable insurance. Kentucky Gov. Steve Beshear, a Democrat, said the system was "working in Kentucky," a state that has dealt with "some of the worst health statistics in the country. ... The only way we're going to get ourselves out of the ditch is some transformational tool," like the new health insurance system.
Blackburn said she wanted to know much has been spent on the website, how much more it will cost to fix the problems, when everything will be ready and what people should expect to see on the site. Blackburn and Rep. Mike Rogers, R-Mich., raised questions of whether the website could guard the privacy of applicants.
"The way the system is designed it is not secure," said Rogers, who is chairman of the House Intelligence Committee.
The administration sought to reassure applicants about their personal information. HHS' Peters said when consumers fill out their applications, "they can trust that the information they're providing is protected by stringent security standards and that the technology underlying the application process has been tested and is secure."
The botched rollout has led to calls on Capitol Hill for a delay of penalties for those remaining uninsured. The Obama administration has said it's willing to extend the grace period until Mar. 31, the end of open enrollment. That's an extra six weeks. The insurance industry says going beyond that risks undermining the new system by giving younger, healthier people a pass.
Sen. Joe Manchin, D-W.Va., who is seeking a yearlong delay to the penalty for noncompliance, said his approach would "still induce people to get involved, but it will also give us the time to transition in. And I think we need that transition period to work out the things." Sen. Jeanne Shaheen, D-N.H., who has urged the Obama administration to postpone the March 31 deadline, said she was concerned applicants would not have a full six months to enroll.
The administration was under no legal requirement to launch the website Oct. 1. Sebelius, who designated her department's Medicare agency to implement the health care law, had the discretion to set open enrollment dates. Officials could have postponed open enrollment by a month, or they could have phased in access to the website.
But all through last summer and into early fall, the administration insisted it was ready to go live in all 50 states on Oct. 1.
The online insurance markets are supposed to be the portal to coverage for people who do not have access to a health plan through their jobs. The health care law offers middle-class people a choice of private insurance plans, made more affordable through new tax credits. Low-income people will be steered to Medicaid in states that agree to expand that safety net program.
An HHS memo prepared for Sebelius in September estimated that nearly 500,000 people would enroll for coverage in the marketplaces during October, their first month of operation. The actual number is likely to be only a fraction of that. The administration has said 700,000 people have completed applications.
Rep. Darrell Issa, R-Calif., said the president had been poorly served by Sebelius "in the implementation of his own signature legislature. So if somebody doesn't leave and if there isn't a real restructuring, not just a 60-day somebody come in and try to fix it, then he's missing the point of management 101, which is these people are to serve him well, and they haven't."
Blackburn spoke on "Fox News Sunday," Beshear appeared on NBC's "Meet the Press," Rogers was on to CNN's "State of the Union," Manchin was interviewed on ABC's "This Week," and Shaheen and Issa made their comments on CBS "Face the Nation."
WASHINGTON (AP) — "Obamacare" escaped unharmed from the government shutdown Republicans hoped would stop it, but just as quickly they have opened a new line of attack — one handed to them by the administration itself.
While Congress was arguing, President Barack Obama's plan to expand coverage for the uninsured suffered a self-inflicted wound. A computer system seemingly designed by gremlins gummed up the first open enrollment season. After nearly three weeks, it's still not fixed.
Republicans hope to ride that and other defects they see in the law into the 2014 congressional elections. Four Democratic senators are facing re-election for the first time since they voted for the Affordable Care Act, and their defeat is critical to GOP aspirations for a Senate majority.
Democrats say that's just more wishful thinking, if not obsession.
Although Obama's law remains divisive, only 29 percent of the public favors its complete repeal, according to a recent Gallup poll. The business-oriented wing of the Republican party wants to move on to other issues. Americans may be growing weary of the health care fight.
"This is the law of the land at this point," said Michael Weaver, a self-employed photographer from rural southern Illinois who's been uninsured for about a year. "We need to stop the arguing and move forward to make it work."
It took him about a week and half, but Weaver kept going back to the healthcare.gov website until he was able to open an account and apply for a tax credit that will reduce his premiums. He's not completely finished because he hasn't selected an insurance plan, but he's been able to browse options.
It beats providing page after page of personal health information to insurance companies, Weaver said.
Under the new law, insurers have to accept people with health problems. Weaver is in his mid-50s, with high blood pressure and high cholesterol, but otherwise in good health. He says those common conditions made it hard for him to get coverage before.
Although Weaver seems to have gotten past the major website obstacles, he's still finding shortcomings. There's no place to type in his medications and find out what plans cover them. "I wish there was more detail, so you could really figure it out," he said.
Such a nuanced critique appears to be lost on congressional Republicans.
"#TrainWreck: Skyrocketing Prices, Blank Screens, & Error Messages," screamed the headline on a press release Friday from House Speaker John Boehner, R-Ohio. A House hearing on the "botched Obamacare rollout" is scheduled for this coming week. GOP lawmakers want Health and Human Services Secretary Kathleen Sebelius to resign.
Administration officials, in their most detailed accounting yet of the early rollout, said Saturday that about 476,000 health insurance applications have been filed through federal and state exchanges. But the officials continue to refuse say how many people have enrolled in the insurance markets.
Without enrollment figures, it's unclear whether the program is on track to reach the 7 million people projecting by the Congressional Budget Office to gain coverage during the six-month sign-up period.
The president was expected to address the problems on Monday during a health care event at the White House. The administration has yet to fully explain what has gone wrong with the online signup system.
"To our Democratic friends: You own 'Obamacare' and it's going to be the political gift that keeps on giving," said Sen. Lindsey Graham, R-S.C.
"Irresponsible obsession," scoffs Rep. Sander Levin of Michigan, ranking Democrat on the Ways and Means Committee, which oversees much of the health law.
Democratic pollster Celinda Lake says she doesn't see how going after the health law rollout will help Republicans by the time of next year's election.
"Americans are technology optimists," said Lake. "You tell them the website has problems today, and they'll assume it will be better tomorrow. I mean, we're Americans. We can fix a website."
There may be a method to the GOP's single-mindedness.
Republicans are intent on making the health law an uncomfortable anchor around the neck of four Democratic senators seeking re-election in GOP-leaning states, weighing them down as they try to unseat them. Republicans need to gain six seats to seize the majority in the Senate, and any formula for control includes flipping the four seats.
Sens. Mark Pryor of Arkansas, Mary Landrieu of Louisiana, Mark Begich of Alaska and Kay Hagan of North Carolina will be facing voters for the first time since they were among the 60 Democrats who voted for the health law in 2009.
More than a year before the election, Republican Rep. Tom Cotton is airing an ad that criticizes Pryor for his vote, telling Arkansans that Pryor "cast the deciding vote to make you live under Obamacare." The commercial's final image shows Pryor with Obama, who took a drubbing in Arkansas last year.
"The bottom line is these candidates will have to answer for why they voted for this bill," said Rob Engstrom, senior vice president and national political director for the U.S. Chamber of Commerce.
If the website gets fixed, other problems may emerge. Republicans can still try linking 'Obamacare' to rising premiums, anemic job growth and broader economic worries.
Will the strategy work?
The chamber spent millions on ads in 2012 criticizing Senate incumbents such as Jon Tester of Montana and Bill Nelson of Florida for their health care votes, yet many of those candidates overcame the criticism and won re-election.
The economy, not health care, remains the top concern of voters. By putting opposition to the health care law ahead of all other priorities, economist Douglas Holtz-Eakin says tea-party conservatives may have overdone it.
"Obamacare was an effective campaign weapon," said Holtz-Eakin, and adviser to Republicans. "The question is, have they damaged it beyond its political viability?"
The online health insurance exchanges are now open in both Missouri and Illinois. The online marketplace is a key component of the federal health care law.
Illinois officials have set up their own marketplace at GetCoveredIllinois.gov.
Missouri voters chose to bar their government from setting up its own marketplace. So the federal government is running the exchange for Missouri residents at Healthcare.gov.
Consumers have until December 15th to sign up if they want coverage to start on January 1, but enrollment is open until March 31.
NEW YORK (AP) — From New York's Liberty Island to Alaska's Denali National Park, the U.S. government closed its doors as a bitter budget fight idled hundreds of thousands of federal workers and halted all but the most critical government services for the first time in nearly two decades.
A midnight deadline to avert a shutdown passed amid Congressional bickering, casting in doubt Americans' ability to get government services ranging from federally-backed home loans to supplemental food assistance for children and pregnant women.
For many employees of the federal government, Tuesday's shutdown meant no more paychecks as they were forced onto unpaid furloughs. For those still working, it meant delays in getting paid.
Park Ranger and father-to-be Darquez Smith said he already lives paycheck-to-paycheck while putting himself through college.
"I've got a lot on my plate right now — tuition, my daughter, bills," said Smith, 23, a ranger at Dayton Aviation Heritage National Historical Park in Ohio. "I'm just confused and waiting just like everyone else."
The impact of the shutdown was mixed — immediate and far-reaching for some, annoying but minimal for others.
In Colorado, where flooding killed eight people earlier this month, emergency funds to help rebuild homes and businesses continued to flow — but federal worker furloughs were expected to slow it down.
National Guard soldiers rebuilding washed-out roads would apparently be paid on time — along with the rest of the country's active-duty personnel — under a bill passed hours before the shutdown. Existing Social Security and Medicare benefits, veterans' services and mail delivery were also unaffected.
Other agencies were harder hit — nearly 3,000 Federal Aviation Administration safety inspectors were furloughed along with most of the National Transportation Safety Board's employees, including accident investigators who respond to air crashes, train collisions, pipeline explosions and other accidents.
Almost all of NASA shut down, except for Mission Control in Houston, and national parks closed along with the Smithsonian museums and the National Zoo. Even the zoo's popular panda cam went dark, shut off for the first time since a cub was born there Aug. 23.
As the shutdown loomed Monday, visitors to popular parks made their frustration with elected officials clear.
"There is no good thing going to come out of it," said Chris Fahl, a tourist from Roanoke, Ind., visiting the Abraham Lincoln Birthplace National Historic Park in Hodgenville, Ky. "Taxpayers are just going to be more overburdened."
Emily Enfinger, visiting the Statue of Liberty, said politicians need to find a way to work together.
"They should be willing to compromise, both sides, and it discourages me that they don't seem to be able to do that," she said. "They're not doing their job as far as I'm concerned."
Joe Wentz, a retired federal employee from Lebanon, Va., visiting San Francisco with his wife, bought tickets to visit Alcatraz on Thursday — if it's open.
Wentz said he's frustrated that some politicians are using the budget to push changes in the Affordable Care Act.
"We've been disgusted a long time that they're not working together," he said.
The shutdown was strangely captivating to Marlena Knight, an Australian native visiting Independence National Historical Park in Philadelphia. She was confounded that the impasse focused on the nation's health care system — an indispensable service in her home country.
"We can't imagine not having a national health system," she said. "I just can't believe that this country can shut down over something like a national health system. Totally bizarre, as an Australian, but fascinating."
It turns out an institution as massive as the federal government takes some time to grind to a total halt: Many federal workers were being permitted to come in Tuesday to change voicemail messages or fill out time cards. But after that, they were under strict orders to do no work, even check their email.
With no telling how long the budget standoff will last, even programs not immediately affected could run out of cash.
Barbara Haxton, executive director of the Ohio Head Start Association, said its preschool learning programs would be in jeopardy if a shutdown lasted more than two weeks. March's automatic budget cuts meant nearly 3,000 children lost access to services and there could be dire consequences if the budget standoff drags on.
"It's not as though this is a throwaway service. These are the poorest of the poor children," Haxton said. "And our Congressman still gets his paycheck. His pay doesn't stop and his health insurance doesn't stop."
Associated Press reporters Kathy Matheson in Philadelphia, Joan Lowy in Washington, D.C., Dylan Lovan in Louisville, Ky., Terence Chea in San Francisco and Amanda Lee Myers in Cincinnati contributed to this report.