OVERNIGHT HEALTH: Emerging Senate deal spares ObamaCare

The bipartisan deal emerging in the Senate would do little to harm ObamaCare if it passes Congress. The bargain under negotiation by Senate leaders would delay the law's reinsurance fee for one year and possibly strengthen income verification requirements for people receiving subsidies on the exchanges. Repealing or delaying the medical device tax — outcomes that seemed to have traction earlier this week — now appear to be off the table.

Delaying the reinsurance fee brings up a little-known fund under the healthcare law that was created to stabilize premiums on the new insurance marketplaces. The three-year fee would apply to all group health plans, but has seen particular opposition from labor unions, which argue that they will see no benefit from paying the tax. The White House recently denied labor's chief priority when it comes to ObamaCare — making union health plans eligible for new tax subsidies — and this delay could be received as an olive branch, though it's sure to anger health insurance companies. 

The deal could also set up another process for verifying the incomes of subsidy recipients. Democrats hardly see this as a concession because it would enforce existing law.

Senate Minority Leader Mitch McConnell (R-Ky.) took heat Monday afternoon because the bargain would leave ObamaCare largely intact. "Mitch McConnell is negotiating the Republican surrender," said Matt Hoskins, executive director of the Senate Conservatives Fund, in a statement.

Read about the developments here and here and here

Will heads roll? Republicans have said that someone should be fired over the rocky rollout of healthcare.gov, but now that call is getting broader bipartisan support. Former White House press secretary Robert Gibbs said on MSNBC Monday that heads should roll over the site's technical problems.

"I hope they're working day and night to get this done. And when they get it fixed, I hope they fire some people that were in charge of making sure that this thing was supposed to work," Gibbs said. "We knew there were going to be some glitches, but these are glitches that go way beyond the pale of what should be expected."


Washington Post blogger Ezra Klein, a big supporter of the Affordable Care Act, offered a similar sentiment.

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"What's abundantly clear to anyone who reported on the run-up to the federal health-care law's launch is that the White House had no idea how badly the Web site would perform," Klein wrote. "They expected problems. But the full extent of the disaster was either obscured or ignored. Heads should roll for that. Changes should be made because of that."

Healthwatch has the story on Gibbs's comments. And Klein's piece is available here.

GOP chorus grows: Rep. John Fleming (R-La.) is the latest Republican to call for Health and Human Services Secretary Kathleen Sebelius to resign. He joins Sen. Pat Roberts (R-Kan.) and Republican National Committee Chairman Reince Preibus.

"Secretary Sebelius has been a governor and a state insurance commissioner; she must know better," Fleming said in a statement. "She was warned repeatedly by all of us who called for a one-year delay of Obamacare’s implementation and taxes to prevent this chaos. Now, it’s time for her to resign or be fired.”

Read the Healthwatch story.

Where there's smoke, there's ... smoke: Just days after House Republicans questioned whether the IRS improperly disclosed confidential tax information, the tax agency responded to the GOP's questions and said no confidential information was shared. The issue stemmed from redactions in emails between IRS officials and the White House. Rep. Darrell Issa (R-Calif.) said the redactions suggested that confidential information had been shared with the White House. But the IRS said it was just an overly cautious redaction, and has provided the full email exchange to Issa's committee.

Read the story here.


State by state

ObamaCare struggles even worse in states that resisted it

Calif. extends hospital bed tax

N.H. lawmakers taking up Medicaid expansion question


Lobbying registrations

Virtual Operations / The Conafay Group on behalf of Colorado State University

FaegreBD Consulting / Remington Medical Records

Health and Medicine Counsel of Washington / Immucor

Health and Medicine Counsel of Washington / Prolong Pharmaceuticals


Reading list

The White House "dodged a bullet" because the government shutdown has overshadowed ObamaCare's troubles, the Los Angeles Times notes.

Medicare Advantage is doing just fine, despite fears that ObamaCare would hurt it, TIME magazine reports.

ProPublica notes that HHS hasn't exactly been transparent with information about the early enrollment process.



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Sam Baker: sbaker@thehill.com / 202-628-8351 / @sam_baker

Elise Viebeck: eviebeck@thehill.com / 202-628-8523 / @eliseviebeck