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New Year Means New Challenges for Health Care Law

Obama
WASHINGTON (AP) -- This could be the year that things finally turn around for President Barack Obama's health care law. Yet it could start with another round of glitches that vex consumers and leave Republicans crowing, "We told you so."

The law's major benefits take effect with the new year, along with an unpopular insurance mandate and the risk of more nerve-racking coverage disruptions.

Big improvements are in store for some, including Howard Kraft of Lincolnton, N.C. A painful spinal problem left him unable to work as a hotel bellman. But he's got coverage because federal law now forbids insurers from turning away people with health problems.

"I am not one of these people getting a policy because I'm being made to," Kraft said. "I need one to stay alive."

What's good for millions like Kraft is secured through what others see as an imposition: requiring virtually every American to get covered, through an employer, a government program or direct purchase of a plan.

But the biggest health care headlines early this year could come from continued uncertainty over the insurance program's messy rollout.

The consumer-facing side of the HealthCare.gov website appears to be largely fixed - with 2.1 million enrolled through federal and state websites. But on the back end, insurers say they are still receiving thousands of erroneous sign-ups from the government.

That means early in the year insured patients could go for a medication refill - or turn up in the emergency room - only to be told there is no record of their coverage.

One of the main worries is over certain error-tainted enrollment records that insurers call "orphans" and "ghosts."

"Orphans" are sign-ups that the government has a record of, but they do not appear in insurer systems. Insurers say those customers never left the government's "orphanage" to "go and live" with the carrier they selected.

"Ghosts" are new customers that the insurer does have a record of, but whose information mysteriously does not appear in the government's computers.

The Obama administration says the rate of such errors has been reduced dramatically, and insurers agree. The catch is that the volume of sign-ups has surged in the meantime, which means even with a lower error rate the number of problem cases keeps growing. And there is no automated way to clear up mistakes quickly.

"There are going to be problems for any number of people who thought they had signed up, and it won't work right off the bat," said Mark McClellan, who oversaw the rollout of Medicare's prescription drug benefit - a program that also had its share of issues. "It would be particularly disruptive for people in the midst of treatment."

Anticipating disruptions, major drug store chains like CVS and Walgreens have announced they will help customers who face coverage glitches, even providing temporary supplies of medications without insisting on up-front payment. Many smaller independent pharmacies are also ready to help.

White House health care adviser Phil Schiliro told reporters the administration was working with insurers and health care service providers to minimize disruptions "as we deal with what are always going to be unexpected problems where there is a transition."

Obama had envisioned that the arrival of the Affordable Care Act's major benefits in 2014 would be like a national seminar, showcasing his philosophy that government can and should smooth the rough edges off an unforgiving economy for struggling working people.

The goal was that in a midterm election year, Democrats would be able to point to millions of newly insured Americans, thanks to subsidized private plans and an expanded version of Medicaid. Media reports would feature compelling cases of people handed a lifeline.

That's indeed happening, but it seems to be only part of the story. The Republican portrayal of "Obamacare" as government inept and out of control appears to be unfolding right alongside.

Legal challenges still lie ahead for the health care law. Supreme Court Justice Sonia Sotomayor, acting Tuesday night on a request from an order of Catholic nuns in Colorado, blocked implementation of portions of the law that would have forced some religion-affiliated organizations to provide health insurance for employees that includes birth control. Several other Catholic groups won similar stays in the lower courts.

Although the stated goal of the law was to cover the uninsured, at least 4.7 million insured people had individual policies canceled because they didn't measure up to new requirements. That forced an apology from the president, who had famously promised that if you like your health plan, you can keep it. The administration says it believes most of those people have secured new coverage.

Americans with job-based health plans are also worried. A recent Associated Press-GfK poll found that most people who've seen their employers scale back coverage blame that on Obama's law, even though businesses were shifting health costs to workers before the law passed.

The nation's divisive debate over health care could go on for years. Having failed to repeal the entire law, Republicans may start targeting pieces of it, such as a Medicare cost control board, or various taxes.

For now, administration officials say they are just focused on getting through the March 31 end of open enrollment. People who enroll by that date will not face the law's tax penalty for remaining uninsured.

The administration and its supporters are also planning a big push to get younger, healthy uninsured people to sign up, key to the law's long-term success.

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urdela1965 January 02 2014 at 8:45 PM

All this is bullshit...Us people that work hard have to pay for those that got it easy in life!

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urdela1965 January 02 2014 at 8:44 PM

All this is bullshit...As people that work hard hav ed to pay those th a t got it easy in life!

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astrodigitalp25 January 02 2014 at 1:30 AM

It's all a big control sham and it's spreading wildly.

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Friday January 02 2014 at 1:30 AM

obamacare is an example of how the socialists (eg democrats/liberals/progressives/communists) plan to change America to their narrow view. obama lied to Americans and everyone now knows what he's really about. he has not served the people or defended our Constitution as he had taken an oath to. Impeachable events in this man's terms? You decide.

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Julia January 02 2014 at 1:09 AM

This law is supposed to help working Americans? Excuse me? I have excellent health care through my work, thank goodness, which we have been told will remain unchanged. I work for a national corporation with enough employees that our premium costs are quite low. Obamacare's premium for my age and zip code would be more than half of my takehome pay. This is affordable? I prefer to spend my golden years living indoors, thanks. Retirement has been pushed back until age 70. Thanks a bunch, Mr. President...NOT.

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westjeffreylee January 02 2014 at 12:53 AM

Its hard to even think about obama care as something we can depend on when everything else the government is in charge of is so far out of controll. At a time when government should be streamlining and down sizing and cleaning up the the problems only they have created, they expand to govern something as important as our helth care. We the people should have never let it get so far out of controll that we have no way out.

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Trisha January 02 2014 at 12:49 AM

Huff Post, why dont you become a reputable and real news company that is FOR the people of the United States since it is also your middles class employees (and maybe owners are too, I dont know) who are being crushed like the rest of us by a this REGIME (Both parties) that no longer resembles our "peoples Government"? Quit giving us news that doesnt matter and only distracts. Im sure ya'll went into this job to be actual journalists at some point right? Not just puppets selling themselves down the rabbit hole out of ignorance. Give it a shot. Obamacare is a distraction. Lets hear about The Rothschilds and the Bilderberg group and how we have been manipulated by them for decades. Dig into the past to interesting items like Operation Northwoods and show the comparison to 9/11. Be a news place we can respect.
Thanks you.

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2 replies to Trisha's comment
Trisha January 02 2014 at 12:51 AM

Lets also talk about the Banks and the Fed reserve...help us out here.

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healinstruct January 02 2014 at 11:22 AM

George Soros has done a real job on them.
They are ardently deceived

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haulfrght January 02 2014 at 12:45 AM

Obama did not find out about the problems until he heard it in the news just like everyone else

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john January 02 2014 at 12:43 AM

Under Obamacare, I picture the emergency rooms filled with people getting 100% care at no expense to them, while most purchasing their own insurance stay away because their deductible is too high.

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2 replies to john's comment
Trisha January 02 2014 at 12:50 AM

Is that what your policy says? Free?

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Julia January 02 2014 at 1:11 AM

And about half of the people in the ER will be illegals. When I lived in Palm Springs we had people coming up from the towns near the Mexican border because so many medical facilities there had gone bankrupt because of the cost of treating illegals.

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rons5152 January 02 2014 at 12:42 AM

I hope people who voted for dumb dumb are happy now lol

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