Enrollment could be lower than 100,000 – Hagan circulates Obamacare investigation plea – House kicks off busy ACA week Presented by

INITIAL ENROLLMENT ESTIMATES: FEWER THAN 100,000 — The Obama administration wouldn’t confirm any of the Obamacare enrollment totals suggested by Wall Street Journal and Washington Post reports, which said that 40,000 to 50,000 people have enrolled in federally-run exchanges. Those numbers, combined with an estimate by consulting firm Avalere Health that about 49,000 people have signed up for coverage via state-run exchanges, could mean fewer than 100,000 people have enrolled in the exchanges so far. Officials are expected to announce enrollment totals later this week. For Pros: http://politi.co/18mXhm3

OBAMACARE: ONCE THE STAR, NOW THE PUNCH LINE – Supportive celebrities were out front when the exchanges launched last month, but now the Obamacare rollout has become the butt of jokes by Carrie Underwood and is made fun of on “South Park.” Between the website failures and the controversy over cancelled plans, the law’s star status has faded lately. POLITICO’s Tal Kopan reports on how it’s being mocked all over the place: http://politi.co/1aBius3


Happy Tuesday and welcome to PULSE. Speaking of Obamacare jokes, we’re certain the law owes us a little comic relief. Your writer found a list of some of the best ones: http://abt.cm/1fxGQIt We’re accepting more Obamacare-themed humor here: [email protected].

“Ain’t too proud to PULSE, you know it sweet darlin.”

IT’S A BUSY OBAMACARE WEEK ON THE HILL — The House is returning from a week-long break and Republicans have lots of Obamacare darts ready at hand. Leaders are planning a vote Friday on the “Keep Your Health Plan Act” allowing insurance plans in effect Jan. 1, 2013 to continue into 2014. And five committees are holding Obamacare-related hearings, almost all scheduled at the same time.

-- There’s an Oversight hearing on Wednesday at 9:30 a.m. The committee’s witness list includes subpoenaed Chief Technology Officer Todd Park, along with Frank Baitman and Henry Chao from CMS’s Office of Information Services, Steve VanRoekel from the Office of Management and Budget and David Powner from the Government Accountability Office. http://1.usa.gov/17HtHgy

-- Also Wednesday morning, the Homeland Security Committee will kick off its hearing on the security of the personal information being entered into HealthCare.gov. Witnesses include Roberta Stempfley and Soraya Correa, both from the Department of Homeland Security. http://1.usa.gov/1ervZSQ

-- A trio of hearings starts at 10:00 a.m. on Thursday. The Energy and Commerce Health Subcommittee will look at problems with the health law beyond just the website. The Education and the Workforce Committee will examine how it’s affecting schools and universities. And the Small Business Subcommittee on Health and Technology will examine the pluses and minuses of self-insuring.

HAGAN WANTS OBAMACARE INVESTIGATION — Sen. Kay Hagan is collecting signatures this week on a letter to Government Accountability Office Comptroller General Gene Dodaro and Health and Human Services Inspector General Daniel Levinson asking for “a complete, thorough investigation” to determine why the HealthCare.gov launch flopped so badly. The North Carolina Democrat, who is up for reelection next year, will ask GAO and HHS watchdogs to report details to Congress on the website’s cost and contractors. The story: http://politi.co/HQSrqR A draft of the letter: http://bit.ly/1bl1XcK

WHAT DOES OBAMACARE SUCCESS LOOK LIKE? — If the Obama administration ever wants to get the Obamacare rollout back on track, it must convince the public that the law is more than a series of cancelled insurance policies and computer hiccups. But it’s not clear how the president’s team can do that, POLITICO’s David Nather reports: “What does the moment of success look like? Democrats aren’t quite sure — which makes party faithful up for reelection in 2014 increasingly nervous and makes the White House’s ability to set realistic expectations exceedingly difficult.” http://politico.pro/1gEoOr7

ENROLL AMERICA SCOOPLET — The Obamacare outreach group has directly contacted more than 302,000 consumers either in person or over the phone, with about half of those contacts occurring since enrollment opened Oct. 1. Enroll America President Anne Filipic will announce that data today — along with releasing the group’s fundraising numbers and sharing details about the second phase of its enrollment efforts in light of the ongoing website problems.

BEGICH SIGNS UP — We still don’t know for sure how many people have enrolled in coverage through HealthCare.gov, but we do know Sen. Mark Begich is among them. The Alaska Democrat said yesterday that he has enrolled in a plan using his state’s federally-run exchange. “I want to have the exact same experience and go through the same steps as other Alaskans when it comes to signing up for health care, which is why I have decided to refuse any federal subsidy and have signed up on Alaska’s federally run Marketplace,” he said in a statement.

-- Of course, we should point out that Begich didn’t have any federal contribution to turn down. To receive an employer contribution to his plan (which would be from the federal government), he would have had to enroll using the D.C. small business exchange. And his senator’s salary is too high for him to qualify for any subsidies.

** A message from AHCA. As Congress mulls options to pay for the doc fix this year, skilled nursing and assisted living providers have smart policy alternatives that lower Medicare costs without cuts. We are AHCA. And we are the solution. Learn more at http://ahcancal.org/solutions. **

CHAO: IT’S “DISTURBING” — According to meeting records released yesterday by the House Oversight Committee, CMS’s Henry Chao told staff he was “surprised” that he never saw a Sept. 3 memo outlining potential security problems with the federal exchanges and agreed that one of the findings “presented a significant risk to the system.” The memo was written by Chao’s boss, Tony Trenkle, whose retirement from the agency was rather abruptly announced last week. The transcript of Chao’s Nov. 1 meeting with Oversight staff: http://1.usa.gov/1bpGIdv

WHY MAKE LAWS WHEN YOU CAN INVESTIGATE THEM? — That’s what House Republicans are thinking right about now. It’s looking like their final 15 days of session in 2013 won’t produce any legislative breakthroughs with the Senate. Obamacare oversight is where the action’s at, folks. Your congressional guide to the rest of the year: http://politico.pro/17rk1X8

CONGRATULATIONS to Elizabeth Jurinka, chief health aide to Sen. Ron Wyden, who married Matt Schumaker on Sunday.

AMERICANS WORRIED ABOUT EXCHANGE PRIVACY — A small majority of Americans are worried that the insurance exchanges will protect personal information, according to two polls conducted by the HealthPocket.com, a website that compares insurance plans. When asked whether they’re confident that the information will be safe from hacking, 57 percent responded no. Fifty-three percent indicated they’re not confident that the information will be treated as private and withheld from other government agencies. http://bit.ly/1i23ZFp

LITTLE EVIDENCE THAT VITAMINS PREVENT CANCER – You should still keep taking them, but there’s limited evidence that taking vitamins can help prevent cancer or cardiovascular disease, according to a review published in the Annals of Internal Medicine. Of 26 studies researchers examined, they found no “consistent” evidence that supplements affect peoples’ risk of developing either disease. However, the researchers did admit to some limitations with the study — most were conducted over less than 10 years and focused on older adults. http://bit.ly/HQyrEO

OPPOSE ABORTION? SUPPORT BIRTH CONTROL — Three-quarters of adults believe anti-abortion policymakers should strongly support birth control, according to a survey released today by the National Campaign to Prevent Teen and Unplanned Pregnancy. Ninety percent of survey respondents also said that using birth control to avoid pregnancy is a personal responsibility. The National Campaign is dubbing today its first annual “Thanks, Birth Control” Day. http://bit.ly/1gEvTrT

EXERCISE IMPROVES MEMORY — Aerobic exercise improved the memory performance of adults ages 57-75 in a study conducted by University of Texas researchers and published in the journal Frontiers in Aging Neuroscience. The adults’ cognition, resting cerebral blood flow and cardiovascular fitness were assessed during a 12-week exercise regimen. http://politico.pro/1aBvJcn

WHAT WE’RE READING

The Wall Street Journal gives an update on the technical struggles some state-run exchanges are facing. http://on.wsj.com/1e04ehA

University of Chicago professor Harold Pollack writes in The Nation that Obamacare’s troubled rollout might force the cooperation health reform needs. http://bit.ly/1cfC28a

The Atlantic editor and psychotherapist Lori Gottlieb writes about her Obamacare experience in a New York Times op-ed. http://nyti.ms/17QDIYZ

Also in the New York Times: Problems with the federal exchange website have prevented tens of thousands of low-income people from signing up for Medicaid. http://nyti.ms/17kBGug

Campaigns in Missouri and Illinois to promote Obamacare have been forced to put their mass media outreach efforts aside due to the website debacle, Kaiser Health News and the St. Louis Post-Dispatch report. http://bit.ly/1bpkTKZ

The Affordable Care Act needs fundamental restructuring, but for now, President Obama should cooperate with Congress on short-term fixes, the Chicago Tribune editorial board writes. http://trib.in/1hZsjHI

The Wall Street Journal reports that 40,000 to 50,000 people have enrolled in the federally-run exchanges. http://on.wsj.com/17PZ5td

The Washington Post writes that enrollment is roughly 40,000, according to sources with access to the figures. http://wapo.st/16Xg0Hi

** The skilled nursing and assisted living profession has some smart solutions to reduce spending without across-the-board cuts to Medicare providers. Our plan to reduce hospital readmissions and thereby improve patient outcomes would produce $2 billion in Medicare savings by 2022. That measure goes beyond what other proposals offer by including every classification of readmissions, providing Congress a more comprehensive view of hospital readmissions and their financial impact on the Medicare program. But this plan is just the beginning. We are AHCA and NCAL. And we are the solution. Learn more at http://ahcancal.org/solutions. **

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