Since the state and federal health exchange marketplaces went live on October 1, 2013, approximately 106,185 people have either selected health plans or fully signed up and paid for coverage through these markets. The first official reporting of these numbers from the Administration comes after weeks of congressional and public frustration and scrutiny over significant problems with the federal enrollment website, HealthCare.gov. Original goals for enrollment extended into the millions by spring 2014, but in the weeks leading up to today's announcement, the Administration sought to significantly lower expectations while promising to fix the enrollment website and help people obtain coverage.
The announcement came on the heels of a politically contentious four and a half hour hearing by the House Oversight and Government Reform Committee on challenges with the HealthCare.gov website. During the hearing, White House Chief Technology Officer Todd Park testified before the committee and could not commit to the Administration having the website problems fixed by November 30, a promise other top Administration officials have been making since Health and Human Services (HHS) Secretary Kathleen Sebelius testified before Congress last month.
Enrollment levels within the exchanges are significant because low enrollment means that next year's premiums will be higher, as costs are spread across a much smaller pool of individuals and individuals who have enrolled are more likely to be high utilizers of health care services. Unless enrollment significantly increases by the March 31st deadline for open enrollment, one of the hallmark issues of the Obama Administration may fail to reach its goal of providing affordable health care to millions of uninsured Americans.
Used in a Sentence: Both the House and the Senate held pro forma sessions to block the President from making recess appointments.
What It Means: Pro forma sessions are authorized by the Constitution, which requires that each House of Congress grant permission to each other if a recess lasts longer than three days. Members of Congress can gavel in and out of the House and Senate galleries to show that either Chamber is still in a pro forma session.
History: Pro forma sessions have become mired in controversy over the years and have been used as a strategy by political parties to restrict a President's ability to make recess appointments to temporarily fill cabinet/political positions. Under the Constitution, the President has the authority to make appointments when Congress is in recess. However, if Congress is in-session (normally conducting daily business and votes or in a pro forma session where business is not being conducted), the President is not supposed to be able to make temporary recess appointments, pocket-veto bills, or call for a special session of Congress. In 2012, the Obama Administration challenged the law and appointments were issued, regardless of the Senate claiming that it was not in recess but otherwise in a pro forma session between recess periods.
As the deadline of February 29 rapidly approaches, House and Senate negotiators continue to remain at an impasse on how to address the looming Medicare physician pay cut. Starting March 1, 2012, physician fees will be cut by 27 percent if an agreement is not reached to avoid the cuts with either a short- or long-term fix. The bipartisan group of lawmakers, several of whom also served on the failed Supercommittee last fall, have been considering proposals that would pay for a fix that lasts anywhere from 1 to 10 years. The disagreement on how to pay for the fix, which the Congressional Budget Office believes would be between $9 billion (one - year fix) and $316 billion (10 - year fix), does not always fall cleanly along partisan lines. Republican negotiators disagree among themselves on using war savings to cover part of the cost of the doc pay fix. Democrats have opposed House Republican proposals for significant cuts to hospitals to make up the cost. MedPAC data citing significantly higher Medicare costs for physician services performed in a hospital outpatient department versus a physician office have painted a bit of bull 's eye on the hospitals, who are aggressively pushing back. If war funds are not an option, health providers fear cannibalism as the provider community seeks to protect its own and avoid being part of a list of offsets for a doc pay fix. Indeed, the same stalemate that affected the Supercommittee and House-Senate discussions that followed at the end of 2011 has reared its head again. This time, the deal - making is further complicated by election-year politics on an issue that affects the future of physician participation in Medicare, and therefore, access to Medicare services.