Obamacare push accelerates as U.S. gov't shutdown nears


By David Morgan and Sharon Begley

Sept 30 (Reuters) - The Obama administration accelerated itspush to persuade individual Americans to sign up for the mostextensive overhaul of the U.S. healthcare system in 50 years onMonday, as the program's foes in Congress fought to delay itslaunch with the threat of a federal government shutdown.

In opinion pieces featured in nearly 30 local newspapers,Vice President Joe Biden and Health and Human Services SecretaryKathleen Sebelius urged millions of uninsured Americans toignore the battle in Congress over President Barack Obama'shealthcare law, and instead focus on the access their familiesneed to medical services.

"Come Tuesday, Americans will be able to see for themselvesthat the Affordable Care Act isn't actually about Washingtonpolitics," Biden wrote in a piece printed in outlets includingthe Des Moines Register in Iowa and the Birmingham News inAlabama. "It's about regular people shopping for insurance theycan finally afford, and purchasing security and peace of mindalong with it."

The key element of the president's healthcare reform, knownwidely as Obamacare, was due to launch on Tuesday with theopening of online insurance exchanges in all 50 states and theDistrict of Columbia offering subsidized health coverage.

State officials and community groups on Monday said theywere putting the final touches on their exchange openings. TheDepartment of Health and Human Services said that 900 businessesand organizations had volunteered to explain the new law toAmericans nationwide.

The roll-out would proceed even as Republican lawmakersfought to delay the overhaul by attaching amendments to agovernment funding measure. Congress faces a midnight deadlineto reach an agreement or force federal agencies to close, orpartially close, at the start of the U.S fiscal year on Oct. 1.

Republican U.S. Representative Charles Boustany ofLouisiana, a leading Obamacare critic, expressed misgivingsranging from the cost of coverage to the role of the InternalRevenue Service, a favorite target for conservatives that willhelp determine eligibility status and subsidy levels forapplicants.

"We know that the IRS is in the mix of this ... We knowthere are major problems there. I have really deep concernsabout where this is going," he said on Fox News.

As many as 7 million Americans are expected to sign up forhealth coverage via the new exchanges for 2014, the yearObamacare's main provisions take effect. Another 8 million areexpected to receive benefits through an expansion of thegovernment's Medicaid program for the poor.

The Affordable Care Act, passed in 2010, requires thathealth insurance companies provide a basic package of benefitsand prohibits them from excluding people due to prior illness.It provides billions of dollars in government subsidies, in theform of tax credits, to help individuals buy insurance on thebasis of annual income. It also requires that all Americansobtain insurance, or pay a fine. For a factbox, see:

Republicans and other groups have fought the law forcreating what they say is an intrusive government system tooversee healthcare that will place financial burdens onindividuals and businesses.


New York, Colorado, Oregon and some other states runningtheir own exchanges plan to open at 8 a.m. local time Tuesday,while others may open as early as midnight. Senioradministration officials say they would prefer to have peopleaccessing the federally-run marketplace for 36 states duringdaylight hours when government and call center offices are fullystaffed.

It promises to be a rocky roll-out. Several exchanges,including Oregon, Colorado and the District of Columbia, havealready said key functions for enrolling won't be in place inthe first few weeks of October.

Over the summer the Obama administration delayed numerousprovisions of the law, most notably the requirement that largeemployers provide health insurance to their workers starting in2014, as well as elements of the exchanges, such as theirability to sell policies to small employers and their workersand a Spanish version of the main website.

Software problems threaten opening-day glitches. Over theweekend, armies of information technology specialists tested andre-tested the complex interfaces and communication links neededto make the exchanges functional.

As opening day neared, many exchanges continued to ramp upeducation and marketing efforts. Kynect, Kentucky's exchange,handed out information at the Kentucky Bourbon Festival.Minnesota's exchange, as well as HHS, held live online chats toget the word out.

From insurance companies to hospital executives to policyexperts and politicians, there will be intense focus on how theexchanges function, and how many customers they attract, fromthe opening bell. For weeks, however, the Obama administrationas well as states have played down expectations for Oct. 1.

"We are expecting a slight upturn of activity," RebeccaLozano of the Portico Health Net, a Minnesota group that willhelp people enroll in coverage, said last week at an eventhosted by Families USA, a non-profit that supports the ACA."We're not imagining a run on the banks" on Oct. 1.

"Those with preexisting conditions are the people we expectto be at the door when the door opens," said Reagan Hunt,executive director of Kentucky Voices for Health. "We have noidea what that number looks like. But in Kentucky, you haveabout 900,000 people who have been denied coverage in the pastdue to preexisting conditions."

Sebelius said on Monday that "the key date really is the15th of December," the deadline for buying coverage that startson Jan. 1. "For millions of Americans, the new options are goingto be affordable, within their own budgets. So Jan. 1 can be anew day. It can begin to change the statistics where we will nolonger have a large population in this country who doesn't haveaccess to the best medical care."

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