Julie Rovner | St. Louis Public Radio

Julie Rovner

The biggest changes in health insurance coverage under the Affordable Care Act are set to begin less than three months from now. Oct. 1 is when people can start signing up for coverage in new state health exchanges. The policies would kick in on Jan. 1, 2014.

It can all be a little confusing, we agree. So two weeks ago, we asked what you wanted to know about the health law.

This weekend marks 100 days until people can begin signing up for new health insurance coverage under the federal health care law. It also marks another milestone: the launch of an enormous public relations effort to find people eligible for new coverage and urge them to sign up when the time comes.

But like everything else about the health law, even this seemingly innocuous effort has been touched by controversy.

The House has passed one of the most far-reaching abortion bills in decades. But it's unlikely to ever become law.

By a mostly party-line vote Tuesday of 228-196, lawmakers passed the "Pain-Capable Unborn Child Protection Act," which would ban nearly all abortions starting 20 weeks after fertilization.

Call it the Affordable Care Act, call it Obamacare, call it whatever you want — it's coming. And soon. In less than four months people without health insurance will be able to start signing up for coverage that begins Jan. 1.

A lot has been said about the law, most of it not that understandable. So starting now, and continuing occasionally through the summer and fall, we're going to try to fix that.

Reaction was swift to the Obama administration's announcement Monday night that it was dropping a long-running legal battle to keep age restrictions on one type of the morning-after birth control pill.

But like just about everything else in this decade-long controversy, the latest decision has pleased just about no one.

As predicted, abortion opponents on Capitol Hill are wasting no time in their efforts to turn publicity over the recent murder conviction of abortion provider Kermit Gosnell to their legislative advantage.

Their latest goal: a federal ban on most abortions after 20 weeks of pregnancy.

The news that U.S. scientists have successfully cloned a human embryo seems almost certain to rekindle a political fight that has raged, on and off, since the announcement of the creation of Dolly the sheep in 1997.

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Transcript

STEVE INSKEEP, HOST:

The administration's actions this week on emergency contraception have left many women's health groups sputtering with anger.

But what really has some of the President Obama's usual allies irritated is the fact that the moves are in direct contrast to speeches he made in just the past week.

Two years ago, a landmark study found that having Medicaid health insurance makes a positive difference in people's lives.

Backers of the program have pointed to that study time and again in their push to encourage states to expand the program as part of the federal health law.

In an effort to find a compromise for a politically fraught issue, the Food and Drug Administration has approved a proposal to make the emergency contraceptive pill Plan B more available to some younger teens without a prescription and to older women by moving the medication out from behind the pharmacy counter.

This is the sixth week of the trial of Dr. Kermit Gosnell, the physician charged with five counts of murder in the deaths of a woman and infants at the Philadelphia abortion clinic he owned and operated.

The budget President Obama will send to Congress Wednesday is expected to include some $400 billion in reductions to Medicare and other health programs.

And if the word around Washington is correct, it may also include a proposal aimed at winning some bipartisan backing — by changing the way Medicare patients pay for their care.

Transcript

DAVID GREENE, HOST:

The Obama administration is delaying the start of a key piece of the Affordable Care Act - the national healthcare law. Workers in small businesses will have to wait an additional year to be able to choose from more than one plan in the new online marketplace that start next January. NPR's Julie Rovner reports that the change might dampen enthusiasm, at least at the start. But not everyone thinks that's a bad thing.

Since the Supreme Court made the Medicaid expansion under the federal health law optional last year, states' decisions have largely split along party lines. States run by Democrats have been opting in; states run by Republicans have mostly been saying no or holding back.

When the nation's governors gathered in Washington, D.C., over the weekend for their annual winter meeting, the gathering's official theme was about efforts to hire people with disabilities.

The most heated part of the fight between the Obama administration and religious groups over new rules that require most health plans to cover contraception actually has nothing to do with birth control. It has to do with abortion.

Specifically, do emergency contraceptives interfere with a fertilized egg and cause what some consider to be abortion?

It's looking increasingly likely that $85 billion of automatic federal budget cuts known as a sequester will come to pass if Congress doesn't act by March 1.

The characteristics of gun violence in the U.S. are largely unknown because key federal health agencies have been banned from conducting such research since the mid-1990s.

President Obama, however, wants to change that.

The Obama administration on Friday issued another set of proposed rules — and asked for yet another round of public comments — in a continuing quest to find a way to ensure that women receive no-cost contraception as part of a package of preventive health services under the 2010 Affordable Care Act without requiring religious employers to violate their beliefs.

The Obama administration has issued a proposal detailing how coverage for contraception will be paid for under Obamacare. The health overhaul law requires insurance plans to provide birth control coverage, but those opposed to artificial contraception argue they should not be made to use their own funds to pay for it. Audie Cornish talks to Julie Rovner.

Jan. 22, 2013, marks the 40th anniversary of Roe v. Wade, the landmark Supreme Court decision that legalized abortion nationwide.

But the conventional wisdom that the court's 7-2 decision marked the beginning of a contentious battle that still rages today is not the case, according to those on both sides of the dispute.

When Congress passed the Affordable Care Act in 2010, few would have predicted that one of the most contentious provisions would have to do with contraception.

But today federal officials are grappling with more than 40 lawsuits claiming that the requirement for most health plans to provide contraceptive coverage to women violates their religious freedom.

And religious groups aren't the only ones going to court.

The bill that prevented the nation from plunging over the fiscal cliff did more than just stop income tax increases and delay across-the-board spending cuts. It also included several provisions that tweaked Medicare and brought bigger changes to other health care programs.

The 113th Congress will be the first one in 40 years to convene without California Rep. Pete Stark as a member.

Stark was defeated in November by a fellow Democrat under new California voting rules. Stark may not be a household name, but he leaves a long-lasting mark on the nation's health care system.

Most of the really big changes made by the 2010 health law don't start for another year. That includes things like a ban on restricting pre-existing conditions, and required insurance coverage for most Americans. But Jan. 1, 2013, will nevertheless mark some major changes.

When it comes to reducing Medicare spending, asking wealthier seniors to pay more is one of the few areas where Democrats have shown a willingness to even consider the subject.

"I do believe there should be means testing. And those of us with higher income in retirement should pay more," said Sen. Dick Durbin, D-Ill., on last Sunday's Meet the Press. "That could be part of the solution."

At least in public, Republicans have been clear that they see the current budget negotiations as a chance to address what they see as the source of Washington's deficit problem: major entitlement programs.

The Affordable Care Act, as passed by Congress in 2010, assumed that every low-income person would have access to health insurance starting in 2014.

That's when about 17 million Americans — mostly unmarried healthy adults with incomes up to 133 percent of poverty, or about $15,000 a year — would gain access to Medicaid.

Friday marks a not-so-happy anniversary for some of President Obama's biggest supporters: It's exactly one year since Health and Human Services Secretary Kathleen Sebelius decided not to lift the age restrictions on availability of the so-called morning-after pill, Plan B.

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