Obamacare faces a deadline
of Oct. 1 for implementation


With time running out, U.S. officials are struggling to cope with the task of launching the new online health insurance exchanges at the heart of President Barack Obama's signature health reforms by an Oct. 1 deadline.

The White House, and federal agencies including the Department of Health and Human Services and the Internal Revenue Service, must ensure that working marketplaces open for enrollment in all 50 states in less than 80 days, and are responding to mounting pressure by concentrating on three essential areas that will determine whether the most critical phase of Obamacare succeeds or fails.

"The administration right now is in a triage mode. Seriously, they do not have the resources to implement all of the provisions on time," Washington and Lee University professor Timothy Jost, a healthcare reform expert and advocate, told an oversight panel in the U.S. House of Representatives last week.

Current and former administration officials, independent experts and business representatives say the three priorities are the creation of an online portal that will make it easy for consumers to compare insurance plans and enroll in coverage; the capacity to effectively process and deliver government subsidies that help consumers pay for the insurance; and retention of the law's individual mandate, which requires nearly all Americans to have health insurance when Obama's healthcare reform law comes into full force in 2014.

Measures deemed less essential, such as making larger employers provide health insurance to their full-time workers next year or face fines, and requiring exchanges to verify the health insurance and income status of applicants, have already been postponed or scaled back.

"The closer you get to the actual launch, the more you focus on what is essential versus what could be second-order issues," said a former administration official. "That concentrates the mind in a different kind of way, and that's what's happening here."

But the risk of failure in the form of major delays is palpable, given the administration's limited staff and financial resources, as well as the stubborn political opposition of Republicans, who have denied new money for the effort in Congress and prevented dozens of states from cooperating with initiatives that offer subsidized health coverage to millions of lower income uninsured people.

Any further delay could help Republicans make Obamacare's troubles a focus of their campaign in next year's congressional midterm elections and in the 2016 presidential race.

Human Services denies that its strategy has changed and insists that implementation continues to meet the milestones laid out by planners 18 months ago.

"All of the systems are exactly where we want them to be today. They will be ready to perform fully on Oct. 1," said Mike Hash, director of the agency's Office of Health Reform.

White House officials acknowledge the approach of the open enrollment deadline has put a greater emphasis on priorities. They describe the strategy as a smart, adaptive policy and assert that delayed or scaled-back regulations demonstrate better policy decisions or flexibility with stakeholders, rather than a need to minimize distractions.

Advocates point out that the reform, formally titled the Patient Protection and Affordable Care Act and informally known as Obamacare, constitutes the most sweeping healthcare legislation since the creation of Medicare and Medicaid, large successful government programs for the elderly and the low income that also faced fierce political opposition when they were created in 1965. Both required years of work after their launch to refine implementation.

The administration has already delayed or scaled back at least half a dozen health reform measures since last year. These include regulations involving star quality ratings for insurance company plans, the choice of insurance plans for small-business employees and a requirement that state Medicaid agencies notify individuals of their eligibility for federal assistance.

Other efforts that could still be delayed include deadlines for some health insurers to get their plans certified by Human Services as well as requirements for how the insurance exchanges provide customer service.

House Speaker John Boehner and other House Republican leaders, warning of a train wreck, have called on Obama to defer an essential task: the individual mandate, which requires people to have insurance coverage in 2014 or face penalties that begin modestly, but rise sharply by 2016.

But experts say it is the other essential tasks — establishing the high-tech capabilities necessary to process government insurance subsidies and create online shopping and enrollment for consumers – that could be most vulnerable with such a compressed timetable.

"The biggest hurdle is to get the systems up and running," said one health insurance official. "Nothing's happened so far that prevents you from being up and running on Oct. 1. But there's virtually no margin for error."

The administration is working according to an ambitious schedule for testing a technology hub and its ability to transfer consumer data on health coverage, income, tax credits and other topics between federal agencies, insurance companies and states. The hub is already exchanging data between the necessary agencies.

A report from Georgetown University's Center on Health Insurance Reforms says state-run exchanges are on track for a successful Oct. 1 launch and have exceeded federal minimum requirements in some cases.

Failure to have adequate systems in place by Sept. 4, when Health and Human Services is due to give insurers final notice about which health plans are qualified to be sold on 34 state exchanges run by the federal government, could delay open enrollment by days or weeks but still allow the law's core reform provisions to take effect on Jan. 1, experts said.

Insurers will have several days in August to review plan data as it would be presented to prospective enrollees in side-by-side comparisons online. The administration also needs to test the system with a wider audience than the IT experts working on the exchanges to make sure they are consumer-friendly.

Michael Marchand, spokesman for Washington's Health Benefit Exchange, said the state's online marketplace had conducted frequent tests with the federal data hub, which had worked well so far. But any last-minute changes to the government's requirements to its operations could throw a wrench into the IT system, he said.

"If you start adding or removing lines of code it could bring the whole thing down," he said. "As you add or take away pieces, you have to re-test from the beginning."


U.S. quakes tied to injection
of waste water underground


The number of earthquakes in the central and eastern United States has increased dramatically over the past few years, and scientists think the reason could be due to the disposal of wastewater associated with oil and gas production.

According to a report by the U.S. Geological Survey, there were more than 300 earthquakes above magnitude 3.0 from 2010 to 2012. That’s a five-fold increase from earthquakes observed from 1967 to 2000, when the average number was 21 per year.

In 2011, a 5.6 magnitude quake struck central Oklahoma, injuring several people and damaging over a dozen homes. According to the report, wastewater disposal appears to have been the cause of the temblor. Had an earthquake that size hit a more populated area, there would be the potential for severe damage and possible deaths.

“There is a hazard, and I think it’s greater than people thought before,” said William Ellsworth, a geophysicist with the U.S. Geological Survey. “If small earthquakes start occurring near injection sites, that’s something to pay attention to. With that in mind one can ask how this can be managed. Clearly there’s a lot of research to be done.”

Wastewater earthquakes occur because water that is salty or mixed with chemicals needs to be disposed of so as not to contaminate freshwater sources such as aquifers. The most common way of doing that is to inject the water deep underground.

Ellsworth’s research showed that when wastewater is deposited near faults and underground conditions are right, earthquakes can be more likely. If water pressure inside a fault gets high enough, it can cause the release of tectonic stress in the form of an earthquake. Even faults that have not moved for millions of years can be made to slip if the conditions are right.

Wastewater is often a byproduct of certain types of energy production, extracting oil and gas from shale rock formations, for example. Wastewater can also be produced through hydraulic fracturing, also known as fracking, when water is injected into rock formations to extract oil and gas.

Ellsworth said no fracking sites have been implicated with earthquakes.

The time between the injection of wastewater and an earthquake is variable, Ellsworth said.

“It can be very soon, or it can be years,” he said. “It’s very complicated and very dependent on the conditions under ground.”

Despite the dramatic increase in the number of quakes, Ellsworth points out that very few of the more than 30,000 wastewater wells appear to have caused earthquakes.

Still, the research raises red flags, and according to Ellsworth, shale rock suited for this kind of drilling can be found all over the world, and how the wastewater will be dealt with remains a question.

In the U.S. the regulations about wastewater disposal center on the protection of drinking water and do not address the potential for man-made earthquakes.


Mostly peaceful protests come
after Zimmerman verdict


Passionate, but mostly peaceful protests, have erupted in several U.S. cities after a Florida man was acquitted of murder and manslaughter in the highly-publicized shooting death of a black teenager last year.

Verdicts in racially-charged cases have, on occasion, triggered violence and destruction on a massive scale.  The 1992 acquittal of Los Angeles police officers in the beating of a black motorist sparked days of ferocious riots and looting in the city.  Dozens of people were killed, hundreds were wounded, and property damage topped $1 billion.

By comparison, reaction to the acquittal of Florida shooting suspect George Zimmerman has been relatively peaceful.

Late Saturday, a six-woman jury arrived at a verdict in one of America’s most closely-watched court cases of recent years.

An attorney for the family of deceased 17-year-old Trayvon Martin, appeared on the Fox News Sunday television program.  Darryl Parks described the verdict as unbelievable, but said the Martin family wants the public to remain calm. “That is their  decision.  We accept their decision, but we do not agree with their decision," he said.

In 2012, Zimmerman, a neighborhood watch volunteer, spotted Martin walking at night through his Florida community.  A confrontation and struggle ensued, ending with Zimmerman shooting Martin.

The court case appeared to hinge on conflicting accounts of who had incited hostilities, and whether Zimmerman was acting in self-defense.

The verdict was appropriate, according to a member of the Senate Judiciary Committee, Republican Orrin Hatch, who spoke on ABC’s This Week program. “If the rule is that you have to prove guilt beyond a reasonable doubt, there were plenty of reasonable doubts there," he said.

Although acquitted of criminal wrongdoing, Zimmerman could still face civil charges if the Martin family or the U.S. Justice Department pursue that avenue.


French president optimistic
in his Bastille Day speech


World dignitaries including United Nations Secretary-General Ban Ki-moon joined French President Francois Hollande for the Bastille Day parade in Paris Sunday.

Close to 5,000 troops, including U.N. soldiers in blue berets and servicemen from 13 African countries marched past the presidential stage where Hollande stood with Ban.

France's biggest holiday took place in the shadow of a deadly train crash just 20 kilometers south of the French capital. At least seven people were reported killed in the Friday train derailment. Many others were injured.

In a televised interview Sunday President Hollande said more has to be done to maintain traditional rail lines.

But the president focused on France's achievements. He said that France's economy is beginning to recover, citing an increase in industrial production and a slight recovery in consumption.

The traditional military parade on the Champs Elysees was led by a Malian officer, drawing attention to France's role in liberating the African country's north from Islamist and other insurgent groups.

Bastille Day is France's biggest national holiday. It commemorates the storming of the Bastille fortress in 1789, which marked the start of the French Revolution.


Fish oil linked to cancer
of prostate in new study


Fish oil supplements that are high in omega-3 fatty acids have been quite popular among people who take them to help with issues such as heart health.

Past research has indicated that omega-3 fatty acids, which are found in fish, fish oil and other foods such as wild rice and walnuts, can decrease the likelihood of cardiovascular disease.

But now new research released this week indicates that too much omega-3 could put men at a higher risk of developing prostate cancer, especially a deadly form of the disease. The finding confirms similar conclusions made in several earlier studies.  
While some experts have expressed skepticism about the study’s findings, men taking the supplement may find themselves weighing the benefits fish oil capsules may provide for their heart health versus the possible harm and increased risk of developing prostate cancer.

The study, conducted by researchers at Seattle’s Fred Hutchinson Cancer Research Center, found that high concentrations of three anti-inflammatory and metabolically related fatty acids called eicosapentaenoic acid, eocosapentaenoic acid  and docosahexaenoic acid  that are found in fatty fish such as salmon as well as in fish-oil supplements, are linked with a 71 percent increased risk of developing high-grade prostate cancer, the kind that experts say are more likely to be fatal.

The Seattle study also revealed that too much of the fatty acids can also lead to a 44 percent increase in the risk of low-grade prostate cancer — which grows slowly — as well as an overall 43 percent increase in risk for all forms of prostate cancers.

To reach their findings, the researchers studied a group of about 843 men who had prostate cancer and another group of 1,383 men who didn’t have the cancer. They found that the prostate cancer patients had higher levels of the omega-3 fatty acids in their blood than those in the non-cancer group.

The researchers said that the consistency of their findings suggest that these fatty acids are connected with the development of prostate tumors. They also caution those who want to increase their dosage of omega-3 fatty acids to consider any potential risks.

The researchers said they’re unclear so far about why the high levels of omega-3 fatty acids would increase prostate cancer risk. They do point out that omega-3 fatty acids converting into compounds could damage cells and DNA, and their role in immunosuppression.  They said that they don’t know whether or not these effects can actually impact cancer risks and that further research into possible mechanisms will be needed.

These new findings, published July 11 in the online edition of the Journal of the National Cancer Institute, confirm those made in 2011 by the same Seattle researchers.


Effort to end filibusters
to generate Senate battle


Washington is bracing for a major legislative battle this week, not over a specific bill, but over the rules governing the U.S. Senate.  The ability of the minority party to block votes, a procedure known as a filibuster, could be curtailed.  Weakening the filibuster might stem chronic legislative gridlock, but could also erode a historic American safeguard against the raw will and power of majority rule.

Until recent years, filibustering meant holding the Senate floor and speaking non-stop to prevent a vote, as portrayed by Jimmy Stewart in the 1939 movie Mr. Smith Goes to Washington.

Backers of racial segregation famously or infamously filibustered civil-rights legislation in the 1950s and 60s.  Earlier this year, Republican Sen. Rand Paul held the floor for 13 hours to draw attention to the use of domestic drones.

Most modern filibusters are never seen.  A senator files a motion to prevent a vote, and unless a three-fifths supermajority disagrees, the vote is blocked.  Once a rare practice, almost all Senate votes of consequence must now overcome a filibuster.

“Is there anybody out there in America that thinks this body is functioning well," asked Majority Leader Harry Reid.

The Nevada Democrat says his party will move to change filibuster rules this week unless Republicans allow confirmation votes on high-profile nominees submitted by President Barack Obama to lead federal agencies.  Reid says the ability of the government to function is at stake.

“The Constitution gives the president, whoever that president may be, the right and the power to choose his team.  It grants the Senate the right to advise and consent on those choices.  But consistent and unprecedented obstruction by the Republican caucus has turned ‘advise and consent into deny and obstruct," he said.

Republicans warn of dire consequences for American democracy.

Minority Leader Mitch McConnell said, “That would violate every protection of minority rights that have defined the U.S. Senate for as long as anyone can remember.  Let me assure you this Pandora’s Box, once opened, will be utilized again and again by future majorities."

In 2005, Democrats were in the minority and defended the filibuster to block judicial nominees submitted by then-president George W. Bush.

“They think the Senate should be a rubber stamp for this president," said Sen. Reid at the time.

Then-majority leader Bill Frist accused Democrats of abusing the filibuster and setting a dangerous precedent. “To enshrine new tyranny of the minority into the Senate rules forever," he said.

Changing the Senate rules by a simple majority vote has been dubbed the nuclear option, given its potential to forever alter America’s legislative landscape.


Latin leaders defend asylum
and rail against U.S. spying


South American leaders had strong words for Washington Friday over allegations of U.S. spying in the region and defended their right to offer asylum to fugitive former U.S spy agency contractor Edward Snowden.
 
Washington wants Snowden arrested on espionage charges after he divulged extensive, secret U.S. surveillance programs. Stuck in the transit area of Moscow's international airport since late June, he is seeking asylum in various countries.
 
Capping two weeks of strained relations over the Snowden saga, presidents from the Mercosur bloc of nations met in Montevideo, Uruguay. Complaints against the United States were high on the agenda, as Washington warned the international community not to help the 30-year-old Snowden get away.
 
“We repudiate any action aimed at undermining the authority of countries to grant and fully implement the right of asylum,” Mercosur said in a statement at the close of Friday's summit.
 
The statement called for “solidarity with the governments of Bolivia, Nicaragua and Venezuela, which have offered to grant asylum to Mr. Edward Snowden.”
 
The Mercosur bloc comprises Venezuela, Brazil, Argentina, Uruguay and Paraguay.
 
“This global espionage case has shaken the conscience of the people of the United States and has upset the world,” Venezuelan President Nicolas Maduro said.
 
The meeting began as reports emerged that Snowden wants to travel eventually to Latin America after seeking temporary asylum in Russia.
 
The U.S.-Russian relationship would be troubled if Moscow were to accept an asylum request from Snowden, the U.S. State Department said. President Barack Obama raised U.S. concerns directly with Russian President Vladimir Putin Friday.
 
Leaders throughout Latin America are also furious over reports the U.S. National Security Agency targeted most Latin American countries with spying programs that monitored Internet traffic, especially in Colombia, Venezuela, Brazil and Mexico.
 
In its statement, Mercosur said, “We emphatically reject the interception of  telecommunications and espionage activities in our countries, as they are a violation of human rights and citizens' right to privacy and information.”
 
It also called for the spy scandal to be brought before the U.N. Security Council.
 
The espionage allegations were published by a leading Brazilian newspaper, O Globo, Tuesday. The U.S. ambassador to Brazil, Thomas Shannon, said this week the reports gave an incorrect picture of U.S. data gathering.
 
“This is the world we live in; a world with new forms of colonialism,” Argentine President Cristina Fernández said in her closing remarks in Montevideo. “It is more subtle than it was two centuries ago, when they came with armies to take our silver and gold.”
 
Colombia, Washington's closest military ally in Latin America, and Mexico, its top business partner, have also joined the chorus of governments seeking answers.
 
“Any act of espionage that violates human rights, above all the basic right to privacy, and undermines the sovereignty of nations, deserves to be condemned by any country that calls itself democratic, “ Brazilian President Dilma Rousseff told reporters on arrival at the meeting.
 
Rousseff, who was imprisoned under military rule in Brazil in the early 1970s, said the rights issue was particularly important for South American countries that lived under dictatorships for years and are now democracies.
 
U.N. human rights chief Navi Pillay made her first comment on the Snowden case Friday, saying people needed to be sure their communications were not being unduly scrutinized and calling on all countries to respect the right to seek asylum.
 
Snowden said in a letter posted Friday on the Facebook page of the New-York based Human Rights Watch that the United States had been pressuring countries not to accept him. Obama has warned of serious costs to any country that takes him in.
 
Despite their fiery rhetoric and public offers of asylum, few in Latin America seem particularly keen to welcome Snowden and risk damaging trade and economic ties with Washington.
 
Cuba and Venezuela are both in a cautious rapprochement with the United States that could be jeopardized if they helped Snowden.
 
Still, leaders recalled that many of their own citizens sought asylum abroad during the military dictatorships of the Cold War era.
 
South American leaders rallied in support of Bolivian President Evo Morales last week after he said he was denied access to the airspace of Portugal, France, Italy and Spain on suspicion Snowden might be on board his plane as Morales flew home from a visit to Russia.
 
Bolivia is an associate member of Mercosur, and Morales attended Friday's meeting. The Mercosur statement said bloc member countries would call their ambassadors in from the four European countries for consultations.