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Geneva [Switzerland], June 29 (ANI): Aspartame, one of the world's most common artificial sweeteners, is set to be declared a possible carcinogen next month by a leading global health body, pitting it against the food industry and regulators, reported Reuters. Aspartame is used in products from Coca-Cola diet sodas to Mars' Extra chewing gum and some snapple drinks. The <keyword id="665762" type="General" weightage="50" keywordseo="international-agency-for-research-on-cancer" source="Orion">International Agency for Research on Cancer</keyword> (IARC) and the <keyword id="43588" type="General" weightage="50" keywordseo="world-health-organization" source="Orion">World Health Organization</keyword>'s (WHO) cancer research arm will list it as "possibly carcinogenic to humans" for the first time in July, according to two sources with knowledge of the process. Following a meeting of the group's external experts earlier this month, the IARC ruling is intended to assess whether something is a potential hazard or not, based on all the published evidence. It does not take into account how much of a product a person can safely consume. This advice for individuals comes from a separate WHO expert committee on food additives, known as the Joint WHO and Food and Agriculture Organization's Expert Committee on Food Additives (JECFA), alongside determinations from national regulators, Reuters reported. In the past, similar IARC rulings for different substances have raised concerns among consumers about their use, led to lawsuits, and pressured manufacturers to recreate recipes and swap for alternatives. This has led to criticism that the IARC's assessments can be confusing to the public. JECFA and the WHO committee on additives are also reviewing aspartame use this year. Its meeting began at the end of June and is due to announce its findings on the same day that the IARC makes public its decision on July 14, as per Reuters. Since 1981, JECFA has said aspartame is safe to consume within accepted daily limits. For example, an adult weighing 60 kg (132 pounds) would have to drink between 12 and 36 cans of diet soda - depending on the amount of aspartame in the beverage - every day to be at risk. Its view has been widely shared by national regulators, including in the United States and Europe. An IARC spokesperson said both the IARC and JECFA committees' findings were confidential until July. But they added that they were "complementary", with IARC's conclusion representing "the first fundamental step to understand carcinogenicity". The additives committee "conducts risk assessment, which determines the probability of a specific type of harm (e.g., cancer) to occur under certain conditions and levels of exposure," Reuters reported. Whereas, industry and regulators fear that holding both processes at around the same time could be confusing, according to letters from U.S. and Japanese regulators seen by Reuters. Nozomi Tomita, an official from Japan's Ministry of Health, Labour and Welfare wrote in a letter on March 27 to WHO's deputy director general, Zsuzsanna Jakab, "We kindly ask both bodies to coordinate their efforts in reviewing aspartame to avoid any confusion or concerns among the public." The letter also called for the conclusions of both bodies to be released on the same day, as is now happening. The Japanese mission in Geneva, where the WHO is based, did not respond to a request for comment, according to Reuters. However, Frances Hunt-Wood, the secretary general of the <keyword id="17858097" type="General" weightage="50" keywordseo="international-sweeteners-association" source="Orion">International Sweeteners Association</keyword> (ISA) said, "IARC is not a food safety body and their review of aspartame is not scientifically comprehensive and is based heavily on widely discredited research," The body, whose members include <keyword id="6042988" type="General" weightage="50" keywordseo="mars-wrigley" source="Orion">Mars Wrigley</keyword>, a Coca-Cola unit and Cargill, said it had "serious concerns with the IARC review, which may mislead consumers". Kate Loatman, the International Council of Beverages Associations' Executive Director said public health authorities should be "deeply concerned" by the "leaked opinion", and also warned it "could needlessly mislead consumers into consuming more sugar rather than choosing safe no-and low-sugar options," Reuters reported. Aspartame has been extensively studied for years. Last year, an observational study in France among 100,000 adults showed that people who consumed larger amounts of artificial sweeteners including aspartame had a slightly higher cancer risk, according to Reuters. Furthermore, it followed a study from the <keyword id="17858098" type="General" weightage="50" keywordseo="ramazzini-institute" source="Orion">Ramazzini Institute</keyword> in Italy in the early 2000s, stating that some cancers in mice and rats were linked to aspartame. However, the first study could not prove that aspartame caused the increased cancer risk. The questions were raised about the methodology of the second study, including by EFSA, which assessed it, reported Reuters. The IARC said it had assessed 1,300 studies in its June review. Aspartame is authorized for use globally by regulators who have reviewed all the available evidence. Also, major food and beverage makers have for decades defended their use of the ingredient. The soft drinks giant Pepsico tweaked recent recipes which demonstrated the struggle the industry has when it comes to balancing taste preferences with health concerns. Pepsico removed aspartame from sodas in 2015, bringing it back a year later, but removed it again in 2020, according to Reuters. Sources close to the IARC said that Aspartame has been listed as a possible carcinogen which is intended to motivate more research, which will help agencies, consumers and manufacturers draw firmer conclusions. But it will also likely ignite debate once again over the IARC's role, as well as the safety of sweeteners more generally. Last month, the WHO published guidelines and advised consumers to not use non-sugar sweeteners for weight control. The guidelines caused an uproar in the food industry, which argues that they can be helpful for consumers wanting to reduce the amount of sugar in their diet, reported Reuters. (ANI)

WHO's views on sweetener Aspartame may pit it against the food industry and regulators

ORLANDO (Reuters) - The second U.S. patient to be diagnosed with the deadly Middle East Respiratory Syndrome (MERS) spent at least four hours in the public waiting room of a busy Florida emergency department before he was seen by a doctor, a hospital official said.
Almost eight more hours passed before staff at Orlando's Dr. P. Phillips Hospital determined the patient had traveled from Saudi Arabia, where he worked at a hospital, began to suspect his exposure to MERS and had him moved to an isolation room, the hospital's chief quality control officer said.
The official, Dr. Antonio Crespo, said that as of Tuesday, he had changed procedures in the emergency department of Dr. P. Phillips Hospital so that any patient who comes in with flu-like symptoms will be asked whether they traveled to Saudi Arabia or other countries experiencing MERS outbreaks. 
"That is one of the learning lessons of this experience. Yes, we could have asked this sooner. I think we have created more awareness," Crespo told Reuters in an interview.
The extended window of time may have exposed hospital staff and other patients to the virus, which is responsible for a worsening outbreak in Saudi Arabia and is estimated to kill about a third of infected patients.
Florida officials said on Tuesday two healthcare workers who were in contact with the patient in the ER late last week had since developed flu-like symptoms and were being tested for MERS. Results are expected on Wednesday.
The possibility that the illness, which has no known treatment, was spreading raised new concerns about the ability of global health officials to contain it.
While the Orlando patient waited to be admitted, he was treated in a single room in the emergency department where healthcare workers wore gloves and gowns due to his diarrhea, but did not wear goggles and face masks appropriate for protecting them from the virus, Crespo said.
Florida officials said they were monitoring the health of 20 healthcare workers who had been in contact with the patient, including a doctor who had already left for Canada. They also were trying to track down nearly 100 people who may have overlapped with the patient at two Orlando medical facilities he visited.
(Editing by Michele Gershberg and Ken Wills)

Florida MERS Patient Sat In A Busy ER For Nearly 8 Hours

<div class="KonaFilter image-container display-table float_right"><div><div class="image on-image">Geoff Burke/USA TODAY Sports via ReutersUnited States president Barack Obama touches the Stanley Cup prior to an event honoring the 2013 NHL Stanley Cup champion Chicago Blackhawks at The White House. Mandatory Credit: </div></div></div>(Reuters) - Uninsured Americans are showing more interest in the coverage offered under President Barack Obama's health care law despite technical problems that have hindered enrollment through a government website, according to a Reuters/Ipsos poll.
The glitches have crippled HealthCare.gov, the new online insurance marketplace meant to serve people in 36 states, frustrating millions of would-be applicants since it opened for enrollment on October 1.
The poll's findings are good news for <keyword id="6579869" type="PERSON" weightage="60" keywordseo="ObamaCare">Obamacare</keyword> supporters who worry the problems and bad press could dissuade people from signing up, particularly the young and healthy who are crucial to diversifying the pool of insured and keeping premiums down.
The uninsured view the 2010 Patient Protection and Affordable Care Act, commonly known as Obamacare, more favorably since online marketplaces opened - 44 percent compared with 37 percent in September, according to the Reuters/Ipsos poll. It found that 56 percent oppose the program compared with 63 percent in September.
A higher proportion of the uninsured also said they are interested in buying insurance on the exchanges, with 42 percent in October, saying they were likely to enroll compared with 37 percent in September. The results have a credibility interval, a measure of accuracy, of plus or minus 3.2 percentage points.
For a graphic, see: http://link.reuters.com/myw44v
"The launch of the exchanges, that's the first real world event for a lot of people," said Chris Jackson, an Ipsos pollster. "There's been this sense that once people got familiar with it, public opinion would start to move in its direction."
The online poll of nearly 12,000 people was conducted in October. Some 1,100 of the respondents identified themselves as uninsured.
Among the general public, support for the law rose from nearly 44 percent to 47 percent, with a credibility interval of 1 percentage point, according to the poll.
The non-partisan Congressional Budget Office estimates that up to 7 million people are likely to sign up for coverage on the private exchanges for 2014, but that number has been called into question due to HealthCare.gov's problems. The Obama administration has said it is working around the clock to fix the website by the end of November.
<h3>OVERCOMING OBSTACLES</h3>
The results showed that the rise in both the law's popularity and in the uninsured's willingness to buy was much greater in the 14 states that chose to run their own exchanges and whose sites have generally operated more smoothly than HealthCare.gov, which serves the other 36 states.
More than half of respondents in state-run exchanges now favor the law compared with about four in 10 elsewhere.
To the uninsured the faulty website is "a technical barrier that is being repaired and it pales to barriers they've faced in the past," said Sara Collins, vice president at the Commonwealth Fund, a private health care research foundation.
The law bans insurers from discriminating against those with pre-existing conditions and provides subsidies to help low-to-middle income Americans buy private insurance. The Congressional Budget Office has projected it will cut the uninsured population by half, or about 25 million people, in the next decade.
Melissa Harvey, an asthmatic who spends $500 per month on prescription medicines, has been seeking insurance for five years. The 37-year-old has been without coverage since she lost her job as a public defender and moved back to Colorado to start a private law practice.
"I wish the plans were cheaper," Harvey said of the insurance offered on Colorado's state-run exchange. "But at the same time, the plans I am looking at would be less per month than what I'm paying in prescription costs."
At the same time, news reports about HealthCare.gov's struggles have kept Amanda Wood from visiting the site to check out health plans in New Jersey.
Wood, 25, said the problems remind her of frustrations trying to register electronically for classes when she was in college. "It's a huge website," Wood said. "I would just prefer to wait until it's working."
Among the majority of uninsured Americans surveyed in the poll who said they oppose the law, many resent its requirement to buy coverage or face a fine.
"I don't believe the government should have to tell me I have to buy any insurance," said Joshua Lucas of Arizona, a stay-at-home father of two. "I'm 34 years old, and I am in great health, so I don't feel like I have to have it."
(Additional reporting by Curtis Skinner in New York and Deena Beasley in Los Angeles; Editing by Michele Gershberg, Ross Colvin and Grant McCool)

Interest In Obamacare Is Rising Despite Website Problems

<div class="KonaFilter image-container float_right"><div class="image on-image"><a href="http://www.flickr.com/photos/whitehouse/">Flickr/whitehouse</a></div></div>WASHINGTON (Reuters) - Millions of Americans will learn on Tuesday what President <a>Barack Obama</a>'s landmark health care law actually means for them, as the administration opens new insurance marketplaces in 50 states despite the government shutdown.
The launch marks a milestone for Obama's signature domestic policy achievement, which aims to provide subsidized health care to millions of the uninsured, the most ambitious U.S. social program since <a class="cite">Medicare</a> was introduced in the 1960s.
The marketplaces, or exchanges, require health plans to provide a broad range of essential benefits that were not necessarily part of individual policies in the past, including mental health services, birth control and preventive care.
The coverage is linked to other insurance market reforms and new consumer safeguards including a ban on discrimination based on gender and health history.
It also mandates that Americans obtain insurance or pay a fine.
"Nothing like this has ever existed before," said U.S. Health and Human Services Secretary <a class="cite">Kathleen Sebelius</a>.
Republicans have fought for months to delay or stop <keyword id="6579869" type="PERSON" weightage="60" keywordseo="ObamaCare">Obamacare</keyword>, most recently triggering a shutdown of the <a class="cite">federal government</a> on Monday night by insisting that a routine funding measure include a delay in Obamacare, which the Democratic-controlled <a class="cite">Senate</a> rejected.
Officials running the new exchanges braced for technical glitches that could hamper the enrollment effort.
But the president said that whatever the outcome of talks in <a class="cite">Congress</a>, the health care reform launch would proceed.
"The Affordable Care Act is moving forward. That funding is already in place. You can't shut it down," Obama resolutely informed his Republican opponents in a televised statement at the <a class="cite">White House</a> on Monday.
As many as 7 million Americans are expected to sign up for insurance in 2014 through the exchanges, which open for enrollment into new insurance plans on Tuesday and will accept applications through March 31. An additional 8 million people are expected to receive health benefits through an expansion of the government's Medicaid program for the poor.
Republicans have blamed Obamacare's requirements for pushing up the cost of health insurance for business and individuals, a claim the Democrats deny.
"What I want is to keep the government running and at the same time to deal with the harms, the millions of Americans who are ... at risk of losing their health care, are facing skyrocketing insurance premiums," <a class="cite">Texas </a>Senator <a class="cite">Ted Cruz</a>, who has been leading the charge among Republicans in <a class="cite">Congress</a> to defund the law, said in an interview with CNN.
The Patient Protection and Affordable Care Act has been the object of intensive Republican attack since it was signed into law in 2010. Its foes tried and failed to use the <a class="cite">U.S. Supreme Court</a> and a presidential election to get it overturned in 2012.
<h3>SLOW START</h3>
In the early planning, the administration aimed to create new health care markets that would make shopping for insurance as simple as buying an airline ticket online. But repeated delays and technical difficulties mean the new sites in many states won't have all of their functions ready in the first weeks, at the earliest.
<a class="cite">Minnesota</a> officials said on Monday that they were not yet sure what time their state's exchange would launch, and that the timing would only be determined after further testing on Tuesday morning to see if the system connected properly with <a class="cite">federal government</a>'s network for determining subsidies.
The <a class="cite">U.S. Department of Health and Human Services</a>, which will operate federal marketplaces in 36 states that are not running their own, has also said that technical glitches are likely.
"We will fix them and move on. Is it a sign that the law is flawed and failed? I don't think so. I think it's a sign that we're building a piece of complicated technology," Sebelius said.
Senior administration officials and organizers working to help reach the uninsured with news of Obamacare benefits believe enrollment will get off to a quiet start on Tuesday and build slowly through the six-month enrollment period.
The first enrollees are likely to be people with pre-existing health conditions and older people who have had a hard time obtaining coverage up to now. But Obamacare's success will depend on young healthy adults, whose lower risk profile is needed to compensate for higher cost beneficiaries.
However, the law remains unpopular with 46 percent of the public. Anti-Obamacare forces have spent hundreds of millions of dollars in television advertising, outspending Obamacare supporters by more than four-to-one. Meanwhile, millions of potential beneficiaries don't know the law exists.
Officials said Tuesday would also see a ramp-up in the administration's multimillion-dollar media campaign to reach prospective beneficiaries through television, <a class="cite">Twitter</a>, Facebook and social organizations including churches.
In particular, they are targeting young and healthy Americans whose participation will help offset the cost of covering sicker beneficiaries. The advertising campaign is targeting black and Hispanic men between the ages of 18 and 35 in large cities in <a class="cite">Florida</a>, <a class="cite">Texas</a>, <a class="cite">Illinois</a> and <a class="cite">California</a>.
"People are just starting to tune in," Sebelius said. "As we ramp up our communications and connect it with real facts, for the first time, a lot of Americans will be learning what the law means for them."
(Additional reporting by Lewis Krauskopf and Sharon Begley in New York; Editing by Michele Gershberg and Lisa Shumaker)

Obamacare Launches To Millions Despite Shutdown Drama

<div class="KonaFilter image-container display-table float_right"><div><div class="image on-image">AP</div></div></div>WASHINGTON (Reuters) - The White House is coming under pressure from some of its closest allies on healthcare reform to name a chief executive to run its federal health insurance marketplace and allay the concerns of insurers after the rocky rollout of Obamacare.
Advocates have been quietly pushing the idea of a CEO who would set marketplace rules, coordinate with insurers and state regulators on the health plans offered for sale, supervise enrollment campaigns and oversee technology, according to several sources familiar with discussions between advocates and the Obama administration.
Supporters of the idea say it could help regain the trust of insurers and others whose confidence in the healthcare overhaul has been shaken by the technological woes that crippled the federal HealthCare.gov insurance shopping website and the flurry of sometimes-confusing administration rule changes that followed.
The advocates include former White House adviser Ezekiel Emanuel, the brother of President Barack Obama's former chief of staff Rahm Emanuel, and the Center for American Progress, the Washington think tank founded by John Podesta, the president's newly appointed senior counselor.
The White House is not embracing the idea of creating a CEO, administration officials said.
"This isn't happening. It's not being considered," a senior administration official told Reuters.
Some healthcare reform allies say the complexity of the federal marketplace requires a CEO-type figure with clear authority and knowledge of how insurance markets work.
Obama's healthcare overhaul aims to provide health coverage to millions of uninsured or under-insured Americans by offering private insurance at federally subsidized rates through new online health insurance marketplaces in all 50 states and in Washington, D.C.
Only 14 states opted to create and operate their own exchanges, leaving the Obama administration to operate a federal marketplace for the remaining 36 states that can be accessed through HealthCare.gov.
The marketplace is now officially the responsibility of the U.S. Centers for Medicare and Medicaid Services (CMS) and its administrator, Marilyn Tavenner. Healthcare experts say there is no specific official dedicated to running the operation.
A CMS spokesman said exchange functions overlap across different groups within the agency's Center for Consumer Information and Insurance Oversight.
The lack of a clear decision-making hierarchy was identified as a liability months before the disastrous October 1 launch of HealthCare.gov by the consulting firm McKinsey &amp; Co.
Obama adviser Jeffrey Zients, who rescued the website from crippling technical glitches last month, also identified the lack of effective management as a problem.
<h3>POTENTIAL CEO CANDIDATES</h3>
Former Microsoft executive Kurt DelBene has replaced Zients as website manager, at least through the first half of 2014.
"We're fortunate that Kurt DelBene is now part of the administration - there's no one better able to help us keep moving forward to make affordable, quality health insurance available to as many Americans as possible," Obama healthcare adviser Phil Schiliro said in a statement to Reuters.
The White House appears, for now, to be concentrating on ironing out the remaining glitches in HealthCare.gov to ensure millions more people are able to sign up for coverage in 2014. Good enrollment numbers are seen by both critics and supporters of Obamacare as a key measure of the program's success.
"So my sense is that they're not thinking about appointing a CEO in the short term," said Topher Spiro, a healthcare analyst with the Center for American Progress.
The CEO proposal calls for removing day-to-day control of the marketplace from the CMS bureaucracy and placing it under a leadership structure like those used in some of the more successful state-run marketplaces, including California.
The new team would be managed by a CEO, or an executive director, who would run the marketplace like a business and answer directly to the White House, sources familiar with the discussions say.
They point to insurance industry and healthcare veterans as potential candidates, including former Aetna CEO Ronald Williams, former Kaiser Permanente CEO George Halvorson and Jon Kingsdale, who ran the Massachusetts health exchange established under former Governor Mitt Romney's 2006 healthcare reforms. None of the three was available for comment.
Healthcare experts say the idea should have been taken up by the administration years ago.
"It's the right thing to do. It's just two years late," said Mike Leavitt, the Republican former Utah governor who oversaw the rollout of the prescription drug program known as Medicare Part D as U.S. health and human services secretary under President George W. Bush.
"The administration is confronted by a series of problems they cannot solve on their own. They do not possess internally the competencies or the exposure or the information," he told Reuters.
Emanuel, one of the administration's longest-standing allies on healthcare reform, recommended a marketplace CEO in an October 22 Op-Ed article in the New York Times, calling it one of five things the White House could do to fix Obamacare.
"The candidate should have management experience, knowledge of how both the government and health insurance industry work, and at least some familiarity with IT (information technology) systems. Obviously this is a tall order, but there are such people. And the administration needs to hire one immediately," he wrote.
The administration has adopted Emanuel's four other recommendations: better window-shopping features for HealthCare.gov; a concerted effort to win back public trust; a focus on the customer shopping experience; and a public outreach campaign to engage young adults.
(Reporting by David Morgan in Washington; Editing by Karey Van Hall, Michele Gershberg, Ross Colvin and Will Dunham)

White House Rejects Idea Of Creating An Obamacare CEO

<div class="KonaFilter image-container display-table float_right"><div><div class="image on-image">AP</div></div></div>(Reuters) - Americans got their first look on Saturday at an overhaul of the troubled enrollment website at the heart of President <a>Barack Obama</a>'s health care law, but it was unclear yet if the <a>White House</a> had made good on its pledge to fix the glitches.
The <a>Obama administration</a> promised five weeks ago that by this weekend it would fix HealthCare.gov, the site designed to help people sign up for medical coverage but which has been plagued by errors, outages, and slow speeds since a disastrous October 1 launch.
Account creation and log-in functions appeared to work smoothly on the site on Saturday, but it was uncertain whether it could handle target traffic loads of 50,000 users at once.
HealthCare.gov is a key portal for <keyword id="16284" type="PERSON" weightage="60" keywordseo="Obama">Obama</keyword>'s signature domestic achievement, the 2010 Patient Protection and Affordable Care Act, also known as Obamacare, which aims to extend coverage to millions of people and reduce health care costs.
Making Obamacare work has enormous political stakes for the administration and its Democratic allies who are heading into congressional elections next year.
The administration said on Saturday that 90 percent of website users can now create an account on the system.
"We're on target to meet our stated goal for the site to work for the vast majority of users," said <a class="cite">Aaron Albright</a>, a spokesman for the Centers for <a class="cite">Medicare</a> and Medicaid Services (CMS), the agency responsible for the website.
But some information technology experts said the metric cited by the agency was misleading, noting that a claim of anything below 100 percent success was impossible to verify.
"It prevents anyone from the outside from contradicting them," said Jonathan Wu, co-founder of the consumer financial website ValuePenguin. He said only those working on the website know whether the 90-percent figure is accurate.
And there is little insight on how well the website works beyond the first step, where users choose a password and enter an email address.
Far more difficult to gauge, Wu said, is whether the website is better at verifying identities and calculating government subsidies for those whose income falls below 400 percent of the federal poverty level.
Navigator groups - those tasked with helping people sign up for new medical benefits - had not planned for a busy weekend following the U.S. Thanksgiving holiday on Thursday. Several groups contacted by Reuters said they would not be open, while others described a trickle of would-be applicants on Saturday.
In McAllen, <a class="cite">Texas</a>, the group <a class="cite">MHP</a> (Migrant Health Promotion) found that the website - while improved - still has glitches, particularly at the later stages of the process where subsidies are calculated, according to <a class="cite">Rachel Udow</a>, who oversees the program.
"That was a barrier to paying the first month's premium," she said, explaining that insurance carriers could not determine how much to charge the customer's credit card. "The problem came right at the point of paying."
<h3>LOOMING DEADLINES</h3>
The <a class="cite">Obama administration</a> hopes eventually to enroll about 7 million uninsured and under-insured people in 2014 under the new law, with many of those consumers expected to qualify for subsidies.
To work, the program must draw millions of young, healthy consumers whose participation in the new insurance exchanges is key to keeping costs in check.
If the website does not work for the "vast majority" of visitors this weekend as the administration has promised, uninsured Americans could face problems getting coverage by an initial December 23 deadline.
It also could create ripples that extend to the 2014 elections when control of the <a class="cite">U.S. House of Representatives</a>, now dominated by Republicans, and the <a class="cite">Senate</a>, where Democrats have a majority, will be up for grabs.
Congressional Democrats facing re-election already have shown signs of distancing themselves from the president and his health care program. If the website does not show significant improvement soon, some Democrats might call for extending Obamacare's final March 31 enrollment deadline for 2014.
That would delay the fines that are mandated by the law for those who do not have insurance by that date, a scenario that insurers say would destabilize the market. It also would fuel Republicans' arguments that Obamacare is fatally flawed and should be scrapped.
With Republican lawmakers busy in their districts on the holiday weekend, political reaction on Saturday was muted.
Obama's approval ratings have plunged with the site's problems and after his admission that he overreached in promising that everyone who liked their health care plan would be able to keep it under the new law.
"It is a lot harder to reboot public trust than it is to reboot software," said David Brailer, chief executive of the <a class="cite">Health Evolution Partners</a> private equity firm and a health official in former President <a class="cite">George W. Bush's administration</a>.
<h3>SUNDAY BRIEFING</h3>
On Friday evening, ahead of the self-imposed Saturday deadline to get the insurance shopping website working for the "vast majority" of users, CMS announced it was taking it down for an unusually long 11-hour maintenance period.
CMS is slated to take the site down again between 1 a.m. and 5 a.m. EST (0600-1100 GMT) on Sunday to perform more upgrades, and <a class="cite">Jeffrey Zients</a>, the Obama aide tasked with leading the rescue mission, was set to brief reporters on the site's progress at 9 a.m. EST (1400 GMT) on Sunday.
Officials have been careful to say that the overhauled site won't work for everyone and could still be overwhelmed by traffic at times.
"There will be moments, most likely in the middle of the day, where demand will be greater than that capacity," Zients told reporters earlier this week.
His tech team created a new "queueing" feature that, in peak periods, will suggest a better time to return to the site. The administration has also directed users to visit it during off-peak hours in the morning, evening and weekend.
(Editing by David Lindsey, Michele Gershberg and Paul Simao)

It's Still Not Clear If The Crucial Obamacare Website Overhaul Worked

<div class="KonaFilter image-container float_right"><div class="image on-image">twitter.com/ladygaga</div></div>(Reuters) - New Year's Day will bring a fresh test for President Barack Obama's healthcare overhaul, as hundreds of thousands of Americans will begin to use the program's new medical coverage for the first time.
For the nation's healthcare system as well as its politics, the stakes are huge in Wednesday's launch of the program known as Obamacare.
For anxious Democrats with an eye on the 2014 congressional elections, it is a chance for the Obama administration to rebound from the disastrous rollout of the website that enrolls people in private coverage through the program - and show that the White House's effort to help millions of uninsured and underinsured Americans is finally gaining its footing.
Or, as Republican congressman Fred Upton and other critics of Obamacare warned in recent days, Wednesday could represent the beginning of another debacle that fuels Republicans' push to make dissatisfaction with Obamacare the chief issue in the November elections.
More immediately, the question is whether the program will work as advertised on January 1, after a chaotic enrollment period in which problems with the HealthCare.gov website led to a series of deadline extensions and undermined public support for Obamacare and the president.
The White House said early Sunday that about 1.1 million people have enrolled in coverage plans through the federally run HealthCare.gov, which covers 36 states. That figure does not include the latest enrollment data from 14 states that run their own healthcare enrollment sites - including California, Connecticut, Kentucky, New Yorkand Connecticut - and where response to Obamacare has been enthusiastic, so the total enrollment nationally is likely more than 1.5 million.
That is well short of the 3.3 million enrollees administration officials were hoping for by now, but it represents a dramatic improvement from a month ago, when barely 150,000 had signed up because of a series of technical problems with the HealthCare.gov site.
Many of the newly insured under the Patient Protection and Affordable Care Act - about 975,000 on the federally run exchange - signed up just ahead of a deadline on December 24 to receive benefits on January 1, giving health insurers a tight framework to create accounts that can be accessed by doctors.
One fear, as expressed by administration officials and insurance industry executives, is that some people who need medical care during the first days of 2014 will head to the doctor, only to find there is no record of their new insurance.
That could mean patients would have to pay upfront and submit a bill to their insurance carriers later.
And even though the Obamacare program is not directly responsible for the private insurance purchased through its online exchanges, White House officials have acknowledged that any early problems with the coverage are likely to reflect on the administration.
Some insurance executives say that even a few stories of coverage problems during the next few weeks - which seems inevitable when dealing with such a massive program - could damage the reputations of the White House and the healthcare overhaul.
"The big moment of trust is 12:01 a.m. on January 1st, when a mother is standing in a pharmacy with a baby in her arms trying to get a script filled," Aetna Inc Chief Executive Mark Bertolini said this month. "Getting that information right so that we don't have these events which ultimately end up in our lap if we don't do them well, it's very important for us all to get it right."
A senior administration official acknowledged that "there will be bumps in the road."
"We need to plan for them, we need to anticipate and we need to make sure that we are ready to respond," the official said.
Physicians say they are used to dealing with changes to patients' insurance coverage and it is not unusual for there to be lag times between enrolling in a new insurance policy and the time it becomes official.
Some doctors will be willing to delay billing. Others may not be.
"Come the start of the year there will be dueling narratives: the people who have never had insurance before who are actually getting decent care for the first time in their lives, and people who are having issues with the administration's new policies," said Dan Mendelson, chief executive of Avalere Health, which has been tracking the healthcare overhaul.
"They are going to kind of cancel each other out," he predicted. "Three months from now when we are in the electoral cycle, the policies will be judged on the basis of enrollment (numbers), rather than any technical problems."
Mendelson expects the early 2014 problems to be limited given the light pace of enrollment spread out across the nation, and the fact that hospitals and other providers are experienced in troubleshooting coverage questions for patients.
<h3>'WE CONTINUE TO HOLD OUR BREATH'</h3>
Stories of patients with Obamacare plans who were turned away or asked to pay higher-than-expected medical fees upfront because of technical or administrative delays within the program would help the case of Republicans and other foes of the law.
During the past week, Republicans signaled that they will be closely watching what happens with Obamacare enrollees who seek medical care during the first several days of the new year.
"We continue to hold our breath with the next shoe to drop," said Upton, a Michigan Republican who is leading a charge in the House of Representatives against Obamacare.
"When folks visit their doctor or take a child to get necessary treatment (this) week, will the services actually be available? The consequences of the administration's incompetence could not be greater," Upton said.
Some Democrats, including House Minority Leader Nancy Pelosi of California, see the start of Obamacare coverage on January 1 as a turning point for the program that will work in Democrats' favor and reverse polling trends against Obama and his party.
"By the time we get into the spring, I think the Affordable Care Act will either be a (political) wash or a plus for Democrats," Pelosi told reporters last week.
As many as 7 million people had been expected to sign up for Obamacare coverage when the 2014 enrollment period ends on March 31, but that estimate has been thrown into doubt because of the program's error-plagued rollout.
<h3>GETTING IT RIGHT</h3>
The Obama administration and several of the state-run exchanges have urged consumers to call up their new insurance plans to make sure they are covered.
The administration and several states have offered their call-center personnel to assist in cases in which there are problems with enrollments.
Late last week, the U.S. government indicated that it was ready to respond to any stories of distressed patients who emerge beginning this week.
The administration said it has set up contacts at all of the health plans working in the federal marketplace to "have a mechanism to address the issue (and) ... make sure that it can be resolved as quickly as possible."
Doctor groups said they were confident their current systems for handling patients who need help clarifying insurance coverage would make sure people receive needed care.
"Whenever a patient changes an insurance company or plan there is a period of adjustment," said Dr Richard Schilsky, chief medical officer with the American Society of Clinical Oncology.
While there may be a period of limbo for some people between signing up and the insurance taking effect, unless there is a medical emergency, patients probably will be able to wait a week or so to see a doctor, Schilsky said.
"If someone needs care, they will get it," he said.
Dr Charles Cutler, chair of the Board of Regents of the American College of Physicians, said many fellow experts in internal medicine who treat people for chronic disease would not be concerned if it took several weeks to get insurance information for a patient.
"In my practice we assume people are honest," said Cutler, whose practice is in suburban Philadelphia. "If they say they have signed up but are not in the system, we will get it straightened out."
(Reporting by Toni Clarke in Boston and Michele Gershberg in New York; Additional reporting by Roberta Rampton in Washington; Editing by David Lindsey, Vicki Allen and Eric Beech)

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