DEVELOPMENTS

— The Obama administration said health care plans offering benefits for heterosexual couples must also provide coverage for married same-sex couples, starting next year. The policy applies to plans offered in the health care law’s insurance markets and many plans outside that marketplace. Gays and lesbians have said they’re not sure how the rules of the new insurance exchanges apply to them, particularly in states that do not recognize same-sex marriage.

— President Barack Obama’s appearance touting the health care law on the “Between Two Ferns” satirical online talk show this week has drawn 15 million views. The website Funny or Die said Obama’s interview with Zach Galifianakis will likely beat Justin Bieber’s record of 17.8 million views for the talk show.

Associated Press

Despite a disastrous start and relentless Republican opposition, President Barack Obama said Friday that enrollment in his signature health care program is high enough to make it stable for the millions who have signed up.

“We look forward to seeing more and more people take advantage as some of the politics of the thing get drained away, as people start feeling more confident about the website,” the president told WebMD in his latest attempt to spread the gospel about the law known by his name.

The president’s remarks were made public as House Republicans held the 51st vote in 38 months to repeal or undermine the law, and the first since they won a fiercely contested election for a House seat in Florida this week in a race that featured health care as an issue.

The measure calls for a delay in imposing penalties on individuals who fail to purchase health insurance under the law.

The vote was 238-181, with all Republicans in favor and all but a dozen Democrats opposed. Among the 12 Democratic supporters were Reps. John Barrow of Georgia and Patrick Murphy of Florida. The bill faces certain death in the Democratic-controlled Senate.

In addition to attacking the president’s health care law, the legislation would overhaul the system for paying doctors and others who treat Medicare patients.

By itself, the makeover in the payment system enjoys widespread support among lawmakers in both parties as well as from medical organizations. It is designed to end a cycle of uncertainty that has periodically threatened providers with abrupt cuts in their reimbursements.

Without action by Congress, for example, the fees paid to health professionals who treat Medicare patients is scheduled to drop by 24 percent on March 31.

Yet the decision by Republicans to combine the change in the payment system with a delay in the penalty for failing to purchase health insurance meant that even the American Medical Association backed away from the bill.

In a statement after the vote, the organization that lobbies on behalf of doctors said it intends to continue working toward legislation that both Congress and Obama could accept.

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The political backdrop was unmistakable as Republicans pressed ahead on an issue they hope to ride to a takeover of the Senate and continued control of the House in November.

Rep. Nancy Pelosi of California, the Democratic leader, said opposition to the legislation came from “doctors, insurors and seniors,” yet she added that Republicans decided to “proceed with their reckless partisan antics.”

Rep. Dave Camp, R-Michigan and chairman of the House Ways and Means Committee, said the legislation “breaks the cycle of uncertainty for doctors and their patients, providing permanent relief and improving how Medicare pays doctors.”

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For his part, Obama played pitchman in a 30-minute interview with WebMD, a self-described leading source of information about health care issues. He reeled off the toll-free telephone number for the program and repeatedly urged his listeners to check out its website, now repaired after its woeful debut last fall.

Enrollment for the current year expires on March 31, and administration officials are hoping for a late rush of applications beyond the 4.2 million they say have already signed up. That is particularly true for younger people, whose health is often good and whose participation therefore helps bring down the cost of coverage for sicker people.

“The number of people who have signed up is large enough that I’m confident the program will be stable,” he said.

“At this point, enough people are signing up that the Affordable Care Act is going to work; the insurance companies will continue to offer these plans.”