“The lack of competition in nearly a dozen states could present problems when the insurance exchanges that are part of the Affordable Care Act launch in October. The exchanges are supposed to give Americans who do not get health insurance from their employers the opportunity to choose from an array of private insurance plans. The idea is to generate competition between insurers that will lead to lower premiums.”

“Some 500 healthcare provider groups and companies, patient advocates and employers on Thursday signed a letter to Congress urging repeal of the Independent Payment Advisory Board in fear that not only will its cost-cutting powers hurt patients’ access to care, but that it will also raise costs for employers, and actually raise costs in the long run.”

“The Department of Health and Human Services has just handed out a $3.1 million PR contract to improve the public image of Obamacare. Advertising Age reports that the firm Weber Shandwick will help ‘roll out a campaign to convince skeptical — or simply confused — Americans the Affordable Care Act is good for them and convince them to enroll in a health plan.'”

“Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama’s health care overhaul, sources in both parties said.”

“Cary Pigman, a Republican lawmaker in the state House of Representatives, sees uninsured patients every shift as an emergency room doctor in a rural part of central Florida, where nearly 30 percent of residents lack coverage. With a week remaining in Florida’s legislative session, Dr. Pigman might be expected to be sympathetic to hospitals and other groups urging the Republican-dominated legislature to accept $50 billion in federal money over a decade to extend coverage to 1 million poor Floridians. But that’s not the case.”

“The health care law is ‘the most disruptive instrument to the American workplace in my lifetime.’ That’s the perspective of Richmond businessman William J. Goldin, Jr., president of family-owned Strange’s Florists, Greenhouses and Garden Centers since 1978, who testified before the Small Business Committee last week. Even proponents of the controversial health care law are now worried, as the predictable problems become a reality.”

“Implementation got off to a bad start because the Obama administration didn’t want to release unpopular rules before the election. Regulators have been working hard but are clearly overwhelmed, trying to write rules that influence the entire health care sector — an economic unit roughly the size of France. Republicans in Congress have made things much more difficult by refusing to provide enough money for implementation.”

“Democratic senators, at a caucus meeting with White House officials, expressed concerns on Thursday about how the Obama administration was carrying out the health care law they adopted three years ago. Democrats in both houses of Congress said some members of their party were getting nervous that they could pay a political price if the rollout of the law was messy or if premiums went up significantly.”

“A recent decision by HHS illustrates the arbitrary nature by which some implementation decisions are being made at CMS while highlighting the problem of a top-down approach in Obamacare. After months of small businesses anxiety in Massachusetts surrounding the impact of fewer rating factors due to an ACA mandated one-size-fits all policy, the Federal government recently pulled a piecemeal delayed implementation of the regulations out of thin air.”

“The office implementing most of President Obama’s healthcare law is not furloughing its workers as a result of sequestration, its director said Wednesday. Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, said Wednesday that his office has not cut its workers’ hours and pay as a result of the automatic budget cuts that went into effect in March.”