“If anyone ever doubted the extent to which Congressional committees could turn good intentions into a bureaucratic nightmare, they need only to look at PPACA’s premium subsidy provisions and their potential impact on insurance exchanges.”

ObamaCare directs states to set up exchanges to manage its new insurance subsidy system. “But states view the project as an enormous undertaking, requiring them to design a system, develop the information technology and put it into action in just three years amid tight budgets.”

“It is true that the tax credits will reduce the effective premium that many households will face for health insurance coverage. However, the key question from a policy perspective is whether the benefits of the Obamacare tax credits outweigh their costs. Since the Families USA report failed to list any of the costs or concerns of the Obamacare tax credits, Heritage will fill the void.”

“States establishing Obamacare exchanges are making a one-way, lose-lose bet. If Obamacare persists, exchanges will become bloated administrative nightmares. If Obamacare is defeated, states will have wasted time and energy that should have been directed towards that effort. Obamacare is President Obama’s problem. Don’t make it your state’s problem.”

“We investigated what would happen to the estimates from the Congressional Budget Office, the official scorekeeping arm of Congress charged with analyzing the budget implications of legislative proposals, if different assumptions were made about how the health overhaul will work.”

“But our recent health reform has created a situation where there are strong economic incentives for employers to drop health coverage altogether. The consequence will be to drive many more people than projected—and with them, much greater cost—into the reform’s federally subsidized system. This will happen because the subsidies that become available to people purchasing insurance through exchanges are extraordinarily attractive.”

“ObamaCare was not about fixing the insurance market. It was about seizing control of it. Thus it shouldn’t be surprising that a new analysis by the Congressional Research Service says that states can use ObamaCare to erect a de facto single-payer system by simply excluding from their exchanges every plan but a state-run ‘public’ plan. ‘There is no specific language in [the president’s health plan] that would prohibit an exchange from denying certification to every private plan that applies,’ the analysis finds.”

“Back when Secretary Sebelius was nominated for her current position, a colleague enthused that, ‘An insurance commissioner is a great choice for Secretary of HHS, because his or her direct contact with consumers provides unique insight into the challenges…..’ Unfortunately, Secretary Sebelius’ current direct contact with the Beltway political class and its ideological agenda obviously have far more significance than her previous direct contact with consumers, whose suffering under ObamaCare has only just begun.”

New insurance exchanges are supposed to make insurance companies more responsive to market forces, but will instead give government control over the market. “In theory, they will expose health insurance customers to greater competition while protecting them through regulation. Insurers participating in the exchanges, for example, will face strict limits on how they can price their premiums according to individual risk factors. In practice, they will likely prove difficult to design and implement, and may ultimately undermine the country’s quality of care. No matter what, there is little doubt that the exchanges will fundamentally alter the health insurance landscape across the states.”

“[A]lthough the PPACA adds a number of significant elements to the U.S. health care system (in particular, the exchanges), it’s primarily an entrenchment and expansion of the existing system. Given the failures of that system, though, that presents a serious problem.”