The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

Earlier this week, as was widely reported, Judge Rosemary Collyer of the District of Columbia District Court prohibited the Obama administration from continuing to divert money Congress had appropriated for federal tax refunds to instead pay insurance companies billions of dollars in “cost sharing reductions,” part of the Affordable Care Act.

The decision affects more than just the cost sharing reduction program. Just as a teaser, if upheld on appeal – and expect this case to get to the United States Supreme Court – the decision means that some high level Obama administration officials run a serious risk of criminal charges being brought against them should a subsequent President and Attorney General be motivated to pursue them.

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Let’s face it: When it comes to products most of us buy, health insurance is one of the least popular. And new survey results from the Kaiser Family Foundation out Friday morning find that sentiment reaching new lows.

Kaiser’s Larry Levitt said it makes perfect sense why consumers are feeling cranky about their coverage. “People are paying more, and in many cases getting less,” he said. The most obvious reason people aren’t psyched, Levitt said, is due to the explosion in health plans with high deductibles.

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Kaiser’s latest poll shows that people with ACA plans are generally satisfied with their coverage.  Two-thirds say their coverage is excellent or good, but a growing number say it is only fair or poor. The poll reveals warning signs for the future:  A diminishing number of participants feel their health insurance is a good value, those with high-deductible plans are most dissatisfied, and families feel it is increasingly difficult to pay off debt and save for the future.

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To see how vacuous the 2016 presidential campaign has become, consider just one issue: health reform. Exhibit 1: A new study from the liberal Urban Institute estimates that Bernie Sanders’s pet proposal for a single-payer health-care program would cost $32 trillion over the next decade. That’s right: $32 trillion! Exhibit 2: Continuing her strategy for bankrupting America just a little more slowly than Senator Sanders, Hillary Clinton is now calling for a Medicare “buy-in.” Exhibit 3: And Donald Trump’s plan for health-care reform is — well, who the heck knows? It would be helpful if, just for a little bit, we all paid attention to actual issues. Then again, given these three candidates and their proposals, maybe it’s bad news no matter what.

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Health plans are seeking double digit rate increases for their 2017 Obamacare plans—17.3% in New York, 25% in Michigan, 20% in Oregon, as examples.  From special enrollment periods to countless exemptions, the Obama administration traded short term political gain for the long-term stability of the program and its risk pools. The big premium spikes for 2017 are an economic reckoning of this shortsightedness. The policy mistakes have compounded Obamacare’s woes. Fixing them will require more than regulatory tweaking.

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As senior House Republicans work on a promised replacement for the Affordable Care Act, a pair of GOP lawmakers plan to introduce an alternative Thursday that would dramatically reshape the nation’s healthcare system.

The sweeping legislation – co-sponsored by Rep. Pete Sessions (R-Texas) and Sen. Bill Cassidy (R-La.) – stands little chance of becoming law as long as a Democrat is in the White House.

But just as Sen. Bernie Sanders of Vermont shook up the Democratic presidential primary by pushing the liberal dream of a “single-payer” government-run health system, Sessions and Cassidy are resurrecting a long-held conservative goal of overhauling of the healthcare system by rewriting an important part of the tax code.

In the process, the two lawmakers are also highlighting the difficult trade-offs that would be necessary in any replacement for the health law President Obama signed in 2010, commonly called Obamacare.

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America had managed to get through the vast majority of its history without any contraceptive mandate. President Obama’s first term, all of which took place before the implementation of the directive, was not marked by a national crisis of access to birth control. The administration erred, however, when it allowed only a very narrow religious exemption, one that applied to churches but not to religious charities such as the Little Sisters of the Poor. After being slapped down by the courts once again on this issue, it makes you wonder why the Obama administration thought this entirely avoidable culture-war fight was worth starting in the first place.

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Highmark could soon be in good company in suing the federal government over Affordable Care Act reimbursement.

Other insurers have contacted Highmark since the Pittsburgh carrier filed a lawsuit Tuesday over reimbursement for losses incurred in providing coverage under the ACA, president and CEO David Holmberg said Wednesday. The companies are weighing their options to recoup billions of dollars they say are owed, he said.

“The losses were pretty significant,” Mr. Holmberg said. “We ended up with the other companies standing here holding the bag. We saw no path forward.”

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It’s been six years since the passage of the Affordable Care Act and it’s still unpopular with the voters. Hardly a week goes by without the discovery of new problems and new victims.

Paul Ryan says he wants an alternative. Donald Trump does too. Republicans in the House are actually trying to come up with something. But if past Republican proposals are a guide, there is a danger they will propose something most people see as Obamacare lite. There is even a chance they could propose something that is more unpopular than Obamacare itself.

John C. Goodman lists eight ideas Republican health reformers should avoid if they want to be successful in the November elections.

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Last Thursday, the Obama administration suffered a legal setback, when a federal judge in Washington ruled that the administration exceeded its authority by paying out cost-sharing subsidies to health insurers under the Affordable Care Act.

The administration will doubtless appeal the case, which was brought by the Republican-led House of Representatives, but whether those appeals succeed may well depend on whether courts view the case as one of statutory interpretation, or one with constitutional implications.

In its briefs in the case, the administration tried to portray House v. Burwell as a successor case to King v. Burwell, another lawsuit surrounding Obamacare subsidy payments, which the Supreme Court decided in June 2015.

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