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

More Democrats seem to be having doubts about the federal health care law, a contentious issue for most of President Barack Obama’s tenure and one of the defining elements of his legacy.

With the administration counting down its final year, Sen. Bernie Sanders’ call for “Medicare for all” appears to have rekindled aspirations for more ambitious changes beyond “Obamacare.”

That poses a challenge for Hillary Clinton, who has argued that the health care law is working and the nation should build on it, not start over.

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Six years after the introduction of Obamacare, Americans are still divided over the controversial health reform law even though most tend to support many parts of the measure, a new HealthDay/Harris Poll found.

However, none of the current crop of presidential candidates appears to inspire much hope that they’ll properly handle health care policy if elected, the poll results show.

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Barred from restaurants, banned on airplanes and unwelcome in workplaces across America, smokers have become accustomed to hiding their habits. So it’s no surprise many may now also be denying their habit when they buy health coverage from the federal health law’s insurance exchanges.

Insurers — who can charge higher rates in most states to admitted smokers — are steamed.

They say the cheating that smokers do to escape tobacco surcharges on their monthly premiums means higher rates for everyone else.

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The desire for autonomy and work-life balance is driving more workers into freelance roles, but at the same time there are growing incentives for companies to employ workers via contracts rather than hire them full-time.

Chief among those incentives is the cost of providing (or not providing) health care to workers under the Affordable Care Act. Nearly three-quarters of companies said that they would contract with more freelancers this year because of Obamac\Care, according to a new survey by online work platform Field Nation and executive development firm Future Workplace.

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In the face of losses in the Affordable Care Act marketplace, Blue Cross and Blue Shield of Illinois is looking for new ways to cut spending.

Starting June 1, the Chicago-based health insurer will no longer accept credit cards as a form of payment for members who buy their own health insurance on or off the Illinois marketplace. The company began notifying customers of the change last month. Blue Cross will still accept other forms of payment, including debit cards.

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Among the most hotly debated of the issues Hillary Clinton and Bernie Sanders have taken on in the Democratic primary contest is how best to get to universal health insurance coverage. The former secretary of state favors incremental steps, and the senator calls for a single-payer system. That debate, and their focus on universal coverage as their goal, appears to have had a modest and perhaps surprising effect on attitudes toward the Affordable Care Act. The health-care law is an issue about which public attitudes seldom shift, yet the share of Democrats who want to expand the Affordable Care Act rose over the past year.

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Sound fiscal policy is essential for sound governance. History shows that powerful nations that engage in reckless spending and borrowing eventually fall into periods of decline. It would be disastrous if the United States were to drift into such a slide.

What’s needed are fundamental reforms that will change the direction of key programs in ways that will last for decades. This kind of project will take many years to achieve, and some very important policy changes are likely to require lengthy transition provisions to reassure voters who are accustomed to current arrangements. But the current welfare state wasn’t built in a day, and changing its orientation is going to require persistence and patience.

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House Ways and Means Committee Chairman Kevin Brady (R-Texas) said Friday that House Republicans would unveil their ObamaCare replacement plan sometime in the next 45 days.

“The task force is working on it,” Brady said at a Bloomberg Government event. “We’ll be laying that out here over the next month and a half.”

Republicans have said that they plan to have Speaker Paul Ryan’s (R-Wis.) policy task forces lay out their plans before the Republican National Convention in July.

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For years, voters in this swing state have rejected tax increases and efforts to expand government. But now they are flirting with a radical transformation: whether to abandon President Obama’s health care policy and instead create a new, taxpayer-financed public health system that guarantees coverage for everyone.

The estimated $38-billion-a-year proposal, which will go before Colorado voters in November, will test whether people have an appetite for a new system that goes further than the Affordable Care Act. That question is also in play in the Democratic presidential primaries.

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Key Findings:

  • Health care is one of the top four issues mentioned by voters when asked which issues they most want to hear candidates discuss in the campaign, but half as many cite health care as mention the economy and jobs.
  • When asked specifically what health care issues voters would most like to hear the presidential candidates discuss, the 2010 health care law (ACA) and health care costs top the list.
  • Overall ratings of the ACA lean negative this month, with 38 percent saying they have a favorable view and 49 percent saying they have an unfavorable view.
  • The percentage of Democrats who have an unfavorable opinion of the law increased 6 percentage points from last month. Of the Democrats who did not express a favorable opinion, 40 percent want to expand what the law does.