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

Senator Rubio is proposing to fix a longstanding problem in federal tax law. He wants to make sure that all Americans get a comparable tax break for health insurance, regardless of whether or not they get their insurance through their place of work. For many years, federal law conferred a generous tax break for health insurance only on employer-paid premiums, which are excluded from the taxable compensation of workers for both income- and payroll-tax purposes.

Obamacare’s defenders would say that Obamacare fixed this problem by giving households credits that they can use when they buy insurance through the law’s “exchanges.” But the Obamacare credits are not connected in any way with the value of the tax benefit for employer-provided coverage, they are income-tested and thus phase out for middle-income families, and they can be used only to purchase heavily regulated plans.

Rubio’s proposal would truly level the playing field by first getting rid of Obamacare and then giving Americans who buy insurance on their own, rather than through their place of work, a tax credit of roughly comparable value to the tax break conferred on an employer plan of average cost.

The State Department released the last batch of Hillary Clinton’s emails on Monday, and the exercise has been instructive about her recklessness with classified material. But as a side note, we ought to memorialize what President Obama’s aides were telling Mrs. Clinton about the Affordable Care Act, which was the opposite of what their boss was telling the public.

Despite her duties as top diplomat, Mrs. Clinton found time to follow ObamaCare’s progress in Congress, and she received regular updates from Neera Tanden, then a White House health staffer. Ms. Tanden is now president of the liberal Center for American Progress, Mrs. Clinton’s economic policy shop.

The insurance industry must be kicking itself for backing ObamaCare. Several have since posted big losses and it looks like Blue Cross Blue Shield got the losing end of the stick, too.

Fitch Ratings looked at nearly three dozen BCBS companies and found that 23 saw a decline in earnings that totaled $1.9 billion in the first nine months of last year, while 16 had net losses.

Blue Cross Blue Shield of Michigan lost $622 million from January through September last year. Blue Cross plans in Texas, Oklahoma, New Mexico and Montana lost $442 billion. And those in Pennsylvania, Delaware and West Virginia lost $266 million.

The reason is ObamaCare.

Or as Fitch puts it: “Cost and utilization trends from state insurance exchanges from the Affordable Care Act have been higher than anticipated and are the primary drivers of declining earnings.”

When pressed during last Thursday night’s campaign debate in Houston for details of his proposed plans for replacing Obamacare after it is repealed, presidential candidate Donald Trump (?-NY) once again sputtered out something about eliminating “those lines” that states draw in regulating health insurance. What that exactly means involves some Trump-Land-to- Policy-World translation, and a little primer on what’s usually understand and misunderstood in this area of health policy.

Trump appears to be borrowing some of the language behind a traditional conservative Republican health reform proposal, which involves facilitating competition in health coverage through the sale and purchase of insurance products across states. It’s sometimes referred to as interstate competition or competitive federalism, or even just “consumer choice.”

Cato’s Michael Cannon has doubled down in his latest Forbes column on his outrageous claim that,“Yes, Marco Rubio’s Obamacare Replacement Plan — Tax Credits — Is An Individual Mandate.”

Sen. Rubio’s health policy plan provides an advanceable, refundable tax credit that can be used to purchase insurance. This idea is a centerpiece of free-market health policy. It would create fairness by equalizing the tax treatment of health insurance between those currently receiving employer-based health insurance and those who are shut out of this market.  It would allow portability of coverage, make costs more transparent, and turn down the fires on the inflation-generating tax exclusion for job-based health insurance.

Cannon explains the Rubio tax credit this way: “If you purchase a government-approved health plan, you could save, for example, $2,000 on your taxes. If you don’t, you pay that $2,000 to the government. That is exactly how Obamacare’s individual mandate works.”

Political uncertainty isn’t the only threat to the Affordable Care Act’s future. Cracks also are spreading through a major pillar supporting the law

Health insurance exchanges created to help millions of people find coverage are turning into money-losing ventures for many insurers.

The nation’s largest, UnitedHealth Group Inc., could lose as much as $475 million on its exchange business this year and may not participate in 2017. Another major insurer, Aetna, has questioned the viability of the exchanges. And a dozen nonprofit insurance cooperatives created by the law have already closed, forcing around 750,000 people to find new plans.

More insurer defections would lead to fewer coverage choices on the exchanges and could eventually undermine the law, provided the next president wants to keep it.

More than 7 in 10 (72 percent) in our national survey said they get good value for what they pay toward the cost of their health care. But a significant 22 percent disagree.

That may be because few see added benefits in the face of cost increases. Only 1 in 6 adults believe their benefits have increased in the past two years, and 12 percent believe they’ve declined.

While health care ranks fourth as an important voting issue, presidential hopefuls have proposed a range of visions for the future of the health care system, from the full repeal of the Affordable Care Act to the adoption of a universal government plan. The survey finds that when given four broad approaches for the future of the health care system that are currently being discussed, Americans opinions are split.

The recent lawsuit filed by the Health Republic Insurance Company of Oregon regarding ObamaCare’s “risk corridor” program raises the question: Does the federal government have a duty to defend the lawsuit? Could they confess that the plaintiffs are right, or, better still, settle the case for the face value? Nicholas Bagley of the University Of Michigan School Of Law does not think the feds will do that while they can still argue that the claims are unripe. But if the case gets past the initial procedural hurdles, they’ll be sorely tempted to cut a deal.

Six states filed a new lawsuit Wednesday against the Obama administration over the Affordable Care Act.

The complaint that Texas, Wisconsin, Kansas, Louisiana, Indiana and Nebraska filed in the Northern District of Texas takes issue with the Health Insurance Providers Fee assessed to health insurers to cover federal subsidies.

The lawsuit says nothing in the Affordable Care Act’s language provided clear notice that states would also have to pay the fee.

“This notice was not even provided by rule but was ultimately provided by a private entity wielding legislative authority,” the suit says.