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

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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Major insurer Highmark Inc. is suing the federal government, saying the feds failed to live up to obligations to pay the insurer nearly $223 million from an ObamaCare program known as “risk corridors,” which aimed to limit the financial risks borne by insurers entering the new health-law markets.  The suit is likely to draw close attention because it comes from a company that continues to be a major player in the exchanges.

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The Supreme Court unanimously remanded a case challenging the ACA’s contraceptive mandate back to the United States Courts of Appeals for the Third, Fifth, Tenth and D.C. Circuits. The decision will give the parties an opportunity to reach a compromise that “accommodates petitioners’ religious exercise” while ensuring women covered by the petitioner’s health plans receive coverage that includes contraception.  The Beckett Fund for Religious Liberty, which brought the lawsuit one behalf of the Little Sisters of the Poor, called the ruling a win for the petitioners.

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Most big employers provide wellness programs now, and the Affordable Care Act gave the idea a boost in 2010 by letting companies offer employees financial incentives— such as lower health insurance premiums, gift cards or prizes—worth up to 30 percent of the cost of their health insurance.

But as the wellness industry has grown, questions have started to arise about just how effective these programs really are—and how fair. It’s not clear the programs financially benefit employers, and evidence is also mixed on whether they make employees healthier. And now, some employees have begun to bristle at the omnipresence of wellness in corporate culture and see the requirement to share personal health data with their employer as an intrusion on their privacy.

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The legal war over ObamaCare is back.

A federal judge gave House Republicans a significant victory on Thursday when she ruled that the administration is illegally making certain ObamaCare payments without a congressional appropriation.

Still, the case is far from over. Democrats are turning their attention to the appeal of the ruling, and experts say the case does not pose the same mortal threat to the healthcare law that previous challenges did.

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John Boehner isn’t popular with conservatives these days, but the former House Speaker deserves an apology from those who derided his lawsuit challenging President Obama’s usurpation of legislative power. Mr. Boehner went ahead despite skeptics from the left and right, and on Thursday the House won a landmark victory on behalf of Congress’s power of the purse.

Federal Judge Rosemary Collyer handed down summary judgment for the House, ruling that the executive branch had unlawfully spent money on ObamaCare without congressional assent. Judge Collyer noted that Congress had expressly not appropriated money to reimburse health insurers under Section 1402 of the Affordable Care Act. The Administration spent money on those reimbursements anyway.

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