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

Federal health officials approved loans to Obamacare health insurance co-ops despite “specific warnings” about across-the-board failures from Deloitte Consulting, according to a blistering Senate staff report released Thursday.

The report was released by the Senate Permanent Subcommittee on Investigations at a hearing that featured Andy Slavitt, the embattled acting administrator of the Center for Medicare and Medicaid Services (CMS)  — the section of the U.S. Department of Health and Human Services that manages Obamacare.

A $5 billion lawsuit filed by a nonprofit insurer against the Obama administration for a program implemented under Obamacare is raising questions about the use of a fund available for settlements with the government and whether Congress can, and should, intervene.

According to legal experts, if the Obama administration decided to settle its class action lawsuit with Health Republic Insurance of Oregon, one of 23 co-ops started under Obamacare, and other insurers for all or part of the $5 billion it’s seeking, the money would come from the Judgment Fund, an indefinite appropriation created by Congress and administered by the Department of Treasury.

The central feature of the latest plan in Nebraska is to deliver Medicaid expansion benefits through health plans sold on the Obamacare exchange, instead of through the state’s managed care system. But, at the end of the day, this is really just a more expensive way to expand Medicaid under Obamacare.

Nebraska’s own actuaries estimate that using these plans to expand Medicaid would increase per-person costs by 94% next fiscal year. By 2021, the cost difference is expected to reach 150%. Overall, this plan would cost taxpayers billions of dollars more (as if regular Medicaid expansion wasn’t expensive enough) and leave even fewer dollars for the truly needy.

If you bought health insurance last year through Obamacare, you may be pleasantly surprised at tax time to find out you have money coming to you.

But it’s just as likely the surprise will go the other way: You might owe Uncle Sam some money if the government subsidy you received for buying insurance through the Affordable Care Act marketplace was too large based on your income. And if you skipped buying health insurance entirely, you probably will face a penalty. On average, those penalties this year are running $383 among H&R Block customers. That’s an increase from $172 a year ago.

If this is confusing or unpleasant, don’t decide to ignore the matter.

Sen. Marco Rubio (R-Fla.) is opening a new front in his attacks on ObamaCare as he campaigns for president.

After trying to bring publicity to his efforts to limit the Affordable Care Act’s “risk corridors” program, Rubio and Sen. Orrin Hatch (R-Utah), the chairman of the Finance Committee and a campaign backer, wrote a letter on Tuesday arguing that the Obama administration is breaking the law with another “bailout” of insurance companies.

Their letter concerns ObamaCare’s “reinsurance” program, designed to protect insurers against high costs for sicker enrollees in the early years of the law. Under the program, the government collects money from insurers and then redistributes it to those with high-cost enrollees.

Most of the criticism of Obamacare by its right-of-center opponents has focused on its regulatory mandates, botched implementation and rising premiums for less-favored purchasers. Far less attention has been paid to how little the new health law accomplished in fulfilling its advocates’ promises to boost the growth of small business and new entrepreneurial start-up firms.

The Bureau of Commercereports that new business formation inched up slightly for a few years from its low point in 2010 – after four years of decline. But its 2013 figure of 406,000 new businesses remains far below the recent pre-recession peak number of 560,000 in 2006.

Similar measures of entrepreneurial activity by the Kauffman Foundation find modest evidence of recent upticks, but levels still below historical norms.

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President Barack Obama was in Milwaukee Thursday to congratulate the city for winning a federal health insurance sign up contest during the latest open enrollment period under the Affordable Care Act.

Gov. Scott Walker said greater enrollment is good, but the complaints he says he hears about the law are bad.

“What we hear routinely from small business owners and farmers across the state is that it’s anything but affordable,” Walker said. “They’ve actually seen their health care costs go on up dramatically even with the so-called Affordable Care Act.”

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California politicians and interest groups have been working overtime to figure out a way to fix an illegal Medicaid provider tax—the subject of my recent Mercatus Center study. These taxes are problematic because they are generally accompanied with the guarantee of increased Medicaid payments to the providers paying the tax—payments largely financed with federal matching funds. As a result, provider taxes, which reek of government favoritism because of how the benefits often target select providers, raise Medicaid spending.

California’s tax is illegal under federal law because the state was holding numerous insurers harmless from the tax that should not have been. The state has recently come up with a revised tax plan that it is submitting for federal approval.

Unlike the last few election cycles, paid political advertising that features healthcare issues hasn’t played a starring role in the early primaries.

But once the Democratic and Republican nominees are selected, watch out.

The Affordable Care Act and other healthcare issues are going to get plenty of screen time, according to experts who track campaign advertising. Indeed, one analyst estimates healthcare messages, combining both pro- and anti-Obamacare ads, will account for nearly one-fifth of the more than $6 billion that will be spent in this year’s massive onslaught of television and digital advertising to voters in the presidential, congressional and gubernatorial campaigns.

Health Care Service Corp. improved its net loss in 2015, but the Blue Cross and Blue Shield conglomerate continues to hemorrhage money in the Affordable Care Act’s nascent marketplaces.

HCSC, which owns the Blue Cross and Blue Shield affiliates in Illinois, Montana, New Mexico, Oklahoma and Texas, lost $1.5 billion on its individual ACA-compliant plans in 2015, according to financial filings. After factoring in a premium deficiency reserve, an accounting measure that predicts future losses, the insurer lost $866 million last year on its ACA plans, said Ken Avner, HCSC’s chief financial officer.