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

WASHINGTON — Hoping to avoid another political uproar over the Affordable Care Act, the Obama administration is trying to persuade states to cut back big rate increases requested by many health insurance companies for 2016.

ObamaCare enrollees are less satisfied with their plans than people with other types of health insurance, according to a new poll.

The poll from the Deloitte Center for Health Solutions, the research arm of the consulting firm, finds that 30 percent of people with insurance through ObamaCare’s marketplaces are satisfied with their plans.

When the ACA networks began covering patients in 2014, one of the first complaints was that many plans were trying to cut costs by including many fewer providers in their networks than pre-ACA health plans. In some cases, patients even had to cancel previously scheduled surgeries and lost access to prescription drugs, since the surgeons and/or the hospitals were not in their new networks. Now, a study by the health consulting firm Avalere confirms that these were not isolated cases – on average, exchange plans include a 34 percent fewer in-network providers than non-exchange plans (such as employer-sponsored plans), with even larger shortcomings in specialties like oncology and cardiology.

During the legislative debate over the passage of President Obama’s healthcare law, supporters of the program were sensitive to any suggestion that it represented a government takeover of the healthcare system.

Unless conservatives change their strategy soon, history is likely to record them as the unintended enablers of Obamacare’s expansion. Yet another key moment for a turn toward free-market reform is upon us. Will congressional Republicans again pursue a strategy that sounds serious but results in Obamacare’s unimpeded implementation? Or will they try to actually impede the law in real time and make clear to the American people which party is on their side as we approach 2016?

Senate Majority Leader Mitch McConnell championed a renewed push to bypass a filibuster and repeal Obamacare with 51 votes on Tuesday, he announced in a joint statement with Utah Senator Mike Lee, one of the most conservative Republicans in the chamber.

Neither Republicans nor Democrats have spent much time, at least not in public, discussing changes to the Affordable Care Act (ACA) that could refine or improve the legislation. Republicans have mostly focused on strategies to repeal the ACA, which, even with their control of the House and Senate, appears highly unlikely because they could not muster the 67 votes needed to override a presidential veto. Democrats, while privately acknowledging there are changes that could improve the legislation, have publicly devoted most of their energies to defending the ACA.

After weeks of hemming and hawing on how they’re going to use reconciliation, Senate Republicans finally committed on Tuesday to using the budgetary tool to fully repeal Obamacare.

But it’s what Majority Leader Mitch McConnell did not say in a statement released in conjunction with Sen. Mike Lee that leaves room for things to get interesting: He did not say reconciliation would only be used for a repeal of the Affordable Care Act.

Health and Human Services Secretary Sylvia Burwell said Tuesday that the Government Accountability Office has not told HHS how 11 fictitious applicants were able to maintain coverage as fictitious applicants on Healthcare.gov in an undercover investigation.

“We have asked the GAO in terms of ‘can we understand how you did this, they believe they are protecting their sources and methods,” Burwell said at a House Education and Workforce hearing Tuesday.

In King v. Burwell, Chief Justice John Roberts did the Obama administration a bigger favor than he realized. Writing for a himself and five colleagues, Roberts blessed the administration’s expansion of the Affordable Care Act’s individual mandate, employer mandate, and premium subsidies in the 34 states that refused to establish exchanges — even though the majority, to say nothing of the three dissenters, recognized that expansion was in direct conflict with “the most natural reading of the pertinent statutory phrase.”