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

The Affordable Care Act narrowly escaped a judicial decision that would have shrunk its reach Thursday when the Supreme Court ruled the IRS could continue distributing insurance subsidies nationwide. Now, with the law no longer under an immediate meaningful threat of repeal, some are looking to stretch Obamacare further.

Specifically, governors in several states are renewing their push to expand Medicaid, hoping to bring the federal low-income health insurance program to more of their state’s residents.

Despite the Supreme Court decision to uphold the subsidies for private insurance in King v. Burwell, the fundamental problems with the Affordable Care Act remain. Ironically, it is the growing government centralization of health insurance at the expense of private insurance that must be addressed.

Despite having survived a challenge in the U.S. Supreme Court, the federal government’s health insurance markets face weighty struggles as they try to keep prices under control, entice more consumers and encourage quality medical care.

The government’s insurance markets – as well as more than a dozen run by states — have been operating for less than two years and are about to lose their training wheels. Start-up funds that have helped stabilize prices and partially pay for administration of the marketplaces are ending, feeding fears that premiums may rise after next year at a steeper rate.

By one standard no government program can fail, and that’s the standard being applied to ObamaCare by its supporters: If a program exists and delivers benefits, the program is working.

Paul Krugman, Nancy Pelosi and others consistently point to the fact that people are willingly receiving ObamaCare benefits as proof of the program’s value. Mr. Obama himself says: “When you talk to people who actually are enrolled in a new marketplace plan, the vast majority of them like their coverage. The vast majority are satisfied.”

The House voted Tuesday to abolish a cost-cutting board under ObamaCare that has drawn criticism from members of both parties.

Lawmakers voted 244-154 to abolish what is known as the Independent Payment Advisory Board (IPAB). The board is tasked with coming up with Medicare cuts if spending rises above a certain threshold, but has been criticized as outsourcing the work of Congress to unelected bureaucrats.

Repeal of the board has split Democrats, 20 of whom cosponsored the repeal bill. Eleven voted with Republicans on Tuesday to kill it.

Jonathan Gruber, the embattled Massachusetts Institute of Technology economist whose comments about President Barack Obama’s health law touched off a political furor, worked more closely than previously known with the White House and top federal officials to shape and influence the law, according to previously unreleased emails.

Long before there was the Affordable Care Act, presidential candidate and Democratic front-runner Secretary Hillary Clinton was advocating for her own version of health care reform, popularly known as “Hillarycare.” While the Clintons failed to successfully implement Hillarycare, a little over a decade later, President Barack Obama passed “Obamacare,” which effectively overhauled the United States health care system. While the general refrain in the media touted that Obamacare was different than Hillarycare, the two are actually very similar in structure and regulation.

The Affordable Care Act created a new kind of “cooperative” heralded by supporters of health reform. These Consumer Operated and Oriented Plans, chartered and regulated by the states, would compete with for-profit health-insurance companies and were meant to appease disgruntled advocates of a single-payer and “public option” model for the nation’s health-care system.

Most of the 13 state-run public health insurance have collectively spent $4.8 billion in federal funding during their first 17 months of operations and face serious cash-flow problems, according to a website named after the late conservative commentator Andrew Breitbart.

And with major insurance carriers seeking HIX premium increases of up to 51% in some states, the report suggested marketplace mergers as one political solution. It noted that both Covered California and Vermont Health Connect significantly overestimated enrollment and now must slash advertising, outreach and technology services.

The Congressional Budget Office (CBO) has just released a report on the budgetary and economic effects of repealing the Affordable Care Act (ACA). Press reports reflect what CBO has reported pursuant to its scoring instructions – specifically, that relative to its scorekeeping baseline, repeal of the ACA would worsen the federal deficit but bolster the economy. CBO’s new inclusion of economic feedback with the score – finding that the ACA’s adverse economic effects make the deficit $216 billion worse over the next decade than it otherwise would be – is naturally fostering additional attention. Less noted, however, is the important fact that CBO’s analysis actually indicates that repealing the ACA would lower, not increase, federal deficits.