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

Millions of Americans could lose Obamacare subsidies under a Supreme Court ruling this month, but many in the GOP don’t need their votes anyway.

That’s a major political calculus for Tea Party Republicans, who are likely to resist any efforts to extend the subsidies, even temporarily. They’re much more worried about angering their base by appearing to concede to Obamacare than whether a handful of constituents lose their subsidies.

If the Supreme Court later this month strikes down Obamacare subsidies in states with federal insurance exchanges, the narrative is simple: The health care law could be fatally crippled and marketplaces will fall into 34 simultaneous death spirals.

But what if Obamacare’s conservative challengers lose King v. Burwell?

If that question seems less sexy in a policy sense, that’s because it is. Essentially, if the Court decides the federal government is on the right side of the law, nothing happens; business continues as usual in all 50 states’ Obamacare exchanges. People keep their insurance as is.

But politically, an Obama administration win would mean volumes.

Washington has made a hash of health care. But that doesn’t mean that government should abandon the project of reforming our medical system. Those reforms are best carried out by the states. The federal government should provide states the resources and the opportunity to replace Obamacare with something better, something that is fair both to Julie and to those who are paying her medical bills.

The health law was designed to cover the poorest people by expanding Medicaid, the federal-state program for low-income people. But the Supreme Court made that optional. The result in states that didn’t expand Medicaid is a gap, where some people make too much money to qualify for Medicaid but not enough to qualify for insurance subsidies.

Tom Price, the chairman of the House Budget Committee, is the latest Republican to unveil a conservative health-care plan to replace Obamacare. It’s a good plan, although it could be made better — and it helps to clarify some of the trade-offs involved in health policy.

Price’s plan would give people tax credits to buy health insurance. The credits would be based on age but not on income. Everyone between 35 and 50 would get $2,100 a year, for example. Both the Affordable Care Act and some other conservative health-care bills, such as the one proposed by Senator Orrin Hatch and colleagues, instead phase out tax credits with income. The credits could be used to buy insurance in a much less regulated market than Obamacare creates: No longer would insurance policies have to cover a federally approved list of essential health benefits, for example.

The plan has already elicited some reasonable criticism over the choices Price made. If you offer the same tax credit regardless of income, you send money to people who don’t need it. On the other hand, you relieve the administrative difficulty and unpredictability of an income-based credit. A lot of people don’t know how much help they can count on from Obamacare; they would have more certainty with Price’s plan.

The House Ways and Means Committee on Tuesday voted to repeal two pieces of ObamaCare.

The committee advanced measures that would repeal the medical device tax and a cost-cutting panel known as the Independent Payment Advisory Board (IPAB). Both bills are scheduled to go to the House floor the week of June 15.

The health law’s expansion of Medicaid in many states hasn’t benefited nonprofit hospitals in those states as expected, according to a new report by Moody’s Investors Service.

Hospitals in the mostly blue states that expanded Medicaid were largely expected to benefit from fewer unpaid bills and more paying customers, but that hasn’t generally translated into better operating margins or cash flow, Moody’s found.

Performance improved across the board—including in the mostly Republican-led states that opted out of the law’s Medicaid expansion—as the economy gained steam last year and unemployment declined.

About 13 percent of people who signed up for health insurance coverage in 2015 under the Affordable Care Act have fallen off the rolls, many because they failed to pay their share of premiums, the Obama administration said Tuesday.

Approximately 6.4 million Americans could lose their subsidies for health insurance if the Supreme Court rules against the Obama administration this month, according to new federal data released Tuesday.

The Obama administration has posted the 2016 rate increases in excess of 10% that the Obamacare health plans are requesting.

There are a lot of them.