Articles on the implementation of ObamaCare.

Obamacare’s second biggest flaw is that even as it upended the half-century long consensus over who should be in Medicaid, the law inexplicably left intact a feature of Medicaid that we have known for decades fuels excess spending: its open-ended matching rate.

So long as states put up a dollar to fund Medicaid, Uncle Sam is obliged to match it with anywhere from $1 to $3 federal dollars depending on that state’s unique matching rate. It has been proven empirically that this formula fuels higher spending. An analysis by Thad Kousser at UC Berkeley showed that all other things being equal, shifting a state from the lowest to highest federal matching rate increases discretionary Medicaid expenditures by 22 percent.

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It’s been just over seven years since President Obama declared: “It is not sufficient for us simply to add more people to Medicare or Medicaid to increase the rolls, to increase coverage in the absence of cost controls and reform. Another way of putting it is we can’t simply put more people into a broken system that doesn’t work” [emphasis added].

Regrettably, the law he signed less than 10 months later fell far short of the president’s own benchmark as it relates to Medicaid. Not only did the ACA fail to impose any cost controls on Medicaid, it likewise contained no reforms to reverse or even corral the perverse incentives that for decades had simultaneously led to indefensible levels of Medicaid overspending even while creating enormous problems of access to the very people the program aimed to help. Instead, it amplified those incentives, making an already-bad situation even worse.

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Health care has been central to U.S. political debate for nearly a decade as Democrats created a new entitlement with little public support.

Compared to that effort, the Senate this time has been a model of deliberative democracy. On Dec. 19, 2009, a Saturday, then Majority Leader Harry Reid tossed the 2,100-page bill the Senate had spent that fall debating and offered a new bill drafted in an invitation-only back room. Democrats didn’t even pretend to care what was in it while passing it in the dead of night on Dec. 24, amid a snowstorm, in the first Christmas Eve vote since 1895.

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The House passed legislation Tuesday to ensure that immigrants in the country illegally can’t access tax credits for health insurance premiums.

Rep. Lou Barletta’s (R-Pa.) bill, approved in a largely party-line vote of 238-184, would require the Treasury Department to confirm that people applying for the tax credits are verified as U.S. citizens or legal residents by the Commissioner of Social Security or the Secretary of Homeland Security.

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One of the nation’s biggest health insurers says it will not return to Ohio’s public insurance exchanges next year, a decision that could open more holes in the Affordable Care Act’s increasingly thin system for helping people buy coverage.

The move announced Tuesday by Anthem could leave shoppers in 20 counties without an option for buying individual coverage on the exchange unless another insurer steps in.

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Blue Cross and Blue Shield of Kansas City announced yesterday it has decided to exit the Obamacare exchange next year. The decision affects about 67,000 Blue KC customers in 30 counties in western Missouri as well as Wyandotte and Johnson counties in Kansas. Danette Wilson, Blue KC’s president and CEO, said that the company has lost more than $100 million total on its exchange plans since the ACA rolled out in 2014.

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The Trump administration and House of Representatives Monday asked a federal court for another 90-day delay in a lawsuit over Obamacare insurance subsidies. “The parties continue to discuss measures that would obviate the need for judicial determination of this appeal, including potential legislative action,” the House and White House wrote to the court. If the request is approved, the parties would have to file another update in 90 days. “We continue to work with the Trump administration on a solution,” said AshLee Strong, spokeswoman for House Speaker Paul Ryan.

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The Trump administration took another step Wednesday toward deregulating federal insurance exchanges created under the Affordable Care Act.

For coverage in 2018, consumers can buy an ACA-approved plan directly from a broker or an insurer’s website instead of having to go through HealthCare.gov, the CMS announced. The news comes just two days after small businesses were given permission to skip the federal marketplace to sign their employees up for SHOP coverage.

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The Department of Health and Human Services on Tuesday released a checklist for states that choose to seek waivers from certain Obamacare requirements.

Through the waivers, commonly known as “innovation waivers” or 1332 waivers, states can ask the federal government to allow them to set up high-risk pools, reinsurance programs or another proposal that would reduce costs for customers or allow for more people to be covered.

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New York’s health insurers will request double-digit rate increases for ObamaCare policies for 2018 while debate rages in Washington on overhauling the law, analysts told The Post.

The insurers officially submit their rate plans to state regulators on Monday.

Last year, the state Department of Financial Services approved an average 16.6 percent hike for individual policies and an average 8.3 percent for small group policies on the state’s ObamaCare exchange — the highest in four years.

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