Articles on the implementation of ObamaCare.

The third open-enrollment season for health plans under the Affordable Care Act moved into its final hours Sunday night with little fanfare from Obama administration officials who had been urging consumers to buy insurance.

It was unclear whether the close of the three-month enrollment window drew any stampede of last-minute shoppers on HealthCare.gov, as was the case during the first two sign-up years. In each of those, federal health officials trumpeted a late surge of people choosing health plans as evidence of Americans’ eagerness for coverage.

But on Sunday, the officials provided no figures about the final weekend’s volume of traffic on the federal insurance website.

As the third open enrollment season for health insurance under the Affordable Care Act comes to a close on Sunday, a new poll reveals that many uninsured Americans still aren’t paying attention.

The poll by the Kaiser Family Foundation, released Thursday, found that the majority of the uninsured say they don’t know the deadline for getting coverage this year. Virtually no one knew that the fine for going without health insurance in 2016 has jumped to $695 per adult or 2.5% of household income — whichever is higher.

Most uninsured Americans are sitting on the sidelines as sign-up season under the federal health law comes to a close, according to a new poll that signals the nation’s historic gains in coverage are slowing. The survey released Thursday by the Kaiser Family Foundation finds that:

– Only 15% of the uninsured know this year’s open enrollment deadline, which is Sunday.

– More than 7 in 10 say they have not tried to figure out if they qualify for the two main coverage expansions in the law, Medicaid and subsidized private health insurance.

– Only 1 in 100 know the minimum penalty for being uninsured is going up to $695 in 2016.

Oklahoma declined to set up an insurance exchange or to expand its Medicaid program, which has some of the nation’s most restrictive eligibility criteria. State officials say the number of private insurers participating on the federal insurance exchange here has fallen, and the premiums of the insurance plans on offer have increased.

The public’s attitude can also be an obstacle: Supporters of the Affordable Care Act often encounter stony skepticism here.

“‘Obamacare’ is a cuss word in this state,” said former Gov. David Walters, a Democrat.

One reason why the anger over ObamaCare has subsided somewhat could be that more than 70 significant changes have been made to the law since it was enacted in 2010—delaying, weakening, and eliminating some of its more onerous and burdensome provisions. The law that is being implemented is not the one Congress passed.

By our updated count at the Galen Institute, at least 43 of the changes to the Affordable Care Act have been made unilaterally by the Obama administration, 24 have passed Congress and been signed into law by President Obama, and three were made by the Supreme Court, which had to rewrite the law to uphold it.

Yesterday, the nonpartisan Congressional Budget Office released its annual ten-year Budget and Economic Outlook. The document contains the CBO’s updated estimates for economic growth, employment, and the nation’s fiscal health. The most notable change was to enrollment in Obamacare’s health insurance exchanges. The CBO, bowing to reality, slashed their 2016 estimates of exchange enrollment from 21 million to 13 million. Furthermore, the CBO implied that it expects exchange enrollment to peak at 16 million: a far cry from the 24 million it predicted last March.

This is the second year that the Affordable Care Act and taxes will collide, and two changes this year could make the cumbersome tax filing process a bit more complicated.

Janna Herron of The Fiscal Times fills you in on what you should know this time around—the forms, the penalties, and the deadlines.

When the Affordable Care Act was drafted, the Congressional Budget Office expected people to sign up quickly for new health insurance.

Now, two years into the law, it’s clear that progress is going to be slower. The Obama administration acknowledged as much in late 2014, and again in October, when it presented its own modest predictions. Monday, the budget office also agreed, slashing its 2016 estimate by close to 40%.

The Obama administration’s top health insurance official told Congress Thursday he wants to “loosen up capital rules” to allow private investors to become part owners of the dozen surviving ObamaCare co-ops.

Andy Slavitt, the acting administrator for the Centers for Medicare and Medicaid Services which oversees the ObamaCare co-ops, told the Senate Finance Committee that his agency would also look approvingly on co-op mergers with existing insurance companies.

The new private investment policy represents a major reversal for the Obama administration, which has previously hailed the non-profit co-op health insurance model as a tool for providing competition to private, for-profit insurers.

In the wake of Louisiana governor John Bel Edwards’ announcement last week that his state would expand Medicaid under ObamaCare, the White House rolled out a new scheme to persuade the 19 states that are still holding out to fall into line and expand their programs: throw more money at them.

But these state officials should resist the temptation, for at least three reasons:

  1. First and most obvious is that expansion states have all experienced the same thing: More people signed up than expected, and it blew a hole in the states’ budgets.
  2. The second reason is that there’s no such thing as “free” federal dollars. The money comes with conditions, which effectively shifts policymaking from the receiving state’s legislature and governor to a distant federal bureaucracy (in this case, the Centers for Medicare & Medicaid Services), which dictates how states must spend federal Medicaid funds.
  3. The third reason is less abstract: Medicaid will harm those it’s meant to help. Often lost in the expansion debate is that Medicaid is the worst form of health coverage in the country.