Articles on the implementation of ObamaCare.

Earlier this month, the Department of Health and Human Services (HHS) released new county-level enrollment data revealing how many Americans had picked plans on the health insurance marketplaces. This new data also includes information on a number of key factors: consumers’ age, race/ethnicity, income, financial help received, metal level of plan selected, and new or renewal customer status. The maps show the distribution of consumers in a state who enrolled in marketplace plans in the 37 states that used HealthCare.gov as an enrollment platform during the 2014 open enrollment period. The map is interactive, and clicking on a county within a state displays more information on the number and proportion of consumer who enrolled there.

Obamacare continues to be haunted by its complexity.

The federal insurance exchange created under the health law doesn’t effectively verify critical information about applicants’ income and citizenship—information that is used to determine whether an applicant qualifies for federal subsidies—according to a new report by the Health and Human Services (HHS) Office of the Inspector General.

It’s the latest confirmation of continuing technical troubles for the health care law, and yet another indication of how difficult it’s proving to get the law to work as intended.

On the 9th floor of a glassy high rise in downtown Washington, partitions are coming down to make more room for workers handing out billions of dollars in Obamacare-funded research awards.

Business has been brisk at the Patient-Centered Outcomes Research Institute or, PCORI, as it is known. The institute was created by Congress under the Affordable Care Act to figure out what medical treatments work best — measures largely AWOL from the nation’s health care delivery system.

In February of 2015, IRS issued Notice 2015-16 which was intended to discuss a number of potential approaches to the implementation of pieces of the tax. At the time, IRS requested comment on a number of issues including the definition of applicable coverage, how to figure the cost of that coverage, and the caps used to calculate the tax.

In July of 2015, IRS issued Notice 2015-52 (downloads as a pdf) to address even more concerns, including who may be liable for the tax, employer aggregation, allocation of tax and payment of the tax. Here are some of the highlights with a little bit of commentary:

One of the last remaining features of the Affordable Care Act (ACA) that has yet to be implemented is the so-called “Cadillac tax,” which takes effect in 2018. Section 4980I will impose a 40 percent excise tax on employee benefits the cost of which exceeds certain statutory limits. The Cadillac tax is intended to limit the generosity of employer coverage on the theory that excess coverage encourages excess health care expenditures and thus drives up the total cost of health care. The tax is also, however, one of the major anticipated sources of revenue under the ACA, expected to raise $87 billion over the next 10 years.

Fed up with the insurance industry, Democrats used the health care overhaul to create nonprofit co-ops that would compete with the corporations. Now a government audit finds co-ops are awash in red ink.

Only one out of 23 — the co-op in Maine — made money last year, said Thursday’s report from the Health and Human Services inspector general’s office. Thirteen lagged far behind their sign-up goals for 2014.

As Medicare and Medicaid reach their 50th anniversary on Thursday, the two vast government programs that insure more than one-third of Americans are undergoing a transformation that none of their original architects foresaw: Private health insurance companies are playing a rapidly growing role in both.

This Viewpoint discusses 4 key changes that could improve the Affordable Care Act and create broad support across the states.

The Affordable Care Act (ACA) is best seen as transitional legislation on the road to long-term structural reform of the US health care system. This is not so much because the ACA is politically controversial and there is bound to be pressure for changes, despite the US Supreme Court’s King v Burwell decision,1 but rather it is because the ACA’s design still lacks the consistent, strategic building blocks needed for a stable, long-term system redesign.

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.

Welfare: During the debates on ObamaCare, Medicaid got little attention. That was a mistake, since enrollment and the cost of treating all those jumping onto the program is surging beyond expectations.
At first, ObamaCare tried to force states to expand eligibility for Medicaid by including childless adults and people with incomes 38% above the poverty line. In 2012, the Supreme Court blocked this attempt, making expansion optional for states.