Articles on the implementation of ObamaCare.

Here is something few pundits predicted.

Poor, long-uninsured patients are getting Medicaid through Obamacare and finally going to the doctor’s office for care. But middle-class patients are increasingly staying away.

Take Praveen Arla, who helps his father run a family practice in Hillview, Kentucky. The Arlas’ patient load used to be 45% commercially insured and 25% Medicaid. Those percentages are now reversed, report Laura Ungar and Jayne O’Donnell in USA Today.

WASHINGTON — For years, Harvard’s experts on health economics and policy have advised presidents and Congress on how to provide health benefits to the nation at a reasonable cost. But those remedies will now be applied to the Harvard faculty, and the professors are in an uproar.

Members of the Faculty of Arts and Sciences, the heart of the 378-year-old university, voted overwhelmingly in November to oppose changes that would require them and thousands of other Harvard employees to pay more for health care. The university says the increases are in part a result of the Obama administration’s Affordable Care Act, which many Harvard professors championed.

By Tevi Troy
The Affordable Care Act, otherwise known as ObamaCare, has had a tough run of it since being signed into law nearly five years ago. It has faced constitutional challenges, voters ousting congressional Democrats who supported it, and the disastrous rollout of its federal website in October 2013. This past fall, supporters launched a public-relations campaign dedicated to the proposition that things were finally going well for ObamaCare’s 7 million sign-ups, but their campaign was derailed when the Obama administration admitted that it had added 400,000 dental patients to the roster of health-insurance enrollees to falsely claim it had reached the 7 million number.

By Grace-Marie Turner

The Internal Revenue Service usurped its authority and overturned longstanding norms of federalism in ruling that health insurance subsidies could be available through federally-created exchanges, the Galen Institute and state legislators argued in an Amicus brief submitted Monday in the pending King v. Burwell lawsuit.

The U.S. Supreme Court will hear arguments in the case on March 4, and a decision is likely by June.

The new Republican Congress may not be able to repeal and replace Obamacare entirely, but it could make substantial progress by targeting the health law’s key structural components.

This November’s electoral wave reopened and widened the strategic playing field for critics of the Affordable Care Act (ACA). Republican control of both houses of Congress, plus larger majorities of state governors and state legislatures present both opportunities and challenges to move beyond rhetorical opposition and advance changes in national health policy. Initial speculation tends to focus more on tactical considerations on Capitol Hill: which items are easiest to pass in the Senate, how to use budget reconciliation, and which votes will “look good” politically even if vetoed by President Obama.

The one state that not only embraced Obamacare but insisted on going beyond it to a full single-payer system was Vermont, the haven of hippies and expatriate New Yorkers, which has become one of the most liberal states in the nation. In 2011, it adopted a form of neighboring Canada’s government-financed health care and promised to implement it by 2017. (And Jonathan Gruber was a key architect of this plan as well as of Obamacare.) This week, however, Governor Peter Shumlin, a Democrat, admitted the state couldn’t afford the plan’s $2 billion price tag and consequent sky-high taxes, and pulled the plug. The lessons for Obamacare are obvious and profound.

By Bruce Parker | Vermont Watchdog

Jonathan Gruber’s health care forecasting is failing in Colorado as Vermont’s Gov. Peter Shumlin prepares to use the economist’s math for single-payer health care.

As Vermonters anxiously await a Gruber-modeled financing plan for Green Mountain Care, modeling done for Colorado’s health exchange by Jonathan Gruber Associates has proven wildly erroneous.

By Stephanie Armour:
Some free health clinics serving the uninsured are shutting their doors because of funding shortfalls and low demand they attribute to the Affordable Care Act’s insurance expansion.

Nearly a dozen clinics that have closed in the past two years cited the federal health law as a major reason.

The closings have occurred largely in 28 states and Washington, D.C., which all expanded Medicaid, the federal-state insurance program for low-income people, and are being heralded by some clinic officials as a sign the health law is reducing the number of uninsured.

Continued at… http://www.wsj.com/articles/health-law-hurts-some-free-clinics-1418429551

By Sam Baker and Sophie Novack:
Republicans want the Supreme Court to blow a major hole in Obamacare next year, but they are still debating whether they would help repair it—and what they should ask for in return.

There’s a very real chance the high court will invalidate Obamacare’s insurance subsidies in most of the country, which would be devastating for the health care law. It would become almost entirely unworkable in most states, and the cost of coverage would skyrocket.

With the Supreme Court due to rule on a major ObamaCare legal challenge by next summer, thoughts in Washington are turning to the practical and political response. If the Court does strike down insurance subsidies, the question for Republicans running Congress is whether they will try to fix the problems Democrats created, or merely allow ObamaCare’s damage to grow.