Articles on the implementation of ObamaCare.

Congressional Republicans are warning the Obama administration not to settle with insurers that have sued the government over an Affordable Care Act program to compensate them for losses under the law, saying such a move would bypass spending limits set by Congress.

Forty-six House Republicans signed a letter sent Thursday to Health and Human Services Secretary Sylvia Mathews Burwell saying they oppose any settlements and could sue the administration to block them.

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With major insurers retreating from the federal health law’s marketplaces, California’s insurance commissioner said he supports a public option at the state level that could bolster competition and potentially serve as a test for the controversial idea nationwide.

“I think we should strongly consider a public option in California,” Insurance Commissioner Dave Jones said in a recent interview with California Healthline. “It will require a lot of careful thought and work, but I think it’s something that ought to be on the table because we continue to see this consolidation in an already consolidated health insurance market.”

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Hillary Clinton surely is hoping health reform remains a side issue the presidential campaign as bleak news of its failures have propelled Obamacare back into the spotlight.  Clinton owns Obamacare after telling Iowa voters: “I will defend the Affordable Care Act, but as president I want to go further.”  She actually wants to double down, even after seeing public support for the health law tumble. She wants to create another big government “public option” that would have unlimited calls on taxpayer dollars and government force and would quickly drive remaining private insurers out of the market, leaving people with only the “choice” of a government-run health plan.  We can and must do better than Obamacare, and the voters know it.

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Complications arising from the Affordable Care Act (ACA) premium tax credits (PTCs) are causing millions of people to effectively break the law. People who benefit from advance premium tax credits (APTCs) must file tax returns and include a form to reconcile the advanced amount to the actual end-of-year entitled amount. The failure of so many people to fulfill this new legal requirement has led the government to spend more than it should have as APTCs tend to be higher than legally entitled amounts.

The big news is that tax filers, as of April 28, 2016, reported $15.8 billion in total APTC payments. According to data released by HHS, I estimate the amount of APTCs paid in 2015 equaled $26.7 billion—nearly $11 billion more than the amount reported by tax filers. It appears that about 3 million households that received an APTC in 2015 had not filed the required paperwork with the Internal Revenue Service (IRS) by the end of April 2016.

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As many as 20 million Americans soon will be getting a letter from the Internal Revenue Service “suggesting” they sign up for ObamaCare insurance.

Getting a letter from the IRS can be a threatening and nerve-racking experience; it seldom is seen as a suggestion and more of a threat.  But at President Obama’s direction, the IRS is “reaching out” to people who paid the tax penalty for not buying mandatory health insurance or who claimed an exemption in hopes of “attracting” more people to sign up for ObamaCare insurance.  The government is particularly interested in compliance from healthy young people.

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As ObamaCare’s troubles mount, I’ve heard my patients and my peers in healthcare ask: How could the law’s authors not have seen this coming?

For my part, I think a different question needs to be asked: What if they did? What if ObamaCare was purposely designed to fail?

Every day, it seems like there are a dozen new headlines about the crisis facing ObamaCare. Premiums are rising faster than ever. Meanwhile, health insurance companies are abandoning the law’s exchanges left and right, unable to compete in the top-down, regulation-driven environment created by the law. Less than three years into its implementation, the law has never looked so precarious.

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Roughly 8 million people faced ObamaCare individual mandate penalties this year totaling more than $3 billion, an analysis of the latest IRS data reveals.

Despite the controversy and high-stakes legal battle that has surrounded the individual mandate, the scope of the penalties paid this year has gone unreported by major news outlets as attention has focused on ObamaCare’s latest and most glaring problems: weak enrollment, surging premiums, and insurer losses that have provoked the exit of UnitedHealth, Aetna and Humana from most state exchanges.

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Deep into the final year of his presidency, Barack Obama is working behind the scenes to secure Obamacare’s legacy, struggling to bolster a program whose ultimate success or failure will likely be determined by his successor.

With no lifeline coming from the divided Congress, Obama and his administration are redoubling their pleas for insurers to shore up the federal health care law and pushing uninsured Americans — especially younger ones — to sign up for coverage. The administration is nervously preparing for its final Obamacare open-enrollment season just a week before Election Day, amid a cascade of headlines about rising premiums, fleeing insurers and narrowing insurance options.

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Progressive senators and activists are launching a campaign Thursday calling for every American to have the choice of a public health insurance option.

They aim to build on Democratic presidential candidate Hillary Clinton’s support for a public option with what they hope will be the biggest health care push by Democrats since the passage of the Affordable Care Act in 2010.

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The premium-stabilization programs of the Affordable Care Act (ACA) will expire this year, and even insurers like Blue Cross Blue Shield — once considered the companies of last resort — are considering leaving the exchanges.

While many Blues plans continue to assert their commitment to the ACA market, successive rate hikes and insurer withdrawals from the exchanges temper their assurances.

“These Blue Cross plans will stay longer, but they can’t stay forever,” said Robert -Laszewski, president of Health Policy and Strategy Associates and former insurance executive. Laszewski, a consultant for the plans, added that Blue Cross Blue Shield of Texas lost 40 percent of its reserves in the first two years of ObamaCare. “They can’t continue losing surplus forever.”

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