“When I wrote last week about the slow start for Obamacare’s small business exchanges, I mentioned that some states could slow down the marketplaces’ progress even further in 2015 because of a possible delay recently created by the Obama administration.
The small business exchanges, like the law’s individual exchanges, are a virtual marketplace where businesses with 50 or fewer employees can compare health plans. Besides offering a limited tax credit, Obamacare small business exchanges, or SHOP, are supposed to offer one particular feature that changes the healthcare landscape for small companies: choice.”

“For Democratic lawmakers who were hesitant to sign onto the sweeping 2010 health care law, one of the most powerful selling points was that the Affordable Care Act would actually reduce the federal budget deficit, despite the additional costs of extending health insurance coverage to the uninsured.
Four years after enactment of what is widely viewed as President Barack Obama’s key legislative achievement, however, it’s unclear whether the health care law is still on track to reduce the deficit or whether it may actually end up adding to the federal debt. In fact, the answer to that question has become something of a mystery.”

“When it came time to renew his company’s health plan last fall, Jerry Eledge found himself in a bind that many small-business owners know all too well.

On one hand, “it’s kind of a moral obligation” to offer insurance, said Mr. Eledge, who runs Community Quick Care, a growing chain of primary health care clinics in the Nashville area. And yet, premiums for his existing plan were going up 20 percent, while other group plans promised as much as a 50 percent increase, even as deductibles and co-pays were becoming less generous. “We found no really good alternatives for 2014 at all,” he said. “Before Gary came along, we weren’t sure what we were going to do.”

“Opponents of Obamacare’s Medicaid expansion have traditionally argued that it will significantly burden state budgets and provide people with substandard health coverage. A new academic paper suggests what may be the strongest argument yet against the expansion: that it will keep many beneficiaries in poverty because it creates strong disincentives for work.”

“The national debate over the Affordable Care Act seemed an unlikely topic of discussion at Tuesday’s meeting of the Fairfax County Board of Supervisors — especially since the item on the agenda was whether to reappoint a longtime member of the local water authority.

Yet the law was what the supervisors focused on, specifically a letter to members of Congress written last fall by water board veteran Burton J. Rubin, warning that the insurance requirements of the Affordable Care Act would cause the water authority to stop insuring its employees.”

‘Paul Siperke is the co-owner of Fat Head’s, a popular brew pub in Cleveland. He has fewer than 50 full-time employees, so he’s classified under the Affordable Care Act as a small business. He doesn’t have to provide health insurance to his employees, but that’s what he’s been doing since the bar opened in 2009, despite some pretty dramatic volatility in rates.

“They just seemed to keep going up every year,” he says. “One year we got a 38 percent increase, another year we got 11. One year we got three.”‘

“Gene Sperling, former director of President Obama’s National Economic Council and former Assistant to the President for Economic Policy, argues that Obamacare should appeal to those who desire competition and choice in health care. But the very nature of Obamacare fosters neither.”

“A new investor report predicts that Standard & Poor’s 500 companies could shift 90 percent of their workforce from job-based health coverage to individual insurance sold on the nation’s marketplaces by 2020.”

“Whenever somebody says that an argument is settled, you can be sure that it is not. If it were settled, there would be no need to say so. No president will hold a press conference to announce that the argument over the prohibition of alcohol is settled, precisely because it truly is settled. So when President Obama declared the debate over his health-care law “settled” and “over,” as he did at an April 17 press conference, his performance was self-refuting.”

“Kyle Cheney of Politico is a solid, straight news reporter. So I was a little surprised this morning to see his analysis of state Obamacare exchange spending features numbers much smaller than the ones I have been using, most notably a figure of $248 million for Oregon and just $57 million for Massachusetts. Total federal grant funding to Oregon’s failed exchange, according to CMS, is $305 million. Massachusetts, according to CMS, is at $179 million. These are huge disparities.”