Despite the setbacks of the past eight months, including the inability of Republicans to agree on a single alternative to the ACA, it is still not too late for this Congress to pass health care reform legislation.

At this point in the Obama administration’s first term, the ACA hadn’t been passed – not even out of committee – and Democrats weren’t the least bit united either. That had, and that point in time, three separate bills – quite different from each other – going through different House committees, and three additional very different bills going through three different Senate committees. In addition, there were numerous other proposals introduced by various Democrats, which had been sidelined by their own leadership.

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The Department of Health and Human Services announced today it’s slashing the advertising and promotional budget for the Affordable Care Act for next year. It’s planning to spend $10 million to promote the law in the open enrollment period that starts in November — compared to the $100 million the Obama administration spent last year.

On a conference call with reporters, HHS officials argued that last year’s promotional spending — which was doubled from the year before — was ineffective because signups for new customers actually went down.

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A bipartisan group of governors is trying to jump-start efforts to strengthen private insurance under the Affordable Care Act, urging Congress to take prompt steps to stabilize marketplaces created by law while giving states more freedom from its rules.

In a blueprint issued Thursday, the eight governors ask House and Senate leaders of both parties to take several steps to reverse the rising rates and dwindling choices facing many of the 10 million Americans who buy health plans on their own through ACA marketplaces.

Specifically, the state leaders say Congress should devote money for at least two years toward “cost-sharing subsidies” that the 2010 health-care law promises to pay ACA insurers to offset deductibles and other out-of-pocket expenses for lower-income customers.

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In an effort to promote medical breakthroughs, the 21st Century Cures Act tries to create an “information commons”: a government-regulated pool of data accessible to all health researchers, regardless of background, training or motive.

Although speeding research is a noble goal, there’s little evidence that patients are willing to sacrifice their privacy the way that the 21st Century Cures Act requires.

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A group of 11 states and the District of Columbia running their own Obamacare exchanges want more federal funding to stabilize exchanges facing higher premiums and insurer defections.

The states wrote to leaders of the Senate Health, Education, Labor and Pensions Committee with their ideas on Tuesday. Those include guaranteeing insurer payments and establishing a permanent reinsurance fund to help insurers.

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Congressional Democrats may be tempted to think they shouldn’t negotiate with Republicans on health care because, so far, the GOP has shown itself incapable of fulfilling its commitment to repeal and replace the Affordable Care Act (ACA). “Why rescue Republicans from their failure?” the thinking goes.

This is a short-sighted perspective. Yes, the GOP effort has stalled, but, absent some kind of bipartisan deal which brings more stability and consensus to health policy, it is still possible that Republicans will succeed in pushing substantial changes on their own, despite strong opposition from Democrats.

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Residents in every U.S. county are expected to have at least one insurer to buy coverage from on Obamacare’s exchange when open enrollment starts in November, but several difficult decisions lie ahead for customers, particularly those who will not receive any help paying for their premiums.

Those customers are facing significantly higher costs for their policies, and those whose current insurer isn’t providing coverage for 2018, whether subsidized or not, likely will have to change doctors and hospitals to make sure they aren’t slammed with high out-of-pocket medical expenses.

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While Republicans were trying and failing to repeal Obamacare, Democrats in Congress were quietly lining up behind a single-payer health plan that, as written, would fundamentally reshape American health care for every single person in the country.

That plan has now gained the backing of 60 percent of House Democrats, the most support a single-payer plan has ever enjoyed in Congress, and Sen. Bernie Sanders (I-VT) is planning a national campaign for a similar proposal in early September.

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Govs. John Kasich of Ohio (R) and John Hickenlooper of Colorado (D) announced Monday that they have reached an agreement on a bipartisan proposal to stabilize ObamaCare markets.

The governors, who have been calling for bipartisanship on healthcare in a series of recent interviews, are not yet releasing the details of their stabilization plan.

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While Republicans fret over how many taxpayer-funded patches they will have to stick on ObamaCare to keep it on life-support, Democrats are already moving on to their real goal: a government-run, single-payer healthcare system.

Moderate Republicans like Sen. Lamar Alexander (R-Tenn.) are hoping to find bipartisan support for legislation that will save the individual (i.e., non-group) health insurance market and keep the ObamaCare exchanges from collapsing.

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