“A top insurer in the North Carolina Obamacare exchange reported that its customers are both older and less healthy than it expected and warned that premiums are likely to rise next year.

“Not as many of the state’s young and healthy enrolled as expected,” Blue Cross Blue Shield of North Carolina announced in a press release. The company expected 50 percent of its Obamacare exchange customers to be younger than 35, but just 32 percent of customers are below age 35 and just 25 percent are between the ages of 18 and 34.”

“Indiana Gov. Mike Pence on Thursday said he wants to use Medicaid funding under the federal health-care law to expand coverage in his state, but that any expansion of it would have to come on his own terms.

The proposal is the latest from a small group of mostly Republican governors pursuing alternative ways to tap billions of dollars in federal Medicaid money available under the Affordable Care Act. Most GOP governors are refusing the additional federal money outright, while those who have wanted to expand Medicaid faced objections from GOP-led legislatures.”

“States that experienced severe technical problems in running their ObamaCare exchanges would have to reimburse the federal government for the cost under a Republican bill introduced Wednesday.”

“Arkansas’ “Private Option” Medicaid expansion has generated significant interest among red-state policymakers and the national press. And now that more data on the potential price tag is coming to light, Razorback taxpayers are taking notice too. Cost overruns are racking up and Arkansas officials are now considering asking for a Washington D.C. bailout, forcing all federal taxpayers to pick up the tab for a poorly-designed program. The state’s Medicaid director has abruptly resigned, and the political winds are gusting strongly against the program in Arkansas, at least among Republicans.”

“As regular NRO readers will know, one of the key races that Republicans need to win in order to retake the U.S. Senate is occurring in Arkansas, where Representative Tom Cotton is challenging Democratic incumbent Mark Pryor. The race to replace Cotton in the House of Representatives, while not nearly as consequential, is also quite interesting, because a central issue in that campaign is the fact that the Republican-led state legislature worked with the Democratic governor to implement Obamacare’s Medicaid expansion.”

“Of all the various Republican health care reform ideas, the most popular by far is letting people buy health insurance across state lines. It polls off the charts, provokes spontaneous applause in town hall meetings, is the talk of conservative policy wonks and state lawmakers, and features in virtually every serious Obamacare-replacement plan.”

“That brings up a question I’ve been pondering: Why did the Barack Obama administration put exchanges, and particularly state-based exchanges, at the heart of the operation? Billions have now been spent setting them up, and they will cost more money to run — more than some of these states can really afford”

“According to a new Avalere Health analysis, 17 of the 26 states that did not expand Medicaid in the first three months of 2014 still reported growth in Medicaid enrollment, ranging from 0.1 percent in Texas to 10.1 percent in Montana. Since these states had decided not to expand Medicaid eligibility levels under the Affordable Care Act (ACA), these numbers show the impact of the “woodwork effect,” which is when individuals who were previously eligible, but not enrolled in Medicaid, newly sign up as a result of increased outreach and awareness. These enrollees may place a strain on state budgets, since states are required to contribute to the cost of their coverage based on traditional Medicaid matching rates.”

“Even states that refused Obamacare’s Medicaid expansion are seeing enrollment growth in the health-care program, according to a new analysis.
Medicaid enrollment in 17 of the 26 states that hadn’t expanded Medicaid as of the end of March saw their rolls increase by a combined 550,300 new beneficiaries, reports the Avalere Health consulting firm.”

“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.”