“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.”

“Enrollment in California’s healthcare program for the poor has soared as the state implements President Obama’s federal overhaul, pleasing advocates who have sought expanded coverage but also presenting new costs for the state.

Nearly one-third of California’s total population — roughly 11.5 million people — will be enrolled in Medi-Cal next year, according to Gov. Jerry Brown’s administration.

Enrollment is expected to exceed previous estimates by 1.4 million, and administration officials said it would cost the state $1.2 billion more than originally thought.”

“Conservatives have long argued that “first dollar” insurance coverage helps raise the cost of health care, as people tend to overconsume services they perceive as free. Implementation of state insurance exchanges appears to confirm that hypothesis: Several states that used “free” federal dollars to build complicated exchanges may end up scrapping them.”

“The Washington Post is reporting that the federal government is in talks to take over the Oregon health exchange. This news comes after many failed attempts at launching state-based exchanges, with more than 25% of the state based exchange executive directors having resigned, and multiple states losing CIOs, and COOs for poor performance as a result. However, this may be just the first shoe to drop as many state-based exchanges do not have good sustainability plans in place to support themselves going forward. This could be the first of many takeovers of exchanges, and certainly will not be the last bailout of one.”

“The day that many health policy wonks have been waiting for has come: Obamacare’s first open–enrollment period has officially ended on April 15, 2014. Wasting little time, the Department of Health and Human Services (HHS) has released the last of its first–year enrollment reports. The update from HHS contains some good news, and some not–so–good news. Overall, it appears highly unlikely that the healthcare law will collapse.”

“The race for people to #GetCovered through Obamacare’s state and federal health insurance exchanges has officially crossed the wire. In its sixth and final enrollment report released late last week, the Department of Health and Human Services disclosed that a total of 8 million individuals have signed up for an Obamacare compliant plan within the individual health insurance market.”

“Yesterday Massachusetts officials announced plans to default to Healthcare.gov, but also announced a quixotic sprint to try first try to rebuild the entire site in five months with a brand new, no-bid taxpayer-paid contract to health care software developer hCentive. This move comes eight months into open enrollment, after launching the worst performing exchange in the country, spending most of the $180 million from Washington and announcing that original contractor CGI would be fired—even though it is still working on the project. The announcement should leave taxpayers and policymakers scratching their heads and wondering about the lack of accountability, government management and procurement.”

“Remember Cash for Clunkers? That program gave car buyers rebates of up to $4,500 if they traded in less fuel-efficient vehicles for new vehicles with better gas mileage. But because most of the vehicles garnering such rebates would have sold anyway, taxpayers ended up paying about $24,000 per additional car sale these incentives produced.[1] Obamacare appears to be in a fierce race to beat Cash for Clunkers to become the poster child for mismanagement of federal taxpayer resources.”

“Despite Obamacare’s strong national enrollment numbers, several states are at risk for big premium hikes.

Each state is its own insurance market, and they had wildly different experiences during Obamacare’s first open-enrollment window. So although nationwide statistics are important for judging the law’s political success, the substantive tests for the law’s future mostly lie with the states—and some of them aren’t looking so hot.”