“The District’s health exchange has a problem — a big money problem.

Like the 14 states that started online marketplaces, the District faces a year-end deadline to prove its Web site can move past technology glitches to meet the next looming challenge in President Obama’s Affordable Care Act: financial self-sufficiency.”

“Virginia Gov. Terry McAuliffe is considering expanding health coverage for the poor without the approval of the state legislature, a move that would muscle his top priority past Republican opponents but also throw his young administration into a partisan firestorm and uncertain legal territory.”

“Fans of Kathleen Sebelius, the lady who made Obamacare so wildly popular, say her greatest accomplishment was persuading red states to accept the Medicaid expansion. Alas, these states have been lured with false promises of flexibility and free money.”

“An Oregon state board unanimously agreed to a plan Friday to use the federal government’s technology to run the state’s health insurance exchange.”

“A bill barring the state’s health insurance exchange from hiring individuals convicted of certain felonies failed to advance Tuesday.
Under the proposal by Assemblywoman Connie Conway (R-Tulare), Covered California would not be able to hire people who have been convicted of certain crimes–felonies concerning breach of trust or dishonesty–for jobs where enrollees’ financial or medical data could be accessed.”

“New Hampshire’s rollout of the Affordable Care Act has been one of the rockiest in the nation, putting Democratic Sen. Jeanne Shaheen on the front lines of Republican efforts to make the 2014 elections a referendum on the health law.”

“Oregon and Washington state strongly embraced Obamacare and opened their own health insurance exchanges. The states are similar, not just geographically but politically, economically and demographically. As the first enrollment season winds down, Washington has some of the best results in the country. Next door, Oregon’s exchange website is still broken.”

“The change has allowed Massachusetts to raise its Medicare payout by $257 million, forcing cuts to hospitals in 40 other states. The National Rural Health Association and 20 state hospital associations in January sent a panicked letter to President Obama, noting that the Massachusetts manipulation of the program would hand that state $3.5 billion over the next 10 years at the expense of Medicare beneficiaries everywhere. They quoted Mr. Obama’s former head of the Centers for Medicare and Medicaid Services, Donald Berwick, admitting that ‘What Massachusetts gets comes from everybody else.'”

“California’s health insurance rates for a new state-run marketplace came in lower than expected this week, but one downside for many consumers will be far fewer doctors and hospitals to choose from. People who want UCLA Medical Center and its doctors in their health plan network next year, for instance, may have only one choice in California’s exchange: Anthem Blue Cross. Another major insurer in the state-run market, Blue Shield of California, said its exchange customers will be restricted to 36% of its regular physician network statewide. And Cedars-Sinai Medical Center, one of Southern California’s most prestigious and expensive hospitals, said it’s not included in any exchange plans at the moment.”

“As the director of the California exchange put it, ‘These rates are way below the worst-case gloom-and-doom scenarios we have heard.’ But a few days later there is lots more information coming out and it would appear we have a case of apples to oranges to grapefruit. And, we have a pretty good case of rate shock.”