“California officials have floated the idea of legislating lower prices. One way would be to throw West Los Angeles and Orange County into the same risk pools. That might reduce premiums in West L.A., but only by increasing premiums in Orange County. With a few simplifying assumptions, premiums in both West L.A. and the O.C. could rise by 19 percent. An alternative would be to cap premium increases. One state official proposes a cap of 8 percent. But that would just be an implicit form of government rationing. If insurers cannot charge premiums that cover their costs, they will cover fewer services.”

“November 16th is the deadline for states to submit a blueprint to the federal government for Obamacare’s insurance exchanges — a key component of the new healthcare law. Already, the exchange system is proving to be an unmitigated disaster.”

“Leaders of the deeply conservative state say that even if Mississippi receives boatloads of cash under President Barack Obama’s health care law, it can’t afford the corresponding share of state money it will have to put up to add hundreds of thousands of people to the government health insurance program for the poor.”

“A state-run health insurance exchange is unlikely to be ready for a scheduled January 2014 rollout, Pennsylvania’s top insurance regulator said Wednesday. Insurance Commissioner Michael Consedine said development of the online exchange—a key element of the federal Affordable Care Act—has stalled because too many questions about its cost and other operational details remain unanswered by the federal government.”

“Republican Gov. Phil Bryant says the 2010 federal health care overhaul is slowing Mississippi’s economy because business owners are confused about how much it will cost them to meet demands of the law.”

“Since passage of the Affordable Care Act (ACA), the American Action Forum (AAF) has tracked the state of its regulatory implementation. To date, the ACA has imposed a total of $27.6 billion in new regulations – at least $20.4 billion in lifetime costs on private entities and $7.2 billion in increased burdens on state budgets. In this paper AAF examines how this $27.6 billion in new costs break down on a state-by-state level. The data show that five states will endure at least $1 billion in ACA regulatory costs.”

“The experts believed states would want to tailor the exchanges to their own populations. But the task has proved exceedingly complicated. Participating states must set up a call center as well as a Web site that allows people to easily find and understand health plans, in much the way that Orbitz and Travelocity help people find airline flights.”

“A D.C. board has voted to require individuals and small-business owners in the District to purchase their health insurance through the newly minted health exchange it oversees. The D.C. Health Benefit Exchange board approved the regulations late Wednesday, with just one modification to shrink the size of businesses that would come under the regulation.”

“The concerns are also damning in the context of the the normal tug of war between the states and Washington DC. That’s because in his testimony, Mr. Consedine states he wrote to HHS weeks ago and has not received a reply. While its’ not unusual for the Feds to stiff politically inconvenient inquiries, I am fearful that the reason why HHS seems unwilling to provide a timely reply is because it doesn’t know the answers.”

“PPACA is poised to radically expand Medicaid coverage beginning in 2014—adding to an already crushing state burden of Medicaid costs. The “perfect storm” of Medicaid overspending, excessive regulation, and PPACA expansion is leading to serious discussions among governors and state Medicaid directors about block-granting federal Medicaid funding in return for significant state flexibility in Medicaid program design and administration.”