“Landrieu, critics believe, pledged her vote in exchange for gaining $200 million additional federal funds for Louisiana’s Medicaid program. Except that, due to a drafting error, the law ended up giving Louisiana $4.3 billion in extra Medicaid funds: more than twenty times the assigned amount. How this happened, and how Congress failed to fully fix it, is a microcosm of our new health law’s many flaws.”

“A bill conservative Republicans see as an important step toward giving Kansas full control over health care programs received first-round approval Tuesday in the state House, advancing another protest from the GOP-controlled Legislature against Democratic President Barack Obama’s policies.”

“An Obamacare exchange will offer less choice, not more. Consumers who want to buy affordable plans for catastrophic care would not be able to. Health savings accounts probably would be verboten. Like Henry Ford, who said customers could have any color car so long as it was black, Obamacare says state exchanges can offer any plan, so long as it is gold-plated.
What happens if a state allows a wide variety of plans at different prices and coverage levels? Washington would declare that it allows too much choice — and take over.”

“When the Supreme Court hears the state challenge to ObamaCare later this year, most of the attention will likely be on the challenge to the law’s individual mandate to purchase health insurance and its implications for the Constitution’s Commerce Clause. But in a somewhat unexpected move, the Supreme Court has decided to allow for a full hour of oral argument regarding another part of the case: the expansion of Medicaid, the joint federal-state health program for the poor and disabled, which is expected to account for half of the law’s health coverage expansion.”

“The individual mandate may be getting more attention, but in a time of persistently high unemployment there needs to be just as much concern about the employer mandate. While these results are specific to Indiana, there are likely other states where small and mid-size businesses are responsible for a significant portion of the job growth. Reforming healthcare need not compromise jobs and small businesses, but unfortunately the Affordable Care Act will do just that.”

“Under the health care overhaul, the federal government will start taxing itself and the states beginning in 2014. And that’s giving state Medicaid directors heartburn. A report released Tuesday by the actuarial firm Milliman Inc. said the tax will cost the Medicaid program between $36.5 billion and $41.9 billion over 10 years. At least $13 billion will be borne by states, and at least $23.5 billion by the federal government, based on the state-federal Medicaid matching formula.”

“Nineteen rural state hospital associations have signed onto a letter urging President Obama to nix the healthcare reform law’s special deal for Massachusetts hospitals in his 2013 budget proposal next month. The hospital groups say a provision in the law shifts $367 million annually in Medicare funding from 49 states to the Democratic-led commonwealth. The provision’s aim was simply to increase Medicare payments for a single, 15-bed hospital in Nantucket but ended up raising payment rates for the state’s 60 urban hospitals by 8 percent.”

“Because, even if one were to accept the White House’s accounting (which one shouldn’t), that would mean that 22 states — roughly 40 percent of the country — are not ‘on their way’ toward erecting the Obamacare exchanges. Isn’t that a problem? Further, upon closer inspection, it’s clear that many of the 28 states that are supposedly ‘on their way’ really aren’t ‘on their way.’ That’s just comical White House spin, in which the truly inconsequential — the acceptance of minor federal grant money, or the setting up of a committee to “study” the question — is elevated into a sure sign that Obamacare is a fait accompli. It’s ridiculous.”

“That is, states must now accept a comprehensive reorganization of Medicaid or forfeit all federal Medicaid funding—even though the spending power is circumscribed to preserve a distinction between what is local and what is national. If Congress is allowed to attach conditions to spending that the states cannot refuse in order to achieve an objective it could not outright mandate, the local/national distinction that is so central to federalism will be erased.”

“Twenty-six states on Tuesday asked the Supreme Court to overturn the health care reform law’s mandatory state expansion of the Medicaid program, a sleeper issue in the health care reform lawsuit that could determine how much leverage the federal government has with the states on any issue.
The states, led by Florida, argue that the federal government can’t force them to expand the Medicaid program, which has operated as a partnership between the feds and the states, as part of the 2010 health reform law. They argue that the Medicaid expansion is possibly more coercive than the law’s individual mandate.”