“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.”

“What this means, however, is that Covered California is creating for itself a very favorable and already higher baseline from which to compare next year’s individual health insurance premiums. That’s how they’re able to create the appearance that Obamacare’s reforms will lower individual premiums. To put it simply: Covered California is trying to make consumers think they’re getting more for less when, in fact, they’re just getting the same while paying more.”

“In 2012, the average individual insurance plan cost Californians $177 per month, according to online insurance marketplace ehealthinsurance.com. Yet the report put out by Covered California lists the average “silver” plan on the exchange as costing individuals $321 per month. That’s an 80 percent increase — or even more for those who still have the freedom to go without insurance and currently pay $0 in premiums. That freedom will disappear come January.”

“The Affordable Care Act may not be so affordable for some Nevadans. The law, commonly called Obamacare, combines benefit mandates and subsidies designed to make health insurance less costly for millions of Americans who now lack coverage. But observers ranging from state insurance officials to employee benefit consultants say some consumers could see premium increases big enough to price them out of insurance markets. If that happens, fewer people than expected could buy into the system, and that might mean the difference between Obamacare’s success or failure.”

“A California law that created an agency to oversee national health care reforms granted it broad authority to conceal spending on the contractors that will perform most of its functions, potentially shielding the public from seeing how hundreds of millions of dollars are spent.”

“Another GOP governor has pledged to go ahead with Obamacare’s Medicaid expansion, and once again, industry was standing right there with him… The same thing is happening in Ohio and Missouri. In Idaho, the GOP governor and legislature decided to build an Obamacare exchange thanks to industry pressure.”

“Cary Pigman, a Republican lawmaker in the state House of Representatives, sees uninsured patients every shift as an emergency room doctor in a rural part of central Florida, where nearly 30 percent of residents lack coverage. With a week remaining in Florida’s legislative session, Dr. Pigman might be expected to be sympathetic to hospitals and other groups urging the Republican-dominated legislature to accept $50 billion in federal money over a decade to extend coverage to 1 million poor Floridians. But that’s not the case.”

“A recent decision by HHS illustrates the arbitrary nature by which some implementation decisions are being made at CMS while highlighting the problem of a top-down approach in Obamacare. After months of small businesses anxiety in Massachusetts surrounding the impact of fewer rating factors due to an ACA mandated one-size-fits all policy, the Federal government recently pulled a piecemeal delayed implementation of the regulations out of thin air.”