“The government may be paying incorrect subsidies to more than 1 million Americans for their health plans in the new federal insurance marketplace and has been unable so far to fix the errors, according to internal documents and three people familiar with the situation.”

“States that experienced severe technical problems in running their ObamaCare exchanges would have to reimburse the federal government for the cost under a Republican bill introduced Wednesday.”

“In his Monday Think Tank post previewing political and policy battles over insurance premium increases, Drew Altman wrote that “85% of those who purchase insurance in the new marketplaces will get a government subsidy in the form of a tax credit to help defray the cost of the premium. That means that most people buying in the exchanges won’t pay much even if their premium cost goes up significantly” in 2015.”

“Last summer, the federal government was greeted with raised eyebrows when it awarded a UK-based firm a contract worth $1.2 billion to process Obamacare applications. At the same time, the company was being investigated for overbilling the British government tens of millions of pounds.

Though it managed to work through a year of Obamacare’s implementation relatively unnoticed, the contractor, Serco Inc., is back in the spotlight—and raising questions over the validity of its work.”

“Senate GOP leaders on Tuesday called for a vote to kill ObamaCare’s tax on medical devices, as part of a broader package to revive tax breaks that expired at the end of last year.

But the tax package is popular with members of both parties, and it’s unclear if Republicans have the leverage to win a vote on the medical device tax.

Republicans stopped short of saying they would oppose the tax package without the medical device vote.”

“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.”

“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.”

“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.”