“Indiana Gov. Mike Pence on Thursday said he wants to use Medicaid funding under the federal health-care law to expand coverage in his state, but that any expansion of it would have to come on his own terms.

The proposal is the latest from a small group of mostly Republican governors pursuing alternative ways to tap billions of dollars in federal Medicaid money available under the Affordable Care Act. Most GOP governors are refusing the additional federal money outright, while those who have wanted to expand Medicaid faced objections from GOP-led legislatures.”

“Massachusetts pioneered universal health care in 2006. Under then-Governor Mitt Romney, it was the first state to guarantee access to insurance — and drove its uninsured rate down to just 4 percent.

Which makes it baffling that Massachusetts did arguably the worst of any state in implementing Obamacare. Like a handful of ardent Obamacare supporters in other states, Massachusetts officials tried to pull off an ambitious launch — and failed badly.”

“A few months into Obamacare’s coverage expansion, there’s been plenty of debate about where the millions of newly insured have obtained coverage — whether through the law’s exchanges, directly from an insurer, through expanded Medicaid or through an employer. The health-care law’s immediate impact is a little more clear in hospitals, which are starting to report who’s coming through their doors during the first months of expanded coverage under the Affordable Care Act.”

“In the midst of all the turmoil in health care these days, one thing is becoming clear: No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.”

“Whenever somebody says that an argument is settled, you can be sure that it is not. If it were settled, there would be no need to say so. No president will hold a press conference to announce that the argument over the prohibition of alcohol is settled, precisely because it truly is settled. So when President Obama declared the debate over his health-care law “settled” and “over,” as he did at an April 17 press conference, his performance was self-refuting.”

“A left-leaning think tank whose research is often taken seriously by backers of the health-care overhaul has published a paper suggesting the administration should scrap the health law’s requirement that employers offer coverage or pay a penalty.”

The federal government will bear a disproportionate burden of premium increases in states with high rates of subsidized enrollees. Double digit premium increases are likely in many markets in 2014. Age distribution among enrollees varies by state, which may influence plans’ interest in each market.

“With enrollment in the Obamacare exchanges now closed, Democrats and their friends in the media are ebullient. Obamacare is an enormous success, they say, and conservatives have been humiliated. On closer inspection, however, things seem decidedly less bullish for President Obama’s signature achievement. “

“Our analyses as well as that of others find that eliminating the employer mandate will not reduce insurance coverage significantly,
contrary to its supporters’ expectations. Eliminating it will remove labor market distortions that have troubled employer groups
and which would harm some workers. However, new revenue sources will be required to replace that anticipated to be raised
by the employer mandate.”

“One of the principal flaws in the coverage of Obamacare’s exchange enrollment numbers to date has been that the press has not made distinctions between those who have “signed up” for Obamacare-based plans, and those who have actually paid for those plans and thereby achieved enrollment in health insurance. A new survey from McKinsey indicates that a large majority of people signing up are now paying for their coverage. This is progress for the health law. But the survey still indicates that three-fourths of enrollees were previously insured.”