The administration’s victory in the latest Obamacare case, King v. Burwell, has relieved Congress of the need to quickly repair or replace the Affordable Care Act. But that does not mean Congress should sit back and wait for the 2016 election and a Republican president to fix the law. In fact, Republicans may have an easy way to reach their policy objectives, in a manner that might attract bipartisan support and even a signature from President Obama.

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The Affordable Care Act lives to see another day. Late last month, the Supreme Court upheld the distribution of subsidies, as well as the mandates and penalties attached to them, in the 34 states that use the law’s federal healthcare exchange.

Yet despite this decision, one thing remains painfully clear: The Affordable Care Act isn’t working for millions of Americans. No ruling from the Supreme Court can change that fact.

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Congressional Republicans see a repeal of a tax on medical devices as their best opportunity to chip away at the Affordable Care Act after the Supreme Court’s recent decision turning away a challenge to a key component of the law.
The House has already voted to repeal the tax, and Senate Republicans are weighing the best timing for a vote to undo the levy, which helps underwrite the health law.

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Roberts’s intellectual complexity does not prevent him from expressing himself pithily, as he did with those words when dissenting in a case from Arizona. Joined by Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr., Roberts’s dissent should somewhat mollify conservatives who are dismayed about his interpretive ingenuity four days earlier in writing the opinion that saved the Affordable Care Act. Furthermore, they, including this columnist, may have missed a wrinkle in Roberts’s ACA opinion that will serve conservatives’ long-term interests.

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The urge to merge is sweeping managed health care. Aetna announced Friday a $37 billion deal to acquire Humana. Anthem and Cigna are in merger talks and could be next. The national for-profit insurers are on an anxious mission to consolidate. These combinations will sharply reduce competition and consumer choice, as five big insurers shrink, probably, to three.

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Oregon’s insurance regulator has approved big premium increases sought by health plans for 2016 under the health law, and in some cases ordered higher raises than insurers requested, signaling that the cost of insurance for people who buy it on their own could jump after two years of relatively modest growth.

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Convention claims the Supreme Court’s King v. Burwell decision is a loss for conservatives. But Democrats shouldn’t celebrate. Politically, it’s a win for the right, skirting potential harm in terms of legal precedent as well as improving positioning for 2016.

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Why is Obamacare still so unpopular? Why aren’t the working class and middle-class signing up for it? Why is the Obamacare population sicker and causing so many big rate increases a year earlier than expected? Is Obamacare financially sustainable in its present form? Is it politically sustainable as it is?

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“The Patient Protection and Affordable Care Act grew out of a long history of failed health insur­ance reform.” Chief Justice John Roberts, in upholding Obamacare subsidies.
Obamacare is the newest chapter in that long history of failed health insurance reform. Conservatives who hope one day to replace it would do well to learn from its errors and conceits.

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Days after the Supreme Court delivered a victory for his health care law for the second time, President Obama flew into mostly Republican territory on Wednesday and began an aggressive push to get states that have resisted parts of the law to expand care to more of their poor residents.

“With the Supreme Court case now behind us, I’m hoping what we can do is focus on how to make it even better,” Mr. Obama said to an audience here that included health care administrators and people who got health insurance under the Affordable Care Act.

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