In King v. Burwell, Chief Justice John Roberts did the Obama administration a bigger favor than he realized. Writing for a himself and five colleagues, Roberts blessed the administration’s expansion of the Affordable Care Act’s individual mandate, employer mandate, and premium subsidies in the 34 states that refused to establish exchanges — even though the majority, to say nothing of the three dissenters, recognized that expansion was in direct conflict with “the most natural reading of the pertinent statutory phrase.”

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FOR FIVE years, Republicans have been trying, unsuccessfully, to repeal Obamacare. But where the GOP has failed, a bipartisan coalition including dozens of Democrats aims to succeed — at least in part. That’s the strange-but-true implication of the new push to repeal the so-called “Cadillac tax” on high-cost employer-paid group health plans.

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While the debacle known as ObamaCare has been superseded for the moment by the disastrous Iran nuclear deal and the fireworks in the GOP presidential race, the political battle to repeal this law will continue. Pushed through against popular will by using obscure parliamentary tricks and dispensing old-fashioned “favors” with key lawmakers, ObamaCare has been an unmitigated disaster rife with price hikes, website crashes, lost coverage and corruption.

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Several factors are driving employers to private health insurance exchanges, one of the biggest being the 40% excise tax on high cost health care plans set to go into effect in 2018, said Jay Kirschbaum, St. Louis-based senior vice president and practice leader in Willis North America Inc.’s national legal and research group.

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Marilyn Tavenner, who spearheaded the fraught Affordable Care Act rollout for the Obama administration, is but the latest ACA insider to cash in. Lobbying for America’s Health Insurance Plans is a natural transition for the former director of the Centers for Medicare and Medicaid Services (CMS).

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Health care consolidation is not a sexy issue. It’s not the sort of thing you want to bring up at a dinner party, unless you’ve already completely exhausted proposed changes to the local noise ordinances, the weather, and the best way to get from LA to Newport Beach without enduring the 405. And yet, this is a topic you ought to pay attention to, because the mergers creating mega-insurers and mega-providers are going to have a big impact on your life in the near future.

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If the Supreme Court had ruled in favor of the plaintiff in King v. Burwell (AIS Alert, 6/25/15), there was optimism among some employers that certain provisions of the Affordable Care Act (ACA) would crumble. With the law now more firmly in place, more employers are looking to private exchanges as a possible strategy to help sidestep the so-called Cadillac tax, which is slated to go into effect in 2018.

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The Internal Revenue Service and the Department of Treasury are seeking comments on several unanswered questions about the impending Cadillac tax, including what constitutes employer-sponsored coverage and different approaches for determining the cost of applicable coverage.

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Five years after Obamacare became law, uninsured rates have fallen to historic lows, but attitudes on the Affordable Care Act remain mostly stagnant and entrenched along party lines.

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