Health care reform has dominated our nation’s political and social conversations for the past six years. After the implementation of ObamaCare, it is clear the law brought radical change and real pain to our nation’s families, economy, and health care system. The promised “affordable health care fix” made things worse.

The pending King v. Burwell case reveals another interesting legal problem with the policy and text of the Affordable Care Act. As written, the federally controlled subsidies and employer mandates are not allowed, unless a state chooses them. Now the Supreme Court debates, behind closed doors, the question of state responsibility and textual intent to determine the direction of health care in America. The resulting Supreme Court opinion could dismantle the structure of ObamaCare and give America a second chance to get health care reform right.

Ironically, the issue of state responsibility could take ObamaCare down and lift individual citizens up.

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Health insurers on many state exchanges are requesting the right to increase premiums by upwards of 50%

President Obama’s signature legislative achievement–the healthcare law popularly known as Obamacare–is facing a potentially existential fight in the Supreme Court in 2015.

But it’s not just the courts that supporters of the program need to worry about. According to a report published Friday in the The Wall Street Journal, health insurers are requesting the right in many states to increase premiums by upwards of 50%. Health Care Service Corp.–the leading health insurer in New Mexico, has asked state regulators to allow it to increase its premiums on average by 51.6%, for instance. Customers of CareFirst BlueCross BlueShield in Maryland may face an average premium increase of 30.4%.

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Health Reform: So much for the “affordable” part of the Affordable Care Act. Looks like ObamaCare premiums will rocket next year while sky-high deductibles make it too costly for many to see the doctor.

Last Monday, IBD’s Jed Graham broke the news that big insurers in six states “are seeking to raise rates an average 18.6% next year.”

BlueCross BlueShield of Tennessee — which currently accounts for 70% of the ObamaCare enrollees in that state — is looking to increase premiums a whopping 36.3%.

CareFirst — which has 80% of the ObamaCare enrollees in Maryland — is pushing for a 30% increase.

Oregon’s Moda Health wants a 25.6% increase, on average, for the roughly half of ObamaCare enrollees it covers in the state.

The Wall Street Journal followed up on Graham’s reporting later in the week, noting that New Mexico’s market leader, Health Care Service, wants an average 51.6% boost in premiums.

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“A different health care issue has emerged for Democrats, in sync with the party’s pitch to … middle-class voters … high out-of-pocket costs for people already covered. Democrats call it ‘underinsurance.’ After paying premiums, many low- and middle-income patients still face high costs when trying to use their coverage. … [T]he value of a health insurance card is being eaten away by rising deductibles … Several liberal-leaning organizations have recently focused on the issue.”

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Community Health Alliance, a Knoxville-based health insurance cooperative, is looking to increase monthly premiums by double digits in 2016 for those who enroll in plans on the federally run exchange as the newly established company tries to find an equilibrium.

The co-op’s plans — ranging from $68.22 to $1,062.05 per month — were the least expensive while they were available for purchase on the exchange.

The co-op is asking the Tennessee Department of Commerce and Insurance for an average 32.6 percent increase for 2016 plans. The minimum a plan will increase is 16.2 percent, while the maximum increase is 65.2 percent.

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Though supporters of President Obama’s healthcare program tout its success in providing insurance to millions of Americans, recent rate filings from large insurers have revealed that the law is built on a shaky foundation.

In recent weeks, large insurers selling coverage through Obamacare have proposed massive rate increases for 2016 – even exceeding 40 percent – because they haven’t been able to sign up enough young and healthy customers.

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Obamacare has enmeshed many Americans in a bureaucratic nightmare. True, the law has helped some uninsured people obtain coverage. But millions of people have seen their health-insurance plans canceled, because the plans did not meet the requirements of the Affordable Care Act. Others, particularly young Americans, have seen premiums rise to pay for the roster of newly added benefits. Tommy Groves (not his real name), a young professional working at a small firm in Washington, D.C., was among the nearly 5 million Americans who received termination-of-coverage letters from their health-insurance providers because their plans did not comply with the ACA’s requirements. While about half the states offered to extend canceled plans for another year, later increased to two years, the District of Columbia required its residents to get new insurance.

Read more at: http://www.nationalreview.com/article/418322/obamacare-horror-story-young-americans-diana-furchtgott-roth-jared-meyer

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The collapse of Hawaii’s state-run health exchange has observers wondering which of the other beleaguered exchanges could be next to fail.

Hawaii dumped its Obamacare exchange last week after state lawmakers refused to pump an additional $28 million into what they saw as a failed experiment.

Despite using up $135 million of an appropriated $205 million, Hawaii Health Connector fell well short of goals, enrolling just 37,000 Hawaiians since 2013.

The program ceased taking new enrollees on Friday, and health officials will end outreach services at the end of the month. The exchange’s 70-plus employees, temps and contractors will go home for good on Feb. 28, 2016.

The decision by lawmakers to abandon the exchange came after the federal Centers for Medicare and Medicaid Services restricted the state’s grant money. Earlier this year, the group warned Hawaii Health Connector would lose funding for not integrating with Medicaid or reaching target enrollment goals.

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The Internal Revenue Service (IRS) is charged with administering many key provisions of the Patient Protection and Affordable Care Act (PPACA). One might expect the IRS to follow the law when doing so. In drafting regulations to implement the PPACA’s tax credit provisions, however, the IRS seems to have a habit of ignoring the statutory text where the IRS does not like the result.

University of Iowa law professor Andy Grewal has found multiple instances of the IRS expanding tax credit eligibility beyond that provided for by the text of the PPACA and, in the process, increasing potential employer exposure to penalties under the Act. I discussed two of professor Grewal’s finds in a prior post. (See also this forthcoming article.)

In a new post on the Yale Journal on Regulation blog, “Notice & Comment,” professor Grewal identifies another IRS departure from the statutory text.

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It’s time now for your monthly reminder that Obamacare neither “working in the real world,” “proving its critics wrong,” nor “blowing away expectations:”

Colorado (higher taxes): “The Connect for Health Colorado board of directors voted unanimously Thursday to raise the fees it charges on health insurance policies to bolster its finances as federal grants run out later this year. The state health insurance exchange raised the fee on 2016 plans purchased through its marketplace from the current 1.4 percent of premiums to 3.5 percent, the same rate charged on the federal exchange…Although insurance carriers pay the fees to the exchange, they acknowledge fees are passed on to consumers in one form or another…The fee increases are projected to help bring revenues to about $40 million in fiscal year 2015-16. It would cover operational expenses, but not capital costs, such as improving the computer system…”

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