Add Tennessee and Kansas to the list of states that have been warned by the Obama administration that failing to expand Medicaid under the Affordable Care Act could jeopardize special funding to pay hospitals and doctors for treating the poor.

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Although the Affordable Care Act (ACA) was enacted 5 years ago, 2014 was the first year of implementation for most of the health law’s major provisions. In fact, it turned out to be a glitch machine. Defying the expectations of even the law’s most ardent critics, Obamacare’s rollout of the federal online health exchange was a disaster, combined with the cancellation of millions of private health insurance policies (if you “liked” your plan, too bad), a delay in reporting requirements of the employer mandate, and new administrative exemptions from the individual mandate penalty.

Nonetheless, the Obama administration’s allies insist that the law is “working” and that it will even become popular with the majority of Americans with the passage of time. The law’s congressional supporters, they hope, will reap political benefits rather than political retribution.

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Is it better to follow the strict letter of the law or to adjust it where appropriate to produce a more equitable result? This is one of the oldest questions in legal thought, one that can be traced back at least to Aristotle — and on Wednesday the U.S. Supreme Court weighed in, 5-4, on the side of equity, with Justice Anthony Kennedy providing the deciding vote.

Ordinarily, a decision like this one, involving the interpretation of the Federal Tort Claims Act would be of interest only to practitioners who are specialists in statutory interpretation. But this isn’t an ordinary spring. In June, the Supreme Court will hand down its most important statutory interpretation case in a generation, essentially deciding whether the Affordable Care Act will survive or fall. The interpretation question before the court in that high profile case, King v. Burwell, bears a striking structural resemblance to the obscure one the court decided Wednesday.

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WASHINGTON (AP) – The IRS’ overloaded phone system hung up on more than 8 million taxpayers this filing season as the agency cut millions of dollars from taxpayer services to help pay to enforce President Barack Obama’s health law.

For those who weren’t disconnected, only 40 percent actually got through to a person. And many of those people had to wait on hold for more than 30 minutes, IRS Commissioner John Koskinen said Wednesday.

The number of disconnected callers spiked just as taxpayers were being hit with new requirements under the health law. Last year, the phone system dropped 360,000 calls, Koskinen said.

For the first time, taxpayers had to report whether they had health insurance last year on their tax returns. Those who received government subsidies had to respond whether they received the correct amount. People without insurance faced fines, collected by the IRS, if they did not qualify for an exemption.

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Health Reform: Back in 2013, ObamaCare supporters couldn’t talk enough about how California was a showcase for how the law would succeed. Isn’t it funny that nobody is making such claims any more?

New York Times columnist Paul Krugman wrote a few months into ObamaCare’s first open enrollment period that “What we have in California, then, is a proof of concept. Yes, ObamaCare is workable — in fact, done right, it works just fine.”

It turns out that California is a proof of concept, but not in the way Krugman thought.

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On December 17, 2014, Vermont Governor Peter Shumlin publicly ended his administration’s 4-year initiative to develop, enact, and implement a single-payer health care system in his state. The effort would have established a government-financed system, called Green Mountain Care, to provide universal coverage, replacing most private health insurance in Vermont. For Americans who prefer more ambitious health care reform than that offered by the Affordable Care Act (ACA), Shumlin’s announcement was a major disappointment. Was his decision based on economic or political considerations? Will it damage the viability of a single-payer approach in other states or at the federal level?

Shumlin’s exploration of a single-payer health care system, which included three assessments by different expert groups, was among the most exhaustive ever conducted in the United States.

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Kaiser Health– This month’s Kaiser Health Tracking Poll finds public opinion of the Affordable Care Act (ACA) continues to be almost evenly split, with 43 percent reporting a favorable view and 42 percent reporting an unfavorable view. The share with a favorable view exceeds the share with an unfavorable view for the first time since November 2012, albeit by one percentage point, and the difference is within the survey’s margin of sampling error and is not statistically significant.

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Kaiser Family Foundation: This month’s Kaiser Family Foundation tracking poll finds that 43 percent of Americans have a favorable view of the health care law, while 42 percent have an unfavorable one — the first time since 2012 that the law has been in positive territory. That difference is not considered statistically significant.

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Sen. Ron Johnson (R-Wis.) unveiled legislation on Tuesday that would allow people to temporarily keep their ObamaCare plans if the Supreme Court guts the law’s subsidies.

Johnson’s bill is the latest Republican effort to put forward contingency plans for the possibility that the high court could strike down subsidies that help 7.5 million people afford health insurance.
Many Republicans, including Johnson, who is up for reelection next year, worry that without a plan, they will face intense political pressure to simply restore coverage under ObamaCare to the millions of people who would lose insurance in the case King v. Burwell. A ruling is expected in June.

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Aiden Hill’s introduction to the secretive culture at Covered California came in his first days on the job. He had just been hired to head up the agency’s $120 million call center effort when he emailed a superior April 18, 2013, and got a text message in reply:

Please refrain from writing a lot of draft contract language in government email … And don’t clarify via email … No email.

Later, concerned about contractor performance, Hill conducted an Internet search for “best practices” information to forward a superior. Afterward he got this text:

Aiden—Please stop using government email for your searches.

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