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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King vs. Burwell is on the horizon. If the plaintiffs are successful, so goes the theory, subsidies end in 37 exchanges operated by the Department of Health and Human Services and serviced by HealthCare.gov. Coverage gets more expensive, and people won’t be able to afford their policies.

But, this outcome was foretold all the way back in the Senate mark-up of the proposed ACA legislation. Purposely requiring subsidies in state-run exchanges remains the incentive for states to set them up. The administration did not expect so many states elected not to set up their own exchanges, and it is now a big problem. As was noted in 2009 by critics of the bill, if states don’t hand out subsidies, people won’t be able to afford to buy coverage.

In the health savings account industry, the problem is compounded. The ACA law also created a perpetual rule change engine.

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The fight over ObamaCare’s Medicaid expansion escalated Monday, as Texas’s Republican governor backed a lawsuit from Florida fighting the expansion effort.

Last week, Florida’s Republican Gov. Rick Scott announced he would sue the Obama administration over what he calls an effort to force the state to expand Medicaid under ObamaCare.

Texas’s Republican Gov. Greg Abbott on Monday announced his support for the lawsuit.

“When the federal government exceeds its constitutional authority, the States must take action,” Abbott said in a statement. “[I] commend Governor Rick Scott’s decision to take legal action to protect these important constitutional principles.”

At issue is the Obama administration move to link Florida’s rejection of a Medicaid expansion to separate federal funding that helps hospitals in the state care for the uninsured.

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During the 2008 financial crisis, “too big to fail” became a familiar phrase in the U.S. financial system. Now the U.S. health-care system is heading down the same path with a record number of hospital mergers and acquisitions—95 last year—some creating regional monopolies that, as in all monopolies, will likely result in higher prices from decreased competition.

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