“But the company now faces a new problem because of the Obama health law. Automation Systems Inc. has expanded to include 37 employees today, and Schanstra says he wants to hire more — maybe as many as 200 or 300 in the next 10 to 15 years. But once the business crosses the 50-employee threshold, it will have to pay $40,000 in penalties, plus $2,000 for each additional employee. That’s because of the so-called employer mandate, a fee imposed on businesses that get too big without providing health care the federal government deems acceptable.”

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“Can’t get enough of Obamacare’s individual mandate? Get ready for ‘mandate plus.’ … They want more incentives — such as a late enrollment fee — to get healthy people to sign up quickly… The states could impose some of these incentives, too, and they could become a future lobbying battleground. But right now, the insurers are focused on persuading the Department of Health and Human Services to add them on its own.”

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“If you work for a small business, your next health insurance premium may give you sticker shock. Many of the small-business and individual insurance policies are working the health reform law’s 2014 fees into their 2013 bills, contributing to double-digit premium increases for some people. All those new consumer benefits packed into the health reform law — birth control without a co-pay, free preventive care and limits on when insurers can turn down a customer — had to be paid for somehow.”

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“The answer is that replacing Obamacare is by necessity a long-term project; you have to start somewhere. Moreover, it remains essential. Like it not, health-care policy is central to the struggle over the size and scope of governmental power. Without a better approach than Obamacare, there will be no success in limiting government or in lessening the dependence of citizens on the state.”

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“Thus, as it now stands, only 14 to 16 states (plus the District of Columbia) are likely to actually be operating state-run exchanges come October, when open season begins. There may be another two or three states with so-called partnership exchanges, but the feds will be responsible for most of the major functions in those states. Indeed, the final count could be lower as some states trying to set up their own exchanges—faced with significant technical challenges and limited remaining time—give up and default to a federally run exchange.”

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“No matter what, it’s clear that ObamaCare isn’t resulting in lower premiums. And for many people, in the years after the law, premiums aren’t just going to up up a little. They’re going to rise a lot.”

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“Should premiums continue to rise, more and more uninsured Americans are going to choose to pay the penalty rather than purchase expensive insurance. And those who go without insurance are more likely to be the ones who can afford to do so — young and healthy Americans with limited medical expenses. Should this occur, insurers would have to raise premiums even more to subsidize the expenses of the sicker beneficiaries they must cover under the law. This, in turn, would cause additional people to forgo insurance and pay the fine. And so on. This is known in the health care policy community as the “death spiral” and it’s one of the biggest threats to the structure of Obamacare.”

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“During his first campaign for the presidency in 2008, the president promised that his health reform plan would ‘bring down premiums by $2,500 for the typical family’ by the end of his first term. Well, that first term is just about up. And health insurance isn’t any cheaper. In fact, it’s more expensive. Premiums have increased by an average of $3,065. And they’re about to go up even more, as Obamacare takes effect during the president’s second term.”

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“Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.”

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“Young adults will see higher health insurance premiums under the Affordable Care Act (ACA) because of a provision that links prices for older and younger patients, according to a new study. Actuaries at management consulting firm Oliver Wyman predicted the law’s age rating restrictions could mean a 42 percent hike in premium costs for people aged 21 to 29 when they buy individual coverage.”

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