“Cary Pigman, a Republican lawmaker in the state House of Representatives, sees uninsured patients every shift as an emergency room doctor in a rural part of central Florida, where nearly 30 percent of residents lack coverage. With a week remaining in Florida’s legislative session, Dr. Pigman might be expected to be sympathetic to hospitals and other groups urging the Republican-dominated legislature to accept $50 billion in federal money over a decade to extend coverage to 1 million poor Floridians. But that’s not the case.”

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“The health care law is ‘the most disruptive instrument to the American workplace in my lifetime.’ That’s the perspective of Richmond businessman William J. Goldin, Jr., president of family-owned Strange’s Florists, Greenhouses and Garden Centers since 1978, who testified before the Small Business Committee last week. Even proponents of the controversial health care law are now worried, as the predictable problems become a reality.”

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“Implementation got off to a bad start because the Obama administration didn’t want to release unpopular rules before the election. Regulators have been working hard but are clearly overwhelmed, trying to write rules that influence the entire health care sector — an economic unit roughly the size of France. Republicans in Congress have made things much more difficult by refusing to provide enough money for implementation.”

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“Democratic senators, at a caucus meeting with White House officials, expressed concerns on Thursday about how the Obama administration was carrying out the health care law they adopted three years ago. Democrats in both houses of Congress said some members of their party were getting nervous that they could pay a political price if the rollout of the law was messy or if premiums went up significantly.”

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“A recent decision by HHS illustrates the arbitrary nature by which some implementation decisions are being made at CMS while highlighting the problem of a top-down approach in Obamacare. After months of small businesses anxiety in Massachusetts surrounding the impact of fewer rating factors due to an ACA mandated one-size-fits all policy, the Federal government recently pulled a piecemeal delayed implementation of the regulations out of thin air.”

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“The office implementing most of President Obama’s healthcare law is not furloughing its workers as a result of sequestration, its director said Wednesday. Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, said Wednesday that his office has not cut its workers’ hours and pay as a result of the automatic budget cuts that went into effect in March.”

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“Nevertheless, there is merit to continued evaluation of full-scale alternatives to the PPACA. One common defense of the law is that there has been no competing alternative, which is not true. But there is virtue to continuing to develop and refine as many alternatives as may be proposed. Toward that end, this short paper outlines one practical, conservative approach to replacing the law with a market-based reform plan.”

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“Buried deep within President Obama’s $3.77 trillion budget is a tiny little proposal to increase Medicaid spending by $360 million. In a budget as large as this one, $360 million is scarcely worth mentioning. It amounts to less than one-hundredth of one percent of total outlays. But this 0.01 percent is worth mentioning, because it proves the president’s health-care law will not work.”

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“Groups on both sides of the healthcare debate are lobbying Congress to scale back a tax in President Obama’s healthcare law that could end up costing the states billions of dollars. Supporters and opponents of the healthcare law are both eyeing changes to the law’s tax on insurance plans, which could cost the states nearly $15 billion.”

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“In the coming years, treatment programs and medical colleges will face pressure to ramp up to create a larger system. But until then, addiction treatment may represent an extreme example of one of the Affordable Care Act’s challenges: actually delivering the care that people are supposed to receive.”

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