“As the federal government tries to leave the states with the freedom to set up individualized local health exchanges, state officials say they’ve received so little guidance that they’re afraid they’ll have to make changes as more regulations come out after the presidential election.”

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“I just cannot get over that blow against not only sound jurisprudence and the rule of law — bad enough — but against the legitimacy of our government altogether. By recognizing that Obamacare was unconstitutional but shying away from striking it down, John Roberts fundamentally shook my faith in our system of justice.”

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“The ACA health insurance subsidies are the most significant expansion of entitlements since the 1960s. In light of the precarious fiscal outlook for the federal government, its cost is a central concern to policymakers and taxpayers alike. When the ACA passed in June 2010, the Congressional Budget Office projected the budget cost between fiscal 2012 and fiscal 2019 to be $462 billion. By June 2012, the cost for these same years had jumped to $574 billion, an increase of nearly 25 percent.”

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“The most important provisions of ObamaCare are scheduled to take effect in 2014. I have been researching ObamaCare and assisting with its implementation, and have come to this realization: Without further reforms, the law will create unnecessary costs for working-class Americans.”

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“California officials have floated the idea of legislating lower prices. One way would be to throw West Los Angeles and Orange County into the same risk pools. That might reduce premiums in West L.A., but only by increasing premiums in Orange County. With a few simplifying assumptions, premiums in both West L.A. and the O.C. could rise by 19 percent. An alternative would be to cap premium increases. One state official proposes a cap of 8 percent. But that would just be an implicit form of government rationing. If insurers cannot charge premiums that cover their costs, they will cover fewer services.”

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“U.S. health care suffers from three major problems: millions of people go without insurance, health care costs are rising at unaffordable rates, and the quality of care is not what it should be. The Affordable Care Act (ACA) primarily addresses the first — and easiest — of these problems by expanding coverage to a substantial number of the uninsured. Solutions to the other two remain aspirations and promises.”

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“The Patient Protection and Affordable Care Act of 2010 (PPACA) could create a new divide between consumers who have high-end dental coverage and consumers who have bare-bones dental coverage, or no dental coverage at all. The National Association of Dental Plans has published data supporting that possibility in a summary of results from a recent survey of 3,044 consumers.”

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“The Medicare Shared Savings Program, created under the Affordable Care Act, will reward participating accountable care organizations that succeed in lowering health care costs while improving performance… We used a simulation model to analyze the effects of the Shared Savings Program quality measures and performance targets on Medicare costs in a simulated population of patients ages 65–75 with type 2 diabetes. We found that a ten-percentage-point improvement in performance on diabetes quality measures would reduce Medicare costs only by up to about 1 percent. After the costs of performance improvement, such as additional tests or visits, are accounted for, the savings would decrease or become cost increases.”

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“Yes, we are facing a fiscal cliff, but we are also facing an entitlements cliff and, thanks to ObamaCare, a health care cliff. Those three cliffs aren’t separate; they’re intertwined. Go over one and we will be pulled over the other two.”

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“Republicans on the Oversight and Government Reform Committee threatened to issue subpoenas if the IRS doesn’t turn over more records about how it’s implementing the law’s insurance subsidies. Republicans believe the IRS is planning to hand out billions of dollars in subsidies that aren’t authorized by the healthcare law.”

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