“Pennsylvania will not set up its own health care exchange under the federal Affordable Care Act, at least not for now, Gov. Tom Corbett said Wednesday, putting the state on a course to join others led by Republicans that will let President Barack Obama’s administration run its exchange. Setting up a state-based exchange would be irresponsible, Corbett said, as he faulted federal authorities for what he called inadequate answers to his questions about cost and other issues.”

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“Recent decisions by the Obama Administration concerning the health care exchanges and Medicaid expansion underscore what a risky proposition the Patient Protection and Affordable Care Act (PPACA) is for the states. Congress presumed in PPACA (Obamacare) that the states would agree to build and run exchanges and could be forced to expand Medicaid. The Supreme Court, however, ruled the Medicaid expansion voluntary, which has made states increasingly concerned over new burdens related to costs, control, and coverage—in both the exchanges and Medicaid.”

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“President Barack Obama may have defeated opponents of his landmark health care law in the courts and at the ballot box, but the sweeping reforms still face a rocky road ahead. Advocates are concerned that the funding needed to help expand coverage to 30 million uninsured Americans could take a hit in budget negotiations as Obama battles his Republican rivals over the so-called fiscal cliff tax and austerity crisis.”

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“Obviously not everyone will make the choice to go uninsured. People who are risk-adverse, or who have ongoing medical needs, or who have small children, will continue to be covered. But every year, every person will have to decide how best to spend their money. A very large number will decide they have better things to do with that money than spend it on insurance coverage they don’t want and never use. The odds are that after all the trauma and expense of enacting and implementing ObamaCare, we will have fewer people insured than we did before it was enacted.”

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“Thus, having transformed the individual mandate into a tax, the court may face renewed challenges to ObamaCare on uniformity grounds. The justices will then confront a tough choice. Having earlier reinterpreted the mandate as a tax, they would be hard-pressed to approve the geographic disparity created when states opt out of the Medicaid expansion. But that possibility is inherent in a scheme that imposes a nominally uniform tax liability accompanied by the practical equivalent of a fully off-setting tax credit available only to those living in certain states. To uphold such a taxing scheme would eliminate any meaningful uniformity requirement—a result that the Constitution does not permit.”

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“The health insurance tax will raise families’ insurance costs by as much as $7,000 over a decade, according to a study conducted by the firm Oliver Wyman on behalf of America’s Health Insurance Plans (AHIP), the insurance industry’s leading trade group.”

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“After three years, Obamacare remains unpopular. Both the raw numbers and the intensity favor its opponents. Last month, for the first time ever, Gallup found that a majority of Americans oppose a government guarantee of health insurance for all. The ongoing resistance to Obamacare is a grassroots phenomenon. It has probably intensified since the election, as many disappointed voters (and non-voters) have sought an outlet for their frustrations.”

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“New Obamacare regulations targeting the fast food and grocery store market that require signs detailing calorie and nutritional information on every product will force pizza makers like Domino’s to post up to 34 million different signs in every store: One for every possible pizza order… Fouracre-Petko said that just posting generic nutrition signs in Domino’s will cost $4,700 per location, senseless, she said, because virtually all Domino’s customers order by phone and get their food delivered, so most will never see them.”

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“Now that the election is out of the way, the Obama administration is able to reveal more about its regulatory plans for implementing that law. On Friday, the Department of Health and Human Services released 373 pages of new Obamacare regs, and buried deep within is a 3.5 percent ‘user fee’ — that is, tax — on premiums from health plans sold on Obamacare’s soon-to-be-established federal exchanges. This tax comes above and beyond Obamacare’s $100 billion excise tax on insurers.”

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“New Jersey Gov. Chris Christie (R) declined to set up a state-based insurance exchange under the healthcare law Thursday — the same day he met with President Obama on Hurricane Sandy aid. The move will be welcomed by conservatives who blamed Christie for praising Obama’s response to the storm. Sandy hit just before the election and distracted national media coverage from Obama’s campaign against Mitt Romney. “

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