“Republicans on a House Appropriations subcommittee beat back Democratic efforts Wednesday to protect the health reform law, winning passage of a spending bill that would defund the Affordable Care Act, eliminate a decades-old health research agency and slash the budget for other health programs. The subcommittee approved the Labor-Health and Human Services appropriations bill on a mostly party-line vote of 8-6.”

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“Another prominent religious college has filed suit against the Obama administration over a policy meant to ease women’s access to free birth control. The suit from Ill.-based Wheaton College — dubbed the ‘Notre Dame’ of Protestant higher education — states that the controversial policy violates the religious freedom of people who object to birth control or consider forms of it equal to abortion.”

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“Instead of betting on entrepreneurs, Obamacare assumes that improvements in the delivery of medical care will arise as a result of shifts in market power. This turns on a shortsighted view that once providers are grouped into larger networks, they’ll make wider use of things like information technology to better coordinate the care of patients, in turn lowering costs.”

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“In short, small business owners will change from investing in their employees and their company to a strategy of avoiding growth that will require them to comply with the health care law. Support for the law is very low among small businesses surveyed (21%), and almost eight-out-of-ten (77%) of small businesses surveyed support its repeal.”

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“Where things can get a little complicated, however, is when you sell your home for a substantial profit, and your adjusted gross income for the year exceeds the $200,000 or $250,000 thresholds. The good news: The surtax does not interfere with the current tax-free exclusion on the first $500,000 (joint filers) or $250,000 (single filers) of gain you make on the sale of your principal home. Those exclusions have not changed. But any profits above those limits are subject to federal capital gains taxation and could also expose you to the new 3.8% surtax.”

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“The Patient Protection and Affordable Care Act (PPACA) provides tax credits and subsidies for the purchase of qualifying health insurance plans on state-run insurance exchanges. Contrary to expectations, many states are refusing or otherwise failing to create such exchanges. An Internal Revenue Service (IRS) rule purports to extend these tax credits and subsidies to the purchase of health insurance in federal exchanges created in states without exchanges of their own. This rule lacks statutory authority. The text, structure, and history of the Act show that tax credits and subsidies are not available in federally run exchanges. The IRS rule is contrary to congressional intent and cannot be justified on other legal grounds. Because the granting of tax credits can trigger the imposition of fines on employers, the IRS rule is likely to be challenged in court.”

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“If the courts were to accept Adler’s and Cannon’s argument, that could effectively enable states to kill federal exchanges by empowering them to cut off the subsidies. Without subsidies, the federal exchanges would not be economically viable because they couldn’t get as many people to sign up for coverage.”

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“While the resistance of Republican governors has dominated the debate over the health-care law following last month’s Supreme Court decision to uphold it, a number of Democratic governors are also quietly voicing concerns about a key provision to expand coverage. At least seven Democratic governors have been noncommittal about their willingness to go along with expanding their states’ Medicaid programs, the chief means by which the law would extend coverage to millions of Americans with incomes below or near the poverty line.”

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“Regulations are slowly strangling HSAs. Under Obamacare, “fully insured” policies must spend at least 80 percent (small group and individual market) or 85 percent (large group market) of every premium dollar on health care related expenses (called the medical loss ratio or MLR). The remainder can be spent on administrative costs (improving health care delivery or combating fraud) and profits.”

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“But while much attention has focused on Congress’s intention to repeal or replace the Affordable Care Act, too few are studying the law’s practical impact. The best place to see the effects of the law is in our nation’s laboratories, the states. Although the Supreme Court has ruled on the constitutionality of the act, Wisconsin shows that it is bad policy.”

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