"The Affordable Care Act may not be so affordable for some Nevadans. The law, commonly called Obamacare, combines benefit mandates and subsidies designed to make health insurance less costly for millions of Americans who now lack coverage. But observers ranging from state insurance officials to employee benefit consultants say some consumers could see premium increases big enough to price them out of insurance markets. If that happens, fewer people than expected could buy into the system, and that might mean the difference between Obamacare’s success or failure."
"A California law that created an agency to oversee national health care reforms granted it broad authority to conceal spending on the contractors that will perform most of its functions, potentially shielding the public from seeing how hundreds of millions of dollars are spent."
"Another GOP governor has pledged to go ahead with Obamacare’s Medicaid expansion, and once again, industry was standing right there with him... The same thing is happening in Ohio and Missouri. In Idaho, the GOP governor and legislature decided to build an Obamacare exchange thanks to industry pressure."
"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."
"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."
"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."
"In a 2010 paper I authored for the Heritage Foundation, I documented the delayed and failed effort by the Massachusetts public exchange (Connector) to offer real choice and savings to small businesses. My report suggested the experience served as a warning to other states. I suppose I should have targeted it toward the federal government instead."
"Despite surviving a number of threats, President Obama’s health care law remains harmful, unstable, and unpopular. It also remains vulnerable to repeal, largely because Congress and the Supreme Court have granted each state the power to veto major provisions of the law before they take effect in 2014."
"A newly unveiled component of President Obama’s healthcare law forcing insurers to pay annual fees is sowing angst in state capitols, where officials view the provision as a $15 billion tax that could disrupt Medicaid programs and other services. The health insurance providers fee, included in the healthcare reform law over the objections of congressional Republicans, is designed to raise tens of billions of dollars in the coming years."
"For states, it’s the medium to long-term fiscal picture that presents the biggest worry. The long-term politics of federal budgeting make short-term state policy choices rather dicey: Who knows what Congress will do as the cost of government health programs rise and the already bad budget situation grows worse? Cost shifting to states may not be inevitable, but it's quite likely, which means that even if expanding Medicaid is essentially free now, it almost certainly won’t be in the future."
