ObamaCare’s impact on health costs.

“Conservatives have long argued that “first dollar” insurance coverage helps raise the cost of health care, as people tend to overconsume services they perceive as free. Implementation of state insurance exchanges appears to confirm that hypothesis: Several states that used “free” federal dollars to build complicated exchanges may end up scrapping them.”

“The first thing Michelle Pool did before picking a plan under President Barack Obama’s health insurance law was check whether her longtime primary care doctor was covered. Pool, a 60-year-old diabetic who has had back surgery and a hip replacement, purchased the plan only to find that the insurer was mistaken.”

‘Paul Siperke is the co-owner of Fat Head’s, a popular brew pub in Cleveland. He has fewer than 50 full-time employees, so he’s classified under the Affordable Care Act as a small business. He doesn’t have to provide health insurance to his employees, but that’s what he’s been doing since the bar opened in 2009, despite some pretty dramatic volatility in rates.

“They just seemed to keep going up every year,” he says. “One year we got a 38 percent increase, another year we got 11. One year we got three.”‘

“Gene Sperling, former director of President Obama’s National Economic Council and former Assistant to the President for Economic Policy, argues that Obamacare should appeal to those who desire competition and choice in health care. But the very nature of Obamacare fosters neither.”

“The day that many health policy wonks have been waiting for has come: Obamacare’s first open–enrollment period has officially ended on April 15, 2014. Wasting little time, the Department of Health and Human Services (HHS) has released the last of its first–year enrollment reports. The update from HHS contains some good news, and some not–so–good news. Overall, it appears highly unlikely that the healthcare law will collapse.”

“The race for people to #GetCovered through Obamacare’s state and federal health insurance exchanges has officially crossed the wire. In its sixth and final enrollment report released late last week, the Department of Health and Human Services disclosed that a total of 8 million individuals have signed up for an Obamacare compliant plan within the individual health insurance market.”

“Yesterday Massachusetts officials announced plans to default to Healthcare.gov, but also announced a quixotic sprint to try first try to rebuild the entire site in five months with a brand new, no-bid taxpayer-paid contract to health care software developer hCentive. This move comes eight months into open enrollment, after launching the worst performing exchange in the country, spending most of the $180 million from Washington and announcing that original contractor CGI would be fired—even though it is still working on the project. The announcement should leave taxpayers and policymakers scratching their heads and wondering about the lack of accountability, government management and procurement.”

“Health care costs are too damn high—and they’re only getting worse. Last week, researchers at Harvard and Dartmouth released a report estimating that health care costs will continue to grow faster than the economy for at least the next two decades. This is a tremendous burden on average Americans, who already spend nearly a fifth of their average annual pre-tax income on health care.”

“Despite Obamacare’s strong national enrollment numbers, several states are at risk for big premium hikes.

Each state is its own insurance market, and they had wildly different experiences during Obamacare’s first open-enrollment window. So although nationwide statistics are important for judging the law’s political success, the substantive tests for the law’s future mostly lie with the states—and some of them aren’t looking so hot.”

“The first suggested Obamacare premium prices for 2015 don’t look so scary, but a few states could soon be in for some nasty sticker shock.

Health insurers that are still processing enrollments from Obamacare signups are at the same time setting their premiums for 2015 individual policies—and setting the stage for more debate about the Affordable Care Act.”