Here is something few pundits predicted.

Poor, long-uninsured patients are getting Medicaid through Obamacare and finally going to the doctor’s office for care. But middle-class patients are increasingly staying away.

Take Praveen Arla, who helps his father run a family practice in Hillview, Kentucky. The Arlas’ patient load used to be 45% commercially insured and 25% Medicaid. Those percentages are now reversed, report Laura Ungar and Jayne O’Donnell in USA Today.

By Jonathan Ingram, Josh Archambault, and Nic Horton — Mr. Ingram is Research Director, Mr. Archambault a Senior Fellow, and Mr. Horton is a Policy Impact Specialist at the Foundation for Government Accountability.

Tomorrow, a new Congress convenes, with the largest Republican majorities in nearly a century. These Republicans, elected on the promise of rolling back Obamacare, are ready to start chipping away at the law. One of their first targets? Obamacare’s immoral funding scheme that prioritizes able-bodied adults over the truly needy.

Obamacare Values The Able-Bodied Over The Truly Needy

By Tevi Troy
The Affordable Care Act, otherwise known as ObamaCare, has had a tough run of it since being signed into law nearly five years ago. It has faced constitutional challenges, voters ousting congressional Democrats who supported it, and the disastrous rollout of its federal website in October 2013. This past fall, supporters launched a public-relations campaign dedicated to the proposition that things were finally going well for ObamaCare’s 7 million sign-ups, but their campaign was derailed when the Obama administration admitted that it had added 400,000 dental patients to the roster of health-insurance enrollees to falsely claim it had reached the 7 million number.

Jeryl Bier
The Department of Health and Human Services (HHS) is looking for vendors to run its “National Data Warehouse,” a database for “capturing, aggregating, and analyzing information” related to beneficiary and customer experiences with Medicare and the federal Obamacare marketplaces. Although the database primarily consists of quality control metrics related to individuals’ interactions with customer service, potential contractors are to “[d]emonstrate … experience with scalability and security in protecting data and information with customer, person-sensitive information including Personal Health Information and Personally Identifiable information (personal health records, etc.).” Vendors are also instructed that one of the requirements of a possible future contract would be “[e]nsuring that all products developed and delivered adhere to Health Insurance Portability and Accountability Act (HIPAA) compliance standards.”

The new Republican Congress may not be able to repeal and replace Obamacare entirely, but it could make substantial progress by targeting the health law’s key structural components.

This November’s electoral wave reopened and widened the strategic playing field for critics of the Affordable Care Act (ACA). Republican control of both houses of Congress, plus larger majorities of state governors and state legislatures present both opportunities and challenges to move beyond rhetorical opposition and advance changes in national health policy. Initial speculation tends to focus more on tactical considerations on Capitol Hill: which items are easiest to pass in the Senate, how to use budget reconciliation, and which votes will “look good” politically even if vetoed by President Obama.

The one state that not only embraced Obamacare but insisted on going beyond it to a full single-payer system was Vermont, the haven of hippies and expatriate New Yorkers, which has become one of the most liberal states in the nation. In 2011, it adopted a form of neighboring Canada’s government-financed health care and promised to implement it by 2017. (And Jonathan Gruber was a key architect of this plan as well as of Obamacare.) This week, however, Governor Peter Shumlin, a Democrat, admitted the state couldn’t afford the plan’s $2 billion price tag and consequent sky-high taxes, and pulled the plug. The lessons for Obamacare are obvious and profound.

Avik Roy: Last week, Vermont Governor Peter Shumlin (D.) announced that he was pulling the plug on his four-year quest to impose single-payer, government-run health care on the residents of his state. “In my judgment,” said Shumlin at a press conference, “the potential economic disruption and risks would be too great to small businesses, working families, and the state’s economy.” The key reasons for Shumlin’s reversal are important to understand. They explain why the dream of single-payer health care in the U.S. is dead for the foreseeable future—but also why Obamacare will be difficult to repeal.

Leading left-wing economists worked on Vermont plan

WASHINGTON – Trying to head off a new round of consumer headaches with President Obama’s health care law, the insurance industry says it will give customers more time to pay their premiums for January.

America’s Health Insurance Plans, the main industry trade group, says the voluntary steps include a commitment to promptly refund any overpayments by consumers who switched plans and may have gotten double-billed by mistake.

Over the past year, the ranks of people working part-time jobs by choice — as opposed to business-driven factors — has grown by more than one million, the fastest pace in at least two decades.

The timing with ObamaCare’s first year of subsidies to buy health insurance is likely more than coincidental. While analysts on the left and right have sparred over whether businesses have shifted to part-time jobs to limit liability under ObamaCare, no one disputes that the law will lead more people to choose to work part-time. Any disagreement is over whether the law should get credit for making less work possible or blame for making work less financially rewarding.

By Bruce Parker | Vermont Watchdog

Jonathan Gruber’s health care forecasting is failing in Colorado as Vermont’s Gov. Peter Shumlin prepares to use the economist’s math for single-payer health care.

As Vermonters anxiously await a Gruber-modeled financing plan for Green Mountain Care, modeling done for Colorado’s health exchange by Jonathan Gruber Associates has proven wildly erroneous.