Articles on the implementation of ObamaCare.

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.

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.

By Stephanie Armour:
Some free health clinics serving the uninsured are shutting their doors because of funding shortfalls and low demand they attribute to the Affordable Care Act’s insurance expansion.

Nearly a dozen clinics that have closed in the past two years cited the federal health law as a major reason.

The closings have occurred largely in 28 states and Washington, D.C., which all expanded Medicaid, the federal-state insurance program for low-income people, and are being heralded by some clinic officials as a sign the health law is reducing the number of uninsured.

Continued at… http://www.wsj.com/articles/health-law-hurts-some-free-clinics-1418429551

By Sam Baker and Sophie Novack:
Republicans want the Supreme Court to blow a major hole in Obamacare next year, but they are still debating whether they would help repair it—and what they should ask for in return.

There’s a very real chance the high court will invalidate Obamacare’s insurance subsidies in most of the country, which would be devastating for the health care law. It would become almost entirely unworkable in most states, and the cost of coverage would skyrocket.

With the Supreme Court due to rule on a major ObamaCare legal challenge by next summer, thoughts in Washington are turning to the practical and political response. If the Court does strike down insurance subsidies, the question for Republicans running Congress is whether they will try to fix the problems Democrats created, or merely allow ObamaCare’s damage to grow.

By Aliya Sternstein, A core Internal Revenue Service system for calculating Obamacare fees for health insurers and drug manufacturers has security weaknesses, according to an internal audit.

Under the Affordable Care Act, insurers must report their net premiums to the tax agency annually, and pharmaceutical companies must submit sales data from certain government programs.

By Scott Gottlieb Dec. 7, 2014 5:12 p.m. ET
Here’s a dirty little secret about recent attempts to fix ObamaCare. The “reforms,” approved by Senate and House leaders this summer and set to advance in the next Congress, adopt many of the Medicare payment reforms already in the Affordable Care Act. Both favor the consolidation of previously independent doctors into salaried roles inside larger institutions, usually tied to a central hospital, in effect ending independent medical practices.

Why the hell did Jonathan Gruber say that? And that? And that? And (sigh) the other thing? Those are the questions on the minds of virtually everyone in the health care world—especially the people who worked the hardest on Obamacare. Ever since the videos started popping up, one after another, America has come to know Gruber—the MIT economist who worked closely on both Obamacare and Romneycare—as the guy who thinks voters are “stupid.” And the guy who thinks Obamacare was passed because of trickery. And who says, ha-ha, voters don’t understand economics. For a while, Fox News didn’t have to bother running anything else.

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

After months of secretly negotiating a backroom deal with the Obama administration, Governor Gary Herbert (R-UT) has finally released (some of) the details of his Obamacare expansion plan. We’ve not hesitated to share our disappointment over Herbert’s recent actions to bring Obamacare to Utah (which has always seemed out of character for him), but we’ve also met with the governor and his chief of staff privately to share our concerns about this welfare program. Sadly, Gov. Herbert continues to move forward with an Obamacare expansion plan that is bad for taxpayers and the truly needy.