Health insurers in Michigan are seeking another round of double-digit rate increases next year for plans they sell to individuals, although smaller increases for their small group plans.

Insurance giant Blue Cross Blue Shield of Michigan has asked state regulators for permission to boost its premium rates by an average 18.7% for individual plans, along with a 14.8% increase for its Blue Care Network individual plans. Those plans — closely associated with the Affordable Care Act, commonly referred to as Obamacare — cover about 200,000 individuals in the state, down from 310,000 people as recently as a year ago.

. . .

If you’re looking to find a smashing Obamacare success story—a place where the nation’s biggest and most controversial new law in a generation has truly lived up to its promise—you might stick a pin directly in North Carolina.
The central pledge of the Affordable Care Act was to make insurance available to people who didn’t have it, creating a new safety net for millions nationwide. And in North Carolina that’s exactly what happened. People flocked to the program: More than 600,000 people there signed up for Obamacare policies in 2016, and roughly 90 percent of those got financial help to pay their insurance bills, also through Obamacare. Thanks directly to the ACA, the number of people without health insurance in North Carolina has plummeted by 30 percent in the past three years. Far more people are covered, and far more of them can afford their health insurance.

. . .

The Republican assertion that the administration is spending on health insurance subsidies without required congressional authority hasn’t gotten much news coverage. Many people dismiss it as yet another time-wasting attempt by Republicans to undermine the president’s signature domestic policy achievement.

But the central issue goes beyond health care to the fundamental division of federal power, particularly in a time of deep fissures between the legislative and executive branches.

Congress is supposed to approve every penny of federal spending. But the institution is in such partisan disarray that the appropriations process barely functions, giving rise to the temptation for presidents to assert greater power over the purse, marginalizing Congress.

. . .

In 2013, one Affordable Care Act component taking effect — a medical device excise tax — imposed a new financial burden on American Laboratory Products Co.

The 2.3 percent tax on revenue took a bite out of the company’s bottom line, “no question about it,” said Sean Conley, president of the family-owned-and-operated Alpco. “This obviously has an impact on where our funds go and makes it a bit more challenging to continue to create new jobs.”

The controversial medical device tax was a focus of conversation Friday when U.S. Sen. Kelly Ayotte visited the company for a discussion and tour.

. . .

The battle between congressional Republicans and the White House over the Affordable Care Act is again escalating—in court and on Capitol Hill.

The administration on Wednesday appealed a federal trial judge’s ruling that the government is improperly reimbursing insurers under a program to cover discounts for low-income consumers.

And House Republicans on Thursday began two days of hearings to hammer away at the issue. They released a report that said the administration distributed the funds even though it was aware it needed Congress’s approval.

. . .

An investigation by House Republicans argues that the Obama administration is illegally making certain payments under ObamaCare and that officials initially recognized they did not have authority to do so before reversing course.

House Republicans argue that the administration is unconstitutionally making ObamaCare’s “cost sharing reduction” payments to insurers — which help lower out-of-pocket healthcare costs for low-income ObamaCare enrollees — without a congressional appropriation.

. . .

Obamacare enrollment has a smoking problem.

A new study from the Yale School of Public Health finds that an anti-smoking provision in the health law is discouraging people from signing up for insurance while simultaneously failing to get them to kick the habit.

Under the Affordable Care Act, individual health insurance plans sold on statewide marketplaces can only set how high their premiums are based on three factors: a customer’s geographic region, age, and smoking status. This is meant to let health insurers adjust their prices for how much medical care an enrollee may wind up using.

. . .

House Republicans on Thursday released an investigative report and held the first of two hearings questioning the legality of Obamacare’s cost-sharing reduction program. That program is also the subject of a House lawsuit against the administration.

At issue is whether the cost-sharing program is legally funded. House Republicans, through an investigation conducted by the Ways and Means and Energy and Commerce committees, concluded that the health care law does not provide funding for the cost-sharing program.

. . .

It’s policymaking 101: When a policy delivers benefits to people, support for the policy grows. Political scientists call situations like these “policy feedback loops,” and they are a big part of the story of how Social Security and Medicare became so entrenched in American life. But what happens if hyper-partisanship stops the loop? Consider the Affordable Care Act (ACA). Over the past four years, some 20 million people have gained health coverage and the already-insured have received new protections. But public opinion of the ACA has remained mixed.

The numbers are stark. Monthly tracking polls show that 49 percent hold unfavorable views of the ACA versus just 38 percent holding favorable views.

. . .

Republicans and Democrats continued to talk at each other Friday about Obamacare’s cost-sharing reduction program in an Energy and Commerce oversight subcommittee hearing.

The hearing was the second in two days following the release of a GOP report claiming that payments to the administration’s program were made illegally.

Republicans suggested that the way the payments have been handled sets a dangerous precedent for the future and nullifies Congress’s power of the purse. Democrats chalked the investigation up as yet another GOP attempt to sabotage the Affordable Care Act. They also said since there is already a court case on the matter, Congress doesn’t need to do its own investigation.

. . .