“The most important front right now is to ensure that states do not create the health-insurance exchanges Obamacare needs in order to operate. Refusing to create exchanges is the most powerful thing states can do to take Obamacare down. Think of it as an insurance policy in case the Supreme Court whiffs.”

“The Patient Protection and Affordable Care Act (PPACA) is designed to extend health-insurance coverage to tens of millions of uninsured Americans. Rarely is it mentioned, however, that Medicaid, the government-run health-insurance program for the poor, will provide more than half of that new coverage under the law. The PPACA assigns Medicaid this central role, despite long-standing concerns about Medicaid’s costs and the quality of its care.”

“Now that the Supreme Court has concluded hearings on the president’s health law, many states find themselves in a holding pattern, postponing major decisions about the law until they get some constitutional clarity.
But states shouldn’t wait on the Supreme Court to oppose implementation of this harmful law.”

“Landrieu, critics believe, pledged her vote in exchange for gaining $200 million additional federal funds for Louisiana’s Medicaid program. Except that, due to a drafting error, the law ended up giving Louisiana $4.3 billion in extra Medicaid funds: more than twenty times the assigned amount. How this happened, and how Congress failed to fully fix it, is a microcosm of our new health law’s many flaws.”

“A bill conservative Republicans see as an important step toward giving Kansas full control over health care programs received first-round approval Tuesday in the state House, advancing another protest from the GOP-controlled Legislature against Democratic President Barack Obama’s policies.”

“An Obamacare exchange will offer less choice, not more. Consumers who want to buy affordable plans for catastrophic care would not be able to. Health savings accounts probably would be verboten. Like Henry Ford, who said customers could have any color car so long as it was black, Obamacare says state exchanges can offer any plan, so long as it is gold-plated.
What happens if a state allows a wide variety of plans at different prices and coverage levels? Washington would declare that it allows too much choice — and take over.”

“When the Supreme Court hears the state challenge to ObamaCare later this year, most of the attention will likely be on the challenge to the law’s individual mandate to purchase health insurance and its implications for the Constitution’s Commerce Clause. But in a somewhat unexpected move, the Supreme Court has decided to allow for a full hour of oral argument regarding another part of the case: the expansion of Medicaid, the joint federal-state health program for the poor and disabled, which is expected to account for half of the law’s health coverage expansion.”

“The individual mandate may be getting more attention, but in a time of persistently high unemployment there needs to be just as much concern about the employer mandate. While these results are specific to Indiana, there are likely other states where small and mid-size businesses are responsible for a significant portion of the job growth. Reforming healthcare need not compromise jobs and small businesses, but unfortunately the Affordable Care Act will do just that.”

“Under the health care overhaul, the federal government will start taxing itself and the states beginning in 2014. And that’s giving state Medicaid directors heartburn. A report released Tuesday by the actuarial firm Milliman Inc. said the tax will cost the Medicaid program between $36.5 billion and $41.9 billion over 10 years. At least $13 billion will be borne by states, and at least $23.5 billion by the federal government, based on the state-federal Medicaid matching formula.”

“Nineteen rural state hospital associations have signed onto a letter urging President Obama to nix the healthcare reform law’s special deal for Massachusetts hospitals in his 2013 budget proposal next month. The hospital groups say a provision in the law shifts $367 million annually in Medicare funding from 49 states to the Democratic-led commonwealth. The provision’s aim was simply to increase Medicare payments for a single, 15-bed hospital in Nantucket but ended up raising payment rates for the state’s 60 urban hospitals by 8 percent.”