A U.S. appeals court on Tuesday allowed Democratic state attorneys general to defend subsidy payments to insurance companies under the Obamacare healthcare law, a critical part of funding for the statute that President Donald Trump has threatened to cut off.

The U.S. Court of Appeals for the District of Columbia Circuit granted a motion filed by the 16 attorneys general, led by California’s Xavier Becerra and New York’s Eric Schneiderman.

President Donald Trump, frustrated that he and fellow Republicans in Congress have been unable to keep campaign promises to repeal and replace Obamacare, has threatened to stop making the so-called cost-sharing subsidy, or CSR, payments.

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The seeds of Friday’s failure to pass a health care bill were sown long ago, back when the Republicans used “repeal and replace” as a rallying cry in their successful campaign to regain control of the U.S. House of Representatives. Return to the status quo ante is not nor has ever been possible and the insurance markets have been changed too much by Obamacare for that to happen. However, the various actors inside the Republican’s House majority could not agree on what “repeal and replace” meant.  Whether it was to be done all at once or in stages was never decided, never agreed upon except by congressional leadership who essentially sprung their approach on everyone else.

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This week, the Congressional Budget Office released its cost estimate of the House Republicans’ American Health Care Act. CBO concluded that the proposal would reduce deficits by $337 billion over the next decade, but would result in an increase in the uninsured of 14 million people in 2018 and 24 million in 2026 when compared to current law.

CBO has a poor record of predicting coverage. In 2013 CBO predicted that 24 million people would be on the Obamacare exchanges, that law’s health insurance marketplaces, in 2017. This year, 9.5 million are enrolled.

CBO’s new estimate neglects the behavioral effects that would result from the Republican plan. By dismantling Obamacare, insurance companies would be able to offer a wider variety of plans and people would be more enthusiastic about buying them.

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Despite the maze of federal rules, taxes, and penalties Obamacare has created, Democrats are doubling down on government interference in health care by advocating for an old, already passed-upon idea: a government-run plan option, or a so-called “public option.” They forget why this idea was not included in their original plan: it simply doesn’t work. In a health system that values innovation, choice, first rate care, and groundbreaking treatments for patients, market forces must be at play to drive efficiency and effectiveness from not only hospitals and doctors, but insurers as well.

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A grace period in President Barack Obama’s health care law is allowing exchange customers to dodge the penalty while also helping them get more out of their medical coverage.

Insurers told the administration Monday in an annual meeting that making changes to the grace period is one way to make it easier for them to continue to participate in Obamacare’s exchanges. As is, the grace period leads to higher costs for health insurance policies, forcing some insurers to leave the exchanges due to massive financial losses.

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“Irony is wasted on the stupid.” This quote, attributed to Oscar Wilde, seems fitting in light of the Obama administration’s new campaign to block two blockbuster mergers between the health insurers Aetna and Humana and Anthem and Cigna. (It is also fighting hospital consolidation in many states.) The administration is rightly worried that this will lead to higher health care costs through reduced competition, yet it ignores the fact that its signature law, the Affordable Care Act, was specifically designed to foment such consolidation.

The central planners behind the Affordable Care Act – also known as Obamacare – were convinced that consolidation in health care would lead to decreased health care spending by eliminating duplication, standardizing treatment protocols and incentivizing better utilization. As three of Obamacare’s primary authors wrote in The Annals of Internal Medicine in 2010, the law was designed to “unleash forces that favor integration across the continuum of care.” No part of health care was supposed to be spared – doctors, hospitals, insurers, pharmaceutical companies and others were given regulatory and financial incentives to merge.

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Most of the criticism of Obamacare by its right-of-center opponents has focused on its regulatory mandates, botched implementation and rising premiums for less-favored purchasers. Far less attention has been paid to how little the new health law accomplished in fulfilling its advocates’ promises to boost the growth of small business and new entrepreneurial start-up firms.

The Bureau of Commercereports that new business formation inched up slightly for a few years from its low point in 2010 – after four years of decline. But its 2013 figure of 406,000 new businesses remains far below the recent pre-recession peak number of 560,000 in 2006.

Similar measures of entrepreneurial activity by the Kauffman Foundation find modest evidence of recent upticks, but levels still below historical norms.

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government report published Thursday shows ObamaCare is still far from achieving one of its goals.

President Barack Obama’s health care reform law, the Affordable Care Act, has brought the number of people lacking health insurance to a historic low. Yet it also aimed to reduce visits to emergency departments, where the uninsured would often go to receive care but which are often strained with high volumes of patients and deliver more costly services.

But findings from the Centers for Disease Control and Prevention suggest that not having health care coverage isn’t the only factor keeping people from defaulting to the ER for care, and that “ER use overall has not changed significantly after the first full year of ACA implementation.”

Under ObamaCare, most health insurance plans must cover a set of preventive services without any cost to patients. Patients are soon discovering, however, that anything else discussed during a visit with their health care providers could cost them. “There are times when a person might be charged cost-sharing for a service that is unrelated to the screening or preventive service, while they are not charged cost-sharing for the screening or preventive service itself,” says Jesse Bushman, director of advocacy and government affairs at the American College of Nurse-Midwives. But doctors don’t always tell patients about the possibility of fees up front.

Government health officials worked diligently this year to improve consumer experience on Healthcare.gov and make sure people know what they are getting for their money when they pick health insurance. But one thing is out of the government’s control: whether doctors and hospitals will agree to accept patients who buy these plans. Surveys and data are limited, so it’s difficult to gauge the extent of the issue, but anecdotal evidence from patients and providers show it is a struggle. Some newly insured patients wonder whether it’s worth paying for coverage they can’t actually use. Even when they do find a provider, reports show they face crippling out-of-pocket costs they didn’t expect.