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Jonathan Gruber, the embattled Massachusetts Institute of Technology economist whose comments about President Barack Obama’s health law touched off a political furor, worked more closely than previously known with the White House and top federal officials to shape and influence the law, according to previously unreleased emails.

Long before there was the Affordable Care Act, presidential candidate and Democratic front-runner Secretary Hillary Clinton was advocating for her own version of health care reform, popularly known as “Hillarycare.” While the Clintons failed to successfully implement Hillarycare, a little over a decade later, President Barack Obama passed “Obamacare,” which effectively overhauled the United States health care system. While the general refrain in the media touted that Obamacare was different than Hillarycare, the two are actually very similar in structure and regulation.

The Affordable Care Act created a new kind of “cooperative” heralded by supporters of health reform. These Consumer Operated and Oriented Plans, chartered and regulated by the states, would compete with for-profit health-insurance companies and were meant to appease disgruntled advocates of a single-payer and “public option” model for the nation’s health-care system.

The Supreme Court will soon decide King v. Burwell, the case that will determine whether tax credits being paid in at least 34 states without their own exchanges are legal. If the Supreme Court makes the administration follow the letter of the law, billions of dollars of federal tax credits will continue to flow to 16 states, but not the rest. This will result in a political crisis giving Congress and President Obama the opportunity to fix the worst aspects of Obamacare.

Most of the 13 state-run public health insurance have collectively spent $4.8 billion in federal funding during their first 17 months of operations and face serious cash-flow problems, according to a website named after the late conservative commentator Andrew Breitbart.

And with major insurance carriers seeking HIX premium increases of up to 51% in some states, the report suggested marketplace mergers as one political solution. It noted that both Covered California and Vermont Health Connect significantly overestimated enrollment and now must slash advertising, outreach and technology services.

The Congressional Budget Office (CBO) has just released a report on the budgetary and economic effects of repealing the Affordable Care Act (ACA). Press reports reflect what CBO has reported pursuant to its scoring instructions – specifically, that relative to its scorekeeping baseline, repeal of the ACA would worsen the federal deficit but bolster the economy. CBO’s new inclusion of economic feedback with the score – finding that the ACA’s adverse economic effects make the deficit $216 billion worse over the next decade than it otherwise would be – is naturally fostering additional attention. Less noted, however, is the important fact that CBO’s analysis actually indicates that repealing the ACA would lower, not increase, federal deficits.

The wait is almost over for what could be the last big legal threat to ObamaCare.

Court watchers are working themselves into a frenzy awaiting a decision on King v. Burwell, one of the most anticipated cases of the year.

On opinion days, dozens of reporters are packing into the court or swarming the steps outside, while nearly 10,000 people tune into SCOTUSblog for live updates. False reports attempting to predict the timing of the decision have only further fueled the hype.

Across Capitol Hill, Republicans in the House and Senate briefed their members for the first time on Wednesday, trying to calm fears about what could happen to the 6.4 million people whose health insurance subsidies are at stake in the case.

State Republican leaders are ratcheting up the pressure on Congress to overhaul the Affordable Care Act if the Supreme Court this month rules that subsidies on the federal exchange are invalid.

Republicans from 33 states have written to Congress as part of a coordinated message urging federal legislators to develop a plan that would free states from the pressure of setting up their own exchanges to salvage subsidies, according to the Foundation for Government Accountability, a conservative think tank.

America’s biggest health insurers are about to get even bigger, driven into a wave of consolidation by Obamacare’s new regulations and markets.
Anthem’s disclosure Saturday that it’s offered about $47 billion for Cigna Corp. is the first public confirmation the deal-making is in full swing. Cigna rejected the offer on Sunday, despite Anthem’s attempt to pressure Cigna’s board by taking the offer public. Anthem, Aetna Inc. and UnitedHealth Group Inc. all are poised to emerge as buyers or sellers when the dust settles.