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A new survey shows that 44% of Covered California policyholders find it difficult paying their monthly premiums for Obamacare coverage.

And a similar percentage of uninsured Californians say the high cost of coverage is the main reason they go without health insurance.

The issue of just how much people can afford will loom large as the state exchange prepares to negotiate with health insurers over next year’s rates.

Many analysts are predicting bigger premium increases for 2016 in California and across the country. Insurers have more details on the medical costs of enrollees, and some federal programs that help protect health plans from unpredictable claims will be winding down.

The cost of Obamacare could rise for millions of Americans next year, with one insurer proposing a 50 percent hike in premiums, fueling the controversy about just how “affordable” the Affordable Care Act really is.

The GOP’s months-long debate over when and how to send a repeal of Obamacare to the president’s desk now appears to have an answer.

They can’t do it all at once.

Repealing the law “root and branch” is probably out of the question, the chamber’s parliamentarian is hinting, because some parts of Obamacare don’t affect the federal budget. That’s a must in order to use the obscure procedure known in Senate parlance as reconciliation, which allows lawmakers to avoid the 60-vote filibuster hurdle and pass bills on a simple majority vote.

That’s not the GOP’s only problem. Under those rules any Obamacare repeal has to reduce — not increase — the deficit. So Republicans will have to pick and choose which parts of the Affordable Care Act they most want to ditch.
Obama will, of course, veto any bill that significantly damages his signature domestic policy achievement.

The HSA Council’s study is designed to address the uncertainty surrounding Cadillac Tax liability by providing a relational
tool employers can use to compare the cost of their plan against average plan data compiled by AHIP and KFF, the
industry benchmarks. Some employers are currently contracting for healthcare plan designs through 2018. Since
industry data is not consistent and there are considerable state-by-state variations in average premiums, employers and
brokers are looking for affordable plan designs that allow them to avoid the Cadillac Tax. HSA-qualified plans can be
that solution.

Democrats and Republicans are sitting on the edge of their seats, waiting to see what the Supreme Court will decide in King v. Burwell, the looming decision about the Affordable Care Act, or Obamacare, as it has come to be known.

If the Supreme Court agrees with the challenge, an estimated 13 million people will lose their federal health insurance subsidies. The plaintiffs have argued that based on the literal reading of the legislation, the government is only supposed to provide citizens with subsidies in states that set up their own health care exchanges (a total of 16 states). The sentence in the law upon which their claim is based, The New York Times reported, was based on a sloppy error made during the drafting process.

There have been numerous disasters along the way as the federal government and the states have struggled to implement the Patient Protection and Affordable Care Act (a.k.a. Obamacare), but none come close to Oregon’s sorry effort for the millions of dollars lost, the raw political opportunism, and the melodramatic plot twists. Now from the Insult-to-Injury Department comes word that it all could have been avoided.

Earlier this month, five years after President Barack Obama signed ACA, The Hill published a series of articles about how Obamacare is working around the country. It reported that many of the 13 states that established their own stand-alone health-care marketplace exchanges are looking for ways to mitigate the damage and get something up and running before federal funding dries up.

Sometime in the next few weeks, the U.S. Supreme Court will rule on whether the federal government can subsidize people’s health insurance in the 37 states that haven’t set up Affordable Care Act exchanges. Behind that fight is another one, just as interesting and almost as important: Who gets the blame if the government loses?

The case, King v. Burwell, revolves around a phrase in the law that says insurance subsidies are available on exchanges “established by the state.” The plaintiffs and their supporters say this shows Congress meant to use the subsidies as a cudgel to compel states to create their own exchanges. Now that the strategy has failed, they argue, with some states refusing to build exchanges and instead defaulting to the one run by the federal government, the government should accept the consequences and withdraw those subsidies.

Senate Republicans want to create a top watchdog to dig into ObamaCare.

GOP Sens. Pat Roberts (Kansas) and Rob Portman (Ohio) have introduced legislation that would create an Office of the Special Inspector General for Monitoring the Affordable Care Act (SIGMA).

The Department of Health and Human Services (HHS) already has an inspector general, but Roberts said he wanted to create a position that could investigate ObamaCare across the federal government.

“While all of the federal agencies charged with implementing Obamacare have their own Offices of the Inspector General, they are all investigating this law in their own silos,” Roberts said in a statement.

Under Obamacare, doctors have been strained by costly new regulations, intricate payment “reforms” that tie their Medicare reimbursement to complex federal reporting requirements, and mandates that they install and make “meaningful” use of electronic health records.

Add a new burden to the mix: The proportion of patients they see are rapidly shifting away from commercial health plans and toward Medicaid, which sometimes pays doctors pennies on the dollar that they were previously reimbursed under private insurance.

The data comes from ACAview, a product of athenahealth that aims to measure the impact of Obamacare on medical practices. The project, jointly funded with the Robert Wood Johnson Foundation, is the first large-scale examination of data derived directly from outpatient medical practices belonging to more than 60,000 providers. It gives a unique insight into how the Affordable Care Act is impacting patients at the point of care.

About a decade ago, a doctor friend was lamenting the increasingly frustrating conditions of clinical practice. “How did you know to get out of medicine in 1978?” he asked with a smile.

“I didn’t,” I replied. “I had no idea what was coming. I just felt I’d chosen the wrong vocation.”

I was reminded of this exchange upon receiving my med-school class’s 40th-reunion report and reading some of the entries. In general, my classmates felt fulfilled by family, friends and the considerable achievements of their professional lives. But there was an undercurrent of deep disappointment, almost demoralization, with what medical practice had become.

The complaint was not financial but vocational — an incessant interference with their work, a deep erosion of their autonomy and authority, a transformation from physician to “provider.”