Summary: The hits just keep coming for President Obama’s beleaguered health care reform law. If you’ve had trouble keeping up with all of the bad news surrounding ObamaCare, I don’t blame you. For the sake of convenience, let’s take a look at some of this news and then consider the “big picture” for the floundering Affordable Care Act. Health Insurance “Exchanges” We’ll begin with the health insurance “exchanges,” which are the primary mechanism by which ObamaCare distributes massive government subsidies to private health insurance companies. These “exchanges” feature only government regulated and approved insurance plans, from which consumers are allowed to choose. When writing the law, Congressional Democrats and the White House left the dirty work of setting up these expensive, complicated “exchanges” to the states. After a majority of states flatly refused to comply with this unfunded mandate, the Obama administration started scrambling to set up dozens of “exchanges” by itself. At the same time, the federal government is also burdened with the cost of conducting a massive public relations outreach campaign for ObamaCare, which remains unpopular with more than half of Americans. Compliant states are also struggling to implement their “exchanges,” with Idaho official Stephen Weeg acknowledging that the state bureaucracy will need to “beg, borrow, and steal” in order to get its “exchange” operational by the October 1st start date for enrollment. The federal Department of Health and Human Services even broke ObamaCare’s own rules by approving Utah’s unique “dual exchange” system. It is clear that the Obama administration is becoming desperate to salvage its crumbling law by any means necessary. By the way, even if these “exchanges” are actually set up according to design, some of the nation’s largest insurance companies are still expressing reluctance to provide coverage plans for them in the first place. Perhaps private insurers do not find the idea of entering such government dominated “exchanges” an attractive prospect, after all? Lawsuits Lawsuits continue to plague ObamaCare, as well. Earlier this month, a group of small business owners sued the federal government on the grounds that the text of the ObamaCare law does not authorize the government to issue subsidies to private insurance companies in those states with federally-run health insurance “exchanges.” The Pacific Legal Foundation filed a separate lawsuit that uses Supreme Court Chief Justice John Roberts’ flimsy defense of ObamaCare’s individual mandate as a “tax” against the law. Revenue-raising bills, such as taxes, must originate in the House of Representatives in order to be constitutional, but the final version of ObamaCare began in the Senate. This is just a small sampling of the growing number of lawsuits brought against ObamaCare so far. Medicaid Expansion ObamaCare’s Medicaid expansion isn’t exactly going to plan, either. The law offers full funding for the first few years for those states that expand their Medicaid programs, and then promises 90% of the funding for future years. However, there is no guarantee behind that money, and truthfully, the federal government cannot afford to hold up its end of that bargain for very long. Once that happens, state legislatures across the country will get stuck with the tab for Medicaid expansion, which will crowd out other state budgetary priorities such as education and infrastructure. As a result, many governors are refusing to take such a risky deal. Even Missouri, which has Democratic Governor Jay Nixon, is turning down Medicaid expansion due to resistance from the state legislature. A recent study published in The New England Journal of Medicine casts doubt on the belief that Medicaid expansion is even a good idea. After Oregon expanded its Medicaid program in 2008, researchers found that, “…Medicaid coverage generated no significant improvements in measured physical healt
