Quotes of the day

House Republicans have no scheduled votes or hearings on ObamaCare, signaling a shift in the party’s strategy as the White House rides a wave of good news on the law.

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Not a single House committee has announced plans to attack the healthcare law in the coming weeks, and only one panel of jurisdiction commented to The Hill despite repeated inquiries.

GOP campaign committees also declined to say whether they will launch any new efforts on the law.

The lack of action highlights the GOP’s struggle to adjust its message now that enrollment in the exchanges beat projections and the uninsured rate is going down.

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But 51 percent of New Hampshire adults oppose Obamacare while just 37 percent support it, the University of New Hampshire Survey Center reported last month in a WMUR-Granite State poll. Sixty-one percent of the state’s voters think medical costs will increase under the act.

“The perception is, ‘it will hurt my family and costs will go up’,” said Andrew Smith, director of the center. “In a political campaign, that is a big boulder to push uphill.”

Skeptics include people like Derek Gagnon, a 33-year-old auto mechanic who says he would not even consider voting for anyone who had backed the Affordable Care Act.

He has no health insurance, but he also says he has no intention of signing up for the private insurance offered through the government-run website, HealthCare.gov.

“I shouldn’t be forced to do something like that in a free country,” said Gagnon, referring to the law’s requirement, known as the “individual mandate,” that almost all legal U.S. residents buy health insurance or pay a fine.

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Democrats and Republicans agree on one thing about the hotly contested Affordable Care Act: When it comes to voter intensity, the GOP holds a clear upper hand.

But a trio of major liberal groups hopes to change that in coming months, with plans to spend tens of millions of dollars persuading residents in a dozen key states to vote for Democrats based on the issue. Whether they succeed could help determine not just control of the Senate but the fate of key gubernatorial races and the law’s viability.

The Service Employees International Union, the Planned Parenthood Action Fund and MoveOn.org have each launched campaigns in recent weeks aimed at mobilizing support for the law and the officials who back it. By focusing on more popular parts of the law — including Medicaid expansion, free birth-control coverage and a bar on denying coverage for preexisting conditions — the groups hope to coax individuals who often skip voting in midterm elections to make it to the polls…

The organizations now plan to apply that same machinery to the midterms, with a particular focus in states that did not expand Medicaid but have competitive gubernatorial or Senate races, such as Louisiana and Florida. They are shifting thousands of workers and volunteers who had been focused on enrollment to become steeped in Medicaid expansion. And they plan to return to the people they enrolled in coverage and ask them to vote.

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Nearly half a billion dollars in federal money has been spent developing four state Obamacare exchanges that are now in shambles — and the final price tag for salvaging them may go sharply higher.

Each of the states — Massachusetts, Oregon, Nevada and Maryland — embraced Obamacare, and each underperformed. All have come under scathing criticism and now face months of uncertainty as they rush to rebuild their systems or transition to the federal exchange.

The federal government is caught between writing still more exorbitant checks to give them a second chance at creating viable exchanges of their own or, for a lesser although not inexpensive sum, adding still more states to HealthCare.gov. The federal system is already serving 36 states, far more than originally anticipated…

Their totals are just a fraction of the $4.698 billion that the nonpartisan Kaiser Family Foundation calculates the federal government has approved for states since 2011 to help them determine whether to create their own exchanges and to assist in doing so. Still, the amount of money that now appears wasted is prompting calls for far greater accountability.

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Despite Obamacare’s strong national enrollment numbers, several states are at risk for big premium hikes

Premiums will go up, on average, across the board—premiums go up every year. But a range of factors could drive higher-than-average increases in certain places. States that fell short of their overall enrollment goals, and where the people who did enroll are mostly older and sicker, are more at risk for large premium hikes. So are states that don’t have much competition among insurers.

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“If you lose on all of those, then you’re really looking bad,” Pearson said…

Ohio and Arizona, both of which allowed plan extensions, are on Levitt’s list of states to watch for big premium hikes. He and Pearson mentioned Iowa, which allowed a two-year extension for canceled plans and was the second-worst state at enrolling its eligible population.

Health care analysts are also keeping an eye on premiums in Maryland, Mississippi, New Mexico, and South Dakota, where officials had to beg and plead just to get one carrier into the state’s private market.

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A majority of Americans want to keep the federal health care law as is, or make some changes to improve it, according to a new national poll.

But a CNN/ORC International survey released Sunday also indicates public attitudes have been largely unaffected by news that 8 million people have enrolled in health insurance plans under the Affordable Care Act, known as Obamacare.

Despite a victory lap by the White House following the release of that number, only 12% of Americans surveyed consider the law a success. Nearly half say it’s too soon to tell, and just under four in 10 consider it a failure.

According to the poll, 61% want Congress to leave the Affordable Care Act alone (12%) or make some changes to the law in an attempt to make it work better (49%).

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Via Pew.

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In Kentucky, a new Marist poll conducted for NBC News finds that 57 percent of registered voters have an unfavorable view of “Obamacare,” the shorthand commonly used to label the 2010 Affordable Care Act. That’s compared with only 33 percent who give it a thumbs up – hardly surprising in a state where the president’s approval rating hovers just above 30 percent.

By comparison, when Kentucky voters were asked to give their impression of “kynect,” the state exchange created as a result of the health care law, the picture was quite different.

A plurality – 29 percent – said they have a favorable impression of kynect, compared to 22 percent who said they view the system unfavorably. Twenty-seven percent said they hadn’t heard of kynect, and an additional 21 percent said they were unsure.

“Call it something else, and the negatives drop,” said Marist pollster Lee Miringoff.

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Via Pew.

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A law can do some good, of course, while not living up to the promises made about it. It cannot be denied that the law has made some people better off. The coverage expansion means that more Americans have the extra measure of financial security that comes from knowing that medical expenses will not drive them into poverty. That’s a real good, something the law’s critics have sometimes failed to acknowledge.

But Obamacare’s champions have greatly exaggerated what this good involves, and so what it should mean for our overall assessment of the law. During the battle to enact Obamacare, and subsequently, supporters have claimed that the expansion would save thousands of lives. A study of Oregon Medicaid recipients — the best such study we have — has instead found that coverage did not significantly improve any physical health outcomes. If the value of insurance is that it protects against financial calamity, then the approach of Obamacare is radically misconceived: We ought instead to have undertaken reforms to enable everyone to purchase catastrophic coverage. In other words, different policies could have achieved the good that Obamacare has done, at much lower cost. Or perhaps even more good, since the expansion has included fewer people than expected.

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Obamacare’s near-death experience during the last months of 2013 has distorted the media’s treatment of the program, making it seem more successful than it is. From 2009 through mid 2013, the critics were not saying that the exchange websites would be a catastrophic failure. They were, by and large, taken by surprise as much as the administration was by their early dysfunction. Leaving aside those chaotic months, the picture of Obamacare today looks more like one the critics painted than the one supporters did: a lot of trouble for a small gain

For the law to be repealed in 2017 requires three things: Republicans have to remain committed to its repeal, they have to sweep the 2016 elections, and they then have to follow through on their pledges. That is not the way to bet. But it is still the right goal to work toward, given that the law is likely to have bad effects on American health care and governance and that its structure does not permit much constructive reform.

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In the first look at how insurers plan to adjust prices in the second year under the federal health-care law, filings from Virginia carriers show they are opting for premium increases in 2015 that will pinch consumers’ pocketbooks but fall short of some bigger rate predictions.

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