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Talk about looking a gift horse in the mouth: In an all-too-rare but refreshing show of harmony, the U.S. House of Representatives last week approved a bipartisan compromise bill that fixes a serious, long-festering problem with Medicare payments and sent it to the Senate...where it awaits an uncertain future. ... Senate Democrats are balking because this bill contains the Hyde Amendment, banning federal funds for abortions. We don’t like it either, but it should not be an excuse for blocking a good bill that makes no change in the abortion status quo. Democrats also want those four years for CHIP; they should settle for two and try again later. (3/29)

Heritage Foundation microsimulation analysis of the 2015 health insurance offerings on the ACA exchanges found that the sharp 2014 price spike was not reversed. The average health insurance premium rose by 5% this year, much higher than the rate of inflation. But that increase is modest compared to the massive increase in non-group health insurance rates in 2014, which was around 50% on average, with some consumers facing much worse rate jumps. (Salim Furth, 3/30)

Two reports released in the past week demonstrate a potential bifurcation in state insurance exchanges: The insurance marketplaces appear to be attracting a disproportionate share of low-income individuals who qualify for generous federal subsidies, while middle- and higher-income filers have generally eschewed the exchanges. ... It raises two obvious questions: Whether and how the exchanges can succeed long-term with an enrollment profile heavily weighted towards subsidy-eligible individuals—and whether an insurance market segregated by income was what Obamacare’s creators originally had in mind. (Chris Jacobs, 3/30)

Obamacare just passed its fifth anniversary as a law, but don’t be surprised if you don’t hear much about it. After all this time, polls show the public still doesn’t like it. Results are more important than perception, of course. So let’s ask: If Obamacare is measured on four important metrics — cost, coverage, competition and choice — are we better off now? (Alyene Senger, 3/29)

Obamacare doesn’t address a looming doctor shortage. Obamacare is silent on the question of states’ certificate-of-need laws. While Georgia hasn’t expanded Medicaid as envisioned by Obamacare, that would not be much of a salve, either. An expanded Medicaid wouldn’t do anything about low reimbursement rates that keep many health providers from taking Medicaid patients in the first place. ... The problem with trying to fix health care is that it’s typically done by pulling one lever here and another there, in the hopes that a flat-lining system will be miraculously cured. Health care is too far removed from anything resembling a rational market for one or two fixes here and there to make a difference. (Kyle Wingfield, 3/30)

Wisconsin’s governor, and likely Republican presidential candidate, didn’t take the [health law's Medicaid expansion] offer. In doing so he bolstered his Tea Party bona fides by refusing to accept this Obamacare expansion. But exactly how he did it says a lot about Scott Walker. Instead in 2013, Walker laid out a plan to reshuffle thousands of low-income people between the state’s Medicaid plan, BadgerCare, and the Obamacare insurance exchanges that will end up costing the state’s taxpayers hundreds of millions of dollars and cover tens of thousands of fewer people. But, the Tea Party activists in Iowa and the other primary states are likely to love it. (Robert Laszewski, 3/30)

Remember Michigan's Medicaid expansion, which Tea Parters furiously warned would be "big government" disaster? Well, it's been about a year since the law went into effect. And it looks like that Orwellian prediction was wrong, wrong, wrong. To date, 600,000 Michiganders have gained health insurance through Medicaid. These are adults at 133 percent of the poverty line or below ($15,000 annually for one person or $30,000 for a family of four). ... [Gov. Rick] Snyder deserves credit. He fought for months with members of his own party. (Susan J. Demas, 3/31)

Medicaid expansion doesn’t benefit only the 35,000 New Hampshire residents who previously didn’t have access to health insurance, it’s also keeping elder care costs down and helping businesses in the state comply with the Affordable Care Act’s employer mandate. And, until 2020, it’s 100 percent paid for by the federal government through the tax dollars that New Hampshire residents already pay into Medicaid. In 2020, that percentage of federal subsidy drops to only 90 percent. Deciding not to renew Medicaid expansion will send New Hampshire’s Medicaid tax dollars to Washington, D.C., without any increased return to the state, and at the same time it will drive up costs for the state’s residents. These increased costs will disproportionately fall on New Hampshire’s elderly. (Ben Geyerhahn, 3/31)