Obamacare

“Republicans are shifting their tactics on Obamacare, an abrupt change from the party’s “repeal-only” rhetoric that dominated the last five years of debate,” The Hill reports.

“The GOP is coalescing around the idea that incremental changes, rather than a sweeping repeal effort, can be more appealing to voters – while also holding out the possibility of hollowing out the law from within.”

“Elizabeth MacDonough holds no elected office. Few people outside of Capitol Hill even know her name. And forget about knowing her political leanings or loyalties. But she may very well be the most powerful person in Washington in determining how far Republicans can go in trying to repeal Obamacare,” Politico reports.

“As the Senate parliamentarian, MacDonough will make the decisions on which pieces of the law qualify to be repealed using a complicated budget procedure called reconciliation. Her decisions would allow Senate Republicans to vote to kill major provisions of the health care law under a simple 51-vote majority without giving Democrats a chance to filibuster.”

Wonk Wire: Republicans united on the politics of Obamacare

Jonathan Gruber, the health economist whose incendiary comments about “the stupidity of the American voter” have embarrassed the Obama administration, apologized for what he described as his “glib, thoughtless and sometimes downright insulting comments,” the New York Times reports.

Said Gruber: “I am not a political adviser nor a politician.”

Gruber also minimized his role, saying he had used an “economic microsimulation model” to help the administration and Democrats in Congress assess the impact of policies in the Affordable Care Act.

“The GOP is refocusing its attention on the courts as it searches for any way to weaken President Obama’s signature healthcare law while he continues to wield a veto pen,” The Hill reports.

“The reach to the Supreme Court is part of a flurry of recent legal action that reflects a growing consensus within the GOP that the party must rely on courts instead of Congress to strike down ObamaCare, especially as more pieces of the law are put into place.”

Wonk Wire: Where are the soaring health care costs?

“I would assume you could have a mulligan here, a major do-over.”

— Sen. Mitch McConnell (R-KY), quoted by the Wall Street Journal, suggesting a major revamp of national health care legislation if the Supreme Court rules against a key provision of Obamacare.

A new Rasmussen survey finds that most voters for the first time want Congress to fix the new national health care law rather than repeal it.

While 30% of likely voters still think Congress should repeal it entirely and start over again, 52% prefer instead that Congress go through the law piece by piece and improve it. Just 13% want to leave the law as is.

Wonk Wire: Obamacare supporters’ rhetoric could undermine latest legal challenge

“House Republicans filed a long-threatened lawsuit Friday against the Obama administration over unilateral actions on the health care law that they say are abuses of the president’s executive authority,” the New York Times reports.

“The lawsuit — filed against the secretaries of the Health and Human Services and Treasury Departments — focuses on two crucial aspects of the way the administration has put the Affordable Care Act into effect.”

“With the health insurance marketplace now open for a second year, President Obama will be depending more than ever on the insurance companies that five years ago he accused of padding profits and canceling coverage for the sick,” the New York Times reports.

“Those same insurers have long viewed government as an unreliable business partner that imposed taxes, fees and countless regulations and had the power to cut payment rates and cap profit margins.”

“But since the Affordable Care Act was enacted in 2010, the relationship between the Obama administration and insurers has evolved into a powerful, mutually beneficial partnership that has been a boon to the nation’s largest private health plans and led to a profitable surge in their Medicaid enrollment.”

Gallup: “As the Affordable Care Act’s second open enrollment period begins, 37% of Americans say they approve of the law, one percentage point below the previous low in January. Fifty-six percent disapprove, the high in disapproval by one point.”

“Repeal is highly unlikely, given Obama’s veto power, but the law’s new low in approval — and new high in disapproval (56%) — could potentially have an impact on its future. The president himself has acknowledged he will consider modifications to the law, which could include repealing the tax on medical devices.”

Wonk Wire: Who still lacks health insurance?

A new Gallup poll finds that 71% “of those who bought new health insurance policies through the government exchanges earlier this year rate the quality of their healthcare and their healthcare coverage as ‘excellent’ or ‘good.’ These positive evaluations are generally similar to the reviews that all insured Americans give to their health insurance.”

“Among those who bought new health insurance policies through the exchanges, the majority are about as satisfied with their coverage and healthcare as are other Americans — suggesting that the end result of the exchange enrollment process is a generally positive one for those who take advantage of it.”