Obamacare, which Republicans spent months trying but failing to overturn, will play a starring role again in Congress this summer, this time helping determine the fate of Supreme Court nominee Brett Kavanaugh. Democrats said Tuesday they plan to make the confirmation of Kavanaugh a fight over the future of Obamacare, which is under a lower court challenge that is winding its way toward possible consideration by the Supreme Court.

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Over the weekend, former Centers for Medicare and Medicaid Services (CMS) acting administrator and Obamacare defender Andy Slavitt took to Twitter to denounce what he viewed as the Trump administration’s “aggressive and needless sabotage” of the health care law:

Unfortunately for Slavitt, the facts suggest otherwise. The Trump administration took actions to comply with a federal court order that vacated rules promulgated by the Obama administration—including rules CMS issued when Slavitt ran the agency. If Slavitt wants to denounce the supposed “sabotage” of Obamacare, he need look no further than the nearest mirror.

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One of the few major pieces of legislation moving this summer is the farm bill. Versions of the farm bill have passed both the House and the Senate, and a conference committee will begin the process of reconciling their differences shortly. Among the most striking and contentious differences are the House reforms to the Supplemental Nutrition Assistance Program (SNAP, or “food stamps”) that include work requirements. The Senate bill contains no work requirements.

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Health care is fast becoming an unsustainable expense for American families. This year the total cost of insurance for the typical family of four eclipsed $28,000, according to the Milliman Medical Index. Rising insurance premiums are also eroding worker compensation, as companies shift increased costs to employees.

Health care in the U.S. suffers symptoms of what Justice Louis Brandeis once termed the problem of “Other People’s Money.” Often a patient ordering and receiving medical care mistakenly believes he is not the one paying for it. This misconception is due in large part to the employer tax exemption for health insurance, which conceals the true cost of coverage from most workers.

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Sen. Dianne Feinstein of California, for instance, has officially endorsed a public insurance option, as have other Democrats running in swing districts in Kentucky and Illinois. Meanwhile, single-payer advocates have won Democratic congressional primaries in New York, Nebraska, Texas, and Pennsylvania, among other places.

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A federal judge on Friday blocked Kentucky’s closely watched plan to require many Medicaid recipients to work, volunteer or train for a job as a condition of coverage.

The state had been poised to start carrying out the new rules next week and to phase them in fully by the end of this year.

Judge James E. Boasberg of Federal District Court for the District of Columbia, an Obama appointee, ruled that the Trump administration’s approval of the plan had been “arbitrary and capricious” because it had not adequately considered whether the plan would “help the state furnish medical assistance to its citizens, a central objective of Medicaid.”

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California’s leading progressives are currently debating — amicably, for the moment — when the right time will arrive to destroy the state’s healthcare system.

The frontrunner in the race for the governor’s mansion, current Lieutenant Governor Gavin Newsom, has long championed single-payer health care. But he recently softened his support. “[Single-payer] is not an act that would occur by the signature of the next governor,” he recently said. “There’s a lot of mythology about that.”

The CMS is ratcheting up scrutiny of state Medicaid programs.

The agency announced Tuesday that it is boosting audits to confirm that Medicaid beneficiaries are correctly identified as expansion or pre-expansion enrollees. States receive higher federal match rates of around 90% for expansion enrollees, while the match rate can be as low as 50% for pre-expansion enrollees.

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The Las Vegas Metro Chamber of Commerce would like to get back into the health insurance business.

Such a move became more likely Tuesday when the Trump administration announced a rule that would let small businesses or associated groups band together to purchase what are known as association health plans. The U.S. Department of Labor said the move will enable groups that share a commonality — such as an industry or geographic location — to obtain more affordable coverage.

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This year will be the last in which uninsured Americans are forced to pay ObamaCare’s penalty for lack of coverage. The change—part of the GOP’s tax reform—comes as relief on the demand side of health insurance. Yet nothing has changed on the market’s supply side. Without additional reforms to ObamaCare’s restrictions on insurers, millions of Americans will continue to choose from a limited range of lackluster plans.

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