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Kentucky Republican Matt Bevin ran for governor on a platform devoted almost exclusively to killing Obamacare, including its expansion of Medicaid insurance to the poor. He didn’t do it. Following in the steps of eight Republican governors who sought to expand Medicaid without appearing to do so, he applied for federal permission to add Republican-friendly tweaks to the program instead. The decision was a nod to reality. By the time Bevin took office at the beginning of 2016, almost one in three Kentuckians had Medicaid or insurance through a federally subsidized Affordable Care Act plan. Many of them didn’t know it when they elected the new anti-Obamacare governor, a side effect of how Kentucky marketed the plans. (Newkirk, 1/23)

Deep in the Sandhills of rural Nebraska, where a two-lane highway curves between prairies and grass-covered dunes, there is a county full of surprises. It's home to Hyannis, a small village without stoplights, where fresh hot coffee is free, everyone waves and, in 1931, a news report named it "The Richest Town in America." (Ravitz, 1/24)

If the healthcare law is in a death spiral, it increases the need to repeal and replace it, since it suggests that health insurance markets will collapse without government action. That’s why it is a key argument for Republicans. Yet non-partisan healthcare groups that have studied the law say that while it has some serious problems and faces challenges, they do not see it as collapsing into a death spiral. (Sullivan, 1/24)

The outreach workers joined the line at a Michael “Air” Jordan shoe launch. They went to Denny’s after the District’s clubs had closed. They hung out at happy hours with $4 drinks and $7 bar food, laundromats, gyms, and Sunday brunches. This month, as Republicans in Congress moved to dismantle the Affordable Care Act and President Trump signed an executive order weakening its provisions, D.C. health insurance exchange officials were rushing to sign up millennials before the open enrollment period ends Jan. 31. (Brown, 1/23)

The Affordable Care Act includes special provisions that make the process of getting black lung benefits easier for coal miners. If the ACA is repealed, gaining these benefits could become much more difficult, effectively harming a group of people that President Donald Trump has promised to protect. (Lofton, 1/24)

From an upscale assisted living center here, 87-year-old Brendan Wall has some advice for members of Congress eager to repeal the Affordable Care Act: Slow down. “They haven’t said what they’re going to replace it with or how they’re going to replace it,” said Wall, who taught philosophy and religion for more than 30 years. (Aleccia, 1/24)

As President Donald Trump and Republicans in Congress devise a plan to replace the 2010 health law, new research suggests a key component of the law helped people with chronic disease get access to health care — though, the paper notes, it still fell short in meeting their medical needs. (Luthra, 1/23)

More than 200,000 King County residents get insurance through the ACA, said King County Executive Dow Constantine. That has helped cut the country’s uninsured rate by half since 2013, to 7.7 percent. Statewide, some 600,000 residents have gained coverage through Medicaid expansion. But many stand to lose coverage if Republicans in Congress follow through on vows to repeal parts of the ACA, such as Medicaid expansion and subsidies to individuals who enroll in coverage through the state insurance exchange. (Young, 1/23)

Top Pennsylvania officials  said Monday that they were bracing for "disastrous" consequences if Medicaid expansion under the Affordable Care Act is repealed - including the loss of health insurance for more than 670,000 Pennsylvanians, many from poor and rural areas. And 400,000 more residents who signed up for coverage through Obamacare's insurance exchange will also be left in the lurch, they said. (Couloumbis, 1/23)

Gov. Mark Dayton was seeking a more vigorous role for the state government and more requirements of the state’s insurance companies in response to the state’s health insurance crisis before he collapsed Monday. In his seventh State of the State address Monday night, Dayton was to propose letting Minnesotans buy unsubsidized insurance coverage from the state’s MinnesotaCare program, which could expand choice and save Minnesotans money. He did not get a chance to finish the speech, though, after apparently fainting. (Montgomery and Stassen-Berger, 1/23)