Â鶹ŮÓÅ

Four years ago, Alabama’s new Republican governor, along with the state's first majority-GOP legislature since Reconstruction, faced a tough, high-stakes decision: Make the best of a federal health care reform law they hated, or stiff-arm President Barack Obama. ...One thing they didn’t seem to consider was whether Alabamians would be able to receive subsidies to make their health insurance more affordable if the state defaulted to a federally operated exchange, according to documents and interviews with principal figures in the debate. ... In June, the Supreme Court is expected to issue a ruling on King v. Burwell, a lawsuit alleging that these tax credits should only be available in state-run exchanges. The consequences for those in Alabama and 33 other states who get health insurance from federally operated exchanges could be dire. (Young, 4/6)

So far, few provider practices have benefited from the CMS' value-based payment modifier program, according to agency data. The payment initiative, outlined in the Affordable Care Act, is meant to encourage physicians and practice groups to provide high quality and cost-effective care. Eventually, the value modifier will apply to all healthcare practitioners, but this year it was voluntary and applied only to groups of 100 or more eligible professionals. (Dickson, 4/6)

People who didn’t sign up for health insurance on the online marketplace this winter have one last chance to sign up in coming days. As the Affordable Care Act goes fully into effect, people who are eligible to buy insurance but who chose not to in 2014, will have to pay a fine when they file taxes next week. (Hoban, 4/7)

Health exchange managers plan to increase user fees and assessments on Coloradans who buy health insurance in order to fund exchange costs that could soar to $44 million a year. (Kerwin McCrimmon, 4/6)

Independence Health Group Inc., the nonprofit holding company for Independence Blue Cross and other businesses affiliated with the Philadelphia region's largest health insurer, on Monday reported a decline in net income to $69.18 million last year from $142.64 million in 2013, despite a 19 percent gain in revenue, to $13.2 billion, and the addition of two million members to Independence's operations in 25 states. Alan Krigstein, executive vice president and chief financial officer of Independence, said the company spent $40 million to be ready for the Affordable Care Act in 2013 and an additional $20 million to $25 million last year. The spending paid off in 2014 with the addition of 285,000 individuals in Pennsylvania and New Jersey buying Independence Blue Cross policies through the exchanges established to implement the act, Krigstein said. (Brubaker, 4/6)