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None of the health care reform plans currently under discussion in Washington address the critical issue of paying for coverage for sick people, according to an MIT economist who had a hand in crafting the federal Affordable Care Act. ... [Jonathan] Gruber said health coverage could be expanded without an individual mandate if there was a reinsurance program instead that paid insurers for covering sick people. “That could work, if you spend enough money,” Gruber said, “But we’re going to have to increase the deficit to do that.” The math of insurance, he noted, doesn’t work unless lower-cost healthy people subsidize coverage for sicker people whose care is more costly. (Dayal McCluskey, 2/14)

Congressional Republicans working on rewriting rules for the struggling individual insurance market might want to study five different reform proposals chosen as finalists in a national competition among actuarial professionals. (Meyer, 2/15)

Following an executive order from President Trump to “minimize the economic burden” of the Affordable Care Act, the Internal Revenue Service said it is backtracking on its plan to reject 2016 tax returns that do not indicate whether the taxpayer complied with the act’s individual mandate. Supporters of the act, which is known as Obamacare, fear this behind-the-scenes change could undermine enrollment in health insurance. (Pender, 2/14)

If the debate in Washington over the future of Obamacare seems distant and abstract, a network of health foundations in Pennsylvania seeks to make it close and clear, at least statistically. The Pennsylvania Health Funders Collaborative, which supports the Affordable Care Act, drills down to the local level, detailing the impact by county, hospital, and congressional district (the elected representatives who will decide the issue). (Sapatkin, 2/14)