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Did Obamacare work? It’s worth asking as President Trump presses his promise to repeal and replace the “disaster” of Obamacare. Ever since the Affordable Care Act was passed in 2010, it has been so contentious that it can be difficult to see beyond the partisan debate. But by looking at the many ways the law has changed health care, it’s possible to hazard some judgments. (Margot Sanger-Katz, 2/5)

As they struggle to figure out how to deliver on the most important (and repeated) promise they made to their constituents over the last eight years — repealing and replacing the Affordable Care Act — Republicans face two sets of problems, both of which are far thornier than they imagined. The first are the policy problems, which arise from the fact that health care reform is incredibly complex (and yes, they’re just realizing that now). The second are the political problems, which may be even more challenging. (Paul Waldman, 2/3)

So powerful is the political appeal of entitlement programs that modern democracies routinely choose bankruptcy over curtailing them. That’s even true of ObamaCare. Despite surging premiums, lagging enrollment, the growing burden on the economy, and the enduring opposition of most voters, the debate is about replacing rather than simply repealing it. (Phil Gramm, 2/2)

President Trump and Republican leaders in Congress have made their intention to repeal the Affordable Care Act (ACA) clear. Repealing the ACA without an immediate replacement would take health coverage away from tens of millions of Americans, remove popular protections for consumers against insurance companies, and unravel states’ individual insurance markets. And beyond these devastating impacts, the Republicans’ likely plan would also give a windfall tax cut to the highest-income Americans. At the same time, it would raise taxes significantly on millions of low- and moderate-income families due to the loss of their premium tax credits. (Brandon DeBot, 2/6)

In the waning days of this year’s Affordable Care Act sign-up period, the Trump administration declared war on the health law, releasing an executive order that could weaken its requirements and yanking advertisements and outreach off the air. Those actions appear to have made a difference. Sign-ups for health plans in the states managed by the federal government are down slightly compared with last year. About 9.2 million Americans picked an Obamacare marketplace plan for this year, according to a government report released Friday. Last year, that number was 9.6 million. (Margot Sanger-Katz, 2/3)

On February 3, 2017, the Centers for Medicare and Medicaid Services released its final snapshot of plan selections for the fourth Healthcare.gov open enrollment period, which ended on January 31, 2017. As of that date, 9,201,805 individuals had selected plans through Healthcare.gov in the 39 states that it serves. About 3 million of these were new consumers and 6.2 million were returning consumers. (Timothy Jost, 2/5)

One of the most fraught questions in Donald Trump’s Washington is how Republicans will reform health care. No aspect of the debate over ObamaCare presents as much risk, or opportunity, as what to do with the law’s expansion of Medicaid, which gave government health insurance to millions of Americans. It won’t be easy, but President Trump and Congress have an opportunity to control Medicaid costs, improve the health of enrollees—and also win bipartisan support. (Regina Herzlinger and Richard Boxer, 2/5)

There are only so many ways to cut Medicaid spending.You can reduce the number of people covered. You can reduce the benefit coverage. You can also pay less for those benefits and get doctors and hospitals to accept less in reimbursement. Or you can ask beneficiaries to pay more. (Aaron E. Carrol, 2/6)

At long last, Medicaid expansion is finally receiving a full hearing in the Legislature. And with the defeat of many expansion opponents in last year’s elections, there is a good chance a revenue-neutral bill could clear both chambers. (2/5)