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In a welcome break from political stasis, Congress may be on the verge of passing important bipartisan legislation to fix the way Medicare pays doctors. A bill before the Senate this week, which the president is willing to sign, would shift toward paying based on how well doctors care for their patients, rather than on how much care they provide. The fix isn't perfect, but it's far better than most of us expected from a polarized Congress. Yet much of the commentary about the bill is very negative. Stranger still, it comes in the form of two contradictory arguments -- both wrong. (Peter R. Orszag, 4/14)

Tomorrow, the Senate will consider H.R. 2, a Medicare-reform bill that has already acquired a classic Beltway acronym, MACRA. Conservatives should give their full support: According to a report released last week, MACRA not only would pay for itself but would result in large net savings to the Medicare program over time, reducing unfunded liabilities and preventing massive new debt. (Ryan Ellis, 4/13)

The estimate of the legislation’s long-term impacts by Medicare’s chief actuary is sober reading. The legislation provides for a bonus pool that physicians can qualify for over the next 10 years but applies only in 2019 to 2024. The budgetary “out-years” provide for minimal increases in reimbursement rates. Beginning in 2026, physicians would receive a 0.75 percent annual increase if they participate in some alternative payment models or a 0.25 percent annual increase if they do not. Both are significantly lower than the normal rate of inflation. (Chris Jacobs, 4/13)

There are two major differences between this so-called “fix” and previous ones. The first one is real: Previous increases have been offset by cuts to other government spending, and this one is not. The second one is fiction: That this doc fix is a permanent solution to the fee problem. (John R. Graham, 4/14)

Early this summer the Supreme Court will render a decision on King v. Burwell, the case challenging the IRS workaround that allows ObamaCare subsidies to be paid through federal exchanges. Many on the right believe that if the justices rule against the administration, it would be the final stake in the heart of ObamaCare. Nothing could be further from the truth. ... Without an effective response from Republicans, there is little doubt that the crisis would allow President Obama to permanently cement ObamaCare in place. (Sen. Ron Johnson, R-Wis., 4/13)

One of the core purposes of the Affordable Care Act is to expand health care to people who previously lacked it, and today Gallup-Healthways released new numbers showing once again that the law is accomplishing this goal. But buried in the data is an indicator of a different kind of success: Republican resistance to the law at the level of states is also having a substantial impact by limiting the drop in percentages of uninsured people, keeping the uninsured rate higher than it might otherwise have been. (Greg Sargent, 4/13)

As the figure above shows quite incredibly clearly, since the implementation of the Affordable Care Act, the share of the uninsured has fallen sharply. As this Gallup-Healthways poll indicates, about 88 percent of adults are now covered, compared to about 82 percent at the peak uninsured rate before Obamacare kicked in. Moreover, the largest gains have accrued to the young, those with low incomes and Hispanics. For example, since late 2013, the share of the uninsured is down just two percentage points for those with incomes about $90,000 (most of whom already had coverage); for those with incomes below $36,000, it’s down nine percentage points. (Jared Berstein, 4/13)