The bad news is that many of the health care law’s serious effects were delayed until after the election. Ten of its 18 new tax hikes have yet to kick in. And there is still so much about the law that we don’t even know.

Former House Speaker Nancy Pelosi (D–CA) was absolutely right when she famously remarked in 2010 that “we have to pass the bill so that you can find out what is in it.” Thus far, we have seen revelations of increasing costs, higher taxes, and a flood of directives from Washington bureaucrats—yet there are countless major features of the law that have not been decided.

Just a few of the questions that remain: What will a qualified health plan look like? What will be in the essential benefits package that insurers are required to provide? How will the employer and individual mandates to purchase insurance be implemented? The list goes on.

Thankfully, this isn’t the end of the story. Obamacare is not here to stay. Despite the 2012 election, the assumption that the health care law will stay on course is another example of the left’s wishful thinking. Of course, efforts for a complete repeal will likely face the same fate as efforts in the last Congress did. But there are ample reasons, as well as opportunities, to change the course of this law.

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“Anyone who actually read, or even skimmed, the CBO [Congressional Budget Office] report knows that it found that [Obamacare] would reduce, not increase, the deficit,” wrote liberal economist Paul Krugman (referencing an outdated CBO analysis), “because the insurance subsidies were fully paid for.”

As usual, however, Krugman missed the more fundamental point underlying Ferguson’s argument: It’s Obamacare’s spending that matters.

In government budgeting, spending comes first; it drives all other fiscal consequences. Spending is how government programs and agencies do what they do. “In a fundamental sense, the federal government is what it spends,” says longtime budget expert Allen Schick.

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Once again, Congress is scrambling to stop a scheduled 27 percent payment cut to physicians who serve Medicare patients. This frequent exercise serves as a perfect example for the need to move Medicare away from its current price control model toward a market-based, premium support model. Congress should take immediate action to link any “fix” with structural Medicare policy reforms.

The “Sustainable Growth Rate” (SGR) is in no way a sustainable long-term solution for Medicare. This complex government formula sets payments to physicians for providing Medicare services. When enacted as part of the Balanced Budget Act of 1997, these cuts (on paper) were designed to help Congress meet its balanced budget targets—but the cuts turned out to be temporary.  (Read the rest on The Foundry…)

Today, the Sixth Circuit Court of Appeals issued a decision upholding Obamacare against a constitutional challenge. While this is disappointing, there are several reasons to believe that this flawed decision is not predictive of how the Supreme Court will rule.

In recent years, the Sixth Circuit has achieved a growing reputation for not just reversals, but summary reversals at the Supreme Court. In a summary reversal, the Supreme Court unanimously reverses a lower court decision without hearing argument or even having a full merits briefing—because the decision is so clearly wrong. It is a sure sign of an activist court misapplying the law.

Among the liberal judges who have helped the Sixth Circuit achieve this less-than-stellar reputation is Boyce Martin. When he was the chief judge, he infamously manipulated the panel of an affirmative action case to make sure liberals outnumbered conservatives. He also shifted the timing of the review of an en banc case—he waited until conservative judges had left the court to circulate the petition, so that they would not be on the panel to hear the case. Martin is the author of today’s unfortunate opinion.

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Writing for The Heritage Foundation, Rita Numerof, Ph.D., explains:

ACOs are merely the latest in a long history of health policy ‘silver bullets.’ Since the 1970s, Congress and successive Administrations have promoted a number of mechanisms to control rising health care costs, including the introduction of Medicare hospital payment formulas based on fixed payments for hospital services (payments for diagnostic related groups of services, or DRGs), as well as health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Costs have continued to rise despite these efforts. At the same time, concerns about fragmentation of care and diminished quality have increased significantly.” (Read the rest at The Foundry…)