Bruce Shutan

Technical difficulties may have marred public exchanges' first year of operation, but at least providers were able to breathe a collective sigh of relief about not being inundated with a sharp increase in new or sick patients scheduling appointments.

While several reasons have been suggested for a plateau effect in public exchange enrollment, it may all come down to dollars and cents, as well as carrots and sticks.

While the U.S. Supreme Court ponders its decision in King v. Burwell, a senior economist at the nonprofit, nonpartisan RAND Corporation suggests that the time may have come to re-evaluate the tax-favored status of employer-provided health benefits coverage to offset the costs of lost subsidies, maintain budget neutrality and end a bifurcated system that favors the wealthy.

Sometimes what happens in Vegas doesn’t just stay on the Strip – it blows across the Sagebrush State like a wayward tumbleweed. Case in point: Nevada Health Link enrollees have been reporting mistakes on the 1095-A IRS forms to calculate their premium tax credit on the federally supported state-based HIX.

If there was a most-improved public HIX award, Maryland Health Connection certainly would be in the running for such an honor. Nearly twice as many state residents enrolled for 2015 in half as much time compared to the previous year.

While the Affordable Care Act bans pre-existing condition exclusions, cherry picking and higher premiums for sicker individuals, a 2014 federal discrimination complaint and new study suggest that some public exchange plans have jacked up certain prescription drug prices.

As many as 90,000 Sears employees are finding it easier to shop for health care, are savvier about their coverage choices and finally understand the meaning of value since the 129-year-old retailer switched to a private health insurance exchange three years ago.

One key consumer-operated and oriented plan based in the Midwest recently lost the battle for hearts, minds and pocketbooks along the highly competitive landscape of an emerging online marketplace when it was forced to liquidate, but does that spell doom for other CO-OPs?

The Multi-State Plan program created under the Affordable Care Act may actually lead to further consolidation of the health insurance industry rather than increase competition through the public exchanges.

Some of the nation’s most foremost authorities on health economics and policy learned a painful – and ironic – lesson about their respective area of expertise recently when they were forced to pay more for their health care in 2015.

The many tradeoffs that health insurers had to make from both a regulatory and plan-design standpoint in order to adapt under the Affordable Care Act appear to be paying off as the landmark legislation approaches its five-year mark.

Technology has clearly revolutionized health care – from mobile apps that help employees stay fit and eat right to telemedicine that brings operational efficiency to treatment. But perhaps most compelling is the way it is helping elevate the open-enrollment experience in keeping with the intended consumer-friendly spirit of the Affordable Care Act.

Former president Bill Clinton once conveyed messages of hope by referring to a small town by the same name, and the place of his birth, in Arkansas. Once again, hope springs eternal in the Natural State – this time for preserving and advancing a model that other conservative regions could emulate in crafting a viable political alternative to Medicaid expansion under the Affordable Care Act.

Another bullish forecast about private HIX growth estimates that the roughly 2.5 million current enrollees (excluding retirees) could triple in the coming year.

Two Republican-led states are to some extent placing pragmatism over politics when it comes to the HIX marketplace, though their respective solutions veer off in different directions.

Colorado’s health insurance exchange is under fire on a number of fronts, including an expanded audit passing the Senate and failed House attempt to disband the state-run HIX.

Some industry research has suggested that private exchanges will transform themselves into a clogged eight-lane freeway teeming with traffic within the next few years from a lonely country road less traveled today. But a recent published report argues that some of the nation’s top employers are now adopting a cautious approach.

Commentary: Re-enrolling in a health insurance plan isn't easy — even with advice from your broker, one Covered California participant finds.

The winter holidays weren’t so merry for CoOportunity Health, whose health plans were pulled in both the individual-market and SHOP exchanges in Iowa and Nebraska for 2015 as regulators review the startup’s financials.

While employers deal with ACA reporting requirements and communication campaigns that explain the public health insurance exchanges, some have turned to health care technology startups in hopes of elevating the open-enrollment experience for their employees.