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Andy Kim decided to run against House Republican Tom MacArthur last year as he watched TV coverage of GOP efforts to repeal Obamacare while waiting in a hospital room for news on his unborn son. Kim was sparked by MacArthur’s amendment that would have let insurers charge more for patients with pre-existing conditions and his central role in helping the repeal pass the House. An ultrasound had just shown that Kim’s son was dramatically underweight, and he wondered "if my baby boy is going to have a problem for the rest of his life." (John, 4/6)

The Council of Economic Advisers was established by law in 1946 to provide presidents with objective economic advice. Naturally, as an arm of the White House, the analyses produced under each administration tend provide economic justification for a president’s policies. But they are supposed to be grounded in facts. Thus The Fact Checker was surprised to come across a three-page report issued by the CEA in March, just as lawmakers were deciding whether to add money to the omnibus spending bill to temporarily restore cost-sharing reduction (CSR) subsidies. (Kessler, 4/6)

The Obamacare markets are proving surprisingly resilient, but experts say the latest federal enrollment numbers suggest they are increasingly becoming a destination for just highly subsidized and sick customers. Despite huge rate hikes and GOP efforts to dismantle the law, enrollment dropped just 3 percent this year, with 11.8 million individuals signing up for coverage nationwide, according to the final open enrollment report released this week by CMS. (Demko, 4/5)

Insurers dealing with the death of the Affordable Care Act's cost-sharing reduction payments may hit a stumbling block: the law's method for dealing with risk adjustment. The calculation is supposed to help carriers that bear a higher share of risk in the individual market by having those that shoulder less risk make payments to offset costs. It is a formula that has been problematic since the start for smaller plans in particular, but actuaries are on the alert that it could cause more headaches to come. (Luthi, 4/5)

Maryland Gov. Larry Hogan signed measures on Thursday to help stabilize health insurance rates in the Maryland Health Care Exchange’s distressed individual market. Hogan signed measures to create what’s known as a reinsurance program, which protects insurers against very high claims. The exchange’s board will need to apply for a federal waiver to create the program. (Columbus, 4/5)

The legislation creates a reinsurance program that will be run by the state’s Health Benefits Exchange to protect insurers against catastrophically expensive claims. To do so, health insurers will pay $380 million in taxes over the next year to help contain surging premiums for 150,000 Maryland residents. Many insurers saw it as a reasonable price to pay to prevent a market collapse. (Dresser, 4/5)