With the private option now on the table, Kaiser Health News reported that Medicaid expansion is gaining more traction in Utah and other Republican-led states such as New Hampshire, Florida, and Pennsylvania. Arkansas, however, may be poised to go in the opposite direction: The state legislature is locked in a fight over whether to defund its own recent expansion.

The Supreme Court extended an injunction for a Denver-based Catholic charity, Little Sisters of the Poor Home for the Aged. The court decision temporarily exempts the nonprofit from several requirements of the ACA.

Website Blunders Abating?

After the healthcare.gov website’s botched rollout last November, the federal government received dismal approval ratings on its performance in several public polls. But after a much-publicized scramble to fix the main health insurance portal, media reports suggested that its performance has improved markedly. Polling numbers are trending upward, and a security scare over potential hacking turned out to be a false alarm.

Will it be enough to make up for lost ground? Despite a recent surge, most analysts doubt whether the government can meet its initial goal of 7 million new enrollees by the end of March. On Feb. 25, President Obama announced that more than 4 million people have signed up for health care through ACA marketplaces. A recent “Avalere Health 2014 Industry Outlook” report, however, suggests that despite rapidly accelerating enrollment, the final tally may reach only about 5 million. Nor have the missteps ended entirely: The website was down for maintenance on National Youth Enrollment Day.

And after so much attention on the federal site, however, the spotlight is being trained more harshly on some of the 14 highly uneven state-run exchanges. States like California and Washington are posting encouraging enrollment numbers. Others have been far less fortunate. The state-run exchanges in Oregon and Maryland are so troubled that officials there are considering switching to the federal health care exchange next year.

Political Duel Continues over Health Care Reform

Both Democrats and Republicans are honing their health care reform talking points and tactics in the run-up to midterm elections later this year. In his defense of the ACA during January’s State of the Union address, President Barack Obama signaled his intent to more aggressively paint Republicans as obstructionists by challenging them to specify a viable alternative instead of repeatedly calling for a full repeal. “I know that the American people are not interested in refighting old battles,” he said.