During an interview with Fox News host Greta Van Susteren on Wednesday night, Republican National Committee (RNC) Chairman Reince Priebus made a rather bold prediction about President Obama’s second term, asserting that the president’s “brand” would suffer over the next four years as Americans come to grips with what Priebus paints as the dire consequences of health care reform.

Priebus was reacting to a just-released Congressional Budget Office (CBO) report with updated projections on the federal budget and Americans’ insurance coverage under Obamacare. The report reassessed the number of Americans who will no longer receive employer-sponsored health insurance as the health law takes effect, increasing it from 4 million to 7 million Americans. This led Priebus to forecast a slippery slope in which more and more Americans lose their health coverage, indelibly tainting Obamacare’s — and President Obama’s — public image:

PRIEBUS: I think over time people are going to see, over the next four years, that this is not going to be a new story, this is going to be — next year — another story is going to come out and instead of seven million people dropped off the health care rolls, you’ll find it’s going to be 14 million… And more people aren’t going to be able to keep the insurance that they were promised. Businesses are out there saying, wait a second, this is too expensive and so we’re not going to provide this to our employees, so what we’re going to do is drop the insurance, pay the fine and it’s cheaper, and people are going to be left out in the cold. We knew this was going to happen, and we said it’s going to happen, and I think over time the Obama brand — the next four years — the reality of what the truth is going to be under his signature program, which was Obamacare, is going to go down in flames and people aren’t going to like it.

Watch it:

But there isn’t actually any evidence supporting Priebus’s claim that the number of Americans losing employer-sponsored insurance will somehow double next year. As Wonkblog’s Sarah Kliff explained on Wednesday, the reason the CBO increased its projections of Americans who would lose employer-provided coverage is due to the recent “fiscal cliff” deal that set low income tax rates on those making less than $450,000. As Kliff noted, “providing health insurance as a tax-free form of income becomes less attractive when marginal tax rates are lower — and when a publicly-subsidized option becomes available.” Ironically, this problem would have been exacerbated even further if GOP leaders like Priebus and House Speaker John Boehner (R-OH) had gotten their way and codified lower tax rates for millionaires and billionaires.

And it’s misleading to equate Americans losing their employer-sponsored insurance with Americans losing any form of insurance — particularly since Americans who lose employer-sponsored coverage can still receive federal subsidies to help them purchase private insurance on the individual marketplace. Predictions of how many employers will drop coverage may also be overblown, as studies have shown that Obamacare only modestly increases large businesses’ health care costs while actually lowering costs for small businesses.

As part-time workers, the poor, and Americans with pre-existing and costly medical conditions learn more about the law’s substantial benefits for them, support for repealing Obamacare has plunged to an all-time low. In the meantime, however, it appears that reform critics will continue their misleading smear campaigns against the health care overhaul.

Michigan Gov. Rick Snyder (R) is set to announce his support for Obamacare’s optional expansion of the Medicaid program at a press conference on Wednesday afternoon. The announcement, which comes a day before the governor will address his budget priorities for the upcoming legislative session, will make Snyder the sixth Republican leader to agree to the health law’s Medicaid expansion.

Implementing this aspect of President Obama’s health reform law will be particularly impactful in Michigan, where an estimated 470,000 uninsured residents will gain health coverage. The health policy groups that provided Snyder’s office with research about expanding Medicaid — including the fact that the state could save up to $1 billion over the next decade by accepting the federal funding to increase their Medicaid rolls — are welcoming the governor’s decision:

Snyder’s support for Medicaid expansion “really is a big deal,” said Marianne Udow-Phillips, director of the Ann Arbor-based Center for Healthcare Research & Transformation, which provided research to the governor’s office. CHRT concluded Michigan would save more than $1 billion in the next ten years as the federal government picks up the cost for health care for those who currently are not covered by insurance.

Moreover, most primary care doctors reported to CHRT that they are able to accept new patients who now would have insurance, she said.

“What’s really powerful about this is that the governor did come at this from a very objective, analytical approach,” she said. “He looked at the facts, he pulled research from our center and … lots of people,” Udow-Phillips said. “I don’t want to say we’re surprised, but we’re very pleased that the facts did speak for themselves.”

The state’s Medicaid expansion will still have to be approved by Michigan’s legislature, where conservative opponents of Obamacare could present a roadblock. State-level resistance to health care reform has considerably slowed the implementation of the Affordable Care Act — but, as Snyder joins the growing list of Republican leaders who are conceding that implementing Obamacare makes sense for their constituents, the tide may be about to turn.

Obamacare has already begun making big changes to the way that insurers and hospitals do business — and now, it’s changing the very way that medical schools train doctors. As Modern Healthcare reports, medical colleges are expanding programs to teach doctors how to coordinate care with other health care workers, focus on patients’ comprehensive, long-term care, and encouraging more general practitioners and primary care providers in anticipation of a changing medical landscape under Obamacare.

One of the most significant ways that Obamacare hopes to transform the American medical industry is by shifting it from an expensive system of private practices to a coordinated care model in which hospitals, nurses, general practitioners, and physicians work together to provide centralized and patient-focused care — what some in the industry refer to as a “medical home” — to lower costs and improve health outcomes. But this strategy’s success depends entirely on a medical workforce that understands how to coordinate care and work in teams — and medical colleges understand that:

Those trends [towards group practices] are gathering speed under Obamacare as government spurs the creation of new health care models like medical homes and accountable-care organizations, which make doctors responsible for soup-to-nuts care and patients’ health over the long term.

Schools like Weill Cornell are teaching would-be doctors how to work more effectively with other health professionals so that they may lead the changes rather than get swept up in them. They are putting a heavy premium on teamwork among doctors, nurses, nurse practitioners, social workers, health aides and physician assistants. Doctors prescribe the medicine, but it may be the nurse, the social worker or the home health aide who makes sure it gets taken. [...]

“If care is to be transformed, that can’t happen unless we transform the process of training physicians,” said Carol Aschenbrener, chief medical education officer of the American Association of Medical Colleges.

Teaching hospitals such as NYU Langone are also expanding programs for alternative degrees in public health and hospital administration in an effort to get ahead of the coordinated care curve. Weill Cornell has programs that offer students financial incentives to go into primary care, as well as classes that train doctors to get used to following patients’ treatment regimens and care over the long-term.

That’s especially good news considering the primary doctor shortage that America is potentially facing, and in light of the fact that wasteful Medicare spending is largely spurred by patients not following their treatment regimens. Coordinated, bundled care that streamlines the fragmented health care system will simplify Americans’ care and help them properly follow their treatments, lead healthier lifestyles, and thereby lower health care spending.

Taken together, recent changes in medical school training curricula are very promising for the future of American health care, and a stark reminder that Obamacare doesn’t just aim to reform private insurance — it also contains bold ideas for reforming the very way that health care is delivered in America.

According to a just-released study by the Commonwealth Fund and Georgetown University, most states are woefully behind in implementing even the most basic Obamacare consumer protections.

The report finds that “only 11 states and the District of Columbia have passed rules needed to implement the law.” That means the other 39 states — which constitute an overwhelming majority of the American population — find themselves playing catch-up when it comes to enacting Obamacare’s core regulations, including provisions that prevent insurance companies from denying coverage to Americans with pre-existing conditions and charging outsized premiums to elderly Americans.

It isn’t all bad news, as the study focuses on individual state efforts to change their insurance regulation rules — the federal government can still step in to enforce the measures in lieu of state action. And state insurance regulators that notice “problems in those areas – either through a review of insurer filings or through complaints from consumers – could contact insurers directly and ask that they fix the problems, or could notify the federal government, which can seek penalties against insurers that violate the health law.”

Still, the report’s findings illustrate the complexity of implementing the massive health care overhaul, which leaves a considerable amount of deference to unpredictable state governments. So far, as many as 30 GOP-led states have refused to implement Obamacare’s Medicaid expansion to help low-income Americans, and about half of U.S. states have refused to establish their own insurance marketplaces. And with 2014 fast approaching — and with it, full Obamacare implementation — many Americans may find their states unprepared for the impending changes.

Oklahoma Gov. Marry Fallin (R) has refused to accept Obamacare’s optional expansion of the Medicaid program, denying an estimated 130,000 of her low-income constituents access to health care. And the direct impact of the GOP governor’s decision is evident even within her own extended family.

Fallin’s aunt, 85-year-old Dorthea Copeland, runs a free health clinic in Pottawatomie County, an area of Oklahoma that has an 18 percent poverty rate and a 28 percent uninsurance rate. Copeland’s clinic provides care for the Oklahomans who fall into the coverage gap between earning too little to be able to purchase private insurance and earning too much to qualify for Medicaid assistance — the same group of people who stand to gain coverage under Obamacare’s expansion of the public program.

But since Copeland’s niece has refused to raise the Medicaid program’s eligibility level, the clinic is currently overloaded with low-income patients who don’t currently qualify for government assistance. As Oklahoma Watch reports, Copeland’s volunteer staff — who served over 850 patients last year — are now struggling to keep up with the increasing demand for health services:

On any given Thursday evening, about 20 people pitch in. But it’s not quite enough to keep up with rising demand. On this night, five people will be told they’ll need to wait at least a week to see a doctor.

“It’s getting worse all the time,” says Ty Johnson, who shows up every week to handle patient intake. She bustles about the crowded clinic with a clipboard, calling out names and handing out paperwork. “We’re getting more and more people.”

Not everyone makes the cut. To qualify, patients must be Pottawatomie County residents, must have no other form of insurance coverage and must fall below income caps that are considerably lower than those contained in the Obama expansion plan.

“There is just more need than we can handle,” says Stephanie Scrutchins, who determines eligibility.

Under Oklahoma’s current law, families can’t get Medicaid coverage unless they have dependent children and their annual income falls below $6,996 for a family of four — one of the lowest eligibility thresholds in the nation. The health law seeks to expand the program to include families of four earning up to $30,656 each year. But Fallin says it would be too costly to add additional low-income residents to her state’s Medicaid rolls, despite the fact that outside reports estimate expanding Medicaid would actually save Oklahoma nearly $48 million per year.

When Oklahoma Watch asked Copeland what she thought about her niece’s decision to reject the Medicaid expansion, she didn’t comment. “You know, I don’t get into politics,” she said. “I just run my little business here. Hopefully, we’ll do all that we can for the people that come in. Right now I’m looking at all the returns I’ve got for next Thursday night, wondering how in the world we’ll get them done.”

The verdict is in: Americans don’t just support Obamacare — they consider implementing its central tenets a “top priority” for their state legislatures.

A new Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health poll finds that strong majorities of Americans consider implementing Obamacare’s statewide insurance exchanges and Medicaid expansion either a “top” or “important” priority for their state:

Americans increasingly embrace Obamacare as it is implemented. Although public sentiment on the landmark reform law was ambivalent as it was being debated in Congress, Americans have consistently supported its individual provisions, and support for fully repealing the law plunged to an all-time low after the presidential election. And House Republicans can’t find any co-sponsors for their latest Obamacare repeal bills now that the president is beginning his second term.

But GOP governors don’t seem to have gotten the memo. Only four Republican governors have expressed support for expanding their states’ Medicaid programs, while the vast majority — including those representing some of America’s poorest and least-insured states — have refused to participate in the expansion, despite the fact that expanding Medicaid will actually save states billions of dollars. The outlook for the Obamacare insurance exchanges is also grim, with as many as half of U.S. states refusing to set up their own exchanges, deferring instead to the federal government.

Even though President Obama will be inaugurated for his second term on Monday, GOP lawmakers across the country are still in denial about the fact that Obama’s re-election secured the future of his landmark health reform law. Republicans have been digging in their heels against reform, allowing deadlines to come and go without making any progress toward implementing the Affordable Care Act in their states.

But even in states led by GOP politicians who remain resistant to health reform, like Virginia’s Gov. Bob McDonnell (R), some Republican officials are taking matters into their own hands to prepare for Obamacare’s implementation. As the Huffington Post reports, Virginia Republicans — including some members of the governor’s own administration — are working behind the scenes to plan a health exchange, despite Gov. Bob McDonnell’s resistance to reform:

McDonnell surprised no one when he decided last month Virginia wouldn’t create a health insurance exchange under Obamacare. The trouble, though, is that health care reform is coming to the state and its residents whether Virginia’s Republican politicians want it or not. It’s a reality Republican opponents of Obama’s health care law are facing across the country.

That’s why the McDonnell administration and some GOP legislators are working behind the scenes to get ready, as the Richmond Times-Dispatch reported Wednesday.

Against McDonnell’s stated position that the federal government should do all the work to set up and maintain a health insurance exchange, the Richmond Times-Dispatch reported some Republican legislators are pushing for the state to work in partnership with federal authorities, an option seven other states including neighboring West Virginia and North Carolina already have chosen. Twenty-five states, including Virginia, will have a federally operated exchange while 17 states and the District of Columbia will run their own. Mississippi’s case is still up in the air.

Virginia isn’t alone. Even before the presidential election, conservative officials in states like Mississippi, Kansas, and Arizona were working under the radar to quietly prepare their states for the inevitable wave of health care reforms. Those Republican lawmakers have begun to clash with the other members of their party because they realize that resisting Obamacare may not be in their best interests anymore — particularly when it comes to setting up exchanges, which the federal government will simply step in and do for the states that refuse to do it themselves.

Four public colleges and universities — Florida’s Palm Beach State College, Pennsylvania’s Community College of Allegheny County, Ohio’s Youngstown State University, and New Jersey’s Kean University — are planning to move adjunct and “contingent” faculty members to part-time status in order to avoid an Obamacare provision requiring businesses with 50 or more full-time employees to provide health coverage for at least 95 percent of their workers.

Advocates such as Gwen Bradley, a representative of the American Association of University Professors, warn that the colleges’ intent to cut hours to avoid extending benefits presents a concerning trend that will harm workers who do not enjoy broad benefits or salaries to begin with:

“Adjuncts are very precarious anyway,” said Bradley. “They usually have very low wages, and are often already below the thresholds for health care. But for those people who have it, being cut down to lose it is very devastating.”

Only contingent faculty—as opposed to full-time, tenure-track faculty—would be affected by the change in policy. Since the Affordable Care Act requires that employers provide health care to any employee who works 30 hours per week or more, universities like Palm Beach State College have opted to cap the time that contingent faculty are allowed to work at just below the 30-hour benchmark.

“It’s about having their course load reduced so they’re teaching less and having less paid for their salaries,” said Craig Smith, the director of the American Federation of Teacher’s higher education division. For many contingent faculty members, “it’s not like they were receiving health care in the first place.”

The IRS released new regulations last week to make it harder for employers to circumvent Obamacare and deny their employees heath insurance. One rule stipulates that “employers could still fall under the mandate if they employ enough part-time workers to equal 50 full-time workers,” which would force employers to make draconian, self-defeating cuts to workers’ hours in order to game the system. As the AFT’s Smith puts it, employers who pursue such extreme hour cuts are “just using the Affordable Care Act as an excuse.”

The planned move by the four colleges comes on the heels of similar actions by several restaurant chains, including Olive Garden, Red Lobster, Papa John’s, and isolated Wendy’s and Taco Bell franchises. Olive Garden and Red Lobster chains faced particularly harsh public backlash and falling profits in the wake of their decisions.

ThinkProgress has previously reported that a massive contributor to America’s annual $2.7 trillion health care expenditures is the staggering 50 percent of Americans who simply do not take their prescribed medications properly.

Now, Wonk Blog’s Sarah Kliff is reporting that corporate pharmacy giant Walgreens wants to start bucking that trend by forming “accountable care organizations” (ACOs) in conjunction with local physicians and hospitals. ACOs are coordinated care systems that are paid on the basis of their performance. If an ACO successfully provides Medicare beneficiaries with quality care while keeping costs under a year-to-year target, it is rewarded with higher Medicare reimbursements from the government by netting the savings — but if it goes over the annual target, it has to swallow the losses.

Although most ACO applications so far have been partnerships between more specialized health care providers, more convenient access to local pharmacies might make them effective venues for managing and tracking Americans’ treatments after their hospital visits:

While a pharmacy-run ACO is not the traditional model, [Walgreens' Senior Vice President Jeffrey Kang] argues it actually makes a lot of sense. Pharmacy stores are open every day of the year, making them a more accessible point of contact than most doctor offices. They have begun to handle basic health care, like vaccination and preventive check-ups, right in the store, which could prevent more costly diseases down the line.

Health care research shows that unnecessary hospital readmissions are often caused by a patient not following the prescribed medical regiment after discharge, creating another place where pharmacists could easily intervene. [...]

“The way I like to describe it is as a physician-led plan where we’re an active partner,” Kang says. “They’re the quarterback who creates the treatment plan. We can be care extenders who help implement and execute the plan.”

In order to make that active partnership work, Walgreens is working to become better integrated with its partner health care systems. While both the pharmacies and doctors, for example, already have electronic medical records, they now need to ensure that each system can interface, allowing all health care providers to track a given patients’ care.

Walgreens’ decision to venture into the coordinated care market underscores the broad innovative potential of Obamacare provisions such as ACOs. Centering medical treatment followups in pharmacies could go a long way towards making sure that Americans stay on their treatment regimens, thus reducing sickness, deaths, and costly hospital re-admissions.

However, lawmakers should make sure that pharmacies that provide more extensive services have the proper oversight, so as not to fall into the same pitfalls as laxly regulated compounding pharmacies in the wake of last year’s deadly meningitis outbreak.

Many Obamacare provisions are intended to protect Americans from the private insurance industry, such as measures to prevent insurers from denying coverage to Americans with pre-existing conditions and to keep rising insurance premium rates in check. Nevertheless, as the New York Times reports, some of America’s largest insurers are exploiting a lack of stringent oversight in Obamacare to hike their premiums by double-digits anyway.

Insurers like Aetna and Anthem Blue Cross are requesting rate hikes as steep as 26 percent — amounting to hundreds of dollars that Americans will be forced to pay in higher premiums every month — in states such as California and Florida, and there is little that states can currently do to stop them:

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.

While Mr. Jones has not yet weighed in on the insurers’ most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.

While Obamacare does require state regulators to review any rate increase request above 10 percent, it does not endow those regulators with any meaningful veto power. Such rate-setting policies are left to states’ discretion, and although 37 states may currently negotiate or reject insurers’ desired hikes, some states with large markets — such as California — do not have this ability.

Large insurers claim that the hikes are necessary in order to keep up with general medical inflation. But since medical inflation has actually been relatively low in recent years, this claim falls flat. Insurers may actually be raising their rates in an attempt to counteract other Obamacare consumer protection measures such as the “80/20 rule” that requires insurance companies to spend at least 80 percent of the premiums they charge on actual care rather than their profits or overhead. In 2014, Obamacare will also end the practice of medical “underwriting” — taking a consumer’s current health into consideration when setting his or her premium rates — so insurance companies may be trying to lock in higher rates on sicker Americans while they still can.

Fortunately, the 80/20 rule — which has already put over $1.5 billion in insurance rebates back in consumers’ pockets — will help ensure that Americans are refunded some of their money if the latest round of rate hikes are excessive. But the only way to ensure that Americans are not held hostage to the whims of private insurers is to expand state regulators’ ability to negotiate and control premium rates.

And lawmakers are quite aware of the discrepancy. Three years ago, Sen. Dianne Feinstein (D-CA) introduced the Health Insurance Rate Authority Act of 2010 in an effort to give regulators more control over insurance rate hikes, but the bill died in committee. President Obama has also called for greater federal oversight of insurance rates.