The main objective of the Affordable Care Act (ACA) was to increase enrollment in health insurance among those who were previously uninsured. Official estimates from the Census Bureau have consistently overstated the number of people who are uninsured. A major factor in the overestimate is the undercount of people in Medicaid. Also, millions of Americans have been officially uninsured despite their eligibility for public insurance or employer coverage. With the passage of the ACA, fewer than 10 percent of the remaining uninsured do not have a realistic path to securing health insurance. The future of the ACA is now uncertain, but any future policy changes will likely need to provide a sure path to insurance coverage for all Americans as well.

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President Obama promised that the Affordable Care Act would increase competition and choice in insurance markets. In a 2009 speech to a joint session of Congress, for example, the president said, “Individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers.” This claim, along with many othersmade by ACA supporters, have proven to be wrong. In fact, Americans have far fewer choices for individual market coverage today than they had before the ACA took effect and there is a rapidly declining number of insurers now offering coverage in the ACA exchanges.

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When Illinois’ Obamacare co-op went belly-up last month, Valerie Kincaid faced losing not just her insurance but her team of cancer doctors, too.

For six years, the 41-year-old leukemia patient has relied on doctors at Northwestern Memorial Hospital in downtown Chicago to keep her disease at bay. Once a month, she visits the hospital to receive an oral therapy that keeps her chronic lymphocytic leukemia under control and allows her to live a relatively normal life with her husband, Brian, and her 11- and 13-year-old sons.

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Less than half of the approximately 27 million uninsured people in the U.S. are eligible for federal financial assistance, an analysis released Tuesday by the Kaiser Family Foundation shows.

Roughly 11.7 million, or 43 percent of that population, are not taking advantage of some sort of federal assistance to get health insurance that they are eligible for, according to the analysis. That assistant may be in the form of a subsidy to purchase a policy on the Affordable Care Act exchange or a Medicaid plan a consumer is eligible for but not signed up for.

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When the Affordable Care Act was signed into law in 2010, it promised to extend health insurance to tens of millions of people. And although the law has helped push the U.S. uninsured rate down to a record low, the ACA’s new insurance markets are proving to be volatile, with insurers recording big losses and pulling out. Meanwhile, there are still millions of people without health insurance.

One key to stabilizing the law is drawing in more of those who are uninsured, particularly the younger, healthier ones. In fact, young people are the most likely to go uninsured, according to a detailed analysis by the Kaiser Family Foundation. The analysis shows that those who lack insurance cut across age and income and vary from state to state. Taking a look at who these people are can give clues to how the health law is falling short, and what can be done to fix it.

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The Affordable Care Act (ACA) extends health insurance coverage to people who lack access to an affordable coverage option. Under the ACA, as of 2014, Medicaid coverage is extended to poor and near poor adults in states that have opted to expand eligibility, and tax credits are available for low and middle-income people who purchase coverage through a health insurance Marketplace. Millions of people have enrolled in these new coverage options, and the uninsured rate has dropped to the lowest level ever recorded. However, millions of others are still uninsured. Some remain ineligible for coverage, and others may be unaware of the availability of new coverage options or still find coverage unaffordable even with financial assistance.

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Doctor and hospital switching has become a recurring scramble as consumers on the individual market find it difficult or impossible to stay on their same plans amid rising premiums and a revolving door of carriers willing to sell policies. “In 2017, just because of all the carrier exits, there are going to be more people making involuntary changes,” said Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation, a New Jersey philanthropy. “I would imagine all things being equal, more people are going to be disappointed this year versus last year.”

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Blue Cross and Blue Shield of Illinois will be the only insurer offering PPO health insurance plans on the state’s Obamacare exchange next year, according to information released Friday by the state Department of Insurance.

That’s down from five insurers that offered individual PPO plans on the exchange this year. Many consumers prefer PPO health plans because, unlike HMO plans, they allow patients to see specialist doctors without a referral and see physicians who are out-of-network, albeit at higher costs.

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More than 250,000 people in North Carolina are losing the health plans they bought under the Affordable Care Act because two of the three insurers are dropping out — a stark example of the disruption roiling marketplaces in many parts of the country.

The defections mean that almost all of the state, from the Blue Ridge to the Outer Banks, will have just one insurer selling ACA policies when the exchanges open again for business in November. The remaining company, Blue Cross Blue Shield of North Carolina, agonized over whether to leave, too. Instead, it is raising its rates by nearly 25 percent.

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A growing number of people in Obamacare are finding out their health insurance plans will disappear from the program next year, forcing them to find new coverage even as options shrink and prices rise.

At least 1.4 million people in 32 states will lose the Obamacare plan they have now, according to state officials contacted by Bloomberg. That’s largely caused by Aetna Inc., UnitedHealth Group Inc. and some state or regional insurers quitting the law’s marketsfor individual coverage.

Sign-ups for Obamacare coverage begin next month. Fallout from the quitting insurers has emerged as the latest threat to the law, which is also a major focal point in the U.S. presidential election.

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