ObamaCare’s impact on health costs.

As open enrollment starts Tuesday on the Affordable Care Act exchanges, consumers in some parts of the country are bracing for huge rate hikes, while many others are preparing to change insurers and likely doctors.

The crazy quilt of 2017 changes is creating angst among both supporters of the law and consumers under 65 who don’t get their insurance through work. And it comes as enrollment needs a big boost, especially of younger, healthier people to help offset insurers’ costs of covering the sicker people who have signed up so far.

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The cost of health insurance in the Obamacare exchanges is set to rise significantly in 2017. Here in Missouri, premiums are rising by over twenty points on average. But for the Show-Me State, that average rate increase only tells part of the story.

For one, the high cost of Obamacare-approved insurance plans isn’t hitting customers uniformly across the state; indeed, rural customers are far more likely to be charged more for health insurance than their urban peers, even within an “Affordable Care Act” marketplace.

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The 25 percent increase in Obamacare premiums for 2017 announced on October 24 is eye-popping.  That is five times the increase that workers are likely to see in the cost of health benefits offered by employers.  Politically, this is a disaster.

However, the jump in premiums is overdue.  Insurers in the exchange market have found that the cost of providing coverage is much higher than they initially projected.  We expect insurers to offer coverage to everyone, regardless of their health condition.  That’s good social policy, but it is expensive.

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Obamacare customers are acting more cost-conscious than other people with insurance — and it could be affecting their health.

A new survey finds that 50 percent of people who buy health plans through government-run Obamacare marketplaces say they cut back on getting health care services as they try to manage costs.

That can include not going to the doctor as often when they’re sick, skipping preventative care visits and lab tests, and delaying elective surgeries.

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Americans in the health insurance markets created by President Barack Obama’s law will have less choice next year than any time since the program started, a new county-level analysis for The Associated Press has found.

The analysis by AP and consulting firm Avalere Health found that about one-third of U.S. counties will have only one health marketplace insurer next year. That’s more than 1,000 counties in 26 states – roughly double the number of counties in 2014, the first year of coverage through the program.

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On Tuesday the Internal Revenue Service (IRS) announced some tax benefits will increase in 2017 in order to adjust for inflation. According to the IRS the standard deduction for married couples in 2017 will be $12,700, up from $12,600, and both the earned income tax credit and the amount exempt from the estate tax will also see slight increases. The top individual tax rate will apply to those making $418,400 or more as opposed to $415,050 or more in 2016.

Yesterday the American Action Forum released an analysis of Donald Trump’s proposal to cut 70 to 80 percent of U.S. Regulations. The analysis finds that in order to achieve this goal, between $700 and $800 billion in regulatory costs would need to be cut. The analysis further shows that it would likely take a generation in order to accomplish this goal.

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The architects of the Affordable Care Act thought they had a blunt instrument to force people—even young and healthy ones—to buy insurance through the law’s online marketplaces: a tax penalty for those who remain uninsured. The full weight of the penalty will not be felt until April, when those who have avoided buying insurance will face penalties of around $700 a person or more. But for the young and healthy who are badly needed to make the exchanges work, it is sometimes cheaper to pay the Internal Revenue Service than an insurance company charging large premiums, with huge deductibles. The IRS says that 8.1 million returns included penalty payments for people who went without insurance in 2014, the first year in which most people were required to have coverage.

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Skyrocketing premium increases on the Obamacare exchanges for 2017 were announced Monday afternoon by the Department of Health and Human Services, averaging nearly 25% across 38 federal exchange states. More than 70% of consumers in states using the federal exchange will be able to find a premium that is less than $75 a month once financial assistance is factored in, according to the HHS report. That’s because 85% of enrollees in the Obamacare exchanges receive subsidies to offset the cost of the premium increases. But someone has to make up the difference, and it is, of course, middle-income taxpayers. Douglas Holtz-Eakin, former director of the Congressional Budget Office and current president of the American Action Forum, estimates that taxpayers will fork over $32 billion in ACA subsidies this year and up to $50 billion next year.

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Obamacare enrollees will face varying rate hikes depending on which state they live in. Insurers in some states had underpriced their products in the first few years of the marketplaces set up under President Obama’s health care law and now are trying to make up for their losses with big cost increases. The highest AVERAGE premium increases are in Arizona, 116%; Oklahoma, 69%; Tennessee, 63%; and Minnesota, 59%. Millions of people in other states will find premiums for their current plans spiking at least as high.

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The 3.5 million uninsured people that the administration hopes will sign up for Obamacare this year generally worry about cost and may lack knowledge about the marketplace, according to analysts and advocates.

The Affordable Care Act has put the nation’s uninsured rate to a historic low, but there are still roughly 24 million uninsured people in the United States. Of that group, the Department of Health and Human Services estimates that 10.7 million will be eligible for financial assistance this year. Officials expect about one-third of that group to sign up for an Obamacare plan during the three-month open enrollment period beginning Nov. 1.

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