ObamaCare’s impact on health costs.

Prices for medicine, doctor appointments and health insurance rose the most last month since 1984. The price increases come amid a broader debate about climbing health care costs and high premiums for Obamacare coverage.

A recent report by Kaiser/HRET Employer Health Benefits forecasts that the average family health care plan will cost $18,142, up 3.4% from 2015. That’s faster than wage growth in America.

Medical care costs altogether rose 1% just in August from July, according to the Consumer Price Index, a report on price inflation from the U.S. Labor Department.

Premiums on the Obamacare exchanges are expected to rise by double-digits this year.

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According to a recently-updated analysis conducted by the Kaiser Family Foundation of 14 major cities, the lowest-cost and second-lowest cost silver plans are expected to rise by a weighted average of 9% in 2017. But residents in some states are going to have it far worse. Through last weekend, insurers in a dozen states had their rate requests for 2017 finalized. Residents in the vast majority of the approved states are looking at double-digit percentage increases. As aggregated by ACASignUps.net, four of the first 12 states to finalize their rate requests for 2017 are looking at weighted increases of at least 30%.

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The Obama administration has repeatedly inferred that most people are fully subsidized under Obamacareand the big 2017 rate increases therefore don’t matter:

“Headline rate increases do not reflect what consumers actually pay,” Kathryn Martin, HHS’s acting assistant secretary for planning and evaluation, said in a statement. “Even in a scenario where all plans saw double-digit rate increases, the vast majority of consumers would continue to have affordable options.”

To be as precise as they are careful to be, they correctly claim that 85% of those buying on the exchanges are subsidized. But they also never mention that half the people who buy Obamcare individual health insurance–on and off the exchanges–don’t get a subsidy and take the full whack from all of the big rate increases and even higher deductibles. The middle class seems to be invisible to them.

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As the election enters the final two months, reporters have been speculating on an “October Surprise,” or perhaps a September one.

There are plenty of candidates, beginning with more Wikileaks about Hillary Clinton’s emails as Secretary of State. There is speculation about pay-to-play at the Clinton Foundation and what’s hiding in Donald Trump’s taxes.

What has received too little attention is the steady collapse of Obamacare and the impact that will have on insurance premiums, which will arrive just before Election Day. The Chicago Tribune called them “cardiac-arrest-inducing premium increases.”

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Floridians who buy their own health insurance in 2017 are likely to see their premiums rise by an average of 19 percent over the current year, according to an analysis released Friday by the state’s Office of Insurance Regulation.

The average increase calculated by the state applies to all health insurance plans sold in Florida next year that comply with the Affordable Care Act’s minimum coverage requirements, whether those plans are sold on the ACA exchange at HealthCare.gov or off of it.

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In the last few years, even though premiums in the Affordable Care Act’s health insurance marketplaces were rising, most customers could avoid a big price rise by shopping for a cheaper plan.

Next year, according to a preliminary analysis, that is going to be a lot harder.

Even someone who shopped wisely this year and is willing to switch plans to get the best deal next year is looking at an average premium increase of 11 percent, according to an analysis of rate filings in 18 states and the District of Columbia provided by the McKinsey Center for U.S. Health System Reform.

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The Affordable Care Act enrollment period doesn’t begin until November, but the recent departure of several health insurance providers from federal and state marketplaces is raising concerns of fewer choices and higher premiums.

But federal officials emphasized that consumers will still have affordable coverage options during a Wednesday conference call. Even if insurance premiums increase by 25 percent, 60 percent of Indiana consumers would be able to purchase coverage for less than $75 per month, according to a report from the U.S. Department of Health and Human Services.

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State insurance officials say they are feeling pressure to approve large ObamaCare premium increases to prevent more insurers losing money from dropping out of the market altogether.

Tennessee’s insurance commissioner, Julie Mix McPeak, this week announced the approval of premium hikes of 62 percent, 46 percent and 44 percent, respectively, for the three insurers on the state’s marketplace.

She said her department’s actuaries had found the rate increases to be justified.

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With the fourth open-enrollment period set to begin this fall for the marketplaces set up by the Affordable Care Act, it’s becoming clear that the market for health insurance has not evolved as expected, or hoped.

The market is smaller than projected. The people who have bought health plans overall are sicker than predicted. And health insurers have incurred larger losses than anticipated.

As a result, some large national insurance companies, including UnitedHealthcare, Humana and Aetna, plan to abandon markets across the country next year. And health insurers in Wisconsin are proposing the largest rate increases yet for health plans sold on the online marketplaces throughout the state.

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Increasingly, U.S. consumers may have fewer insurance options under Obamacare.

The latest evidence comes in a study from consulting firm Avalere Health, which examined areas, known as rating regions, that insurers use to set premiums and decide where to offer plans to individuals under the Affordable Care Act.

According to Avalere, 36 percent of the approximately 500 rating regions in the U.S. may have just one health insurer when the 2017 signup season starts on Nov. 1. Another 19 percent could have just two carriers. There was far more competition this year, with about two-thirds of rating areas having three or more health insurers vying for customers’ business, according to Avalere.

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