Six years after ObamaCare was signed into law – and countless assurances later that the law is “working” – America’s major insurance companies are facing mounting losses and threatening to pull out of the exchanges, leaving customers facing higher costs and fewer options.

In the most recent example, Tennessee regulators are bowing to pressure to let insurers refile their 2017 rate requests, which could lead to steep hikes for customers. A state official acknowledged to The Tennessean they are “not alone” in letting companies seek bigger increases — as some insurers head for the exits.

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“If Hillary Clinton were able to institute a public option, I anticipate it would accelerate insurers’ exit from Obamacare exchanges, making it unlikely that exchanges would ever become profitable, as Medicare Advantage and Medicaid managed-care are. While those programs have bipartisan political support, Republican politicians are fully committed to opposing Obamacare exchanges.

However, a public option administered by the same contractors (subsidiaries of health insurers) which process Medicare claims would be a good business opportunity for insurers. So they should be quite happy to allow Obamacare beneficiaries to shift from risk-bearing plans to a government plan.”

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Aetna’s decision to abandon its ObamaCare expansion plans and rethink its participation altogether came as a surprise to many. It shouldn’t have. Everything that’s happened now was predicted by the law’s critics years ago.

Aetna CEO Mark Bertolini said that this was supposed to be a break-even year for its ObamaCare business. Instead, the company has already lost $200 million, which it expect that to hit $320 million before the year it out. He said the company was abandoning plans to expand into five other states and is reviewing whether to stay in the 15 states where Aetna (AET) current sells ObamaCare plans.

Aetna’s announcement follows UnitedHealth Group’s (UNH) decision to leave most ObamaCare markets, Humana’s (HUM) decision to drop out of some, Blue Cross Blue Shield’s announcement that it was quitting the individual market in Minnesota, and the failure of most of the 23 government-created insurance co-ops.

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It’s hard to exaggerate the alchemy of distortions that are turning ObamaCare into such a pending disaster that big insurers like Aetna, Anthem, Humana and UnitedHealth Group,once supporters, can’t cut back their participation fast enough.

ObamaCare was always going to be a questionable deal for taxpayers if the only people who signed up were poorer people whose premiums were largely paid by taxpayers. That was fine as far as insurers were concerned. They can make a profit even if taxpayers are the only ones paying.

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Humana is the latest health insurer to significantly pull back its participation selling subsidized individual coverage under the Affordable Care Act, announcing plans to scale back next year to “no more than 156 counties” across 11 states.

The decision means Humana will reduce its Obamacare geographic presence by nearly 1,200 counties from the 1,351 counties across 19 states where the insurer currently sells individual coverage on exchanges under the health law now. UnitedHealth Group is scaling back to three states and Aetna said this week it was evaluating its participation in 15 states and wouldn’t expand to new states next year.

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Hospital system Catholic Health Initiatives’ experiment with health insurance has hit the end of the road after a couple years of heavy losses. CHI is “exploring options to sell” its health plan subsidiary, executives said in new financial documents.

The documents, released this week to bondholders, explain that top CHI executives “decided to exit the health insurance business” in May after undergoing a strategic review in March. CHI’s consolidated insurance division, QualChoice Health, formerly known as Prominence Health, has hemorrhaged money since its inception. QualChoice sells Medicare Advantage plans and commercial plans to employers in six states.

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A network of clinics that serves low-income patients in rural Northern California is finally finding balance after being deluged with newly insured patients under the Affordable Care Act.

After a more than two-year moratorium on nearly all new adult patients, the Redding-based Shasta Community Health Center has reopened its doors to some newcomers this month, and it will start accepting more new patients in September.

When Medi-Cal, California’s version of Medicaid, was first expanded under the Affordable Care Act in early 2014, the number of people insured under the program doubled to around 40,000 people in the region served by Shasta Community Health. Not only did the clinics see new patients, but the demand for services soared from existing ones who were newly insured.

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Aetna became the latest health insurer to cast doubt upon its future in the Affordable Care Act’s insurance exchanges after it called off a planned expansion Tuesday and suggested it could abandon that market completely.

A departure by Aetna, the nations’ third-largest insurer, could further reduce the number of choices for customers and eventually push insurance prices higher. Competition by insurers is a key feature of the exchanges, designed to keep a lid on prices, but several insurers are abandoning them because they are losing enormous amounts of money.

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A company that offers health insurance plans in New Hampshire under the Affordable Care Act is suing the federal government over a part of the health care law.

The lawsuit from Minuteman Health aims to block the current form of the federal Risk Adjustment program, which aims to stabilize the health care market by spreading the costs that come from covering sicker people among insurers with healthier clients.

CEO Tom Policelli says what’s actually happened is that health care co-ops like Minuteman pay millions to their larger competitors that offer more expensive plans.

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Health insurers have been taking a financial beating for the ages on ObamaCare, but Aetna was always more bullish than the rest of the industry—until now. The entitlement’s keenest corporate patron announced Tuesday that it is cancelling its ObamaCare expansion plans for 2017 and may withdraw altogether.

Aetna posted fabulous second-quarter earnings, though the exception is its Affordable Care Act line of business that the company expects will lose more than $300 million this year. Aetna runs ObamaCare plans in 15 states and planned to join another five exchanges.

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