Substantially more health plans on the federal insurance marketplaces require consumers next year to pay a hefty portion of the cost of the most expensive drugs, changes that analysts say are intended to deter persistently ill patients from choosing their policies. The class of medicines known as specialty drugs treat chronic illnesses such as multiple sclerosis, rheumatoid arthritis, HIV, hemophilia, some cancers, and hepatitis C. Some medicines can cost $10,000 a month. Even a small cost-sharing requirement means patients could have to come up with thousands of dollars to get the medicines.

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Oscar Insurance Corp., the Silicon Valley-backed health-care startup, continued to lose tens of millions of dollars in the third quarter as the company exits some markets and works to diversify away from of its Obamacare business.

The New York-based company sells health insurance to individuals in new markets set up by the Affordable Care Act. Its attempt to reinvent the insurance business has been marked by large losses — in the third quarter, closely held Oscar lost $45 million in New York, Texas and California, according to filings with regulators. That follows losses of $83 million in those states during the first six months of this year.

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Obamacare architect Jonathan Gruber told CNN’s Carol Costello on Monday that it is not possible to just “get rid of the parts” of the health care law that people do not like because that was tried and “premiums went through the roof.”

Costello interviewed Gruber on her show and asked how Americans’ health care premiums would be affected if President-elect Donald Trump repealed parts of the Affordable Care Act that are unpopular after taking office.

“So, let’s say he keeps the parts of the law that people really like,” Costello said. “What would that do to all of our premiums? If he could keep all of the elements that you say that Congress might reject.”

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The White House is urging people to sign up for coverage through ObamaCare, hours after the Republican electoral sweep that likely dooms the healthcare law’s future.

Spokesman Josh Earnest said Wednesday the Obama administration remains committed to its enrollment drive, which opened Nov. 1.

“There is no specific thing in mind that we’re going to do differently now,” Earnest said as he addressed reporters for the first time since President-elect Donald Trump declared victory.

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While Obamacare has brought health insurance to millions of people in the U.S., some in the program are finding that the medical care they need is too expensive to actually use.

Michelle Harris, a 61-year-old retired waitress in northwest Montana, has arthritis in both shoulders. She gets a tax subsidy to help buy coverage under Obamacare, though she still pays $338 a month for the BlueCross BlueShield plan. Yet with its $4,500 deductible, she says she’s doing everything she can to avoid seeing a doctor. Instead, she uses ibuprofen and cold-packs.

“It hurts, but we don’t have that kind of money,” Harris said in an interview. “So I deal with it.”

Open enrollment for the insurance exchanges created by the Affordable Care Act kicks off Tuesday, and there’s a good chance consumers logging on to compare plans will face some sticker shock.

Monthly insurance premiums for popular plans on HealthCare.gov are rising by 25 percent on average next year, according to government data. But the increases will be more dramatic in certain parts of the country, especially for consumers not receiving subsidies, the numbers show.

. . .

The fourth open enrollment for health coverage under the Affordable Care Act opened Tuesday, a critical 90 days that the Obama administration hopes will boost participation and stabilize markets roiled by premium increases and insurer withdrawals.

HealthCare.gov and state equivalents began taking applications Tuesday morning from people signing up for individual health coverage and learning about their eligibility for subsidies. This year is especially critical because consumers so far have been sicker and older than expected, which has led to higher-than-anticipated costs.

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As premiums for Affordable Care Act (ACA) insurance plans skyrocketacross the country, the Department of Health and Human Services (HHS) appears to be spinning the bad news by noting that 2017 premiums are about what the Congressional Budget Office (CBO) expected they would be when the law passed in early 2010. However, CBO’s November 2009 estimate of future premiums involved significant and generally unforeseeable errors in key underlying assumptions having nothing to do with the ACA. A valid understanding of the ACA’s effect on insurance premiums would need to account for these errors.

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If you are wondering why the Obamacare exchanges are in so much trouble, a whole slew of “experts” think they have the answer. From President Obama to health insurance industry CEOs to the editors of The New York Times to health policy gurus everywhere – the verdict is almost unanimous. Not enough young and healthy people are buying health insurance.

So, what’s the solution to that problem? Carrots and sticks, according to the conventional wisdom. We need to make health insurance more attractive to the young.

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Anthem Inc. said it may join other major U.S. health insurers in largely pulling out of Obamacare’s markets in 2018 if its financial results under the program don’t improve next year.

Anthem retreating from the Affordable Care Act would mean that almost all of the major American for-profit health insurers have substantially pulled back from the law. The other big insurers — UnitedHealth Group Inc., Aetna Inc. and Humana Inc. — have already scaled back, after posting massive losses. The retreats threaten to further destabilize coverage in the markets for individual coverage, known as exchanges, that provide insurance to millions of Americans.

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