Delawareans are again facing steep price increases for health insurance next year under the Affordable Care Act.

Insurance Commissioner Karen Weldin Stewart has approved an average rate increase of 32.5 percent in the individual market for Highmark Blue Cross Blue Shield of Delaware, which has the vast majority of the individual market share in Delaware. That follows an average premium increase of 22.4 percent for individual Highmark plans this year.

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Six and a half years after the ACA was signed into law, health reform no longer feels like a steady forward march toward progress. It feels more like World War I: dotted with landmines, lined with trenches, and ending inconclusively. In 2010, the Congressional Budget Office predicted that 21 million people would be enrolled in the ACA’s insurance exchanges by 2016; as of now, only 12 million are. That gap between hype and reality is likely to further expand over time.

What happened? It’s a long story, of course. But the simple answer is that the ACA’s exchanges were designed poorly and implemented poorly, by overconfident advocates who dismissed any and all criticism, no matter how well-reasoned.

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Last week, the comptroller general — the government’s chief accountability officer — issued an official statement that the administration has been sending unlawful payments to insurance companies through the ACA’s reinsurance program. These payments have totaled $3 billion thus far and have forced taxpayers to finance a larger part of insurers’ most expensive enrollees’ claims.

The U.S. House of Representatives filed suit against the administration for unlawful payments through another ACA program. These payments are to insurers for them to make plans more attractive by reducing enrollees’ deductibles and cost-sharing amounts. Congress never appropriated funds, yet the administration has paid insurers at least $10 billion through this program thus far.

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Evergreen Health, Maryland’s version of the innovative nonprofit insurers created under the Affordable Care Act, decided Monday to become a for-profit company to avoid the possibility of a shutdown, according to its chief executive.

If the switch is approved as expected by federal and state officials, Evergreen’s unprecedented move will leave standing only five of the 23 co-ops, or Consumer Operated and Oriented Plans, which started nearly three years ago.

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South Carolina became the fifth state to have only one company offering health insurance through its Affordable Care Act exchange.

The South Carolina Department of Insurance announced on Tuesday that Blue Cross Blue Shield of South Carolina will be the sole provider for South Carolinians looking to get covered through the ACA, better known as Obamacare, according to The Post and Courier.

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Federal auditors ruled on Thursday that the Obama administration had violated the law by paying health insurance companies more than allowed under the Affordable Care Act in an effort to hold down insurance premiums.

Some of the money was supposed to be deposited in the Treasury, said auditors from the Government Accountability Office.

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If policy makers want to instigate more competition in the ACA, they can start by broadening “credibility adjustments” to make it easier for new plans to get started. The exemptions should cover all new carriers that enter the exchanges. They should be deeper and apply for an extended period over which a new carrier faces high startup costs.

A far better alternative would be to scrap the caps on health plan operating margins altogether, and make it easier for new plans to channel revenue into startup costs and investors to turn profits off these investments. The law already provides some flexibility toward these ends. It states that the HHS Secretary can adjust the individual market cap if “the Secretary determines that the application of the 80% may destabilize the individual market in such State.” So long as consumers have transparency (and reliable metrics) on the value of the benefits that different plans offer, the exchanges would benefit from giving new health plans far more flexibility on how they allocate their capital.

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Minnesota’s commerce commissioner called for reforms to strengthen the federal marketplace Friday after announcing monthly premium increases of at least 50 percent for 2017.

“While federal tax credits will help make monthly premiums more affordable for many Minnesotans, these rising insurance rates are both unsustainable and unfair,” Minnesota Commerce Commissioner Mike Rothman said in a statement. “Middle-class Minnesotans in particular are being crushed by the heavy burden of these costs. There is a clear and urgent need for reform to protect Minnesota consumers who purchase their own health insurance.”

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We keep reading that Donald Trump poses a unique threat to constitutional norms if he’s elected. His liberal critics would have more credibility if they called out the ObamaAdministration for its current (not potential) abuses of power, and here’s an opportunity: The Administration is crafting an illegal bailout to prop up the President’s health-care law.

News leaked this week that the Obama Administration is moving to pay health insurers billions of dollars through an obscure Treasury Department account known as the Judgment Fund.

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It never rains that it doesn’t pour. Even as nonpartisan experts at the Government Accountability Office concluded that the Obama administration broke the law with Obamacare’s reinsurance program, the Washington Post reported the administration could within weeks pay out a massive settlement to insurers through another Obamacare slush fund—this one, risk corridors.

The Post article quoted Republicans criticizing risk corridor “bailouts.” But in reality, the Obama administration itself has admitted using risk corridors as a bailout mechanism—trying to pay insurers to offset the costs of unilateral policy changes made to get President Obama out of a political jam.

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