A total of $1.23 billion in federal taxpayer dollars has now been sunk in 12 of 23 co-ops created under Obamacare that have gone out of business, representing another Obamacare failure, lawmakers say. Co-ops in Arizona and Michigan went out of business last week, adding themselves to the 10 that have already failed in Utah, Kentucky, New York, Nevada, Louisiana, Oregon, Colorado, Tennessee, South Carolina, and a co-op that served both Iowa and Nebraska.

The Affordable Care Act’s third open enrollment season started Nov. 1, and federal officials are hoping to reach about a million people like Thomas across the country. Newark has an estimated 112,000 uninsured people, around one-third of the city’s population. It is one of five areas – along with Houston, Dallas, Chicago and Miami – where the federal government is focusing enrollment efforts. Altogether, Washington will spend more than $100 million on marketing and enrollment.

A lack of oversight when implementing the consumer operated and oriented plans (CO-OPs) as well as their inability to compete are to blame for the small insurers’ recent string of failures, experts said Thursday at a hearing held by the House Energy and Commerce Committee’s Subcommittee on Oversight and Investigations.

Health plans that offer coverage of doctors and hospitals outside the plan’s network are getting harder to find on the insurance marketplaces, according to two analyses published this week. Two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January, an analysis by the Robert Wood Johnson Foundation found. Those cutbacks will affect customers in 37 states, according to the foundation.

When open enrollment began on the nation’s healthcare exchanges on November 1, many people who bought insurance for 2015 found that the 2016 plans they had to choose from have narrower networks of hospitals. In addition, premiums might be significantly higher. Insurers have asked the federal government for permission to increase premiums by as much as 40 percent or more. All of this is happening because health insurers say that people who have signed up for coverage under the Affordable Care Act have been sicker than expected.

As Marketplace enrollees begin to shop for coverage starting in 2016, the number of insurance choices available to them is changing in some parts of the country. In early 2015, an average of 6.1 insurer groups offered coverage in each state, up from an average of 5.0 in 2014. Since then, some insurers have announced their exit or been required to withdraw from the Marketplaces, most notably a number of nonprofit Consumer Operated and Oriented Plans (CO-OPs) and some larger insurers like Blue Cross Blue Shield of New Mexico. Despite these withdrawals, the Department of Health and Human Services (HHS) recently announced that the average number of issuers per state is increasing slightly in 2016 and that about 9 out of 10 returning Healthcare.gov customers will have 3 or more insurers from which to choose in 2016.

Yesterday’s post discussed what we know about Obamacare as its third open enrollment season commences. Here are four major questions about the future of Obamacare that remain unanswered.

“Cheap” could cost you more for Obamacare next year. People who buy the cheapest health plans on the biggest Obamacare exchange without getting financial assistance are facing the largest increases for premiums and out-of-pocket costs in 2016, new analyses show.

In Tennessee, the state insurance commissioner approved a 36 percent rate increase for the largest health insurer in the state’s individual marketplace. In Iowa, the commissioner approved rate increases averaging 29 percent for the state’s dominant insurer. Health insurance consumers logging into HealthCare.gov on Sunday for the first day of the Affordable Care Act’s third open enrollment season may be in for sticker shock, unless they are willing to shop around. Federal officials acknowledged on Friday that many people would need to pick new plans to avoid substantial increases in premiums.

Obamacare’s third open enrollment season kicked off yesterday, beginning the next chapter in its turbulent history. Today’s post discusses what we know about Obamacare. Tomorrow’s will discuss what we don’t yet know.