The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

The Obama administration Monday confirmed a 25% average jump in premiums for the Affordable Care Act’s benchmark health plans and acknowledged later sign-up deadlines for hundreds of thousands of people whose insurers are dropping their plans because of rising costs.

Sharper increases had already been posted in states around the country. Market-leader insurers that are continuing to sell coverage through HealthCare.gov or a state equivalent have been granted average premium increases of 30% or more in Alabama, Delaware, Hawaii, Kansas, Mississippi and Texas. In states including Arizona, Illinois, Montana, Oklahoma, Pennsylvania and Tennessee, the approved rate increases for the market leader top 50%.

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The Obama administration is trying to calm the panic over soaring ObamaCare premiums by pointing to subsidies many will receive to offset the cost — but analysts and GOP lawmakers counter that those subsidies nevertheless will stick taxpayers with a rising bill.

With enrollment set to begin Nov. 1, the administration announced Monday that premiums are set rise an average of 25 percent across the 39 states served by the federally run online market. Some states, such as Arizona, will see premiums jump by as much as 116 percent.

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Democrats are increasingly acknowledging that the Affordable Care Act has an affordability problem.

Former President Bill Clinton said recently that people who are ineligible to get subsidies to buy ObamaCare insurance are “getting killed.”

Minnesota Gov. Mark Dayton said this month that “the reality is the Affordable Care Act is no longer affordable to increasing numbers of people.”

Even President Obama said in a speech last week that “there are going to be people who are hurt by premium increases.”

The core problem with President Obama’s most recent speech in defense of his health care law was not that he simply overestimated the merits of Obamacare. It’s that he refused to acknowledge that conservatives have reasonable disagreements with him about the direction of health care policy. President Obama claims that Republicans have offered no alternatives to the health care law when they have in fact outlined their own far-ranging plans for health policy. President Obama believes that only comprehensive insurance policies are real insurance. Conservatives generally believe, by contrast, that people should be free to buy cheaper policies that protect them only from financial catastrophes arising from their health needs.

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States are beginning to turn to hospitals to cover the cost of Medicaid expansion once the federal match begins to drop next year. The Affordable Care Act provides 100% federal financing for those made newly eligible for Medicaid under the law. The federal match rate falls to 95% in 2017, 94% in 2018, 93% in 2019, and then 90% in 2020 and beyond. Starting next year, eight of the 32 states that have expanded Medicaid planned to use provider taxes or fees to fund all or part of the states’ share of costs, the report said. These states have chosen to implement a new or modify an existing provider assessment specifically for the purpose of covering the costs of expansion.

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Democrats are already looking beyond ObamaCare’s slow-motion failure, and Colorado is showing where many want to go next: Premiums across the state are set to rise 20.4% on average next year, and some have concluded that the solution is more central planning and taxation. Voters will decide on Nov. 8 whether to try the single-payer scheme that blew up in Vermont.

Amendment 69 would alter the state’s constitution to create a single-payer health system known as ColoradoCare. The idea is to replace premiums with tax dollars, and coverage for residents will allegedly include prescription drugs, hospitalization and more.

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When Illinois’ Obamacare co-op went belly-up last month, Valerie Kincaid faced losing not just her insurance but her team of cancer doctors, too.

For six years, the 41-year-old leukemia patient has relied on doctors at Northwestern Memorial Hospital in downtown Chicago to keep her disease at bay. Once a month, she visits the hospital to receive an oral therapy that keeps her chronic lymphocytic leukemia under control and allows her to live a relatively normal life with her husband, Brian, and her 11- and 13-year-old sons.

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Despite significant challenges the Affordable Care Act has imposed on the U.S. health care system, President Obama defended his signature health care law in a speech on Thursday that described his pride in the law and acknowledged significant challenges his successor will face. Republican lawmakers pointed to some of the law’s challenges during the speech. “Obamacare is collapsing. Insurance companies are abandoning the program, leaving stranded families to face higher premiums and fewer choices,” said Wyoming Republican Sen. John Barrasso, in a statement sent out about halfway through the remarks.

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A new study in the New England Journal of Medicine suggests that the assumption that the ACA would lead to lower Emergency Room use was wrong as Medicaid expansion in Oregon produced a spike in ER visits. A surge in ER use will likely produce adverse health consequences for many and may be contributing to skyrocketing Medicaid expansion spending, which was 49% higher per enrollee in 2015 than the government expected.

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Bob Kocher and Ezekiel Emanuel, who worked in the Obama White House on health care reform, argue that it’s “misleading” to raise concerns about the fact that individual market health insurance premiums have nearly doubled under Obamacare. “Premiums today,” they say, “are 20% lower than the Congressional Budget Office predicted when the ACA was passed.” Their argument is nonsensically out of touch, and it illustrates why the designers of the ACA got so many things wrong. The unaffordability of exchange-based insurance is the ACA’s most serious problem. As research from Avalere Health has shown, enrollment in ACA-based insurance is alarmingly low among those whose incomes exceed 200% of the federal poverty level.

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