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

“You bet I voted for that bill. I’m proud I did it!” yelled Russ Feingold at a Wisconsin campaign stop in 2010. That pride—in ObamaCare—lost the three-term Democratic senator his job. Now his party’s ownership of the health-care law may once again decide the Senate.

ObamaCare is roaring back as a political liability to Democrats in a way not seen since that 2010 wave election. Right in time for this fall’s presidential contest, insurers are bailing out of the government system, leaving millions of voters with dwindling options and skyrocketing premiums. ObamaCare was always destined to crack up, but there is something notable that it comes precisely as so much control of Washington is up for grabs.

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Progress in reducing the number of people without health insurance in the U.S. appears to be losing momentum this year even as rising premiums and dwindling choice are reviving the political blame game over President Barack Obama’s health care law.

The future of the Affordable Care Act hinges on the outcome of the presidential election, and it’s shaping up as a moment of truth for Republicans.

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Massachusetts will be responsible for at least $162 million in new costs over the next decade to fund the federal expansion of health insurance coverage, according to a new report.

The paper from the Pioneer Institute, a free-market-oriented Boston think tank, said that additional spending will squeeze the state budget and divert money from other priorities such as education and transportation.

The costs come in the form of a fee that is part of the Affordable Care Act, which extended insurance coverage to millions of people. The law makes more Americans eligible for Medicaid and provides subsidies to many people on private insurance plans, depending on their level of income. Pioneer said it is the first organization to calculate the long-term costs of the fee.

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Now that the ACA is on the books, and the private-insurance options are on shaky ground, there’s no real reason for proponents of the ACA not to fully embrace the public option. It’s what most of them wanted all along, and the turbulence among the private insurers provides the perfect excuse to pursue it.

The fact that introducing a public option at this stage would only add to the instability of the private options offered on the exchanges is not a reason for the public-option advocates to abandon the idea because they never really wanted a functioning private-insurance marketplace anyway. The goal all along has been government-run health care, even if they haven’t always been willing to admit that.

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Hospital emergency department visits increased in Illinois after the Affordable Care Act took effect — the opposite of what many hoped would happen under the landmark health care law, according to a new study.

“Emergency departments are already overcrowded, and bringing more patients in will continue to make that worse,” said Dr. Scott Dresden, an assistant professor of emergency medicine at Northwestern University Feinberg School of Medicine, and the lead author of the study.

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U.S. Senate Majority Leader Mitch McConnell predicted Monday that the federal health care overhaul championed by President Barack Obama is likely to undergo changes next year, regardless of who wins the White House and which party has the upper hand in Congress.

The Kentucky Republican, who has long advocated repealing the Affordable Care Act, told a business audience in his hometown that the law “can’t possibly go on like it is.” He predicted the overhaul “will be revisited by the next president, whoever that is.”

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As health insurers head for the exits, Americans who have been whipsawed by ObamaCare may get whacked again this fall:  First, they were thrown off private plans that were declared illegal, then they were forced into the ObamaCare exchanges, and now they could face the prospect of being shut out of coverage through their exchanges entirely for 2017.

The Obama administration has only itself to blame for the ObamaCare failures—first for jamming this bill through Congress despite warnings that the structure of the bill was an economic disaster, and then for exacerbating the breakdown through its regulatory dictates.  The ACA was sold on the pretense that we could have a private, competitive market for health insurance, but the law and subsequent regulations put the industry in a straightjacket, with rules at every turn that undermined the industry’s ability to offer attractive, competitive products.

We need to think more broadly about solutions, making sure that people getting coverage now are protected, that those not buying or obtaining coverage have greater incentives to participate, and that the program is financially sustainable.

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With the hourglass running out for his administration, President Barack Obama’s health care law is struggling in many parts of the country. Double-digit premium increases and exits by big-name insurers have caused some to wonder whether “Obamacare” will go down as a failed experiment.

If Democrat Hillary Clinton wins the White House, expect her to mount a rescue effort. But how much Clinton could do depends on finding willing partners in Congress and among Republican governors, a real political challenge.

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Seven years after the passage of the federal Affordable Care Act, health care costs are still going up at a robust rate for many in the region, according to a new survey of Washington area companies. Health insurance costs at a broad sample of local companies are projected to increase by 7.3 percent in 2016, the Human Resource Association of the National Capital Area reported.

The association, which represents area human resource executives, said the survey found more local employers are offering higher-deductible plans and putting new restrictions on expensive prescription drugs. The percent of the organization’s membership offering so-called “consumer-directed” health care plans jumped from only 15 percent in 2008 to 50 percent in 2016.

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The odds remain fairly good that the Democrats can regain control of the Senate in November, especially if Democratic presidential nominee continues her strong showing against Republican businessman Donald Trump in the polls.

At least seven Republican-held seats are seen as being in play, including Illinois, New Hampshire, Indiana and Wisconsin, as well as the three crucial swing states of Ohio, Pennsylvania and Florida. Four other races — including veteran Republican Sen. John McCain’s reelection effort in Arizona — are deemed competitive by political experts.

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