Articles on the implementation of ObamaCare.

About 27,000 Hoosiers will lose their Obamacare plans next year after Indiana University Health Plans announced it is withdrawing from the Indiana marketplace, citing big losses from the new enrollees. It had covered 15% of marketplace enrollees last year. Indiana Sen. Dan Coats, a Republican, said the announcement from IU Health Plans is evidence the healthcare law is “collapsing before our eyes.”  “Because of the broken Obamacare system, Hoosiers continue to face rising premiums and limited choices rather than reliable, affordable healthcare,” Coats said.

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In yet another sign of instability in Obamacare’s health-insurance Exchanges, BlueCross BlueShield of Nebraska has announced it will leave that state’s Exchange entirely, while BlueCross BlueShield of Tennessee will exit the Exchange in all three of that state’s major metropolitan areas. The moves will leave 112,000 Tennesseans and tens of thousands of Nebraskans scrambling to find new coverage for 2017 from a dwindling number of carriers.

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Blue Cross Blue Shield of Nebraska announced Friday that is pulling out of the ObamaCare marketplace in the state, becoming the latest insurer to cite financial losses when reducing participation in the healthcare law.

The move is especially significant given that it is a Blue Cross plan, which form the backbone of the ObamaCare marketplaces. In a few states, the Blue Cross plan will be the only one available on the marketplace next year.

Nebraska, though, will still have two insurers, Aetna and Medica, on its marketplace next year.

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Failing insurers. Rising premiums. Financial losses. The deteriorating Obamacare market that the health insurance industry feared is here.

As concerns about the survival of the Affordable Care Act’s markets intensify, the role of nonprofit “co-op” health insurers — meant to broaden choices under the law — has gained prominence. Most of the original 23 co-ops have failed, dumping more than 800,000 members back onto the ACA markets over the last two years.

Many of those thousands of people were sicker and more expensive than the remaining insurers expected — and they’re hurting results.

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Congressional Republicans are warning the Obama administration not to settle with insurers that have sued the government over an Affordable Care Act program to compensate them for losses under the law, saying such a move would bypass spending limits set by Congress.

Forty-six House Republicans signed a letter sent Thursday to Health and Human Services Secretary Sylvia Mathews Burwell saying they oppose any settlements and could sue the administration to block them.

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With major insurers retreating from the federal health law’s marketplaces, California’s insurance commissioner said he supports a public option at the state level that could bolster competition and potentially serve as a test for the controversial idea nationwide.

“I think we should strongly consider a public option in California,” Insurance Commissioner Dave Jones said in a recent interview with California Healthline. “It will require a lot of careful thought and work, but I think it’s something that ought to be on the table because we continue to see this consolidation in an already consolidated health insurance market.”

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Hillary Clinton surely is hoping health reform remains a side issue the presidential campaign as bleak news of its failures have propelled Obamacare back into the spotlight.  Clinton owns Obamacare after telling Iowa voters: “I will defend the Affordable Care Act, but as president I want to go further.”  She actually wants to double down, even after seeing public support for the health law tumble. She wants to create another big government “public option” that would have unlimited calls on taxpayer dollars and government force and would quickly drive remaining private insurers out of the market, leaving people with only the “choice” of a government-run health plan.  We can and must do better than Obamacare, and the voters know it.

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Complications arising from the Affordable Care Act (ACA) premium tax credits (PTCs) are causing millions of people to effectively break the law. People who benefit from advance premium tax credits (APTCs) must file tax returns and include a form to reconcile the advanced amount to the actual end-of-year entitled amount. The failure of so many people to fulfill this new legal requirement has led the government to spend more than it should have as APTCs tend to be higher than legally entitled amounts.

The big news is that tax filers, as of April 28, 2016, reported $15.8 billion in total APTC payments. According to data released by HHS, I estimate the amount of APTCs paid in 2015 equaled $26.7 billion—nearly $11 billion more than the amount reported by tax filers. It appears that about 3 million households that received an APTC in 2015 had not filed the required paperwork with the Internal Revenue Service (IRS) by the end of April 2016.

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As many as 20 million Americans soon will be getting a letter from the Internal Revenue Service “suggesting” they sign up for ObamaCare insurance.

Getting a letter from the IRS can be a threatening and nerve-racking experience; it seldom is seen as a suggestion and more of a threat.  But at President Obama’s direction, the IRS is “reaching out” to people who paid the tax penalty for not buying mandatory health insurance or who claimed an exemption in hopes of “attracting” more people to sign up for ObamaCare insurance.  The government is particularly interested in compliance from healthy young people.

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As ObamaCare’s troubles mount, I’ve heard my patients and my peers in healthcare ask: How could the law’s authors not have seen this coming?

For my part, I think a different question needs to be asked: What if they did? What if ObamaCare was purposely designed to fail?

Every day, it seems like there are a dozen new headlines about the crisis facing ObamaCare. Premiums are rising faster than ever. Meanwhile, health insurance companies are abandoning the law’s exchanges left and right, unable to compete in the top-down, regulation-driven environment created by the law. Less than three years into its implementation, the law has never looked so precarious.

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