Articles on the implementation of ObamaCare.

House Speaker Paul Ryan says he has heard personally from actuaries for a major health insurer that Obamacare is “failing.” Speaking at a Wednesday breakfast for Ohio delegates to the Republican National Convention, Ryan said that actuaries for Blue Cross Blue Shield have told him the Affordable Care Act is going downhill faster than they expected.

“As I said in the beginning, this healthcare law is going to collapse under its own weight,” Ryan said. “I met with all these actuaries from Blue Cross Blue Shield a little while ago, and they said ‘Well, congressman, the law is failing two years ahead of schedule,'” he added. “Meaning, basically, they saw it coming, but they didn’t think it would be this bad so fast.”

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State and federal officials have negotiated a deal to delay a federal policy that threatened to destabilize health insurance rates at small businesses across Massachusetts.

Governor Charlie Baker’s administration said Tuesday that the agreement will postpone for one year a piece of the Affordable Care Act that requires a change in the way small businesses’ insurance rates are calculated. Massachusetts will have to phase out its current rules and switch to the federal formula by 2019.

The rules apply to businesses with 50 or fewer employees.

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Fifteen of the health insurance cooperatives started with federal dollars through the Affordable Care Act have failed — four of them just this month — saddling taxpayers with an estimated $1.7 billion in bad loans.

Common Ground Healthcare Cooperative is one of seven still standing.

But the next few months will determine whether Common Ground, which insures about 20,000 in 19 counties in eastern Wisconsin, manages to survive.

“I’m confident we’ll make it through this year,” said Cathy Mahaffey, its chief executive officer since 2014.

Beyond that, though, Common Ground faces an uncertain future.

The cooperative has lost $84.8 million from its inception in 2012 through the end of last year and owes the federal government $107.7 million.

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The percentage of Hispanics in Texas without health insurance has dropped by 30 percent since the Affordable Care Act (ACA) went into effect, but almost one-third of Hispanic Texans ages 18 to 64 remain uninsured.

That’s one of the conclusions of a new report released today by Rice University’s Baker Institute for Public Policy and the Episcopal Health Foundation.

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President Obama recently published an overview of the results of ObamaCare in the Journal of the American Medical Association.

It’s a pretty extraordinary article, because in important ways it acknowledges that ObamaCare has basically failed—and it lays the cards on the table for what we always knew was going to be his next step.

Remember that the whole point of ObamaCare was to make health care affordable. Its official name, after all, proclaims it is the Affordable Care Act. But Obama acknowledges that health insurance premiums have turned out to be much higher than the law’s advocates promised us.

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Opt-out payments offered by employers may be used to determine affordability under the Affordable Care Act, depending on whether they are conditional or unconditional, according to IRS proposed rules.

Under the proposed rules, opt-out payments, cash payments given to employees who opt-out of their employer-sponsored health insurance, will be treated as a salary reduction for the purposes of determining health insurance affordability if they are considered unconditional.

An unconditional opt-out payment refers to an arrangement where the employee declines employer-sponsored health insurance without satisfying any other requirements.

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New failures are piling up among the member-run health insurance co-ops carrying out one of the Affordable Care Act’s most idealistic goals, leaving just seven remaining when the health law’s fourth enrollment season starts in the fall.

There were 23 in 2014.

For the rest — which all posted annual losses in 2015, according to the National Alliance of State Health Co-Ops — survival is job No. 1. Some are diversifying to serve larger employers, no longer limiting themselves to their ACA mandate to offer health plans to individuals and small businesses. A Maryland co-op has sued the federal government to avoid paying millions of dollars to other insurers under the ACA’s complex formula to keep premiums stable by balancing risks among insurers and helping ailing ones. Other co-ops are trying to renegotiate contracts with hospitals and other providers.

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Illinois moved Tuesday to take control of Land of Lincoln Health to begin an orderly shutdown of the insurance company, meaning about 49,000 people will lose their health coverage in the coming months.

The state said it will allow policyholders to buy coverage from a different insurer before their Land of Lincoln plans are terminated, but it’s unclear when the policies will lapse.

“It’s a bad day for the marketplace in Illinois and our consumers,” said Jason Montrie, president and interim CEO of Chicago-based Land of Lincoln. “This is the end.”

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Hillary Clinton on Saturday announced her plan to expand investments in community health care centers, the second of two proposals in a week apparently aimed at courting supporters of Sen. Bernie Sanders ahead of his possible endorsement.

The presumptive Democratic nominee’s proposal would double funding for primary care services at Federally Qualified Health Centers, which serve populations with limited access to health care. Community health care centers have been a key priority for Sanders, I-Vt., who successfully fought for the inclusion of $11 billion in funding for such centers in the Affordable Care Act of 2010.

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The number of insurers carrying out one of the Affordable Care Act’s most idealistic goals continues to plummet, with just seven nonprofit member-run health plans set to take part in the law’s fourth enrollment season this fall.

That’s down from 23 such plans — co-ops, as they are commonly known — that started in 2014. Eleven are still in business, but four in Oregon, Ohio, Connecticut and Illinois will fold soon because of financial insolvency. Just Tuesday, the Land of Lincoln Mutual Health Insurance Co. was ordered to close by Illinois regulators.

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