Articles on the implementation of ObamaCare.

For much of this year, Sara Goodrich of Lakeland has gone without health insurance — despite trying over and over again to complete enrollment on HealthCare.gov. “For the last six months, all of the agents have been telling me something else is the issue. Resubmit here, there’s an address error, it’s your birthday, for some reason, that would affect my application, and I just said, I am trying to follow the rules here, and you guys aren’t helping,’” she said.

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.

More than half of the 23 taxpayer-funded Obamacare insurance startups are not offering plans next year, and another in Michigan said Tuesday that it was winding down. Michigan’s Consumers Mutual Insurance announced late Tuesday it would not offer plans in 2016, making it the 12th Obamacare consumer-operated and oriented plan to close up. The closure comes two days into Obamacare’s third open enrollment period, and on the same day a congressional panel lashed out at an administration official about the spate of shutdowns.

Texas — In rural Borden County, 12 people signed up for Obamacare this year. Livid over the government telling them they must buy something and loath to take anything that looks like a “handout,” the uninsured here are likely to stay that way. As Obamacare’s third open enrollment season began Sunday, this rock-solid conservative community of about 650 people offers a window into the challenges health law advocates face to expand coverage around the country.

When it passed Congress in 2010, the Affordable Care Act offered substantial financial support to create nonprofit health-insurance plans. Today 11 of the 23 such regional Consumer Operated and Oriented Plans have failed—seven since the beginning of October. They’ve collapsed despite federal startup loans totaling more than $1.1 billion. These loans will likely never be fully repaid, while insurers and consumers will be on the hook for any unpaid claims left behind by failed insurers.

Texas — In rural Borden County, 12 people signed up for Obamacare this year. Livid over the government telling them they must buy something and loath to take anything that looks like a “handout,” the uninsured here are likely to stay that way. As Obamacare’s third open enrollment season began Sunday, this rock-solid conservative community of about 650 people offers a window into the challenges health law advocates face to expand coverage around the country.

A low-cost health insurance co-op that covers about one in three Arizonans that have an Affordable Care Act marketplace plan won’t be allowed to sell health plans Sunday — the opening day consumers can purchase insurance — after the state of Arizona and the federal government took action against the entity. The Arizona Department of Insurance said Friday afternoon that Meritus Health Partners/Meritus Mutual Health Partners has been placed into “supervision” and only can continue to serve existing clients until the end of the year. The federal government also suspended Meritus from the Affordable Care Act’s federal marketplace, which means the company won’t be able to sell health plans via healthcare.gov when the health-care law’s three-month enrollment period begins Sunday.

When the open enrollment period for the New Mexico Health Insurance Exchange kicks off Sunday, one carrier with thousands of patients won’t be ready to offer plans through the state’s online portal. New Mexico Health Connections has announced that its insurance offerings on the exchange will be delayed by one or two weeks as some technical glitches are resolved. Dr. Martin Hickey, chief executive of the nonprofit insurance cooperative, said the plans should be available by Nov. 15. Hickey said the problem occurred as the co-op was uploading templates to the federal healthcare.gov website, where New Mexicans seeking individual coverage must go to enroll in a policy.

The Affordable Care Act (ACA) called for the establishment of non-profit “Consumer Operated and Oriented Plans” (CO-OP) to offer health insurance at lower prices and with patient, rather than corporate, interests at heart. Almost half the CO-OPs have failed in the first two years, with five failures announced just in the last month. Understanding the reasons why the CO-OPs were set up and why they failed can help us learn important lessons about the potential of government and private enterprise not just in the health care sector, but in all areas of the economy.

Insurance regulators said Friday the financial condition of Health Republic of New York, the largest of 23 health insurance co-ops established by a $2.4 billion Obamacare program, is “substantially worse than the company previously reported in its filings.” It is unclear if the co-op deliberately misled state regulators in its original filings, or if regulators found evidence of financial wrongdoing while they tried to close down the defunct non-profit. The co-op’s insolvency was announced September 25.