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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This past weekend, Democrats finalized their 2016 election platform at a meeting in Orlando. Oddly enough, it calls for the destruction of Obamacare.

“Americans should be able to access public coverage through Medicare or a public option”–that is, government-run healthcare–says the platform. In a nod to former Democratic presidential candidate Sen. Bernie Sanders, who supports a government-run, single-payer “Medicare for All” healthcare system, it also states that “healthcare is a right.”

They’re embracing single-payer because of Obamacare’s ongoing collapse. As a new report from Sen. Ben Sasse, R-Neb., makes clear, Obamacare’s exchanges are crumbling. Consumers in many parts of the country have access to only one or two insurers–and may soon have none at all.

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This week, President Obama published an President Obama published an article in the Journal of the American Medical Association that is likely to be his last and most comprehensive defense of the Affordable Care Act — a.k.a. Obamacare — while in office. Not surprisingly, it’s a rather one-sided accounting.

The president says the law has reduced the number of uninsured Americans, slowed the pace of rising health-care costs, and improved access to high-quality health care for millions of Americans. He also says more progress would have been made if not for the “hyperpartisanship” infecting Washington. He betrays no hint of self-awareness that perhaps his own conduct and statements, and the manner in which the law was pushed through Congress and enacted, might have been causes of the deep divisions in health-care policy that have persisted throughout his presidency.

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Senior Obama administration officials took a series of decisions beginning in late 2013 that ranged from the reckless to the illegal in an effort to keep insurers participating in health insurance exchanges.

 A report issued last week jointly by the House Ways and Means and Energy and Commerce committees explores how the administration came to unlawfully funnel $7 billion in unappropriated money to insurers through a single ObamaCare program.

The program — known as cost-sharing reduction (CSR) — requires insurers to reduce deductibles and other out-of-pocket spending for certain low-income people who signed up for coverage through health insurance exchanges. In turn, the statute authorized the administration to seek an appropriation from Congress to reimburse insurers for the cost of providing these coverage enhancements.

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Health spending in the U.S. grew to $3.2 trillion in 2015, fueled partly by the expansion of health insurance to millions of people under the Affordable Care Act, according to a new estimate published in the journal Health Affairs.

The study also looks forward, projecting that through the next decade, national health spending will climb at 5.8 percent per year, on average, to encompass a fifth of the economy by 2025.

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A top Centers for Medicare and Medicaid Services official defended the health insurance co-ops created under the Affordable Care Act Wednesday, after four more of the nonprofit insurers announced they would take steps to wind down in recent weeks.

Kevin Counihan, the CEO of HealthCare.Gov, told a subcommittee of the House Committee on Oversight and Government Reforms that the co-ops have spurred innovation within the health insurance marketplace and given consumers more opportunities. But Republicans on the panel railed against the program, as about two-thirds of the co-ops have now announced steps to close down.

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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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The Illinois Insurance Department moved Tuesday to shut down Land of Lincoln because of its unstable financial health, leaving about 49,000 policyholders in a lurch. They will lose coverage in the coming months, but neither regulators nor the company have said exactly when.

Policyholders will be able to buy insurance from a different carrier to cover them for the rest of 2016, according to the state Insurance Department. But switching plans is going to cost them.

The co-pays and deductibles enrollees have been paying since January will not transfer to new plans. A new plan will reset deductibles and out-of-pocket maximums paid by consumers.

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President Obama reflected upon the Affordable Care Act in an article published this week in the Journal of the American Medical Association. He acknowledged the law’s shortcomings and outlined what he believes to be the next steps in health care reform.

The President concluded, “Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs.”

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Lawyers well versed in federal health policy are skeptical that a handful of insurers will triumph in their lawsuits against the Obama administration over two separate but similar payment provisions of the Affordable Care Act (ACA).

Six insurers, including several of the ACA-created Consumer Operated and Oriented Plans, or CO-OPs, are suing the administration over money, while a number of others are 23 Comments lawsuits.

The insurers are suing over the ACA’s risk corridor and risk adjustment programs, which make up two of the “three Rs” built into the law to compensate insurers for losses stemming from market volatility in the first few years of ACA implementation.

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