The Obama administration proposed this week new rules for its Risk Adjustment program, a critical component of the Affordable Care Act. There are actually some better-late-than-never parts of the proposal. Most notably the new rules will try to compensate for the extra expense insurers incur when people exploit ACA regulatory and enforcement weaknesses to time their insurance purchases to cover only expensive medical emergencies.

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Iowa Insurance Commissioner Nick Gerhart can hardly believe he’s giving some consumers this advice: If you can’t find an affordable, full-fledged health insurance policy, he tells them, maybe you should consider going without one.

The Affordable Care Act started requiring most Americans to have health insurance in 2014. But the law offers an exemption for people who can’t find policies that would cost them less than about 8 percent of their household incomes.

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Six Republican Senators introduced a bill that would exempt consumers living in counties where zero or one insurer is offering plans on the federal exchanges from the Affordable Care Act’s individual mandate.

The legislation comes after several recent analyses have shown the number of U.S. counties with one insurer offering plans on the Affordable Care Act exchange is expected to increase next year. Pinal County in Arizona currently has no insurers planning to offer plans on the marketplace. Under the 2010 health care law, people who are able to afford health insurance are required to purchase insurance or pay a fine to the federal government.

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The Obama administration said Tuesday that it is planning to test out further steps to tighten the rules for ObamaCare sign-up periods that have drawn insurer complaints.

The Centers for Medicare and Medicaid Services (CMS) said that it will launch a pilot program in 2017 to test ways to put in place a “pre-enrollment verification system,” meaning a way to check documentation to make sure enrollees are actually eligible to sign up for ObamaCare through an extra sign-up period.

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No wonder Politifact awarded President Barack Obama its 2013 “Lie of the Year” award for his Obamacare promise, “If you like your health plan, you can keep it.” My wife has been trying to do exactly that for three years, and has failed every time. But at least she was able to keep her doctor—until now.

I have previously discussed my wife’s struggles to find and keep coverage in the age of Obamacare. It was never a problem before Obama and Democrats decided the government needed to improve access to coverage.

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Along with “stakeholders” (campaign donors), “investments” (government spending) and “obstruction” (Congress), one of our favorite political euphemisms is “improper payments.” That’s how Washington airbrushes away the taxpayer money that flows each year to someone who is not eligible, or to the right beneficiary in the wrong amount, or that disappears to fraud or federal accounting ineptitude. Now thanks to ObamaCare, improper payments are soaring.

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“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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Under intense pressure to curb costs that have led to losses on the Affordable Care Act exchanges, insurers are accelerating their move toward plans that offer limited choices of doctors and hospitals.

A new McKinsey & Co. analysis of regulatory filings for 18 states and the District of Columbia found that 75% of the offerings on their exchanges in 2017 will likely be health-maintenance organizations or a similar plan design known as an exclusive provider organization, or EPO. Both typically require consumers to use an often-narrow network of health-care providers—in some cases, just one large hospital system and its affiliated facilities and doctors.

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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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Senate Majority Leader Mitch McConnell (R-Ky.) says major changes are coming for ObamaCare next year, no matter who wins the White House.

Pointing to rising costs and shaky insurance markets, McConnell said the next president will have to work with Congress to keep the situation from worsening, though he did not specifically say the healthcare law would be repealed.

“It will be revisited by the next president, whoever that is,” McConnell said at an event Monday with the Kentucky Chamber of Commerce. “No matter who wins the election, no matter who’s in control of Congress.”

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