When is a government program not a government program?

When the insurance industry says it isn’t.

In its effort to keep billions in unlawful ObamaCare corporate subsidies flowing, the industry is trying to persuade Congress that it receives no federal funds through the federal “reinsurance” program. Good luck with that.

The ObamaCare statute established the temporary, three-year (from 2014 to 2016) reinsurance program for two purposes: 1) to provide $5 billion to the Treasury; and 2) to provide $20 billion to issuers of individual ObamaCare policies.

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Now that the ACA is on the books, and the private-insurance options are on shaky ground, there’s no real reason for proponents of the ACA not to fully embrace the public option. It’s what most of them wanted all along, and the turbulence among the private insurers provides the perfect excuse to pursue it.

The fact that introducing a public option at this stage would only add to the instability of the private options offered on the exchanges is not a reason for the public-option advocates to abandon the idea because they never really wanted a functioning private-insurance marketplace anyway. The goal all along has been government-run health care, even if they haven’t always been willing to admit that.

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The Centers for Medicare and Medicaid Services on Monday issued a proposed rule to govern how Obamacare exchanges will operate in 2018. The proposal would change Obamacare’s risk adjustment program to account for prescription drug data.

Currently, the government determines which plans have sicker enrollees, and thus should receive assistance, based on claims data.

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U.S. Senate Majority Leader Mitch McConnell predicted Monday that the federal health care overhaul championed by President Barack Obama is likely to undergo changes next year, regardless of who wins the White House and which party has the upper hand in Congress.

The Kentucky Republican, who has long advocated repealing the Affordable Care Act, told a business audience in his hometown that the law “can’t possibly go on like it is.” He predicted the overhaul “will be revisited by the next president, whoever that is.”

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As health insurers head for the exits, Americans who have been whipsawed by ObamaCare may get whacked again this fall:  First, they were thrown off private plans that were declared illegal, then they were forced into the ObamaCare exchanges, and now they could face the prospect of being shut out of coverage through their exchanges entirely for 2017.

The Obama administration has only itself to blame for the ObamaCare failures—first for jamming this bill through Congress despite warnings that the structure of the bill was an economic disaster, and then for exacerbating the breakdown through its regulatory dictates.  The ACA was sold on the pretense that we could have a private, competitive market for health insurance, but the law and subsequent regulations put the industry in a straightjacket, with rules at every turn that undermined the industry’s ability to offer attractive, competitive products.

We need to think more broadly about solutions, making sure that people getting coverage now are protected, that those not buying or obtaining coverage have greater incentives to participate, and that the program is financially sustainable.

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With the hourglass running out for his administration, President Barack Obama’s health care law is struggling in many parts of the country. Double-digit premium increases and exits by big-name insurers have caused some to wonder whether “Obamacare” will go down as a failed experiment.

If Democrat Hillary Clinton wins the White House, expect her to mount a rescue effort. But how much Clinton could do depends on finding willing partners in Congress and among Republican governors, a real political challenge.

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On Tuesday, Commissioner Julie Mix McPeak, who runs Tennessee’s Department of Commerce and Insurance, announced that her department was approving massive premium increases for insurers providing individual health insurance policies through the Patient Protection and Affordable Care Act exchange in the state.

The percentage increases are stunning and prompted the commissioner to put them in context. Her context was more stunning than the increases themselves.

“I would characterize the exchange market in Tennessee as very near collapse,” McPeak said.

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The odds remain fairly good that the Democrats can regain control of the Senate in November, especially if Democratic presidential nominee continues her strong showing against Republican businessman Donald Trump in the polls.

At least seven Republican-held seats are seen as being in play, including Illinois, New Hampshire, Indiana and Wisconsin, as well as the three crucial swing states of Ohio, Pennsylvania and Florida. Four other races — including veteran Republican Sen. John McCain’s reelection effort in Arizona — are deemed competitive by political experts.

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Nearly a third of the nation’s counties look likely to have just a single insurer offering health plans on the Affordable Care Act’s exchanges next year, according to a new analysis, an industry pullback that adds to the challenges facing the law.

The new study, by the nonpartisan Kaiser Family Foundation, suggests there could be just one option for coverage in 31% of counties in 2017, and there might be only two in another 31%. That would give exchange customers in large swaths of the U.S. far less choice than they had this year, when 7% of counties had one insurer and 29% had two.

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Enrollment in the insurance exchanges for President Obama’s signature health-care law is at less than half the initial forecast, pushing several major insurance companies to stop offering health plans in certain markets because of significant financial losses.

As a result, the administration’s promise of a menu of health-plan choices has been replaced by a grim, though preliminary, forecast: Next year, more than 1 in 4 counties are at risk of having a single insurer on its exchange, said Cynthia Cox, who studies health reform for the Kaiser Family Foundation.

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