BlueCross BlueShield of Tennessee sent shock waves Monday across Tennessee with the company’s decision to exit the Obamacare exchange in Nashville, Memphis and Knoxville, a move that highlights persistent volatility in the young health insurance marketplace.

Three years into the Affordable Care Act exchange, the state’s largest insurer is grappling with hefty losses and ongoing uncertainty on the marketplace. BCBST is open to coming fully back into the market once uncertainties about policies and the membership wane.

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In yet another sign of instability in Obamacare’s health-insurance Exchanges, BlueCross BlueShield of Nebraska has announced it will leave that state’s Exchange entirely, while BlueCross BlueShield of Tennessee will exit the Exchange in all three of that state’s major metropolitan areas. The moves will leave 112,000 Tennesseans and tens of thousands of Nebraskans scrambling to find new coverage for 2017 from a dwindling number of carriers.

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Insurers have announced that they are sharply raising prices or pulling out of the Obamacare markets entirely. Many consumers will have fewer choices of insurance plans, and many insurance plans will include fewer doctors and hospitals. Many of the most important problems can be understood if you think of an Obamacare marketplace as a particular kind of restaurant: an all-you-can-eat buffet. It can be a solid business, but it’s hard to get the pricing right. For example, you can be in deep trouble if your buffet suddenly becomes the favorite hangout of the high school football team.  Unless you make major adjustments, you will quickly lose money. That may be what has happened to some of the companies selling health insurance.

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ObamaCare is plainly unaffordable for many young Americans. We’re at the start of our careers—and the bottom of the income ladder—so paying so much for something we likely won’t use makes little sense. The IRS penalty of $695 or 2.5% of our income is often cheap by comparison. We may be young, but we can do the math.

Young Americans aren’t looking for “outreach” and “engagement” from President Obama. We’re looking for affordable health-insurance plans—and ObamaCare doesn’t offer them.

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Legislative auditors said Wednesday they can’t confirm that the Medicaid application backlog numbers state officials have reported are correct.

Applications have been backlogged for about a year following the rocky rollout of a new computer system, an administrative decision that funneled all applications through a single state agency and a larger-than-expected influx of applications during the Affordable Care Act open enrollment period.

The auditors said the Kansas Department of Health and Environment gets the backlog number from Accenture, the contractor that built the new software platform known as the Kansas Eligibility Enforcement System, or KEES.
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A liberal attempt to revive the public option is opening old wounds between the Democratic Party’s liberal and moderate wings. Thirty-three mostly-liberal Democrats, including all the Senate leadership, have signed onto a nonbinding Senate resolution to add the public option to Obamacare. But missing from the list are vice-presidential nominee, Sen. Tim Kaine and a half-dozen other moderates who face reelection in 2018. Kaine’s absence is especially striking since Hillary Clinton embraces the public option.

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Blue Cross Blue Shield of Nebraska announced Friday that is pulling out of the ObamaCare marketplace in the state, becoming the latest insurer to cite financial losses when reducing participation in the healthcare law.

The move is especially significant given that it is a Blue Cross plan, which form the backbone of the ObamaCare marketplaces. In a few states, the Blue Cross plan will be the only one available on the marketplace next year.

Nebraska, though, will still have two insurers, Aetna and Medica, on its marketplace next year.

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A majority of physicians look negatively at their profession and are increasingly burdened by new reimbursement models, according to a new survey.

The Physicians Foundation, a not-for-profit organization that supports research on the impact of the Affordable Care Act on physician groups, surveyed 17,236 physicians across the U.S. (PDF) on a variety of issues related to their field.

The report highlighted low morale among a majority of physicians. Fifty-four percent of physicians rated their morale as somewhat negative or very negative and only 37% were positive about the future of their profession. This is a decrease, however, from 2012 when 68% of physicians described low morale when surveyed by the organization.

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Failing insurers. Rising premiums. Financial losses. The deteriorating Obamacare market that the health insurance industry feared is here.

As concerns about the survival of the Affordable Care Act’s markets intensify, the role of nonprofit “co-op” health insurers — meant to broaden choices under the law — has gained prominence. Most of the original 23 co-ops have failed, dumping more than 800,000 members back onto the ACA markets over the last two years.

Many of those thousands of people were sicker and more expensive than the remaining insurers expected — and they’re hurting results.

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Congressional Republicans are warning the Obama administration not to settle with insurers that have sued the government over an Affordable Care Act program to compensate them for losses under the law, saying such a move would bypass spending limits set by Congress.

Forty-six House Republicans signed a letter sent Thursday to Health and Human Services Secretary Sylvia Mathews Burwell saying they oppose any settlements and could sue the administration to block them.

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