Cost overruns are endemic to government health programs, and ObamaCare is turning out to be no different. Not only are its Medicaid expansion costs exploding, skyrocketing premiums are now pushing insurance subsidy costs through the roof.

A new study from the Center for Health and Economy finds that because of the double-digit premium increases across the country, federal spending on ObamaCare’s insurance subsidies will shoot up by nearly $10 billion next year

That’s because the amount of the subsidy is directly tied to the cost of insurance in any given market. The Obama administration treats this as a cardinal virtue of ObamaCare, because the subsidies largely shield eligible enrollees from premium rate shocks. In fact, the administration has argued that higher premiums are a good thing, because they make more people eligible for those subsidies.

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Judging by appointments to top posts in health care, the incoming Trump administration is on course to validate its campaign promise to “repeal and replace” the Affordable Care Act. Despite the emphasis by many on preserving secondary parts of the law like maintaining children up to age 26 on the parent’s coverage, Americans should understand that the ACA indeed must be eliminated. Why? Because its misguided amalgam of regulations generated skyrocketing insurance premiums, reduced choice of doctors, funneled millions more poor people into substandard programs and accelerated consolidation throughout the health care industry– serious consequences directly harmful to patients.

The ACA’s biggest error was broadening a detrimental misapplication of health insurance that began decades ago. The point of insurance is to reduce risk of financial disaster. Instead, with its long list of mandates and regulations, the ACA furthered the inappropriate construct that insurance should subsidize all medical care and minimize out-of-pocket payments. The ACA’s coverage requirements directly caused more widespread adoption of bloated insurance. When combined with invisible health care prices as well as doctor qualifications, most patients have virtually no incentive and lack sufficient information to consider value; similarly, providers don’t need to compete on price. The consequences are the overuse of health care and unrestrained costs. Health Savings Accounts (HSAs), tax-sheltered accounts for smaller health expenses, are a critical component of reform, because they motivate direct consideration of price. Better than simple tax deductions, HSAs also incentivize saving.

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When the 115th Congress convenes in early January, they’ll waste no time before launching an assault on key parts of President Barack Obama’s signature health care reform law. A bare-bones budget resolution acting as a vehicle to dismantle the Affordable Care Act will get a House floor vote the week of Jan. 9, according to a memo from Rep. Greg Walden (R-OR), the incoming chairman of the House Energy and Commerce Committee, CQ Roll Call reported. That means the Senate could take up and pass the budget resolution during the prior week.

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James, C. Capretta, resident fellow at the American Enterprise Institute and health care policy scholar, answers questions about why Obamacare isn’t working and how those on left and the right aim to alter the health care law. Capretta says, “[Republicans want to] retain the employer-based health insurance system and change the structure of the regulations involving the non-group market that’s now covered by the ACA. They’d have subsidies, tax credits for people outside the employer system to make sure everybody in the United States could get health insurance if they wanted it. This mirrors a proposal that was introduced a couple of years ago by Senator Hatch, Senator Burr, and Congressman Fred Upton. That plan looks a lot like a House’s “Better Way” health care plan. I would say that the leading contender for what would be a replace is somewhere in the universe of those two types of plans.”

Influential members of Congress are supporting reenacting a health care bill that passed Congress last January called the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015, or H.R. 3762. That bill would have repealed Obamacare’s tax hikes, Medicaid expansion, and insurance exchange subsidies. But critically, this partial repeal bill does not get rid of Obamacare’s tens of thousands of pages of insurance regulations, which are responsible for the law’s drastic premium hikes. If Republicans pass a replica of H.R. 3762 in the first quarter of 2017, they will be making a potentially catastrophic mistake that might make it impossible for them to replace Obamacare later on. To avoid those pitfalls, they need to wipe out Obamacare’s costliest insurance regulations in the new partial repeal bill and retain about three-fifths of Obamacare’s tax hikes to create fiscal room for the replacement.

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About 6.4 million people have signed up for health insurance next year under the Affordable Care Act, the Obama administration said Wednesday, as people rushed to purchase plans regardless of Republican promises that the law will be repealed within months.

The new sign-ups — an increase of 400,000 over a similar point last year — mean the health care coverage of millions of consumers could be imperiled by one of the first legislative actions of Donald J. Trump’s presidency. Hundreds of thousands of other people who took no action will be automatically re-enrolled by the federal government in the same or similar plans, officials said, and their coverage could be threatened as well. Consumers still have until the end of January to enroll.

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The news is all full of supporters of the Affordable Care Act warning about how the health insurance system will collapse if, as various Republican repeal programs propose, the “individual mandate” is immediately gutted while parts of the ACA briefly solider on. It’s not that the people issuing the warning aren’t correct. Repeal of the individual mandate without some immediate replacement will clearly reduce the stability of whatever markets would otherwise remain as the ACA continues its death march. It’s just that many of them are hypocrites.

It was the Obama administration and supporters of the ACA who essentially gutted the individual mandate.

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Galen Institute President Grace-Marie Turner on why she supports President-elect Donald Trump’s pick for Tom Price as the next Health Secretary.

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Do you think it is a bit strange that after 7 years, Republicans in Congress still don’t have a replacement plan for Obamacare? Or that they now tell us that developing one will take 3 or 4 more years. And of course, once they have a plan it will take state governments and insurance companies two or three more years to phase it in. So, we are looking at a decade’s delay. That’s if we are lucky.

Suppose the tables were turned.  If Obamacare were a Republican reform and Democrats controlled Congress, how long would it take the Democrats to come up with a better plan? They’d do it in a heartbeat. They would do it by doing what Democrats are traditionally good at: putting ideology aside and finding solutions that make all the major stakeholders better off.

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