“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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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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