The Obama administration failed to follow the president’s health care law in a $5 billion dispute over compensating insurers for high costs from seriously ill patients, Congress’ investigative arm said Thursday.

The opinion from the Government Accountability Office is a setback for the White House and bolsters Republican complaints that administration officials bent the law as problems arose carrying out its complex provisions. The finding may complicate efforts to stabilize premiums in the law’s insurance marketplaces, where about 11 million people get coverage.

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Based on rate increases proposed to North Carolina’s Department of Insurance, state residents who have signed up for Obamacare could face a 19 percent to 25 percent jump in the cost of their health coverage for 2017, Republican Sen. Richard Burr says.

Further, because major health insurers have suffered losses and are exiting the program, in 90 percent of North Carolina counties, residents enrolled in President Barack Obama’s signature health care program will only have one plan from which to choose in their so-called marketplace, Burr wrote in an op ed published in the online North State Journal.

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President Obama would veto a House bill that would provide an exemption from the individual mandate if someone’s insurance coverage ended mid-year because of a co-op closure, the White House said Tuesday.

The House is debating H.R. 954, the CO-OP Consumer Protection Act, and is slated to vote on the measure later today. The bill responds to the closures of three co-ops, nonprofit insurers that were created under the Affordable Care Act, during the past year. Republicans have pointed to the failures of 16 out of 23 original co-ops as a sign of the 2010 health care law’s weakness.

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The House on Tuesday passed a bill that would allow people who enrolled in failed health insurance “co-ops” under the Affordable Care Act to skip this year’s penalty for not having coverage. The Republican-backed bill passed on a mostly party-line vote of 258-165, but 16 Democrats broke with their party to support the measure. “It’s just wrong, it’s wrong, to hold these working families financially responsible for a co-op’s failure because it went under due to factors beyond their control,” said Rep. Charles Boustany Jr. (R-LA).  President Obama says he will veto the bill if it reaches his desk.

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The Obama administration will use targeted, digital messages and online networks such as Twitter in a sweeping campaign to get young adults to sign up for health insurance during the Affordable Care Act’s fall open enrollment, appealing to a group seen as critical to the law’s success.

The administration, which announced the new push on Tuesday, is betting the aggressive campaign will resonate with uninsured consumers age 35 and under. But some Republicans are already opposing some of the outreach efforts and health analysts warn lackluster sign-ups would drive more insurers to abandon the exchanges.

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Vermont did not properly allocate millions of dollars in federal grants when establishing its marketplace created under the Affordable Care Act, a report released Tuesday by the Department of Health and Human Services Office of Inspector General said.

Vermont’s Agency of Human Services did not always follow federal requirements for allocating costs to establishment grants to establish its marketplace or for drawing down establishment grant funds, the report says.

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Two issue briefs published today by The Commonwealth Fund and authored by several RAND Corporation economists (led by Christine Eibner) will be noted by casual readers for their presumably “scientific” conclusions that (1) a set of Clinton proposals will increase the number of insured Americans by over 9 million and decrease average spending by up to 33% for those with moderately low incomes; and (2) a sketchy set of Trump policy stances would increase the number of uninsured individuals by 16 million to 25 million relative to the current-law ACA baseline and disproportionately affect low-income individuals and those in poor health.

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The bitter, long-running fight over ObamaCare’s individual and employer mandates is all over but the shouting.

The problems plaguing the ObamaCare exchanges as enrollment lags, premiums spike and insurers from Aetna to UnitedHealth head for the exits have reached a critical stage, even as the penalties are about to spike for far too many millions of people who get a bad deal from the law. This year, 8 million people paid the individual mandate penalty — not too far from the 10.6 million who had coverage via the exchanges at the end of June. The status quo won’t survive the inevitable political backlash, nor should it. ObamaCare is like a car with a bad muffler: It can keep traveling down the road, even as everyone it passes begs the driver to pull over and get it serviced.

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While health care has not been central to the 2016 Presidential campaign, the election’s outcome will be a major determining factor in the country’s future health care policy. A number of issues have garnered media attention, including the future of the Affordable Care Act (ACA), rising prescription drug costs, and the opioid epidemic.

Hillary Clinton and Donald Trump have laid out different approaches to addressing these and other health care issues. Central among these is their position on the future of the ACA. Hillary Clinton would maintain the ACA, and many of her policy proposals would build on provisions already in place. Donald Trump, in contrast, would fully repeal the ACA, and although his policy proposals and positions do not offer a full replacement plan, they do reflect an approach based on free market principles.

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About 27,000 Hoosiers will lose their Obamacare plans next year after Indiana University Health Plans announced it is withdrawing from the Indiana marketplace, citing big losses from the new enrollees. It had covered 15% of marketplace enrollees last year. Indiana Sen. Dan Coats, a Republican, said the announcement from IU Health Plans is evidence the healthcare law is “collapsing before our eyes.”  “Because of the broken Obamacare system, Hoosiers continue to face rising premiums and limited choices rather than reliable, affordable healthcare,” Coats said.

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