Former House Speaker Newt Gingrich remembers the day 23 years ago when Hillary Clinton, notebook in hand, came to see him and other senior Republicans to talk about “Hillarycare.”

It was early 1993. Clinton, on behalf of her husband, then-President Bill Clinton, was leading a healthcare reform drive that vaulted her onto the national stage.

Hillarycare would famously collapse after a fierce debate. In interviews with Reuters, some participants looked back on it as a crucible for the Democratic presidential front-runner that helped shape her approach to politics and governing.

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Next year’s premiums for health coverage under the Affordable Care Act could rise more than in past years in most markets and declines might be rare, according to a preliminary analysis of insurers’ plans.

Overall, premiums for a popular type of plan — the second-lowest silver plan — could rise 10 percent on average next year in 14 major metropolitan areas, according to an analysis released Wednesday by the Kaiser Family Foundation. Kaiser based its projections on insurers’ preliminary rates filed with state regulators, which remain subject to state or federal review. (KHN is an editorially independent program of the foundation.)

Last year, premiums for the second-lowest silver plan in those metro areas rose 5 percent after state insurance departments signed off, Kaiser said.

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Obamacare has invented a dangerous new way to hide federal spending, including more than $100 billion designed to look like tax cuts.

In defiance of standard United States government accounting practices (and the government’s standard definitions of terms), Obamacare labels its direct outlays to insurance companies “tax credits” (not outlays)—even though they don’t actually cut anyone’s taxes. In this way, Obamacare is masking some $104 billion in federal spending over a decade.

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About 1,000 health care economists from around the country descend on Philadelphia this week for the biennial conference of the American Society of Health Economists.

Think of it as Woodstock for health geeks who will, over several days, present nearly 550 papers covering insurance, hospital mergers and a host of other issues.

Of all those, Obamacare will be the jam that gets played over and over with 78 papers focused on some aspect of the law.

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California Governor Jerry Brown signed a bill into law allowing unauthorized immigrants to buy health insurance on a state exchange created under the U.S. Affordable Care Act, making the state the first in the country to offer that kind of coverage.

The law lets the state request a waiver from the federal government that will be needed to allow unauthorized immigrants to purchase unsubsidized insurance through Covered California, the state’s healthcare exchange.

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Many people contend that we should not worry about the premium rate shock because the ACA insulates most people from gross premiums. The oft-repeated idea is that the ACA basically requires only that people pay a percentage of their income in premiums. So, unless income goes up, a person’s net premium stays the same.

Reporters, pundits and bloggers should stop accepting or repeating this contention. Gross premium increases can matter a lot.

It is true that if you earn less than 400% of the applicable federal poverty level AND you purchased the second lowest silver plan the year before AND you continue to purchase the second lowest silver plan the following year, then your net premiums don’t go up even if the gross premium rises astronomically.

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Millions of people who pay the full cost of their health insurance will face the sting of rising premiums next year, with no financial help from government subsidies.

Renewal notices bearing the bad news will go out this fall, just as the presidential election is in the homestretch.

“I don’t know if I could swallow another 30 or 40 percent without severely cutting into other things I’m trying to do, like retirement savings or reducing debt,” said Bob Byrnes, of Blaine, Minnesota, a Twin Cities suburb. His monthly premium of $524 is already about 50 percent more than he was paying in 2015, and he has a higher deductible.

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The Geisinger Health Plan foresees health costs rising 7.5% next year, but requested a 40% rate increase. The plan, which is run by one of the nation’s top-rated health organizations, underestimated the cost of covering the newly insured under ObamaCare. “Our rates for Medicare, Medicaid and employer-sponsored insurance have been relatively stable, but those products have to bear the cost of our losses on exchange business,” Kurt Wrobel, Geisinger’s chief actuary, said. Many insurers are struggling to find the best ways of providing care to their new customers as they prepare for the fourth year of coverage under ObamaCare.

Last month, the Kaiser Family Foundation released the results of its 2016 survey of 671 people who purchased individual market plans compliant with the new mandates and rules established by the Affordable Care Act (ACA). As many insurers announce large premium hikes for next year and others announce they are withdrawing from the market, the survey reveals that enrollees are increasingly unhappy with their coverage. Given that these enrollees are one of the primary groups that the ACA is supposed to be helping, their declining satisfaction is particularly concerning and suggests a change of direction in federal policy is warranted.

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The Affordable Care Act’s employer mandate has at least modestly led to a rise in involuntary part-time employment, according to a Goldman Sachs study released Wednesday.

“We would estimate that a few hundred thousand workers might be working part-time involuntarily as a result of the Affordable Care Act,” said Alec Phillips, an economist at the investment bank, in a research note.

This is only a fraction of the 6.4 million workers employed part-time for economic reasons, he said, but would be a significant share of the “underemployment gap.”

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