About 27,000 Hoosiers will lose their Obamacare plans next year, after Indiana University Health Plans announced it is withdrawing from the Indiana marketplace.

IU Health Plans joins three other insurers, including United Healthcare, that are dropping out of the marketplace, citing big losses from the new enrollees. It had covered 15 percent of marketplace enrollees last year.

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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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With major insurers retreating from the federal health law’s marketplaces, California’s insurance commissioner said he supports a public option at the state level that could bolster competition and potentially serve as a test for the controversial idea nationwide.

“I think we should strongly consider a public option in California,” Insurance Commissioner Dave Jones said in a recent interview with California Healthline. “It will require a lot of careful thought and work, but I think it’s something that ought to be on the table because we continue to see this consolidation in an already consolidated health insurance market.”

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Residents who buy their health insurance themselves will pay 20 percent more on average next year, and, for the first time, residents in 14 counties will have the choice of only one carrier offering plans in their area via the state health insurance exchange.

The increases are the largest in Colorado since the 2014 launch of the Affordable Care Act, also known as Obamacare. In some parts of rural Colorado, premium increases will top 40 percent, according to figures approved Tuesday by the Colorado Division of Insurance. However, tax credits for low-income residents will help blunt the impact of some of those increases, with consumers who currently receive the credits in line to see an average decrease of 11 percent in their premiums.

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New York has revolted against a critical component of the Affordable Care Act: RiskAdjustment.  If its revolt survives an almost certain legal challenge, a number of states are likely to double down on New York’s actions and remove one of the few remaining fingers holding Obamacare on to a cliff.

Acting under direction of its new Superintendant of Financial Services, Maria Vullo, New York has joined the chorus of those familiar with the program in contending that the federal Risk Adjustment program is backfiring. Critics say the program transfers too much money amongst insurers and is actually destabilizing the market.  New York is the first state, however, to put money behind the critique.

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Sen. Lamar Alexander is introducing a bill Wednesday that would extend Affordable Care Act subsidies to plans off of the exchanges for some eligible consumers.

The Tennessee Republican is proposing that states could opt to expand the Obamacare subsidies to plans sold off of the exchanges.

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This week, the Georgia Chamber of Commerce released a new plan to impose more of Obamacare on their state. The Chamber acknowledged that their “guiding principle” in crafting the Medicaid expansion plan was simply to “take advantage of all federal dollars available.” As such, they’re lobbying for policymakers to expand Medicaid to a new welfare class of more than 700,000 able-bodied adults.

Although the “plan” has few details – so far it consists solely of two PowerPoint slides – one thing is certain: it will be a more costly way to expand Obamacare that combines some of the most expensive aspects of other expansion plans from around the country.

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According to a recently-updated analysis conducted by the Kaiser Family Foundation of 14 major cities, the lowest-cost and second-lowest cost silver plans are expected to rise by a weighted average of 9% in 2017. But residents in some states are going to have it far worse. Through last weekend, insurers in a dozen states had their rate requests for 2017 finalized. Residents in the vast majority of the approved states are looking at double-digit percentage increases. As aggregated by ACASignUps.net, four of the first 12 states to finalize their rate requests for 2017 are looking at weighted increases of at least 30%.

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As the election enters the final two months, reporters have been speculating on an “October Surprise,” or perhaps a September one.

There are plenty of candidates, beginning with more Wikileaks about Hillary Clinton’s emails as Secretary of State. There is speculation about pay-to-play at the Clinton Foundation and what’s hiding in Donald Trump’s taxes.

What has received too little attention is the steady collapse of Obamacare and the impact that will have on insurance premiums, which will arrive just before Election Day. The Chicago Tribune called them “cardiac-arrest-inducing premium increases.”

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