A network of clinics that serves low-income patients in rural Northern California is finally finding balance after being deluged with newly insured patients under the Affordable Care Act.

After a more than two-year moratorium on nearly all new adult patients, the Redding-based Shasta Community Health Center has reopened its doors to some newcomers this month, and it will start accepting more new patients in September.

When Medi-Cal, California’s version of Medicaid, was first expanded under the Affordable Care Act in early 2014, the number of people insured under the program doubled to around 40,000 people in the region served by Shasta Community Health. Not only did the clinics see new patients, but the demand for services soared from existing ones who were newly insured.

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On Monday, Illinois citizens were jolted by a piercing pain in the wallet as federal officials unveiled proposed Obamacare insurance premium rates for 2017. Insurers plan to dial up rates as much as a heart-stopping 45 percent for those who buy plans on the Obamacare marketplace when open enrollment starts Nov. 1.

That means thousands of people will scramble for affordable insurance … and won’t find it.

Is this rate shock unforeseen? Not really. Rocketing Obamacare rate requests have become an annual rite of summer, as welcome as sunstroke.

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The latest rates for health insurance under Obamacare in New Hampshire range from a drop of less than a half-percent to nearly a 60 percent increase, depending on the insurer.

All insurers offering health plans in the exchange had to present their proposals by Monday for the year beginning Jan. 1.

The dominant health insurer, Anthem, had the lowest proposal — a decrease of four-tenths of 1 percent from the preferred provider organization for the “off exchange” population.

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Usually it’s a good thing that everything’s bigger in Texas, but that isn’t true when it comes to health-insurance premiums for Obamacare. Recent federal data show that Texas’ largest insurer on the Obamacare exchanges is seeking average premium increases of nearly 60 percent for 2017- among the highest hikes in the entire country.

As a result, at least 600,000 policyholders with Blue Cross Blue Shield may quickly find their insurance coverage is unaffordable.

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Insurers want to crank up the cost of health insurance premiums by as much as 45 percent for Illinois residents who buy coverage through the Affordable Care Act’s marketplace.

Blue Cross Blue Shield of Illinois, the most popular insurer on the state’s Obamacare exchange, is proposing increases ranging from 23 percent to 45 percent in premiums for its individual health-care plans, according to proposed 2017 premiums that were made public Monday. The insurer blamed the sought-after hikes mainly on changes in the costs of medical services.

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Health plans sold on Michigan’s insurance exchange could see an average 17.3% increase next year, and if recent history is any guide, state regulators could approve the insurance companies’ rate hike requests without many — if any — changes.

The rate increases would mean a financial hit for taxpayers in general and the 345,000 Michiganders who buy their health insurance on the Healthcare.gov exchange, created under the Affordable Care Act, also known as Obamacare.

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A sampling of the 2017 proposed rate increases:

Blue Care Network of Michigan is seeking an average 14.8% rate increase for its plans.

Blue Cross Blue Shield wants an 18.7% increase.

Priority Health has asked for a 13.9% rate hike.

The biggest rate request is from Humana — a 39.2% rise.

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Since Obamacare’s rollout in the fall of 2013, 16 co-ops that launched with money from the federal government have collapsed.

The co-ops, or consumer operated and oriented plans, were started under the Affordable Care Act as a way to boost competition among insurers and expand the number of health insurance companies available to consumers living in rural areas.

Now, just seven co-ops—Wisconsin’s Common Ground Healthcare Cooperative; Maryland’s Evergreen Health Cooperative; Maine Community Health Options; Massachusetts’ Minuteman Health; Montana Health Cooperative; New Mexico Health Connections; and Health Republic Insurance of New Jersey—remain.

Thomas Miller, a resident fellow at the American Enterprise Institute who is an expert in health policy, said each of the seven remaining co-ops have “warning indicators” leading up to when, and if, they fail.

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Thousands of Illinoisans heeded federal law and bought health insurance last year via the state’s Obamacare exchange. They signed up with Land of Lincoln Health, a state-approved insurer. They paid their premiums and deductibles. Many counted on that coverage to manage chronic illnesses or other long-term treatment.

Now, a kick in the teeth: Land of Lincoln has collapsed. Its customers must scramble for new coverage in an upcoming “special enrollment” period. They will have 60 days to find another plan on the Illinois exchange to cover the last three months of the year.

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The big rate increases announced last week for health insurance policies sold by California’s version of the federal health reform are the latest evidence that the Affordable Care Act, despite its name, cannot do much to tame the rise of health care costs.

The government-run health insurance market is facing all the same cost pressures that the private market has confronted for years, plus more that have resulted from the dynamics of the federal law itself.

Covered California, the state insurance agency created to implement the federal law, announced last week that rates for insurance sold through the program will increase an average of 13.2 percent in 2017. The state’s two biggest insurers, Blue Shield and Anthem Inc., will increase rates by 19.9 percent and 17.2 percent, respectively.

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