The Affordable Care Act’s defenders have spent the past six years dismissing the law’s critics for predicting that it would enter a “death spiral.” But it turns out we were prophets – just look at what’s happening all across Arizona.

The past couple of months have seen the Affordable Care Act’s – Obamacare’s – online exchanges crumble in our state. Three years in, health-insurance companies have discovered that the law’s top-down, one-size-fits-all approach is a bureaucratic and financial disaster. So naturally, they’re abandoning the law in droves.

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Minnesota will let the health insurers in its Obamacare market raise rates by at least 50 percent next year, after the individual market there came to the brink of collapse, the state’s commerce commissioner said Friday.

The increases range from 50 percent to 67 percent, Commissioner Mike Rothman’s office said in a statement. Rothman, who regulates the state’s insurers, is an appointee under Governor Mark Dayton, a Democrat. The rate hike follows increases for this year of 14 percent to 49 percent.

“It’s in an emergency situation — we worked hard and avoided a collapse.” Rothman said in a telephone interview. “It’s a stopgap for 2017.”

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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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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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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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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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